HomeMy WebLinkAbout027-270-016GraceZ Berumen 2 � a ✓
N/W'corner Grier.and Ontario Str, Orovill aIt
Permit # 1428-82P,E util MHJamesa Abell
Electric' ���
Gas ..
Support _s,tructure,
,,.r.e
, ,
?Compaction test 3. K'
r 2/-27-16
0 Ontario, Oroville
Perm 1563-87P,E(util, MH) Z
I ELEC O �_'�
=AS 7
+ COMPACTION TES `�..
d.
f SUPPORT STR RE j.
/
_27_16 �P � /8
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Contr: C r Mercado MH ser yv
Perm' 6$2=8 MHI
Is ed
7,m
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s.
PERWIT NO.
�• PERMIT EXPIRES W
� —_—
r �.
0V,tER GRACE BERUMEN '
CONTR. link own
ASSESSOR PARCEL27-27-16
Q HO -Y
LOCATION 7980 4ktbesilo Oroville
7GO�FFICE COPY
Temp. Poaol Address_/
Collo4
Temp. [loc. ELECTRIC DWte�/:,
Meter By Date
Called
Tomp, Goo Sorvlco
Called PG&E
JOS FINALF-0 1.);11v) _
Signnlue _,_ ,
Y .
� -w 'Not Apt treaDto r
MOBILEHOMES MISCELLANEOUS
,o Not Roady . ,.
_ para os081lEHOME UTILITIES (Plans) OK a.CPat a'e i Dato O2CKS. COVERS. CARPORT$• HTC. tPlonal OK *.coot • e
oninq Rpua
i�omonl*-Sotbecko-Eaaoanta t 1. Zom
rq R spuUomamo-Ilolbacb-Eeaoaranu
Solla: SpoGlal MH support-6iletCh ------ —�— 2. FOOIinpO, Slte-Depth-Spatrng-Canntcto_ro
S Locailon-Tool-Fell-C/O--CDntrata -•-_—_ J Docks; Girders and/or Jolets-Dicking-Br$Cinp-Slaets-R3ils
star: Locatron Eaaomant Hooded (Stretch) a. Wood Awn.; Poata-6"m3-Rftro.-Connee.-Sntho.-Rfg.-Orotrno
�S. 1 oclrlcity: Location-Clearances-orad.-/ / Amp-Concrete S. Alum, Awn.; Coluams-Connections-Splrco-Occal-Enclosureo
oes; Ltsulloo—Tpt-lrrap:/ P'L"It./ P,tbI.a "l "ft./ LPG 6. Carports: Windaro-Doors
� z DC7. 6111,4Cfetrtrrce 7. Eloc. --
Card-81 -Data r-'r Card-BI Date Card-81 Date Card-81 Det* - —
E�Pfo_L-a --L7 caro-81 Date
0141O11011 IISSTALL.ATION (Plane) OK o■cept a's
PAing Repulremwnts-Setbacks-Easoutents
�eolinpa' Sft
-Spec lno- Wriapa Lira
06: MH Toot-Daarerd-Volvo-Connector
Electricity: U@/ Teat--Crweavere &oak*-Clea►nacoe
Qfeln: UH Test-Fall-Ftea Coamctd/
Mier: fatal Test-Regulator- onnoctar
teyertd Sewer Cow-acted-C/0 to Grade-MD Approval
PCs and Electricity Tapped
Eaite; Inap.-$ketch
of Otetme=v
Card -B1
Cnrd•81 Date Cad -81 Date
Date. POOLS (Plans) OK except a'a
— 1. Setbacks -Easements
2. Sous: Compaction -Structure Stability --
J. Pool Struet": Steel-Connections-Thickness-Oead Alen -Lining
o, Else.: Receptacles ted Lighting; Dislaneees-GF1
S. Eloc.; Pool Lighting: IS volt* -8F1 -
6. Elec.. Enclosures: Conduit Entries-Terminals-Lretod --
7, Eloe.; Bonding; tdatel w/S'-Circutiting EOuipmont-Heater
0. Eloc,.; Grounding; Eauip.w/S'-Circulating EOuIp--Pool Lgntg. -
Banes-Enclosureo-Peaaltwads-Ins. to Main in Conduit
g. HMlth Department Approval _
/0. Plumb; Cir, Tow -Rater Supply Toot
Card -BI Date Card -81 Date
Card -BI Date Cord -81 Oise
0
'� • • � ,Nen ,A LIi Lr JtJr
. N,n1.r.Wr RESIDENTIAL (Singlo and DupleRj
f I., UNOF nFI_Or1n 11•lan♦) )K
-... t. Zonlny rrqu rCri,enta Soros, ►.-EesemOnts
Ftp., Yarn: Soils->3teel-Floc.---
/" FI Depth
$ells -Steel- / -/:: FI De l D-
-- -4. Fly, Porches Uocko; Selly -Steel- / /^ Fig. Dopin
.._. S. StOm"walls, Ydlll, $IOnI-DIOC kOula-YJre-`------"---•"-
6. StOmwaltg, G_ora o_S_taot-
B{oCkoula-WreDPed-Stab
7. Plrrs-FireplJCo Ft .-Stool ---
-tZ"._
8. 0.1Y,V.: Fall-FlUlnys_Teat-2 ------
-- Y SOaor Tool,
- ---- - 9. Gag Pipe_Size-Ancnot s- - --
Prpo_Teat-Anchors-Rogulator_S-ar i otOC Tosl
11. ElOctric, Uroerpround ---
12. Plenums 6 Ductg: Cbaranca-►tatorlal-SUPDOrt-I_na,'
Q. Grrde,s-SIIIs_ AnChor Oolt!-JOial7-VOnls-Cel - - - -
-"-- - PDIOa ---- Card•BI Date Cerd-BI
Date -- -Card-BI
-Daae- - Card -et Date Card•BI
Ca:d•UI Card -DI Date
- -Date Card-_
Oeto
Oalo GnAY1N0 IConunuM1
----
48. PIODO-Ill Line Fuownll • U Iroe
- -sY. E.I. Doors -One 3'-Chr/c1 Gn-yd atorY. 2 e,ua
- Sid -Is. Width
- 501. P1YwWAJ an Pool UvorAa R`�-Run_L..gMiny-Foe P=otecllon '
52: -step - g- --- ^g-Anlc"ym,t=_q=troy patr,ccr--
_�0_-Nailer[--Vennar _
53. Stucco Yean-Drip_Scro.•C`_F- d- n. Ve�t'
5d. GlazingArea- ----UnOorflr, ACcosa '•
-__ _Gldsa P1otoctron-Skylights-?ioatri
S5. Sonar Nallg; Nolting_BoUa
Cato PLUIt191NG (Permit) OK eaeept 0.3
14. IYalO( HI,. Vont-Access-CCmb-6t-. A,,
_. 1S.-nalor Pipe: Test & Anchors -Null Profocl-- IOP
18. D.ro.V_, Tost-Fltngs & Anrhors_Nail Protection
17. "_Shorey Pan:_Tc; l, First Floor_T�gc[oss
t0. Test Tub 6 Shower 2nd Floor -Tub Access
19. Gey P�De _Biro g Artcl+Ora
Ca.y-01 Da to
Delo FINAL (Plans) OK eit I e'e
56. Eat. Steps -Door 8 Sidollt
57, Smoke Detector
58. F urnace' V t
D_a[e
pato
Cofe _
La_dinps __ _
en !-Clearance-GCtttb. Air_Conn c_t0,_
• In Ga, &": Above Floar-Ducts-Mach. Protection ••
59. Bedroom Exiting
8 Beth Fr,tures 6 T4 Access
St. Elec. Trim 8 Subparbel: Brttakor Sitea_LoDels
82. Stairs 8 Rails
ba, Elec. C
v, a„rvo. wearan cee•Heanh
C31,1_91•91
_
Card•BI Date
D�fe BI -- -----_-
-85
Kit. Flan 8 Appliance, Grnd.-Air GaP-Coshing Clearan-e
pato
r
138.
