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026-181-019
FIRE DAMA E REPORT DATE: t Y ...... A -;P 25-181-19 '��-S. JOHN COWEE [21 P62-,,Will-iam Ave. J, Paler �V/' _�ermit'-,2574-73B,E P -roof &,elec. whin 1 - —Of 26-181-19 ETHEL KIDD p Permit#48.0-89E(upgrade'ele ser to 100 mp) I Lamp)SF 6-181-19 14(ac),90B-' LOPEZ,,Cup 216 t Williams;, ,(6 Wisle j (demol _itilon/sf)_.__,_-_ 26- Permit#1475-"'90'B (demolit,i6n/ t CL KLs- 26-181-1 4119-90P,E(MH) Cu LOPEZ, pe ino 21.62 Williams, alermo (util-, MH) ELEC GAS COMPACTION 301 ION TEST�RE SUPPORT STRUCT'RE 0 26-181719 4120-90MHI(M-H) LOPEZ,,Cuper.tino -.2162 Williams alermo (MHI/41.i'9- r:__ BUTTE COUNTY INTERDEPARTMENTAL CORRESPONDENCE DELIVER TO LAST PERSON NAMED DATE NAME DEPT. I DATE NAME DEPT. FIRE DAMAGE REPORT ri U 'A, � weammia LOCATION: Lk Q unc-1 .4 & CONTRACTOR: DATE: A.P. # ZONING: DATE TO INSPECTOR:PERMIT HISTORY:( ) NONE ( ) AS FOLLOWS: BUILDING INSPECTOR'S REPORT ' Building Description: Commercial/Usage: ResidendaV# of Units: Currently Occupied - AbaneonedNacant Electric: Yes No Electric currently On Off Condition of Electric Gas: Natural Propane / None Currently On Off Obvious Problems: Sanitation: Plumbing Working Well Working / Potable Water Obviaus SewageProblems Description of Damaged Area: 4 - Estimate Valuation of Damaged Area: Condition of Foundation: Mobile Home: Condition of C)tz- Date • 1 Sketch building on reverse and indicate area of damage. I r^ I r� W 6 g I v l� 01=/13UTTE COUNTY FIRE INCIDENT I-Od INCIDENT NUMBER 11942 LOGGED B DH REPORT TI :9E 1?:15 LOCAL FIRE NUMBE 110821 RO AGUILAR 'i ! STATE FIRE NUMBER r az:.=.rte: -sem BI J ' .CASE NUMBER � MEDICS LOCATION 2162 WILLIAIIlS AVE PRA R6 ECC RP BLOOMER PHONE NUMBER REPORTWETHO RADiO ' P pa® ppb ® p a py��q ~ !LDL ND FIRES � EvT7pAATED ACRES �l T!RE WFOii�?Y?� ON TCdI lGTURE FIRE RFSIDENTIA Ei FIRE INFO SENT HO EMAIL BY DH TO T2 OTHER FIRE 7 -DAY LOGGED INITIALS JS MEDICAL AIDS INCIDENT NAME IWILLIAM PSAIOTHER START DAT E 1010412002 START TIME 17:00 J HAZ MAT DIAMOND # 5.0 ,I COMNgEN T S � CAUSE UNDETERMINED DISPATCHED AS VEGETATION, ACTUALLY LAND USE I:Or1ESTiC STRUCTURE -'G ACRES 0 T YPE OF ACRES I� DIAMOND 5 ONLY $ DAMAGE TYPE ALL OTHER DOLLAR DAMAGE 1300.00 SAVE r 2000.00 INJURIESIFATALITIES I # CIVILIAN INJURIES 0 # CIVILIAN FATALITIES 0 EIN!D ! OES # FF INJURIE 0 # FF FATALITIES L 0 r) I_ 4• •� r at nri sg FC -40 o, IFRNiATION 6 FC -40C-40 OF FC -40 INC AGENCY INC # INC P# FC -40 COMP DATE FC -40 COMP BY ;I N...;e:..P6,... knd el... nst EARS Cn ..r... II i II I II fI � J I, . A.P. 2 -181-19 %s. JOHN COWEE 216'2 William Ave ,, , Paler ' ; REPORT Permit 2574-73B, E �' � IT /o — �reroof & . elec .. whin cle -u 26-181-19 QTHEL KIDD Permit#480-89E(upgrade ele ser to 100 amp)SF - 1-19 1469e'�' 90 LOPEZ, Cup no 2166 Williams, le (demolition/sf) 26- Permit#1475-90B(demolition/s (�f6Z Wc((rati ` ii 0 26-181-1 4119-90P,E(MH) LOPEZ, Cupe ino 2162 Williams, alermo (util, MH) ELEC D GAS COMPACTION TEST RE SUPPORT STRUCT RE o 26-181-19 4120-90 I(MH) LOPEZ, ,yCttpertino 2162 Williams alermo -7 (MHI/4119- PERMIT NUMBER — B 2574-73B,E P �i i y E cf r PERMIT EXPIRES / OWNER Mrs. John Cowee CONTR: Owner LOCATION (A.P. 26-181-19 2162 William Ave., Palermo - ` P y ,r 0 COUNTY OF BUTTE Department of Public Works BUILDING.INSPE-CT.IQN_ RECORD Zoning Setback Forms Foundation Piers & Girders ���.Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing Pimg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final ? — Find . Final DATE REMARKS..OR'CORRECTIONS 6— /✓' J t� Al O �o ��dC 7i0 �" COUNTY OF BUTTE — DEPARTMENT OF PUBLIC 7, County Center Drive — Oroville, California 95965 Tel2ohone: 0534-4541 APPLICATION AND PERMIT WORKS. — authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. �• �1lt�C/ Date �� Sign re of Permit/e e) 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 PUBLIC WORKS By Date —2 — 7.'`x-7 Building permit expires Da%_2 :Jak BUILDING Owner SOFT. 0 C. BUILDING VALUATION Mailing Address Q , Tel hone No. — Fireplace Contractor Total Valuation Q J o Mai I i ng Address Permit Fee D p Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Addressp'?� - PLUMBING No.1 @ FEE PERMIT FILING FEE J$2.00 zo 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. p� �— — Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F . S8ff1 ton' Fire Dept. Fire zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 ans Recd I Parcel Approval I Plans Approval Permit Fee $ $ NE ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 ,Qa >� Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ® Duplex ❑ obiI Home ❑ Oth rs ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 010 Receps., switches & fix outlets Znf�25 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. FanorF.A. Furn. Motor 1.00 Evap. cooler, gar. lisp. 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 $ goo $ 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. Al 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. �• �1lt�C/ Date �� Sign re of Permit/e e) 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 PUBLIC WORKS By Date —2 — 7.'`x-7 Building permit expires Da%_2 :Jak D. Plumbing 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. Comments: E. Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: , 5. Underfloor and attic vent' on: 6. Energy:. 7. Comments: F. Commercial uildin s 1. Roof c vering: 2. Distanc to property lines: 3. Physical handicapped: 4. Restroom oors and walls: 5. Exits: 6. Improvements - 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give compl to descri ion): tr i� 2. What, a tion taken (give complete desc iption); or 3. What action recommended: / /.A. Information only - file. B. Hold for ten days, then write letter. %% C. Write letter. / / b. Other: rl'�U C vv L < A� 44 , ❑ Complaint -Date ❑ Other -Date BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION -REPORT ZONING Owner: e�9-7p EL /Z % F7p. A.P. # r Address: Date of Inspection Tenant: Inspector Typeof Ins ction requested: 1. Housing ".2. Financing �[ 4. Work W/O Permit Present use of building: / / 3.. Change of Occupancy to Other (specify) A. Sanitation (Housing) Water closet: Lavatory: Bathtub or shower: 4. Kitchen sink: (/ 5 Hot and cold water to fixtures: Heating facilities: Natural light and ventilation: Room and space requirements: xit:2Bedroom window or door for second exit- 2— — 10. Infestation of insects, vermin, or rodents: 25- 11.- Connection to sewage disposal: `20 12. Connection to water supply: �' Ru —and garbage facilities: ,_;Stairs :(Rise, Run, H droom, 1HR, Tolera 15. Comments: B. Structural 1. Piers and footings: 2. Floor construction: n 3. Wall construction: 4. Ceiling and roof constr c.tion: 5. Fireplaces: 6. Comments: i► C. Electrical 1. Service a 2. Receptacl 3. Fusing: 4. Comments: s, Handrai ttspr,,Fy. t•a:I,1 _ I,S,S,:r•. �.t , '%' i � � of-ty °4,��,�!` � �•: p.r �r�eS';Z'I �i',�, ]l\'r<TI t•.ti...a COUNTY OF BUTTE - DEPARTMENT OF PUBLIC'WORKS"" PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 26-181-19 ZONING ' U BUILDING PERMIT OWNER Cupertino Lopez TELEPHONE k-533-5072 SQ. FT. 0(.`(a`. BUILDING VALUATION OWNER'S MAILING ADDRESS , P.O. Box 647 Palermo 95968 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 2162 Williams Permit fee $ 27,50 PLUMBING PERMIT Filing Fee 10.00 j, ' Each Trap 2.00 Oroville Solar or heat pump water heater 20.00 LOT NO. 20 SUBDIVISION NAMEPARCEL Map of Town ofS Palermo MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE r ! SF ❑ Duplex❑ Mobilehome❑ Other - SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G I W 10.00e TYPE OF .WORK ' New❑ Addition❑ Remodel❑ Utilities❑ Installation❑ Other❑ Describe work: demolishticn► _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee` 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): .., ❑ I am licensed under provisions of,. Chapt. 9, Div. 3 of the Business and Professions Code and 'my license is in full force and effect. License No. Classification I I, as the owner, or myemploy es with wages as their sole compen- sation, will. do the work, and the\.structure is not intended or offered for sale. (Sec. 7044)jY'rt . -, Ls.4 �,. � l\as the owner, am exclusively contracting with licensed contract- I's (Sec. 7044) a ❑ I `am�ezempt under Sec_ -,Business and Professions Code _.4Asr" U for this reason ++ 1 ( t� oR ADDNST ( DWEACCLLING GSCCUP.N) / 2+h�sgft NEW CoNSTR ULTI.oUTLET NO N.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS a (SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 20®50¢ eAL®3o FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESIO.) EA.) 2.00 Temporary service 10.00 Mobile'Home Facilities 15.00 Misc. Whin g 15.00 Permit Feed $ WORKMEN'S COMPENSATi60NSURANCE I declare under -penalty of perjury (check one)" .1 ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department h a Certificate of Workmen's Compensation Insurance or a Certificate 1 of Consent 'to Self -Insure.' ` RI shall+not employsany person in any,ma` ner so as to become subject to the,W.