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HomeMy WebLinkAbout029-110-0139F eroy.Theggvall_ 29-11-13 E%ourth St5 aPP 550 ' 0' . N .. o f.c_,.___. - Richava• Main St, Permit # 2 6-82P E(util/MH) ` 4 GAS t SUPPORT STRUCTUREfREQ., yp. .—C.GPACTION TEST REQ. �f�I Cqn IMG Enterprises ,;Corning.... E<�rm t��3075=8.21 KH2(294'6i9s'2)-"--, Issued a C 29-11-13 -- - ontr.: Northstate Aluminugl, Chico MH) & Permit#3522-82B(cov.'d decks awnings/ NEW OWNER 29-11-13 OTIS WHITE 5320. Church St, Richvale �// /� j Contra: Ralph Johnson (P d Permit#1056-88B(mobilehome/fdn) staiA) 0019- i i -c I a wo jf Y X 650 Kentucky St., P. 0. Box 949, Gridley, Ca., 95948 9L6 -84b-4005 • ❑ Oroville ❑ Chico ❑ Paradise Bidwell Title 1835 Robinson St. 181 E. Fifth St. 6440 Skyway AuthorizedAgent for & Escrow P.O. Box 811 P.O. Box 3037 P.O. Box 490 TicorTitle Insurance Company Orovi Ile, CA 95965 Chico, CA 95927 Paradise, Ca 95967 Company of California Serving the (916)533-2414 (916)894-2612 (916)877-6262 nordrstate since 1929 In reply please refer to: OmAlle order No. Vern E. Drane County Manager June 17, 1988 Chico order No. Paradise order No. Gridley No. 141409 COUNTY OF' BUTTE Dept. of Public Works 7 County Center Drive Oroville, Ca., 95965 Re: Form.433 (A) for Leroy.Then gvall Gentlemen: We handled an escrow for the sale of the Leroy.Thengvall mobilehomeand land located at 5320 Church St., Richvale, Ca. A form 433 (A) was recordedby your office on the mobilehome April 29, 1988. We have attempted to forward the original mobilehome certificate of title and other documents to the State of California, Department of Housing and Community Development in that they should'be surrendered after the filing of the 433 (A) form,.however, they have returned our documents asking that we send the original 433 (A) form to them., I am enclosing a copy of their letter. Would you kindly check your file for this form and.send it to us so.that we can.complete the State's file on this mobile home? Also, if you have the registration for the mobilehome, I would your also -sending this form to us so that we.can submit it to the State. I have the.legal owners' copy which they have stated.is'not.sufficient. Thank you very much. Please contact me if -you should have any questions. Sincerely yours, LW/lw Encl. BIDWELL TITLE & ESCROW COMPANY Linda Wilson, Escrow Officer Formerly Oroville Title Co. (Op �bk ®z NW V!Aom 3l �, o o 3� File No. BUTTE C 0 U rQrvT'Y 1] (For Action 1, 2, 31' V r' Public Works Dept. (For Information ✓ ) �Dep. tor Dir. Sec. Rd. & Br. Mtce. Shop & Yards Bldg. Insp. Admin Design Engr, Bridge Engr. Constr. Engr. Surveys Mapping V Tran sp. Land Dev, — Drng, /S.I. Sub. & Pcl. Maps Permits Addr. r STATE OF CALIFORNIA �UC�✓e� GEORGE DEUKMEJIAN, Governor DEisA ME' NT OF HOUSING AND COMMUNITY DEVELOPMENT Registration and Titling Section 405 Redcliff Drive, Suite 100 6-6-99 0 Redding, CA 96002 (916) 225-2215 Filet: Decal /: - /44,0�3/3cy�,Q y� aerial /: ! o Make: n 9 / Receipt f: Amount: �. IMPORTANT: To complete the attached application, please return this letter, any receipts, any attached documents, and the items checked below to the above.address. 1._ California Ownership Certificate (MCD or DMV) or (if lost) an application for duplicate. (Fee for duplicate is $5.00 each.) Photocopy NOT acceptable. Comer 2. Orig1 copy of registered owners last issued Registration Card (HCD or DKV) or (if lost) an app1L:z:10n for duplicate. (Fee for duplicate Is $5.00 each.) A photocopy, PaAk Operator copy or Legal Ower Informational copy is NOT acceptable. Comment: 3.! Tax Clearance Certificate issued by the co6nty tax cdllector where the mobilehome is located. 4. Secure the HCD Insignia or HUD Label numbers) affixed either next to the front or rear entrance door or the left rear of each section of the•mobilehome and enter number(s) in the space provided on the enclosed application (HCD 480.5), where checked in red. 5. Obtain the length and width for each transportable section (do not include hitch) and enter these measurements (in inches) in the space provided on the application (NCD 480.5) where checked in red. 6._ Statement of Facts for Smoke Detector (HCD 476.6a) completed and signed. 7._ Signature of 8._ Designation of Co-owner Term (HCD 483.1) completed and signed by each co-owner. 9.+ Certification.of Retail Value and Purchase Price form completed and signed. by purchaser: ( ) See Attached. (Compute Use Tax and submit that amount in addition to any other fees required. Use Tax is due unless you can submit evidence of an exemption. This can be a form BT -111 from the Board of Equalization), or Statement of Facts, Use Tax Exemption, HCD 476.7, completed and signed. 12 Please pay additional fees in the amount of S for 11 Bill of Sale from to 12 Turn in Plates/Decals / (or surrender to DMV for a Plate Record Card, or provide a statement that they have been destroyed). 13_ The registration on this unit expires Applications submitted or resubmitted to this Department within 60 days of the expiration date must be accompanied by renewal fees. The fees are $ , and must be paid prior to the expiration date to avoid penalty. 4 Other items: Axj3.3 /I4 Q Initials HCD 493.8(b) (Rev 08/86). . ' r— a nxg**W -w No. ..G:vnty of Butte f "opt of Public Work; Coun;y Ccnicr OrK �rovllle, California 9.1;4r,5 Am www mcmm WA to. ma uourlty of dune 11"m Ocpt of Public Works rrosau 7 County Center Orly an. '1roviila, California Suit. 9�4AS .r a 1'611cl`7 RECORDED B8UT1 31r3 OFFICIAL REC B nw. r' Ivr)"" X O APR 29 ASI 0 59 CANDACE J. GMaS CM-McoW rM NO ;S F 88-133'73 NOTICE OF MANUFACTURED NOME, (MOBILEHOMB), OR COMMERCIAL COACH, L -,-j INSTALLATION ON A FOUNDATION SYSTEM P1:y.r; Recording of this doevmeent at tin rp"ves, of the local agency Indicated k in accordance wish Getlfornio Neom and Safety Code Section 18331. This docwmem k eAdence I1101 such local ogency hos hmd a certifkate of occupancy fee Wtolkolon of the uni t described hereon, upon the real Property described wish certokny below. as of the date of recording. VVhen reeerded, this doevmeat •hail be Indexed by the county recorder to IM named owner e1 the real property and shaft be deemed to ONO comtrvcNN notke as to Ik contents to on mns IMnoher dealing wish the nal Property. per - Leroy T'henevallUAL Butte County Dent of Eublir Workv pA owNu/tlfwe LOCAL AOtNCY SUC40 pteml « C1e101CATt CM OCCWAKV P.. O. Box ox 339 I-7 County -enter t)r_ rAA1l1"O A00•!s1 MAIUNO A 9 Richvale, Butte. C8 95976 Oroville. Byer.. r.1 959A5 iTATI 11► CITY 5320 Church St carNTY Sun 1r IOS6-88 ' ITAILA ION MAIL04 A0041m 0 0411e1M PAL 11upI,O►� pAwe(e Richvale, Butte, CA 95974 dTY COUNTY NAiI 1r1-11ab"Not Ol LOCAL AN KY 011,CIAt CA11 North State National Bank none MIT OIdta 111 6160 properep a.ner. write •SAN&•) OtAUR MARC (it not • de&lqg B&IS. vr►te •m)"t•) P.O. Boz 3235 10AILING ADVARIS OCAL A LICCH89 00. Chico. Butte CA 95927 CITY COVNYY IITATt lip UNIT DESCRIPTION Lancer Homes I_nc. 4/29/82 67AR #MKOAC1Velt 1 WAMI DAN 01 MA"ACtut1 Ato"t p1AAV/,ejmmo S27019A/S270198 12 x 60/12 x 60 232R11/212RI 7 UAIA1 NIWMAlt) 11"91" R WWIN ar K"A/IAHI HUMe1111) R1AL rlo►fSn u0A1 INSO MIOr1 ASuua•t FARCIt p jmu%- 29-11-13 Lots 344, 345, 346 and the West half of Lot 165, according toman ant—_itldd, "Tnvn of Richvale" which map was filed in the office of the Recorder of rh., r .nty of nt,tro_ tate of Califwnia, January 17, 1910, in Book "6" of Maps, at page 53 • • '.4%%l Or *� IICl/ FORM 433(A) 4/86 