Elec. Outlets C6 Receptacle! at Kq: Ct;'ui,ter
Cara
'''
ELECTntCAL
Pc,n,ir) OK oxceot e's
67.
G v F,re Door: Swlny-Lanaing-Closer
'-- '
20.
Fixture 8 Tronsfwrner Clearanco-In
63.
A.C. Duct in Garz e -=Damn,
-
:[.
1io
Elec. ROceptacles Spacing
69.
t#U. Hit.: Vents-CleagnCO-CEJ. Alr-CO.')rteCtdf-P.R.V.-
2?,
-Lt hts 8 Switches eI Ocbrs
-----
Size Boaeg b No. of Conductors-$feplad
70.
In 13raga. Above Floor-Lieen Protection
,_.
2]_
_
Rcaox tnsttloo Closd to EC9e
PtD.• Elec. 8 ucch. Equip. Listza for Local ion
24.
of Studs & C,J;
-
E1urP,
71,
Elec. Rc[c,tac:es In Ga a t7o. (G.F.I.)_Rcsex Protec.
Giound made up w•t2oc Fastener s S 1:Jter
72•
Insuia!,on-FOam_Look00 in Attic i ;Yes
25.
__
2 App)wnce C rtults ,n K tenon 6 C_Or[duCtOr $,Ze
73.
Gard R3,ts d Deck Conslrucuon-Pest Caps
20.
27.
SvDt[ec giro $,ze / 0a. Cu a A1_q,C, ty_„e Size i r pa. Cu or Al
Rargs G'r[, r
a•
Fcn• Vents & Ctawt yore D= -Drama;,- g tvood•Earth Clearance
ga. Cu or AI -Oven CuC. / / gJ. Cu or At, -
Insulated Neutral
Lookee under Floor �, Ye!
_.
:5.
_ Yes ,No
Service -Ryser ----_._._-
Conductors 8 Ground
7S.
Following ,nsild,: Or y y ` NO; Walks
Primes r i.: a Yes C: No:
`
29.
-Main Disconnect
Eouip. Clearances. Panels-ktotaa-aee[h. Equip. -- --
_Yes _ No
74. Stucco: Brown -Finish
30.
Ctotnrs Closet Llgnt-Snorer Light - - '--- -
77.
A.C. Unit. Dlsconrtoct-Ctrnces_Brtr. 6 Cond. Size -115V Outset
.
. •. - ---- - --
a. V
�#_nls^bovs _Root. Ptbg,-Appliance-Frrept.-Ctearance to Cones.
,
'
79.
Rater 1#011, Olsconnect, Electrical, Plumbingr
,`rd
Oa1c Coro -BI Da1C " --
B0.
Eaer,or E'O[. Trim G.F,1. R_a[eptacle-Underground
;
R•I
Date Card -BI - Date-- - - --
8t,
Ventilation throughout House
i
62.
Glans on Projecti--.
! '
)>tE
MECHANICAL IPern•,ry OK e,ccot a's
Cenectiotl! from Prevroua Inspections
J1.
A.L. Ducts Insutalion A Support
-83.
ba
E43 Test_Yetor! TaggeO_Ga!_EIK[ric
32.
Vent Fan. E+hiuISt nbowe Insulation
85.
aat-r 8 Sewer Connected -C/O to_Greee-HD Approval
!,
33.
Conccnsate Otain 6 Overt{ow, $Izo 1L Grade -
8>d•
Enor9# COmPI,_onc_c Cen,ficate-Diner Certificate- s__��
d'
34•
F•11nace-Vent Aci PISS -Comb. Air -Return Air Vent -115V oullel
- --
--- •
"- .•
i
tS.
4nic Acccr: A PI utorm it Fu•nacv in Attic
- --- .--� - -
C.tlr C.udRl Card•OI
OatsCarU•D{
-
--- .- ---
.110
Da
:.,rd.Dt
C.ia' Care (lj Card
Card
-Bl
-Bl _
Oatc at
l:.lrn
Fal
(.JIP ____.-`,\r•1 f1I---__(1•lIC
'
''t,'
Fn�MINGrI'L.: rel OK r rt•ni •':
-ib.
Slit" 1'IOpi•r !d.irry ,.11 a nni Mu:;
•-- ..__
C('--!<
It F.n.,f
..
'
17.
1Y ill•, ~nail•.-N.nlul�. Cp.n ut'I b lLJ[ mq-t'f.11r•.._,.nunit
.._ -... _. -
:P.
Ilrunr•t ; ill•, nvrt I:nd••i, ♦i fins' N.I, lin••
,iii
rill \4,1, m,Y.ijl•• 11.11 Iq sol)
.It,
r ,r, ••.n,,, .... r•.1 C,•,Inry •, $Lin ..[ ri ,.r•.. [nl,
It
,1.•.,d -I A It...n.. \r:.• tt 1{r•.ii i,.,l
_ ..
1,•
„..,,•.. 1•., .1 i ail,. Ar„Ir,,. •. , rn:
I,
rn•i. I.•.•.I I -ill•. lir I'.n l•n il,nrl Il.r l,n..
-
1 r•,,i r,n Ili, nail
-'
.
