HomeMy WebLinkAbout027-310-011027-310-011 PERMIT#98-1308
FORRESTER, Joel /���
8Cr✓;1 Melvina Ave., Palermo
Mobilehome Utiltties /D
ELECTRIC 9 0 C � - �c-l/ � D N4�O�o�
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SUPPORT STRUCTURE RE t�
027-310-011 PERMIT#98-1389
FORRESTER, Joel
8054 Melvina Ave., Palermo
Mobilehome Installation
027-310-011 #98-2557
FORESTER, JOEL
8054 MELVINA, OROVIL E
OWNER G 11120,
MH PERM FND EXT SITE
2�7
3@
1
P
fly ' •�. ,� : � .:
L A N D O F NATURAL WEALTH A N D BEAUTY
PLANNING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (530) 538-7601
FAX: (530) 538-7785
September 22, 2003
Sierra View Realty
P.O. Box 5426
Oroville, CA 95966-0426
ATTN: Bob Stahl
Re: 100% Rebuild -Burn -down letter for 8054 Melvina Ave., Palermo, CA, (APN 027-310-011).
Dear Mr. Stahl;
The above referenced parcel is currently zoned AR -5 (Agricultural Residential, 5 acre minimum).
This zone allows for a single-family dwelling.
This parcel is a 4+ acre parcel which was created before the AR -5 zone, and is considered a legal pre-
existing non -conforming parcel.
Should the dwelling be catastrophically destroyed it may be reconstructed, provided it will not be
placed within the required building setback areas and meets sanitation codes in effect at the time of
reconstruction.
The setback requirements for the AR -5 zoning are 50 feet from the center of the road and 10 feet side
and rear yard property lines.
Should you have any further questions, please contact this office between the hours of 8:00 a.m. and
4:00 p.m., Monday through Friday, at 530-538-7977.
Sincerely
Larry Painter
Planning Technician II
CC: Development Services, Building Division
Butte County Department of Development Services Planning Division
A
RESIDENTIAL
027-310-011 #98-2557
FORESTER, JOEL
8054 MELVINA, OROVILLE
OWNER
MH PERM FND EXT SITE
PERMIT NO.
PERMIT EXPIRES _
OWNER
CONTR.
ASSESSOR PARCEL
LOCATION
THE HCD FORM 433A FOR THIS MH CANNOT
BE RECORDED UNTIL ONE OF THE FOLLOWING
HAVE BEEN TURNED IN TO THE BLDG DIV:
(1) LICENSE PLATE(S) or DECAL(THE
T i INSPECTOR MUST RETRIEVE)
Post -it® Fax Note 7671
Date
paggesP ,�
To
From
�lt�
Co./Dept. / �_ /i��
GG 7
Co.
�!
Phone #
Phone #
Fax #533— /159 9
Fax # 5,:3?—
OL80
i
(2) STATEMENT OF FACTS(ONLY ON
NEW MH'S)
INSPECTOR TO VERIFY SERIAL & LABEL #'S
CHECKED
SRA BY
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
1 Temp. Gas Service
Called PG&E
JOB FINALED (Date) l `7
Signature
V=OK
O = Not OK
NotReady 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-CiO-Concrete
4. Water, Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap; / /1-1t.
/ /Nat. or/ /'L"ft./ /LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Zoning Requirements- Setbacks Easements
Footings; Size -Spacing -Marriage Line
Gas; MH Test )emandVahe-Connector
41 Electricity: MH Test -Crossovers -Breakers -Clearances
51 Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Iwater and Sewer Connected -C/O to Grade -HD Approval
8. as and Electricity Tagged
9. re Downs -Type -Installation Cert.
10. zits; Insp.-Sketch
11ert of Occupancy
12. errpanent Foundation Only: License Decal
B-1 Date Card B-1
Date Card B-1 Date, Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sils-AnchorsStuds-Rttrs-Trusses
9. Siding; Nailing VeneerShxx*-Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Lendings
12. Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
S. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5 Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards4ns. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
0 = Not OK RESIDENTIAL (Single & Duplex)
- - Not Ap fcebie
p
Not Ready
Date
UNDERFLOOR (Plans) OK except #'s
Date
1. ZoningSetbacks-Easments-FloodSlope
FRAMING (Continued)
2.
Ftg., Main; Soils-Elec. Gmd. / P Ftg. Depth
3.
Ftg. Garage; Soils-Steel-Elec. Gmd/ /' Ftg. Depth
4.
Ftg. Porches & Decks; Soils -Steel-/ P Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
50.
6a.
Hold Downs and Special Anchors
51.
7.
Slab, Steel -Wrapped
52.
8.
Piers -Fireplace Ftg.-Steel
53.
9.
D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test
54.
10.
UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
55.
11.
Water Pipe; Test -Anchors -Regulator -Service Test
56.
12.
Electric Underground
57.
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
58.
14. Girders -Sills -Anchor Bolts -Joists Vents-Crippies
15.
Access & Ventilation
16.
Insulation
61.
Insulation -Walls -Ceilings
Date
62.
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
Date
17. Water Htr.; Vent -Access -Combustion Air Baffle
Card B-1 Date Card B-1
18.
Water Pipe; Test & Anchor -Nail Protection
FINAL (Plans) OK except #'s
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
Ext Steps -Door & Sidelight Protection -Landings
20.
Shower Pan; Test, First Floor -Tub Access
Smoke Detector
21.
Test Tub & Shower, Second Floor -Tub Access
Furnace; Vents -Clearance -Comb, Air-Conector-
In Garage; Above Floor -Ducts -Meeh. Protection
22.
Gas Pipe; Sae & Anchors
Bedroom Exiting
67.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Fireplace or Stove, Clearance -Hearth
23.
Fixture & Transformer Clearance -Ins. Protection
Elec. Outlets at Wood Panel, Int. & Ext.
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
Kit. Fixt. & Appliance; Ground. -Air Gap -Cooking Clearance
25.
Size Bo es & No. of Conductors Stapled
Elec. Outlets & Recepticales at Kit. Counter
26.
Romex I stalled Close to Edge of Studs & C.J.
Garage Fire Door; Swing -Landing -Closure
27.
Equip. Ground made up w/Mech Fastners-Bond Gas & Water
A.C. Duct in Garage -Damper
28.
2 Appliance Circuts in Kitchen & Conductor Size GFI
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
In Garage; Above Floor -Meeh. Protection
29.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al
Plb., Elec. & Mech. Equip. Listed for Location
30.
Range Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or Al
Insulated Neutral 0 Yes 0 No
Elec. Receptacles in Garage (G.FI.)-Romex Protection
31.Service-Riser
Conductors & Ground -Main Disconect
Insulation -Foam -Looked in Attic
32.
Equip. Clearances Panels -Motors -Meeh. Epuip.
Guard rails & Deck Construction -Post Caps
33.
Clothes Closet Light -Shower Light -Spa Light
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
34.
Smoke Detector
Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No
83.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
Water Well, Disconnect, Electrical, Plumbing
35.
A.C. Ducts Insulation & Support
Exterior Elec. Trim, G.F.I. Receptacle -Underground
36. Vent Fan, Exhaust above insulation
88.
37.
Condensate Drain & Overflow, Size & Grade
89.
38.
Fumance-Vent Access -Comb. Air -Return Air Vent 115 outlet
90.
39.
Attic Access & Platform if Furnace in Attic
91.
Gas Test -Meters Tagged, Gas -Electric
92. Water & Sewer Connected -C/O to Grade -HD Approval
93.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Date
FRAMING (Plans) OK except #'s
Card B-1 Date Card B-1
40.
Sits Proper Materials & Anchors
Card B-1 Date Card B-1
41.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
Card B-1 Date Card B-1
42.
Bearing Walls over Girders & Floor Nailing
43.
Draft Stop in Walls (rat proof)
44.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45.
Headers & Beams -Size & Bearing
Date
FRAMING (Continued)
46. Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rftr. Ties-Purlin-roff Brac.-Truss-Shting: Rfng.
48.
Fireplace Ties or Type A Flue -Fireplace Throat clearance
49.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
51.
Garage Fire Protection Framing
52.
Property Line Firewall & Openings
53.
Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits
54.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56.
Siding -Nailing Veneer
57.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58.
Glazing Area -Glass Protection -Skylights -Plastic
59.
Shear Walls; Nailing -Bolts
60.
Brace Interior / Exterior Wall Panels
61.
Insulation -Walls -Ceilings
62.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
63.
Ext Steps -Door & Sidelight Protection -Landings
64.
Smoke Detector
65.
Furnace; Vents -Clearance -Comb, Air-Conector-
In Garage; Above Floor -Ducts -Meeh. Protection
66.
Bedroom Exiting
67.
G.F.I. & Bath Fixtures & Tub Access -Spa
68.
Elec. Trim & Subpanel, Breaker Sizes & Labels
69.
Stairs & Rails
70.
Fireplace or Stove, Clearance -Hearth
71.
Elec. Outlets at Wood Panel, Int. & Ext.
72.
Kit. Fixt. & Appliance; Ground. -Air Gap -Cooking Clearance
73.
Elec. Outlets & Recepticales at Kit. Counter
74.
Garage Fire Door; Swing -Landing -Closure
75.
A.C. Duct in Garage -Damper
76.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
In Garage; Above Floor -Meeh. Protection
77.
Plb., Elec. & Mech. Equip. Listed for Location
78.
Elec. Receptacles in Garage (G.FI.)-Romex Protection
79.
Insulation -Foam -Looked in Attic
80.
Guard rails & Deck Construction -Post Caps
81.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
82.
Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No
83.
Stucco Brown -Finish
84.
A.C. Unit Disconnect, Electrical -Plumbing
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
86.
Water Well, Disconnect, Electrical, Plumbing
87.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
88.
Ventilation Throught House
89.
Glass Protection
90.
Corrections from Previous Inspections
91.
Gas Test -Meters Tagged, Gas -Electric
92. Water & Sewer Connected -C/O to Grade -HD Approval
93.
Energy Compliance Certificate -Other Certificates
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVIS N
7 County Center Drive • Oroville, California 95965 • Telephone (530) 53!-75Cq P R No.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 027-310-011
ZONING
BUILDING PERMIT
OWNER FORESTER JOEL
T 533-3421 ELEPHONE
SQ. FT. OCC. BUILDING VALUATION
84,240
OWNER'S MAILING ADDRM BOX 1030, OROVILLE
CONTRATR'd,{` If
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
t
Fireplace
LENDER'S MAULING ADDRESS
Total Valuation $ RA Q
ARCHITECT OR ENGINEER
LICENSE No.
Filing Fee $
20.00
Permit Fee $
286.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Plan Checking Fee $
23.00
BUILDING,gr4 MELVINA
Energy Plan Checking Fee $
OROVILLE
PERMIT FEE $
329.00
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑ Duplex O Mobilehome O Other
SPECIFY
Solar or heat um water heater
23.00
Water piping
15.00 Cz nn
Each gas water heater or vent
15.00 '
TYPE OF WORK
New O Addition O Remodel ❑ Utilities ❑ Installation O Other O
Describe Work: MH PERM FND/EXISTING SITE
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home IS I GI W 920.00
PERMIT FEE = 50.00
ELECTRICAL PERMIT I
Filing Feel 20.00
0.11 R LE
Main Service zoOA OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
12-11—as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A TO 1000A
46.00
NEW CONST. LLI
DWENG C
OR ADDNS. ( a ACC. BLDOCUP. S.
SO
3.52 FT.
=.ESIpT MULTI -OUTLET
97,50
POWER APPARATUS
a SINGLE OtlTL.E7 CIR.
Ex. Occup. OUTLET OR FDRUREs
Bu @ 1.50
Ex. Occup. oilnFrs RESID.PP .OE.
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE S
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
O 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
O 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
gone hundred dollars ($100) or less.)
01"-1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith omply with those provisions.