41 y gyp' • -s FtdD OF. DOCU&TENT re. 9 A0, !O2 6Jn PERMIT NO: — PERMIT EXPIRESlee &7/e OWNER r1TT(; WHITE CONTR. Ram h W Tnhn.t)n ASSESSOR PARCEL 2Q-11-13 LOCATION 53?Q- Cbllrrb St-, Ri rhvnl p f ' do Com. 1?EVE�Q d, AcFZ"-c Temp. Power Pole Called PGI Temp. Elec. Se Called PGI Temp. One Ser ' Called PGI JOB FINALED. Signature = OK `0 = Not OK • Not = ot dyMOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s - 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils;'Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; location -Test -Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -B1 Date Card -B1 Date 10. Roof; Shthg-Roofing Card -B1 Date 'Card -B1 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -131 Date Card -B1 Date 2. Footings; Size -Spacing -Marriage Line Card -B1 Date Card -B1 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and,Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater Card -B1 Date Card -B1 Date 8. Elec.; Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit Card -131 Date Card -B1 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -131 Date Card -B1 Date Card -131 Date RXI W = OK 0 = NotRESIDENTIAL (Single and Duplex) - =Not Applicable - = Not Ready Date UN ERFLOOR (Plans) OK except #'s Date FRAMING (Continued) .Z,2fiing requirements -Setbacks -Easements 44. Hangers -Post Caps -Anchors -Connectors Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 46. Fireplace Ties or Type A Flue -Fireplace. Throat 4. Ftg., Porc s & Decks; Soils -Steel-/ /"Ftg. Depth 47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles P YS'Stem s, Mi' teel-Blockouts-Wrapped 48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwelis, Garage; Steel-Blockouts-Wrapped 49. Garage Fire Protection Framing 7. Slab; Steel -Wrapped 50. Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel 51. Ext. Doors -One T -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 54. Siding -Nailing Veneer 12. Electric; Underground 55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance- Material-Supprt-Ins. 56. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 57. Shear Walls; Nailing -Bolts 15 sulation 58.Insulation-Walls-Clg. s59. Infiltration-Walls-Wndws Card -131 to - Card -B1 Date Card -81 Dat@S(i and -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Card -B1 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchors -Nail Protection 60. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 61. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 62. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors 63. Bedroom Exiting 64. G.F.I. & Bath Fixtures & Tub Access -Spa 65. Elec. Trim & Subpanel; Breaker Sizes -Labels Card -81 Date Card -B1 Date 66. Stairs & Rails Card -61 Date Card -81 Date 67. Fireplace or Stove; Clearances -Hearth 68. Elec. Outlets at Wood Panel; Int. & Ext. Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Elec. Outlets & Receptacles at Kit. Counter 24. Size Boxes & No. of Conductors -Stapled 71. Garage Fire Door; Swing -Landing -Closer 25. Romex Installed Close to Edge of Studs & C.J. 72. A.C. Duct in Garage -Damper 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 27. 2 Appliance Circuits in Kitchen & Conductor Size 74. Plb., Elec. & Mech. Equip. Listed for Location 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 75. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 76. Insulation -Foam -looked in Attic 0 Yes 77. Guard Rails & Deck Construction -Post Caps 30. Service -Riser Conductors & Ground -Main Disconnect 78. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor D Yes 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 79. Following instld.; Drive 0 Yes 0 No; Walks 0 Yes 0 No; Planters 0 Yes 0 No 80. Stucco; Brown -Finish Card -131 Date Card -B1 Date 81. A.C. Unit; Disconnect, Electrical, Plumbing Card -131 Date Card -131 Date 82. Vents Above Roof; Pibg.-Appliance-Firep I. -Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 83. Water Well; Disconnect, Electrical, Plumbing 33. A.C. Ducts Insulation & Support 84. Exterior Elec. Trim; G.F.I. Receptacle -Underground 34. Vent Fan; Exhaust above insulation 85. Ventilation throughout House 35. Condensate Drain & Overflow; Size & Grade 86. Glass Protection 36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Corrections from Previous Inpections 37. Attic Access & Platform if Furnace in Attic 88. Gas Test -Meters Tagged; Gas -Electric 89. Water & Sewer Connected -C/O to Grade -HD Approval 90. Energy Compliance Certificate -Other Certificates Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -B1 Date Date FRAMING (Plans) OK except #'s Card -B1 Date Card -131 Date 38. Sills, Proper Material & Anchors Card -131 Date Card -81 Date 39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Comments at Final: 40. Bearing Walls over Girders & Floor Nailing 41. Draft Stop in Walls (rat proof) 42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 43. Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit job site) "J/COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT .O. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 O APPLICATION ANS. PERMIT ASSESSOR P =EL NUMBER ZON N BUILDING PERMIT OWNER © & LEP�H/OjN/ / L+� SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS ✓''-32 o v (e t , CONTRACTOR'SNAMETELEPHOANE tJBS_ CONTRACTOR'S MAILING ADDRESS 2a /s LL C gZ`s Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 15 - Permit fee $ PLUMBING PERMIT FiIingFee 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[] MobilehomeM Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: 15 09&t 611 ! A)ySrI 10- _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service sooV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declgre under penalty of perjury (Check -One): I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER and Professions Code and my license is in full force and effect. License No��r •S"37 Classification El 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 oCCU1.11) +h�sgft OR ADDNS. \ ACC. BLDGS. NEW CONSTR. I ULTI.OUTLET N0N.RESID BRANCH CIRC ITS 2.50 ea APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLET20 e 50e FIXTURES eALO 30 POR FIXED AR EX. Occup. OUTLETS (RESID )EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 15.00 g Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judg ants costs, and expenses which may in any way accrue ag t sa our i c nsequence of the granting of this permit. X y� Date 'i�-- %�'� K''9 Si atDre f Applic t - Owner El Contractor Tbl Agent ❑ An OSHApermit is r quired or excavations over 5'0" deep and demolition or construct- ion of st v 3 r i eight. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ , occuP. CONST*TYPEJ F P _. PD ND ISSUE This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which PUBLIC By. PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS f(� Data _ ° -8-, Receipt No. /� Q WHITE-D.P.W.. YELLOW -ASSES OR, PINK -INSPECTOR. GOLDENROD -APPLICANT t COUNTY OF BUTTE - DEPARTMENT A .P,UBLIC WORKS -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLF2-,cQ'L14RNIA 95965 -TELEPHONE: 916/538-7541 \` PERMIT APPLICATION DATA SHEET J y Permit No. OWNERr ► / � Ay P. o. �9 — 0. Proposed Building Use / e-rm /I 17�4 I•Bui;lding Inspector Date // o 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 preorer 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. Plans with Energy Design Compliance Statement. . . . : . 