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11 .. .. ..... 1.•., •., 1 •i nal lr,. ,r :. ,ell II,Ji. ♦ I,,i,..•n,.i,
MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE `
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA — 534-4541 '
'- CG PERMIT N0. /1 2
='Address or location
/o'f mobilehome
'c Owner's name /j
Owner's address 7 910 CitiClYc_
rf�yrr,� /6&43 S
Insignia or hw&-number
Manufacturer's name_}/� r C
Serial nurgberof
V.I.N,./> UJ � �%Year of manufacture
fficial Approving Installation
IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION
ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE
'J MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM.
COUNTY OF BUTTE
V DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
OWNER
AIT N N /�f?
BAI-
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__ 1`(/ -��� Date l
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891.2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
Q�te () VYN vw\
OWNER
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 /fy/-7 Date_V
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
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.
Inspector _"/� t— Date 4A
I
J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKSPE /
9!1 T NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 v—�
APPLICATION AND PERMIT
ASSESa50 PARCygL UMBE(i /
(JCJ V'/' - L/<6
ZO NG
BUILDING PERMIT
W
"?o'ra e_& r e-
TE EPHON
�
SQ. FT. OCC., BUILDING
VALUATION
OWy�R'S_MAI LIN DDRESS
oilr e,n v` f ��" v
C 0 NJJ ACOR'S NAME
TELEPHONE
CONTRACTOR' MAILING ADDRESS
Fireplace
CONST UCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ J -r •0�
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
A CT OR ENGINEER'S MAILING ADDRESS
Y'O
Penalty
$
BUILDING AD RESS e7 V1 1 K Y, +
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
V)OV C
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ MobilehomeLV Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S
0.00 ea 110.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities V, Installation❑ Other ❑
Describe work:
dgq
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
5,00 SF/�
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50 0 -S -
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check.one):
C -
❑ 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
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
( DWEACCLLING
oR CONST.GOCCUP.&\ yz¢sgft
S./
NEW CONSTR ULTI.OUTLET
NO N.RESID BRANCH CIRC ITS 2,50 ea
(POWER APPARATUS e\
SINGLE OUTLET CIR.
Ex. Occup(ouTLETs OR FIXTURES BAL@30
900030
FIXED APPLNS. OR
EX. Occup. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
/ 1i% 14 �-
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
$
1 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.
�_ �� _q7
X /�G( .a -r P �` Date D
Signature of Applicant — Ownerg Contractor ElAgent❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3lssttoorriies in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
TOTAL PERMIT FEE $
occUP.
CONST.TYPE
I
I FLoo
PARC L
PO ND
139
This permit is hereby issued under
sions of the Butte County. Code and/or
work indicated above for which
DIRECTO OF PUBLIC
By.
PE T EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date�1-�-o
p
��Za'i�?
Receipt No. O / I.�
WHITE-D.P.W., YHLLOW-ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
` COUNTY OF BUTTE -DEPARTMENT OFPUBLIC WORKS ~BUILDING
7COUNTY CENTER DRIVE - OnOV|LLs. ysuOa ' TELEPHONE: y1
PERMIT APPLICATION DATA SHEET
OWNER A P NI o.
Proposed Building s e Buildi ng Inspec or 6- Date
U tor
At time of permit application, | was advised the following data must be submitted prior to permit processing
ond/oriaauanma: DATE RECEIVED Appnmxso
� ----_- 1. All items hav6 been submitted . . . , . . . . . , . .
~ _----- 2. Plot plans in'dup|icste/trip|ioate. signed by pnapanarof plans. .
------ 3. Complete
plans in duplicate/triplicate, signed by preparerof plans.
------ 4. Complete engineered: plans and co|co, with wet signature on plans.
_---_' 5. Plans with Energy Design -Compliance Statement.
_---_- G, CUSO ''Fee's Poid^ Stamp on Floor Plan . . . . , . . .
-----_ 7 Statement of Intent for Non -Heated and AC Buildings. . , . , `
- --_-_' 8, Fe es of $ , , , , , , , , ,
------ 0, Letter of signature authorization. . . , , . . , . , .
10. Sanitation approval from Health Dept.
11. Planning approval for (A) Use: _------_(B) Parking:-
12.
arki 12. Certificate ofWorkmen's Compensation Insurance; '. . .
-_---_13. Contractor's License Information (no,, name oty|n. o|auoif.)
14, Owner -Builder Verification (Given toownerE].Mai |toowner
�)
_15, Improvements may berequired . , , , , , , , , , , ,
_----'16. Mobi|ehome Installation Data. . . , . , . . . , , ,
17. Pre -inspection for p "/�"=�p`u�`w
m�)d.aa,
' Recorded copy ofAgricultural Acknowledgment Statement.
1Q. Driveway Permit.
__---_20, Plot plan approval from city of
21. _^
-----_22. "
When you issue the er HL. proc!F as fol lows: ___Ai I to owner, Mai I to contractor.
' App|ioant
`
43-
Copyof plarissent -HealthDept., Fi O pt -Other -Date
The following data must be submitted prior topermit issuance: (Circle new itemnotoheoked above),
1, |ndex'permit for above items No.
2' Additional items required:
Contractor, designer, owner, was advised of above required data by—phone ail counte by— date
Contractor, designer, owner, was advised of above required data by—phone mal 0 nt r by-- date
,
Plans checked by by — Date Plans approved4 Date ---__Sets of plans onhold in----Fi|ooabinot _AP folder
- Flours: 10:00 a.m. -3:OD p.m,
.,-
Copy -DPW
.'..�... `
r
TO: Building Department
FROM: Encroachment Permit Section
RE: Driveway Clearance
28-r-0 Refw m GAJ I cl
owner location p #
Driveway permit U� has been issued for the above property.
si ature date
TO Buildina Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supply
pp Y
Hold final for:\
Water .Supply
Final clearance O.R. for:
Clearance for _ bedroo obile ome. Other
NOTE * * *
Water Supply
AP # I—a�
OWNER (M P_ '-I
PERmrr -- '
Nei UTIL.CLEARANCE DATE
INSPECTOR
ELECTRIC
GAS
Support
Struc.
Compaction
Test Req.
Service
Size
Other
Load
T e
Pipe
Size
Length
YES NO
YES NO
P
vv Cr G
IV/ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California -95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT IVO.