-C? laws of California. / � � Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the 'Labor Code,"you must forthwith comply with such provisions`or this permit shall be deemed revoked. j Contractor] r tri MECHANICAL PERMIT Filing Fee ' 10.00 Heating 1. Cooling Hood 3.00 Ventilation a ; — permit Fee $ Contractor. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in conseque ce of the granting of this permit. .�v Date Sign ure of Applicant — Owner ontr R ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE E 5 $ 27.5 0 HAZ CUA PARK SCHL � Flo PAR JPDJHDJ Iss E This permit is hereby issued under sions of the Butte County Code and/or work indicated abo/ve for which fees DIE TOR PUBLIC --�-� PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date �" X10 Receipt No. 66257By WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT (5 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 26-181-19 ZOIti IN -G U , BUILDING PERMIT OWNER Cupertino Lopez TELEPHONE 533-5072 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. Box 647 Palermo 95968 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ 50 ARCHITECT OR ENGINEER17- LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 2162 Williams Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Oroville Solar or heat pump water heater 20.00 LOT NO. 20 SUBDIVISION NAME Map of Town of Palermo PARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[-] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 Building sewer 5.00 Mobile Home S I G I W I 10.00@ TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: demoli chti on Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 500V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F-1NON-RESID I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect.SINGLE License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUR.d New DONS. A Lu 2/,22sgft LTI ULT'-OUTLET LET BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) OUTLET CIR. Ex. Occu Occup(OUTLETS OR FIXTURES 20@50C SAL@30 FIXED ARLNS Ex. Occup. OUTLETS PIRESID IREA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in conseque ce f the granting of this permit. .�. Date Signa ure of Applicant — Owner ontr ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 27.50 HAz I CUA I PARK nFLD I PAR I PD I HD ISS E Th;s permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DI E OR PUBLIC I By PERMIT EXPIRES Date � the applicable provi- resolutions to do have been paid. WORKS Dat e�5` 7 9 /_ Receipt No. 66257 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS A 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT PERMIT NO. l —tel % I -v BUILDING PERMIT o ER � y TELEPHONE y SQ. FT. OCC. BUILDING VALUATION Ow MAILI ADDRESS O n CONTRACTOR'S NAME I TEL PI ONE �0/ V G CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation I S LENDER'S MAILING ADDRESS Filing Fee S 10.00 Permit Fee S AgCt•iITECT OR ENGINEER LICENSE NO. _-Plan Checking Fee I S ARCHITECT OR ENGINEEP•S MAILING ADDRESS Energy Plan Checking Fee I S Penalty S N BUILDING AcOgEss rmit tee I $ — PLUMBING PERMIT Filing Fee I 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT O. SNUtBDI VpI SION NAME '/t T eV R% 0 Ih7� 1�1�� PARCEL MAP Water piping 5.� Each oas water heater or vent 5,00 USE OF STRUCTURE SF [I Duplex❑ Mobilehome] "Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S 1 G V h0.00ea TYPE OF WORK New C] Additionl,_,J Remodel[] Utilities InstallationC Other Describe work: rG,(�� L 1 .� rl �,/1� r Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service a00v OR • ESS 100 AMP OR LESS 10.00 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): j—j !J I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044) • ElI, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADO•L 100 AMP 2,50 NEW CONST. DWELLING OCCUP.h OR ADONS. ( ACC. SLOGS. NEWNON.RESICONSTR.MULTI-OUTLET I O. BRANCH CIRCITS(POWER �2.50ea� APPARATUS SINGLE OUTLET CIR.6) Ex. Occup( OUTLETS OR FIXTURES fie: e53oel Ex. Occup. OUTLETS PIRESIO.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee S WORKMEN'S COMPENSATION INSURANCE I declare under penalty Of perjury (check one): F-1 11 The permit is for 5100.00 (valuation) or less. - I have places on file with the County of Butte Building Deoartment a Certificate of WorKmen's Compensation Insurance or a Certificate of Consent to Sell -Insure. r -1I snail not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: It after making this statement, should you become subject t0 the W. C. provisions Of the Labor Code, you must forthwith Comply with Such provisions or this permit Snail be deemed revoked. Contractor MECHANICAL PERMIT I FifingFee I 10.00 Heating I I I i Coolin g Hood 3.00 I Ventilation Permit Fee S Contractor I I certify trial I have read this application and state that the aoove Information Is correct. 1 agree to comply to all County Ordinances and State Laws relating t0 building construction, and herebv authorize representatives of the County of Butte to enter upon the aoove-mentioned property for Inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may In any way accrue against said County In consequence of the granting of this permit. X Date -- Signature of Applicant - Owner r- I_ ControEtor Agent jJ An OSHA Permit Is reouired for a:covations over 5'0" deep and demolition or construct. on of strueiure over stories in deign,. �- Receipt N06 .ITE•a.P.w.. YE:Low-Asscseo•. ••.i•-."Sotc-o.. aoLaE .00-.o•Llc.v* Mobile Home Installation Fee S Energy Inspection Fee S •oCC CONS 'PQ -- I TOTAL FEE S 11A< CUA PARI( I SCHL i FLO I PAR PO I NO I I SSUEi T. -.;s permit Is nereby Issueo unser the applicable provt- cions of the Butte Ccunty Code and/or resolutions to do work indicated above for which fees have been pard. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date COUNTY OF BUTTE - Department of Public Works . 7 County Center Drive,`dro'ville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner=builder" building permit has been applied for in your name and bearing your signature'. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until.this verification is received. 1. I personally plan.to provide the major labor and materials for construction of the proposed property improvement '(yes or no) le 2. I (have/have not) n,V e— signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction:. Name' Address City Phone Contractors License No. 4. 1 plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address i. City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated:. Name Address Phone Type of Work Signed: Property Owner Social Security N mber Date 5 -- 9 d NOTE: This Owner -Builder Verification is sent to.you as required by Sections 19831.and. 19832 of the California Health and Safety Code. This verification must be completed and.returned to our office before we are per- mitted to issue the permit. 0 Al 0 0 4 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT jRMJT NO.� ASSF�SQ.R Pr RC Ull ,MBE ZONI G t OL/ BUILDING PERMIT R(/D O TELEPHONE el SQ. FT. OCC. BUILDING VALUATION Or E AI ING A D SS LIP C RACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CO SRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ AR#CI,yTECT OR ENGINEER 11LICENSE NO. Plan Checking Fee $ Ener Plan Checkin Fee gy g ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS j, w Permit fee PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 ale r m ' Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF V11 Duplex❑ Mobilehome❑ Other [—' SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 0.00ea TYPE OF WORK New ❑ Addition ❑ Rem del ❑ Utilities nstall ion❑ Othe Describe work: �' i 6 i D Permit Fee $ Contractor ELECTRICAL PERMIT ' Filing Fee 10.00 Main service e001 OR LESS 100 AMP OR LESS 00 10.1 , Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044)Wiring, ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.y , ACC,) h¢sgft 'TBI New CONSTP- U OUTLET NO N.RESID .BRA CH CIRCUITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. EX. Occup( OR FIXTURES 20050! DALO 30 FIXED . OR EX. Occup. OUTLETS TS (RES(RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Mi . 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice o Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. Z �1' k' X c Date Signature of Applicant — Owner kContractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ Occup. CONST.TTPEJ SCHOOL FLOOD PARCEL PD I ISSUE This permit is hereby issued under sions of the Butte County Code and/or Work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date — Receipt No. nk WHITE-D.P.W.. YELLOW-ASSESSOK. PINK -INSPECTOR. GOLDENROD -APPLICANT X: *�ti.