�-- �,
X _ Date /('� -3 `�
Sig at re of App (cant - O Owner ❑ Contractor ❑ Agent
An OS A permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 379.00
4 1
HAz.
r
D. FEES IMP FLAOD
COF
P C PD
HD
ISSU
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. 01
�0,l
BY e
PERMIT EXPIRES ON G[
Date
ReceiptNo. 25C(I In
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
�.k...y»,.r���,.xr��,,r}•.rrw+ei�Y=kms' �'�Yl�~d�ft�,-.M^Y•nry�.J'kfMvJt,-n^F"�''.,�-.r
COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER: i'V r qs±er== ASSESSOR PARCEL NUMBER:
Proposed Building Use: hA j+ Pcxw, ,- Building Inspector: e;_9 Date:
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
Wi avebeen submitted.---------------------------------------------------------------------
3/4 sets, signed by the preparer of plans.lans, 3/4 sets, signed by the preparer of plans. --------------------------------------
04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ---------
06. Energy Design Compliance and supporting documentation. -------------------------------------------
07. Statement of Intent for Non -Heated and A/C Buildings. ------------------------------------------------
❑ 8. Hazardous Material Form.
.11
119. Manufactured Home data and installation instructions including Tie Down Specifications .------------------
❑ 10. Fees of $-------------------------------------------------------------------------------------
❑ 11. Impact fees as shown on the attached schedule. ---------------------
❑ 12. California Department of forestry plan approval/fees.--------------
❑ 13. Flood elevatioh certificate. ---------------------------------------------
1114.
--------------------------------------------
❑14. Sanitation and plot plan approval Health Department.
1115. City of Chico plumbing permit. ---------------------------------------
❑ 16. Plot plan and business license approval from the City.of Biggs. ---
❑ 17. Planning approval for (A) Use: (B) Parking:
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel.
111. 9. Encroachment Permit for driveway (construction approval prior to occupancy). ---•
❑ 20. Pre -inspection for
required Request to Building Inspector on
021. Contractor's license information. (Number, Name Style, Classification).
,1❑22. Workers' Compensation carrier and policy number. -----------------------
V `�"l3. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). -
❑ tter of signature authorization. ------------------------------
. Recorded copy of Agricultural Acknowledgment Statement.
026. Letter of intent on building use.
❑ 27. Manufactured Home utility clearance.
❑28. E . o ations and/or fired permits. ------------------------------ --- --------------------------------
❑29 433 A t Deed,dJ�ZvLH. Title, heck to H.C.D $
030. Other: -------
When you issue the omit, process as follows ❑ Mail to owner, ❑Mail to contractor.
Telephone �� a and hold for pickup at �� 1 -office. Z7�
h inspector.
Applicant: ``— Datt
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Del
Copy of plans sent ❑ Health Department, ❑ Fire Department,
1. Index permit application for the above items numbered:
Date:.
Date:
(Date)
❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail,.d Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by o phone, o mail, o Building Division counter,.by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Dote:
Plans reviewed by: Date: Plans approved by: C-> Date: /L .
Sets of plans on hold in ❑ Plan Cabinet, o A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing'your sib,
Please complete and return this information at your earliest opportunity to avoid Unnecessary'deIay
in processing and issuing your building permit. No building permit will be issued until,ft
verification is received.
1. I personally plan, to provide the major labor and materials for construction of the proposed
property improvement: YES NO 0
2. I HAVE Ca HAVE NOT 13 signed an application for a building permit for the proposed vvo& .:: _ "4
3. I have. contracted with the following person (firm) to provide the proposed construction:''
NSE•
ADDRESS: CITY:
•itis
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work;' but I have hired the following persoiiatr; coordinate; .
supervise, and provide the major`Work:
NAME:
ADDRESS: CITY:. ,t::,..
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to prpvide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK''
SIGNED: ` �---
PROPERTYOWNER:,
SOCIAL SECURITY NUMBER:
DATE: -3
NOTE: This Owner -Builder Verification is required by Section 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
OVER
I OWNER BUILDER INFORMATION • _ -`1
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder otproperty
improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of jec on
a permit. Building permits are not required to be signed by property owners unless they are personally performing dteir
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a buiiriess'.
license from the city or county. They are also required by law to put their license number on all permits for.whIch.tlrey
apply.
Ifyou plan to do your own work, with the exception of various trades that you plan. to subeo
be aware of the following information for your benefit and protection: ` ntra %r`. �`', ►Y=,:.:.
♦ If you employ or otherwise engage ariy persons other than your immediate family, and thework(inc(tiding maLecisls`.r<
and other costs) is 5300 or more for the entire project, and such persons are. not licensed as Go or.
subcontractors. then you may be an employer. ,
♦ If you are an employer, you must register with the State and•Federal Governments as an employer and•1o4. .
subject to several obligations including state. and. federal income tax.withholding, federal social sectQit�►
workers compensation insurance, disability ins'urahc'e costs; and unemployment compensation contributions..
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are ,
%1L
There
with respect to worker's compensation insurance. .x
♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Setvic Amd,-
if you wish, the U.S. Small Business Administration). For more specific information about your obligations ander
State Law, contact the Department of Benefit Payments and.the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to petform dteir
work personally or through their own employees, without a licensed contractor or subcontractor, only under 119W
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally. -
Information about licensed contrac!prs may be obtained by contracting the Contractors State License Board in your-
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" lin the reverse side of this form so that we can confirm dtat.you-._.. .
are aware of these matters. The building permit will not be issued until the verification is returned
+irely. �Vi ira, C.B.O.uilding Inspection
NOTE. This Owner-Builder.Injormadon is required by Section 198.10 of the Calyornla XeaM and Sajety Coda
OVER
TIUS set01 f
2IIar-f*Id-spQ):,
A
ell. tile. A
-Palle a au tlm-tts P -71d it is UD7&. A
71
olanges ol' VfUI to
Written Per.mission from the
altere;U'013z on same without
W"rB- Gount3r or Ants. Dopmrtinaent Of.PLibliu
C
I /U A—
C
IAC All Mat&Ws
Workmanship Be In
nce with Recognized Good Practices and
of a Quality Prescribed for the
,6,' In the Unspecified use
iform. Bujjdjr4-, plumbing & Mecbanica�
Codes
and th@ Building,
39180tr1cW Code.
RV
t
Levu —1
Manufacture Year:
Mobilehome Manufacturer: 5LY �d� t'S 1� 2
If other than single wide, furnish Setup Model Number:
Width:j_(ft•) Length:__(ft•) Tagalong or Expando Size (ft•) x (ft )
after October 7, 1973,
On all mobilehomes manufactured furnish manufacturer's
installation manual and structural setup sheets.
FOOTINGS: Wood pressure treated or foundation grade[✓]Other:
SUPPORTS: Concrete block[✓ Other:
k
Provide Tie Dowp /6 %
n S ecifications for all Mobilehomes:
SINGLE WIDE
Line 1
Line 2�
Line 2
Line I
Pier
and
MULTI -WIDE
Mai. Beaa�c........................................: .
..................................... Main Beams
.............................................
Line S
....
..............
Tag or Triple e4
ine 1
Line 1 Piers:
Size minimum: x
Spacing maximum:
From ends -maximum: `
Line 2 Piers: / Jo
Size minimum: x
x, Spacing maximum:
From ends -maximum. ``'
Line 3 Roof Loads:
Size minimum a)4�n-- ,a
Location (from front):
Line 5 Roof Loads:
Size minimum:
Location (from front):
,ine 1 .
Line 2 '
2
Line 3
Line 2
Line 2
Line 1
Line 1 Openings
Size minimum: [ ] x [
Each side of openings
with width over: `
Line 4 Piers:
Size minimum:
Spacing maximum:
From ends -maximum. -L!
g„
OVER
9Z
o" I 57b',0" I "
j
01/13/99 15:41 BIDWELL TITLE 533-1589 4 5382140 N0.486 D01
" O Main Office ® Oroviile O Paradise
500 wall Sum 18351iobluson S[. 1126A Skyway
LaQonna Joyner P.O. Box 5173 P.O. BOX 811 F_O. Box 490
Pmaidem Chico, CA 95927 Oroville, CA 95965 Paradise, CA 95967
w s � �� _ (530) 894-2612 (530) 533-2414 (530) 877-6262
X530) S33-2553 FAX (S30) 533-1589 FAX (S3o) 872-5129
(530) 846.4583
FAX (530) 894-0713
S&Vbtc ow Aar&
stcjbw 7929
FACSIMILE TRANSMISSION
DATE: ]anuary 13, 1999
TIME: 3:37pm
p Gridley
560 Sc=zky Sc
P_O. Box 949
GMIBY, CA 95948
(530) 8484WS
FAX (SM) 846-0S84
FAX TO PHONE #: 538-2140
ATTENTION: Alice/Building Dept
SENT TO YOU BY: Cindy Costa ORIGINAL WILL FOLLOW
NO. OF PAGES - x_ ORIGINAL WILL NOT. FOLLOW
TO FOLLOW: 4
THIS FAX PERTAINS TO:
Your Ref. AP 027-310-011
Our No. 1-183002
RE-RECORDED GRANT DEED TO CORRECT LEGAL DESCRIPTION FORJOEL FORRESTER.
PLEASE CORRECT THE FORM 433A AND PROVIDE A RECORDED COPY OF THE
CORRECTED FORKTO THIS OFFICE. I WILL PREPARE A NEW AG STATEMENT FOR
MR. FORRESTER TO SIGN STATING THAT IT IS BEING RECORDED TO CORRECT THE
LEGAL DESCRIPTION IN THE ORIGINAL DOCUMENT. CALL WITH ANY QUESTIONS.
CINDY
0
encoax
p�7- 3/D- Oil
01/13/99 15:41 BIDWELL TITLE 533-1589 5382140 N0.486 902
xG `UKylNG REQUESTED, BY: '
5ID101 TITLE & ESCROW COMPANY RECORDED AT THE REKIUESrC F
81DWELL TITLE AND ESCROW COWAM
AND WHEN RECORDED MAIL TO: BUTTE COUNTY RECOROM
.�k 5 �
Joel Forrester � Wtwt ND�
P.O. BOX 1030 ORATE RECORDED;
Oroville CA 95965.
THIS SPACE FOR RECORDERS -USE ONLY
Grant Deed
Document Title (s)
THIS GRANT DEED IS BEING RE --;RECORDED TO CORRECT A TYPOGRAPHICAL ERROR
IN THE LEGAL DESCRIPTION
THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FOR RECORDING INFORMATION
(Additional recording fee applies)
01/13/99 15:41 BIDWELL TITLE 533-1589 4 5382140
RECORDING REQUMM By
DIDWSLL TMU & ESCROW COMPANY
Order# .1-193002
AND WHEN RP,CORDIM MAX To
Joel Forrester
3607 W. Longfellow
Spokane, WA 99205
' SPAM ABOVE TIM LMH FOR RBCORDPR'S USB
AN 027-310-011 Grant Deed
THIS FORD FURNISHHD BY BIDWELL TITLE & ESCROW COMPANY
The undersigned amtor(s) declote(s):
Documentary muWet tax is $19 . e o -
(x) o=putcd on fj!l ralu-. Of gro;.sr q ��: ve;�et:, or
( ) computed on fall value less HM and eummbrences remaining at time of sale.
(x) Unincorporated area ( ) Unincorporated
FOR A VALUABLB CONsmpRATION,receipt of Which is hereby acknowledged.
Robert F. Rabe and Gloria F. Rabe, husband and wife
hereby GRANTS) to,
,Toel Forrester, a married man
Me following described real pmeperty in tie Unincorporated County of Butte
State of California: gala ATTAt; M 11CH2DUL8 C FOR 1.8"L DRSCR28TION
Dated: May 11, 1998
r
Robert P. Ra e
State orcalifbmla
County of QLITT C-- 1 SS,
on"CL_ 1 I `_k rl Defbn; ma
the undenisnad, a NbAq Public in and for said State1ptraanally appearw
peMMlly known to the (or proved to me on qto Dasis of suislbctory aVidence)
to be ft rmn(s) whore tame(s) islste subw Abcd to tiro within inauumcm ino
acknowledged to me this helsficAbey ancuted the same in hiafhorllhoir
auth(Wiaed npaafty(es), and that by DitVpa Aheir slgnatum(s) on qm Jt dmalm
the penon(a) or rho tautly upon behalf otwhich the ptuaan(s) otaed ekecated the
It►s4eutoont.