ASSESSOR PARCEL NUMBER
.2.-7 7—
ZONI
BUILDING PERMIT
OWNER /
;e W4—JJ
�AJDDRESS
T EFL PHONE
SO. FT. OCC. BUILDING VALUATION
O yEj!__AIL
ONTRACTOR'S NAME ITELEPHONE
/�� s • MAY
CONTRACTOR'S MAILING ADDRESS ��
A�wj �j x_45—
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee -
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE ND.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
r
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
SF ❑ Duplex[] Mobilehome[& Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G W
10.00 ea
TYPE OF WORK ,�-
New [-IAddition❑ Remodel [:]Utilities ❑ Installation Ef/ Other ❑
Describe work:_
atz.ELECTRICAL
Permit Fee
$
Contractor
PERMIT
Filing Fee 10.00
Main service 100 AMP OR101 OR LESS10.00
Main service EA. ADD'L too AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Buslnes$
and Professions Code and my license is in full force and effect.
[/Cpm Classification e ✓j
License No. T ``l /�� �" �+' /
❑ 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.6I
OR ACDNS. ACC,
, /zQsgft
MULTI -OUTLET
NEW RE5ID,CONSTNC C ITS
NON.R ESID BRANCH CI!ICU'
2,50 ea
POWER APPARATUS e)
SINGLE OUTLET CIR.
Ex. Occu p� OUTLETS OR FIXTURES
2oe50c
SAL@30
FIXED ALNS.
EX. OCCUp. OUTLETS P(RESID )REAJ
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. IVirin 9
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
op,--l-have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
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.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X D e J r7
Signature of Applicant — Owner ContractorAgenr
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 $ r
Energy Inspection Fee $
TOTAL PERMIT FEE $
Occup.
C04ST.TYPEJ
I
I FLOOD PARCEL PD
HD
Ise
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PE P
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
/��(�
Receipt No.
WHIT!-D.P.W., YELLOW-A88Le 90 R, PINK -INSPECTOR, GOLDENROD -APPLICANT
f COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CA IfFORN1A 95965 - TELEPHONE: 916/534 4T
It
PERMIT APPLICATION DATA SHEET J
Permit No.
OWNER Ira C. C" tf, W F 0 A P. N .
Proposed Building Use ,Building Inspector Date
J4.
At time of�rmit application, I was advised the following data must be submitted prior to permit processing
and://or/195uance: DATE RECEIVED APPROVED
1. All items have been submitted. . .
2.
3.
4.
5.
6.
7
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
Plot plans in duplicate. /triplicate, signed by preparer of plans. .
Complete plans in duplicate. /triplicate, signed by preparer of plans.
ComDlete engineered plans and talcs- with wet sinnature nn plans.
Plans with Energy Design Compliance Statement. y . . . . .
CUSD "Fees Paid" Stamp on Floor Plan ... . . . . .
Statement of Intent for Non -Heated and AC Buildings.
Fees of $ - - - - - - -
Letter of signature authorization. . . . . . . . . . .
Sanitation approval from Health Dept. . .
Planning approval for (A) Use: (B) Parking: .
Certificate of Workmen's Compensation Insurance. . . . . .
Contractor's License Information (no., name style, classif.)
Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ),
Improvements may be required. . . . . . . . . . . .
Mobi lehome Installation Data. . . . . . . . . .
Pre-Inspec. request to
Pre -Inspection for Required- Buildin ins ector
9 P
18. Recorded copy of Agricultural Acknowledgment Statement.
19. Driveway Permit.
20. Plot plan approval from city of
21.
22.
Whe you issue the tro/c�s 3 as follows: ,Mail to ner, Mail to contractor.
Telephones '~s`� and hold for pickup at ll office, Deliver w/inspector.
Other
Applicant
Copy of plans sent Health Dept., Fire Dept„ Other Date
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone---nall—counter by date
Contractor, designer, owner, was advised of above required data by—phone _mall—counter by t/ date
Plans checked by Date Plans approved by abate &-142'
Sets of plans on hold in File cabinet AP folder
— Hours: 10:00 a.m. - 3:00 p.m.
Copy—DPW
i�
(Date)
MOBILEHOME SUPPORT DATA
If other than single wide,
Mobilehome Mfr. YL furnish Setup Model No. Yesr
Width �o� (ft.) Box Lengthy'.! 0 (ft.) -Tagalong`-or- Expando'3ize 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 of Butte).
All center supports measured from front ofM^'
mobilehome unless otherwise specified.
.' Footings (check one)
Single 1. Wood either
pressure treated or
foundation grade:.
x 2. Other: (specify)
Center support Center support
locations* footing sizes
Supports (check one)
(in.) U 1: Concrete block.
L—� x ❑ •2. Other,. (specify)
(ft.)(in.) (in.) (in.) P1 11
4---tagalong or Expands,'
show support details.
(in.) (in.)
4((in.
;0 -Typical Support
in.)' Footing Size
(ft.)(in.) (in.) (in.) Max. Pier Spacing
v -- Max. Overhang
(ft.)l (in.), ., (in.) (in.)
r COW '
l 1� DEPARTMENT
pv" O\ Eu
V
*If center piers are other than drawn above,
� raw 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:t�
2. Installer's name: e19 r/_7 dim � oA-02
3. Is the site currently under permit? Yet No
No
(If yes, furnish permit number „��I"o / ) OR. t
Is the site an existing site? Yes / / No
(If yes, furnish two (2) plot plans.)
4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and
clear of all setbacks.and easements? Yes /-1- No
( If no, clarify )
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.)
5.
:What
is the mobilehome electrical rating? -----------------------
S-0
Amps
6.
What
is the mobilehome site service rating? ---------------------o
®
Amps
7..
What
is the mobilehome site circuit breaker rating? -------------
50
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? ----------------------
/_(in.)
10.
What
is the type of gas service? -----------------------------
Natural LPG
11.
What
is the gas pipe length from meter or tank to the
mobilehome? /
(f t.)
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.)
is of plans and specifications MUS e
kept on the job at all times and it is unlawful t;
make any changes or alterations on same with-
out written permission from the Department of
Public Works, County of Butte. /
back of 5 ft
Property lines an
Of 50ft. from the
r he
a he
ad
centerline shall b
clear of
structures or equ'
for a 2 ft. eave o
ment exccp
rhann
I
NOSE Materials & Workmanship Sha
Accordance with Recognized Good Practices arrr
of a quality prescribed for the Specified use n the
Uniform Building, Plumbing
and the National Electrical Coc!@,Mechani Codes
'Gtility connections shall be within
4 ft. of the mobilehome, either
directly behind or within the rear
half of the roadside (left) of the
mobilehome.
A permit will be required for the
installation of the mobilehome.
S00 SQ. FT. MI.Nt mUM
FO
(563-87
BUM= COUNTY
BUILDING DEPARTMENT
APPROVED
A
M
US,
BUTTE COUNT'/
BUILDING DEPARTMFN'
APPROvI�-p.
