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HomeMy WebLinkAbout027-300-049N 27-30-49ROBERT W. BABB "I e;11V1jV;p2542 Williams Ave, PalermoPermit #4242-76E(ele ser ch &riclean up at new ser) SF,ROBtRTS,' Boyd & Lucille,262b Williams.'Dr., Palermotontr:,North State' Aluminum . � RESIDENTIAL 27-30-49 842-90B ROBERTS, Boyd& I�u�ille 2620 Williams , -i5a%rmo Contr: North State ,Aluminum / icarport/MH_)_--,o,—e<2 JOB FINALE Signature J=OK O = Not OK Not = Not Readyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L"ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance Date Card B-1 Date Card B-1 Date . Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test-Demand-Valve—Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECO, COVERS, CARPORTS, GARAGES, Plans OK except #'s Z 'hg Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel s; nders and/or oists-Decking-Bracing-Stairs-Rails 4. =Beams-Rftrs.-Coonectors S .-Rfg.-Bracing kf Alu . Awn.; Colu s-Conne ns -Sp e- al-Eackwumc .Carports; Windows -Doors 7.•,•ERMtrtt! 8. i s- nchors-Studs-Rftrs-Trusses 9. Sith , ai ing-Veneer-Stucco-Mesh 10_Reef,�-8M - oofing 1 s -Landings Date r11- 0 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater '8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 V OK O=Not OK - = Not Applicable RESIDENTIAL (Sinalt ' = Not Ready & Duplex) Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Fig., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 4. Fig., Porches & Decks; Soils -Steel-/ /Ftg. Depth 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 50. Garage Fire Protection Framing 6a. Hold Downs and Special Anchors 51. Property Line Firewall & Openings 7. Slab; Steel -Wrapped 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 8. Piers -Fireplace Ftg.-Steel 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. Gas Pipe; Size -Anchors 55. Siding -Nailing Veneer 11. Water Pipe; Test -Anchor -Regulator -Service Test 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric; Underground 57. Glazing Area -Glass Protection -Skylights -Plastic 13. Pienums & Ducts; Clearance -Material -Support -Ins. 58. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 59. Insulation -Walls -Ceilings 15. Insulation 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 - Date Card B-1 Date PLUMBING (Permit) OK except #'s Date Card B-1 Date Card B-1 16. Water Htr.; Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchor -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa Date Card B-1 Date Card B-1 66. Elec. Trim & Subpanel; Breaker Sizes & Labels Date Card B-1 Date Card B-1 67. Stairs & Rails Date ELECTRICAL (Permit) OK except #'s 68. Fireplace or Stove; Clearances -Hearth 22. Fixture & Transformer Clearance -Ins. Protection 69. Elec. Outlets at Wood Panel; Int. & Ext. 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 24. Size Boxes & No. of Conductors -Stapled 71. Elec. Outlets & Receptacles at Kit. Counter 25. Romex Installed Close to Edge of Studs & C.J. 72. Garage Fire Door; Swing -Landing -Closer 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 73. A.C. Duct in Garage -Damper 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 75. Plb., Elec. & Mech. Equip. Listed for Location 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral O Yes 0 No 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77• Insulation -Foam -Looked in Attic 0 Yes 30. Service -Riser Conductors & Ground -Main Disconnect 78. Guard Rails & Deck Construction -Post Caps 31. Equip. Clearances Panels-Motors-Mech. Equip. 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector 80. Following instld.; Drive ❑ Yes ❑ No; Walks O Yes 0 No; Planters 0 Yes ❑ No Date Card B-1 Date Card B-1 81. Stucco; Brown -Finish Date Card B-1 Date Card B-1 82. A.C. Unit; Disconnect, Electrical, Plumbing Date MECHANICAL (Permit) OK except #'s 83. Vents Above Roof; Plbg.