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028-180-043
c 28-18=43 - .- 44-9�1PE.. � TERREL Sylvest028-180-043 e 03AG187 �Upham Rd, ngor- LARSEN, GUY & MAUREEN (utilities/mh) - 479 UPHAM RD, BANGOR ELEC 0 6 C• /00 4,r z � / AG EXEMPT BUILDING GAS L PC, 5/411 .10 , !la COMPACTION TEST REQ / SUPPORT STRUCT REQ ----18-43 PermitL -Q-91MHI 5 installation/,P F c r _ ra _ P70 �-, m 111 !�`-�A'917 - BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. l9, Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. r ZONING OWNER e-, Ma PHONE NO. v q 'f cri�e�' OWNER'S AD SS 9. 3 A- 19-0 R 1. Vv LOCATION OF BUILDING 11 V Le-k-4�-L r� i o r^` o, u4 -& v-. of'q-7q__UPhnjm Ar USE OF BUILDING // L..j' Ij'� +T101AQ\0 Qr SIZE OF STRUCTURE 20 SO.FT. TYPE OF CONSTRUCTION: -4 d WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF SIDING p ROOF . OVERING . L014A f20'Ql+1f) FLOOR TYPE ESTIMATED COST OF CONSTRUCTION too AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: Wore- -4tci z f FRONT S SIDE a® C ' REAR AG Buildings shall be a minimum of five.(5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I/KVr-'e- - +-I'%AyK 7 � I declare under penalty of perjury that the building will be used as stated about, and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with Ithe requirements I . effect at that time and before occupancy. n A Date c? - / 9 , c) - Permit Fee - $60.00 Receipt Nom Signature of Owner The above described AG Buildingtd's exempt from a bylilding Manager Building Division By Date White — DFW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant 63 ,5-a e —fir RESIDENTIAL � F499-91P,E �28-18 43 - � ' TERREL, Sylvester *7 9 Upham Rd, 'Bangor (utilities/mh) Soo rq OFFICE COPY � Address -T i JOB FINALED Signature i r; V=Ok � O = Not OK Not Not Readyable MOBILE► HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s I moi -Zoning Requirements -Setbacks -Easements �__-.27 Soils; Special MH Support y4ketch 3. Sewer;. L6cat1o6-Test-F811-C/0 Concrete j„/5. Electricity; Loc n -C ences-Grn rfip-Concrete j V-6. Gas; Locatio ra / /"L"ft. /"Nat. or "ft. 'LPG 7. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBIL"OME INSTALLATION (Plans) OK except #'s Zon' Requirements -Setbacks Easements oo ' Size -Spacing -Marriage Line as; est-Demand-Valve—Connector Ll city; MH Test -Crossovers -Breakers -Clearances o. v� , wm i vu i-rmrrion wnno�.w� Wate!,Ml4 Test -Regulator -Connector j _r,And Sewer Connected -C/O to Grade -HD Approval as and Electricity Tagged 1 its; Insp.-Sketch 10. Cert. of Occupancy 1 Date ' 400 —j Card B-1 1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANgOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-Depth-Spacing-Connectes-Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg.-Rig.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mash 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 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, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosu res -Pane I boards- I ns. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 V OK O=Not OK - = Not Applicable Not Ready RESIDENTIAL (S ' = Date UNDERFLOOF 'Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg.,-Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Fig., Garage; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card 3-1 Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B 1 Date FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearina T ingle & Duplex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. 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 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Pibg.