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027-070-072
I �7-07-72 /� GEORGE ROBISON � � R // W/S CynthiAnn Ct, 350' from, end off Ct, Palermo Permit#2331-86P, E (power p6�/ L e 9 & future lot development) 027-0770-072 93-366 P,E BAKER, ANN 23 CYNTHIANN CT, OROVILLE MH UTILITIES ELEC doo 4. __3 0�� --- - -- —GAS �i2<a In y COMPACTION TEST REQ SUPPORT STRUCT REQ��� 027-07-0-072 93-3 MH BAKER ANN 23 CYNTHIANN CT, OROVILLE�� MHI 027-070-07201-2566 CAMPTON, WOODIE & JOYCE I 23 CYNTHIANNN CT, PALERMO • �� Q CONT: EXECUTIVE HOMES 0 NEW MH EXIS SITE PERM FNDN 0 Irl REQUEST FOR INSPECTION Permit No. BLDG. PLUMB/MECH ELECTRIC M.H.I./M.H.U. PRE - INSPECTION Form Rough Rough Fnd/Ftg Frame/Underfloor Top Out Temp. Service Job Status Stucco Lath Gas Pipinglrest Main Service orrections Permit Renewal Stucco Brown Temp. Gas Underground ff C Aqnffr- VerifyUtilities Woodstove Sewer Piping Well Circuit Ex Mobile Site Brace Panel Water Piping POOL Insulation Shower Pan Nailing Gunite Demo Bonding Light Niche Corrections Corrections Corrections Final Final Final Corrections Ready for C Final Inspec. on: ' Date: 15 .G 2— Call Lj Phone: ki COUNTY OF BUTTE BUILDING DIVISION Vit' DEPARTMENT OF DEVELOPMENT SERVICES J 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE ..k Cry-�-rT -- OWNER PERMIT NO. Y A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 1 6- A i1 7� Date w Inspect nspt r REV 10/92 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA •.(530) 538-7541 CORRECTION NOTICE - OWNER - PERMIT N(5� A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please a tact this office immediately. I ( CS �Q l H e: Date / /r �—Z Inspector REV 10/92 1 NOTES V* PERMIT I ///)/0Z__ _ �L �3 Z —q-qo Z g15 , )(r/ 5AJ 6 G R",c 7a `�avE tiff/. iX47'JXD i U/6- Tp - Eic7lefP& wfj' TO 2�7/o L i RESIDENTIAL 027-070-072 01-2566 CAMPTON, WOODIE & JOYCE 23 CYNTHIANN CT, PALERMO CONT: EXECUTIVE HOMES NEW MH EXIS SITE PERM FNDNI THE HCD FORM 433A FOR THIS MH CANNOT BE RECORDED UNTIL ONE OF THE FOLLOWING HAS BEEN TURNED IN TO THE BUILDING DIVISION: (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). (2) STATEMENT OF FACTS (ONLY ON NEW MH'S). INSPECTOR TO VERIFY SERIAL & LABEL #'S. 11 SPECIAL CONDITIONS , 11 CHECKED OFFICE COPY Address GAS Meter By Da� ELECTRIC Meter a SUB -STANDARD HOUSING LETTER 411 SRA ►- %Ar�e.,1„4s 5 1. ID e. ' ,o 6+ 41 e. -.Y-1' i o r rfb- Ex;61;As 44111 �o L,e ovoy, o �� 9 `t. t4:0 a 3 o s JOB FINALED(D ) ��✓ Signature i ,/ = OK 0 = Not OK - = Not Applicable = Not Ready • MOBILE HOMES'. r • Date MOBILE HOME UTILITIES (Plans) OK except #'s Footings; Soils -Size -Depth -Spacing -Connectors -Steel 1. Zoning Requirements -Setbacks -Easements i 4. 2. Soils; Special MH Support Sketch Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 3. Sewer; Location -Test -Fall -C/O -Concrete 7. 4. Water; Location -Test -Easement Needed (Sketch) Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 5. Electricity; Location- Clearances-Grnd-/ /Amp -Concrete t 10. 6. Gas; Location -Test -Wrap;-/ /" L -ft. , / P Nat. or / w /"L"ft./ /'LPG Ext.; Steps -Doors -Landings 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE F_OME INSTALLATION (Plans) OK except #'s Line 3. Gas; MH Test -Demand -Valve -C ector ctricity; MH Test-Cro vers -Breakers -Clearances D in; MH Test -Fall -Flex Connector Wa , H Test -Regulator -Connector Wa and Sewer Connected -C/O to Grade -HD Approval Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 1e. Exits; Insp.-Sketch 11. Cert. of Occupancy -anent Foundation Only; License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails i 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh t 10. Roof; Shthg-Roofing 4' 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels 1 Date Card B-1 Date Card B-1 6 Date Card B-1 Date Card B-1 F Date 1 FINAL (Plans) OK except #'s t 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. -Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GR 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ./= OK 0 = Not OK - = Not Applicable =Not Ready RESIDENTIAL (; Date FRAMING (Continued) Underfloor (Plans) OK except #'s 46. 1. Zoning -Setbacks -Easements -Flood -Slope 47. 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 48. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 49. 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 50. 5. Stemwalls, Main; Steel-Blockouts-Wrapped 51. 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 52. 6a. Hold Downs and Special Anchors 53. 7. Slab, Steel -Wrapped 54. 8. Piers -Fireplace Ftg.-Steel 55. 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 56. 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 57. 11. Water Pipe; Test -Anchors -Regulator -Service Test 58. 12. Electric Underground 59. 13. Plenums & Ducts; Clearance -Material -Support -Ins. 60. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 61. 15. Access & Ventilation 62. 16. Insulation Date Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s PLUMBING (Permit) OK except #'s 63. 17. Water Htr.; Vent -Access -Combustion Air Baffle 64. 18. Water Pipe; Test & Anchor -Nail Protection 65. 19. D.W.V.; Test Fittings & Anchor -Nail Protection 66. 20. Shower Pan; Test, First Floor -Tub Access 67. 21. Test Tub & Shower, Second Floor -Tub Access 68. 22. Gas Pipe; Sixe & Anchors 69. Stairs & Rails Date Fireplace or Stove, Clearance -Hearth Card B-1 Date Card B-1 Date Elec. Outlets at Wood Panel, Int. & Ext. Card B-1 Date Card B-1 Date Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance ELECTRICAL (Permit) OK except #'s 73. 23. Fixture & Transformer Clearance -Ins. Protection 74. 24. Elec. Receptacles Spacing -Lights & Switches at Doors 75. 25. Size Boxes & No. of Conductors Stapled 76. 26. Romex Installed Close to Edge of Studs & C.J. 77. 27. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 78. 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI 79. 29. Subteed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or At 80. 30. Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or AI Insulated Neutral Q Yes Q No 81. 31. Service -Riser Conductors & Ground Main Disconnect 32. Equip. Clearances Panels-Motors-Mech. Equip. 82. 33. Clothes Closet Light -Shower Light -Spa Light 83. 34. Smoke Detector 84. A.C. Unit Disconnect, Electrical -Plumbing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Exterior Elec. Trim, G.F.I. Receptacle -Underground 35. A.C. Ducts Insulation & Support Ventilation Throughout House 36. Vent Fan, Exhaust above insulation Glass Protection 37. Condensate Drain & Overflow, Size & Grade Corrections from Previous Inspections 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet Gas Test -Meters Tagged, Gas -Electric 39. Attic Access & Platform if Furnace in Attic Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 FRAMING (Permit) OK except #'s Card B-1 Date Card B-1 40. Sits Proper Materials & Anchors Comments at Final: 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing jingle & Duplex) Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor Q Yes 82. Following Instld./Drive:1 Yes ] No/Walks J Yes 0 No/Planters J Yes J No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: FLEETWOOD HOMES OF CALIFORNIA, INC. 18 N. PIONEER AVE. PO BOX 1308 t. WOODLAND, CA. 95776 MC# 17 Date of Manufacture HUD label No.(s) RAD1349295 RAD1349296 Manufacturer's Serial Number(s) and Model Unit Designation SUNCREST 5603B CAFL117A25186-SC13 CAFL117B25186=SC13 Design Approval by (D.A.P.I.A.) RADCO This manufactured home is designed to comply with the federal manufactured home construction and safety standards in force at time of manufacture. (For additional information, consult owner's manual.) The factory installed equipment includes: Equipment Manufacturer Model Designation For Heating NORDYNE MlMB070 For Cooking WHIRLPOOL GS3951 Refrigerator WHIRLPOOL ED5CH Water Heater RHEEM ` 21I40T Smoke Detector KI DOE 1275E Dishwasher WHIRLPOOL DU890S arbage Disposal Microwave/Hood WHIRLPOOL MH6150 1 HOME CONSTRUCTED FOR X ZONE I ZONE II ZONE III EXP. "D" This home has not been designed for the higher wind pressure and anchoring provisions required for ocean/coastal areas and should not be located within 1500' of the coastline in Wind Zones II and 111, unless the home and its anchoring and foundation system have been designed for the increased requirements specified for Exposure D in ANSI/ASCE 7 - 88. ' This home has ( ) has not (X) been equipped with storm shutters or other prolective coverings for windows and exterior door openings. For homes designed to be located in Wind Zones 11 and III, which have not been provided with shutters or equivalent covering devices, it is strongly recommended that the home be made ready to be equipped with these devices in accordance with the method recommended in manufacturers printed instructions. Design roof load zone map: _ North 40 psf X South 20 psf - X Middle 30 psf Other psf 1 1 1 1, I COMFORT HEATING This manufactured home has been thermally insulated to conform with the requirements of the federal manufactured home construction and safety standards for all locations within Uo value Zone 1, 2 , 3 . (See map at bottom) Heating equipment manufacturer and model (See list at left). The listed heating equipment has the capacity to maintain an average 70 degrees Fahrenheit temperature in this home at outdoor temperatures of — 4 4 degrees Fahrenheit To maximize furnace operating economy, and to conserve energy, it is recommended that this home be installed where the outdoor winter design temperature (97 1/2%) is not higher than —10 degrees Fahrenheit. The above information has been calculated assuming a maximum wind velocity of 15 mph at standard atmospheric pressure. COMFORT COOLING F]Air conditioner provided at factory (Alternate 1) Air conditioner manufacturer and model (see list at left). ' Certified capacity B.T.U./hour in accordance with the appropriate air conditioning and refrigeration institute standards. The central air conditioning system provided in this home has been sized assuring an orientation of the front (hitch end) of the home facing . On this basis the system is designed to Maintain an indoor temperature of 75°F when outdoor temperatures are °F dry bulb and °F wet bulb. The temperature to which this home can be cooled will change depending upon the amount of exposure of the windows of this home to the sun's radiant heat. Therefore, the home's heat gains will vary dependent upon its orientation to the sun and any permanent shading provided. Information concerning the calculation of cooling loads at various locations, window exposures and shadings are provided in Chapter 22 of the 1989 edition of the ASHRAE Handbook of Fundamentals. Information necessary to calculate cooling loads at various locations and orientations is provided in the special comfort cooling information provided with this home. :1 Air conditioner not provided at factory (Alternate 11) The air distribution system of this home is suitable for the installation of central air conditioning. The supply air distribution system installed in this home is sized for a manufactured home central air conditioning system of up to 6 3 , 5 0 0 B.T.U. /hr. rated capacity which are certified in accordance with the appropriate air conditioning and refrigeration institute standards, when the air circulators of such air conditioners are rated at b.3 inch water column static pressure or greater for the cooling air delivered to the manufactured home supply air dud system. Information necessary to calculate cooling loads at various locations and orientations is provided in the special comfort cooling information provided with this manufactured home. To determine the required capacity of equipment to coot a home efficiently and economically, a cooling load (heat gain) calculation is required. ,The cooling load is dependent on the orientation, location and the structure of the home. Central air conditioners operate most efficiently and provide the greatest comfort when their capacity closely approximates the calculated cooling load. Each home's air conditioner should be sized in accordance with Chapter 22 of the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Handbook of Fundamentals 1989 edition, once the location and orientation are known./ INFORMATION PROVIDED BY THE MANUFACTURER NECESSARY TO CALCULATE SENSIBLE HEAT GAIN Walls (without windows and doors).. ..................:............ U. .06 Ceiling and roofs of light color ........................................ "U" .03 Ceilings and roofs of dark color ....................................... U. .03 Floors........!.............................................................. "U" .05 Air ducts in floor........................................................... U. .05 Air ducts in ceiling......................................................... "U" NA Air duds installed outside the home ................................. "U" .25 The following are the duct areas in this home: Air ducts in floor .................................. I....................... 90 sq. ft. Air ducts in ceiling.......................................................... NA sq. ft. Air ducts outside the home ............................................... 56 .5 sq. ft. U/O VALUE ZONE MAP WA — — / MT ND VT ME OR MN to WY SD WI Mt NY MA ' RI NV NE IA PA CT IL IN OH NJ CA'_ UT CO Vow x *"*° .. DE KS ,.. VA A, NG u +7NM?1i °DK rA gC 'ZONES U -VALUES ,tea 0.116 L� AK TXS :` ' .,. , oa' .. .. FLEM 0.096 HI O 0.079 BUILDING PERMIT NUMBER: 01-2566 Address or location of unit., 23 CYNTHIANN COURT, PALERMO, CA 95968 .r ,Legal Description of Real Property: `A.P.027, 070-072 SEE ATTACHED i (x) Mobilehome/Manufactured Home ' O Commercial Coach. Has been affixed to the real property above by installation on a foundation system' pursuant to Health and Safety Code Section`18551-. Owner's name: WOODIE CAMPTON & JOYCE CAMPTON Owner's address: 23,CYNTHIANN COURT, PALERMO, CA 95968 INSIGNIA OR HUD NUMBER: RAD 1349295/96 j SERIAL NUMBER OR V.I.N.:.. CAFL-117A/B25186-SCJ 3 MANUFACTURER'S,NAME: FLEETWA OD . r .AYAR: 2001 OFFICIAL APPROVING INSTALLATION: ��C 'DATE: .12/7/01 PHONE: (530) 538-7541 H.C.D. 513C E RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: I BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 10 -Dec -2001 2001-0058542 Has not been compared vith original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551: This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described. with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of -the real property, and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. WOODIE R. CAMPTON & JOYCE E. CAMPTON REAL PROPERTY OWNEWLESSOR _ 23 CYNTHIANN COURT MAILING ADDRESS PALERMO, BUTTE, -CA 95968 CITY •COUNTY STATE ZIP SAME INSTALLATION MAILING ADDRESS. IF DIFFERENT CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner. write "SAME') - - MAILING ADDRESS BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE, BUTTE, CA 95965 CITY COUNTY STATE ZIP 01-2566 (530)538-7541 I�D PE 11 TELEPHONE NUMBER 1 G 1 SIGNATURE OF LOCAL AGENCY OFFICIAL DATE EXECUTIVE HOME'S DEALER NAME (irnot adealer sale. write "NONE") 92081 - DEALER LICENSE NO CITY COUNTY- STATE - ZIP UNIT DESCRIPTION FLEETWOOD 2001 SUNCREST 560-3B MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMUNUMDER CAFLI 17A/B25186-SC13 60'X 25'8" RAD1349295/96 SERIAL Nl,\tD1:R(S) LENGTH x WIDTH INSIGNIA/LAIIF:L NUS1I11iRIS) RI: -\I. PROPERTY LEGAL DESCRIPTION ASSE'SSOR'S PARCEL. NUMBER A.P.' #027-070-072 I SEE ATTACHED IC'D I:0RN1 433(A) ItI'V. 8/91 WI IITE. - Cuu uy Rcco,&i CANARY . I ICD PINK - Applicant GOLDENROD - 110ding Dcpt. 0 FILE No.469 12/10 '01 AM 08:30 ID:EXECUTIVE HOMES FAX:530 891 8753 .- PAGE 2 ORDER NO.: 00198564-002 -CDT, SCHEDULE C THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE., STATE, OF CALIFORNIA., DESCRIBED AS FOLLOWS: PARCEL I: LOT 6, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "CYNTHIANN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIF ORNIA, ON DECEMBER 5,1984 IN BOOK 95 OF MAPS, AT PAGE(S) 69. AP NO. 027-070-072 PARCEL II: AN EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES OVER A STRIP OF GROUND 60 FEET IN WIDTH LYING NORTHERLY, WESTERLY AND CONTIGUOUS TO THE FOLLOWING DESCRIBED LINE: BEGINNING AT A POINT ON THE EAST LINE OF THAT CERTAIN PARCEL DESCRIBRD IN DEED TO NORTHWEST PACIFIC RESOURCES, INC., RECORDED SEPTEMBER 6, 1980, IN BOOK 2539, PAGE 38, OFFICIAL RECORDS, FROM WHICH THE NORTHEAST CORNER OF SAID NORTHWEST PACIFIC RESOURCES, INC.., TARCEL BEARS NORTH 00' 19'39" WEST 60.00 FEET; THENCE FROM THE POINT OF BEGINNING SOUTH 89103' 09" WEST 254.15 FEET; THENCE SOUTH 02° Ol' 51" EAST, 244.14 FEET; THENCE SOUTH 040 56'09" WEST 655.78 FEET TO THE CENTER OF THE EXISTING RIGHT OF WAY AS' CONTAINED IN SAID DEED. PARCEL III: A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES 60 FEET IN WIDTH OVER AN EXISTING ROAD AS SET FORTH ON THAT CERTAIN RECORD OF SURVEY RECORDED JULY 5,19741 IN BOOK 47 OF MAPS, AT PAGE(S) 93, THE CENTERLINE BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTHWEST CORNER OF LOT 3 OF SUBDIVISION NO. 2, AS SHOWN ON THAT CERTAIN MAP ENTI'T'LED, "MAP OF THE SUBDIVISION NO.1 AND 2 OF THE P. C. DRESCHER TRACT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, IN BOOK 1 OF MAPS, AT PAGE(S) 25; THENCE FOLLOWING ALONG THE WESTERLY BOUNDARY LINE OF SAID LOT 39 NORTH 00 IT 00" EAST FOR 89.58 FEET TO A POINT LOCATED IN THE CENTERLINE OF AN EXISTING ROADWAY; THENCE FOLLOWING ALONG THE r&mlm FILE No.469 12/10 '01 AM 08:30 ID:EXECUTIVE HOMES FAX:530 891 8753 PAGE 3 ORDLIR -"` 00198564-002 - CDL SCHEDULE G (CONTIMJED) THENCE CENTERLINE OF SAID ROADWAY, SOUTH 300 44140" WEST, 432.63 FEET; SOUTH/ 350 16' 10" WEST, 496.53 FEET; THENCE SOUTH 650 27'00" WEST, 713.80 FEET; THENCE SOUTH 410 02'0011 WEST, 228.54 FEET; THENCE NORTH 75° 30'35" WEST 106.02 FEET; THENCE NORTH 30 04' 55" EAST 225.42 FTET AND BEING ALSO THE TRUE POINT OF BEGINNING FOR THE CENTERLINE HEREIN DESCRIBED; THENCE FROM SAID TRUE POINT OF BEGINNING NORTH 13° 29'35" WEST, 367.16 FEET; THENCE NORTH 660 11'0511 WEST, 558.40 FEET; THENCE NORTH 53° 07'05" WEST,186.77 FEET; THENCE SOUTH 78°'04' 25." WEST, 285.73 FEET; THENCE NORTH 75° 36' 15" WEST, 245.53 FEET; THENCE NORTH 54° 19' 45" WEST, 283.57 FEET; THENCE NORTH 610 31' 05" WEST, 255.29 FEET; THENCE NORTH 730 35'4.5" WEST TO A POINT THAT BEARS SOUTH 60 FEET FROM THE CENTERLINE OF THE EASTERLY EXTENSION OF BOHEMIA AVENUE; THENCE WEST AND PARALLEL WITH THE CENTERLINE OF THE EASTERLY EXTENSION OF BOHEMIA AVENUE TO A POINT ON THE EASTERLY BOUNDARY OF CITRUS AVENUE AND THE END OF THE HEREIN DESCRIBED LINE. PARCEL IV: A NON-EXCLUSIVE EASEMENT FOR INGRESS AND EGRESS AND PUBLIC UTILITY PURPOSES OVER PARCELS 1 AND 3, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JANUARY 12,1981 IN BOOK 81 OF MAPS, AT PAGE(S) 40. PARCEL V: A NON-EXCLUSIVE EASEMENT FOR INGRESS AND EGRESS AND PUBLIC UTILITY PURPOSES OVER PARCELS 1, 2 AND 31 AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTF, STATE OF CALIFORNIA, ON JULY 6, 1982, IN BOOK 88 OF MAPS, AT PAGE(S) 86. PARCEL VI: A NON-EXCLUSIVE FOR INGRESS AND EGRESS AND PUBLIC UTILITY PURPOSES OVER LOTS I THRU 5, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "CYNTHIANN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 5,1984 IN BOOK 95 OF MAPS, AT PAGE(S) 69. PARCEL VII: A WELL AREA AND EASEMENT OVER LOTS 1 AND 2, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "CYNTHIANN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 5,1984 IN BOOK 95 OF MAPS, AT PAGE(S) 69. PARCEL VIII: A 20 FOOT CROSSING LOTS 4 AND 5, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "CYNTHIANN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE riru. m RECORDING REQUESIED IIY: AND WIIEN RECORDED MAIL 10: IOME STREET ADDRESS CITY, STATE, c1"d ZIP SPACE ABOVE TIIIS LINE CUR RECORDER USE 014LY ,— NOTICE OF MANUFACTURE[) IIOME" (MOI)II.EIIOME) OR COMMERCIAL COACII, INSTALLATION ON A FOUNDATION SYSTEM Recoldinq of This docirnlenl (11 Ilse regiiesl of the local (II(cory Indicotad is ill trccoldnncewith 011ifolnio Ileullh and Solely (..:odr! Section 18551. this documenl is eviilence I11(II sudF burl (,Oenry hos issued c, cellificol0 0l occllp(ulcy for inslollolion of the unit described hereon, upon the real propelly desuibed will) celloinly below, os of the (lisle of Focoicliny. When recorded, this clortmic.ni shall be indexed by the county recorder to Ilse ncnned owner of 1110 real propelly ()fill shall be deeined to yive constluclive notice os to its conlcnls to all persons Ihere()fler deoliny will) the Feld propelly. e REAI rRUI' N IY OWE W/I F.SSOR IOCAI Ar;(I 1(,Y ISSI1111(.; rCRL(I(/ fid Cr:R 11tIC C 'AII(:Y - — M -- �3_��_p_,�__:�. A11111G AI F.SS - �itw!1/1... ...... _.....__..._..._. _—__._...._..._. .. ... .. .. _. AUII II Ir; AhhRF.S$ - /4E errs 9s 96 toHe IIY 1000IIIY 5}ATE Ilr CITY - CollIIIY SIAIE ZIP INSIAIIAl1O1J /AAlrll l(7 nbnRESS, Ir lilt fmiiI - VIII hI11R 1'r RAMC.IrO•. IEIFPII011E 11WArtrR car COIII IIY '--. .. _.... ..............._._------IIIRj F'•--------------•------ SInIF. 71C SI(;I IAHIRE Ur IOCAI AUF,I ICF (-)I j, TAI . _..__._..... ___...- ,� " -y-- rntE 111111 OWIIER (II olw --•-----•--- " bFAI F.R IIAI.(E (II r++I o dc..l.., v.le, MAIIRIG- Uf:MrR ilCf.I ISE ITU. � CITY COIIIIIY----'-"-- SIAtF. ---_.----"Ilr - - �U14I1 DESCRIPIIoi-i ��2 MAImt-ACIUPER-SIIAME ------ ------.-.__.-.eZB.p.I------•-----..-�(c(iy�c. -.� S"SjQ'.�----_.._,.__. nA1F. or'mmiurACI11RF. MODEI IIAMF/IIIIA(nER 0 , x -a0 " SERIAL r-IUMRER(S) 6,� IEIIr;III X WIDIII,t J ...•_._._.__ IIISI(SIIIA/IAnrt 1111mer.R(S) - -�- REAI rROPERIY IEGAI UESCRIr,,o,, ASSESSr)R'S rnnCf:r 1111nMl; tr �`-! - O / D O-7 Q, ' LOT 6, AS SHOWN ON THAT CERTAIN MAP ENTITLES, "CYNTHIANN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 5, (1,984 IN BOOK 95 OF MAPS, AT PAGE(S) 69. Olt +. i or tin ` m , 1- r \Vllllr .. (..o,=1y n.r..n l•. _ (;fir 111 IIF 11 rmir. 'n.=n=Ggl n.1d rl II11W /, li„=,•r 1'1' •c IVC VV VIVl1J 1 LI-,#V%I%IVLIV 1 1 iJvlytJ,%I A -vi v SI A 11; 111: CA 1.11:011 NIA. IT Or,� 111ISINESS, I ItANSW)ICIA'I ION A141) 11OIISINo AoFN(:Y III; VA ItIMFNVol: III)IISIN(.;ANI)I:ONIMI)NITYUBVFIA) PMI;Nl cY L I)IVISIoN (IP ('ODES AND SI'ANI)Altl)S Itl'.(;ISlltA'I ION AND TI I LIN(; PltO(MAF1 h rh�� This onil is a: � Mobilell(nue I I Conuncicial Conch I . ( FI(rtling I.10111C I.. I 'Truck Camper !)coal (License) No.(s) I rade Mime Serial No.