-Appliance-Fireplace: Clearance to Openings 34. A.C. Ducts Insulation & Support 84. Water Well; Disconnect, Electrical, Plumbing 35. Vent Fan; Exhaust above insulation 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 36. Condensate Drain & Overflow; Size & Grade 86. Ventilation Throughout House 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Glass Protection 38. Attic Access & Platform if Furnance in Attic 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card B-1 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s Date Card B-1 Date Card B-1 39. Sils, Proper Material & Anchors Date Card B-1 Date Card B-1 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Date Card B-1 Date Card B-1 41. Bearing Walls over Girders & Floor Nailing • Comments at Final: 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing each time you visit job site) (NOTE: An entry must be made COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATIOWAND PERMIT PERMIT NO. /11 7 ASSESSOR P RC UMBE - -- ZONING �- l l.., BUILDING PERMIT O WNE ol I TEL.EPHO E ��]JCDC SQ. FT. OCC. B LDING VALUATION 'mnwl AI I G OWNERAD S C TRA 'S NA , T PHON CONTRA TID OR'S MING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 1Q,()() LE E/R''S MAILING ADDRESS Permit Fee $ SQ H TEbe T OR E GIN E0. LICENSt.SE NO. Plan Checking Fee a Energy Plan Checking Fee $ A I ECT EEl/JAILJ,1 4 ADDRESW+,, Penalty $ BU DING ADDRESS; a(a an 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 qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK Newts Addition ❑ ReemoodeI ❑ Utilities ❑ Installattsito'n❑, Other ❑ j Describe work: 1D,1L!5 ,A. I nI x a©/ CU U.. fit'r—s lanj Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code a d m license is in full for 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 oR ADDNST DWEACCLLIN GOCCUP S. N) 1/2¢sgft NEW CONSTR. TI -OUTLET I2,50 ea NON-RESID BRANCH CIRCUITS) POWER APPARATUS e\ (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20050t SALO 30 Ex. OCCUp. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 71 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 t—r a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. allso l abiilliie to dgments, costs,nandeexp expeess the nses which may in any wayof Butte aaccrue ainst against sa' Ccliunty in consequ c of a granting of this per X a�� 5 Date t� Signature of Applicant — Owner ❑ Cant for ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ .767 OCCUP. CONST.TYPE ISCHOOLIFLOO.1 PAR 171 Isgu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERAT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. 9 I �ICn WNIT[-D.P.W.. YELLOW -ASSES OR. PINK -INSPECTOR. GOLDENROD -APPLICANT DATE: PLOT PLAN FOR PERMIT APPLICATION THROUGH NORTHSTATE ALUMINUM, INC. 3029A Esplanade • Chico, California 9592 � ,-� B�a In Telephone: (916) 343-7�aH$74�13). ••, R� : - i:-� fro LOCATION ADDRESS: 014NER: �n�yr1 >: 1_I�n„��p Rr„�,Arr�3 COST OF JOB guI4 00 MAILING ADDRESS: rrn� 14ORK TO BE PERFORMED:����r,,,� jI i'+ •,, i# � 1 `� f I I � � � I � I 1 { I eN I I 1 ' � I 1 i ►;� tk Er A. u ^I.\� pG�;,trt to Of ' e, ve •e OL n� • 1 � I will, I I J� 1 � 1 r I 1 I {` ' I 1 a.+ > I j I I •rw+w'� i� s i 1 R J _ � 74r� LTJ, ��c�,e�- << ��� �. ;� �� -i �� �, COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 Tel ep'{ione: 514-4541 APPLICATION AND PERMIT auuwiZ IcNlcacnrauvaa UI Lilt! wwrty UI MUtte tu enter upon the above-mentioned property for inspection purposes. X ptie� Signature of Permiteeor Agent This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Receipt No. - White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date Date BUILDING Owner — SQ. FT. OCC. BUILDING VALUATION Mailing Address 4_. Telephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address f`, ,, r,f 3 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No., j e'� ( Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W. C. SaR44atioa. FireDept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements provements Lawn sprinkler system 2.00 _91d P ec`d Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 r t t n 1 `_ Main service 100 AMP ORSLESS 5.00 - 6 Main service EA. ADD•L too AMP 2.50 OVER 600V Main service 100 AMP OR LESS 25.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service// EA. ADD'L 100 AMP 1.00 NEW CONST.WELING OR ADDNS. 