-Appliance-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates 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: (NOTE: An entry must be made each time you visit job site) MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 - TELEPHONE: (916) 538-7541 PERMIT NO. Address or location of mobilehome 4-1-7!F c,-tfI 411117 Y Owner's name Te- t? -ALF_ (-- Owner's address Insignia or hud number `Uc� Manufacturer's name w /Q iZ { L -j ST ,.cam - Serial number of V.I.fV / � 2<�� �� Z ` Year of manufacture cialF*pprovingii'nstaIIa IF THE,MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE k` MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 7" ' COUNTY OF BUTTE f DEPARTMENT OF PUBLIC WORKS :196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 Y� .r` 747-'E1-1-iott Road, Paradise — Phone: 872-6307 - k -'CORRECTION NOTICE ER "RY PFRKAIT A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office -when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. L_ L'. /= JV 7 I ,PW6A �-✓ &x, -)r U Date g5-- �~ �/ Inspectorffa�_'t COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovlller Cellfornla 95965 - Telephone: 916/538-7541 ' APPLICATION AND PERMIT ASSESSOR PARCEL NU B R 28-18-43 ZONING BUILDING PERMIT OWNER Sylvester Terrel -679-2,566 -TELEPHONE SO. FT. OCC. BUILDINa\IALUATION OWNER'S MAILING ADDRESS ' 573 U ha Rd Bangor CONTRACTO 'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS " 4-7 9 Rd Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 IF Each Trap 2.00 Solar or heat pump water heater 20.00 LOT O. / SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeaX Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W O.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities U Installation Other ❑ Describe work: MHI (MHU# 4 l! -_%) Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. AOD'L 100 AMP 2,50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F1 am licensed under provisions of Chapt. 9, Div. 3 of the Bushes$ and Professions Code and my license is in full force and effect. License No. Classification. 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure Is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.( DWELLING OCCUP.&` OR ADDNS. ACC. BLDGS. / /z¢sgft NEW CONSTR.MULTI-OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20050t eAL@30 FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. IYirin g 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's .Compensation Insurance or a Certificate of Consent to Self -Insure. rVII shall not employ any person in any manner so as to become subject 161,1 to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against s Cou in con uenc of the gran 'ng of this permit. X Date Signature Applicant — Owner Contractor ElAgent El An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ 45.00 Energy Inspection Fee $ OcC CQNV TYPE - TOTAL FEE $ 0 00 r1Az. cuA PARK scr+ FL cOF PAS l� I H Is E. This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do indicated above for which fees have been paid. DI OR J VrF BLIC WORKS —3© By. 4—?7C7t PERMIT EXPIRE Date Receipt No. 83869 WHITE-D.P.W., YELLOW-ASSrSSOR,PINK-INSPECTOR. aCLDENROD-APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVI,I�LE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT''APPLICATION, DATA SHEET 10 Permit No. OWNER ,7 `�X I/P5725-ee _ c=am 4. A. P. No. �X O Proposetd Building Use t^i Building Inspector Date 2, 25 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans . . 4. Complete engineered plans and calcs, with wet signature on plans . . 5. Hazardous Material Form .......................................... 6. Energy Design.Compliance and supporting documentation ......... 7. 'Statement,of Intent for Non -Heated and AC Buildings .............. 0*8. Engineered truss details and layout in duplicate (required prior to plan check) 7 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... School District fees paid .............. 14. Sanitation approval from {iethIu-. Health Department 15. City of Chico plumbing permit. 