6. School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ , . , , , , 9. Letter of signature authorization. . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) _15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . .. Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of 21. En neered trusses in duplicate (required prior to plan check). s . vT fo G c >r6 a 9 o- ..--�-�-u- ,..- — o Issue the e i�it,[r�°c�e�ss as fol to s: Mail to wrier, Mail to contractor. Telephone �.�-� and hold for pickup atffice, Deliver w/inspector. Other Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to 1. Index permit for above items N9. 2. Additional items retaui it issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone_-nail counter by Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by. Plans checked by A2 i -P Copy -DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder _ date — date Date ' 43 .O Return to DPW AGRICULTURAL STATEMENT OF -ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. E A NO �,:�lZ?� Cera:w�l�'�•,_.�;_h,^.;r. The property described herein is adjacent. to land or included &LLFK6= within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising 82-2S534 from the use of agricultural -chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa- sionally generate dust,.smoke, noise, and odor. Butte County has established.agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Lots 344, 345, 346 and the West half of Lot 165, according to map entitled, "Town of Richvale", which mag; was filed in the office of the Recorder of the County of Butte, State of California, January 17, 1910, in Book 116" of Maps, at page 53. Date: State of California ) Butte ) SS. County of ) ... OFFICIAL SEAL NOT SSC - cALFORRlA �M 4�IMon 6prw Atm. �, � 884 On this the 20.th day of August , 1982 , before me, the undersigned Notary Public, personally appeared LeRoy Thengvall known to me to be the person(s) whose name(s) subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. °. Notary Public END Of DOCUMENT Present A.P. N0. cu 0 0 -V rn M ,, AOM YPATO$ TO: FROM: SUBJECT: DATE: Inter-Depart�1 cm®randum 0 0 �O U KA Land Development Section, DPW Building Division, DPW Reversion to Acreage 4/12/,98 We have recently received an application to construct a mobilehome on fdn (use) by nri c whi i -P (owner and/or contractor) at (location) A.P. No. 29-11-19 Permit Appin. No. 1056-88 and he has been advised to contact your section regarding a reversion to acreage map as he is proposing construction across a lot line. Would you .please advise us when he has made the application and paid fees so we can issue the building permit and again when the map is recorded so we can final the job. JFG:ahb WOK to issue permit. MOK to final permit, map is recorded. 2 .F. Glander _ Chief Building Inspector V_ y- 12 J's ignature) (Date) (Signature) (Date) .E. 6861 z T NdV wS Aranduladu0 QtiU W.M r "7l • " 7/i, co RED5 I L eUrrg couri*r.C-caj:r t,� hECD Ar.,.._.....� ALBEF� [4. fh1NG 1 I/1 Q 3 26 Fe 1997 OCT 04 1982 ALBERT M. KINGOCT 2 auna o ELEANOR N. i:CRER ueeomo..,aw�vwo CLERK-RECORDER.iEIFAMKEEWkCmmlyCork onovIurM�u�u v�uesou EE 8 N6 PRATER Y 3 ..OePuh ` 4 9:•30095 5 A•IToRNTY FOIL Petitioner •. 6 - .. 8 IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF BUTTE it n the Matter of the Estate •) ) la of ) NO. 24754 , - 13 RUBY IRENE THENGVALL, also ) ORDER DETERMINING AND CONFIRMING 14 nown as RUBY I. THENGVALL, ) PROPERTY AS COMMUNITY PROPERTY also known as RUBY THENGVALL,) AND AWARDING ATTORNEY'S %-w 15 ,) ' FEES Deceased. ) 16 _ ) 17 The verified petition of PAUL LEROY THENGVALL for do - 18 ermination that property of the -above-named deceased spouse is 19 o:4munity property passing to the surviving spouse without adminis- 20 tration and'for confirmation of the surviving spouse's interest in 21 he community property came on regularly for hearing this day. 22 THE COURT FINDS that: 23 1. Notice of the time and place of hearing has been given as 24 equired by law. as 2. The decedent, RUBY IRENE THENGVALL, also known as RUBY I. � 26 HENGVALL, also known.as RUBY THENGVALL, died on February 19, 1982, • ^� • , Qcor M WNo r 2 3 4 S 6 8 ' 9 10 11 12 13 14' 15 16 U 18 19 20 71 22 23 24 25 26 '.O[AT r ■nq no•r. n u� leaving an estate in California, and was at that time a resident of Butte County, California.- 3. alifornia, 3. The document dated January 29, 1982, is the last will of decedent. 4. By reason of the transfer of the property'described in the petition no inheritance tax became due and a Certificate of No Tax Due is on file herein. S. The property described below is community property and passes to PAUL'LEROY THENGVALL as the surviving spouse of the de— cedent by the terms of the decedent's will without administration: The following described real property in the County of Butte, State of California: Lots 801, 814, 815, 833 and 834, according to -that certain map entitled, "Richvale Colony No. 2', which map was filed in the office of the Recorder of the County of Butte, State of California, January 17, 1910 in Map Book "6', page 95, containing 100.98.acres, more or less. EXCEPTING from Lot 801 the following described parcel of land: Beginning at a point on the center line of the Rich= vale -Nelson Road said point being North 00 38' East a distance of 173.60 feet from the Southwest corner of said Lot 801; thence North 00 38' East along the center line of the Nelson Road a distance of 279.25 feet; thence South 860 52' East'a distance of 62.23 feet to the point of commencement of a curve to the right having aradius of 120.88 feet and a central angle of 73 11' an arc distance of 154.39 feet to point of tangent of said curve; thence South 880 42' East a distance of 126.70 feet to the point of commence— ment of a curve to the right having a'radius of 40.00 feet and a central angle of 890 13' an arc distance of 62.28 feet to point of tangent of said curvet thence South 00 31' West a distance of 67.18 feet; thence r North 880 42' West a distance of 171.50 feet; thence along a curve b the right having a tangent bearing of South 030 04' West, a radius of 32.68 feet and central angle of 680 58' an arc distance of 39.34 feet to the —2- 0 1 point of tangent of said curve; thence South. 720 02' West a distance of 154.83 feet to the point of 2 beginning and containing 1.34 acres, more or less. 3 The following. described real property in the County. of Butte, State of California: 4 Lots 83 and 84, according to that certain map 5 entitled, "Plat of RICHVALE COLONY NO. 7 -,-which map was filed in the office of the Recorder of 6 the County of Butte, State of California, -May 10,. 7 1911 in Map Book "7-, page 61. The following described real property in the County 8 of Butte, State of California: 9 Lots 344, 345, 346 and the West half of Lot 165, according to map entitled, "Town of Richvale-, 10 which map was filed in the office of the Recorder 11 January If the C17,�t1910,of BintBook t•6- of Mapsate Of fcatipage 53. 12 Personal Property 13 1953 Steam Cleaner - 1/2 interest 14 John Deere Plow, 1954 - 1/2 interest 15 John Deere Plow, 1971 - 1/2 interest 16 Caterpillar Tractor D4, 1.940 - 1/2 interest . 17 1967 International Harvester Disc 18• - 1/2 interest 18 1951 Caterpillar Tractor D7 - 1/2 interest 19 1975 Towner Disc 21, - 1/4 interest 20 1945 Marvin Landplane - 1/2 interest 21 1965 John Deere 21' Disc - 1/2 interest 22 1975 Marvin Tri -Plane - 1/4 interest 23 1974 Pike Bankout Wagon' 24 1974 John Deere 7520 6 Chisel - 1/4 interest 25 1975 Dandl Mower--* 1/1 interest 26 1972 John Deere 7700 Harvester - 1/4 interest -7 r wrp •�... u. 2� ���;`•'�.e:o :err �.LF,.; 4,� _ ,. !. r 1 1972 John Deere 7700 Harvester - 1/4 interest . 