This set of plans and specifications MUST be �;, '.
kept on the job at all times and it is unlawful t; NOTE:—All Materials &Workmanship Shall Be it
make any changes or alterations on same with- accordance with Recognized Good Practices arr
out written permission from the Department of of a quality prescribed for the Specified use in the
Public Works, County of Butte. Uniform Building, Plumbing & Mechanical Cod4s
and the National Electrical Code.
N.
A setback of 5. ft ;from the
property lines an a setback
of 50ft. from the, ad Utility connections shall be within '
centerline shall .,b clear of 4 ft. of the mobilehome, either
iA
structures or;equi ment exc.,:,; directly behind or within the rear
fora 2 ft.-eave o rhang, half of the roadside (left) of the
mobilehome, --
' C
a permit will be required for the
` installation. of the mobilehome.
4 �
i.
500 SQ. FT. MINI/%AU,4jj
Ci -
FO n 14lI
BUTTE COUNT I
BUILDING DEPARTMEN-,
APPRQVI�D
1
010 KE C/Ct t�
I k1
�o Y not ✓��G�clab/o
•q
d!Yl _-
}
PERMIT NO. 1428-82- s
PERMIT EXPIRES
OWNER Grace Berumen
CONTR. James„Campbell, Yuba City
ASSESSOR PARCEL 27-27-16
LOCATION N/W cor Grier and Ontario Sts,Orovil]
;i
Temp. Power Pole_
Called PG&E
Temp. Elec. Service_
Called PG&E_
Temp. Gas Service _
Cal led PG&E
JOB FINALED (Date)
Signature
J OK
O = Not OK
= Not Applicable MOBILEHOMES'
= Not Ready
MISCELLANEO0le-
Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) O{' except b'
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/O -Concrete
_
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Gonnec.-Shthg.-Rfg.=Bracing
5. Electricity; 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 ^-
7. Utility Clearance
7. Elec.
Card -B1
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
_
Date Card -BI Date
Date
MOBILEHOME INSTALLATION (Plans) OK except N's
Date
_
POOLS (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4, Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/O to Grade -HD Approval
7, Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
.10. Cert. of Occupancy
9. Health Department Approval
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
= OK
= Not OK
= Not Applicable Not Ready RESIDENTIAL (Single and Duplex)
Date
UNDERFLOOR Plans OK except #'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
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. 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.
11.
Water Pipe; Test -Anchors -Regulator -Service Test
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 q's
Card -BI Date Card -BI Date
Date
PLUMBING (Permit) OK except p's
14. Water Ht.; Vent -Access -Combustion Air
56.
Ext. Steps -Door & Sidelight Protection -Landings
57.
58.
Smoke Detector
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
Card -BI
Date Card -BI Date
64.
65.
Elec. Outlets at Wood Panel; Int. & Ext.
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 exce t 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.
Size Boxes & No. of Conductors -Stapled
70.
Plb., Elec. &Mech. Equip. Listed for Location
23.
24.
Romex Installed Close to Edge of Studs & C.J.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
72.
Insulation -Foam -Looked in Attic ❑Yes73. Guard Rails &Deck Construction -Post Caps
25. 2 Appliance Circuits in Kitchen &Conductor Size
26.
Subfeed 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 Al,
Insulated Neutral ❑Yes El No
75.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters EJ Yes El 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.
Water Well; Disconnect, Electrical, Plumbing
--
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B-1
Card B -I
Date- Card -BI Date
Date Card -BI Date
81.
82.
83.
Ventilation throughout House
Glass Protection
Corrections from Previous Inspections
Date
MECHANICAL (Permit) OK except N's
84.
Gas Test -Meters Tagged; Gas -Electric
31.
A.C. Ducts; Insulation & Support
85.
Water & Sewer Connected -C/O to Grade -HD Approval
_
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---
Card -BI
Date
--- - ---- --- ---
Date _ _ Card -BI Date
Date Card -BI Date
FRAMING(Plans) OK except N's
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI Date Card -BI Date
Comments at Final:
36.
Sills; Proper Material & Anchors
_
37.
38.
39.
_Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing Walls_ over Girders & Floor Nailing__
Draft Stop in Walls (rat proof) _
40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
---44.
41.
42.
43.
45.
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -Connectors
Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnp.-Rfnp.
Fireplace Ties or Type A Flue -Fireplace Throat
Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles
_
46.
47.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions _
Garage Fire Protection Framing
-A-
(NOTE: An entry must be made each time you visit jobsite)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
' APPLICATION AND PERMIT
PERMIT N0.
ASSgr A_=C,EL MB zON G
BUILDING PERMIT
0 E TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER' MAILING KESS }..,
7 O I
CONTRACTOR'S NAM
TELEPHONE
CONTRA T R'S EILING A R S
Fireplace
CONSTRUCTION L R
UNKNOWN*
Total Valuation Is
Filing Fee
$
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUIL ADDRFS$
�
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
100
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
55,00
Gas piping system 1 - 5 outlets
USEOF STRUCTURE
SF ❑ Duplex[]Mobilehome,iUr',/Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lilies Installation ❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main seryice 600V OR LESS
100 AMP OR LESS
0 0.
Main service EA. ADD'L 100 AMP
2;50 M
OR ADONS. (DWELLING
GS.CCUP.N1
/ 20 sq it
CONTRACTORS LICENSE LAW
I declare under penalty of perjury
p y p I y (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No: Classification
❑ 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 CI OUTLET
NON-RESID BRANCH clRc ITs 2.50 ea
NEW NON-RESCONSTID. R (POWER
OUTLET CIR, POWER APPARATUS 8J
So @ 25¢
Ex. OCCUp OUTLETS OR FIXTURES BAL@1
FIXED APPLNS, OR
EX. OCCup.�OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
r
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
S
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X ,�11171/�1��D?— Dated �[. — �`L
ter
Signature of Applicant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structuresover3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE
OCCUP, GROUP
I TYPE of CONST.
PARCEk
V/
P
HD
SSuy
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRERVR OF PUBLIC
By
P IT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. 4, L� Z-)..- <—
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
\OUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS -- BU
-ILDI'NG DIVISION
7 COUNTY CENTER DRIVE - OROVILLE,-CAL!-FORNIA 95965 - TELEPHONE: 916/534-4541
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER-� A. PNo. F%
Proposed Building Use
Permit Fee Based Upon: Complete Contract Price /_—DPW Valuation
:e (Explain)
Building Inspector Date
At time of permit application, I was advised the following data must be submitted prior to permit processing
and/or issuance: , I e 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. State Energy Forms No.
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . . . .
Letter of signature authorizatio,••.
C1 / 10 Sanitation approval from Health Dept. Z�
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. . . . . . . . . . . .
