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027-100-038
�. ..` _ -ter_ /; J - .... . d - , ' jl r _ i p„- .. • - --{+ # l 27-1e-38 to -off 038 •�� TGGrubbs"%d h McFarland 027- �.S THOMAS,` f; . 92=148 ',c�V'' �. ossacountre Rd, app 7/10 mi. Sof S, Cor"q', ,' R.► ,-' 8 Crosac�' ' - , Palermo Area 744 ountreRd,I Palermo'} 'f { 'a Permit ;N442.82P,E(ut&1/MH) �' �;� - FX` mnt,.0 Permit -t Electric -!' - /� Y,�d feed,, tack,, c ic-Ices, ''plgS,=''duck I' f;. Gas �'_ --8 , 2 1, 3/ PGS =`+ a Support structure .e��� �. Compaction test re' 27-10-3 Permit 10-82MHI Iss t - ,.-0.27 10-0"`038* � Y J ,,-;-,;-'92-2837B Cory THOMAS, ,.:{ 7448 a Croscountre Rd,�Per alo garage � . f r 1 u � I • J { • 1 ' r _. f 1 IMPORTANT MESSAPE FOR �,,, �A.M. DATE 2,0 TIME �P.M: M OF PHONE AREACODE NUMBER EXTENSION TELEPHONED PLEASE CALL CAME TO SEE YOU WILLCALLAGAIN- WANTS TO SEE YOU RUSH RETURNED YOUR CALL SPECIAL ATTENTION MESSAGE Y�/ \ a ,,a' G n' e ✓ /1 d n? a -s SIGNED' LITHO IN U.aA ' TOPS ® FORM 3002S COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95985 - Telephone. 918,'538.7541 APPLICATION AND PERMIT PERMIT NO. ee s 027-100-038 A 5 BUILDING PERMIT OWNER CORY THOMAS TELEPHONE—SO. 534-9656 FT. OCC. BUILDING VALUATION g64 M 15,552 OWNER'S MAILING ADDRESS P.O.BOX 587 PALEPdMO 95968 CONTRACTOR'S NAME QVIVER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 5, LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ 142,50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 71.25 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 7448 CROSACOUNTRE ROAD PALERMO 95968 Permit fee $ 228.75 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❑ OtherDET SM4 Cl FY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ' Addition ❑ Remodel ❑ Utilities ❑ Installation 0 her ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 / (o Vain service 200A OR LESS 18•.50 M service 20CATO 1000A) 37.50 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 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) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEwOR AD NS. ( ST. ACC. BLDGS. DWELLING OCCUR.&) 3.6Q sq.ft. NEW CONSTR. ULTI.OUTLET NON•RESI BRANCH CIRCUITS @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 764 Ex. Occup. OUTLETS FIXED P(RESI D.ILINISREA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g '15.00 Permit Fee $ 5. — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling g 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' Signature of Applicant owner U 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 $ OccC0➢ISTTYP� Al TOTAL FEE $ 274. HAz DFEES IMP FLOOD EDF PARCF�Ir ►/ PD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 122531 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT N COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFOF( A 95965 - TELEPHONE (916) 638.7541 PERMIT APPLICATION DATA SKEET OWNER , 6 %J Ao NI ,OUSP. No..02 7 , 100 Qi03� Proposed Building Use G-�' �3-AW, Building Inspector Date �I' L - 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 talcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form. ......................................... I 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. Impact fees as shown on attached schedule. ....... .................... 12. California Department of Forestry plan approval/fees..................... . 13. Flood elevation letter (100 year flood b California gineer. .................. 14. Sanitation and plot plan approval(i Health Department. 15. City of Chico plumbing permit. .... . al .......... 16. Plot plan and business license approvnom City of Biggs/...G..ridl.e.y'. ............ . 17. "Planning approval for (A) Use: ,B) Parking: ........ 18. Contact Land Development about (A) Improve en(B) Drainage. ......... . 19. Driveway permit (construction approval requited prior to occupancy). . . 20. Pre -inspection for / required. .. Building Inspector(Date) 21. Contractor's license information. (No., Name Style, Clas%owne n). .............. . 22. Certificate of Workmans Compensation Insrurance........................ . 23. Owner -Builder Verification (Given to owner' , Mail to.�. .