�R.r^rr.►^,»,�•,,A.w.�.n.....vy......w•r�...,./•M'fv�.r�f>o'.n''"`1'-J�'r""�..1'` ... �{ „ , ...,•�-"+I•vrr„t,�•,�'i.*q�.+,y...y�,.�....a..ti.•-,....ri-y.-.++.,.�.-•,,�•K✓+'r-wl COUNTY OF BUTTE - DEPAA�T�etM€NTAOF"PUBLIC WORKS PE��'R IT NO. r 7 County Center Drive - Or6VIIIe, Califo a 95965'- Telephone: 916/538_-7541 /( � APPLICATION'AND PERMIT 7 U 000 ASS E Z7 PARC L UMB (�). ((,leo ++ ZON1• G 1 ` ' { BUILDING PERMIT S i O R TELEPHONE ,{t �ISO..FT. OCC. BUILDING VALUATION O R' MAILING A D 5 C RAC YO R'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS-"" Fireplace V CO S RUCTION LENDER UNKNOWN Total Valuation �". $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ -A C TECT OR ENGINEER LICENSE NO. Plan Checking Fee .$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS • i �JJZC4 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 j Each Trap 2.00 r mo Solar or heat pump water heater 20.00 LOT NO. SUBDI VISION'NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFX- Duplex❑ Mobilehome❑ SPECIFY Other (( Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Rem del ❑ Utilities nstall ion❑ Other .Describe work: joy- e r , `', IV V ` D Permit Fee $ Contractor cI ,"� ELECTRICAQ'PERMIT Filing Fee 10.00 r 10 Main service 600V OR LESS �- 00 . 100 AMP OR LESS , Main service EA. ADD'L 100 AMP'' 2.50 �- CONTRACTORS LICENSE LAW ! I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification l, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors.(Sec. 7044) ors. ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.DWELLING OCCUP.eI 1 OR ADONS. ACC. BLDGS. �. /20sgft ' NEW NON .RESID R. 'BRANCH CIRCTITS 2.50 ea POWER APPARATUS e t ' (,SINGLE OUTLET CIR. ) 1 Ex. Otcu ' z0es00 v p�OUT!LETS OR FIXTURES• .AL&30 FIXED TS (RES.DOR EX. Occup. OUTLETS (RESID,) EA.) 2.00 � Temporary service i 10.00, AZ' - Mobile Home'Facilities(J ' ,15.00 � g MiW. Wirin '1J° " r ,. - 15.00 , ''Y1 » i Permit,Fee $ , 0 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department' a'Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. _I shall not employ any person in any manner so as -to become subject/ to the W. C. laws of California. Notice o Applicant: If after making this statement,should you become subject to the W. C. provisions of the LabopCode,•you must forthwith comply with such provisions or this permit shall be deemed,revoked. Contractor f / MECHANICAL PERMIT FiIingFee 10.00 Heating`!' Cooling j Hood /` 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all,lbounty Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. ' I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X 1�& ? Date 7 Signature of Applicant - Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- lion of structures oveerj3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TYPEJ SCHOOL FLOOD PARCEL PD I No I ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which .fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. �'S��.� WHITE-D.P.W.. YELLOW.ASSESSOR. PINK -INSPECTOR. GOLDENROD-APPL I CANT i. �i.=tib_=7 . ,r..74,+i fir.. ,. , ... .T.. r .. �i.:F?4,inn•vrt+nr �' • �-m• nv-�-c ono •^r•rars•++-�. y.c.��. �. .. � . � ,., .rrr I" Yri•-..+..r .i r" -i �T'Fk.. •,►--" 41'6F '1 ----.+rr. .ra„f.. f' COUNTY OF BUTTE DEPARTMENT OF, PUBLIC WORKS /PERMIT NO.,,,�, r 7 County Center Drive - Oroville; Califor6a 95965 - Telephone: 916/538-7541 APPLICATCON`AND PERMIT 0 ASS S R PARC L UMB ppp[[[ (�7� .� .,. ZONI G BUILDING PERMIT OWER - 1 TELEPHONE ,- S0. FT. UCC. BUILDING VALUATION O N R' MAILING DRESS_ F 1 ( ( c BRAG OR'S NAME TELEPHONE R .1 CONTRACTOR'S MAILING ADDRESS Fireplace CO RUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ A C ITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS I �N Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 a E` r mD Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFAADuplex❑ Mobilehome❑ Other ttllll�����• SPECIFY Gas piping system 1 - 5 outlets 5.00 " Building sewer 5.00 Mobile Home Is G W 0.00ea TYPE OF WORK New Addition Rem del❑ Utilities /nstall tion❑ Other Describe work: In '` Permit Fee $ Contractor , ELECTRICAL PERMIT Filing Fee 10.00 Main service 600v OR LESS 100 AMP OR LESS 00 10./ Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors.(Sec. 7044) ors. F]I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.y OR ADDNS. ACC. BLDGS. ._� , l2OsgIt NEW CONSTR. TI -OUTLET 2,50 ea NON.RESID .BRA CH CIRC ITS /POWER APPARATUS eI ,SINGLE OUTLET CIR. 00800 Ex. Occup(OUTLETS OR FIXTURES 2AL@ 30t FIXED . OR , EX. Occup. OUTLETS TS (RES(RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 - Mi c. Wirin 9 15.00 V) Permit Fee $ , Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a'Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice o Applicant: If after making this statement,. should you become subject to the W. C. provisions of the Labor. Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating ' f Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. XWG�p ��/+ "`�1� / F Date kA Signature of Applicant — Owner L�J Contractor 1:1 Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TYPEJ SCHOOL FLOOo PARCEL PD NO ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 019 Receipt No. 1 11 l WHIT[-D.P.W.. YELLOW-ASBEBBOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroviile". California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT . PERMIT NO. '� f' ` ASS SS R PARC L UMB C;) o ZONI G BUILDING PERMIT owN,ER 1 ('tib TELEPHONE SQ. FT. OCC. BUILDING VALUATION O N R'S MAILING AJhDRES , f/''"' ' n ,v j f ��� COtN, RAC 1OR'5 NAME / TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace X�STRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ A CFj;1TE T' OR ENGINEER LICENSE NO. !, ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Pa e r mo Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF,K Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G I W O.00ea TYPE OF WORK New❑ Addition❑ Rem del❑Utilities gI.q. nstall tion❑ Other Describe work: t E - 14r i1 / P i1 i t" �QC� iii Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 (;il , Main Service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUSinesS and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, Or my employees with Wages as their sole compen• sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.IM , OR ADDNS. ACC. BLDGS. .� /ZILSgft NEW CONSTR..MULTI-OUTLET 2,50 ea NON-RESID BRANCH CIRCUITS) POWER APPARATUS e SINGLE OUTLET CIR. Ex. OCCUp�OUTLETS OR FIXTURES 20050! SALO 30 FIXED APPLES. OR EX. OCCUp. OUTLETS (RESID) EA.� 2.60 Temporary service 10.00 Mobile Home Facilities) 15.00 Mi c. Wiring_ 15.00 POt "' h Q Permit Fee $ , Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. Ej I have placed on file with the County of Butte Building Department a'Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject I—Nto the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue.,, against said County in consequence of the granting of this permit. j Xp Date Signature of Applicant - Owner�J Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $(� OCCUP. CONST.TYP! ISCHOOLIFL0001PARCIZ1.1 PO 1 11 SSUE This permit is herebyissued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date "] Receipt No. h - WNIT!-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT CO - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541. OWNER -BUILDER VERIFICATION' Attention Property Owner An "owner -builder" building permit has been applied for in.your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally -plan to provide the major labor and materials for.construction of the proposed property improvement (yes or no) �. 2. I(hav ave not) signed an application for a building permit for t e proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the.following person to coordinate, supervise,.and provide the major work Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: QO/1 h'Property Owner Social Security Number Date 2 — (_ Ar 9 NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and L9832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT.OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 OWNER Proposed Building Use PERMIT APPLICATION DATA SHEET Building Inspector Permit No. / i - At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPonvFn 11 1. Al. items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ - 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) _ 8. Mobilehome installation data including manufacturer's installation, y instructions ............................................... �....-.-- 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 12. School District fees paid ................. 13. Sanitation approval from Health Department ... 