2• Miscellaneous tools 3 1953 Caterpillar Tractor D7 - 1/2 interest 4 ------ 5 Household furniture and furnishings 6 6. PAUL LEROY THENGVALL, the*surviving spouse, has a one - 7 half community interest the the above described property. 8 7. ALBERT M.,RING, as attorneyfor petitioner, is entitled .9 to $489.66 as reasonable attorney's fees for services rendered as 10 follows: 11 a. Preparation and presentation of the petition; 12 b. Preparation of Inheritance Tax Declaration; 13 C. 'Preparation of Inventor and 14 Y A ppraisement of estate property. 1S d. Presentation of ducoments fo Referee for appraisal and 16 determination of taxes; 17 3. Preparation and presentation of Order confirming all Pro- perty of estate as Community Property Passing to Surviving Spouse 19 with Administration. 20 IT IS ORDERED that: 21 1. The one half coca nunity property interest of RUBY•IRENE 72 THENGVALL, also known as RUBY I. THENGVALL, also known as RUBY THENG- I 23 VALL, the deceased spouse, in the above-described property passes to 24 PAUL LEROY THENGVALL . the surviving spouse, without administration. 25 2. The one half community property interest of PAUL LEROY 26 THENGVALL, the surviving spouse, in the above-described community rtiw.o n •r u. 1 .r' .r•., •� Nti �4. ' 11 3 4 5 6 9 10 11 12 13 14 is 16 17 19 20 21 22 23 24 25 26 car a =8 property is confirmed to him. 3. PAUL LEROY THENGVALL pay $4879.66 as reasonable attox feet to ALBERT. M. KING forservicesrendered as set forth above. DATED: October �, 1982. L&D MULKEyi JR - Judge of the Superior-if-o-urt, IM FOREWG tWSr!.jAENT. IS A CORRECT CO" Of ON -,:C) O. IK ORIGINAL RECO"D INDUS OF"CE OCT04 DAM ATTEST: CLEM OF TM ufflows WA no Cw- op wM PAU jLE"VA.BECX-z4,1 WLx N. "a fir, a iV Mod Do C* 00cu A ..County of Butte ' Dept. of Public Worki, 7 County Center Qrly- 7,rovllle, California 95965 AND WHEN RECORDED NK TO: "M W-unty of Butte STREET Dent of Public Works, AWRESS 7 County Center Driv, cm. _Qrovillet California STATE. ad ZP 95965 .a S8- 13373 RECORDED BUTTE COUNTY OFFICIAL RECORDS BY PUBLIC VOPKS� X338 APR 29 AMID 59 CANDACE J. ORBBS . Ci.EftKREcOR.DEl7: FEE NO FEE 88-13373 THIS LUBE FOR RECORDER IISE NOTICE OF MANUFACTURED HOME, (MOBILEHOME), OR COMMERCIAL COACH, l -~J INSTALLATION ON A FOUNDATION SYSTEM Paces Recording of this document at the request of the locai 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 u n i t 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 per- sons thereafter dealing with the real property. Leroy Thenevall Butte County Dept. of Public Works REAL PROPERTY OWNER/LESSOR LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY P.O. Box 339 7 County Center Dr. MAILING ADDRESS MAILING ADDRESS Richvale, Butte, CA 95974 CITY COUNTY STATE ZIP 5320 Church St. INSTALLATION MAILING ADDRESS, IF DIFFERENT Richvale, Butte, CA 95974 CITY COUNTY STATE ZIP North State National Bank UNIT OWNER (If also property owner, write "SAME") P.O. Box 3235 MAILING ADDRESS Chico, Butte, CA 95927 CITY COUNTY STATE ZIP UNIT DESCRIPTION Oroville CITY COUNTY STATE ZIP 1056-88 (916)538-j541 BUILDING IT NO. TELEPHONE NUMBER 4/28/88 SIGNATURE OF LOCAI AGENCY OFFICIAL DATE none DEALER NAME (If not a dealer sale, write "NONE") DEALER LICENSE NO. Lancer Homes Inc. 4/29/82 678B < MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER. S27019A/S27019B 12 x 60/12 x 60 232811/232812 ~ SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER 29-11-13 Lots 344, 345, 346 and the West half of Lot 165, according tomap entitled, "Town of Richvale", which map was filed in the office of the Recorder of the County of R„trP, State of California, January 17, 1910, in Book "6" of Maps, at page 53. HCD. FORM 433(A) 4/86 _WP.Q-F pOCUME:NT oQt4EHT Of hCGs U �• 1 o ll . W r`0 ~VNlrr OfJ� NO. 1056-88 Address or location of j I 5.3LU Church 5t. Richvale CA 5 k/ Legal Description of Real Property Los 44 345 346 and the West half of lot 165 acor map entitled, "Town of Richvale which map was filed in the office of the Recorderok e County. 6f Butte, State of California, January 17, 1910, in Book "6" of Maps, nage 93- A sMobilehome/Manufactured Home []Commercial Coach has been affixed to the real property described above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: North State National Bank Owner'saddress: P.O. Box 3235, Chico, CA 95927 INSIGNIA OR HUD NUMBER: 232811/282812. SERIAL NUMBER OR V.I.N. S27019A/527019B MANUFAS,TURER'S NA/y1E Lancer Hora��Inc. YEAR OF MANUFACTURE: 1982 }ICD 5130 (7/80) WWt*--owner, Canary--Pwmi"se, Nuo--0Km M. NORTH STATE I K!, NATIONAL BANK April 15, 1988 Butte County Dept. of Public Works 7 County Center Dr. Oroville, CA 95965 RE: LeRoy Thenvall - Mobile Home Foundation Dear Mr. Glander, Our bank is the lien holder on the mobile home refered to in your letter of 6/3/86, to applicants for mobile homes or permanent foundations. Our bank is consenting tb the placement of the unit on a foundation.. If you need further information or, if I can be of assistance, please do not hesitate to contact me. Sincerely, aAA Richard C. Farley Vice Pres. Loan Officer 916-893-8908 RCF:rm Fifth 8 Salem P.O. Box 3235 Chico, CA 95927-3235 (916) 893-8861 STATE OF CALIFORNIA -DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT rFRTTFTrATF nF TTTI F MnATI FLInmr nrrAi Nn i •n:,:� MANUFACTURER NAME/IDTRADE NAME MODEL DOM DOI DFS SPC EXPIRATION+ LANCER HONES INC/031107 PARK.678E' RELEASE OF DEALER 04/29/82 04/30/82 11/30/82 xx NEW REGISTERED U SERIAL NUMBER LABEL/INSIGNIA NUMBER I S27019A 232811 WEIGHT 024000 LENGTH 000720 WIDTH 000144 ISSUED 12/27/82 I SCC 104 EXEMPT USE SFD T'if I LPT 2 S27019B k 232812 024000 000720 000144 S AND 3 � s CHICO CA 95927 OR .13) TOTAL 4 D E FEES 5 THENEVALL LEROY S.A) PAID: 6 $47.00 A NORTH STATE NATL BK 3. ' D RELEASE OF DEALER D xx NEW REGISTERED OWNER, FILL IN ITEMS 4 - 9 xx . R PO BX 3235 E 4.A) S AND s CHICO CA 95927 OR .13) E NAME - PLEASE PRINT R THENEVALL LEROY S.A) E CURRENT MAILING ADDRESS GM ' I A PO BX 339 B) S I CITY CNTY ST ZIP T L E RICHVALE CA 95974 6. R FUTURE MAILING ADDRESS E 1. ` .. D RELEASE OF REGISTERED OWNER 7.A) ' LOCATION ADDRESS o s 5320 CHURCH ST , N '._ T - CITY CNTY ST ZIP E u RICHVALE CA 95974 R S _ 8. PURCHASE PRICE DATE L NORTH STATE NATL BK E 9. G NEW REGISTERED OWNER SIGNATURE A PO BX 3235 xxx* NEW LEGAL OWNER, FILL IN ITEMS 10 - 12 xxx L 10.A) 0 CHICO CA 95927 W DATE: 12/09/82 16:50:00 B) N NAME - PLEASE PRINT ' E 2.A) R RELEASE OF LEGAL OWNER 11. 1 ADDRESS B) RETENTION OF LEGAL OWNER 12. CITY CNTY „T.-, ' C) xxx NEW IST JR. LIENHOLDER, FILL IN ITEMS 13 - 15 xxx^ ASSIGNMENT OF LEGAL OWNER 13. J NAME - PLEASE PRINT U F N I 14. I R ADDRESS 0 S R T 15. CITY CNTY ST ZIP L xxx NEW 2ND JR. LIENHOLDER, FILL IN ITEMS 16 - 18 xxx • i " E 16. N S NAME - PLEASE PRINT H E 0 C 17. ' L O ADDRESS D N E D 18. R CITY CNTY ST ZIP " IMPORTANT 02-357-00�`� :. THIS CERTIFICATE OF TITLE MAY NOT REFLECT ALL LIENS RECORDED WITH THE DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. THE CURRENT TITLE STATUS OF THE UNIT MAY BE C014FIRMED THROUGH THE DEPARTMENT. 