W17N� " BSS my and amaial 11. n
$lgtmtutR
NAM ?/
and
Gloxi R. Rabe
i�
C1►NT}tlA A. 'ATo
t�llMi ito99ot to
Bum w
4 Ny pamnt. Etptrn oe1. s0.20no
Mitt arae for oaciol sssaarkat tical)
N0.486 D03
i 995•-�0 1922!
Recorded
AfficialyRecordb
I REC KE 18.
i TAXCount 19.6id
Of
M=g Jt@0 98
"AMM 13-NdY-1998
I
I Page 1 of 2
' SPAM ABOVE TIM LMH FOR RBCORDPR'S USB
AN 027-310-011 Grant Deed
THIS FORD FURNISHHD BY BIDWELL TITLE & ESCROW COMPANY
The undersigned amtor(s) declote(s):
Documentary muWet tax is $19 . e o -
(x) o=putcd on fj!l ralu-. Of gro;.sr q ��: ve;�et:, or
( ) computed on fall value less HM and eummbrences remaining at time of sale.
(x) Unincorporated area ( ) Unincorporated
FOR A VALUABLB CONsmpRATION,receipt of Which is hereby acknowledged.
Robert F. Rabe and Gloria F. Rabe, husband and wife
hereby GRANTS) to,
,Toel Forrester, a married man
Me following described real pmeperty in tie Unincorporated County of Butte
State of California: gala ATTAt; M 11CH2DUL8 C FOR 1.8"L DRSCR28TION
Dated: May 11, 1998
r
Robert P. Ra e
State orcalifbmla
County of QLITT C-- 1 SS,
on"CL_ 1 I `_k rl Defbn; ma
the undenisnad, a NbAq Public in and for said State1ptraanally appearw
peMMlly known to the (or proved to me on qto Dasis of suislbctory aVidence)
to be ft rmn(s) whore tame(s) islste subw Abcd to tiro within inauumcm ino
acknowledged to me this helsficAbey ancuted the same in hiafhorllhoir
auth(Wiaed npaafty(es), and that by DitVpa Aheir slgnatum(s) on qm Jt dmalm
the penon(a) or rho tautly upon behalf otwhich the ptuaan(s) otaed ekecated the
It►s4eutoont.
W17N� " BSS my and amaial 11. n
$lgtmtutR
NAM ?/
and
Gloxi R. Rabe
i�
C1►NT}tlA A. 'ATo
t�llMi ito99ot to
Bum w
4 Ny pamnt. Etptrn oe1. s0.20no
Mitt arae for oaciol sssaarkat tical)
01/13/99 15:41 BIDWELL TITLE 533-1589 4 5382140 N0.486 004
• " Or4er No. 1-183002
SUMDULE C
'A 1 T14t
All that certain real property in the
described as follows: California, Co4nty of Butte,
The Southerly 403 feet of the Northerly y
feet of Lot 54shown
on that certain Map entitled, "MaP Subdivision o. 1.5 Ofntheock PalermoSCitrus
S
Tract", which Map was filed in the office of the Recorder of the County of
Butte, tate of California, February 28, 1888.
Reserving therefrom the following described 'real property: The Southerly 165
feet of the Northerly 342 feetof the Easterly 180 feet of Lot 5, in Block 54,
as shown on that certain map entitled, 'Map of Subdivision No. 1, of the Palermo
Citrus Tract", which map was filed in the office of the Recorder of the County
Of Sutte,.State of California, on February 28, 1888.
01/13/99 15:41 BIDWELL TITLE 533-1589 4 5382140
SPATE OF L�! YQil.IV l
N0.486 D05
COUNTY OF _ �
0D — �,before me,.,
Date, a Notary Public
ptrS my appeared �~ TUAE AmD tLoej �-
Name(s)'of signe(s)
SAY 00W*40-Me4� proved to me on the basis of
satisfactory evid=e) to be the pmcm(s) whose mme(s) is/are
subscribed to the within instrument and acknowledged to me _
that be/she/they executed'" same in lds/ber/their authorized
capaeity(es), and that bar bis/her/their signatures) on she
insuumeAt the peraon(a), or the etulty upon behalf of which CYN ` A CO A
the pemm(s) acted, executed the instrument. m -„^ tta�rAc01
owwou�
Q counrrr o� eurrE
by Camn� EnIfea tier. 90, 2609'.
�k
('Phis area for Official notarial seal)
Tbis Notary is attached to thl certain � ?i' ( , dated
0
LEGAL DESCRIPTION
A.P. #027410-011
All that certain real property situate in the County of Butte, State of California, described as follows:
THE SOUTHERLY 403 FEET OF THE SIBbqifEfetY 580 FEET OF LOT 5 IN BLOCK 54
AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF SU13DIVSIONS NO. 1, OF
THE PALERMO CITRUS TRACT", WHICH MAP WAS FILED IN THE OFFICE OF THE
RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, FEBRUARY 28,
1888.
RESERVING THEREFROM THE FOLLOWING DESCRIBED REAL PROPERTY: THE
SOUTHERLY 165 FEET OF THE NORTHERLY 342 FEET OF THE EASTERLY 180 FEET
OF LOT 5, IN BLOCK 54, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF
SUBDIVSION NO. 1, OF THE PALERMO CITRUS TRACT", WHICH MAP WAS FILED IN
THE OFFICE OF THE REOCRDER OF THE COUNTYOF BUTTE, STATE OF
CALIFORNIA, ON FEBRUARY 28, 1888.
RECORDING REQUESTED BY
BIDW* LL TITLE & ESCROW COMPANY
Order # 1-183002
AND WHEN RECORDED MAH, TO
Joel Forrester
3607 W. Longfellow
Spokane, WA 99205
III "III'I'I�I'NI"IIIIII II�I"I
1 998—Qy01 9Z24B
Recorded I REC FEE 10.00
Official Records I TAX 19,80
Countyy Of I
CANDACEuI GRUBBS I
I
I Fay
09:9" 13 -May -1998 I Page 1 of 2
SPACE ABOVE THIS LINE FOR RECORDER'S USE
AP# 027-310-011 Grant Deed
THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY
The undersigned grantor(s) declare(s):
Documentary transfer tax is $19.8 0 -
( x ).computed on fuld value of property conveyed, or
( ) computed on full value less liens and encumbrances remaining at time of sale.
(x ) Unincorporated area ( ) Unincorporated
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Robert F. Rabe and Gloria E. Rabe, husband and wife
hereby GRANTS) to
Joel Forrester, a married man
the following described real property in the Unincorporated County of Butte
State of California: SEE ATTACHED SCHEDULE C FOR LEGAL DESCRIPTION
Dated: May 11, 1998
Robert F. Rabe
State of Caliform
County of a,-8'LlT rC, } SS.
On N\" � \ , k"\':� i� before me,
the undersigned, a Public in and for said State personally appeared
personally known to me (or proved to me on the basis of satisfactory evidence)
to be the person(s) whose name(s) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(es), and that by his/her/their signature(s) on the instrument
the person(s) or the entity upon behalf of which the person(s) acted executed the
instrument.
WITNESS my and and official I.
Signature
MAIL TAX STATEMENTS TO Same As Above
r
Gloria E. Rabe
, and
CYNTHIA A. COSTA D
N i COMW 1103301
1 _� NQTARiY PUBLIC-CALIFORN'A N
Q COUNTY OF BUTTE w
My Comm EXplres Oct 30, 2000
(This area for official notarial seal)
o�
Order No. 1-183002
SCHEDULE C
All that certain real property in the State of California, County of Butte,
described as follows:
The Southerly 403 feet of the Southerly 580 feet of Lot 5 in Block 54 as shown
on that certain Map entitled, "Map of.Subdivision.No. 1, of the Palermo Citrus
Tract", which Map was filed in the office of the Recorder of the County of
Butte, State of California, February 28, 1888.
Reserving therefrom the following described real property:. The Southerly 165
feet of the Northerly 342 feet of the Easterly 180 feet of Lot 5, in Block 54,
as shown on that certain map entitled, "Map of Subdivision NO. 1, of the Palermo
Citrus Tract", which map was filed in the office of the Recorder of the County
of Butte, State of California, on February 28, 1888.
F'LE -COPY
• DEPARTMENT OF HOUSING
• 2986 Bechelli Lane #201
• Redding, CA 96002
•
In
Date: August 12, 1998 �p-IY'pleasereferto:
Office
Oroville
Order M
1-183028-cac
Re : Elder/Forrester
Any recorded documents to which you may be entitled, and your policy of title insurance, if not enclosed; will follow under separate
cover.
In the event your deed was recorded after the first day of January, we suggest that you contact the County Assessor in order that you
may receive future tax bills promptly. First installment of taxes becomes delinquent on December 10 and the second installment on
April 10.
We appreciate your business. If at any time in the future we may be able to assist you or your friends in any way, we shall be pleased
to have you indicate your preference for BIDWELL TITLE & ESCROW COMPANY.
Sincerely,
YOUR BIDWELL TITLE AND ESCROW TEAM
We enclose the following checked items:
Q Check
❑ Note Original
❑ Note Copy
❑ Payment Book
❑ Escrow Statement
❑ Final Settlement Statement
❑
❑
❑
0
❑
❑
Cindy Costa, Escrow Officer
Fire Insurance Policy No.
Bill of Sale
Title Policy
Completed Dealer Transfer
DEPARTMENT USE ONLY
TRANS CODE
'
'
S I A It OF CALIFORNIA +.ry
BUSINESS. TRANSPORTATION, AND HOUSING AGENC`'
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPR `ems
DIVISION OF CODES AND STANDARDS his,
MANUFACTURED HOUSING PROGRAM il.}"
�a
DEPARTMENT USE ONLY
DECAL NO.
I
a�
DEALER REPORT OF SALE OR LEASE WITH AN
OPTION TO BUY A USED MANUFACTURED HOME,
STICKER NO.
SITUS CC
EXP DATE
TAX TYPE
MOBILEHOME, OR COMMERCIAL COACH
ILT I EXT
st n
L D 1✓
ORIGI a LE R E PRICE ILT EXEMPT
®. SFD ❑ F. OCC GROUP
T CODE RATING YEAR
CURRENT SALE. LEASE PRICE
CURRENT SALE n LEASE DATENAME OF MANUFACTURER
MFG LICENSE NO.
MANUFACTURER TRADE NAMEMANUFACT,tURE
l7 )
MODE( NAME OR NUMBERDATE
o
OF MANUFACTURER
G'Cr( %
FOUNDATION TYPE I�seY ons)
❑ 18551 Iperml. 18613 Iden . ❑ 18555
DATEci1RST SOLD `
1 N
y�
SECT I1•4I DECALIIICENSE f
MANUFACTURER 6ERIAl NUMBERI61
HUD LABEL a NCD INSIGNIA NUMBERIS)
LENGTH fir h
WIDTH Iind—)
WEIGHT Its)
4 C
LID
/ 31
D
L
C, 21 /-� t'
L� L i 3 Ll
ADD SECTIONDEPARTMENT
❑
USE ONLY
Receipt Number:
Reeeip[ Date:
CLERK
Registered
Owner(s)
true
narnels)J
Last First Middle
_
t,[print �a,2JT SiCot
PPF
RF
_J? t=a { C c.
ILT
3.
MRF
If applicable, check one of the following: ❑ TENCOM OR ❑ JTRS ❑ TENCOM AND ❑ COMPRO
PEN1
Current Mailing
Address
Street " _
PEN2
City ounty State
c� .9 i�
Future Mailing
Address (if
Street .