(s) Su,nC,6tes% -S--6o -3 Q /We, Ille undersigned, hereby shl(c: Dealer Report Of 5ale ## The Above bescribed Unit Has Been Placed On An Approved Foundation. 5ystem In Accordance With 18551 Of The Health And 5afety Code. /We f Miller agree to in(lenuail'y and save luun)Iess Ibe Director of I lousing andC'onnlnlnily Developmenl, Slate of Calili)anila, and Stabse(Inenl I)urclaasels of said unit 'li,r any loss (bey nl;ay suffer resulting lions regis(ralioil of Ille above-described tinil in C'alift)rnia, or lions issoance of a ('alili)rnill certificate of title covering 11►e Same. /We cerlify under I)ei►ally of I)eriury Ilril Ille lbregoiing is 1111cand correct Fxeculed on /0// Signalure(s) Illinicd nslluc(s) Addlr_ss- �(^'`'w r T S� -73 Sl('Ily _...... ....._.. -.... ......_ ..._ ..._.......... - -- ate —_. IWD4)6.6(It FV 12/0(1) llle soles I)r icc as shov'n does rlol ir,Clot)e orgy an(ounl {,)1: (my in-!)l(ice Iocc,lion. 111e Assessor's Parcel t-lunll)er. of Illy- installylion site is- - as % -070 —ox-;L- C/ O;t•a d Add) 1 C�l...:._ Com' --&s 7-3.. 3c� cP�/ (09�� . l,u"rrl:r: •r(, n�; ;r: ; ;17.111. - 1'111.5 rUllF1 RUST BE CUI91'LI:A11) 1}Y Tllr OW1111;IZ OF A 11ANUrACTURED 11011f: 1-10131.L 11U -W Oil CONIMIC1.A1, COACII Atli) rORWARUrU TO '1'1117 C(-WWTY 71SSI:SSOR 11I'Urd COI-iNX111.1O1 OF THE 3.11STA1.r,ATION OL' '11117 1)14.1.1 ()Il A r(AUNDAT.1d)11 Sv-i•1'I7tl PURSUANT TO SI C'1'1.(.)1.1 1 U:i'-i] I1Rn1;1'11 Alli) (a)UI:_ URiG7.IlA1. 1'III2c;IlA ;I': 1'121 c�li 1'(112: - - I u+� The I) a s i c U n .i. t. S..6 - I)1,e n r�lerinl •,u l Cn.ai„p: - :2. O,/lionol Egvi,,rnenlll;"- 1 Irre o. Ronl J. Sv Iola S _ Nelal• wood. (mn, nrit on• ek.) A. Ac'ce„n„et cc/- 6. fl.—I s 7 3 r2y IIeaG,.p 1)1, A;, 3. O,her (SpecilY) _09/_ C Ai, Crn,.) drnu„ / d. UeG e,y a Lnkdlaran lnr— .,(,C•�,e 14C..u,,ol.,r.. (nolo: I_.1 YES _. .y .._ _..... (�f•,O w 7. TOf�1l SAIrs PRICE %3 � 76 — s r"014n Cool fn,*e I-_1 YES L I 1.10 DOES THE BASIC PRICE ItJCIUUE: n,dhdn Uhh .id,�,: U Yr:s R/I r,o the To. -6o,(/) L_I YES [ _ f,0 rklip.)„wef 11—,U Rehi 10, YES I. 1 0110 Tlrel a Wheel, I_J YES I- 1(7 pe” : R—I O.�Ihnn f:n,., YI:S I CI ,10 ' L --I Y1:5 I- f IO p 1 17111 I : Yr:S (1 ni1Vle h,fl,llle d: I_1 Yrs I_1 • •U Vlll,le s--_,_--_�__ UST NUMBER Of ROOMS: (lEfl(;ill x wrinn) / y 5 . (�rlo x Pohl,:--•- L_1 Yrs , Uftto ---- X Md,l” r—ily R.,... ���' (;ala Or:. L_1 YES . ---_ 0 Ido --- v Kild,en sfolape shed: I_1 Yr$ F<tIo Y -- — Ulilify Ronnl 51,66"Q:1. J YES y LSI t10 Orho Cnn,,,, �— ----- tI1,Etil rM llle soles I)r icc as shov'n does rlol ir,Clot)e orgy an(ounl {,)1: (my in-!)l(ice Iocc,lion. 111e Assessor's Parcel t-lunll)er. of Illy- installylion site is- - as % -070 —ox-;L- C/ O;t•a d Add) 1 C�l...:._ Com' --&s 7-3.. 3c� cP�/ (09�� i 10/10/01 10:15, BIDWELL TITLE CUSTOMER SERVICE 4 530 891 8753 NO.565 P002 • •y',• 1��1'��III����11iI�I�!lI���1��� Rt, CORDING REQUESTED BY Bidwell Title & Escrow Company Reearded ( REC FEE 16.0tL Off icialRecords I TAX 4b.20 AND WHEN RECORDED MAIL TO Woodlc R Campton MAID J BRUBBS 1 Recorder ansa, 1706 Berkshir"c Way ROSEMARY DIMSM l �aaro.. Salinas, CA 93906 Assistant I Fay 09:® 0S -Mar -2001 J NO 1 of 4 CH7, aro. , no. 00194999-001 .srr�a,.F. nuVvn t nib LJ/VrC PvK KGC.VKL)ER'S USE J Panel No. 027-070-072 CRANT DEED THIS FORM IVMSRED BY BIDWELL Tl =- & ESCROW COMPANY T's Undersigned Granuu(s) Duiaro(s) Documentary Transfer Tax is $46.20 10 Univ opo at 0 c"tW on hall value of hnd2eat or properLy omveyad, or !21 Unincorporated Area D hill value las value of lima or enwmwanca rcawning at the time of ss)a 0 Monument Fee of $10.00 FOR A VALUABLE CONSIDERAITON, receipt of which is hereby acknowledged, Ann Bakst, An Unmarried Woman hereby ORANI'(s) to Woodii-e R. Campton and Joyce.E:,Campton, Husband and wife as Joint Tenants the following real property in the 0 City of' 0 Unincorporated Area County of Butte, State of califcmiar , SEE EJiMIT A ATTACHED HERETO AND MADE A PART HEREOF Dated: )February 22.2Qo1 Ann 4.kcr r STATE OF CAL17oR)," COUNTY OF BUTTk SS: On before me, the undersigned, .a Notary public in' 3rtd for ty and State, persona appeared 4orsonally known to me (o p d to me on Lhe:bagis Of satisfactory evido to be erson(s) whose name 19) ie/are subscribed to the within acknowledged to me that ument and in his/hex/their authorized cae/Choy executed ams paCity(leg), and that hi.a/her/their algnature(s) on the instrument the pereon(a), or the entity upon behalf of which the PerSon(a) acted, axOcuted the instrument. !}ITNESS my hand and official seal. slgnstur� NOTETIA 0. SRS ARY F lgLICCGWINNM Co. a& My COMM•t8SION EXPIRES JAN. 16 2W6 MAIL TAX STATEMENTS -to: SEAL 10/10/01 10:15 BIDWELL TITLE CUSTOMER SERVICE 4 530 891 8753 EMBIT A► THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: NO.565 P003 Order No. 00194999-001 ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL 1: LOT 6, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "CYNTHIANN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 5, 1984 IN BOOK 95 OF MAPS, AT PAGE (S) 6'9. AP NO. 027-070-072 PARCEL II: AN EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES OVER A STRIP OF GROUND 60 FEET IN WIDTH LYING NORTHERLY, WESTERLY AND CONTIGUOUS TO THE FOLLOWING DESCRIBED LINE: BEGINNING AT A POINT ON THE EAST LINE OF THAT CERTAIN PARCEL DESCRIBED IN DEED TO NORTHWEST PACIFIC RESOURCES, INC., RECORDED SEPTEMBER 6, 1980, IN BOOK 2539, PAGE 38, OFFICIAL RECORDS, FROM WHICH THE NORTHEAST CORNER OF SAID NORTHWEST PACIFIC RESOURCES, INC., PARCEL BEARS NORTH 00° 19' 39" WEST 60.00 FEET; THENCE FROM THE POINT OF BEGINNING SOUTH 890 03' 09" WEST 254.15 FEET; THENCE' SOUTH 02` 01' 51" EAST, 244.14 FEET; THENCE SOUTH 04° 56' 09" WEST 655;78 FEET TO THE CENTER OF THE EXISTING RIGHT OF WAY AS CONTAINED IN SAID DEED. PARCEL Ill A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES 60 FEET IN WIDTH OVER AN EXISTING ROAD AS SET FORTH ON THAT CERTAIN RECORD OF SURVEY RECORDED JULY 5, 1974, IN BOOK 47 OF MAPS, AT PAGE(S) 93, THE CENTERLINE BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTHWEST CORNER OF LOT 3 OF SUBDIVISION NO. 2, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF THE SUBDIVISION NO. 1 AND 2 OF THE P. C. DRESCHER TRACT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, IN BOOK 1 OF MAPS, AT PAGE(S) 25; THENCE FOLLOWING ALONG THE WESTERLY BOUNDARY LINE OF SAID LOT 3, NORTH 00 17' 00" EAST FOR 89.58 FEET TO A POINT LOCATED IN THE CENTERLINE OF AN EXISTING ROADWAY; THENCE FOLLOWING ALONG THE CENTERLINE OF SAID ROADWAY, SOUTH 30° 44' 40" WEST, 432.63 FEET; THENCE SOUTH 350 16' 10" WEST, 496.53 FEET; THENCE SOUTH 65° 27' 00" WEST, 713.80 FEET; THENCE SOUTH 410 02' 00" WEST, 22B.54 FEET; THENCE NORTH 75° 30' 35" WEST 106.02 FEET; THENCE NORTH 30 04' 55" EAST 225.42 FEET AND BEING ALSO THE TRUE POINT OF BEGINNING FOR THE CENTERLINE HEREIN DESCRIBED; THENCE FROM SAID TRUE POINT OF BEGINNING NORTH 13° 29' 35" WEST, 367.16 FEET; THENCE NORTH 66° Il' 05" WEST, 558.40 FEET; THENCE NORTH 53° 07' 05" wEsr, 100.77 r2;ZT; THENCE SUV'rH jUl 04' 25" WEST, 285.73 FEET; THENCE NORTH 750 10/10/01 10:16 BIDWELL TITLE CUSTOMER SERVICE 4 530 891 8753 - NO.565 P004 Order No. 00194999-001 36! 15" WEST, 245.53 FEET; THENCE -NORTH 54°19' 45" WEST, 283.5'7 FEET; THENCE NORTH 610 31' 05" WEST, -255.29 FEET; THENCE NORTH 730 35' 45" WEST TO Pi POINT THAT BEARS SOUTH 60 FEET' `FROM THE CENTERLINE OF THE EASTERLY " EXTENSION OF BOHEMIA AVENUE; THENCE WEST AND PARALLEL WITH THE .CENTERLINE OF THE EASTERLY EXTENSION OF BOHEMIA AVENUE'TO A POINT ON THE EASTERLY BOUNDARY OF CITRUS AVENUE AND THE, END: OF THE HEREIN DESCRIBED LINE. PARCEL IV: A NON—EXCLUSIVE EASEMENT FOR INGRESS AND EGRESS AND PUBLIC UTILITY PURPOSES OVER PARCELS 1 'AND 3, AS 'SHOWN 'ON THAT "CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA,,ON JANUARY 12, 19'81 IN BOOK 81 OF MAPS, AT PAGES) 40. PARCEL V: A NON-EXCLUSIVE EASEMENT FOR INGRESS AND EGRESS AND PUBLIC UTILITY PURPOSES -OVER PARCELS 1,'2 AND 3, AS SHOWN ON THAT CERTAIN PARCEL.MAP, RECORDED IN THE OFFICE OF'THE RECORDER OF'THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JULY 6, 1982, IN BOOK 88 OF MAPS, AT PAGE (S) 86. PARCEL VI: { A NON—EXCLUSIVE FOR INGRESS AND EGRESS AND PUBLIC UTILITY PURPOSES OVER LOTS 1 THRU 5, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "CYNTHIANN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF TATE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 5, 1984 IN BOOK 95'OF MAPS, AT PAGE (S) 69. , PARCEL VII: A WELL AREA AND EASEMENT,OVER LOTS 1 AND 2, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "CYNTHIANN SUBDIVISION'!, WHICH MAP,WAS RECORDED IN THE OFFICE OF THE RECORDER'OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 51 198Q IN BOOK 95 OF MAPS, AT PAGE (S), 69. PARCEL VIII: A 20 FOOT CROSSING LOTS 4 AND 5, AS SHOWN ON THAT CERTAIN MAP ENTITLED,'. "CYNTHIANN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,, STATE OF CALIFORNIA," ON DECEMBER 5, 1984 IN BOOK 95 OF MAPS, AT PAGES) 69. � l r 10/10/01 10:16 BIDWELL TITLE c CUSTOMER SERVICE 4 530 891 8753 - NO.565 POO5 State of.Georgia , County of v � Signed sealed and delivered in the presence of UnofP dal ealf Notary Public My Commission Expires ftAD.SEft WAM'VON EXPIRES 166 2005 JASNO. Notary Seal. g11t11Nlfi " ,., 0: z FILE No . 469 12/10 '01 AM 08:31 I D :EXECUTIVE HOMES FAX : 530 891 8753 _ PAGE 5 741 T STATE OF CALIFORNIA NUMBER: BUSINESS, TRANSPORTATION AND HOUSING AGENCY ', DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT r ; 1.1 ' r > DIVISION OF CODES AND STANDARDS a MANUFACTURED HOUSING PROGRAM ""°"� a MANUFACTURER CERTIFICATE OF ORIGIN ORTRMUTIDN ORIGINAL (PINK) FORWMD rc/t HE INVENTORY CREDITOR. UNLGS3 THERE 16 NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFCNtt) COPY 1 (vmm) FORWARD TO (HE DEPARTMENT AT P.O. BOA 1820. SACRAMENTO. CA 06814.1828. WITHIN FNE (6) DAYS OF RFLEASE. COPY 2 (YELLOW) DELNER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (OMDENROD) TO BE RETAINED BY'IHE MANUFACTURER. MCD 063.0 - Sltb 1 • (7187) CHECK IF Tt418 IS A DUPLICATE MCO -ENTER ORIGINAL MCO N0. �� ►NUfAQlUAFQ HOME OR MULTI-UMT MANUF6CTURBD HOUSING EWD (SINGLE FAMILY DWELLING) ❑ MUMM (MULTI -UNIT MANUFACTURED HOUSING NUMBER OF TRANSPORTABLE SECTIONS---9—�- flO M RCIAI COACH: OCCUPANCY GROUP MANUFACTURER NAME: MANUFACTURER LICENSE- NUMBER: lLBBTWOOD SONES OF CALIFORNIA, INC. 34 MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE: 18 N. PIONEILR AVS. 95776 ,O Box 1308 NO stele (ZIP) N URER TRADE NAME: MODEL NAME AND/OR NUMBER:MANUFACTURE: NAME OF DEALER OR TRANSFEREE (OWNERSHIP TRANSFERRED TO): CALIF. OVdLtQNUMJff8V— TRANSFEREE DESIGNATION: DATE OF BBCGAZTY K/H BHolf/NORTH, INC. DIALER OR TITAN FEE A ROW (SWW Z NDPLANADR CII State TO 94423 -IWVENTORY.CREDIT.OR NAME: 00"" MINDUORIEN111. CENTRAL PROCROBWO CSNTSR gB BOX 411999 Cirvi M fmvaBute 2 ucTtON MANUFACTURER SERIAL NUMBER I ICD INSIGNIA OR HUD LABEL NUMBER 1-0 �EHGiL19 (INCHES) WEIGHT 9"�qVillk"i66 Geis -2 --770 o a 21,520 TRANSPORTER NAME: �I etete jokyA now -1-1695930 z DE8T1NAmm FOR UNIT DEBCRIaEO ABOVE: NAME SLIM WHO8We(zip)I 1 oeAFY waor rw%oy of penury undr 1Ao Ie..► or It. Sime of Colsomle tial Uv ebe+e Lep► OM true er,d C0/1`9471, Fl -"d- et (Pry) /TOO (CouA1Y) SIGNATURE OF ALM IORIZED AGENT: I,. '� / � �.