14. C.ty of Chico plumbing permit ........................... _ 15. Pot plan and business license approval from City of (aee City for other requirements) 16. Panning approval for (A) Use: (B) Parking: 17. Inprovements may be required. 18. Driveway permit (construcIon approval required prior to occupancy) 19. Pre -Inspection for �a �/' jLo Pre-Inspec. request to� required ..... , Building Inspector 20. Contractor's license information (No., Name Style, Classification) ...... . 21. Certificate of Workmans Compensation Insurance .................... 22. Cowner-Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Fecorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... a ' 25. y 26. When you issue the permit, process as follows: Mail to owner` - Telephone and hold for pickup at office. Other Copy of plans sent Heallj th Pe �y The fo lowing data must be submit -t( 1. Index permit for above it/emsN o. 2. Additional items equ e. Date) Mail to contractor. _Deliver w/inspector. Appl ican.t Date �Fire_pgpt� Other Date pr�ror-�to permit issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by—phone---mall counter by date Contractor, designer, owner, was advised of above required data by—phone —ma ll—counter by date Plans checked by Copy—DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder Date COUNTY OF BUTTE 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965-3397 DEPARTMENT OF PUBLIC WORKS Ethel Kidd 6780 Lincoln St Orovi.11e, CA 95965 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS NOTICE Post job card In a safe, conspicuous place. Do not remove until all . required Inspections are made and building Is approved for occupancy. Plans must be available on job. A. P. No. 26-181-19 Owner ETHEL KIDD Contractor owner Permit No. 480-89E Expires PERMITTEE MUST CALL FOR INSPECTIONS INSPECTION DATE INSPECTOR Footings Piers Underground Conduit Do Not Pour Concrete,Until Above Signed Underfloor Plumbing Underfloor Electrical Underfloor Mechanical Underfloor Framing Slab Do Not Install Floor or Slab Until Above Signed Do Not Cover Until Above Signed Fireplace Footing Fireplace Throat Do Not Continue Fireplace Until Above Signed Stucco Lath Scratch and Brown Do Not Cover Until Above Signed Sewer Service _ Water Service Plumbing Final Electrical Final Mechanical Final Buildinq or MH Final DO NOT OCCUPY UNTIL ALL THE ABOVE IS SIGNED AND THE BUILDING OR MOBILEHOME IS APPROVED' FOR OCCUPANCY CHICO - 196 Memorial Way - 891-275 OROVILLE - 7 County Center Dr. 538-7541 PARADISE - 747 Elliott Road - 87 -63 KIDD, Ethel 26-181-19 ------------- 480-89E 2162 Williams Ave, Palermo (upgrade elec ser)SF KIDD, Ethel ----------------26_181_19--_ ---------- 480-89E ' 2162 Williams Ave - - (upgrade elec ser; 11 BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH Division of Environmental Health 7 County Center Drive Oroville, CA 95965 (916) 538-7281 March 14, 1989 CERTIFIED MAIL - RETURN RECEIPT REQUESTED Ethel M. Kidd c/o Ethel M. Cowee 6780 Lincoln Boulevard Oroville, CA 95965 RE:' Special Inspection - 2162 and 2166 -William . s Avenue, Palermo, CA/AP# 026-181-019-0 Dear Ms. Kidd: On March 10, 1989, an inspection of the dwelling unit at 2162 Williams Avenue, was carried out by Bob Keith, Butte County Department of Public Works, and the undersigned. The inspection revealed a house in very poor condition (2162 Williams) and a mobilehome with additions (2166 Williams) that was also in poor condition. The,following conditions were observed which are. in violation of the California. Health and Safety Code, Section 17920:.3 (a) (1) (5) (6) (8) (11) (13) (15) , (b) (1) (2) (3) , (d) , . (e) , ( f) , (g)(2)(3), (j), and (n); and which render the building substandard and unsafe for human occupancy. 2162 Williams Avenue (House) 1. There is no shower or bathtub in the dwelling. 2. There is no hot or cold water due to electrical shut-off. 3. There are no approved heating facilities .in the dwelling, and an unvented kerosene heater was in use at the time of inspection. 4. The kitchen lacks adequate natural light and ventilation. Rear bedroom may.not have adequate window area. 5. Bedroom in converted garage exhibits excessive dampness. Ethel M. Kidd March 14, 1989 Page 2 6. Entire structure shows lack of proper maintenance. 7. There is a large accumulation of refuse in the rear yard including garbage and rubbish. 8. There is extensive wood to ground contact throughout the house, and inadequate underfloor ventilation or crawl space. 9. Floor is structurally weak in rear enclosed porch, toilet room and kitchen. 10. Ceiling heights are inadequate in kitchen, bathroom, and bedrooms. No under roof ventilation. 11. The water heater is improperly installed, and of inadequate size for the dwelling. ,12. Stove flue in.living room is an unsafe installation. 13. Electrical wiring is unsafe and inadequate service for loads. Romex feeds rear mobilehome and addons. 14. Plumbing fixtures in kitchen and bathroom lack propel vents. 15. House lacks weather proofing on exterior walls, windows, and doors. 2166 Williams - Mobilehome and addition. 1. No permits for this unit found. 2. U zoning allows only one (1) dwelling per parcel. 3. Mobilehome has romex wiring service from front house. 4. Fireplace is an unsafe installation. 5. Exterior ground to wood contact throughtout addition to mobilehome. 6. Plumbing fixtures lack proper vents. Those conditions shall be corrected as follows and within time limits indicated. Obtain required permits from the Butte County Department.of Public Works, 7 County Center Drive, Oroville, CA, prior to making repairs or corrections. EI Ethel M. Kidd March 14, 1989. Page 3 2163 Williams Avenue (House) 1. Provide properly installed shower or bathtub with hot and cold water, proper traps and vent. 2. Provide hot and cold water to all.fixtures. 3. Provide a properly installed heating facility with approved vent flue, separation from combustibles and capable of maintaining a minimum temperature of 70 F, as measured at a point three (3) feet above the floor in all habitable rooms. Remove unvented kerosene fired heater. 4. Provide adequate natural light and ventilation for the kitchen, bathroom, and bedrooms. 5. Eliminate excessive dampness in converted garage room, provide adequate heat, ceiling heights, window area, etc. 6. Provide proper maintenance to structure. 7. Remove all accumulated refuse from the property within seven (7) days, andprovide covered fly -tight containers for refuse storage. Do not allow refuse to accumulate for over seven (7) days.. 8. Eliminate all wood to ground contact throughout the structure. Provide adequate underfloor ventilation and crawl space for all raised floors. 9.. Repair or replace all damaged or deteriorated floor supports, sheathing and floor covering. Make bathroom floor water proof. 10. Provide proper. ceiling heights throughout the dwelling, including kitchen, bathroom and bedrooms.. 11. Provide a proper sized water heater, with approved venting if i; gas fueled, separation from combustibles, temperature -pressure relief valve and discharge line. 12. Remove unsafe stove flue in living room, and provide approved. flue for new heating facility. 13. Provide new 100 amp service. Remove and replace all deteriorated or damaged wiring; outlet boxes and fittings; unprotected wiring; open or exposed splices. Provide outlet boxes -as required. Eliminate wiring to rear mobilehome and 0 Ethel M. Kidd March 14, 1989 Page 4 additions. 14. Provide proper plumbing for toilet, lavatory, bath facilities, and kitchen sink, with traps and vents. 15. Make house weatherproof including roof, siding, windows and doors. 16. Provide smoke detector. 2166 Williams - Mobilehome and additions. Zoning allows only one dwelling per parcel. Remove illegal mobilehome and additions, do not allow it to be occupied. Removal and/or securing to entry shall be completed within THIRTY (30) DAYS from receipt of this notice. Due to the condition of the dwelling at 2162 Williams Avenue, it shall be vacated at once and remain vacant until all corrections are made. Permits shall be obtained and work begun on corrections within THIRTY (30) DAYS from receipt of this notice. Submit floor plan and obtain permits from the Butte County Department of Public Works If you have any questions concerning this letter, contact Mr. Bob Keith at 538-7541, or the undersigned at 538-7281. Sincerely, w�J.Snyd Director Division of Environmental Health HJS/kf cc: Public Works - J. Glander X IN I COUNTY OF BUTTE - DEPARTMENT OF P LIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - lep ne: 916/538-7541 APPLICATION AND PERMI� ASSWS R Pr RC UMBE t/vBUILDING I ' ZONG PERMIT O R TELEP HONE S0. F C. BUILDING VALUATION O EAI ING A O 33 ( �- 0 G C' RACT.. R. NAME k1 r7 VN TELEPHONE CONT• RAC'. DR'3 MA;LING ADDRESS Fireplace CO S RUCTION LENDER UNKNOWN Total Valuation 1$ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ AR TECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS ./ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 PO k rff?0 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping ' 5.00 Each qas water heater or vent 5.00 �{ USE OF STRUCTURE SF'l11 Duplex❑ Mobilehome❑ Other (—' SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G IN 10.00 ea TYPE OF WORK New ❑ Addition ❑• Rem del ❑ 'Utilities nstallation❑ Other Describe work: In c✓ 6 ` O Permit Fee $ Contractor ' ELECTRICAL PERMIT Filing Fee 10.00 Main service Doov OR LESS 100 AMP OR LESS 10.00 J Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 Of the Buslnes$ and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their so a compen- b sation, will do the work,and the structure Is not intended dr offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason oR ADONIS.