F. c-; b .x 10 3 c,
TRF
different than above)
TOO
DUPT
Cit " County tate Zip
SitUS (location)
Address of Unit
Street
E
ouPR
SUED
Cit
Ci County State
'/7� Zip
�• +L.O I L.. l 1J� T i >`_ 1, S % �•
Legal Owner
amolder) (print true
ne
amlsll
�✓ -�
CONF '
REPO
If applicable, check one of the following: •❑ TENCOM OR ❑ JTRS ❑ TENCOM AND ❑ COMPRO
RREG
Mailing Address Street City State Zip
RSF
Junior) N /
Lienholder (Print
PLT
true names(s)I
SIT
UTP RT
ASF
('CP
If applicable, check one of the following: ❑ TENCOM OR ❑ JTRS ❑ TENCOM AND ❑ COMPRO
Mailing Address
Street City State Zip
ADD JR/LHCERTIFICATION
The applicant and dealer signing below state to the best of their knowledge and belief that all statements made in this application are true and correct. The dealer certifies that
the described unit is in compliance with all provisions of the Health and Safety Code and Department regulations adopted pursuant to the Health and Safety Code.
SIGNATUR OF NEW REGI�ITERED OW--NEE-R(SSl:
1. X �_ _ Y ri.�.._�.•.�( _� TOTAL
2. X
3.
C
TURE OF
DEALER ADDRESS: I "7 .7 n ')11 i C �-L • =l. "� �+- L' _ t;., �., . `_ r /� -- T _ _
r`t u
DATE STAMP AREA
MCD 480.3 (REV 10196) Copy 1 - Department. Copy 2 • Purchaser, Copy 3 - Tax Assessor. Copy 4 - Dealer Book No. U 2 8 8 3 21
STATE OF CALIFORNIA
-JSINESS, TRANSPORTATION AND HOUSING A06NCY
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
DIVISION OF CODES AND STANDARDS tF�•'=
REGISTRATION AND TITLING PROGRAM
STA7FIAENT OF ERROR OR ERASURE
Decal (License) Numbers) Trade Name Serial Number(s)
COY,������c� eq� X31
The name appearing on or erased from line �L on the
amc o ocumcnt or orm
was in error and has no bearing on the ownership of the unit. The name signed or erased should not be part of the ownership record.
Ewa the mason av, ME Error or erasure In t is S(lacc.
1
I certify under penalty of perj ry th t the foregoing is true and correct.
Executed on _ �J C at
ac
I ly laic
Signature��%�
Address
City/State
HCD 475.6 (REV. 5/91)
N'Q,
STATE OF CALIFC. .IA -DEPARTMENT OF HOUSING. D COMMUNITY DEVELOPMENT
CERTIFICATE OF TITLE MOBILEHOME DECALNO.
-MANOFACTURER NAME•/ID TRADE NAME MODEL DOM DOT DFS SPC LASiRA3or:
SKYLINE HM INC/90002 OAK MANOR OKH1202 03/19/92 03/20/92 03/31/92
U SE
T 067006218E
2 06700621AE
3
a
�5
6
ULI345665
A ELDER GERALD D/
D CONNIE D JTRS
D 1181 ELLA AVE
R MARYSVILLE CA 95901
E
S
S
E
R ELDER GERALD D/
E CONNIE D J TF.rS
OM
s I 118 LLA AV ,
T LX
E MARYSVILLE w CA 95901
R
D RELEASEXOF REGISTERED OWNER
P S 1181 ELLA AVE
N T Ra��
E u MARYSVILLE r ..�....��
R s CA 95901....:_. ?
1
L 7
��yc" i .�.........
.._...:� ..
L.—........... a
{{{f
A
L
O �l� ! I x
W
E
2.A)
R RELEASE OF LEGAL OWNER
A01,
RETENTION!:bFXLEGAL OWNER
C)z
ASSIGNMENT OF LkGALSQYTNER
J
000720 000156 05�OL92
000720 000156
TOTAL
FEES
PAID:
$57.00
Em
SFDE I Lf
3.)\,\) Rx
l� E� k.9 br:A
NEW R GISTERED OWNER, FILL IN I S 4 9 THE
4.A)
D
'
ORS)
1 NAME - PLEASE PRINT
` u L ^.—"T MAX, !OGRESS
CITYy— CNTY ST ZIP
FUTURE MAILING,• ADDRESS
14
C x?:gv? CNTY,, ST ZIP
S (.e• 'VO
N9q REGISTERED OWNER SIGNATU E l
t `
R NEW LLCAL`OWY=R, FILL IN ITEM9o10 - 12
12.
CITY
>E NEW IST JR.
E
13.
NAME - PLEASE" PRINT'
ADDRESS:
CNTY ST ZIP
r FILL IN ITEMS 13 - 15
U F� qIlk: NAME - PLEASE PRINT
qr
N Z
I R ; 4» ?
� g. y
O S
R T
L
I
E
N S
N E
O C
L O
D N
E D
R
ADDRESS
15.
CITY CNTY ST ZIP
ifiHE NEW 2ND JR. LIENHOLDER, FILL IN -ITEMS 16 - 18 **X
16.
17.
NAME - PLEASE PRINT
ADDRESS
18.
IMPORTNT CITY CNTY ST ZIP
THIS CERTIFICATE OF TITLE MAY NOT REFLECT AALL LIENS RECORDED 14ITH THE DEPARTMENT 01=119-0233
OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. THE CURRENT
TITLE STATUS OF THE UNIT MAY BE CONFIRMED THROUGH THE DEPARTMENT. 0100062
DEPARTMENT USE ONLY
TRANS CODE
SITUS CC
Manufacture Trade Name
DECAL/LICENSE I
DEPARTME T
LOSE ONLY
Registered
Owner(s)
STATE OF CALIFORNIA°=V)` -•I�I�.�
BUSINESS, TRANSPORTATION AND HOUSING AGENCY �f:,DEPARTMENT USE ONLY
DEPARTMENT OF HOUSING AND COMMUNITY DEYELOPM 4,���na� NEW DECAL •
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TITLINOgROORAM---
STICKER I
APPLICATION FOR DUPLICATE
REGISTRATION CARD OLD DECAL • -
1�1,— NIManulaeture Mc" Name or I ILT
1 MANUFACTURER SERIAL NUMBERS)
Lass
DA
IPT DATE(S)
Flyd
1
COS
HUD LABEL OR HCD INsleula a
Middle
'S IN
[Print true
name(s)] _
z con3.
�C I
Current Mailing SUM
Address V'
city 1
Future Mailing street
Address In �� t
dMererd man above) City Cotrim
st.1. Zip
Situs poc.Uon) Street
Address of unit
co.r
�
Legal Owner city State ZIP
(Uenholder) IWInt trw
—W)
Mailing Address Strew CM
State Zip
First Junior
Uenholder
(prim true mama)
Mailing Address Strew
city state av
Second Junior
Uenholder
(prim trw tiro.)
Mailing Address Strew
city Stale
=+v
Mobilehome Part Name
Park
Operetw Name
I/We certify under penalty of per)u under the laws of the State of California that the foregoing Is true and correct and that the
►egistration c:7s:N
'r� LOst, ❑ Stolen, ❑Mutilated, ❑ Illegible
Executed on '` \g r ❑Not Received
at ��C�L L� .�I,.��RYI)
Signature of Applicant
HCD 441.2 (HEY 11/9?)
Lf
CONDITIONAL TAX CLEARANCE CEnTIFICATE
(] Mobilehome
eSi-nuW LUMPANY NAME & ADDRESS
BIDWELL TITLE & ESCROW CO
1835 ROBINSON STREET
OROVILLE, CA 95965
NAMt: 6 AUUnt55 OF CURRENT REGISTERED OWNER (SELLER)
FORRESTER, SAM
FORRESTER, MARIE
1339 COX LANE
OROVILLE, CA 95966'-:-
NAME
5966 :'
❑ Floating Home
Date Requested: 06/18/98
ESCROW NUMBER NAME & PHONE NUMBER OF ESCROW OFFICER
1-183028 CINDY COSTA
(530) 533-2414
NAME OF BUYER (APPLICANT) & ADDRESS TO WHICH FUTURE TAX STATEMENTS SHOULD BE MAILED
FORRESTER, JOEL-
FORRESTER, RAESHELL
P 0 BOX 1030
OROVILLE, CA 95965`.'
MAKE
SKYLINE
MANUFACTURER'S SERIAL NUMBER(S)
06700621A/BE
YEAR
LOCATION OF HOME NOW:
1339 COX LANE
OROVILLE, CA 95966
Parcel Number (If known►:
910-026=034/027-220-064
AFTER ESCROW:
1339. COX LANE
OROVILLE,':, CA 95966
Parcel Number (If known):.
1992 910-026-034/027-220-064
DECAL (LICENSE) NUMBERS)
LAS 6309
CERTIFICATION OF TAX COLLECTOR
To pay taxes in accordance with various provisions of law and to satisfy provisions of section 18092.7 of the Health and Safety
Code, the total amount of 3 340.00 N/ le'���'/3I must be paid on or before 08/22/98
If not Eo paid, the amount of $ . 340.00 2
must be paid on or before 08/77/98
THIS CERTIFICATE IS VOID ON AND AFTER 08/22/98
06/24/98 (date)
Executed on at OROVILLE, CA
(date) (city)
County tax collector for BUTTE
County, State of California.
-
Issued on 06/24/98
(date)
(Signature a title o ax official)
CYNTHIA SWENDEMAN p
CERTIFICATION OF ESCROW OFFICER
I hereby certify under penalty for perjury that the tax liability stated above has been paid in full on or before the date required and all
terms of this statement of conditional tax clearance have been complied with. A copy of this certification has been returned to the tax
collector with the payment. t
E,;ecuted on I:�
(dat
ate) city. nate)
Escrow closed on I J _ y-\,� ,l1 y l�R'Q--
(Signature of escrow
§ 18092.7 H & S Code
TDL 10-02 (1-88)
STATE OF CAUFORNIA
DEPARTMENT USE ONLY BUSINESS, TRANSPORTATION AND HOUSING AGENCY
EC DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TITLING PROGRAM
TRANSACTION CODE P.O. BOX 1828, SACRAMENTO, CA 95809-1828 is
HCD 481.8 (Rev. 09/91) �^a^�
NOTICE OF ESCROW CLOSING
DATE STAMP AREA
Retain the yellow copy for your records. If the escrow is closed prior to your receipt of acknowledgement from HCD that the
escrow has been recorded on the Department's records, then complete the Notice of Escrow Closing section and return this
copy with the completed ttrr(ansfer application to the Department at the above address.
Escrow file number : � " ���
established for the described mobilehome has been closed.
I am submittiI(DATE)
nsfer application to the epartmen for processing.
� , Executed on at ��Cf (C
(STATE)
Signature of Escrow Agent
DESCRIPTION OF MOBILEHOME
0 5
. , r:y, �.
Y.y"-i�' �3..a t'�Yf'yh � s � jc r� t �t a ?• i �
7tLRE ;
}
MM
r,UNIT ,.
`DECAL (LICENSE) NUMBER
,"" i''
SERIAL
HUD LABEL OR HCD INSIGNIA NUMBER
i �^
jNUMBER.-
2
�
i t:S.j� �U l� �`.f � ��` Cts,
�. •.,l\. ` �j h- � : � y,
3
;
4 `
5
6
ESCROW INFORMATION
'��`• 'yam` ISTREE7)'
5 i 1 i (STATE)
(FIRST)
C'
V AGENT _ 1 •�--•
(CITY)
BUYERS NAME
DEALER NAME
SIGNATURE OF
ESCROW 'FILE,
1 ,�•'•"'1 •) I TELEPHONE NUMBER
AR2A CODE -1_
DEALER NUMBER
1• 11 l
COPY 2—YELLOW Retain for your records. Return to the Department only if the escrow is closed prior to your receipt of
acknowledgement from HCD that the escrow has been recorded on the Department's records.