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization.......I.................................. 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. ....... A ....... v :..'................: %..::.. . �-� j 34. When you issue the permit, process as follows: M=office. er. Mail to contractor. Telephone5�1'SF,56 and hold for pickup at Deliver with inspector. Other Parcel Creation Acreage Applicant 'ems Date /Z 9Z 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 pfi r t pernce: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Of -7 4,f 5` I1p C, le J411 % GJi 7G odT �iC r�ii Contractor, designer, o, er, as advised of above required data by _ p one _mail Counter Date PV/' -Z Contractor, designer, o r, was advised of above required data by J/phone _ mail Counter b� Date - Z Plans checked by" CL Date -Z f--- Plans approved by Date ?� Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works I TO FROM: SUBJECT: Building Department Environmental Health Sanitation Clearance CIO ► �fJ S -)-INT l rn S 9. Coy vt��e Owner Location AP# Plan Approved for: Sewage Disposal �rWater Supply Hold final for: Water Supply Final clearance O.K. for: Water Supply � 1 4 -C) Clearance for bedroom mobile home. Other K�6 .-,-"-e- & NOTE ** Date Sanitarian COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMB R6 8 — Q3 ^ ZONING/�'S BUILDING PERMIT OWNER CID r v �a s TELEPHONE 53y- 965 S0. FT. OCC. BUILDING VALUATION OWN O'S Bin:5!? MAILING A � �[0M� -?Sn S. -Z CONT ACCT�OR'_SQN� W TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN c Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ S ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ' 5 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS o ou vFre_ Permit fee $ 2 Z . 75 PLUMBING PERMIT Filing Fee 15.00 Each Trap I 5.00 Solar or heat pump water heater 1 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE /^ , OtherDe-14Building SF ❑ Duplex❑ Mobilehome❑ �/ SPECIFY Gas piping system 1 - 5 outlets 5.00 sewer15.00 Mobile Home S G W 615.00 TYPE OF WORK New Or, Addition D Remodel❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 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 ;Jo. Classification LJ 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 200ATOI000A1 1 37.50 NEW CONST.(DWELLING OCCUPM ACC. SLOGS. I 3.54 sq.ft. v. NEW CONSTR. MULTI.OUTLET NON-RESIC% BRANCH CIRC ITS I @ 5.00 /POWER APPARATUS el l SINGLE OUTLET CIR, Ex. OCcup(OUTLETS OR FIXTURES L 7 A RA Ex. Occup. OUTLETS IIRESIO.IREA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ 9 5. — 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 g Hood 6.50 Ventilation Permit Fee $ L 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 Date Signature of Applicant — OwnerElContractor ❑ Agent Elsions An OSHA permit is required For excavations over 5'0" deep and demolition or construct - ion of structures over 3stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 2-% OCC CONST TYPE TOTAL FEE $ J.HAZ 1 0FEES IMP I FLOOD COF PARCEL I PO HD ISSUE This permit is hereby issued under the of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 1 I-!7/S3I 'NMITC-D.P.W.. YELLOW -A9 eC390R, PINK -INSPECTOR, GOLDENROD -APPLICANT �� �,- �� ��•� � � � ,cods � .,��o-t � - �. .• . _ - : ` j�P � �r� ,_ J�r;o3� �(e...r �� ��i �—awk. •\ ,\ �__ _ ._ . .. - • � .i==may �.• _ �'� s . -�-s� - of � .._ - - � - � � `` .. - ,. •_ 05 ke •r�^, f a ,�_�..w?yc r�6'1 yG �p'V _.—�—�.---i _.—'_ � �, - _ -• `'1 � —� � �' f L- i• Ila 7 �51 l '� _F -• �- t_s - — - -a Om x ;a•- -----.=---- ! 516' �e.� 4 � � �� 3 x z5 !, oVcD County EnvirQ�r,, ntal Health ' - -------- x316 C,7 a m Sig urd +o,. 141 3 1� 5.2s5 BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: (916) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, -iay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public., ASSESSOR PARCEL NO. 00 . 039 ZONING OWNER J" t— of � a �t -= PHONE NO. 5_3`/• OWNER'S ADDRESS p LOCATION OF BUILDING �r / J T7 !