1 ACCLBLDGS.OCCUP. &) 20sgft NEW CONSTR. MULTI -OUTLET NON.RESID. (BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name St le of: y Ex. Occup(OUTLETS OR FIXTURES) @250 BA109 Ex. Occup. FIXED APPLNS. OR P• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 t/ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. rJ I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby MECHANICAL NO. @ FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation +2.00 Hood Permit Fee $ $ TOTAL PERMIT FEE $ a `? auuwiZ IcNlcacnrauvaa UI Lilt! wwrty UI MUtte tu enter upon the above-mentioned property for inspection purposes. X ptie� Signature of Permiteeor Agent This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Receipt No. - White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 �- - Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above -men ' n property for inspectio rposes. % X ignature of Permitee or Agent' Receipt No. / 3 9-36V White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF UBLIC WORKS By Date �� -BviIdinT permit expires Date 2�' BUILDING Owner (Q)Q606-77 LU r Iq SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address S2 1 Telephone No. Low A4 © L —/?,(& Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 (Gas A. P. No ,69 `-" 30— q1 Zoning $ Planning Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W . Seaasatica FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration 'Parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Blda Pp -1N Parcel' Approval I Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 „GU &(F�C7-tilC AyL S Fft Q tC — G�— Main service 100 AMP ORSLESS 5.00 , ca • C%{ i-�•Qi/q� T New Selz,IviG' Main service EA. ADD'L 100 AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service OVER "00V 25.00 100 AMP OR LESS Main service EA. ADD•L 100 AMP 1.00 OR ADDNSNEW // CONST. ACCDWELBLDGS.LING CCUP. &) 22syft NEW CONSTR. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONST. POWER APPARATUS & NON-RESIR D. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: y Ex. Occup(OUTLETS OR FIXTURES) BAL@109 Ex. Occu FIXED APPLNN OR P• OUTLETS (RES* EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 - Licen No. - Classification Misc. Wiring 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ 1, 7$ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above -men ' n property for inspectio rposes. % X ignature of Permitee or Agent' Receipt No. / 3 9-36V White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF UBLIC WORKS By Date �� -BviIdinT permit expires Date 2�' (( .:-. Owner: 1 -,e/L BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT �/ p A. P. # 02 `r 5,1 7 Address: As -q 2� W,,U AP-', AV� Tenant: Building Location:S)T M Type of Inspection requested: Date of Inspection Inspector �11 � 1. Housing / / 2. Financing 3. Change of Occupancy to /TC 4. Other (specify)_6 e V1 cE CA, 61q oAJ PC)/,e %b Present use of building: A. Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4.- Kitchen sink: 5. Hot and cold water.to fixtures: 6. Heating facilities: .7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection to sewage disposal: 12. Connection to water supply: 13. Rubbish and garbage facilities: 14. Comments: B. Structural 1. Piers and footings: 2. 'Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments• 2. 3. 4. Receptacles: Fusing: D. Plumb in 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. Comments: (continued on back) E. Other 4- 1. 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Comments: F.- Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: 4. Restroom floors and walls': 5. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give complete description): 2. What action taken (give complete description): 3. What action recommended: A. Information only.- file. B. Hold for ten (10) days, then write letter. C. Write letter. 77D. Other: a O sNt O r. � r O ✓ r, o Q • Z p, 0 N 9. A C d. O ❑ O r _OS 1 Q 9 b C d 0 L E; c od � •«:i dw• ' O UU a r s.dl rY •� � DE e i o�°GC ✓ Q o a Q 10 .F a �.°s `4 •cr Ta � -'co, (0 C+d 7 Co'ydr, n9.�S Lt _ a of +ao dt, it G o G d -a v C�f �J d a, x' d IA dl� CE gaa J d 6 d mw E ✓ C d d o +JQ`-d'T ad Qftl`9; i d dr9y°� d Y J d d d drej O,•' dw- d r p O J✓ �Dt✓60 1 O 59y + r I I L d Dod L .✓ sly' a' I .00' .00'51 -Q d P a JI L 1.jryd•Q G<< 7 loG d Ci + I C d I I I ry 1 °L ep 'e ISI I IAA v6 GN o J LLWAI I 1A, °nom 11.1 � I IAA o tlf �6 r I IAA 9- d d N O v I A d e dLd LLa✓Or el d ` e Cr V A .71 ro a�.E d d 0' d ui Y 0 6 3 'u. 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P/L" I i I P/L STREET: LOT No.: Name of Park: Street Address• Name of Tenant: Brand Name: State Approval #: State Model # Installer: Address: Telephone: Describe Work to be Done: Cost: $ We, the undersigned, hereby approve the installation of the above structure and agree that the information furnished herein is correct and in accordance with all • applicable provisions of the Health and Safety Code and Related Rules of the State of California. Tenant: Park Manager Signature Signature • E