` STATE OF CAUFORNIA
DF '.TMENT OF HOUSING AND COMMUNITY ' TLOPMENT
DIVISION OF CODES AND STANDARDS
MANUFACTURED HOUSING SECTION
MCD 473.'; IRev. 84M NAME STATEMENT
I am applying to be or have been the registered owner of the following described unit:
DECAL OJccENsE) ;N�UMBRtM MANUFACTURER TRADE NAME SERIAL Nps
ER
Statement of oneand _
I• �( I •
and the same per- C ... ` l .:� �;�'
son are one and the same person.
B. Statement to A name is incorrectly spelled on the Department's records. I request the records be corrected. THE CORRECT SPELLING IE
Correct (Please print) LAsr NAME
Misspelled FIRST NAME MIDDLE NAME
name
C. I have changed g my name without intent to defraud.
Change of FROM (Pleaseprin!)
mom* ;TO (Please print)
(hdiviat.at only) I
1 cerci y under penalty Of penury that the lorepoiny is lrue and coned.
Executed on
y\ \ U at
IDAM
ICrrY) iSTAT
V30
Decal (I cease) Number(s)
For
For the sum of
3v 9 -
STATE OF CALIFORNIA
BUSINESS, TRANSPORTATION AND HOUSING AGENCY
DEPARTMENT OF HOUSING, AND COMMUNITY DEVELOPMENT
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TTI71NG PROGRAM
BILL OF SALE .
Trade Name Serial Number(s)
DAxhi'AMb.;�
` dollars (3 �} and/or other val bl d^
ua a const era, on m the amount of , the receipt of
u er
on the �� y of ' ��1 A2 my/our right title interest in and to the above described unit.
I/We certify under penalty of perj that: (1) Uwe are the lawful owner(s) of the unit, and (2) Uwe have the right to sell it, and (3)
I/we guarantee and.will defend th:, title to the unit against the claims a_nd.demz-ds of any and a1 persct:.s :^si:.g r.inr to th:s e. -*,--
and
(4) the unit is free of all liens and encumbrances, except for the lienholder shown below*, whose lien presently exists and has
not been paid.
Signature of Seller X ', .
Date
Signature of Seller)( Date
Place of Execution (Address) City State/Zi
p
NOTE: The space below is NOT for liens created by the buyer in this transaction.
Lienholder Address City/State/Zip _0
HCD 475.1 (REV. 5/91) REPRODUCED BY MID VALLEY TITLE AND ESCROW COMPANY
Reproduced by First American Title Insurance Co. (MHBS)
STATE OF CALIFORNIA
BUSL SS, TRANSPORTATION AND HOL__,4G AGENCY
DEPARTMENT OF HOUSING AND COMMUNTTY DEVELOPMENT
' DMSION OF CODES -AND STANDARDS
REG'M RA nON�1�•
AND TT7..Ud G SECTION
STATEMF-N-r OF FACTS - SMOKE DETECTOR
cJl.Klrl]Ul
cense) No.(s) Trade Name
LAS6309 OAK MANOR
Serial No.(s)
06700621B/AE
u vre the undersigned hereby state that the unit described above is equipped with an approved smoke detector
%4,Mcb is in proper working order as of_ 2�i o% yg
I certify under penalty of perjury that the fort foregoing (Date)
g g is true and correct.
Fxecut.cd on �jlC•`�
(Date)
NO FEE.. -54 c c s (City) (Scale)
Signature!7R_E_+0H4M9—SE4Pr —h2
Address
Ci State
HCD 476.6A (REV. 5/91)
Xc:11
or the su
he amou>a
STATL OF CAt_1FORNIA
DUSIIJESS, TRANSPORTATION AND HOUSING AGENCY
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
DWISION OF CODES AND STANDARDS
REGISTRATION AND TITLING PROGRAM
er(s) Trade Name
n the day or
AVC certify under Penalty of perju
lwc guarantee and will s
rid
Serial Number(s)
' dollars S
( )and/or other.ya� consideration in
the receiPt of which is her c1MO\vlcdged_1A,-vi � sell, transfer and deliver to
]9
. M)'/6u t title a.Pe)'tn(eres11 t in and to the above described unit.
1M c: ar lau'rit r�s):'of tht,. i�it;'�nif� 7
(4) In o all liens and encu
of been laid. .4
'gnature of Seller
• ,naturc of Scllcr
:ace or % cecut.,A
NOTL-:-Thc
�Clatmsca cmands of an and all: c 1 I. and (3)
for the licii7i'o " how. y ,-M'a sr S r,or to this date
lxlerw''+Bose lien Presently exists and has
,' r t
Date
kzll
tt. Address City/State/Zip
CD 475.1 (REV. 9/9])
r
Decal (License) Number(s)
LAS6309
ju iuc L.Jcpartment
1 (print full name),
I (print full name),
STATE OF CALIFORNIA
BUSINESS, TRANSPORTATION AND HOUSING AGENCY
DEPARTMENT Of I MUSING AND COMMUNITY DEVELOPMENT J `�
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TITLING PROGRAM } +
POWER OF AMRN-y
---F
Trade Name
Serial Numbers)
OAK MANOR 06700621B/AE
Housing and Community Develop lent, and to whom it may concern:
I (print full name),
the undersigned do hereby duly appoint the following named person, � C
f3IDWELL TITLE :� ESCROW COMPANY ((3TEC)
to act as my attorney in fact, only to sign papers and documents that may be necessary in ordei to secure California registration o
Or to transfer my interest in the above described unit.
b f
I further agree to guarantee and save harmless the State of California and the Director of Housing and Commu
all responsibility which might accrue from the issuance Of California registration or transfer of such unit. nity Development from
NOTE: An attorney in fact cannot make an affidavit or certificate of the truth of facts unknown to him.
Signed NO FEE,,q S
Signed BY: Date
6
Signed Date 7-6-98
HCD 475.4 (REV 5/92)
Date
--mow k-1-11se) Irvumner(s)
LAS6309
, ti..
STATE OF CALIFORNIA
BUSINESS, TRANSPORTATION AND HOUSING AGENCY
DEPARTMENT OF I IOUSING AND COMMUNITY DEVELOPMENT
DIVISION OF CODES AND STANDARDS
REGISTRATION AND 'TITLING PROGRAM
POWER Or ATTORNL-y
Trade Name Serial Numher(s)
OAK MANOR 06700621B/AE
- -i--- us ,,.,umnb anu community Development, and to whom it may concern:
I (print full name), FORRESTER
JOEL
I (print full name),
RAESHELL
I (print full name),
the undersigned do hcrch ---------------------------
NO ryl8lp3?[�8M911g12`�m� int
person,
BIDWL'I_L 'TITLE & ESCROW COMPANY (11T,C)
to act as my attorney in fact, only to sign Papers and documents that may be necessary in order to secure California re istration of
or to transfer my interest in the above described unit.
g
I further agree to guarantee and save harmless the State of California and the Director of Housing and CommunityDevelopment
all responsibility which might accrue from the issuance of California registration or transfer of such unit.
NOTE: An attorney in fact cannot make an a davit or certificate of the truth Of facts unknown to him. from
Signed °
X-'
Signed RAESHELt FORRESTER Date 7-6-98
Signed - Date 7-6-98
HCD 475.4 (REV 5,02) Date
h 06,
r
a
�o Q;
STATE OF CALIFORNIA
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
DIVISION OF CODES AND STANDARDS
REGISTRATION AND TITLING SECTION
0
(Information pertaining to co-owner statutory requirements
appears on the reverse side of this form)
DESIGNATION OF CO-OWNER TERM
This unit is a: 0 Mobilehome E] Commercial Coach
Decal(License) No (s) T
Floating Home
rade Name Serial No.(s)
LAS63O9 OAK MANOR O67OO621B/AE
Truck Camper
We request the Department of Housing and Community Development to register our
ownership interest in the unit described above with the following co-owner term:
(READ_ THE FOLLOWING AND CHECK THE APPROPRIATE.BOX)
JTRS, Joint Tenants With Right of Survivorship
Upon the death of a joint tenant, the interest of the deceased party passes to
the surviving joint tenant. The signature of each joint tenant is re uired to
transfer or encumber the title. q
TENCOM AND, Tenants in Common with the names joined by the word AND
Each tenant in common may transfer his or her individual interest without the
signature of the other tenant(s) in common. The signature of each tenant in
common is required to transfer full interest in the title to a new registered
owner or to encumber the title.
TENCOM OR, Tenants in Common with the names joined by the word OR
Any one of the tenants in common may transfer full ownership interest in the
title to a new registered owner without the signature of the other tenant(s)
in common. The signature of each tenant in common is required to encumber the
title.
El COMPRO, Community Property
Full ownership interest in the title may be registered as community property
in the names of a husband and wife. The signature of each spouse is required
to transfer or encumber the title.
SIGNATURE OF EACH C0 --OWNER:
JOEL_FORRESTER :X.'
RAESHELL FORRESTER - ;_X_- ► / --- , �` 1�Lc-----------------------
DATC 7-6-98
11CD 1%3.1 (;)EV 10/86)
L 2_
AP. - Lq 3&
0419
LIFETIME EXTERIORS
8054 MELVINA AVE 530-533-3421
90-4202/1211
PALERMO, CA 95968
AY
1913
To_,
s
OLLARS t. -d d.
L
Butie
community =nl
1.888-84BUTTE (28883)
FOR
NP
i:1211L,202Si:020000'i?213,,NOL-Lq�
0NA ND1995
RESIDENTIAL
027-310-011 PERMIT#99-44E) —
PERMIT NO. FORRESTER, Joel
81S51�Melvina Ave., Palermo
PERMIT EXPIf Mobilehome Utilties
OWNER _
CONTR.
I
i
ASSESSOR PARCEL
qo
LOCATION
I S
OFFICE COPY
Address
GAS
Meter By
ELECTRIC Date_
Meter By Dat
CHECKED
M' SRA BY
FLOOD'CERTIFICATE REQ. .
FIRE SPRINKLERS REQ.
SPECIAL.INSPECTION ITEMS
VERIFY
Temp. Power Pole
Called PG&E
r
Temp. Elec. Service
Called PG&E
Temp. Gas Service
Called PG&E
JOB FINALED (Date)
Signature
V=OK
O = Not OK
`=ttealdy
ble
NoRMOBILE HOMES
K. Z4g Requirements - Setbacks - Easements
yK- Special MH Support Sketch
&,OGas; Locafion-Test-Wrap; / /9_Yt.
/ /Nat. or 'L1ft G
7. We arance & Dibconnect
Ar. -Utility Clearance
Date %;94-010-W Card B- Date Card 8-1
Date Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
A_,7'. Zoning Requirements- Setbacks Easements
(,2"Footings; Size -Spacing -Marriage Line
as; VH Test-DemandVah e -Connector
EI 'city; MH Test -Crossovers -Breakers -Clearances
5 rain; MH Test Fall -Flex Connector
ice— r ater; MH Test -Regulator -Connector
r� Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
ie Downs- pe -Installation Cert.
x' nsp.Sketch
Cert of Occupancy
12. Permanent Foundation Only: License Decal
Dat and B- Date Card B-1
Date Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils-Size-DepthSpacing-Connectors-Steel
3. Decks; Girders and/or Joists-Decking-BracingStairs-Rails
4. Wood Awn.; Posts-Beams-Rttrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sits-AnchorsStuds-Rftrs-Trusses
9. Siding; Nailing VeneerShicco-Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -lendings
12. Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed .
7. Elec.; Bonding; Metal wp3-Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5 Circulating Equip. -Pool Lghtq.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
Date
Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
0= Not OK RESIDENTIAL (Single & Duplex)
- - No t I'ceble
Apps
Not Ready
Date UNDERFLOOR (Plans) OK except #a
1. ZoningSetbacks-Easments-FloodSlope
2. Ftg., Main; Soils-Elec. Gmd. / P Ftg. Depth
3. Ftg. Garage; Soils-Steel-Elec. Gmd/ P Ftg. Depth
4. Ftg. Porches & Decks; Soils -Steel-/ P Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test
10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists Vents-Crippies
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except #'s
17. Water Htr; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sae & Anchors
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
23. Fixture & Transformer Clearance -Ins. Protection -
24. Elec. Receptacles Spacing -Lights & Switches at Doors
25. Size Bo es & No. of Conductors Stapled
26. Romex kstalled Close to Edge of Studs & C.J.
27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water
28. 2 Appliance Circuts in Kitchen & Conductor Size GFI
29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI
30. Range Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or AI
Insulated Neutral 0 Yes 0 No
31. Service -Riser Conductors & Ground -Main Disconect
32. Equip. Clearances Panels -Motors -Meth. Epuip.
33. Clothes Closet Light -Shower Light -Spa Light
34. Smoke Detector
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except #'s
35. A.C. Ducts Insulation & Support
36. Vent Fan, Exhaust above insulation
37. Condensate Drain & Overflow, Size & Grade
38. Fumance-Vent Access -Comb. Air -Return Air Vent 115 outlet
39. Attic Access & Platform if Furnace in Attic
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except #s
40. Sits Proper Materials & Anchors
41. Walls Studs -Nailing Spacing & Braces -Plates -Sound
42. Bearing Walls over Girders & Floor Nailing
43. Draft Stop in Walls (rat proof)
44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45. Headers & Beams -Size & Bearing
Date
FRAMING (Continued)
46. Hangers -Post Caps -Anchors -Connectors
47. Cling. Joist-Rftr Ties-Purlin-roff Brac.-Truss-Shting.-Ring.
48.
Fireplace Ties or Type A Flue -Fireplace Throat clearance
49.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
51.
Garage Fire Protection Framing
52.
Property Line Firewall & Openings
53.
Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits
54.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56.
Siding -Nailing Veneer
57. Stucco Mesh -Drip Screed-Fd.Vents-Underflr. Access
58.
Glaang Area -Glass Protection -Skylights -Plastic
59.
Shear Walls; Nailing -Bolts
60. Brace Interior / Exterior Wall Panels
61.
Insulation -Walls -Ceilings
62.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
63.
Ext Steps -Door & Sidelight Protection -Landings
64.
Smoke Detector
65.
Furnace; Vents -Clearance -Comb, Air-Conector-
In Garage; Above Floor-Ducts-Mech. Protection
66.
Bedroom Exiting
67.
G.F.I. & Bath Fixtures & Tub Access -Spa
68.
Elec. Trim & Subpanel, Breaker Sizes & Labels
69.
Stairs & Rails
70.
Fireplace or Stove. Clearance -Hearth
71.
Elec. Outlets at Wood Panel, Int. & Ext.
72.
Kit. FixL & Appliance; Ground. -Air Gap -Cooking Clearance
73.
Elec. Outlets & Recepticales at Kit. Counter
74.
Garage Fire Door; Swing -Landing -Closure
75.
A.C. Duct in Garage -Damper
76.
Wtr. Htr; Vents -Clearance -Comb. Air Connector-P.R.V.
In Garage; Above Floor -Meth. Protection
77.
Plb., Elec. & Mech. Equip. Listed for Location
78.
Elec. Receptacles in Garage (G.F.I.)-Romex Protection
79.
Insulation -Foam -Looked in Attic
80.
Guard rails & Deck Construction -Post Caps
81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
82.
Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No
83.
Stucco Brown -Finish
84.
A.C. Unit Disconnect, Electrical -Plumbing
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
86.
Water Well, Disconnect, Electrical, Plumbing
87.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
88.
Ventilation Throught House
89.
Glass Protection
90.
Corrections from Previous Inspections
91.
Gas Test -Meters Tagged, Gas -Electric
92.
Water & Sewer Connected -C/O to Grade -HD Approval
93.
Energy Compliance Certificate -Other Certificates
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
-'— –Lunnes'en times nalces'
r Responsabilidad del Relach
i Criterio de Neceeidad
� J
y1
g/" r
Responsabilidad "del Beriefic
fpor el Costo del Cuidado
de Ie Salud .'
1Por favor tenga e -n cuents 1
a, -
condado: •',
f
A.
�aCMSP Inlormaklon Notln Z (6,
D �
r
- -umnes-err olenes nalces
Responsabilided del Rela
Criterio de Necesidad r
iP' A
r Y.j
Responsabilidad del Ben;
par elCosto delCuidac
_ de Is Sslid. :� I
h
Por�'fevor to ga en cues
condedo:
{MSP IntornietlO. N.M.1
A i
• COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
-/-F (39-f
OWNER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately. r.
Htv luiae
CERTIFICATE OF ANCHOR INSTALLATION
Title 25 CCR MobTehome Parks Act Secdon 1326 (b)(3)
I certify those portions of -the tiedown system installed below grade were not damaged prior to or as a
result of the installation, were not modified prior -to or during the installation, 'and were installed in
accordance with the manufacturer's installation instructions, plans and specifications of the engineered
tiedown system referenced on this certificate.
Tiedown System:
Manufacturer.
Model:
Installed by:.. c Date:. 7 g
Cont .Owner. _ -
License No.:
MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING DIVISION --7 COUNTY CENTER DRIVE
OROVILLE, CA 95965 ---PHONE (916) 538-7541
APN:
PERMIT NO.:
Owner's:
Name: (/ �.� /` tJ/'` a
OwnAddress: CJ� E LIE) Nil-
Mobilehomee � r )_ / ` � � �
\1J j+�^+
Year of
Manufacturer T1'�
Manufacture: 6
t
/
Serial numbte/r`�} ��i
Insignia or
+
or V.I.N. r� '!
HUD number:
Official approving installation: 127
Date:
yz ..,-
If the mobilehome is moved or relocated, the mobilehome installation acceptance shall become invalid. This form shall
not be used when the mobilehome is installed on a foundation system. ;
513B White -Owner, Yellow -Installer, Pink -Bldg., Gold -Assessor
s: x .
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 E I NO.
(Rev.12/96) APPLICATION AND PERMIT
ASSESSQ�EIJMBF{i 011
�J 1 �J
ZONING
BUILDINGPERMIT
OWNER
JOEL FORRESTER 1-5
TELEPHONE
9 325-9673
SO. FT. OCC. BUILDING VALUATION
OWNERS,'M AMt LONGFELLOW, SPOKANE WA 99205
CONTRACTORS NAME
TELEPHONE '
CONTRACTORS MAIUNG ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
0
Permit Fee $
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee $
23.00
BUILDING ADDRESS
7
oa-qPERMIT
Energy Plan Checking Fee $
$
FEE $
23.00
LOT NO.
SUB IS IONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehomeyd Other
SPECIFY
Each Trap
7.00
-
Solar or heat um water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities 0 Installation ❑ Other ❑
Describe Work: MnRTT FHnMF UTILI3'IES
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
@20.00 60. 00
PERMIT FEE $
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service zooaoa V Sr.
23.00
it LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.FSINGL
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Lathe following reason:
0as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith co ply with those provisions.
?ate=2_?r� D
Sig at re of App icant - 91bwner ❑ Contractor ❑ Agent
An O HA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A 46.00
NEW CONST. DWELLING OCCUR s0
OR ADDNS. ( 8 ACC. BLDS. 3.50FT_
NEW CONST. MULTI.O-LET
NON-RESID. CIRCUITS@7.50
ATUS
OWERE AOUTLPPARET CIR.
8
Ex. Occup.OUTLET OR FIXTURES
20@'.O0
BAL @ .50
Ex. Occup. OUTLEEDTSA REFS D,OERq 5.00
Temporary Service 23.00
00 20
Facilities Home ome aces .
Mo20. OC
Misc. Wiring 23.00
I [ E
PERMIT FEE S U . UU
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST.TYPE
TOT L FE 166 , 0
HAZ.
D. FEES IM
�.
FLOG
P C
PD
HD SSUE
This permit is hereby issued under the
of the Butte County Code and/or Resolutions
indicated above for which fees have been
By /
PERMIT EXPIRES ON cp
applicable provisions
to do work
paid.
ate
/
De(
Receipt No.
WHITE-D.D.S.-B.D. CANARY ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTYtOF BUTTE DMMART'MENT OF DEVELOP�I MNT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 1
PERMIT APPLICATION DATA SHEET
OWNER: ' , �A r re sie r• ASSESSOR PARCEL NUMBER: 4 2 `7— 31— O —0 l
Proposed Building Use: Building Inspector: Date:
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
❑ 1. All items have been submitted.
2. Plot plans, 3/4 sets, signed by the preparer of plans. ------
� 3, Complete plans, 3/4 sets, signed by the preparer of plans.
04. Enginee'r'ed plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ---------
06.* Energy -Design Compliance and supporting documentation.-------------------------------------------
E!7.,
------------------------------------------
E7.. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------
❑9. Manuficiured Home'data and installation fnsiructions includig n Tie'Down SP ecifications.==-=-=---
w.
�0. Fees of $ 140Y)-0 -------------------------------------------------------------------------------------
❑ 11. Impact fees as shown on the attached schedule. -----------------------------------------------------------------
❑ 12. California Department of Forestry plan approval/fees. ---------------------------------------------------------
❑ 13 ood elevation certificate.------------------------------------------------------------------------------------
W4.
�I Sanitation and plot plan approv . d Health Department - ------------------------------------------ 49
-
�� ❑ 15. City of Chico plumbing permit.-----------------------------------------------------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs.----------------------------------------------
0
-----------------------------------------ti-
❑ 17. Planning approval for (A) Use: (B) Parking: -------------------------
OX�
2croachment
ntact Land Development about 11 Improvements, 11 Drainage, ElLegal Parcel -----------------------
Permit for driveway (construction approval prior to occupancy). ---------- ate,' F
020. Pre -inspection for required Request to Building Inspector on (Date)
❑21. Contractor's license information. (Number, Name Style, Classification). ----------------------=-------------
,�❑22. Workers' Compensation carrier and policy number. -----------------------------------------------------------
42T. Owner -Builder Verification (Given to owner ❑, Mailed to owner 06). -------------------------------------- 1
e55-
tter of signature authorization. --------------------------------------------------------------------------------
corded copy of Agricultural Acknowledgment Statement. --------------------------------------------------
❑ 26. Letter. of intent on building use. ----------- ---------------------------------------------------------------------
❑27. Manufactured Home utility r • ---------
❑28. Existing violations and/or expired permits. ----------------------------------------------------------------------
❑29. 1143 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .---------------
E130.
--------------
❑30. other: -------
When you issue the permit, process as follows ail to owner, ❑Mail to co actor.
Telephone s33 _ �� 4c f and hold for pickup at 11 office. ❑ eliver with inspector.
Applicant: �— Date:
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Airtion Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By:
1. Index permit application for the above items numbered: ❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by o phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building DivisQn counter, by Dae:
Plans reviewed by: Date: Plans approved by: Date:
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
E.H. SE ONLY
Plot Plan Attached
Floor Plan Atta hed
Sent to B.D. /
i'Y PA -V l nL 7,� 31 b -,q* I )
Owner Location AP##
Plan Approved for: Sewage Disposall- . Water Supply: Public Private Well
Clearance for dwelling. Other
Hold final for:
Final clearance O.K. for:
NOTE:
PIL., (I )a J�L -
Environmental Health Specialist
8/96
Date
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay
in processing and issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
property improvement: YESFNO 13
2. I HAVE�KL. HAVE NOTigned an application for a building permit for the proposed work,
3. 1 have contracted with the f wing person (firm) to provide the proposed consauction:. ;
_ r� —
'. r
ADDRESS: -4-/e,
CITY:wz-
PHONE: S >�, 5'3"3-- -3,-4 -2 l CONTRACTOR'S LICENSE NO.
4. 1 plan to provide portions of this work, but I have hired the following person to coordinate;
supervise, and provide the major work:
NAME:—
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED: a s .
PROPERTYO
SOCIAL SECURITY NUNMER:_ _ �-
DATE:
NOTE: -------------This,-Owner-Builder Verification is required by Section 198.31 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.