( DWEACCLLIN SLOGS. '/z2sgft NEW CONSTF;L M u TI.OUTLE11 NON-RESID BRANCH CIRC ITS !2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 2uunuc AL@30 eLe FIXED APPLNS, OR Ex. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Mi Wiring 15.00 , —� Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for S100.00 (vaivation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice o Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FilirgFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above Information is correct. I agree to comply to all County Ordinances and State Lams relating to building construction, and hereby authorize representatives of th( Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. 1 Z X WS: / �p Date Signature of Applicant - Owner(�1 Contractor ❑ Agent ❑ An OSHA permit isrequired for excavations over 5'0" deep and demolition or Construct- ion of structures aver 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ) TOTAL PERMIT FEE $ / OC cup. CONST.T7 P[ JsCHooLJ FU)OD PARCEL PD I ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. - WHITE-D.P.W.. TELLOW-A3aZ330R, PINK -INSPECTOR. GOLDENROD -APPLICANT ::), -05-- g' 9 r CbUNTY OF BUTTE -DEPARTMENT OF PUBLICWCfS PERMIT NO. 7tCourty Center Drive - Oroville. California 95965 -Telephone: / 8}7141' r + APPLICATION -AMD PERMIT ry ASSESSOR PA CEL NUMBER ' 26-1�1-19 ZONING_ U �,. BUILDING PERMIT OWNER ftertino Lopez TELEPHONE 533--5072 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. Box 647 Palermo 95968 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN ' Total Valuation $ Filing Fee $ 1000 LENDER'S MAILING ADDRESS r: Permit Fee $ • ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS y, Penalty $ BUILDINC2 nQDRESSWilliams - 21 �j Permit fee $ • PLUMBING PERMIT Filing Fee 10.00 = Each Trap 2.00 Orovillei Solar or heat pump water heater 20.00 LOT N19 1 SUBDIVISION NAME PARQ�# L MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE, SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY ; - Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ ❑ InstallationOther F-1 Describe work: demoliehtion _ - sr PermitFee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 ' Main service 10OV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the�Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended�or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUPM OR ADDNS. ( ACC. BLDGS. 1 2/z¢sgft NEW CONSTR. ULTI-OUTLET NO N•RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20050t 9AL03o FIXED APPLNS. OR EX. Occup. OUTLETS IRESID.I EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ® I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequencof a granting of this permit. X Date Signotu a of Applicant — Owner F Contra r ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 27.50 HAz I CUA��FLD I PAR PD I HD I I SU This permit is hereby issued under sions of the Butte County Code and/or work indicated abre f r which fees lR CTO F PUBLIC By PERMIT EXPIRES Date the applicable pro - vi resolutions to io have been paid. WORKS Date Receipt No. 66257 WHITE-D.P.W., YELLOW-ASS[530R, PINK -INSPECTOR, GOLDENROD -APPLICANT % COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS !/ 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLIGATIONI AND PERMIT PERMIT NO. 1 ASSESSOR PARCEL NUMBER 26-181-19 ZONING U BUILDING PERMIT OWNER Cupertino Lopez TELEPHONE 533-5072 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. Box 647 Palermo 95968 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee s ---T77.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGRESS Williams Permit fee $ 27.50 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Oroville Solar or heat pump water heater 20.00 LOT N019 I SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: demolishtion Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. )cense No. Classification 1, as the owner, or my employees with wages as their Sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) 1 I, "as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.4 OR ACDNS. ACC. BLDGS. ) , 2/2Qsgft NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS 1! (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20050c eAL090 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. bVirin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequenc of a granting of this permit. X—a Date Signatu of Applicant — Owner F Contra Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 27.50 HAz I CUA PARK I SCHL I FLD I PAR PD I HD I suE This permit is nereby issued under sions of the Butte County Code and/or work indicated ab ve f r which fees R CTO F PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS 1- Date ✓— r- -� Receipt No. 66257 WHIT[-D.P.W., TEL LOW -AS St:590R, PINx•INSP EC TO R, GOLDENROD -APPLICANT .N COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916.1538-7541 APPLICATION AND PERMIT ASSESSOR A CEL NUMBSZONING — — BUILDING PERMIT Ow NER %� T P�iO C 5 wV SO. FT. OCC. BUILDING VALUATION OW R'S .y1AI NG ADORE C b N T R A C T O1rSN ME © TELEPt.ONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total VaIUdIIOn ( S LENDER'S MAILING ADDRESS Filing Fee S 10.00 Permit Fee $ ARCHITE=T OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITEZT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee _LS Penalty S BUILDING COAE55 r 14 /, rol (� KJ Permit lee I $ PLUMBING PERMIT FilingFee I 10.00 Eacn Trap I 2.00 Solar or heat pump water heater 20.00 LOT NO. SU BOI VISION NAME PARCEL MAP Water piping 5,00 Each oas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex7l Mobilehome❑ " Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W h0.00ea TYPE OF WORK New Addition;_) Remodel❑ Utilities❑ InstallationC Other Describe work:042:2AQZ -L S/-1 TZ;i)---J _ . Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1001AMPORSLESS 10.00 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): ❑NON.RSSID, I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as .their sole compen- sation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. AOO'L loo AMP I 2.50 NEW DoNST, OWELLtNG OCCUP.& OR ADONS. ACC. SLOGS. ) �, hcsoft NEw -ONSTR �tuLTI.OUTLET BR ANC I+ CI?C ITS 12.5Oea� POWER APPARATUS 8 SINGLE OUTLET CIR. ) Ex. FIXTURES Ie20l30e ALL- 30c FIXED APPLNS. OR Ex. Occup. OUTLETS IRESIO.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g Permit Fee 15.00 $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): )) The permit Is for 5100.00 (valuation) or less. ❑ I have placed on file wltn the County of Butte Building Deoartment a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California, Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with sucn provisions or this permit snail be deemed revoked. Contractor MECHANICAL PERMIT I FiIingFee I 10.00 Heating Coolln g Hood 3,00 Ventilation Permit Fee $ Contractor I certify that I nave 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 nereby autnortze representatives of ine County of Butte to enter upon the above-mentioned property for Inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may In any way accrue against said County in consequence of the granting of this permit. X Oate r^ Signature of Applicant - 0,vner 1_ -_Contractor L -I Agent LJ An OSHA Permit 'is. required for excavations over 5'0" deep and demolition or construct. ,on of structures over A stories In ne,gnt. Mobile Home Installation Fee $ Energy inspection Fee S occ cons7- 1a. -- '-- TOTAL FEES HAi CUA PARK I SCNL i FLO I PAP I HD PO I SSUE T�;.q permit is nereby Issued uhaer sions or the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date ine applicable provt- resolutions to do have been paid. WORKS Date t Receipt No'. - �.w.. LLow.As5E3sox. o%s-Ec-0v. coLDEM-00-Ao•LICA.T COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Orovil,le, CA 95965 Phone: 916-53877541 ' OWNER -BUILDER 'VERIFICATION Attention Property Owner: An 'owner -builder" building permit has'been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary'delay in processing and issuing your building permit. No building permit will be issued until -this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) {P 2. I (have/have not) h ave— signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone. Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate,.supervise, and provide the major work: Name Address City -Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner 7 _ Social Security Number Date _5- S7 -- 9 0 NOTE: This Owner -Builder Verification is sent to.you as required by Sections 19831.and .19832 of the California Health and Safety Code. This verification must be completed and.returned to our office before we are per- mitted to issue the permit. RESIDENTIAL . m 41120 -90 _.... . 267181-19 _. LOPEZ, Cupertino P,E(MH) 2162 Williams, Palermo (util, MH) to 1. r i OFFICE COPY Addres &z— 1 GAS Date Meter y ELECTRIC I Meter By Daft l� u - JOB FINALED We -- j Signature 3 J=OK O=Not OK = Not Applicable Not ReadRESIDENTIAL ,(Single = y, & Duplex) Date y UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. ties -Pu rlin-roof Brac-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel-Blockouts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6: Stemwalls, Garage; Steel -Blockouts-Wrapped 50. Garage Fire Protection Framing 6a. Hold Downs and Special Anchors 51. Property Line Firewall & Openings 7. Slab; Steel -Wrapped 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 8. Piers -Fireplace Ftg.-Steel 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W'.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. Gas Pipe; Size -Anchors 55. Siding -Nailing Veneer 11. Water Pipe; Test -Anchor -Regulator -Service Test 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric; Underground 57. Glazing Area -Glass Protection -Skylights -Plastic 13. Pienums & Ducts; Clearance -Material -Support -Ins. 58. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 59. Insulation -Walls -Ceilings 15. Insulation 60. Infiltration -Walls -Windows 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 PLUMBING (Permit) OK except #'s Date Card B-1 Date Card B-1 16. Water Htr.; Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchor -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa Date Card B-1 Date Card B-1 66. Elec. Trim & Subpanel; Breaker Sizes & Labels Date Card B-1 Date Card B-1 67. Stairs & Rails Date ELECTRICAL (Permit) OK except #'s 68. Fireplace or Stove; Clearances -Hearth 22. Fixture & Transformer Clearance -Ins. Protection 69. Elec. Outlets at Wood Panel; Int. & Ext. 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 24. Size Boxes & No. of Conductors -Stapled 71. Elec. Outlets & Receptacles at Kit. Counter 25. Romex Installed Close to Edge of Studs & C.J. 72. Garage Fire Door; Swing -Landing -Closer 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 73. A.C. Duct in Garage -Damper 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 75. Plb., Elec. & Mech. Equip. Listed for Location 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Ins.ilated Neutral ❑ Yes ❑ No 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 30. Service -Riser Conductors & Ground -Main Disconnect 78. Guard Rails & Deck Construction -Post Caps 31. Equip. Clearances Panels-Motors-Mech. Equip. 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No Date Card B-1 Date Card B-1 81. Stucco; Brown -Finish Date Card B-1 Date Card B-1 82. A.C. Unit; Disconnect, Electrical, Plumbing Date MECHANICAL (Permit) OK except #'s 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 34. A.C. Ducts Insulation &Support 84. Water Well; Disconnect, Electrical, Plumbing 35. Vent Fan; Exhaust above insulation 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 36. Condensate Drain &Overflow; Size &Grade 86. Ventilation Throughout House 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Glass Protection 38. Attic Access & Platform if Furnance in Attic 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric - 90. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card B-1 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s Date Card B-1 Date Card B-1 -- 39. Sils. Proper Material & Anchors Date Card B-1 Date Card B-1 ------ 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Date Card B-1 Date Card B-1 --- 41. Bearing Walls over Girders & Floor Nailing ---- Comments at Final: 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing each time you visit job site) (NOTE: An entry must be made v=Ok O=Not OKNot j = Not Readyable MOBILE .HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Le< g9aeg Requirements -Setbacks -Easements Soils; Special MH Support Sketch ewer; Location -Test -Fall -C/O Concrete ater; Location -Test -Easement Needed (Sketch) I. tricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. as; Location -Test -Wrap: / P'L"ft. / /"N r% /'L"ft./ /"LPG Linty Clearance Dat 0 Card B-1 Date Card B-1 Date _ Card B-1 LIP ate Card B-1 Date MOBILE HOME 114STALLATION Plans OK except #'s Zoning Requirements -Setbacks Easements ootin s; Size -Spacing -Marriage Line as; MH Test-Demand-Valve—Connector ectricity; MH Test -Crossovers -Breakers -Clearances rain; MH Test -Fall -Flex Connector reWa_ttr.;_MH Test -Regulator -Connector a!p4nd Sewer Connected -C/O to Grade -HD Approval as SperElectricity Tagged it_1,:�2sp.-Sketch 1 . rt. of Occupancy n Date i / Card B-1 Date Card B-1 Dat— 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; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs :Coonectors Shthg.-Rfg: Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 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, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater -8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboa rds-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT N0. Y Address or loci of mobilehome Owner's name { Owner's address—. � '�� � 2� • a 1 Insignia or hud number— Manufacturer's umber Manufacturer's name' %G Seri al-n�imber f V.I.iV?� Year of manufactu& (Date) � (Official Appia ing Installation) IF.TFiE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATII ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN T+ MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. r • 5138 White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE DEPARTMENT°OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE Hurts PERMIT NO. A routine inspection indicates that -the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correectiork is completed. If you have any question pertaining to this matter, `,a d11additional explanation, please contact this office immediately. a < Date—4 Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-27.51 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE 99 6fi W PERMIT A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. EX 01 - T 7111" rV lot - l.> • &fir 7- �w t, Date :'_'7o'_'/,nspector C COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 1 _ 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION,AND PERMIT ASSESSOR PARCEL NUMBER 26-181-19 ZONINGQ-911- I BUILDING PERMI OWNER Cupertino Lopez TELEPHONE 533-5072 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. Box 647 Palermo 95968 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $15.00 Ener Plan Checking Fee Energy g $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $15.00 PLUMBING PERMIT Filing Fee 10.00 2162 Williams, Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 1 3 e430. 00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utiliyies_F-1,,- ostallatioq❑'- Other ❑ Describe work: Q Bedroom) _ Permit Fee $40.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV OR LESS 100 AMP OR LESS 10 00 10-00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BuSIneSS and Professions Code and my license is in full force and effect. License No. Classification 91 *I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. ( DWELLING occuP.&) OR ACDNS. ACC. BLDIT 2'/20sgft LET NEW CONSTRESID, RANCH CIRCUITS) NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES eAL SOS eALvso FIXED APLNS. Ex. Occup. OU LETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 1 15.00 15. Misc. Iyirin g 15.00 Permit Fee $37-90 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit, is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save,lindemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County i'n coneq nce of the granting of this permit. s i Date — Sign lure of Applicant — wner ❑ Contractor ❑ AgentCD An OSHA permit is required for excavations over 5'0" deep and demolition or construct- uctures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 92.50 HAz I I CUA PARK SCHL FLDHD V_ PAR PD SSUE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees 1 T A OF PUBLIC By PERMIT EXPIR S Date the applicable provi- resolutions to do have been paid. WORKS �Lt� LReceiptrNo. 