16. Mobi lehome Installation Data. . . . . . . . .
.
17. Pre -Inspection for RequiredPre-Inspec. request to
- Building Inspector —(Date)
18. Other
When you issue the permit, process as follows: ----/,-Mail to owner- Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other
Applicant )4� lot 17 4,49 Date
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 abov t ime of application, circle item.)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Desig
Plans checked by_
Plans approved by
Other:
Copy—DPW
s advised of above required da
By--- )
Telephone
_Mail Other
Date 5 U -m
Date
Date �Z.
To: Building Depat Limant is
Fror,:. hvi ronment al Health
Subject: Sanitation Clearance
C 4001 r-
O;:mner Loc, tion Ate:
Plan Approved for: Se?,.aze disposal v.ater supply
Hold final for: •rater supply
Fir_al clearance O.K. for: water supply
Clearance for bedroom mobile home. Other
San.itarian
liate .
Z--
Sanitarian
--
We, DONALD G. DELANY, MARIA R. DELANY and GRACE BERU14EN
are the owners of certain property situated at 7914 Resovoir
Road, Oroville, California.
We give our permission to ANGEL LOERA and SOLEDAD R.
LOERA to move their 10'x56' trailer house onto the property
situated at 7914 Resovoir Road, Oroville, California, more
particularly described as follows:
The following described real property in the County
of Butte, State of California:
Lot 6, in Rlock 147, of Subdivision No. 3:..of the Palermo
Citrus Tract, according to the Official Map thereof,
recorded in the office of.the Recorder of the County of
Butte, State of California, January 2, 1889.
�I
DONALD G. DELANY
MARIA R. DELANY
�I- BERUMEN��
State of California
County of Butte
On May 26 , 1982, before me, the undersigned a Notary
Public in and for said State, personally appeared DONALD G.
DELANY, MARIA R. DELANY and GRACE BERUMEN, known to me to
be the persons whose names are subscribed to the within
instrument and acknowledged that they executed the same.
WITNESS my hand and official seal.
CAL
NOTARY PUBLIC
My Commission expires JUNE 15, 1984
I�eme>�eaeoeea®aooeeuonneoeeuurmennne�
'OPPICIAL SEAL
RACHEL LOUISE REYNOSO
NOTARY PUOUC•
C 'rte' CALIFORNIA
COUNTY OF BUTTE
r
My Commission Eaplras hlne 15, 1984 S
.••aboaeae6ieao�enueauauaeuoneumnoneoe�u�eaooa�
RECORDING REOUESTED BY
Oroville Title Company
OFF ICIAlRECO ' '
Order No. 101854
CUTRr'tpTr: copp���-,;:,,
ns
•
11n.E CO. • "•'
AND WHEN RECORDED MAIL TO
- - 'OROVtLLE
NameDONALD G. DeLANY, et ' al
E.
COUNTS( REC.F�
Street 7741 Occidental
.'- :' EE'
Addr It
city Palermo, CA 95968
Stab I . _
... r ;�,`„• ,
L—
.. ..
SPACE ABOVE THIS LINE,FOR RECORDER'S USE.-
SE.MAIL
MAILTAX STATEMENTS TO
• �••i - +-µ.
Nome
,� r ^ •
y
(S)+declare (s).
Address Same as above
T;^ f U_ -:i r.S:onc-d orontor q� ai +
r� ? �?-
-y t, tax is $_9,�.� 1r._ �. ' �.
oc! ur:sTer _r.,
:6ri ()—value o�rroparty=conveyed, Or J�e .tea
- _ 'fir Fiw.i
Stab
J'y
C
v.olue,lass values of diens and
r'
'
-
)'computed:c,_jjul! .<
encumcrances remaining at. time of iale�•g' 'ft.l, �`
.. - - ..
-
,m, . �.i'••�[,"?; 4y , �il� �, '..``'� "fir .�f ,
Unincorporated area: ( City
(X)
i
D.T.T. a.........Grant
-
®estP
TO 405 CA (7-73) ` THIS FORM FURNISHED
BY TITLE INSURANCE AND TRUST COMPANY
FOR A VALUABLE CONSIDERATION, receipt of, which is hereby acknowledged, ' .LEON W : BELL`
IDP NAE BELL h' ' f .
"ro4.7 All
art ;I.•; y
�.
hereby CRANT(S) to DONALD G. DeLANY and MARIA •R. DeLANY}, Yiis,wife; -and?
- ".• - - `'. _ K••�at� X44 �+,-.\�da � f.,iE. ✓• -
GRACE BERUMEN •a married woman all as Joint Tenants
the following described real property to the
County of a <BLl tt e'~ t }
,State of California
...'v` -SEE" EXH1B•IT'�'t�`'t�,�ATTAI;��i RET%5"��°I�7i�E'�A�ART Fi�'REOF'�� -
J
" '^. .. ` fie,. .,,'`"T .3?iy v.<xt:�•z�A�.--'T :7."s�:._"` �.
We, Donald -G. DeLany' and Maria _R. DeLany, husband and wif"e, two..ofw the'' x'
<-..
,Grantees herein, .do hereby. 'waive , any.: commuriity: interest In ,the pro:pertyti_
descr-ibed
'in 'Deed '-,and' do `hereby:_conserit'-to-"accepting -the.tltle,f; r
__.conveyed herein with ""Grace.. Berumen -a married woman; `all _as {J'oint��':
Tenants.
Donald G. DeLany Maria R. DeLany
I,• Grace B-erumen, a married woman, one of the Grantees herein, do hereby
consent to accepting the title conveyed herein with Donald G. .DeLany and
Maria Re DeLany, husband and wife, all as Joint Tenants.
_ Grace Berumen . .
Dated May 2, 1977 - G / /' • .
e IYn W. Be 11
STATE OF CALIFORNIA
COUNTY OF �14tv�7At }SS �d-�?71/ Bpi
1
On -l'�!i r r �.3 f 7 % before me, the under- p 11
signed, a Notary Public in, and for said State, personally appeared _
zKzz
known to me A i
to be the person --S whose name --5 subscribed to the within
� <
instrument and acknowledged thatexecuted the same. � + A. BRANDMEIR=1WITNESS my hand and official seal. ir,� Y: NOTARY FL;BLIC - CAUFORNIA 1i
Prine!p;( Offics in SAh MATEO Ccunty
Signature L��Pc.% A7yCommissimExpires July l8.'1980 •�
N
/>
Name (Typed or Printed) (This area for aificial notarial seal) rn
Tide Order No. Escrow or Loan No.