OVER
I OWNER BUILDER INFORMATION I
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your'protection, you should be aware that as "owner -builder" you are the responsible parry of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply. .
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including tnaterials
and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including.state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
♦ There may be financial risks for you if you do not catty out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or throuPg, h their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contrac9rs may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
r rely,
Mic el C. Vi iia, C.B.O.
M ger, Building Inspection
NOTE. This Owner-Builder.lnformation is required by Section 198.10 of the California Health and Safety Code
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Mobilehome Manufacturer: 5r -Y 1,,,✓,,7 . A7,4 e--7 1,.•c • Manufacture Year: Q
If other than single wide, furnish Setup Model Number: 0" 1-102
Width:(ft.) Length: )60 Tagalong orExpando Size ' (ft.) x (ft.)
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's
installation manual and structural setup sheets.
FOOTINGS: Wood pressure treated or foundation grade[�Other:
SUPPORTS: Concrete block[✓f -Other:
Provide Tie Down Specifications for all Mobilehomes: pie'/1— LJ -5 /d % 0
Pier Footings Sizes and Location
SINGLE WIDE MULTI -WIDE
Line 1 e I
Line 2 Line 2
................................................................................................
Main Beams
Line2.................................:..................................................:........... e 2
Line I Line 3
Line 2
................................................................................................
Main Beams
Line 2
Line 1
................................................... ine S
Tag or Triple ine 4
ine 1
Line 1 Piers:
Size minimum: r I x
Spacing maximum: 1 9`
From ends-maximum:l 9`
Line 2 Piers: /. ,yp
Size minimum: x
. Spacing maximum: I �— ` `
From ends -maximum] `
Line 3 Roof Loads:
Size minimum,
Location (from front: p,,D
SON '�
Line 5 Roof Loads:
Size minimum:
Location (from front):
Line 1 Openings
Size minimum: [ ] x [ ].
Each side of openings
with width over: `
Line 4 Piers:
Size minimum: x
Spacing maximum: `
From ends -maximum: `
OVER
1. Owner's Name: 12/1- G � ��
2. Assessor's Parcel Number: Z7 - Y -Off
3. Installer's Name:
currently Yes No �
4. Is the site cu y under permit? [ � [ ] Permit No.
5. Is the site an existing site? Yes[ ] No[ �]�(If yes, furnish two plot plans).
6. What is the electrical rating of the mobilehome?Amperes.
7. What is the mobilehome site circuit breaker rating? 2-019 Amperes.
8. What is the electrical rating of the mobilehome site? • 100 Amperes.
9. Is the. main service remote from the mobilehome site? Yes[✓] No[ ] If it is, what is
the rating? 2 -AD Amperes.
10. Is ,there any other electric load to be served by the mobilehome site electric service
(i.e. well, garage etc.)? Yes[ -I --No[ ] If yes, please identify the load and size:
a) The mobile hom�j ft)
te:
Load- t tl -,1 i Amperes-
b) The main service:
Load- Amperes -
11. Type of gas service at mobilehome site: Natural[ ] , Propane[-I'None[
12. Size of gas pipe at the mobilehome site from the meter or
tank: 91ef inches.
13. What is the gas pipe length from the meter or tank to the mobilehome?±E-) (ft.).
14. What is the mobilehome gas demand? B.T.U.*
*(This information is not required if the pipe length is less than 6 feet on natural gas or
less than 50 feet on propane).
THE OTHER SIDE'OF THIS FORM. MUST BE COMPLETED IN ORDER TO
PROCESS THIS PERMIT APPLICATION.
May 1995 8.5
MV
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SEC. 4
ILL.
CENTERLINE SUPPORT.REOUIREMENTS
THIS SHEET TO E3E 114SERTED WITH SUPPLEMENT
TO FIELD INSTALLATION 4ANUAL -FbR Zoq ROOF-.
SNOW LOAD S"Lif
MR
I
SERIES DESCMPTION
Oc:xk AOOF
LIVE LOAD
ICIIECI:11 Or
t
JORDED.%LkIL TO:
i BUILDING DIVISION
JTER DRIVE
OR0�7LLE 95%5
1 998-0Ca25887
Recorded I REC FEE 10.00
Official Records I COPIES 2.50
Countyy Of I
Be
CANDACEuJ. GRUBBS I
Recorder I
I Cindy
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code requires this acknowledgment' ' " 't.,r
q gmenf to be recorded prior to is of a building permit.
The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of
this property may be subject to inconveniences or discomfort 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 Hinted to cultivation,
plowing, spraying, pruning; and harvesting which occasionally generate dust, smoke, noise, and•odor.::Butte County has
established ag*ic�altr:ral purposes, and iesidents iA .thin said zones and on adjacent prgpeaty should bcprepared to accept such
inconvenience or discomfort from nor mal„liecessary'farm operations.
All that real property situate in the County of Butte, State of California, described as follo"Is:
Date:__ — (S _Q PROPERTY OWNERS:
rsL fi0/L2-�yrtJ7�
State of California )
County of BU-rr -c )
On _(�3" 1 S -9g before me,
L1
a <<. � ±•SYS:
personally appeared personally
known to me (or proved to me on the bash of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and
that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted,
executed the instrument.
WITNESS my hand an official seal. MQNTHIACYA. COSTA COMM/ 1103301
QNOTARY PUBLIC-CALIFORNIA,y
SignatureL L(91—� COUNTY OF BUTTE w
My Comm. Expires OcL 30, 2000
SCHEDULE C
All that certain real property in the State of California, County of Butte,
described as follows:
The Southerly 403 feet of the Southerly 580 feet of Lot 5 in Block 54 as sown
on that certain Map entitled, "Map of Subdivision No. 1, of the Palermo Citrus
Tract", which Map was filed in the cffice of the Recorder of the County of
Butte, State of California, February 28, 1888.
Reserving therefrom the following described real property:. The Southerly 165
feet of the Northerly 342 feet of the Easterly 180 feet of Lot 5, in Block 54,
as shown on that certain map entitled, "Map of Subdivision N0. 1, of the=a'_ermo
Citrus Tract", which map was filed in the office of the Recorder of the County
of Butte, State of California, on February 28, 1888.
)',)I:; seoion n; �Sf ba ; ompfElQdli
ROM LEDGER: j ��.�
V1
LAND DEVELOPMENT
BUILDING / VIRONME L HEALTH PERMIT CLEARANCE
Building Permit No.
OWNERS -A A.P.
NAME: 2 [MCS^NUMBER:
PRINT LAST NAME FIRST
ADDRESS/ LOCATION:
COUNTY ZONING (o Z(� 90
DESIGNATION: A (l I'Yl �j FLOOD ZONE: FLOOD MAP: v
O b Zo �2
APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL:
PARCEL CREATION BY DEEDS OR MAP fOR7-. L oT S' PV4U M,4e#:-
DEED INFORMATION:
DATE OF CREATION: I �� DEED REFERENCE: r
LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO
COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO
COMMENTS/CONDITIONS: wn S 1-7-50—Z7 I Q Zgjr--b rcg V"•S�1/�oN
MAP INFORMATION:
DATE OF RECORDING
LOT BOOK PAGE
COMPLIANCE WITH OLD SUBDIVISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT
PAGE 23): YES NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW:
A. Construct road to B. Meet parcel size required by zone. C. Most current E.H.D. requirements.
\CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BUILDING DMS/ON UNLESS OTHERW/SENOTED.
X 1. Maintain a 50 ft. building setback from centerline of road.
2. Maintain a ft.building setback from right-of-way/centerline of
_ 3. Comply with Zoning code for building setback from road. .
_ 4. Maintain a 100 ft. leachfield setback from all existing wells.
5. Maintain a ft. leachfield setback from
_ 6. Pay water tender fees in the amount of S to Battalion Number of the Butte County Fire Department.
_ 7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290.
_ 8. Connect to a public water supply.
_ 9. Connect to a public sewer system.
_ 10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National
Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile
homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department
specifications, serves the parcel.
_ 11. Pay T.O.D. (Thermalito Drainage District) fee in the amount of $
_ 12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below)
_ 13. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010.
_ 14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated
in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be made to the Flaw ng DA sba
_ 15. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic
safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3
requirements of the Uniform Building Code.
16. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors.
X 17. Pay school impact mitigation fees.
X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions. of Chapter 3, Article II of the Butte
County Code.
_ 19. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California
Clean Air Act of 1988 as amended.
20. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find
pending examination of the site by a professional archaeologist. This person would then be able to assess the site
significance and suggest appropriate mitigation measures.
21.
22.
23.
24.
_ 25.
26.
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MASTER LIVING ROOM
BEDROOM DINING 17A"
No. I ROOM
17'-4" 9'-411
2245/6026 .38F-DROOM 2BATHS CATHEDRAL (1,539 SO,FT,)
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BEDROOM
No. 2
BEDROOM
No. 3
16'
A. P. # _ 3 — Q
OWNER
PERMIT
o.
MH UTIL. CLEARANCE DATE 2�, 0-0 J:�r?
INSPECTOR Tie/,
ELECTRIC
GAS
SUPPORT
STRUCTURE
COMPACTION
TEST REQ.
SERVICE
OTHER
PIPE
YES
NO
YES
NO
SIZE
LOAD
TYPE
SIZE
LENGTH
. . P�105 ��-
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 Counti Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERYT, NO.
(Rev.12/96) APPLICATION AND PERMIT 6
ASSESSOR PARCEL NUMRER
027-31 -0-011
ZONING
ARMH-5
BUILDING PERMIT
OWNERTELEPHONE
SO. FT. OCC. BUILDING VALUATION
. OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
NQNE
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation Is
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDIN§ ff4SSMELVINA AVENUE, PALERMO
U
Energy Plan Checking Fee
$
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF El Duplex ❑ Mobilehome] Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation X] Other ❑
Describe Work: MHI/98-1308
Gas piping system 1 - 5 outlets
15.00
sewer
15.00
—Building
Mobile Home I S I G I W
920.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
800VOR LE
Main Service 20 A OR LESS
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
121�7, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ 1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Main Service 200A TO IDOOA
46.00
NEW CONST. OW EWNG OCCUP.
OR ADDNS. ( a ACC. BLDS.
SO
3.50FT.
NOµq °SID. T. MULTI -OUTLET
97.50
POWER APPARATUS
a SINGLE OVRET CIR.
Ex. OUTLET OR FDMAES
EO
BA0 @ I:00
ccu
Ex. Occup. °F"�E�°rs aEslo,°EA.
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
S
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
Cell certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith c mply with those provisions.
X Date �� ^ `�"
Sig a re o licant - ®'Q-wner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$ 100.00
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 143.00
HAZ.
D. FE IMP
...
FLOOD
..._
COF
_
pfC0. PD
HD
ISSUE
This permit is hereby issued under
of th Butte Counly Code and/or
it ca a ove fwhich fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date %
Date
Receipt No. 244354
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
�. _ c� k .. `.� ' �^. k ' � ' .x,t�sa... r.. -.: .: �; : h �fF 5+ �'7e��'.7FrP+'.a�7M• .".} _ � � .r. � - ,.
,�o�Yt�� � � 4 /���A//`, as �l tvas ��,•.��toN ode
�.?
BUTTE COUNTY SCHOOLS IMPACT FEE CE ' -�IiIICATI FORM `S �J�
(One form per Building)
36 16, ESC
School District Oro % VC. h 1 d !7' Building Department No.
A.P. Numberf'/� / - �� ^ (Jurisdiction:Q City � County
Property Owner
Property Location/f
Z
Subdivision
Residential Development
Commercial/Industrial
Es-
En
No of Living
Mobile Home
Units
Installation
New
Lot No.
Addition
Addition
Building Department Representative
(Floor Plans reviewed by School District Personnel)
District Identification No. 990010,
Or�/ ` School District certifies that
CJ U s� M Q/.v./ 09-1,/ 1/42 U e
Address) "
has complied with the requirements of Resolution No.
representing A�- (e DD r square feet.