- •"''..Y... ...'.- -�-+ ,_. • ORTRMUTIDN ORIGINAL (PINK) FORWMD rc/t HE INVENTORY CREDITOR. UNLGS3 THERE 16 NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFCNtt) COPY 1 (vmm) FORWARD TO (HE DEPARTMENT AT P.O. BOA 1820. SACRAMENTO. CA 06814.1828. WITHIN FNE (6) DAYS OF RFLEASE. COPY 2 (YELLOW) DELNER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (OMDENROD) TO BE RETAINED BY'IHE MANUFACTURER. MCD 063.0 - Sltb 1 • (7187) ` COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12�96) APPLICATION AND PERMIT 01-566 ASSESSOR 0THLNIfMBY_072 ZONING BUILDING PERMIT OWNER WOODIE AND JOYCE CAMPTON TEn7!LF4402 JJL SO. FT. OCC. BUILDING VALUATION OWNERS TrCM IIANN CT, PALERMO cow"'AcTMITTTIVE HOMES T%1j"%992 DDNTRAcTI "TNtMXNADE CHICO, CA CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING 23stYNTHIANN CT, PALERMO Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New X Addition --❑ Remodel ❑ Utilities ❑ Installation ❑(1 Other ❑ Describe Work: il5 '$" X bo 7 r-na l a Pao m-ra c -A Litne, nto 0 :OAp I ng�dg=LJ'r20_ t'0QJQQ0TYVK,�F_ Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home I S I G I W 00 n PERMIT FEEL ELECTRICAL PERMIT Fling Fee 20.00 Main Service A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. rr �, r o License Class C 4-q Lic. No. l9 "IONS .-5 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. �( I have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers compensationurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date ID ak I Signature of Applic ❑ Owner ❑ Contractor ❑ Agent it An OSHA permitis re ' ed for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service TO tOooA 46.00so NEW CONST. DWELLING OCCUP. SO DWE200ALLING OR ADONS. ( & AOC. BLDS. 3.50 FT. NON-RESID. T.MULTI-OUTLET @7.50 POWER APPARATUS a swoLE ovn ,R. 204 .00 EX. Occup. OUTLET OR FDMRES SAL @ I.50 Ex. Occup. oFL'LLITi RM .) A 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI: $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE T TAL FEE $ HAZ D IMP D COF pARC0. r HD ISS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work Indic at Ove for Mach fees have been paid. Q -3D 0 By / Date 101-3010, PERMIT EXPIRES ON Dale Receipt No. 336604/$227.35 3?,0 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT M i;VUF1.1 Y I.A- [K) 111; - IM-A'AlI I'MIJ4I• 01= I)FVf_L_t?I'ME1d I-„ElIVI(*I_'.: -• 11011.1)INq !)IVI's I(.)II T County CcrntFlr f.7rivn oloville, California 95965 Telephone (530) 53n-75 11 r 1;nrnl 111). A1* �c� �c� anN�a������nn1T aS� Ilev.12%Or) rINA 61AI-DING PERMIT so. ry occ. BUILDING VALUA'1"1011 -C4 -------------.... - - =_-- ----- -- corn rove rw�' T, ;F-1 -1n .._ .. _ i cofaro+-Tonri f " _ A ,n -- --- - - --- - - ------ • COIl,TMXj nOtllFl+(1En 0 1 I.ErIoEn'! 1!.•rl.Pr!1 nr!or!•s N1CIelECt Oftln?!r!F Ea---�--- -------_-..-_------------ -'lr,.sr�E!rn. --- --- ---------------- -------------- - —---...... - — -- MCI,IECT On rrrO,IFEr 7r 1.. •....Ira lnOn!S, lArf'o. l USF OF.glW. lILInE SF LJ Oupl9r. (J Mobil -17 Other \ / TYPE Or wonK Ntry hddiLon U nemodO D Uliri"n Cl k!s!np,ti"i Cl 0111-r ('.l ------ U1escriha Work: l2v�� S2_.._Q_��'�S_ Y1 f'� I(i1rJ ()l(1 ('I -Q f1 i I, it -An -O t n lel r rtPERMa.T FE[_ Pn') 512/1 S1.1ER:WT O-rl•IEfi AMS VIAT RECE- WEI-) aa�.35 Ph : "'RECEdRT NVAARER ✓_ C) L '^ TCS FII- PUT YNTO COMPUTER --- --- —� . tirolInco -Tolel Valuallorl flonnil Fee 20.00 _flan Checkii15t Fee --'”------ �_ 1.27 3s..... Energy flan Checking Fee ----------- -------------- f FEE f _ _rE_RMIT PLUMBING PERMIT -- - Filinp Fes, gO.no Each Timp 7.00 Solar or"hent -pump water heater 23.00 Walnr )i in 15.00 Each gas water healer c_r vent 15.00 - - _-..__.. Ges_pping nyslem 1-`5 outlets 15.00 envier- -Building Mobile Home S I C, W @20.00 rEnfAIT FEE`_ -^ Fillrlg ren 20.00 I-- ....._—. ELECTRICAL rEnM1T "Ov on tEss Main Service ( 720,1 on tEss �_ - — 23:00 40.00 Main Service ( 200A To 10"A - -- ..co�f.l cry Eu_i K1 occur. ` on moons. a A -CC. stns.:5Pr -- .-- So ._..... I. sirZ`i";1`—" i40VrTET Igll.nEslO. 1/ ,hn[t6-OUTLETI- 1 -- Co?7.50 . Ex occup. oVTIET on rimunFs r!xeo )rrun. on - EY. Occup_.--( oultErs inESlo.► Temporary Service Mobile Ilome Facilities_ _ --. PERMIT PEE 1 .$ e•.0 rA ea UU 23.00 20.00 - 23.00 MECHANICAL rEnfAIT riling Fen 20.00 Renting- ' Cooling Ifood — -- - 0.50 ventilation - --- Mobile 1101,19 Installation res - En9rgy k,sp9clion Fee .Or� Cr11 ^s TJrF 01AL FEE !I n.00D or .r c4_ - I^ --- lhrn permit i, hereby 1?su*d under th,r erpl!cnbh Lrnvi9inn, Of the Putty county Code elnd/or fie?olulionR h rto v,0fl( IndicPtrd Pt.ove for which tons have barn paid. By 11ni. . PEHMI"r Ey,Pim; ON t;t►t)11l Y �)I' 11111 11; - 1)VPAIIIM1=N I• t.)1' 111V1=I.t.11'M1aJ I �;�{1V11;1 111111-I)IPp„ 111VISIt,)11 1 Cc+unty Cnnt[►r Drive O►oville, California 95965 - TP1911t011n (530) 5311-7511 rr.rlrvl 11• IAV. 121Q q [ r!�E�eonn��-crrr•-n nor•' MAI I )IFJG PERMI T 4 7.-4�...__- L��� so. Fr. orc. 13, lL7 vn�ur, r 1c)i i - Corrt ton• 11+,n! i--- tr,.nnr1► ---------- ---•- ... .. ... .. ��-�1�� _.. --- comn.cron 1 ir.•scn i .• - --..-...__. i corn InV'nOtl tll(,EI / -- IEr10 Et1't 11.•.11 tN) NMN _._._. _ _..__._ __.__ _ IrOp ACO i TOtel VAIIIA11011 G w ' /ACNIIEcf an Ilq!1 f.En Fling Faw - 2(t.01t I MCHIECT On P10-110.1`1111 In llr/,1 Mr!`•!j-1 .... __ .... ._.......__._ - ... — _ _-��- ----� P011llll I A9 G� �f L Plan Checicing Fee ''FJlMln nrnrt!-1s , Erlalgy flan 1. Checltutg FPO 1; � 3��r:�h_w.�n�__��,-.__��,.�Y +mom---•--------- .__-------�-------------------- ..f....... tl .. . ------ --- - _ -----..-.. ._... - -- - ---...... __. f EnMIT FEE f ... IAflq, 111wOr/n!CN 1•i,l �•/j� .-r A f,••1rE1. /1•r ...__._..__._—.. ._._—.—_.__..______E 0 (ac PLUI:IP1►1G PEFIMIT riling rte, �;;:nr; I --Each Trap- - 7.nn IISF[.)F.S1RUr.:�fllnE----- ----------..._ -- ---- --•-- Solar or hent pump v+ntcr heater - 23.00 aF CI UuplAr. ('I f.bbil-hemq Ullter _Watnrpiping - -- - ----- - IS.00 rG, - �Ecrr •------- -` -- ---- --- - -.---- -..—_ _--_--_-• -Each gas vraler healer C( vent 15.00 TYPE OF WOnI; - ----- -- ._ ...-_-- / Oas Fftflng nyslem 1 - 5 outlets - - - 15.00 PlA•.v AddiLon U fl -11-10 I-) LRiriHen fa 6tstae,lint U [ill, -r t'.1 ------ -©wilding sertnr- _ _ — 15.00 I` -- —_..— ---1 00 .... . IQ Jr / Mobile IlomP@ S O W 20.00 Ueacriba Work:-- --..._._ .. QI�lulQ-�...'_---- -------..._._ r•E n M rr r- EE x �(j ELECMICAL PEfiMlr Filling ray 20.r�tt f+lein_S_orvlce _( zaen (Ess _J w _ - 29.00 •T TI- plain —1 Service_.20CA to In10"A o-:+EUJr1n occur.ac on+.Oorrs. •J�CC.Bins. � _ 9.5Prr. II.OIJILEI j —1/..11l.nESIO. aaN1C rl3ILI_...C?7.50 "VERMT 1- FC(: PAT() IA 511 IERIFF OTHER AMOVIAT RECEIVE -I-) t � D-�7, -�) 5 -t, ."'RECE "i' NVMRCR �C.Q a " T -O Fir_- PUT INTO COMPUTER Ex. Occup:.--(otntFt on rnitmr! E�vOCCUP.rIXE0/.r1'Vr9. on Temporary Service Mobile Home Facilities ' ----_---- PE)lI•tll' PEE --- IAEC14AIlICAL PEnmrr-- 1tenting�.--------- Cooling I.lood Venutntioir _..__----------_.___-- 29.00 -- Filing rnn 20.09 --.--._...- PERMIT FEp t Mobile Ilonte Installation Fee 111;-- Ennrgy Inspection Fee------ —O..r...--- cnr•g Atyr TO. AI- FEEI 1 fl.[MO COI 710-1 permit la hareby I-1su.d under Ilia nPPI!^nhl4 f,rnvl.inne, Of IIIA Putt-! Counly CM* end/or flnsolugon-1 In rin ,+n111 Indi,7.00 al�,ovq for which foaa hove b—, Pnid. By PEr1Mlr ExPInEs 011 _ _ Y» � ;} • ♦ r' ti _..w� ' '. � a:l1.i� i. `.� i�+ s.[F... l� �' .I� L'. ' v`ir L COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965.- TELEPHONE (530) 538-7541 PE"IT APPLICA TION DA TA SHEET OWNER: ASSESSOR PARCEL NUMBER: Proposed Building se: Building Inspector: Date: lb- 16161 At time of permit application, I was advised the following data must be ed prior to permit processing and/or issuance: Date Received By 111. All items have been submitted -------------------------------------------------------------------------------------- 02. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ 06. Energy Design Compliance and supporting documentation. ---------------------------------------------------- 117. --------------------------------------------------- ❑7. Statement of Intent for Non -Heated and A/C Buildings. -------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9 ` anufactur me data and installation instructions ' cl Tie Down Specifications.---------------- , 0. Fees = ---- .lc�00-----------�t��--33_- a---� 6 3 pact fees as shown on the attached schedule. -- - - � - — -�=- - i�-�,�. �--��-t-M __ rs'r� O 0 0 C California Department of Forestry plan approval/fees. --�� --- - — ----1----------------------- ❑ Flood elevation certificate. ---------------------------------------------------------------------------------------- anitation and plot plan approval � `6 Health Department. ------------------------------------------- L t� 15. City of Chico plumbing permit. ----------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- '❑ 17. Planning approval for (A) Use: Q K (B) Parking: -------------------------- ❑ 18. Contact Land Development about ElImprovements, ❑ Draina.egal. Parcel.-----------------------�— ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------- 020. Pre -inspection for required Request to Building Inspectorn (Date) ❑21. Contractor's license information. (Number, Name Style, Classification). ----- ------------------------- ❑ 22. Workers' Compensation carrier and policy number. ----------------------------------------------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------- ------------------------ ❑24. Letter of signature authorization. -------------------------------------------------------------------------------- ❑ 25. ecorded copy of Agricultural Ackno led gment Statement. -------------------------------------------------- 6. Letter of intent on building use. ---1C--- -- ----- — ---------------------------- 027. Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑28. Existin vie ations and/or qxpired permits. Oheck ------------------------------------------------------------------ � �'l9. ❑433 A ant D06VM.H. Title_�Jj to H.C.D $ ��--------------- 1130. Other: When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. 5Tavc-r, 12evleoJ El Telephone and hold for pickup ato ce. ❑Zhith inspector. 'PAaiv� v� pkok ?01K1'_1 ►re O tAkd Applican Date: Al Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ ther: Date: By: 1. Index permit application for the above items numbered: 2 ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data b ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data b ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, o er,xyas advised of the above r �1 to by ❑ phone, 13 mail, ❑ Building Division counter, by Date: Plans reviewed by: Date: `!i .O Plans approved by: Date: ns Sets of plaon h d in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: _,TG:-- Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance rA E.H. USE ONLY Plot Plan Attached Floor Plan AVlached Sent to 0, 'y, Owner Location AP# Plan Approved for: Sewage Disposa Water Supply: Public Private We Clearance for dwelling. Other L r Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist 8/96 Date . .. ... .. _. .. ,w _ . �..ti :'�7 c ^Rv, .,•s, rr.. i. .,.. r-�.�,—.r'..w^:Ty .� ..Y. ,.,�,�� .r-. �r .... ..�.� } BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form r Building) , School District Df 4 1 � A—�) Building Department No. A.P. Numberv /�� • �� V • u�/J� Jurisdiction: city County Property Owner Property Location/Address � L1-\ —1 I )v i �/t V 1 \� Subdivision Lot No. Residential Development No of Living Mobile Home Units Installation 0 New Addition Building Depaltment Representative ............................................................................................................... [ Sq. Footage Addition/ *Supplemental to (Group R) i Conversion Permit # '(No foundation inspection ........................... Sq. FootageC� ~� (Floor Plans reviewed by School District District Identification No. - 0200,38 chool District certifies that J 0 (Including Exterior Roofed Areas) Date (Applicantp (Street Address) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. by payment of $ ....• representing ` square feet. AB 2926 $ FULL MITIGATION $ o -©t School District Representative Date Paid by Check # ' Remarks: V v4� Notice: You may protest the imposition of thdfees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), withinr90 days from the. date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), thisproject may be subject to additional school fees to fully mitigate its impact on the school district's schoolsmay be subject to addtional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/98)dmm y OF IM I I I--' -D IPAII I M11 --t-1 UO 1: IIF -NEI.o I I M1.441 SI -I IV I(, I-.!, • k I IJI I I. I) Ir4(- I)IVII OCT 3 1 2001 C'mIlIty G0111101. (Wifornia 95965 (530) 5:313-75,11 A 1 1:1 1A C/01 0 N A N 1'.) 1) F R MIT ....... ------- ---- D"ll 0INGPERMI F . .. .... ... - - ---------- . .............. OCC. SUILDIIIG VALU,�.IIQII (I f n 6 w;;; ------------- C�o, K7 e, . ... ... . . .... . ... q copenwionli CO I OR Tntp,,Dc� It F. I 'Dtl Fit n In tF11n n i 11-A I.q A(IfIr-19 ToDd Valu Atloit mrwircr on Fi-7!pq:rn Filing raq .... ... 20 . 0 0 AACPWICIt on r"n""T111 pl-�1111 Nfmit Fee Plan U.C16,10 Fee F-)cr-&Pnnr-qs 1111019Y ['Inn Checldiiq Fqq In Sr L1 Diipl,)x UI Mnbil-ho!�q . • 61110r I YPE Or. WORK Cl Rame-lpf U) Litiriti-n Poscribm Work: A(4 "PERM11- FEE PAITT) 5RA 51 1EPTIT OTHER AMOVIAT RECEIVEI-) 1-0 PUT T -N-1-0 COMMIT -1k rERMIT I PLUF413ING PERMIT ri141p F-, Each 7.011 SoInr or hantyump venter Mentor 2.3.00 watnt Tiny...__.._..._......__._... f) is , 'nn Each gets venter heater cr vent Is 00 Ig Ityrtom 1 5 outlets 15.00 _qmsy�)i --L .-1------.---..---.—.-- sw.-eqr15.00 -.-Building Mobile I -§ I 120.00 . . . .. - -r p F n m I F E E ELECTRICAL rERMIT Pinup ren 2f., no on tEss Mdifl So(-vlccie .-(..2o'j,"�Ion L . ........ 23 00 himill SqrvI(;q 200.E TO 1--.A 40,00 occur. on SV it Clotc�7.5 0 Por. FJ1 ArrjjD,," -!jT.E-0U I Er cl . .0.ccu� _(OUTIET on rmiunF.3 - — -- \/ 2'I.C1 L rh so I I f'Llrq. on Ex. occup. UILETS --5 0 1*emRq�rjfy. Service 27.01) Mobile I longe Facilities 20.00 23.09 11EIIMI7' FEE V MECHANICAL PE1711,41-1- riling rn, 20.00 Healing Cooling I loud 0.50 ventiltilioll rEt S Mobilo 1161119 Installation Few Ennrgy I—p9ctioll Fee 1'()A"Al- FF:E_t .l_ �Kflo- l parmit 1-1 Itareby IQnj)md under tha 11-1 i'll" Of 1110 PtItt? COUrIlY Coda sed/or H9oalti1k,11,0 tn III) V101k lndi�-Ilqd 1%1.,nvq for which k".1 11mv9 boon rofld. By PEMAIT EyvinF.-s (m s P N ' STRUCTURES AND EQUIPMENT INCLUDING OVERHANGS SHALL BE CLEAR OF ALL EASEMENTS. AET BACK OF 3� - FT. FR0M THE SIDE AND V FT. FROM THE REAR PROPERTY LINES AND D FT. -FROM THE ROAD CENTERLINE SHALL BE CL..-` R OF STRUCTURES AND EQUIPMENT EXCEG �) 9=0 A 2 FT. EAVE OVERHANG. 0 ' ` A -- REVIEWED BY 'i IJ BUTTE CO. FIRE PEt• T. CALIF. DEPT. of FQRES T RY r_�)& ,N C] approved as subm' itted approved with conditions - — ---- r4te heet. 292-1 DL) lb4 a4ureige N s Date - -. co v4 rf-� C) %6veto \/I :100 PLANNING DIVISION -BUILDING PLAN APPROVAL Use: d I� Date: Parking:, Landscaping: Other: Signature: CDF FIRE SAFE'REQUIREMENTS f AP# PERMIT # NAME Under authority -of' PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal „or exceed these standards. Field inspections' will be made by the'Butte- County Building Department, for compliance. 1272.00 Maintenance,of Defensible Space. -To ensure continued maintenance of properties in conformance with these k. standards.and measures and to assure continued avail- ability,,access and,utilization•of the defensible space provided for in.these standards, annual maintenance must be provide for by the land owner. Driveway -Standards 1273.02 Surface.. All driveway, 'surfaces, and structures (bridges, 1273 .•07 culverts and other appurtenant structures which supple- ment the roadway bed or .shoulders) .shall provide unob- structed access to conventional drive vehicles, includ- ing sedans.and fire apparatus weighing up to 40,000 pounds. , [� 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius I 1. No roadway shall have a horizontal inside radius of - curvature of -less than 50feet and additional sur- face width of 4 feet shall be added to curves of ,50- 100 feet- .radius;',, 2 feet to those from 100-200 feet 2. The length of vert ical . curves in 'roadways exclusive of gutters, ditches and drainage structures designed - to hold or divert water shall be not less than 100 feet. 1273.05 Turnarounds.. If required, will have a minimum turning I radius of 40'feet from the -center of the road. [ ,1273.05 Turnouts. Shall:be,a minimum of '10 feet wide and 30 feet long with a•minimum 25 foot taper on each end. 1270.10 Width. All driveways shall I provide a minimum 10 foot traffic lane and unobstructed vertical clearance of 15 'feet along its entire length., ' Page 1 of .3--, 02 -O %- 7 Z Q (r 2 j�� �o C�►�t t .tl �� Pr je C� AP # PERMIT # NME [�] 1273.10 Turnouts. Driveways exceeding 15.0 feet in length, but less than .800 feet in length,"shall provide a turnout near the midpoint of the driveway. Where a driveway . exceeds 800 feet,. turnouts shall be provided no more than'400 feet apart. ] 1273.10 Turnaround. 'A turnaround shall be provided at all building sites on driveways over 300 feet in length and' shall be within,50 feet of the building. 1273.11 Gates [X]' J.`-date entrances" shall be at least two feet wider than the.roadway it serves. [ 2. The gates must be located at least 30"feet from the roadway and.shall open to allow a vehicle to stop without obstructing .traffic on that roadway. [Yv] .3. .Where a one-way road with a single traffic lane provides entrance,. a 50 foot turning radius shall be • used. Fuel Modification 4 1276.01 Setback for Structure Defensible Space. [ 1. All parcels 1 acre and larger shall provide a mini- mum 30 foot setback for,buildings and accessory buildings from,ul] property lines and/or the center of the road. r [ J 2. For parcels less than '1 acre,, local jurisdiction shall provide for the-same-practical effect. See ` Other Requirements below.: 1276:02 Disposal of Vegetation'and.Fuels. Disposal, including chipping,•burying, burning or removal to a landfill site approved by',the local jurisdiction, -of flammable vegetation and fuels caused by site development and ' construction, road and driveway construction and fuel—, modification shall be completed prior to.completion of , road construction, �r f__ial inspection of a bui-lding ` permit. • - Page 2 of 3 I T 2 ? � o ?•- 7.Z p ��256� «�iaN GC�d�Oc� AP # PERMIT # NAME Other Requirements , [ ] If Building Setback is 15 to 36 Feet:. „ - Class A or B rroof Enclosed. eaves ; [" ] If Building Setback -is Less rThan 15 Feet Choose any 3'of the following: '- Metal or no, doors on side toward property line with insuffi- cient setback ' C1ass,A or B roof with enclosed eaves _ - Interior automatic spri_ikler system per NFPA'13D Glass -area -not to exceed _0!'of wall area toward property • line withinsufficient setback Siding from the following list: Stucco - 3 coat - Hardi-Board or Plank. Masonry ;. Masonry veneer Metal -Other Butte County,Fire Department.'approved materials '.Date Signature Page 3 of 3 AP 07 2� OWNER 13 A -/CC PERMIT MH UT IL. CLEARANCE DATE. j1 INSPECTOR ELECTRIC GAS Support Compaction Service OtherPipe Struc. Test; -Re . Size Lpad F -Te Size Len th YES NO 'YES NO'J% J o-, a a y ,.�; .-BE IDENTIAL 027-07=0=072 93-366 P,E�_- t BAKER, .ANN , 23 CYNTHIANN CT, OROVILLE Mi UTILITIES ,tl " p 1 II OFFICE }r COPY Address GAS q Meter By Date ELECTRIC Meter By Da �"JOB FINALED (Date) '5 Signature - V=OK O = Not OK ; = N t Ready ble '• MOBILE HOMES Date/Initials MOBIL HOME UTILITIES (Plans) OK exceot #'s '.I Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Graders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftre: Connectors Shthg -Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 8. 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 MISCELLANEOUS 1,g R__opuirementa-Setbacks-Easements 2. _5oK--Special MM -Support Sketch 3. Sewer; L - est -Fall -C/O Concrete Location -Test -Easement Needed (Sketch) "w E ' city; Location-Clearences-Grnd-/ /Amp -Concrete ;. Location -Teat -W p: / /" U'ft. P'Nat. or/ P'L" "LPG 7. Well Clearance & Disconnect ' 18. Uti 'Clears Date/Initials MOBILE HOME INSTALLATION, (Plans).OK except #'s 2. Footings• e -Spacing -Marriage Line .j H Test-Demand-Valve—Connector lectrlcity; MH Test -Crossovers -Breakers -Clearances j�irDrain; MH Test -Fell -Flex Connector . ater; MH Test -Regulator -Connector, ( atw4n–d Sewer Connected -C/O to Grade -HD Approval of I. . Date/Initials 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 8. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Pane Iboards- Ins. to Mein in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test V=OK O = Not OK - = Not Applicable = Not Ready RESID'ENTiAL (Single & Duplex) Date/Initials UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ N Fig. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd. / /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date/Initials PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor-Naii Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date/initials ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mach. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels -Motors -Mach. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date/Initials MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date/Initials FRAMING (Plans) OK except #'s 39.';Sils,_Proper Material & Anchors 40. Wells Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Wells over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing ._ Date/Initials FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic .Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Wells -Windows Date/Initials FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor -Mach. Protection 75. Pib., Elec. & Mach. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg: Appliance -Fireplace: Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Comments at Final: Y • 3 Date /:,`�/ Inspector REV 10/92 COUNTY OF BUTTE ' BUILDING DIVISION ' DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872.6307 CORRECTION NOTICE' #erre 9 - 7 OWNER PERMIT NO. ' A routine inspection indicates that the following violations of Butte CountyOrdinances exist at 'L the above address and should be corrected. Please notify this office when correction of work :• is completed. If you have any questions pertaining to this matter, or need additional explanation, ; - please contact this office immediately. /— P Y • 3 Date /:,`�/ Inspector REV 10/92 u Al REV IM2 COUNTY OF BUTTE BUILDING DIVISION _ A DEPARTMENT OF DEVELOPMENT SERVICES 's 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA -. (916)'538,-7541- , > 747 Elliott Road, Paradise, CA - (916) 872-6307 <, CORRECTION NOTICE . OW PERMITN A routine inspection indicat s that the following violations of Butte. County Ordinances exist at ' the -above address and sPdulcl be corrected. Please notify this office when correction of.work is corr;pleted. If you a any questions pertaining to this matter, or need additional explanation,.,' 4i - please contact office immediately. > yi u Al REV IM2 MOBILEHOME INSTALLATION ACCEPTANCE ',A COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE � OROVILLE,CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT N0. 73 Address or location of mobileomey ��91AJ A-' Owner's name 14jU 1' r A —Ll n Owner's address s Insignia or hod number 3:7M1 �� -~"`>' ' • , Manufacturer's game /,v� Serial number oftV.I.N.�' a � Year of manufacture 72.1 l 'VOfficialf'Appro'ving7l! taIIation) / / ` (Dote) -1 r IF THE MOBILEHOMEAS MOVED 0$'RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5" 7- 5136_ White- Owner, Yellow - Installer, Pink - D..P.W COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS /-PERMIT N - 7 County Center Drive - Oroville. California 95965 -Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 027-07-0-072 ARMH ZONING 5 BUILDING PERMIT OWNER ANN BAKER _ TELEPHONE 8888 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 23 CYNTHIANN CT OROVILLE CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ 20.00 ARCHITECT OR ENGINEER LICENSE ND. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 23 CYNTHIANN CT OROVILLE Permit fee $ 35.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome®X Other SPECIFY Gas piping system\t - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities❑ nstallationaX Other Describe work: 500 S FT MIN MHU# Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR 00V OR LESS 18.50 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 Main service 200A TO IOOOA) 37.50 NEW CONST. / DWELLING OCCUP.&\ OR ADDNS. 1 ACG. BLDGS. // 3.64 sq.ft. NE w coNSTR ULT I -OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS &) SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20L. 76d ' FIXED APPLNS. OR EX. QCCUp. OUTLETS (RESID.) EA.1 3.00 Temporary service 15.00 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. 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 15.00 Heating Cooling Hood 6.50 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. X �; ^`� �O 1» Date f-e—L- a C) 3 Signature of Applicant — Ownerg Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S 70.00 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HAz .r 1 0FEESIMP -- FLOOD CDF PARCEL PD i! This permit is hereby issued under the sions of the Butte County Code and/or work indicated above f Frees F PUBLIC DIRBy PERMIT EXPIRES Dat applicable provi- resolutions to do -have been paid. i WORKS Da Receipt No. WNITC-D.O.W., Y - pggOR, PINK -INSPECTOR, GOLDENROD -APPLICANT "4r •.caltii"*t'1`i-. r t fr✓:.,rr+y rr',.y r� , c i COUNTYOF BUTTE - DEPARTMENT O�F�DEELOMENTSERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA" 965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER Z--�/ VA) �'/�/`�%� /�, P. No. Z % Proposed Building Use 4ftl--Z7 Building Inspector Date /l -3 At time of permit.,;application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ......................................... 2. Plot plans, 3/4 sets, signed by preparer of plans. ......... .............. . 3_ Complete plans, 3/4 sets, signed by preparer of plans . ..................... . .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5.. Hazrdous Material Form . .............................................. 6. Energy besign .Compliance and supporting documentation . ................. . 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... I'm IZ 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 0. Fees of $ . ......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees...................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land DevelopmentAbout (A) Improvements (B) Drainage. ........... 19. Driveway permit (construction approval required prior to occupancy). . . Preanspedion requ 20. Pre -inspection for required. .. to Building Inspector J (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ................. 23. Owner -Builder Verification (Given to owner , Mail to owner ......... 24. Recorded copy of Agricultural Acknowledgement Statement.....- ............... . 25. Letter of signature authorization . ......................................: . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. . . 27. Letter of intent on building use . ......................................... -16 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed # and (B) Parcel meets zoning area and frontage requirements . ............... ) ' 31. Existing violations/expired permits ........................................ 32. Plan check list . ..................................................... 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. L�Telephone CT.34/- &edt?nd hold for pickup at 640 office. Deliver with inspector. Other Parcel Creation / Acreage i Applicant �""'`�� Date Z �/ 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 prior to permit issuance- Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by Date Contractor, designer, owner, was advised of above required data by _phone_ m ounte _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works t=me of permit application, _ was advised the above tees are required to be paid pr== issuance -of the permit. ADT ICANT � DATr r _ ... '�-�v� COUNTY OF BUTTE - DEPARTI�V'T. OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CUTTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (9.16)5387541 074A r- O Z 7, 0 70- D 7 Zi w-NER A . P . NO. :.10 BUILDING USE 23 f+/ %rirWnJ LAU�DnTE -POSED REC.- -DAT-_ REC 0410 1. School Distric Fees (paid.at District -Office) ...... .........: ........ W 2. She_--: ff Fees (paid. at Building Department) O� Residential .. ... . k X 3(00 _ 0 o 1.3!3'IZ '211619-3 unit amt. Commercial(per sq. ft.) x _$ sq.ft. , amt. 3. Urban Area Fees (paid at - Building Departmett Residential'(per unit) X _ a units amt. Commerical(per sq. 'a. X _ sq.ft. amt. 4. Recreation Distrtc t Fees (paid at District, Of==ce) .......................... 5. Drainage District Fees (Contact Land Development) ,„ 6. Other 7. Other t=me of permit application, _ was advised the above tees are required to be paid pr== issuance -of the permit. ADT ICANT � DATr r _ ... '�-�v� COUNTY OF BUTTE - 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 tomplete 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.impro_vement (yes or no) 2. I..(have%have-not)signed an. application for a building permit for the proposed work. 3. I have.contracted with the following.person (firm) to provide the proposed construction: Name 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 .a,City Phone contracto-rs 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 f Signed: Property Owner.., Social Security Number „ 'Date f�A�- //; 9 � NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of- the -California, Heal-th and.=Safety_.Code. This verification must be completed and returned to our office before we are per - to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT' a" /lrlli� PERMIT NO. ASSESSOR PARCEL NUMBER 6 Z 7- a 70 --Q% _Z__ ZONING _ BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATIONS3(/-�B� G_ADDRESS t OWNER'SAILI G `r J741)C/( CONTRACTOR'S NME 9,MMAILI_NG TELEPHONE CONTTRAACCT�J,O//RS ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS " Permit fee $ 3 00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehoma Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G W 615.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallatiorA Other ❑ Describe work: SILO 5 Fr Ml /!/ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 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 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 200A TO 1000A1 NEW CONST. DWELLING OCCUP.&) OR ADDNS. ACG. SLOGS. NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRC ITS U26.1 POWER APPARATUS 6 SINGLE OUTLET CIR. / EX. OCcup(OUTLETS OR FIXTURESFIXED APPLNS,ORI, Ex. Occup. OUTLETS IRESID., EA. Temporary service 15.00 Mobile Home Facilities 15.00 Misc. lyirin g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 1 15.00 Heating Cooling Hood 6.50 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 7acrue said County in consequence of the granting of this permit.X Date �3 Signature of Applicant — Owner❑ Contractor G Agent ❑ t An OSHAwork 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 S Energy Inspection Fee $ occ CONST TYPE TOTAL FEES If O JC 6p HAz DFEES IMP FLOOD COF PARCEL PD HD ISSUEagainst This permit is hereby issued under the sions of the Butte County Code and/or indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date j I ` Receipt No. /35 37 WHITE-D.P.W.. TELLOW—A DE33OR. PINK -INSPECTOR. GOLDENROD -APPLICANT I . Owner's Name: r r -. 2.' Installer's Name: (71.J r1 17V 3.. Is the site currently under permit? Yes .. No (If 'yes, furnish.permit number ) OR Is the site an existing site? Yes .'No (If yes, furnish -two plot plans.) 4:Will the mobilehome be. located at least 5 ft. away from septic tank .and leach fields and clear of all setbacks and easements? Yes,L/-' J No- EJ • (If no, clarify .5. What -is the mobilehome electrical rating? ---------------J CU Amps .6. 'What is the mobilehome site service rating? -- dkm Amps 7. What is the mobilehome site circuit breaker rating? ----- Amps 8. Is there any other electric load to be served by the ___-- £= a mobilehome site service? ---------------------- Yes No (If yes, identify the load and size: (Load) a (Amps) 9. What is the mobilehome site gas pipe size? -------------- 31 (in.) _ -L, - ... - 10.. What s.the type of.gas service?..------------------- . .Natural. LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- (ft.) * 12. What is the mobilehome gas demand? =----=---- --------- (BTU) *(This information not required if pipe length. less than 6 ft. on natural gas or..less than 50 ft. on LPG.) Q NEXT PAGE MUST BE COMPLETED TO PROCESS PERMIT APPLICAIDN: APPROVE, i MOBILEHOME SUPPORT DATA If `other" t�ha^n single wide, ,' / LMobilehome Mfr. 5.`�i(�f!VC fuTnish Setup Model No. Year Width �'Z- .(ft..). Box Length :,:((ft.) Tagalong or Expando Size�ft. x ft. 77 On. all- mobilehomes manufactured after October '7,, 1973, furnish manufacturer's installatio-n manual and structural setup ' sheets -(if' not on file. with- the County- of But-te) . ' FOOTINGS (check one)1. Wood -pressure treated or foundation grade.❑ 2. Other (specify) SUPPORTS ..(check one)Concretd.blo6k.2. Qther (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -GIDE . Line Main Beams - Line 2 — � Main Beams — — — — — — — tine t Llne —__ — — -- — --- 4-LSne -Tag or Triple Line Line 1 Piers: Line 1 Openings: _. Size -Min. ------------ ik n Size -Min. ------------------ .k � _ ._Spacing-Max.r r-rr_ ... ...