0200019 - '— STATE OF CALIFORNIA -DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT REGISTRATION CARD MOBILEHOME DECAL NO' LAD3135 MANUFACTURER NAME/10 LANCER HORES INC/031107 TRADE NAME PARKNOOD • • MODELDOM 6786" 04/29/82 DOT 04/30/82 DFS 11/30/82 SPC EXPIFUiiG1 U SERIAL NUMBER L S27019A LABEL/INSIGNIA NUMBER WEIGHT LENGTH WIDTH ISSUED 232811 024000 000720 000144 12/27/82 SCC EXEMPT 04 USE tiPi Z S27019B 232812 024000 000720 000144---- SFD LPT a TOTAL FEES S 5PAID: $47.00 A NORTH STATE NATL BK ~ D ' D R PO BX 3235 E S s CHICO CA 95927 E 5 F ' R THENEVALL LEROY LEGAL Ok"SER COPY E G M I A PO BX 339 INFORMATION OilLY sI T L e RICHVALE CA 95974 R O s 5320 CHURCH ST. " w N T E u RICHVALE CA 95974 R 5 L NORTH STATE NATL BK j G A PO BX 3235 L 0 CHICO CA 95927 w DATE: 12/09/82 16:50:00 N E R J u f N I I R O S R T L I E N S H E O C L O 0 N E D R THE IMPORTANT 02-357-00099 OWNER INFORMATION SHOWN ABOVE MAY NOT REFLECT ALL LIENS RECORDED WITH THE DEPARTMENT •2 OF HOUSING AND COMMUNITY TITLE STATUS OF THE DEVELOPMENT AGAINST THE DESCRIBED UNIT. THE CURRENT UNIT MAY BE CONFIRMED THROUGH .THE DEPARTMENT. 0200019 M ZI par s RERMIT'NO., 2496-82p,pE, PERMlf4X'PlRES OWNER Leroy Thengv#1 CONTR. Owner ;ASSESSOR PARCEL 29-11-13 LOCATION E S -F 5 5 0' N-5517ff a—P S Ricc le f t. Temp. Power Pole I Called PG&E Temp. Elec.'Service Called P,9&,ELJ Temp. Gas Service .lk— Called PG&E JOB FINALEI Signature J OK O = Not OK — = Not Applicable * = Not Ready MOBILEHOMES t MISCELLMN-EOUS �$ Date MOBILEHOME UTILITIES (Plans) OK except #'s Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except It's oning Requir s—Setbacks—Easements 1, zoning Requirements—Setbacks—Easements 2. itectal MH SuEporDSketch 2. Footings; Size—Depth—Spacing—Connectors' Sewer; ocation—Test—Fall-C/O—Concretez 49 3. Decks; Girders and/or Joists-Decking—Bracing—Stairs—Rails Ale-WaTeir; Location—Test—Easement Needed (Sket ) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.-Bracing EI tricity; Location—Clearances—Grnd.—/ mp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures —Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors - * ity Clearance 7. Elec. CWd'BI ate Card -BI Date Card -BI Date Card -BI Date 545B I Date Z.Card-BI. Date Card -BI _ Date Card -Bl Date Date M06fLE , OME INSTALLATION (Plans) OK except #'s Date POOLS (Plans) OK except #'s o equirements—Setbacks—Easements A 1• Setbacks—Easements ootings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability s; I�uH Test—Demand—Valu — 1z4y 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining gj/Efctricity; MH Test—Crossovers—Breakers—Clearances ain H Test—Fall—Flex Connector 4. Elec.; Receptacles and lighting; Distances—GFI 5. Elec.; Pool Lighting; 15 volts—GFI ater; MH Test—Regulator—Connector 7. Water ewer Connected—C/O to Grade—HD Approval 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater r I and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool L ht 9• Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits p.—Sketch ert. of Occupancy 9. Health Department Approval 10. Plumb; .Cir. Test—Water Supply Test Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date w V = OK O = Not OK - = Not �P licable • RESIDENTIAL (Single and Duplex) 1 = Not Pzady e . Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 48. 49. Property Line Firewall & Openings Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. 8. Piers -Fireplace Ftg.-Steel D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test e. 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date ' Card -BI Date Card -BI Date Date FINAL (Plans) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. 63. Stairs & Rails Fireplace or Stove; Clearances -Hearth ---- 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer • Date ELECTRICAL Permit OK except p's 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. 23. Size Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 72. Insulation -Foam -Looked in Attic ❑Yes 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 73. Guard Rails & Deck Construction -Post Caps, 25. 2 Appliance Circuits in Kitchen &Conductor Size 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 26, Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes []No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes []No: Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. 79. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I -BI Date Card -BI Date 81. Ventilation throughout House Card Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except q's 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates _ 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Comments at Final: _ _ v Card -BI Date Card -BI Date Date FRAMING(Plans) 36. OK except q's Proper Material & Anchors _ 37. 38. 39. _Sills; Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing _ Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub _40. _ 41. 42. 43. 44. 45. 46. 47. Header & Beam -Size & Bearing _ Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin - Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing _ (NOTE: An entry must be made each time youvisit jobsite) COUNTY OF, BUTTE _I DEPARTM�-NT OF PUBLIC WORKS 196Memorial Way, Chico —Phone: 891-2751 s• 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. ` Inspector!; r/' /=fes / Y r�i_ _ Date �� !�✓ — 6 l� ti 1114 ;t - L �_ J✓_ C,arn � n7 1 e1, 1^ f (T74 to� `IV $ r UNIFORM BUILDING CODE, 1973 EDITION - Loose Leaf $16.00 - 1976 Edition - Loose Leaf $22.00 Soft Cover $14.00 Soft Cover $19.80 or DWELLING HOUSE CONSTRUCTION PAMPHLET, 1973 Edition 1976 Edition - $3.30 per copy $2.75 per copy Send to: International Conference of Building Officials 5360 South Workman Mill Road Whittier, CA. 90601 UNIFORM MECHANICAL CODE, 1973 Edition - $8.00 -per copy 1976 Edition - $10.80 per copy Send to: International Conference of Building Officials 5360 South Workman Mill Road Whittier, CA. 90601 or same address as shown for Uniform Plumbing Code UNIFORM PLUMBING CODE, 1973 Edition - $8.00 per copy 1976 Edition - Loose Leaf $12.30 Send -to: International Association of Plumbing & Mechanical Officials Soft Cover'J$10.80 5082 Alhambra Avenue N► - Los Angeles, CA. 90032 or same address as shown for Uniform Building Code NATIONAL'ELECTRICAL CODE, 1975 Edition - $5.50 per copy Send to: Stacey's Technical Store, 581 Market Street, San Francisco, CA. 94104 or National Fire Protection Association, 470 Atlantic Avenue, Boston, Mass. 02210 1978 Edition available for $6.25 per copy at: International Conference of Building Officials 5360 South Workman Mill Road, Whittier, CA. 90601 COUNTY OF BUTTE 4 DEPARTMENT OF PUBLIC WORKS 196 Merno'rial Way, Chico — Phone: 891-2751 7 Cou2ty Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. v �* inspgctor. Date �'_ COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number for the following location: Owner' Owner's Address Mobilehome Mfg. Model Year Insignia No. ° Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date �" By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. ! 4 10 - 4TH P!ER g v,5a, GC DOUBLE (;:� e D F WIDE FRONT 1ST PIER D PIER f 3RD PIER q ;? 1 VARIES TO 70' • 0" LOCATION OF'PIERS FROM FRONT OF HOME .%IC—,,EL 1ST PIER 2ND PIER 3RD PIER 4TH PIER LOCATION CAPACITY LOCATION CAPACITY LOCATION CAPACITY LOCATION CAPACITY 41A ' � ... / % Gid � .._ AB � :� • L.�� 1. LGCP%T;ON AND CAPACITY OF PIERS WILL BE SUPPLIED SY MANUF ACTURER IN APPROPRIATE COLUMN ABOVE, CAPACITY WILL BE DETEREN"11NED BY THE BELOVI SCHEOU!..E-. i 2. PIERS NIARKED F & R SHALL HAVE'A CAPACITY OF Yz OF THE CAPACITY OF THE CENTERLINE P!ER ADJACENT TO IT.jw 5 e i - Z h • S l . ;SII ,�:•: ai : 1" G y t' 3 t v' .;i. '`'±`. , x.' ,, : r-^ '•`{ r � Y d "y.i6,t •4`�3 .. ,.. i ��� I a '��• 4 t< e.,f T e�����/�.