District Representative
Gffkla! c
Paid by Check # /Al'Y rA),Remarks:
Sq. Footage 15-60
(Group R)
I
Sq. Footage
�L (Including Exterior
Roofed Areas)
9(1?00.
Date
-L -r--
e2, .1 -4 1,1"e.
(Applicant)
(Phone Number)
(State) (Zip Code)
by payment of $ 3 0 Q. &0
B 2926 $
ULL MITIGATION $
w.7Z�
Date
Notice: You may protest the imposition of the fees Identified above by submitting a written protest to the District, in compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the Imposition of the fees In any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls 12/971dmm
COUN,TY''OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
�:- 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541
.Ow- PERMIT APPLICATION DATA SHEET
OWNER: t/ OY re ter ASSESSOR PARCEL ER: 00 -- �0 //
Proposed Building Use: Building Inspector: Date:
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
111. All items have been submitted -------------------------------
02. Plot plans, 3/4 sets, signed by the preparer of plans. ------
E13.
-----
❑3. Complete plans, 3/4 sets, signed by the preparer of plans.
❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.
05. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ---------
❑ 6. Energy Design Compliance and supporting documentation.
117. Statement of Intent for Non -Heated and A/C Buildings. ----
JQ 8. Hazardous Material Form. -------- --------------�Down
M9 Manufactured Home data and installation instructions rncludin T
(0Feesof---------------------
--------------------------
mpact fees as shown on the attached schedule. -----------------------------
❑ 12. California Department of Forestry plan approvall ees.---------------------
❑ 13. Flood elevation certificate.
1114. Sanitation and plot plan approval Health Department.
❑ 15. City of Chico plumbing pemrit. ---------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ---
❑ 17. Planning approval for (A) Use: (B) Parking:
11
1118. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. -----------------
❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------
020. Pre -inspection for required. Request to Building Inspector on
❑21. Contractor's license information. (Number, Name Style, Classification). ---------------------- -------------
0 22. Workers' Compensation carrier and policy number. --------------------------------- ------------------------
023. Owner -Builder
----------------------
❑23.Owner-Builder Verification (Given to owner ❑, Mailed to owner El) - ----------- ---------------------------
❑24. Letter of signature authorization.-------------------------------------------------------------------------- ----
❑25. Recorded copy of Agricultural Acknowledgment Statement. ------------------------------------
❑ 6. Letter of intent on building use. -------------
Manufactured Home utility clearance. -----
028. Existing violations and/or expired permits.
�
(Date)
029. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .---------------
030.
--------------
❑30. Other: -------
When you issue lheep5mi r�gas follows ❑ Mail to owner, Mail tX-7 ractor.
Telephone 5 / and hold for pickup at UrD l� toffice. ❑ Deliver with inspector.
Applicant: Date:
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Arr ution Date: By:
Copy of plans sent ❑ Health Department; ❑ Fire Department,_p 9ther: / , -� Date: By:
1. Index permit application for the above items numbered: I Za ❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required d&a by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, otivner w a ed of the above r uired b ❑ phone, ❑ mail, ❑ Building viscounter, by Date:
Plans reviewed by: Date: Plans approved by:yC cam— Date:
Sets of plans on holdb ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division
-;
t
9
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541
SCHEDULE OF FEES. DUE
OWNER
PROPOSED BUILDING USE AV N I
1. BUILDING PERMIT FEES
-- Balance Due ... ............. $
-- Additional Fees Due ........... $
-- Additional Fees Due ........... $
-- Revised Plan Checking Fee ........ $
SCHOOL DISTRICT FEES
( aid at District Office)
3. SHERIFF FEES (paid at Building Division) /� r
Residential ........ ' / x $360.00 = $ �p
Units
Commercial (sq.ft.)... x $0.03 = $
Sq. Ft.
4. URBAN AREA FEES (paid at Building Division)
Residential (per unit) . x - = $.
#Units Amt.
Commercial (sq.ft.) .. x =$.
Sq.Ft. Amt.
5. RECREATION DISTRICT. FEES (paid at District Office)
6. THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at Building Division)
7. SRA FIRE INSPECTION AND PLAN CHECK
$89.00 (paid at Building Division)
8. WATER TENDER FEES (Battalion # )
$200.00 (paid at Building Division)
9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division)
10. OTHER
A. P. # (XJ`
DATE
RECEIPT # DATE REC
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit.
These fees may be changed during the plan checking process.
APPLICANT DATE
Pursuant to Goverrilat Code Section 66020, you are hereby notified that items 2,3;4,5,6,8,9, and 10 above may have been imposed on your
project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may.
protest. The requirements for a protest are specified in Government Code Section 66020(a).
Original -Building Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 2/97)
�� ,. r � .. ., ....rrir ,� ..=rte -„-✓`,r= -; r` �,y _.
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
' 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541
SCHEDULE OF RECEIPT OF FEES
OWNER (� �i e ! f ®�tC S C A.P: i1 t/�l /(O y®//
PROPOSED BUILDING USE A/ /`� y DATE l0 J / 9,5-
RECEIPT # DATE REC
1. BUILDING PERMIT FEES
-- Balance Due ................ $
-- Additional Fees Due ........... $
-- Additional Fees Due ........... $
-- Revised Plan Checking Feef �;.
S o •�.00L DISTRICT FEES ��D
-�� %
(paid at District Office)
33�SHERIFF FEES (paid at Building Division) _
Residential ........ _/_ x $360.00 = $ Jy,41 ffo
Units
Commercial (sq. ft.). x $0.03 = $
Sq. Ft.
4. URBAN AREA FEES (paid at Building Division)
Residential (per unit) . x = $
#Units Amt.
Commercial (sq.ft.) .. x =$
Sq. Ft. Amt.
J
5. RECREATION DISTRICT FEES (paid at District Office)
6. THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at ;Building Division)
a
t
7. SRA FIRE INSPECTION AND PLAN CHECK Y
$89.00 (paid at Building Division)
8. WATER TENDER FEES (Battalion U )
$200.00 (paid at Building Division)
9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division)
10. OTHER
At time of permit application, I was advised the above fees are required to be paid pr okt issuance of the building permit.
These fees may be changed during the plan checking process.
DATEAPPLICANT —J. 4,,,,�,—
Pursuant to GovemfnQht Code Section 66020, you are hereby notified that items 2,3,4,5,6,8,9, and 10 above may have been imposed on your
project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may
protest. The requirements for a protest are specified in Government Code Section 66020(a).
Original -Building Div. 2nd Copy: - Applicant 3rd Copy-dOwnei' ( ev. 2/97)
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.,
Please complete and return this information at your earliest opportunity to avoid unnecessary delay`
in processing and issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
property improvement: YES 2' NO 0
2 • I HAVE U'AAVE NOT 0 signed an application for a building permit for the proposed wipe
3. I have contracted with the following person (firm) to provide the proposed construction:.
ADDRESS: ( CTTY:.. .s..�
PHONE: CONTRACTOR'S LICENSE NO. �P
4. 1 plan to provide portions of this work, but I have hired the following person to coordinate;
supervise, and provide the major work:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.A.
- -
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTYOWNER:
SOCIAL SECURITY
DATE: �o - .3�4 _F 8
- - NOTE: This Owner -Builder Verification is required by Section IQ83I-ijid79Mof?!ie
California Health and Safety Code. This verification must be completed iutd
returned to our office before we are permitted to issue the permit.
OWNER BUILDER INFORMATION I
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of property
improvements specified.
For your protection. -you should be aware that as "owner -builder" you are the responsible party of record on such
a permit. Building permits are not required to be signed by property owners unless they are personally performing their
own work. If your work is being performed by someone other than yourself, you may protect yourself from possible
liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business
license from the city or county. They are also required by law to put their license number on all permits for which they
apply.
If you plan to do your own work, with the exception of various trades that you planto subcontract; you should
be aware of the following information for your benefit and protection:
v
♦
If you employ or otherwise engage any persons other than your immediate family, and the wgrk (including materials
and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments as an employer 'and you are
subject to several obligations including state and federal income tax withholding, federal social security ,taxes, :.
Workers compensation insurance, disability insurance costs, and unemployment compensation contributions:. ,
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance. '
♦ For more specific information about your obligations ulder Federal Law, contract the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
State Law, contact the Department of Benefit Payment" and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perfortn'their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions. ,
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contactprs may be obtained by contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
r rely,
Mic el C. Vi iia, C.B.O.
M ger, Building Inspection
NOTE. This Owner-Builder.Injormation is required by Section 19830 of the California Health and Safety Code-
OVER
oda
OVER
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
=COPY of Document Recorded
15 -Jan -1999 1999-0002136
Has not been compared with
original
BUTTE COUNTY RECORDER
' SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section
.18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon,
upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the
county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons
`'thereafter dealing with the real property.
JOEL FORRESTER
REAL PROPERTY OWNER/LESSOR
"PO BOX 1030
MAILING ADDRESS -
FOROVILLE, BUTTE, CA 95966
CITY COUNTY STATE ZIP
8054 MELVINA AVE.
INSTALLATION MAILING ADDRESS, IF DIFFERENT
�OROVILLE, BUTTE, CA 95966
CITY COUNTY STATE ZIP
SAME
j UNIT OWNER (ifalso property owner, write "SAME")
MAILING ADDRESS
QR 00MUT STATE Tm
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
OROVILLE, BUTTE,,CA 95965
CITY COUNTY STATE ZIP
98-2557 (530)538-7541
BUI TNGPERMITNO. TELEPHONE NUMBER
11/20/98
SIGNATURE OF LlAL AGENF AL DATE
NONE
DEALER NAME (dnot a dealer sale, write "NONTE )
DEALER LICENSE NO.
' UNIT DESCRIPTION
' SKYLINE
1992
OAK MANOR
MANUFACTURER'S NAME
DATE OF MANUFACTURE
MODEL NAME/NUMBER
06700621A/BE
60'X 26'
ULI1345664/5
SERIALNUMBER(S)
LENGTH XWIDTH
INSIGNIA/LABELNUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION
SEE ATTACHED
ASSESSOR'S PARCEL NUMBER A.P. #027-310-011
HCD FORM 433(A) REV. 8/91
WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD- Building Dept.
E
BUILDING PERMIT NUMBER: 98-2557
Address or location of unit: 8054 MELVINA, OROVILLE, CA 95966
Legal Description of Real Property: A.P. #027-310-011
SEE ATTACHED
(z) Mobilehome/Manufactured Home
() Commercial Coach
Has been affixed to the real property above by installation on a foundation system
pursuant to Health and Safety Code Section 18551. .
Owner's name: JOEL A. & RAESHELL FORRESTER
Owner's address: PO BOX 1030, OROVILLE, CA 95966
INSIGNIA OR HUD NUMBER: ULI 345664/5
SERIAL NUMBER OR V.I.N.: 06700621A/BE
MANUFACTURER'S NAME: SKYLINE YE 1992
OFFICIAL APPROVING INSTALLATION:
DATE: 11/20/98
PHONE: (530) 538-7541
H.C.D. 513C
J;-
LEGAL DESCRIPTION
A.P. #0027-310-011
All that certain real property situate in the County of Butte, State of California, described as follows:
THE SOUTHERLY 403 FEET OF THE NORTHERLY 580 FEET OF LOT 5 IN BLOCK 54
AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF SUBDIVISION NO. 1, OF
THE PALERMO CITRUS TRACT", WHICH MAP WAS FILED IN THE OFFICE OF THE
RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, FEBRUARY 28,
1888.
RESERVING THEREFROM THE FOLLOWING DESCRIBED REAL PROPERTY: THE
SOUTHERLY 165 FEET OF THE NORTHERLY 342 FEET OF THE EASTERLY 180 FEET
OF LOT 5, IN BLOCK 54, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF
SUBDIVISION NO. 1, OF THE PALERMO CITRUS TRACT", WHICH MAP WAS FILED
IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON FEBRUSRY 28, 1888.
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