MAIL TAX STATEMFNTS AS DIRECTED ABOVE
Retr-sn to DPW AGRICULTURAI;: STAfl. ENT O.F AdHOWLEDGEMENT
FOR RESIDENTIAL -DEVELOPMENT
Section 26-8.1 of the Butte County Code requires this' acknowledgement, -E
' be recorded prior to issuance of a building permit, 6'1
The property described herein is adjacent to land or included MAY ZG -4 O 1927
within an area zoned for agricultural purposes, and residents of
this property may be subject to inconveniences or discomfort arising EL.EAN0RM.acCKEIR'"� �
from the use of agricultural chemicals, including, but not limited to R6F c����RUER EJ
pesticides, and fertilizers; and from the pursuit of agricultural operations includingF,
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. o
All that real property situate in the County of Butte, State of California,
described as follows:
' Date: MAY 26, 1982
PROPERTY OWNERS:
State of CALIFORNIA. )
On this the
26TH day of MAY 19 82 ,
SS.
before me,.the
,
undersigned Notary Public, personally
County of BUTTE )
appeared
■nunntnmm��emeuaenmaunumnnnnmt� ,
OFFICIAL SEAL
RACHEL LOUISE REYNOSO
.
NOTARY PUBLIC - CALIFORNIA _
r COUNTY OF BUTTE
-
known to me to
' ""-• My Commission Expires lune 15, 1984
®eu� epei�' �ff"��"f��t441ii '� �Q j S
be t`�i
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.
'
' ~
r .t� r .I �9 I
31
Notary Publics"
,� �: • t..l �'i6:+-.w4y ef�},37 �_ i^S
#
`• _ is . ♦
'
Present A.P. 27— 2 % r
}
X r+y .K�'.f i6 ,$",_
f ' 4'~
s.a�'= rpt ;;,. ,.g
N0.
r`
+:SS ., '.it •,".f':" ......�.�_. �riii''�-•,3.;......r.. �->•.=LS+
v: Lt •Y�l.l liU . < .L�/1zp JY
EXHIBIT�►►A"
All that certain real property situate in -the County of Butte; State i
of California, described as follows. -
All the surface and '60% of the oil, gas and mineral rights in or on and
which may be produced from the following described property:_. �
Lot 6 in Block 147 of Subdivision No -3 of the Palermo Citrus Tract
,,
according to the Official Map thereof, recorded in the office of the ,
Recorder of the County -of Butte, State of California, January 2, 1889.
END CF DOCUA4EWI
r.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 -Telephone 916/534-4541
APPLICATION AND -PERMIT
(�Q
PERMIT NO.
l A-7 — 2,
A SS E55QR RCEL BER
���`)
ZONING
BUILDING PERMIT
OWNER �
r
TELEPHONE
SO. FT. OCC. BUILDING VALUEITION
OWNER'S A NG A ES
e�
CONTRACTOR'S NAME ^`�'
W
TELEPHONE
CONTRACTOR'S MAILING 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
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS -
Permit fee
f- D
BUILDING A DRESS
o
PLUMBING PERM1'T
Filing Fee 10.00
�v S
Each Trap
2.00
Repair drainage or vet ing
5.00
Water piping
LOT NO.
SUBDIVISION NAMEPARCEL
MAP
Each qas wat hel r vent
5,00
Gas piping sys - 5 outlets
USE OF STRUCTURE
SF❑ Duplex❑ Mobilehome��ther
SPECIFY
Building sewer
Lawn spr er ystem
5.00
TYPE OF WORK
New ❑ Addition ❑ odel ❑ tilities ❑ Installa on t.
Describe work:!
Pe it Fee
$
Coma
tLECTRICAL PERMIT
Filing Fee 10.00
a service 600V OR LESS
100 AMP OR LESS
5.00
uN4401service
�(
EA. ADD'L 100 AMP
2;50
NEW CONST. DWELLING
OR ADDNS. ( ACC. BL GS.CCUP.BI)
20 sq It
CONfRACTORS LICEIIAE LAW
I declare under penalty of perjury (check one):
EJI am licensed under provisions of Chapt. D .3 of t e usiness
and Professions Code and my license n f 11 force and effect.
License No. Classific io
0�1, as the owner, or my employees with w es as th r sole compen-
sation, will do the work,and the structure 's not I to de, or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contractin ith 'censed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Bu sine s a Professions Code
for this reason
NEW CONSTR. (.OUTLET 2.50 ea
NO N.RESID BRANCH CIRC ITS
NEW CONSTR. (POWER APPARATUS e1
NON-RESID. SINGLE OUTLET CIR. 1
so@zg¢
Ex. Occup(OUTLETS OR FIXTURES BAL@100
EX. OCCU IXED APPLES. OR
p•�OUT LETS (RESID,) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring
7.50
Permit Fee $
Contractor
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.
®/1 shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shat l be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
S
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
again aid County ii conse nce of the granting of this per it.
C/,/ /�Z
%� -� Dat
Signature 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 $ 100
TOTAL PERMIT FEE ,
OCCUP, GROUP I
TYPE OF CONST.
PARCEL
PD
ND
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.�
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT, OF PUBLIC WORKS -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE,-CALIFORNIA 95965 - TELEPHONE: 916/534-454.1
PERMIT APPLICATIDN DATA SHEET
Permit No.
OWNER A. P. No.
Proposed Building Use __ A 14
Permit Fee Based Upon: Complete Contract Price DPW Valuation
�Oqr/Explain)
Building Inspector Date 5—
At time of permit application, I was adviseA the following data must be submitted prior to permit processing
and/or Issa3nce: DATE RECEIVED APPROVED
t� All items have been submitted. . . . . . . . . . . .
2. Plot plans in duplicate/triplicate. . .. . . . . . . . .
3. Complete plans in duplicate. /triplicate. . . . . 3. . .
4. Complete engineered plans and calcs.
5. Plans with Energy Design Compliance Statement. . Angel Loera R. 27'27-16�
6. State Energy Forms No. Permit #142 82Mf'x.
7 Statement of Intent for Non -Heated and AC Buildings.lssued
8. Fees of $ t- --- -
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. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . .
.
17. Pre -Inspection for RequiredPre-Inspec. request to. Building Inspector (Date)
18. Other
When you issue the permit, process as follows: 4ff'1Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other
Applicant—
Copy
PPIicantCopy 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 Date
Plans approved by Date
Other:
Copy—DPW
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, OrOVille, CA. 95965 Phone: 91$-534-4541
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 in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing 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 S
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 coord;,,arA 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:
S igned :
Property Owner L`
Social Security numb r
Date
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
permitted to issue the permit.
We, DONALD G. DELANY, MARIA R. DELANY and GRACE BERUMEN
are the owners of certain property situated at 7914 Resovoir
Road, Oroville, California.