- .�. - --.._.... _. _ _ Each Sid9Vof Openings From Ends -Max.------- '_ " With Width Over --------- Line 2 Piers: Size -Min.------------ ;k 2 O„ Spacing -Max. From Ends -Max -------- Line 3 Roof Loads* Size -Min. ------------ Location (From Front) Line 3 Piers: (Under Bearing Wall Only) Size -Min ------------------- k Spacing -Max---------------- From Ends -Max -------------- r_ �� Line 4 Piers: _ ....... Size -Min.------------ ij Spacing-Max.'-------- From Ends -Max:------- .:1. .. - - e 5mPiers: . (Under Bearing.Walls,-Only Size -Min ------------------- 'k Spacing -Max^--------------- r From Ends -Max .------------- Line 5 Roof Loads: Size -Min .----------y "x „x 11x "x IX "x1.,k ., "x .� Location (From Front) t� i • • ; 5 r COUNTY OF BUTTE- DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovilo, Cah ornia 95,965 - Telephone: 916/538-7541 APPLICATION AND PERMIT' PERMIT NO. ASSESSOR PARCEL NUMBER ZONING 027-07-0-072 rmh-5 BUILDING PERMIT OWNER TELEPFf NE ann baker 34-8888 SQA FT. OCC. BUILDING VArt ATION OWNER'S MAILING ADDRESS 23 CYNTHIANN CT OROVILLE CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ Permit Fee Plan Checking Fee $ 20.00 $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 23 CYNTHTANN CT. OROVILLE Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT O ]SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE q� , SF ElDuplex❑ MobilehomeDa Other "{�vy SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I 1 (01 QI @ 15.00 45.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities [N( Installation❑ Other ❑ Describe work: MHII 1 BDRM Permit Fee $ 60.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Cha t. 9, Div. 3 of the BuSlness p and Professions Code and my license is in full force and effect. No. Classification i77(T� 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) El 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 200ATOI000A) 37.50 NEW CONST. ( DWELLING OCCUPM OR ADONS. ACC. BLDGS. // 3.64sq.ft. NEW CONSTR. ULTI-OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 APPARATUS. (POWER APPARATUS e) &) SINGLE OUTLET SIR Ex. cTLETS OR FIXTURES Ocup(OU 20 @ 76111 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESIO.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring -15.60 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 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X �""^r� Date r-RAra ��. 9 Signature of Applicant — Owner Contractor ❑ Agent F-1sions 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 S Energy Inspection Fee $ OCC _T CONST TYPE I TOTAL FEE $ Zi 9,q sn IHAz DFEES IMP FLOOD _� COF PA EL PD HD SUE i This permit is hereby issued under the of the Butte County Code and/or work indicated above for which fees EC ' R OF PUBLIC By PERTXPIRES Date applicable provi- resolutions to do have been paid. WORKS DateZ Z�ZL qty Receipt No. 135340 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT Z6/S at�Q tsl[elaadS �la[�all Iuauiuosrnu`l E73ION, :io} -x•O aoueivalo luut1 :joj Inn PIoH lay1O -auIoy ol!goiu ulooJpaqsoj aouejualo II014� a1Lntld oi[gnd :Xldc[nS iaaeM f IusodslQ a'0I?A\9S :Jo•I panoiddy.0'2[d #d`d uoi aorl JaumO 2!:z —Z,O -Ze • aau�s��al� uoiaeaiu�S=.L�3f£{fls r{llL'al-1 ItiauauIuoIInu3. :Woul juaul�l�c[aQ �ucplmQ :01 ."'�--.,,� � P,h:nV ma,l loll _ . • _ i �.q v'� - ... a Y' COUNTYOF BUTTE - DEPARTMEf'TO�F�� .ELOMENTSERVICES -BUILDING DIVISION j 7 COUNTY CENTER DRIVE - OROVILLE,,CALIF.ORMA'95965 -TELEPHONE (916) 538-7541 P RMITAPPLICAT O.N DATASHEET s� OWNER y/UN �14r- ' A- A. P. No. G 2 --670 - 07Z Proposed ding Use ,y'F/' U Building Inspector Date z I //f3 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ........................ ................. 2. Plot plans, 3/4 sets, signed by preparer of plans . ......................... . 3_ Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on.plans. ............. 5. Hazardous Material Form . ............................................. . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ . ......................... *. ................ 11. Impactfees as shown on -attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . ll 13. Flood elevation letter (100 year flood by California Engineer. . . - V:'- ka`14. Sanitation and plot plan approval Health Department . ............ 7y;--7-3 7 15. City of Chico plumbing permit . ......................................... . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. . Driveway (construction approval required to occupancy). N.......... permit prior 20. Pre4rispectionreqs Pre -inspection for required. .. to Bu;;a;n9 Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. -��- -� 24. Owner -Builder Verification (Given to owner , Mail to owner _). ........... Recorded copy of Agricultural Acknowledgement Statement: '.................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance ........................................... ....................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits. .........' 32. Plan check list . ...................................................... Fi 33. ' 34. , When you issue the permit, process as follows: Mail to owner. Mail to contractor. !;?e'lephone 4-34/-M" and hold for pickup at %/L_ office. Deliver with inspector. Other Parcel Creation Acreage Applicant C--"- Date -z -3_ 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 prior to permit issuance: (Circle new item not checked above). r 3 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by ,,S- Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works p COUNTY OF BUTTE --Department-of Public Works 7 County Center Drive,zOroville, 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 .(have/have-not) 1r�i�)p�... signed an application for a, building permit .for the proposed work:T , 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 follow-irg- 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 , Social Security Number Dated -U- 1 I y 3 NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and l9832:of,::the_Calif:ornia-Heal-th_.and:.Safety-,,Code..- _-: _ --• -• - - - This verification must be completed and returned to our office before we are per= mitted*to issue the permit._ �- �' • SVS9, . EnWonmsntal Health ass�4 actives $ � QSos ec.CK°° e edvecn c� TEB 111993. okamoo afo Y'"A006 'aproviil2, California Accost ty �$'� vo ' �o of n l � z t 3 W060 . aV,°,s a i'��' an a e c �L of 4�a� � ti�'es o� ons Dt oi�ro -va exti g )t n th�hsaes fr in' 'e pe4 2 O 8 'l OTL All ers oft' ' CO 500. SQ.- FT. MIN1MUM. MOBILES or Ll 1 op as F �a k �.eQ�`QSI a APPROVED o Butte County Envir ntal afth D (1 . o...) �05, 7v tinct, axe-urni-;A o DPW AGRICULTURAL STA-TEMENT OF ACVIOWLEDG rE'`1E,�1T ' FOR RESIDENTIAL REVELOP.IMNT Section 26-8.1 of the Butte County -Code.' > requires this acknowledgement be recorded prior to issuance of a buildino permit. 93-06530 3 All that real .property. situate in the County of Butte, State of California, described as follows: j SEEEEEXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF C®' ®f BUTTE • = BIIII �,rof Date: , .) i, q PROPERTY OWNS S Ann Baker State of On this the I day of T,6A 914 tq R Y 1993, beforeme, the SS. undersigned Notary Public, personally'appeared' County of t) P.. OFFICIAI;'SL 'L`"' 1•, EUPFK •.yC q BARBARA A. WOOD`dJARD s x' d " NOTARY PUBLIC - CALIFORN,"1 ' .BUTTE COUNTY rdC IFORtSP My Comm. Expires Sept. 25,19.93 Ann Baker Personally known to me. El Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) was subscribed to the within instrument and acknowledged that' she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No..1- O•27,-070=072 - — _ .._... Notary Public_--.. The property. described herein is adjacent ' 1 9 3-006 5.30 I Rec Fee 11.00 to land or included within an area zoned 1 'Cash 11.00 for agricultural purposes, and residents i Recorded I ` of this property may be subject to incon- Off ibial .Records ( ` ; veniences or discomfort arising from the County of-` use of agricultural chemicals, including, Butte I - but not limited to herbicides, pesticides, Candace -.T. Grubbs I and fertilizers; and from the pursuit Recorder ' of agricultural operations including, 12:33pm 16=Feb-93' 1 PUBL XX 3 but not limited to cultivation, plowing,-- -•- - - - - - spraying, pruning, and harvesting which '- occasionally generate dust, smoke, noise, and odor. )Butte Countv 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: j SEEEEEXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF C®' ®f BUTTE • = BIIII �,rof Date: , .) i, q PROPERTY OWNS S Ann Baker State of On this the I day of T,6A 914 tq R Y 1993, beforeme, the SS. undersigned Notary Public, personally'appeared' County of t) P.. OFFICIAI;'SL 'L`"' 1•, EUPFK •.yC q BARBARA A. WOOD`dJARD s x' d " NOTARY PUBLIC - CALIFORN,"1 ' .BUTTE COUNTY rdC IFORtSP My Comm. Expires Sept. 25,19.93 Ann Baker Personally known to me. El Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) was subscribed to the within instrument and acknowledged that' she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No..1- O•27,-070=072 - — _ .._... Notary Public_--.. 93-06530 2_1 *�•- •W'uk�I • -EXHI$IT '!A" pESCRIPTIOIt: 7 � '_ALCTNA'' CERTAIN ; REAL PROPERTY . SITUATE IN ----THE ' STATE OE, GLIFlm,iM7 COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: T PARCEL I • "� �, LOT 6, AS SHOWN ON THAT CERTAIN NAP ENTITLED,-CYNTHIANN SUBDIVISION", WHICH NAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY 6F BUTTE, STATE OF CALIFORNIA, ON RSCEMBER, 5, 1984, IA BOOK 95 OF NAPS, AT PAGE(S) PAGE 69. RESERVING THEREFROM A NON-EXCLUSIVE EASEMENT FOR INGRESS AND EGRESS AND PUBLIC UTILITY PURPOSES AS SHOWN ON SAID SUBDIVISION HAP. . ALSO RESERVING THEREFROM A WATERLINE EASEMENT AS SHOWN ON SAID SUBDIVISION MAP. ALSO RESERVING THEREFROM A 20 FOOT CROSSING AS SHOWN ON SAID SUBDIVISION MAP. PARCEL II - AN EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES OVER A STRIP OF GROUND 60 FEET IN WIDTH LYING NORTHERLY, WESTERLY AND CONTIGUOUS TO THE FOLLOWING DESCRIBED LINE: BEGINNING AT A POINT ON THE EAST LINE OF THAT CERTAIN PARCEL DESCRIBED IN DEED TO NORTHWEST PACIFIC RESOURCES, INC., RECORDED SEPTEMBER 6, 1980, IN BOOK 2539, PAGE 38, OFFICIAL RECORDS, FROM WHICH THE NORTHEAST CORNER OF SAID NORTHWEST PACIFIC RESOURCES. INC., PARCEL BEARS NORTH 00 DEG. 19' 39" WEST 60.00 FEET; THENCE FROM THE POINT OF BEGINNING SOUTH 89 DEG. 03' 09" WEST 254.15 FEET; THENCE SOUTH 02 DEG. O1' 51- EAST, 244.14 FEET: THENCE SOUTH 04 DEG. 56. 09" WEST 655.78 FEET TO THE CENTER OF THE EXISTING RIGHT OF NAY AS CONTAINED IN SAID DEED. PARCEL III�� 3A/NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES 60 ET IN WIDTH OVER AN EXISTING ROAD AS SET FORTH ON THAT CERTAIN 'R CORD OF SURVEY RECOP.DED JULY 5, 1974, IN BOOR 47 OF MAPS, AT 1-`PAGE(S) 93, THE CENTERLINE BEING MORE PARTICULARLY DESCRIBED AS -FOLLOWS: BEGINNING AT THE SOUTHWEST CORNER OF LOT 3 OF SUBDIVISION NO. 2. AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF THE SUBDIVISION NO. 1 AND 2 OF THE P. C. DRESCHER TRACT-, WHICH KAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, IN BOOK 1 OF MAPS, AT PAGE(S) 25; THENCE FOLLOWING ALONG THE WESTERLY BOUNDARY LINE OF SAID LOT 3, NORTH 0 DEG. 17' '00" EAST FOR 89.58 FEET TO A POINT LOCATED IN THE CENTERLINE OF AN EXISTING ROADWAY; THENCE FOLLOWING ALONG THE CENTT.RLINE OF SAID ROADWAY, SOUTH 30 DEG. 44' 40" WEST, 432.63 FEET; THENCE 'SOUTH 35 DEG. 16. 