84547 .W., YELLOW- ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT f, COUNTY OF BUTTE - DEPARTMENT -OF PUBLIC WORKS - BUILDING DIVISION y 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 9 PERMIT APPLICATION DATA SHEET OWNER �_, u Proposed Building Use /'/ /'� f L� ' Bui Iding Permit No. Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED All items have been submitted .................................... Plot plans in duplicat ri licate gned by preparer of plans........ a. Complete plans in du `cate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mdbilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... chool DistrJ'Qt fees paid .............. Sanitation approval from t'1 V r 1 `C Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... - 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required . Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. A02 . Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... il R2corded copy of Agricultural Acknowledgment Statement .........f;;; 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone Other and hold for pickup at office. Deliver w. /inspector. App Iicant E , /.Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted p for to mit i s ce: (Circle new item not checked above). 1. Index permit for above items No. ; 2. Additional items required: Contractor, designer, wner was Contractor, designer, owner, war, Plans checked b, Copy—DPW sed of above required data by✓phone_—mail counter by L -.date IZA-9/ sed of above required data by—phone _mall—counter by date Date Plans approved by N) Date 2-i" Sets of plans on hold in File cabinet AP folder 9 � a TO Buildi`na Department FROM: Environmental -Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal OL -1 Water Supply Hold final for: Water Supply ^anal clearance 0 K. for: Water Supply clearance for gbedroom mobile home. Other NOTE * * * w Date Sanitarian COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZON�Ng _._" . ..�.._ ....� �....�.._ .._...._.___�.._._.._.--- ..._._._.._...___ ..... _.---(/L_..._....._.._...__._._,._.....__...BUI.LDING..P_.ERMIT .. __.._._.....__._._.._- -- OW ER TELEPHONE10 C2 r a0 Z '33 -sol S0. FT. OCC. BUILDING VALUATION OER' MAILy�JG AODRE,SS WTAl T C TRACTOR'S NAME V1 r TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CO S RUCTION LENDER Cc UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ Permit Fee $ ARC,H11 ECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 1 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS f/ I (D �J 1 r - 1 0 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 V,Nc LJt C Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping . 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeOther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home VGJW 9 TYPE OF WORK New❑ Addition [1 Remodel[] Util• ies;( Installation[] Other ❑ Describe work:, Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 VAMP OROR LESS10.00 Main service EA. ADO'L too AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions Of Chapt. 9, Div. 3 Of the Bushes$ and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.a New DONSTR.( A , 2h2sgft ULT'OUTLET NON•RESID BRANCH CIRC ITS 2.50 ea /POWER APPARATUS &) I SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES e2AL@L030¢ Ex. Occup. OUTLETSPRESID IREA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for 5100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee f Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyotocc Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ CONST TYPE TOTAL FEE $ 0 ` HAZ CUA PARK -r I FLD I PAR I PO HD I ISSUE Th's permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been aid. p WORKS Date pt No. D.P•W.. TELLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT r r COUNTY OF BUTTE - Depar•tment.of Public Works 7 County Center Drive, O.roville, CA 95965 Phone: 916-538-7541 OUNE -BUILDER VERIFICATION Attention Property. Owner: An 'owner -builder" building permit has been applied for in your name.and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) �-j2— 2. I (have/have not)Q '� signed an application for a building permit For the proposed work.' 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following. person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work. Signq.d: Property Owner Social Security Ndmber- Date /',I - 30--c/U NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we.are per- mitted-to_issue-the--permit. All that real.:property. -situate in .the County of Butte, State of California, described as follows: Lots.18, 19 and 20, in Block 19, as shwn on that certain Map entitled "Map of the town of Palermo, Butte County, California" which Map was filed J V in the office of the Recorder of the Counthyof Butte, State of California February 17, 1891 in Book 5 of Maps,.at page 4. Date: �))' / PROPERTY OWNERS: State of Ca ) On this the 13 day of February 191 before me, the SS. undersigned Notary Public, personally appeared County of Butte ) Cupertino E Lopez and Joannne Lopez OFFICIALSn Personally known to me. M Proved to me on the basis LIWEI.NARDIN of satisfactory evidence. KOTA" PUBUC • CALF" WMCOMY to be the person(s) whose name(s) are Mbcomm UP" May 2l,1994 subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. l Present A.P. No. r Notary Public END OF DOCUMENT Return to DPWAGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT. FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. _ — - — - — ---. The property described herein is adjacent ;. 91-005706 ; Rec Fee 5•.00Cash to land or included within an area zoned ' 5.00 for agricultural purposes, and residents Recorded of this property may be subject to incon- Official Records ; veniences or discomfort arising from the County of ' ' use of agricultural chemicals, including, Butte ; but not limited to herbicides, pesticides, Candace J. Grubbs _ and fertilizers; and from the pursuit I Recorder ; of agricultural operations including, 8:01am' 14-Feb-91but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real.:property. -situate in .the County of Butte, State of California, described as follows: Lots.18, 19 and 20, in Block 19, as shwn on that certain Map entitled "Map of the town of Palermo, Butte County, California" which Map was filed J V in the office of the Recorder of the Counthyof Butte, State of California February 17, 1891 in Book 5 of Maps,.at page 4. Date: �))' / PROPERTY OWNERS: State of Ca ) On this the 13 day of February 191 before me, the SS. undersigned Notary Public, personally appeared County of Butte ) Cupertino E Lopez and Joannne Lopez OFFICIALSn Personally known to me. M Proved to me on the basis LIWEI.NARDIN of satisfactory evidence. KOTA" PUBUC • CALF" WMCOMY to be the person(s) whose name(s) are Mbcomm UP" May 2l,1994 subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. l Present A.P. No. r Notary Public END OF DOCUMENT j1 Y .TOM-- W 9-6 WILDING ®EP RI &W N 0.12Tµ -- property Nnvs and a setback �+ ! centerline shall be char of I f , ructUYes O�'�171�55men-ieYc�pt _`� _.l........... �rcczR mveOve(ha n9 t I 0 P_ j ; I - -------- — .TOM-- W 9-6 WILDING ®EP RI &W J so 0 0 W 0 0 lb D- cn Z Y tr W a. 5� TOWN OF PALERMO T. 18N.R.J / so L KENILWORTH 150 i sa ' 'leo ' ioo 1 10 2 V�� I i i 3 31 2.. 30 3 0 1 I , I I - _ 4 40139138137 36 135134133 29 5 6 7(1/163 I I 1 28 6 t I 27 w 161 I 1 46.0 26 ------- T 24 I OI ----I'----25--- I - -- 12 0 O 9 --------- ( I 13114 I5 1 161 17 I I' 181119120 24 % 150 ----Io 22 • -- -12---21 ' 150 175 I �. 75 I�f� --- � 150 /WILLIAM ISO 1 100 150 32 2 I I I I I 1 31 � - - - 3 - --------- 4 - -- I I I 40 139138 137 I I I I 361351343 I ,.,i 2/ 30 - - -- - --_ 29 ! 1 28 6 7(1/163 I I 1 t 1 1 I 27 --- 29` 2625 t w 11 9___-- 113 114 SIS 16 I II I X17 18 11912 24 23 10 11 - -� /9 - -- 12 I 1 .75 I -22- . Rn 751 150 0 v LUDLUM to so so 2/ 150 3 w 11 12 e It 1502 so so 2/ w 11 12 150 so so 2/ AP # OWNER PERMiT It4), L2 'V MH UTIL.CLEARANDATE '" INSPECTOR ELECTRIC GAS Support Struc. Compaction Test eq. Service Other Pipe YES NO YESI NO . Size Load Type Size Length ,:n' 30 1 1 4-1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 26-181-19 ZONING ^ �I Qr BUILDING PERMIT LL OWNER Cu erti o Lo ez_1533-5072 TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER' MAILING ADD ESS P.O. Box 647 Palermo 95968 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER Nonp LICENSE NO. Plan Checking Fee $15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 9169 Williams, Orovillp Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome[J Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installationg] Other ❑ Describe work: MHU # '� Q _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORV OR LESS10.00 Main service EA. ADD•L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions Of Chapt. 