� i -� SEP 17 1973. RIDGE BEAM PIER SUPPORT CAPACITY SCHEDULE NUMBER OF STUDS _ .. PIER SUPPORT CAPACITY - ": IN UNIT AT RIDGE . �y4 SEAM SUPPORT 2 x 3 STUDS 2 x 4 STUDS �l ` 1 ° 1150 2200 2 2300 4400 3 3450- 6600 4 46i? 0 ; r Sf300 F 5 5750 t ,'00 6 6900 ,13,200., 7 6050 15,400 V 8 8800 _ _�• 11,600 •:.:y. p -'+►a+wn•yrn.wy..e+.+xee+.we.+am�o�.e.+.{R.y'!�+rwr.ww...ve..•.Bowe+rwa�avmrws�'.•�+.•sevr+rsre:r.aa.-. w,;l ! DETAIL C - TABLE 1 (CENTERLINE PIERS) PACE 7 Irl ,Ml�MY,�/M.a.Ymall�fJZ, 'tiN4�YM.t?w-'Vf�II•a DOUBLE WIDE _ 53c) o --��, FRONT LOCATION OF PIERS FROM FRONT OF HOME `V100EL 1ST PIER 2ND PIER 3RD PIER 4TH PIER p _ LOCATION CAPACITY LOCATION CAPACITY LOCATION CAPACITY LOCATION CAPACITY Al AlAlr "j 1. LOCATION AND CAPACITY OF PIERS—�� WILL BE SUPPLIED BY.MANUFACTURER IN _ APPROPRIATE COLUMN ABOVE, CAPACITY WILL BE DETEREMINED BY THE BELOW � SCHEDULE. _2. PIERS MARKED F & R SHALL HAVE A CAPACITY OF 1/2 OF THE CAPACITY OF THE CENTERLINE PIER ADJACENT TO IT. ;y};� t. i SEP 17 1973 _ RIDGE BEAM PIER SUPPORT CAPACITY SCHEDULE r-- rit• NUMBER OF STUDS PIER SUPPORT CAPACITY IN UNIT AT RIDGE _ - BEAM SUPPORT 2 x 3 STUDS 2 x 4 STUDS w.�.... -- 1 1150 2200-�.__..Y......�.._� 2 2360 4400 ' - 3 _. 3450 - 6600 4 —_ 46000 • 5 5:50 �.' rte;" .•`110 6 6900:.13,200 7 -- 8050 -k"'-15,400 8 8800 4 17,600 '�1n:F:`1SR 1.•r@ltWfOh N3u;YJw12N�$�9gp.@�y tflfdffi bNiL'i6!tYE1Ylf^JW�@l/.if::^IIOAYVN.Ltf'WRN[!$�4'N:C.vi .r'4%fslEri typ)R'wtvY4u eY+l.. . �f r{i+➢SOUlQ9fdI:QiFW'dll52i`:I.:e��Cb:lfhSblhiJ.n lY.9M 1 DETAIL C - i -ABLE 1 (CEN!TERUNE PIERS) • r, PaE 7a '..5wwpr5:rrnwcaa'+.i�scrsmvntd::wvam��p.++w.:t...ar;q:+:mane.."n�waBarew:nx:aw.*wte�.,ony.N�.a.,ewama.:.nwew;+zq�• � T. 99 k- ' 4 Aw SPACING I { qIY 1 �.9 •i b o- - -- - -------o- - - -�- - - --a- -- -� - - --� COLUMN SUPPORTS MOHILEHOME SUPPORT PLAN MOBILEHOME DATA MANUFACTURER'S INSTALLATION INSTRUCTIONS AVAILABLE? ❑ yes ❑ no DATE OF MANUFACTURE DESIGN ROOF LIVE LOAD (psf) DESIGN WIND LOAD (psf) MAXIMUM ALLOWABLE PIER SPACING (ft) REQUIRED PIER CAPACITY (lbs) REQUIRED COLUMN CAPACITY (lbs) kEQUIRED TIEDOWN SPACING (ft) REQUIRED TIEDOWN CAPACITY. (lbs) SITE DATA LLOWABLE SOIL BEARING PRESSURE (psf) STABLISHED WIND PRESSURE OF AREA (psf) IEDO'WNS REQUIRED? ❑ yes ❑ no EQUIRED ROOF LIVE LOAD (psf) NOW LOAD MAINT. PROGRAM O yes O no PARK APPROVAL INSTALLATION APPROVED PARK OWNER/OPERATOR/MANAGER -10- 0 LOAD BEARING SUPPORTS ❑ MANUFACTURED SUPPORT LISTED AND LABELED CAPACITY ❑ FIELD ASSEMBLED SUPPORT DESIG'J CAPACITY (lbs) FOOTING MATERIALS ❑ 2x PRESSURE TREATED LUMBER SIZE CAPACITY (lbs) g ❑ 3-" THICK CONCRETE SIZE CAPACITY (lbs) ❑ OTHER APPROVED MATERIAL MATERIAL SIZE CAPACITY (lbs) TIEDOWNS MANUFACTURER RATED CAPACITY (lbs) SPACING — (ft) MOBILEHOME SUPPORT DATA • f r rr If other than single wide, g 2 Mobilehome Mfr.— L C.� t furnish SetuV Model No. U Year Width(ft.) Box Length co 6 (£t.). Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973; furnish manufaciurer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports 'measured from front of mobilehome unless otherwise specified. Footings (check one) Single - El1. Wood either pressure treated or foundation grade. 2x . (ft.)(in;) (in.) (in.) U]�2.,Other: ( specify) Center support locations*. Center support footing sizes Supports (check one) (in.) 1: Concrete block. .2: Other,. (speci#y) (in.) (in.) r 4—Tagalong or Expando,' show support details. (ft.)(in.) (in.) (in.) -- Typical Support (in.) (in.) Footing Size (ft.)(in.) (in.) (in.) ` Max. Pier Spacing 5J -- Max. Overhang . (ft.) (in.) Al 3075 -f�Z BUTTE CUUN 1 Y WILDING DEPARTMENT *If drawn All PRRQV mat IEU L center piers are other than above, ;draw in locations, spacing,. and dimensions. BUTTE COUNTY ..DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: / o 2. Installer's name: 3. Is the site currently under permit? Yet / / No (If yes, furnish permit number _24 �} �„ S ) OR Is the site an .existing site? Yes / / No 7_ (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of. all setbacks.and easements? Yes / /. No (If no, clarify ) ( ) 5. :What is the mobilehome electrical rating? ----------------------- /�-� Amps 6. What is the mobilehome site service rating? ---------- C Amps 7.. What is the mobilehome site circuit breaker rating? ------------- _ Amps 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- Yes %[ No / / (If yes, identify the load and size: Lt) (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- ✓ 1 (in.) 10. What is the type of gas service? ----------------------------- Natural 777 LPG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand?------------------------------� b (BTU) -� (This information not required if pipe length less than 6�ft. on natural gas . or less than 50 ft. on LPG.) COUNTY OF BUTTE--DEPART.ME,NT OF PUBLIC WORKS ' 7 County Center Drive - broviIIe, CaIiforni%95965 - Telephone 916/534-4541 -I ' APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER_w"K TL VIR� TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS C%NJ Fj.A TORS NA E �/f_!A TELEPHONE CO TRACT�RO•S MAILING ADDRESS�� (/� Fireplace T CONSTRUC✓ION/`VLENDE UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINE LICENSE No. Plan Checking Fee $ /6-00 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUIj.QK4G ADDR15rSPLUMBING PERMIT Fi ling Fee 10.00 / "Al M/V /'T s/ - Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OFSRUCTURE [:1SF Duplex❑ Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK �,� New ❑ Addition ❑ Remodel [:1Utilities ❑ I talla 'oni� other ❑ Describe work: ;*2 Zr77L Pzfei, / 2qf& -. $'Z Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main seryice 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCOP.N OR AODNS. ACC. BLDGS. 2G Sq ft CONTRACTORS LICENSE LAW I declare rider penalty of perjury (Check One): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full .yd �fgrce 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. ATI.OUTLET 2.50 ea NO N.R ES, D BRNCH CIRC ITS NEW CONSTR. POWER APPARATUS &I NON.(POWER SINGLE OUTLET CIR. sD @ 2$¢ Ex. Occup o XED Ts OR FIXTURES BAL@1 IXAPPLES, OR EX. Occup.(.UTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. LI have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agains aid Count in con equence of the granting of this permit. , � Date Ignature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for xcavations ver 5'0" deep nd demolition or construct- ion of structures over 3 ire ries i height. J Mobile Home Installation Fee $ 100 Auy yo,00 TOTAL PERMIT FEE $ %, ca OCCUP, GROUP I TYPE OF CONST. PARCEL PD I HD 99UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF UBLIC r d BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS D t��e�r �� I �L'^^aa_ Receipt No. p O.Oo1Z q ,13 G D.faU WHITE-D.P.W., YELLOW-ASSESR, PINK -IN ECTa R, GOLDE OD -APPLICANT S This set of plans and specifications MUST be, kept on the job at all times and it is unlawful to make any changes or alterations on same with, out written permission from the Department of Public Works, County of Butte. G20 / N I 10 5TALLAM �,ac'�O �jC X70i lr . 5163M r 05I M 0�j LT. A setback of 5 ft. from the property lines and a setback of 50ft. from the, road centerline shall be clear of stnKftires or equipment except fw a 2 ffit- eave a erfkvV. NOTE.