16. Plot plan and business license approval from City of 4 (see City for other requirements) ,17. Planning approval for (A) Use: (B) Parking: 18. Improvements may be required. Contact Land Development Section, DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required . Pre-Inspec. request to ` Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 1 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... NiA 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 42 6. M &L e1Lr-Xe,4,u��� O 27. When Issue the permit, process as follows: Mail to owner. Mail to contractor. Telephoneand hold for pickupatoffice. Deliver w/inspector. Other " C ' Applicant ZDate r' / Copy of Haz-Mat form sent Health Dept. Fire Dept. air Pollution Date Copy of plans sent ---HealthDept. Fire Dept. Other Date By The following data must be submitted or to p rmit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designerown, was advised of above required data by4_,phone___nall_co nter by...date Contractor, designer, owner, was advised of above required data by_phone_mall_c unter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPWq-f�' a/ILC% % o x 9 //7tt f S �rLe,tJ f e� lwz yS �c/itr & COUNTY OF.BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 9167538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and aterials for construction of the proposed property improvement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name AL14 Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address .y,,, A Phone Type of Work �/ / Signed: Property Owner _,��,�,4� Social Security Nr r. Date % NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO, 7 County Center Drive - Orovlllet Callfornla 95965 - Telephone, 916/538-7541 APPLICATION AND PERMIT 99 E99 .2_,/J Is,3 z N IAG BUILDING PERMIT wNe HONE SO. FT. OCC. BUILDING VALUATION OWNER'S MASI"ING ADDRESS 9"/16 9 5.? CONTRACTOR'S NAME ev 1_0;P1 TELEPHONE 1 CONTRACTOR'S MAILING ADDRESS , Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ O�1 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING A'ODRESS Permit fee $ �' 00,. PLUMBING PERMIT Filing Fee 10.00 a� Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5,00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehongeOther ,gLSPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW 10-00 ea TYPE OF WORK New ❑ AdditionFl. Remodel ❑ Utilities ❑ Installatiort�l Other ❑ Describe work: Mild 4`41— Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00, Main service ;$o AMP OR ORSLESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUS Ines$ and Professions Code and my license Is In full force and effect. License No. Classification. ❑ as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. AOO'L tog AMP 2.50 NEW CONST. DWELLING OCCUP.d` OR AODNS. ( ACC. BLDGS. f , vrsq it NEW CONSTR. U TI.OUTLET N ON.R ESID BRANCH CIRC ITS 2.50 ea — "" POWER APPARATUS e` (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES ot e0L9 30 i.L&30 FIXED EX. OCCup. OUTLETS P(RESID )APLNS.REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement. should you becomesubject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3,00 Ventilation permit Fee $ Contractor I certify that l have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structuresover3 stories in)!might. Mobile Home Installation Fee $ , Op Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HAZ. CUA PARK SCHL FLD coF PAR PD I Ho. Issue This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. IJ �� WHITE-O.P.W.. YELLOW-ASeE330N. PINK -INSPECTOR. GOLDENROD -APPLICANT F�W l:T.{�1�ns andspEcifications MUST bethe fobat IJ. times and it is unlawful t© �c make �„y or alterations on same without eeiba ck o '5 -ft. t%oia� t2>ts itten pasionfrom the D6p8rtment of'P0_ property lines and a sett n the.road 1t1/ortcs,, County of Butte. - oy 8a €t: from. sum"� be bllev of h !\ _ r e8o I ���1� ince e►A.fl4 save ones wz$ �' �' ; . _ `� - ,MSM - -- _ -If •!� a JA 3s•9� s � IN .?o o NOTEu--g Materiels & VVmkmansNP 9 Be In A000rdance with Recognized (food Pmc.'tioes end — � � • v �� of e guaiity prescribed for the Specified UN in 00 _ kWform Buildino. Plumbing & Mscmoel CotMe :*w National EeCUiDd Code• 17 COLD..1CC. /Z SEC71' 0A , ROC4- a. 1A 1. L 9 417 BUTTE COUNTY __. BUILDING DEPARTMENT A P P R O V E D ♦t3$i � bfr ♦ � 400 to uu is - of 2iT,tjlq t I 4 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville; CA PHONE: 5384541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name: 2. Installer's Name: v 3. Is the site currently nder permit? Yes F No (If yes, furnish permit number ) OR Is the site an existing site? . Yes Wr No F-1 (If yes, furnish. two plot plans.) 