� G + h� /V `7� ✓ ,/ —M USE OF BUILDING A ' 14 -r,4,r �- f CJ / 1 C kev_s, r 6 s rDu,-s SIZE OF STRUCTURE f r X _ SQ. FT. TYPE OF CONSTRUCTION: WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COV ING, FLOOR TYPE /V / ! ESTIMA CQSj,,,OF CONSTRUCTION $_/0 �CJC AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows: , FRONT l' oc f "4-- SIDES 6 REAR S11 AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome and 40 feet from a commercial building. AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation USGS Datum. I declare under penalty of perjury that the building will be used as stated above and the purposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Permit Fee - $50.00 Receipt No. 12 7-5 .J 1 Signature of Owner The above described AG Building is exempt from a building permit. Manager Building Division By L Date Rl ?- 2-- White —DPW, Yelow —Assessor, Pink — B. I., Goldenrod —Applicant FLOQD PARC P.D. ROOFING ISSUE I Manager Building Division By L Date Rl ?- 2-- White —DPW, Yelow —Assessor, Pink — B. I., Goldenrod —Applicant I 1 t �- PERMIT NO. .2442-82P ,E PERMIT EXPIRES_1Z1� / OWNER Ralph McFarland r -S CONTR. Owner ASSESSOR PARCEL 27-10-38 LOCATION WS Crossacountre Rd, app 7/10 mi. S of Grubbs Rd, Palermo Area Temp. Power Pole_ Called PG&E _ Temp. Elec. Service Called PG&E meg` v / C Temp. Gas Service CalleJdpG&E / f JOB FINAG Signature v J V = OK O = Not OK = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS �' Date MOBILEHOME UTILITIES -(Plans) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's oning Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—Easements tls; Special MH Support—Sketch 2. Footings; Size-Depth—Spacing—Connectors ewer; Location—Test—Fall-C — rete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails ,, d er; Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing ectricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L" ft./ /"Nat. or /"L" ft. /" LPG 6. Carports; Windows—Doors tility Clearance 7. Elec. _— Card -BI Date Card -BI Date Date' and -BI Date d -B1 Dat 2%.�and-BI Date Card -BI _ Date Card -BI Date Date � MOBIJZHOME INSTALLATION (Plans) OK except N's Date POOLS (Plans) OK except k's . Zo g Requirements—Setbacks—Easements 1. Setbacks—Easements o gs; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability At-GbaM Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining Electricity; MH Test—Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI 5. DrainMH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI �4e ; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed Wa nd Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 111-`Gait Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Health Department Approval Insp.—Sketch 1D -."Cert. of Occupancy 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date V = OK O = Not OK - = Not-Readyable * = Not Ready RESIDENTIAL, (Sing to and Duplex) Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer - 1 6. Stemwalls, Garage; Steel -Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents -L nderflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except N's 57. Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except N's - 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. 23. Size Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. 70. Plb., Elec. &Mech. Equip. Listed for Location 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes73. 25. 2 Appliance Circuits in Kitchen & Conductor Size Guard Rails & Deck Construction -Post Caps - _ 26. Subieed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral El Yes ❑No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. 80. Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card E -I Date Card -BI Date 81. Ventilation throughout House Card B -I Date Date Card -BI Date MECHANICAL (Permit) OK except q's 82. Glass Protection 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval V _ 32_ Vent Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates _ 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic - --- -- Card -BI Date Card -BI Date Card -BI- Date _ Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except p's Comments at Final: 36. 37. Sills; Proper Material & Anchors Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. Bearing Walls over Girders & Floor Nailing 39. 40. Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties- Purlin-Roof Brac.-Truss-Shthng.-Rfnp. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles - 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) z —rg'z-- -Z-7^fib -7cf �D COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the ali orniadministrative Code, Title 25, 5hapteq 5, under permit n mber , fl' 7 for the fowing location: w s (,*6.ssa&)d d-r'f;, k J 14 op /o m S Di _; ki)96 s RJ 1 e* PA c) Owner _ 1, R-r�- I o SFA v- Owner's Address Mobilehome MfgSa V1 S�f mPD in Model Year79 Insignia No. D4� /6—/4 % - 04-5W �' Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Directoe of Public Works -� Date % :'- �� % By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector Date— _I —3- (';�' L COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS ' 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 ,CORRECTION NOTICE o, l r f BUILDING OR PROPERTY ADDRESS 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 Inspector, �% \ '. ,' Date ' 9 2— COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE AW#; kt, r4 XJ0 0 P&cjACbVw7-d 67 BUILDING OR PROPERTY ADDRESS 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 smatter, or need additional explanation, please contact this t ci a immediately. ; �) CA-; qt�L*-7jF_ El- -7-0 c.r k--L� 'L/) i-t.)r 7h` Inspector ���`%�' Date r I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR =/0 r3� ZONING BUILDING P RMIT �10f�1�j ,P/4 Iq( fFA R� ^ /�Jl 'L'L'AVJJr' //`/--�//7L TELEPHONE !/'J"',",�` E SO. FT. OCC. ILDING VALUATION L^`� rEOR'S MA LS�jJO � ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ S OQ Penalty $ ARCHITECT OR ENGINEE MAILING ADDRESS Permit fee $ BUIL. N_G ADR S �!-�/.�M!r%U/V%-F,E /vP �/O PLUMBING PERMIT Filing Fee 10.00 S O� ses Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Instaltion ther ❑ Describe work: IV2 V7 U_ P&P-" f .0 Z-FZ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR00V OR LESS5.00 Main service EA. ADD'L 100 AMP 2,50 • NEW CONST. / DWELLING OCCUP.y) OR ADDNS. \ ACC. BLDGS. 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): F -1I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. Icense 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 CONSTR. .OUTL T 2.50 ea NON.R ESID BRANCH CIRC ITS NEW CONSTR. \ POWER APPARATUS 8) NON.RESID. SINGLE OUTLET CIR. Ex. Occu S0@� P�o FIXTURES gAL@1 IXED A POR LINIS Ex. Occup.�OUTLETS (RESID.)REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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 onsent to Self -Insure. 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. Heating Cooling Hood 3.00 Ventilation Permit Fee 3 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 co qu e o the granting of this permit. Gvs,/,��� Datel� �_ Signar re of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition Or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ ,da TOTAL PERMIT FEE 0.0 D OCcuP. GROUP I TYPE OF CONST. PARCEL PD ND ss This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF LIC ?,ill BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Dat Receipt No. :Z/nnyy WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT MOBILEHOME SUPPORT DATA If'other than single wide, "�' 0 Mobilehome Mfr. �g�, �j •noJ furnish Setup Model No. �V,%, gi M t tj Year Width— 9A _(ft.) Box Length 12.5 (ft.) Tagalong or Expando Size ft. x — ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County bf Butte). All center supports measured from'front of mobilehome unless otherwise specified. ,. Footings (check one) Single 1. Wood either - pressure treated or foundation grade. ��P, 4x30 � . .. • • - . - • (ft.)(in:) (in.) (in.) ❑ 2. Other: (specify) Center support Center support locations* 4 footing sizes Supporta (check one) 1 (in.) Concrete block. 4 x ❑ 2: Other. (specify) (ft.)(in.) (in.) (in.) O N. <--Tagalong or Expando,' show support details. @, V 1'1 x' A, -- Typical Support SO (in.) (in.) Footing Size (ft.)(in.) (in.) (in.) -- Max. Pier Spacing ` ft-xin.) Max. Overhang (ft.)j (in.) (ft.)