—All Materials & Wor6men's1LIip 'had! Be in Accordance with Recognized Good Prbdiice'� and of a quality prescribed for the SPOCNIfied 'use in the Uniform Building, Plumbing & Mechanical Codes and the National Electrical 'Code, ° coo I i I Utility connections shall -be within 4 ft. of he mobilehome, either directly behind or within the rear half of he roadside (left) of the. V it be requ of the mnF for the 'OUN-1 Y EPARTMENI ApaRnvF.t)l m IMG ENTERPRISE INC --?�"4 MIKE SCHULZ FOREMAN 3835 Gardiner Ferry Rd. Corning, CA 96021 GENERAL (916) 824-2458 CONTRACTORS LIC.N412293 ;.�--+�`.-r./'L�sswv--Zs-*.rs=^-.r-c++twi"�`...w...a.4,*-rr.►Z.r�•w-s.t'..e-^�..m�+-...,•-,..sr,....�-�.;..r.•.:r<.v,..--..-..•-r-.F.,aa;..-�.7�"+-:i.... .r .� COUNTY OFtUTTE.- DEPARTNIENT ;OF,PU.3LIC WORKS - BUILDING DIVISION / 7 COUNTY CENTER DRIVE - OROVILLE,•CALIFO.RNIA 95965 - TELEPHONE: 916/534-4541 �cl PERMIT APPLICATION DATA SHEET Permit No. OWNER �C%�� 7��C/l/�y A. P. No. Proposed Building Use Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector Date ' 8e__ 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. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. . . S_U946D�tatement of I enttffor Non -Heated and AC Buildings. Fees of $ %2- . . . . . z- 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 2. Certificate of Workmen's Compensation Insurance. !�• %0 gL 3. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . Pre-Inspec. request to (Date) . . 17. Pre -Inspection for Required, Building Inspector 18. Other When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and 01rfor pickup at &k -f) office. Deliver w/inspector. Other Applicant' s Date Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time ofi , circle item.) 1. Index permit for above Items No. 2. Additional items required: ( �r, Designe , Owner) was advised of above requireTelephone Mail —Other By Date lw-l© a2 Plans checked b Date Plans approved b Date Other: Copy—DPW COUNTY OF BUTTE - DEPARTMEM-0_F_P`UB_LM WORKS 7 County Center'Drive - Orovilie, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PE4MIT NO. — , Z -- ASSESSOR PAP EL _NUMBFaR 3 z;I BUILDING PE IT OWNER L E—O !/✓� SQ. FT. OCC. DING VALUATION OWN 'S MAIL. I G ADDRESS /'� (j/� CON A OR'S NAM TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN C Total Valuation $ Filing Fee $ r=g_ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ AZO Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $/,Cleo BUILDDIN A DRE r PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping SUBDIVISION NAME PARCEL MAP ey4dq-11 TV Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USEOFSRUCTURE SF Duplex❑ Mobilehome Other ❑ SPECIFY Building sewer 0 Lawn sprinkler system 5.00 TYPE OF WORK / New ❑ Addition ❑ Remodel ❑ Utilities I'� Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2,50 NEW CONST. ( DWELLING OCCUP.EI\ OR ADDNS. ACC. BLDGS. 2� sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt.9, Div. 3 of theBusiness and Professions Code and my license is in full force and effect. License No. Classification ❑ I, a he owner, or my employees with wages as their sole compen- s ion, will do the work,and the structure is not intended or offered or sale. (Sec. 7044) c 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 NEWCONSTR LOUT LET NON.RESID BRANCH CIRC ITS 2.50 ea NEW CONSTR ( POWER APPARATUS a� NON .RESID. SINGLE OUTLET CIR. s0@2SO Ex. OCCUp OUTLETS OR FIXTURES BALO1 IXED APPLNS, OR Ex. Occup.(oUTLETs (RESID,) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 , Misc. Wiring 7.50 Permit Fee 1 $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 ha placed on file with the County of Butte Building Department a ertificate of Workmen's Compensation Insurance or a Certificate f Consent to Self -Insure. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIirig Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that 6ave 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, a hereby authorize representatives of the Countyot Butte to enter upon the a ve- entioned property for inspection purposes. I also a e t s e, in mnif and keep harmless the County of But a against all liab. ities, en , c ts, and expenses which meinny ay accrueagains said my 'n on quence of the granting of thit. X A4,0Date�r+l� Signatur of picant — ner Contractor ❑ Agent An OSH perm' is require or excavations over 5'0" deep and demolition or construct- ion of str cture over ren st0 s in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ r OCCUP, GROUP TYPE of CONST. PAR; E PD ND ss0 This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC R OF PUBLIC By Pqw1fEXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Dattee -, `- Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT t Return to DPW AGRICULTURAL STATEMENT. OF ACKNOWLEDGEMENT t�,l: r� toR .RESIDENTIAL DEVELOPMENT Section 26-8.i of the Butte County Code requires this acknowledgement be recorded prior to issuance 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 arising `92'�2SS.�Q from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, 'but not.limited to cultivation'; plowing, spraying, pruning, and harvesting which occa- sionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and -residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm op( --,rations., All that real property situate in the County of Butte, State of California, described as follows: Lot 344., 345, 346 a.n'i d the ,e. t half of hot 165, according to map ent-tled, "Town of Richvale", which l.uan vvas filed in the office of the Recorder of t;:e Cotu1t)r of Butte, State of California, Jn.nuary 17, 1910, ?.n Book "6" of Pups, at page 53. • 'F m r Date: k' /G PROPERTY.. -,OWNER F A deceased' State of California ) On this the 20th day of August , 1982, , Butte) SS. before me, the undersigned Notary Public, personally County of -� 1 appeared L,t•I:uj/ Thullgva l l t, -------------------- OFFMSEAL known to me to be the person(s) whose name(s) NOTARYp/1dttONCALOp A subscribed to the within instrument and acknowledged M� ��� that he executed the same for the purposes aim Otherein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. I ,( �-7'1 l e . Notary Public Present A.P. No. �...-,✓`.._ �"� -�� ... .-,-r.�....ti .. .r. rte.-..,. � - ..._, .. .�..r."^y=w✓.`.'�'�'4-.. COUNTY OF BUTTE � DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET J Permit No. OWNER A. P. No. Proposed Building Use Permit Fee Based Upon: V Complete Contract Price DPW Valuation f Oter Ex in) 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 duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate. /triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . ... �0. 9Letter of signature authoriz.ron. . . . . . . . . .14 Sanitation approval from ealth Dept. q AWL 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif.)` 14. Owner -Builder Verification (Given to owner El, Mail to owner ❑ ) 15. Improvements may be required. ... . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . Pre-Inspec. request to 17re-Insl5e tion for Required. Building Inspector (Date) o/ �4 8. Other When you issue the permit, proces Us follows: Mai4toow rr. Mail to contractor. Telephone and hold for pickup atoffice. Deliver-w/inspector. Other/` Appl icant Date Copy of plans sent Health Dept., Fire Dept., 6ther Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designe , wner) as advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date ?