4. Will the mobilehome be located at least 5 ft, away from septic tank and leach fields and clear of all setbacks and easements? Yes a No (If no, clarify 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- * 12, What is the mobilehome gas demand? ---------------------- (BTU) *(.This=)in'format`ion-not required if pipe length less than 6 ft. on natural.-gas,..�or--;less than 50 ft. on LPG.) �.; � �'fi�-����� �.�: i(�.J.st •lir- 5. What is the mobilehome electrical rating? --------------- _/00/4/14,0-S Amps 6. What is the mobilehome siteservice rating? ------------- �V �M Amps 7. What is the mobilehome site circuit breaker rating? =---- 0 0 1q/U% Amps 8. Is there any other electric load to be served by the mobilehome site service? -------------------------------- � Yes .a No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? -------------- `3� n. 10. What is the type of as YP g ? ------------------- service. Natural F I LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- * 12, What is the mobilehome gas demand? ---------------------- (BTU) *(.This=)in'format`ion-not required if pipe length less than 6 ft. on natural.-gas,..�or--;less than 50 ft. on LPG.) �.; � �'fi�-����� �.�: i(�.J.st •lir- MOBILEHOME.SUPPORT DATA - --.. �/� ���� If other than single wide, Mobilehome Mfr. /� w furnish Setup Model No. Year _ WidZ f.t, ): Box--Leng-th_ (ft:)--3`ag4iartg-or-E pan o- size - - On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not.on file with the County of Butte). FOOTINGS (check one)a 1. Wood -pressure treated or foundation grade . 2. Other (specify) SUPPORTS (check oneU 1. Concrete block.12. Other (specify) - Pier Footing Sizes and Locations SINGLE -WIDE Line 1 MULTI -WIDE Tine 7 Hain Beams Line 2 � Tin Line 2 Maio Beams . — — — — _Line 2 + Line Tag or Triple Line 1 Line 1 Piers — - - Line 1 Openings: Size -Min. ------------ k k size -Min. ---------------- Spacing -Max, --------- k Each Side of Openings From Ends -Max. --- 1 i -- �'Wlth Width Over--------- Line 2 Piers: _-_ Line 3 Piers: (Under Bearing Wall Only) Size -Min. -- -- �"x Size-Min.----------- Spacing-Max---------- „ "x " — Spacing -Max .--------------- �_ u From Ends -Max .---^ ^ From Enda-Max.------------- r_ Line 3 Roof Loads: - - Size -Min ----- k Sc " 'kk Location (From Front) �_ - �' Size -Min .------------ 'k " Spacing -Max.--------- , n From Enda-Max.------- Line S Roof Loads: Size -Min. ------------ Location (From Front) Size -Min ------------------- ..x n Spacing -Max ----------------- From ------ -------From Enda-Max.------------- ' j; - BUILDING DEPOTMENT - APPR' VED 101 Alm BUILDING DEPOTMENT - APPR' VED AP # OWNER PERMIT'#-�`7T�� Nfit UTIL.CLEARANCE DATE INSPECTOR ELECTRIC GAS Support Struc. YES NO Compaction Test Re .. Service Size Other Load Type Pipe Size Length YES • NO 1� �p 3 1LI 46 • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS • - 7,County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 28-1843 ZONING A5 BUILDING PERMIT OWNER- Sylvester Terrel TELEPHONE 679-2566 SO. FT. OCC, BUILDING VALUATION OWNER'S MAILING ADDRESS 573 Upham Rd Bangor 95914 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADCRESS Upham Rd - Bangor Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP �%— Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeffK Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I fp 10.00 ea 30.00 TYPE OF WORK New F-1 Addition ❑ Remodel❑ Utilities Installation❑ Other [:1 Describe work: 14x65 1981 mobile Permit Fee $ 40,00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 10.00 Main service EA. AOD'L 100 AMP 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): El am licensed under provisions of Chapt. 9, Div. 3 of the BuSlnesS and Professions Code and my license is in full force and effect. License No. Classification, 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLINGoCCUP.& / OR ADDNS. ( ACC. BLDGS. , /20sgft NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2.50 Be POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 2ALOt eLe30 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 15,00 Misc. Wiring g 15.00 Permit Fee $ 37.50 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ® Ishall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation penult Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Co ty in nseque ce of the gr ting of this permit. X Date Z S Signotur of Applicant — Owner W Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height.�``GG Mobile Home Installation Fee $ Energy Inspection Fee $ occ �pN TTYPE - TOTAL FEE $ 92.5 HAL PA PARK sc FLD cOF PAR P l,H Is uE This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. D) E OR .F PUBLIC WORKS By Date L %� PERMIT EXPIRES ate /^ / �`—L L__�. Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT PHI; A c +v e/420.7¢ . �` 1 F A setback of 5 ft. from the ,Thls s' t€pians and specifications 1VfUS� be ` properYlines and a setback '1 kcpt:ori th'i�16ti 'at U,times and it is unlawful to of 80 IL ftWZe rgad 1 '" ` centerliae'b2ii 11 be Ulbar of �.. rrtake.�ny �cf��nres or alterations on sumo wl#�out � ~, ttert p8rnngn from the Department of Pe stractlu►a 6r equipme i! except worlds, c4Unty+ of Buf . for a save overhang A" lip vM o � � NOTE. All Materials E W&kmenft SW Be in �, U Accordance with Rpra;nzed Good PracficN and of a quality prescribed for the Specified use in the \\ 1 Q Uniform Buildlnq, Fiurnbing & Maci anioal Cocker and _ .•. the NatiorW Electrical Codo. - r �� \X ••�� �f... /222.24 �- � � ` �` �- F-1 7' �E.P.3K'T/OAC/ ,PbC.t� lL.4L L c FE�C/CL� , U11, AI /k /I/— BUTTE COUNTY -DING DEPARTMENT p P R OV E D Jj "7l �i . K.+t r^�'"yq,.,: z i�,ri ns�,e` �.e ,..�i� �. • ( .' .. :a,,r�y„ i,r, , ,� , COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT 'APPLICATION DATA SHEET Permit No, 0WNER t A. P. No. Proposed Building Use A4 lam(. 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 APPROVED 1. All items have been submitted. 2. Plot plans in duplicat rl Ica e, igned by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... >13. School District fees paid .............. MT414. Sanitation approval from 040 u/ "-C . Health Department C 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 9. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector �(Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 3. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 4. Recorded copy of Agricultural Acknowledgment Statement ......... Xlql 25. Letter of signature authorization_. ' ............................... . 26. n�-Q.e 27.. When you issue the permit, process as follows: Mail to owner. Mail to contractor. L Telephone 4C;Z9 2S' and hold for pickup at office. Deliver w/inspector; Other " Applica Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent ---Health Dept. Fire Dept. Other Date By The following data must be submitted prior tVY r it i s aaqc (C' le ew it %n t checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone--nail—counter by ..date Contractor, design9r, owner, was advised of above requi d data by_phone_mall_counter by date Plane=by Date approved by _ Date Sets ofpla s onh�.n File cabinet AP f Ider � Copy—DPW TO ...Building Department FROM: Environmental Health SUBJECT; Sanitation Clearance Owner Location AP# f Plan Approved for: Sewage Disposal water -Supply �✓G�� Hold final for: Water Supply `a Final clearance O.K.-for: Clearance for -3 bedroo mobile home. Other NOTE * * * Water Supply /c)�vr/ Sanitarian Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the -major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) /7 "'?v e signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: U& -LOW , Name l..l & .L O W 2:2 Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinatesup rvise, and provide the major work: Name 4z, Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name AddressPhone Type of Work Signed: Prope Socia Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. 