(in.) BUTTE COUNTI *JILDING DEPARTMEN . APPROVE -D' *If center piers are other than drawn above, �2 draw in -locations, spacing,. and dimensions. / BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: 3. Is the site currently under permit? Yet No (If yes, furnish permit number 2.442— K– ) OR. ; Is the site an existing site? 'Yes / v/ No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft_. away from septic tank and leach fields and clear of.all setbacks.and easements? Yes No ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- IDfl Amps 6. What is the mobilehome site service rating? --------------------- `a�...� _. Amps 7.. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served by the mobilehome siteservice? -------------------------------------------- -------- Yes No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ----------------------% 10. What is the type of gas service? Natural /% LPG 11. What is the gas pipe length from meter or tank to the mobilehome? 2.9 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.) rt « COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT N - -2, - L4�- � J 9 l ASSESSO PARCE NUMB R ZO NG BUILDING PE IT, TELEPHONE SO. FT. OCC. B DING VALUATION OR' M I G A DRES _ r C 6 C NTRACTO S WAME 0 TELEPHONE ' CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNO, Total Valuation $ Filing Fee $ 4�Q-Q�� LENDER'S MAILING ADDRESS _ Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING DDRE S PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping10187) LOT NO. SUBDIVISION NAME PAR/CEL MAP O b " Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobi lehome 9KIO"ther SPECIFY Building sewer , Lawn sprinkler system 5.00 TYPE OF WORK New f_1 Addition❑ Remodel❑ Utilities Installation❑ Other❑ Describe work: Permit Fee $ 14000 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main seryice 100 AMP 01 OR OL SLESS O00 t Main service EA. ADD'L 100 AMP 2.50 NEW CONST.( DWELLING OCCUP.N OR ADONS. ACC. SLOGS. 2� sq ft CONTRACTORS LI NSE 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 ❑ 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) 1, 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 CONSTR. -OULET 2,50 ea NO N.R ESID BRANCH CIRC TS NEW CONSTR. POWER APPARATUS 6\ NON-RESID. (SINGLE OUTLET CIR, ! Ex. Occup OUTLETS OR FIXTURES_ � BAL@100 APP LHS. OR Ex. Occup.(OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 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. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabi 'ties, judgments, costs, and expenses which may in any way accrue again aid County in cons 9uehce o the gr nting of this permit. r / X Date Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required fore ca,a,i.ns over 5'0" deep and demolition or construct- ion of structures over 3 in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PAR L PollND ISSU This permit is hereby issued under ions of th to Count Code and/or work indi ted above o which DI E OF PUBLIC BY PERM XPFRES a the applicable provi- resolutions to do fees have been paid. WORKS Date lIflY Z stories Receipt NO. / q �G?-l� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 1'A Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. c -c:.^UAL' : � ;C:':�: . ,• �,r.4 Aug IS 9 52 rf �?.,. ELEANOR ii. CLERY,- RECORDER The property described herein is adjacent to land or included 9� FEE within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited -to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa- sionally generate dust,.smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: _ SEE ATTACHED LEGAL DESCRIPTION -WMT3W-1W-'V=• PROP TY OWNERS: s State of Ca _ ) On this the 1 h day of A.u,s-t , 19s_, SS. before me, the undersigned Notary Public, personally County of R tte ) appeared VIVIAN MC FARLAND and RALPH MC.FARLAND ONLY---------------------------------------- OFFICIAL SGAL �. ANG=ELA D. KELLY ..