� Other: Copy pPw r RICHVALE SANITARY DISTRICT P.O. BOX 1 RICHVALE, CA 95974` August 31, 1982 The Richvale Sanitary District Board met ®n the above date and .approved the request by LeRoy Thengvall for a sewer Hook-up from Fir. Thengvall's lot to the established seer line. The lot lVes'Zwktkin the existing Sanitary/Ristrict boundaries. ll VWU- �cc-D P s �, lAff Z -o T //t) C- 0, r�T'Ij y C�X,W 8 23 r?— /Q!U �— e2r,C4 91 s� —f Z", Lk Gary S j :/Treasurer r AP # 43 OWNER PERMIT4���= �Zs MH UT IL .CLEA DATE INSPECTOR ELECTRIC GAS. Support Struc, Compaction Test -Req. Service Si7zee�� Other. Load 'Te Pipe Size Length YESI NO YES NO ,. � 1 PERMIT NO. 3522-$2B PERMIT EXPIRES OWNER LEROY THENGVALL CONTR. Northstite Aluminum ASSESSOR PARCEL - 29-11-13 LOCATION 50 -'N -Main St, Rich- . 9 7 s ' -14 } i 0 Temp. Power Pole Called PG&E ' Temp. Elec. Service Called PG&E_ Temp. Gas Service Cal led PG&E JOB FINALED (Date Sig V = OK O = Not OK - = Not Applicable MOBILEHOMES * = Not Ready ` MI CELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except H's Date DEC4eSCW6RS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements onin Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch o i s; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/O -Concrete *11becks; Girders and/or Joists -Decking -Bracing -Stairs -Rails - 4. Water; Location -Test -Easement Needed (Sketch) 4. W Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing_ 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L" ft./ /"Nat. or/ /"L"ft./ /"LPG arports; Windows -Doors - 7. Utility Clearance 7. Elec. g Card -BI Date Card - BI Date C d -BI ate Card -81 Date Card -BI Date C -BI A Date %:.f Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s Date POOLS (Plans) OK except it's 1. Zoning Requirements -Setbacks -Easements 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector - 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances __ 4, Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK 0 = Not OK a - = Not Applicable RESIDENTIAL (Single and Duplex) * = Not Ready Date UNDERFLOOR (Plans) OK except k's Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts _ 8. D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Jest -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 57. Smoke Detector _ 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meeh. Protection 15. 16. Water Pipe; Test & Anchors -Nail Protection D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access _ _ 18. 19. Test Tub & Shower, 2nd Floor -Tub Access Gas Pipe; Size & Anchors 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 62. Stairs & Rails -` - `- 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Perrr,it OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. 69. A.C. Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meeh. Protection 20. Fixture & Transformer Clearance -Ins. Protection -- - 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. &Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. - -_ 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 72. 73. 74. Insulation -Foam -Looked in Attic ❑Yes Guard Rails &Deck Construction -Post Caps Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes - 25. 2 Appliance Circuits in Kitchen & Conductor Size 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or All _-_ _ 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes ❑No Service -Riser Conductors & Ground -Main Disconnect 75. 76. Following instid.: Drive ❑ Yes []No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No Stucco; Brown -Finish -- 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet - 30. Clothes Closet Light -Shower Light - 78, Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. ----- Card B -I Card B -I ------------ - ----- _Date_ --_- _ Card -BI - Date -_ Date Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing 80. 81. Exterior Elec. Trim; G.F.I. Receptacle -Underground Ventilation throughout House 82. Glass Protection Date MECHANICAL (Perrnit) OK except N's 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31, A.C-.-Ducts: Insulation & Support _ 85. Water & Sewer Connected -C/0 to Grade -HD Approval _ 32. 33. Vent Fan_ Exhaust above Insulation _Condensate Drain _& Overflow; Size & Grade 86. Energy Compliance Certificate -Other Certificates 34. Furnace -Vent: Access -Comb. Air -Return Air Vent -115V outlet --35.-Attic Access & Platform if Furnace in Attic Card -BI Card -BI - - -- - - - - -- - ------ - Date - Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's Comments at Final: _ _36. 37. 38. -38. 39. 40. Sills; Proper Material & Anchors_ walls: Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floo_r_Nailin_g__ Draft Stop in Walls (rat proof) _ _Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access: Size &_ Romex Protection -Draft Stop -Ins. Baffles _ Bdrm. Windows or Exiting Doors -Sill Hg_t. &_Dimensions Garage Fire Protection Framing (NOTE: Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - M'E DEPARTNT OF PUBLIC WORKS — 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 - APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCH NU MBE,R/ 3 ZO."M� BUILDING PERMIT owNE�r TELEPHONV SQ.FT.1 OCC.1 BUILDING VALUATION -o✓ Op U MAILJ,p1G ADDRES� � � ����� 'O �/ 3y, �C%" R/�5 CONC(��0R//))�+CT lI„� ^///17,,1/ TELEPHONE CONTRACC`T/TO(JR''S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ ,p(� Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ e),ew ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ •b Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ > Qp BUIL ADDRESS PLUMBING PERMIT Filing Fee 10.00 OF I-YA/ �72,�ri ,`�!'T['V /�-�= Each Trap 2.00 Solar Water Heater 20.00 � �• 1?16 �7.ri Water piping 5.00 jjT)N0. SUBDIVISION NAME 1l U�L / /c4& / PARCEL MAP Each qas water heater or,vent 5,00 Gas piping system 1 - 5 outlets 5.00 3516 USE OF STRUCTURE SF [:1Duplex ❑ Mobi lehome Q�Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition ❑ pemodel ❑ Utilities Installation❑ Other Describe work: DC_G/L- S Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELINGOR ADONS. ( ACCLBLDGS.CCUP.&\ / 2'/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ' ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. ,cense 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) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NNEW ON-CON5TR. BRANCH CTRCTITS 2.50 ea NEw .COIJSTR. (POWER APPARATUS &1 NONRESI D. SINGLE OUTLET CIR. 1 Ex. Occup(o OR FIXTURES 9AL@300 BAL@30 FIXED A Ex. Occup. OUTLETS P(RESID )LNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 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 C rtificate of Workmen's Compensation Insurance or a Certificate Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10,00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, an ereby authorize representatives of the Countyot Butte to enter upon the ab a -m tioned property for inspection purposes. I also a s e, ind mnify nd keep harmless the County of Butte against all Iia ' ,ties, en , cost', and expenses which may in any way accrue agai said ty ' onse ence of the granting of this per it. j ��-� Date Signatur of p ,cant — ner Contractor ❑ Agent ❑ An OSH perm' is require f r excavations over 5'0" deep and demolition or construct- ion of st cture over 3 stori.e iiin heigghht.. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ &0, 0 O OCCU P. GROUP TYPE of CONST.—F1PARCEL PD HD ISSUE This permit is hereby issued under sioris of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY PEf3WIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date / 7"4 Z ,Receipt No. (SW / WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT M c)'