7C7 BU�T�OUNTY „S H(One .FormLper�BuildinFEE gERTIFICATION FORM�/ A.P. Number aW- A5- y3. Building Department No. School District City D County EZ Jurisdiction Property Project: Location/Address (.(, id. ;34,�p/�. Subdivision' ` ' Lot Number Residential Development: �a a Sq. Footage # of Living MHI Addition (Group R) Units Commercial/Industrial: Sq. Footage New Addition (Including Exterior Roofed Areas) 2 57 Buil g De r ment Representative Date (Floor Plans reviewed by School'District Personnel) gis ' ct Id' No. y D4U� ` chool District certifies that (Ap 1'c nt Name) (Phone Number) �,�Str et Address) � Gtr (V ty) (State) (Zip Code) has complied with the requirements of Resolution No. �Q by the,,'pay e) of 1"48 0� representing square feet. Scliool Distri t Representative Date PAID BX-C9E`CK NO. REMARKS: .BANK; NO,, . :,-.PAID;,BY CASH / white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) w \ . � f / y \ ` . } \�\ � �«\ . I I -00906 RECORDING REOUESTED BY 9 BI9 ELL j'I'ILE AND ESCI'OW COMPAD]Y ORDER # 4-148369 AND WHEN RECORDED MAIL TO Name FM• SYLVESTER N. TFRREL 600 UPHAM ROAD Street BANGOR, CA., 95914 Address City State 91-000906 ; S Rec Fee DOC Recorded Check MAIL TAX STATEMENTS TO { Official Records ; I County Of Name Butte ; Street SAME AS ABOVE Candace J. Grubbs ; Address Recorder cttY a B:OOam 8 -Jan -91 State L CE) 029=180-043 SPACE ABOVE THIS LINE FOR RECORDER'S USE - ^Pp Individual Grant Deed THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY �« U,IU«„gt,cu grantor(s) declare(s): Documentary transfer tax is $71.50 ( X) computed on full value of property conveyed, or _ TRAN: ( ) computed on full value less value of liens and encumbrances remaining at time of sale. TAX F ( X) Unincorporated area: ( ) City of and FORA VALUABLE CONSIDERATION, receip AS HIS SEPARATE PROPERTY pt of which is hereby acknowledged, JAMES W. ARNOLC hereby GRANT(S) to SYLVESTER N. TERREL, At1 UNM MII..MAN the following described real property in the County of BUTTE State of California: THE LEGAL DESCRIPTION IS ATTACHED Dated: OCTOBER 8, 1990 JAMES W. MOLD - E STATE OF CALIFORNIA j COUNTY OF BUTTE }SS. On�!2 6) before me, the undersigned,— a Notary Public in and for said State, ' personally appeared JAMES W ARNOLD personally known to me or proved to me on the basis of sat- isfactory evidence to be the person whose name IS plT subscribed to the within instrument and acknowledged �r"'`''' ®C ,�iC).��>L SEA that iil; `F +,';::''= . � 11frIll t. 0LEDS'OE executed the same. WITNESS my hand and official seal. 't"`±='';;e. V. i4OTl+kv"'I;?LIC-ChLIFORNIA TA-�... . .......... . CUTfE COUNTY PAy Com, Expires Feb. 1, 1993 Signature (This area for official notarial sea MAIL TAX STATEMENTS AS DIRECTED ABOVE hf, 91 009.06.. • Order No. 4-148369 SCHEDULE C The land referred to herein is described as follows:. All that certain real property situate in the County of_Butte, State of California, described as follows: Parcel 1, as shown on that certain Parcel Map being a portion of Section 12, Township 18 North, Range 5 East, M.D.B. & M., filed in the office of the Recorder,. County of Butte, State of California, on May 26, 1976, in Book 57 of Parcel Maps, at page 41. EXCEPTING THEREFROM that portion lying within the following described parcel of land: A cemetery in the Southeast corner of the Southwest quarter of said Northeast quarter, as described in Deeds, dated May 12, 1875, and.recorded June 7, 1875 in Book O of Deeds, at page 610; and dated November 9', 1914 and recorded January 15, 1915 in Book 147 of Deeds, at page 485; and dated October 28, 1929 and recorded November 2, 1929 in Book 22 of Official Records, at page 472;' and dated December 8, 1971 and recorded December 13, 1971 in Book 1720 of Official Records, at page 32, records of Butte County, California. AP No. 028-180-043 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovll le, Callfornla 95965 - Telephone: 916/535-7541 APPLICATION AND PERMIT PERMIT NO. ASSF530H PARCEL. NUM ' �'�/ g � � . N BUILDING PERMIT WN CA v S vz�S T It L it IHa"il SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ApOR ESS� 4 �� / /, CONTRAC OR'3 