�� : NOTARY FVC1 IZ: • CALIFORNIA 1` PRINCIPAL OFFICE IN j BUTTE COUNTY ' � MY COMMISSION EXPMES SEPT. 7,'1982 known to me to be the person(s) whose'name(s) are subscribed to the within instrument and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. otary Public Present A.P. N0. i • All that certain real property situate in the County of Butte,'State Of California, described as follows:, A portion of Lots 14 and 15 and a portion of Lot 7, Palermo Citrus Tract, Subdivision No. 4, Section 10, Township 18 North, Range 4 East, M.D.B. & M., being more particularly described as follows: Parcel 2, as shown on that certain Parcel Map recorded in the Office of the Recorder of the County Butte, of State of California, on October 20, 1981, in Book 86 of Parcel Maps, at 49. page TOGETHER WITH AND RESERVING THEREFRO14 a 60 foot non-exclusive right of way for ingress and egress and public utility purposes as shown on said Parcel Map.. o • o yR�^ l d ALSO IOGEfHER WITH AND RESERVING fHEREFRO14 a 20 foot non-exclusive right of Nay For ingress and egress and For public utility purposes as .-shown_on said_ flap.._ --- � -v �� -- -- - - a ALSO TOGEIHER r1IIH a 60 foot non-e�cl;jsive easement for ingressand egress and public utility VIC' �1.0 purposes as sha=m on that certain Parcel Map —_ recorded July a, 1982} in Book ;f of Parcel Maps, -at C71 page 41*. k- k - +{r A setback of 5 ft. from }'he Property lines and a setback of 50ft. from the road centerline shall be clear of structures or equipment excepi for a 2 ft, eaVe overhang,.. °�► permit will be required for the installation of the mobilehome. SOO SO. FT. MINIMUM 90, X� FOR MOBILES Utility connections shall be 4 ft. of the mobilehome, eifi'r. directly behind or within the reia. half of the roadside (left) of the mobilehome• yOTE:— All Material Materials & Workmanship Shall ge tn' /I 1 This set 6f plans and specifications M .accordance with RpCOgnized Good 'Practices and kept on the job at all times and it is un a of a quality prescribed for the Specified use in the make any changes or alterations on same Uniform Buil ing, Plumbing & Machanical Codes and written permission from the Department o the Nationa Electrical Code. Works, County of Butte. Ourre couNrr BUILDING DEPARTMENT APPROVED ge Ito tout blic BUILDING DIVISION COUNTY OF BUTTE - DEPA,RTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (916) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT Pr.Rh T NO (D Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. _ ®©^ �3 /� ZONING �S OWNERb/ PHONE NO. 5-341— q S [ OWNER'S ADDRESS 7 !o LOCATION OF BUILDING 7 d GDCIAl -/-V USE OF BUILDING A )-1�c7kevs A e Gs v s SIZE OF STRUCTURE ' 2� ' X _ SO. FT. TYPE OF CONSTRUCTION: WOOD FRAME -LZ STEEL CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COVERING,FLOOR TYPE , ^ /'0;F ESTIMATE CQSLOF CONSTRUCTION $74— AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows: FRONT^6'C) '12o— -L SIDES $, REAR S AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation USGS Datum. I declare under penalty of perjury that the building will be used as stated above and the purposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date AL1012, Permit Fee - $50.00 Receipt No. 1'2-Z-531 Signature of Owner �. The above described AG Building is exempt from a building permit. FLOODPARC I P.D. I ROOFIy� ISSUE Manager Building Di i ion By Date 8-t 2- �► Z. White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant i r COUNTY OF BUTTE - DEPATN4I ENT OFTUBLIC WORKS - BUILDING DIVISION } ' ' 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538.7541 PERMIT APPLICATION DATA SHEET OWNER Gal4A. P. No. aZ 7' �� -O31, Proposed Buildin _ Use Building Inspector l� Date V ((7k2-- At 2 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. 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 Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). P64 0�, � -- 20. Pre -inspection for required. .. w B1�in(Data, 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 . ......................................... 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 . ...................................... Plan check list. ... ..... .............. . 34. When ou issue the permit, process as follows: Mail to owner. Mail t�oora gor itr Telephone S3�f- �(Sb and hold for pickup at �' J��iver with inspector. Other N W,714¢ -- Parcel Creation AcreageApplicant ate 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 _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works