9, Div. 3 of the BuSIneSS and Professions Code and my license Is In full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. {Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR AODNS. ( ACC. SLOGS. /20sgft NEW CONSTR ULTI.OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 20®90Q eAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. �vl I shall not employ any person in any manner so as to become subject t� to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that i have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue said County in consequence of the granting of this permit. 1 ` _ U��� X ~� Date Sign ure of Applicant — Owner ff -tractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ 45.00 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 70.00 HAz CUA '— PARKscH '— FLD PAR PD HDJ IV This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIREC=OF LIC BY 9 PE T EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date 7 QRZ �� , 1 Receipt No. 84547 WHITE-D.P.W., YELLOW -ASSESSOR, PINK-tNSPECTOR, GOLDENROD -APPLICANT J–I COUNTY OF BUTTE - DEPARTMEM410T PUBLIC WORKS - BUILDING DIVISION. 7 COUNTY CENTER DRIVE-�OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 N PERMI11 T APPLICATIPN DATA SHEET (.( tin �� YI Z_ Y_ Permit No. _ l _ / . OWNER �fA. P. No. (:26 Proposed Building Use v'�/ Building Inspector a121 Dated ,5e,9 90 At time of permit application, I was advised the following data must be submitted prior Ito permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................ ... .... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... A. Engineered truss details and layout in duplicate (required prior to plan check) _. 9. Mobilehome installation data including manufacturer's installation instructions....................................................... a / 3 10. Fees of $ ........................ 11. Chico Urban Area fees paid .......... .......................... 1 Par e,f es paid ......................................... 13. r D virlin School District fees paid .............. 5 r 4. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required . Pre-inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23., Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 2 Letter�j f ig-natureujhonzation . .............................. . 26. J "� V 0 64 ra n e e - When you 'issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for Xckup at office. Deliver w./inspector. Other Applicar�lJ/.rG_ Date Copy of Haz-Mat form sent Health Dept. Fire Dept. ---AirPollution Date Copy of plans sent _J lealth Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone----nall—counter by ..date Contractor, designer, ,owner, was advised of above required data by—phone —mal l—counter b, date tt Plans checked by I Date -L4- Plans approved.by Date >-1cht Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER zONIN .. BUILDING -PERMIT- -7-.1_.---- o ER K i nc� ® Q 6L TELEPHONE SO. FT. OCC. BUILDING VALUATION OW ER S MAI G ADORES ,/� C Q' 1 Vit �.1� C/MTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CO S RUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ AR HITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS `, ' j W (J Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 n V Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeX Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e /TeYPE OF WORK New ❑ Addition [I �od I ( ] Utilities ❑ InstallationKl Other ❑ Describe work: ([�/ (jQ� _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW penalty I declare under p y of perjury jur y (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.( DWELLING OCCUPM OR ADONS. ACC. BLDGS. /z¢sgft NCONSTR. NON•RESID, BRANCH CIRCU ITS 2.50 ea POWER APPARATUS 6 (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 8 AL0 0 3 ALo Ex. Occup. OUTLETS PR RESIO )EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury. (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct• structures over in height. Mobile Home Installation Fee $ OI� Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HAZ I CUA I PARK I SCHL I FLD I PAR Po HD I ISSUE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date _ the applicable provi- resolutions to do have been paid. WORKS Date `_ /3�srories rReceiptNo. I� / / D. P. W.. YELLOW-ASSCSSO R, PINx-INSPECTOR, GOLDENROD -APPLICANT _- _COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916.-533-7541 OTRIER-BUILDER VERIFICATION Attention Property Owner: - An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) lj signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. -Iplan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following perscas to provide the work indicated: Name Address Phone Type of Work Signed Property Owner Social Security Ndmber Date D NOTE: -This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we.are per- l mitted_to-issue-the--permit. -- ••-•-• ^r•n •--v..rc..y�'!r"Etitar.7.f..:; ✓'r.n�'.YY },ri \ n ••'''vr`r ..J�a-..-r.,... -... . .._.r • ;.i " .. ,�.. .�.. ,�.r.�:� �ti,.r'-n......:r[,'S,l• ..2'r' . n BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (onCe� Form per Building) �f0'r PU r �/ P � A.P. Number Building Department No. School DistrictOrQ Wt_;0P1 City Q County `' Jurisdiction Property Owner 0,0 'r f V1koo Project Location/Address C MA �G 11'l , ( ►� �� ; `� Subdivision Lot Number Residential Development: �Q O a Sq. Footage # of Living MHI 'Addition (Group R) Units Commercial/Industrial: Sq. Footage New Addition (Including Exterior Roofed Areas) Zt�e !ntative •`I Datd (Floor Plans reviewed,by School District Personnel) Dis0a.ict Id No.. J(AOIDlicant Name)I a/6;Z. �. School District certifies that ..�. LLL � one Number) r e �S-'t're-e-t Address) t ` l 14 (City) ( Stat Z p s C, e � hias complied with the requirements of Re JARon No. •. by• th ayment of $ representing Wsquare�fe,���/ r School Distric Representative Date, n PAID BY CHECK NO. REMARKS:At Lxj y BANK NO PAID BY CASH white -applicant, yellow -building department, pink-school.district SCHOOL.FEE (8/88) , BUTTE COUNTY DEPART14ENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 C MOBILEHOME INSTALLATION SHEET 1. Owner's Name: 106Y,-4 I ti 2. Installer's Name: VIER i 3. Is the site currently under permit? Yes © No (If yes, furnish permit number L H1 7 — O ) OR Is.the site an existing site? Yes F No1 0, \ I (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of ail setbacks and easements? Yes �� No U (If no, clarify 1 5. What is the mobilehome electrical rating? --------------- �Amps 6. What is the mobilehome site service rating? ------------- o� 00 Amps 7. What is the mobilehome she circuit breaker rating? ----- 5 Amps 8. Is there any other electric load to be served by the mobilehome site service? ---------------------------------- Yes 5 No 1' .(If yes, identify the load and size: WC_ U (Load) a0'� (Amps) as pipe g ?-------------- ✓ 9. What is the mobilehome site i e size. � (in.) _.., 10. What is the type of gas service? ------------ X ------ Natural CJ LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- -; 12. What is the mobilehome gas demand? ---------------------- (BTU) *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) rn�� 4i2o_� 4 WILDING F 'EiPA �URo, Bu. MOBILEHOME SUPPORT DATA Q If other than single wide, 'Mobilehome Mfr. 13r\;L tiK furnish Setup Model No. Year 2 -- Width 149 (ft.) Box Length jf(ft.) Tagalong or Expando Size ft. x ft. 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). FOOTINGS (check one) x1l. Wood -pressure treated or foundation grade. F1 2. Other (specify) SUPPORTS (check one) 1. Concrete block. a 2. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Main Beams Line 2 Main Beams Tag or Triple — — — — — — — — — — — F_tine 4 Line 1 Line 1 Piers: Size -Min. ------------ Spacing -Max. -'------- From Ends -Max. ------- Line 2 Piers: Size -Min. ------------ 9-/ Spacing -Max. ---------From Ends -Max.------- Line 3 Roof Loads: Size -Min. ---------- Location (From Front) Size -Min ------------- Spacing-Max ---------- From ------------Spacing-Max.--=------ From Ends -Max -------- Line------ Line 5 Roof Loads: Size -Min. ------------ Location (From Front) Line 1 Openings: Size -Min. ------------------ Each Side of Openings With Width Over --------- Line 3 Piers: (Under Bearing Wall Only) Size -Min. ------------------ "x ' Spacing -Max.--------------- „ From Ends -Max -------------- _ e .5 Piers: (Under Bearing Walls Only) Size -Min ------------------- Spacing-Max ---------------- From ------------------ Spacing-Max.--------------- From Ends -Max.------------- -