N M TELEPHONE' CONTRACTOR'SCONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $- Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ , PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME - PARCEL MAP Water piping - 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomejo— Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home W 0.00 ea d,Ba7 TYPE OF WORK New Addition❑. Remodel❑ Utilitie49/_ Installation❑ Other ❑ Describe work: Permit Fee $ Q ©. Contractor ELECTRICAL PERMIT Filing Fee 10.00 00V OR Main service 100 AMP ORSLESS 10.00 la.66 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. AOD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.21 OR AODNS. ACC. BLOGS. t �ZICSQft NEW CONSTR. ULTI.OUT LET NON-RESID BRANCH CIRC ITS 2.50 ea —•" /POWER APPARATUS tri SINGLE OUTLET CIR. I Ex. OCcU OUTLETS OR FIXTURES p 250@030 ALO20@30 Ex. Occup. out OUTLETS P(RESIO.)REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 � Misc. Wiring 15.00 Permit Fee ; WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling 9 Hood 3,00 Ventilation Permit Fee ; Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required For excavations over 5'0" deep and demolition or construct- ucturees�rover 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE i— TOTAL FEE $� HAL CUA I PARK SCHL FLD I CDF I PAR PD l HD. ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date receNo. Z; �5 4 , 0�1�� .W.. YELLOW-ASSC330R. PINK -INSPECTOR. GOLDENROD -APPLICANT .. ,� .� .. - Re' turh to ?DPW AGRICULTURAL STATEMENT` OF ACKNOWLEDGEMENT 9 f 12888 FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County, Code requires this acknowledgement be recorded prior to issuance of a building permit. The property described herein is adjacent 9 1-0 1 2889 Rec Fee 7.00 to land or included within an area zoned 1 Cash T. 0:0 for agricultural purposes, and residents Recorded 1 of this property may be subject to incon- Official Records veniences or discomfort arising from the County of use of agricultural chemicals, including, Butte but not limited to herbicides, pesticides, Candace J. Grubbs and fertilizers; , and from the pursuit of agricultural operations including, Recorder X 2 but not limited to cultivation, plowing, 1:27pm 47Apr-91 spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real :prope:rty. situate in the County of Butte, State of California, described as follows: a7�6e /`�'/ r Date: —tom 1 State of �v) County of SS. _) OMCLu, SEAL L. LANCASTER Personallyknown to me. Proved to me on the basis (WMyC=mEvUesFebnWrY1 NOTARY PUBLIC -CALIFORNIA BUTTE COUNTY of satisfactory evidence. 91990 Vo be the person(s) whose name(s) IS ubscribed to the within instrument and acknowledged that e executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. PROPERTY OWNERS - On this the q� day of A6r/ J , 19 , before me, the undersigned Notary Public, personally appeared ,jV)(ves,-er N. 7.«e- 0� l� �d�� Notary Public v 9 1 -12888 Order No. 4-148369 SCHEDULE C The land .referred to herein is described as follows: All that certain real property situate in the County of Butte, State of California, described as follows: Parcel 1, as shown on that certain Parcel Map being a portion of Section 12, township 18 North, Range 5 East;M.D•.B. & M., filed in the office of the Recorder, County of Butte, State of California, on May 26, 1976, in Book 57 of Parcel Maps, at page 41.• EXCEPTING�THEREFROM that portion'lying within the following described parcel of.land: A cemetery in the Southeast corner of the Southwest quarter of said Northeast quarter, as described in Deeds, dated May 12, 1875, and recorded June 7, 1875 in Book 0 of Deeds, at page 610; and dated November 9", 1914 and recorded January 15, 1915 in Book 147 of Deeds, at page 485; and dated October 28, 1929 and recorded November 2; 1929 in Book 22 of Official Records, at page 472;'and dated December 8, 1971 and -recorded December 13, 1971 in Book 1720 of Official Records, at page 32, records of Butte County, California. AP No. 028-180-043 Comp GR Fac. <.. a3.� _�- Drill '1� EIY E UMENT