10- WEST, 496.53 FELT; THENCE SOUTH 6S DEG. 27• +00" WEST, 713.80 FEET; THENCE SOUTH 41 DEG. 02' 00- WEST. 228.54 •FEET; THENCE NORTH 75 DEG. 30' 35- WEST 106.02 FEET; THENCE NORTH t3 DEG. 04. 5§" EAST 225.42 FEET AND BEING ALSO THE TRUE POINT OF BEGINNING FOR THE CENTERLIFE HEREIN DESCRIBED; THENCE FROM SAID ,,TRUE POINT THENCE NORTH F 66 DEG. IN 1't 05""i WEST, 13 SSB 940 3FEET THENCE 5- WEST, 367�NORTH 16 ES3 DEG. 07' 05" WEST, 186.17 FEET; THENCE :LOUTH 70 DEG. 04' 25" WEST,' 285.73 -FEET; THENCE NORTH 75 DEG. 36' 15- NEST, 24S.S3 FEET: THENCE NORTH 54 DEG. 19' 45- WEST, 283.57 FEET; THENCE NORT11 61 DEG. 31' 050 WEST, 255.29 FEET: THENCE NORTH 73 DEG. 35' 45" WEST TO A POINT THAT BEARS SOUTH 60 FEET FROM THE C£NTrRLINR OF THE EASTERLY EXTVNSION OF BOHEMIA AVENUE; THENCE WEST AND PARALLEL WITH Tilt CENTERLINE OF THE EASTERLY EXTENSION OF BOHEMIA AVF.HUE TO A POINT ON THE EASTERLY BOUNDARY OF CITRUS AVENUE AND THE END OF Tile iitREIN DESCRIBED LING. °3-06530 RON—EXCU SIVE EASEMENT UTILITY FOR INGRESS AND EGRESS ANC PUBLIC _ 4 PARCEL MAP PURPOSES � PARCELS 1 AND 3, AS SHOWN ON IN THE THAT c' ;:OF BUTTE :o STATE OF;CALI�ORNIA ONCJ01' THE ANUARY 1RECORDER OF THE COUNTY F'MAPS, kAT PAGE (5){',!0 1981, IN BOOK 81'OF ' l 40— �"+A� �NON—EXCLUSIVE `'EASEMENT ' FOR INGRESS AND EGRESS AND, PUBLIC POSES ` OVER PARCELS ICERTAIN ;,PARCEL NAP, RECORDED IN THE . OFFIED OF' AS SHOWN ON THAT COUNTYiOP.}BUTTE, STATE OF THE RECORDER OF.THEt, - OF MAPS, 11TPAGE(S) 86:• CALIFORNIA ON 6, 1982, IN BOOK ' 88 �`t,A A+ WON—EXCL[TSIVE ;: EAS Y k� 5UTILITYiPUgppSES ZKENT FOR INGRESS AND EGRESS AND PUBLIC " LOTS 1 THRU 5,, AS SHOWN ON THAT CERTAIN MAP RECORDED IN RECORDER OP THE <•„ ENTITLED, " CYNTHIAHN SUBDIVISION",, WHICH MAP NAS THE OFFICE OPS THE COUNTY OF BUTTE t' t' «CALIFORNIA; :eON DECEMBER 5 . STATE : OP �,�.x ` ,69., } ti41` �> . 1984, IN BOOK 95 OF NAPS, AT PAGES) � . � ;PARCEL VII '' i�.ft �` e `�? f i,��•.;_',� p `A WELLN,,AREA .AND EASEMENT OVER 'LMS 1 AND 2, AS r SHOWN ON ,. CERTAIN'- MAP, w THAT ' ' + ENT21'LED, CYNTHIANN SUBDMSION^, WHICH MAP RECORDED'IN, THE OFFICE OF 'THE RECORDER OF THE COUNTY OF BLTiTEf f STATE OF CALIFORNIA, ON DECEMBER 5, 1984, IN•BOOK 95 OF MAPS,,AT'a i PAGES) 69. t . � PARCEL VIZI- � ,, • At 20 FOOT.'. CROSSING OVER • LOTS . 4 AND 5, AS SHOWN- ON THAT CERTAIN , aiNAP;!ENTITLED,''CYNTHIANN SUBDIVISION WHICH MAP WAS RECORDED ZN'- `�>THE OFFICE.' OP THE' RECORDER OF THE COUNTY OF BUTTE, STATE''' OP tCALIFORNIA,. ON DECEMBER 5, 1984, IN BOOK 95 OF MAPS, AT PAGE (S) i - • _ 1 ' r t ' EN® OF DOCUMENT T�►q �' (�. QI �� — O Ov BUTTE. COUNTY"SCHOOLS IMPACT FEE CERTIFICATION FORM _� mGZ (One Form Per Buirding) ® oyc0 School District JJ r G II Building Department No. �o A.P. Number Z -7, Jd 70 026diction 0 City Property Owner / m �� PropertyfLocatio�n/Address � 3 Subdivison County n-Lh i 0-n n C. • Norm./) Residential Development 0 No. of Living Units Lot No. 0 Sq. Footage _ .. _. .._ _..,..___Addition.--..— - (Group R) Commercial/Industrial Sq. Footage New Addition (Including Exterior Roofed Areas) Z �J R3 Building Department Repre enta a Date (Floor Plans reviewed by School District Personnel) `District Identfication No. 9306 71 L x ` - ' School District certifies that (Applicant) (Street Address (Phone Number) (City) (State) (Zip Code) nn/l has complied with the requirements of Resolution No: 1�45-7U by payment of $ Q y representing �O y square feet. V // -9 Date Paid by Check Number Remarks: Bank Number /L Paid by Cashtj t If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this;project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeformmkf (4/92) .y i ''s 2331F66PE_ _ GEORGE ROBISON o W/S'Cynthiann Ct. Palermo OFFICE COPY Address GAS Meter By Date ELECTRIC Meter By Date Al COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,Af•alifornSa,95965 - Telephone 916/534-4541 APPLICAT109 AND PERMIT PERMIT NO. ASSESSOR, PARCEL,NUMBER --'�� - /'I- v / ZONING ,, , I/ � BUILDING PERMIT OWNER /3 ..Ej EPt/ SQ. FT. OCC. BUILDING VALUATION OWNER'S 1MAILING ADDRESSt6 r' CON TRACTOR'S NAME - 14, k I/'I i TELEPHONE CONTRACTOR'S M^AILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN C 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 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 _•r / -} / Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 { r Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomet Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ JUtilities ❑ Installa1tion❑ Other 0 Describe work: l ` !' fV-t' 'r/ r''1 1V- I� .'' Gr i/de L t.� / to ilf 1.e)p �:�i! .n `f Permit Fee $ If, f Contractor ELECTRICAL PERMIT Filing Fee 10.00 / Main service 1000V OR 0 AMP ORLESS10.00 Main service EA. ADD -L 100 AMP 2.50 9. 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.& , h¢sgft New CONSTRA MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. ) , Ex. Occup(OUTLETS OR FIXTURES 2ALe 30 eL0 FIXED PR Ex. Occup. OUTLETS (RESID IEAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Mi.sc._bYixi-n g it �'(� -15:00 V1- J vI(, ) . t.'(, Permit Fee $ 'Qj- ., ; Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. Signature of Applicant — Owner Q Contractor ❑ Agent El 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 $ S oc CUP. CONST.TYPEJ IFLOODIPARCF1,1 PD I HD I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for whr h DIRECTOR OF PUBLIC t r By f-.-r•:..T_i. PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date `. ►"j'.-' ]� _ )��' ' Receipt No. WNITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE _ DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 F 7 County Center Drive, Oroville — Phone: 534-4541 Skyway.and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Q Inspector__ _ _ Date v __ . t t � . Q Inspector__ _ _ Date v __ ;.COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS EIT O. 7 County Center Drive - Orovilley California 95965 - Telephone 916/534-4541) APPLICATION AND PERMIT ASSES PARCEL UMBAR /Jp ZON BUILDING PERMIT OWN / SQ. FT. OCC. BUILDING VALUATION OWN 'S MAI N DRE S ' 1(o AC OR'S N 14 F TELEPHONE NT A O 'S MA LING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is 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` �� -S Vb^ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 All, klrM Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MTP Water piping 5.00 tf Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ ❑ DuplexMobilehome)� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00 ea TYPE OF WORK New ❑ Addition Remodel ❑ A it litiesInstalls io ther �] . Describe work: 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 19 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.S� , ) �xdsgft NEW CCOrNiSTR.(A MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea /POWER APPARATUS e� (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20050Q 9ALe 30 Ex. Occup. OUTLETS P(RESID.)RE A.) 2.00 Temporary service 10.00 Mobile Home Facilities A 15.00 M.� 9,0 i h Permit Fee. $ 62 X2 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 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 County 01 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 sai County in consequence of the granting of this permit. %� Date 8—II—&L Signature of Appl cant - Owner X Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occU P. CONST.TYPE FLOOD PARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE TOR OF P BLIC /� BY PERMIT EXPIRES Date / the applicable provi- resolutions to do fees have been paid. WORKS Date•Z i` •// Receipt No. WHITE-O.P.W., YELLOW -ASSES OR, PINK -INSPECTOR, GOLDENROD -APPLICANT OWNER COUNTY OF BUTTE - DEPARTMENT QF _PUBLIC WORKS - BUILDING'DIVISION: 7 COUNTY CENTER DRIVE - OROVI1269N A'4 NIA 95965 - TELEPHONE: 916%534-4541 s t PERMIT APPLICATION DATA SHEET _ Permit No. 1 A. P. No.% -D Proposed Building Use V I� e c-Crt Y I C - Permit Fee Based Upon: Complete Contract Price DPW Valuation Othe7(�Epp�ain) Building Inspector Date At time of permit 'application, I was advised the following data must be submitted prior to permit processing andJor iss6ance': DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2.., Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . 10. Sanitation approval from Health Dept, 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif,) , 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . ©Mobi lehome Installation Data./ \41 �. ud•Pre-Inspec. request to17. Pre -Inspection for Reire,Building Inspector i r .00 Recorded copy of Agricultural Acknowledgment Statement. 19. Other `When you issue the permit, process asfofollows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant C. �` ft�- -- Date i J Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone, -'Mail Other By Date Plans checked by rDate Plans approved by ✓' Date Other: Copy—DPW COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 r OWNER -BUILDER VERIFICATION Attention Property- Owner: 1 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) 4,10-5. 2. I , (have/have not) ,,ti!•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. 1 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 �eo 942iSova Social Security Number Date TL 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. r COUNTY OF BUTTE - DEPARTMENT OF PU LI WORKS 7 County Center Drive - Orovlle, California,,95965 -Te le one 16/534-4541 APPLIC1A1'ION AND PERMIT PERMIT NO. ASSESSQ PARCE fr UMB0R� / ZON �+.� /'Yrp BUILDING PERMIT OWNF,", S FT. OCC. BUILDING VALUATION OWN 'S MAI N DRE S \ r 1 ro CO ACOR'S N M 13 TELEPHONE CON AC O '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 ADORE S) Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each gas water heater or vent 5.00 USE OF STRUCTURE t SF [:1Duplex ❑ Mobi lehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is 10.00ea TYPE OF WORK v New F]Addition Remodel ❑ It lities Installs tiother Describe work: 1 - P i Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 p� v Main service e10V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 \ CONTRACTORS LICEN 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 Irl ,full forte 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) 7 ❑ 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.ej , New DCONSTR( A , ��2sgft ULTBI.OUTLET NON.RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES 20090Q a AL030 APLNS. FIXED Ex. Occup. OUTLETS PIRESID 1REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 M.� V r VI 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 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. 1 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 sai County in consequence of the granting of this permit. %� Date 8 _'I _8'� Signature of Appl cant — Owner Xj Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ S41, ` OCCUP. CONST.TYP! I 111.00111PARCELI PD I ND 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. WHIT E-D.P.W.. YELLOW -ASSES OR. PIN. -INSPECTOR. GOLDENROD.APPLICANT