We give our permission to ANGEL LOERA and SOLEDAD R.
LOERA to move their 10'x56' trailer house onto the property
situated at 7914 Resovoir Road, Oroville, California, more
particularly described as follows:
The following described.real'property'in the County
of Butte, State of California: --
Lot 6, in Block 147, of Subdivision No. 3 of the Palermo
Citrus Tract, according to the Official Map thereof,
recorded in the office of the Recorder of the County of
Butte, State of California, January 2, 1889.
-0 0''`Z` "g
OD4 4::��
DONALD G. DELANY
MARIA R. DELANY
� %p.d�on,c.Lm�Yv
GRACE BERUMEN
State of California
County of Butte
On May 26, 1982, before me, the undersigned a Notary
Public in and for said State, personally appeared DONALD G.
DELANY, MARIA R. DELANY and GRACE BERUMEN, known to me to
be the persons whose names are subscribed to the within
instrument and acknowledged that they executed the same.
WITNESS my hand and official seal.
NOTARY PUBLIC 47
My Commission expires JUNE 15, 1984
0l1911LS1".BC}"_:77f'<S29iY1:ElE.",,!!!C?`s.',i5°.�"913E:IE111111�
01`1, "AA].I,.?AL
j• s•;,._1 ;c^I"3 1 �:;ii:. = t�E'f^�OSO �
o�!+- ._r•, 1No I ^
JUTTE
r?llaslelllea�e:etl.�c:;.:�: �,+:z_::.::x7:N9':46ii:➢129331III�
set. of plans and specifications MUST be NOTE:—All Materials & Workmanship Shall Be in
kept on the job at all times and.it is unlawful t: Accordance with Recognized Good Practices ancl.
make any changes or alterations on same with- of a quality prescribed for the Specified use in the
out written permission from the Department of Uniform Building,' Plumbing & Mechanical Codes
Public Works, County of Butte. and the National.Electrical Code.
A setback of 5
ft. from the
property lines and a setback
of oft.
from the road
centerline shall be clear
equipment ex'
structures Qave o er ang.
fora2f
r ..
BUTTE COUN 0
BUILDING DEPAPTMEN
APPQOVeD.
ADi
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:
:What is the
mobilehome electrical rating? -----------------------
Amps
3.
Is. the site currently
under permit?
Yet
No,/ /
What is the
(If yes, furnish
permit number
)y'le�)
) OR
.Is the site an existing site?
Yes / /
No C -7 --
is
(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
(BTU)
.
clear of. all setbacks.and
easements?
Yes /
t
No
(If no, clarify
)
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.)
(
---------------------------------------------------
)
t
5.
:What is the
mobilehome electrical rating? -----------------------
Amps
6.
What is the
mobilehome site service rating? ---------------------=
Amps
7..
What is the
mobilehome site circuit breaker rating? ---------------
vvZ� Amps
8.
Is there any other electric load to be served by the mobilehome
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.)
siteservice?
---------------------------------------------------
Yes No T-1
(If
yes, identify the load and size: W (Load)
aQ�
,_(Amps)„
9.
What
is
the mobilehome site gas pipe size? ----------------------
10.
What
is
the type of gas service?---=------------------------- Natural /% LPG /C/�
11.
What
is
the gas pipe length from meter or tank tothe mobilehome?
�y (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.)
MOBILEHOME SUPPORT DATA
If other than single wide,
Mobilehome 14f r. furnish Setup Model No. Year
Width 110 (ft.) Box Length 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 of Butte).
All center supports measured from front of
mobilehome unless otherwise specified.
Footings (check one)
Single❑�1. Wood either
pressure treated or
foundation grade.
x 2. Other: ( specify)
(ft.) in:) (in.) (in.) ❑
Center su port Center su ort
locatio s* footing izes Supporta (check one)
(in.) ; Concrete block.
x .2: Other. (specify)
(ft.)(in ) (in. (in.)
--Tagalong or Expando,'
show support details.
(ft.)(in.) (in.) (in.)
Typical Support
(in.) (in.) Footing Size
x
(ft.)(in. (i .) (in.) -- Max. Pier Spacing
(ft.)(in.)
Max. Overhang
(ft. (in.) (in.) (in.)
BUTTE COUNTI
BUILDING DEPARTMtN
APPROVED'.z
*If center piers are other than drawn above, /L
draw in -locations, spacing,. and dimensions.
r
BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS "' a
7 County Center Drive, Oroyille, CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's name: AA1 [ L 0
2. Installer's name: S e-
36' Is the site currently under permit? Yes 747 No
(If yes, furnish permit number ) OR
......Is the site an existing site? Yes / / No
(If!yes, furnish two (2) plot plans.)
4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and
clear of.'all setbacks.and easements? Yes /Tr No
(If no, clarify ) --
5. What is the mobilehome electrical rating? ----------------------- O Amps
6. What is the mobilehome site service rating? ------ Amps -
7.. What is the mobilehome site circuit breaker rating? ------------- U Amps
8. Is there any other electric load to be served by the mobilehome
siteservice? -------------------------------------------- ------- Yes No
(If yes, identify the load and size: V_" Z (Load) _(Amps)
9. What is the mobilehome site gas pipe size? ------------------ (in.)
10. What is the type of gas service? ----------------------------- Natural 77 LPG / 44-
11.
411. What is the gas pipe length from meter or tank to the mobilehome? / () (ft.)..
12. What is the mobilehome gas demand? ------------------------------ (BTU)
BTU
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.) -
MOBILEHOME SUPPORT DATA
If other than single wide,
Mobilehome Mfr. furnish Setup Model No. Year 3
Width t0' (ft.) Box Length941 _(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 of Butte).
All center supports measured from front of
mobilehome unless otherwise specified.
Footings (check one)
Single Wood either
p` x
(ft.)(in.) (in.) (in.)
Center sup ort Center supp r
location * footing si es
(in.)
x
(ft.)(in.
.. L�_ I
(ft.)(in.) in.) (in.)
(ft.)(in.)
(ft.)I (4n•)
pressure treated or
foundation -grade.
2. Other: ( specify)
Supporta (check one)
1: Concrete block.
.2, Other. (specify)
Tagalong or Expando,'
show support details.
Z x ZOJ -- Typical Support
a.) (in.) Footing Size•
HIT
x
Max. Pier Spacing
(ft.)(in.)
x
in.)I (in \)
*If center piers are other than drawn above,
draw in "locations, spacing,_ and dimensions...
i6) -- Max. Overhang
(ft.)(in.)
i4z1-82
BUTTE COON("!
9UILDING DEPARTMEh
APPRUVFaGJ -. �y