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030-360-009
i � � � � � �� r vmc) OFFICE cope Address GAS Meter a Meter E3y ELEC-rFjjC Date Da tw-- Z' ti Illy-, ml r vmc) OFFICE cope Address GAS Meter a Meter E3y ELEC-rFjjC Date Da tw-- Z' Illy-, ml r vmc) OFFICE cope Address GAS Meter a Meter E3y ELEC-rFjjC Date Da tw-- Z' .'-c•-� ;.oqy.,•-,� n .F_�sT�.' . .. _ til t'"C`f'Y.'gCh7u"^.`' ,' -_ .. .� .F. .+ ., .- r..l:asv- .. .. , .. ... _ ._ - -.-• r , COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMI . No. (Rev. 12/96) APPLICATION AND PERMIT 99"-�M ASSESSOR PARCEL NUMBER OZ 009 ZONING AR BUILDING PERMIT OWNER MC CONNELL, RUSSELL TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1772 BIGGS AVENUE, OROVILLE CONTRACTOR'S NAME OWNERTE ,2NE4 L 484 CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Film Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee $ sn� [�� b TT T BUILDING ADDRESS 1772 BIGGS AVENUE, OROVILLE Energy Plan Checking Fee $ " PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF p; Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 I Solar or heat.pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 " TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RE TAG SERVICE FOR SHOP Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home s G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service '.0' . A o LESS 23.00 • 00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class LIC. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for thea performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( g ACC, BUDS. so 3.50FT. NEW NON -RESIST ANOI OUTLET @7.50 owER APPARArus d PSINGLE OUTLET CIR. Ex. Occup.OUTLET OR FDRURES 209 I.00 BAL @ .so Ex. Occup. ouTEiEDrs A=..OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.90 Misc. Wiring 23.00 pRT?—INSPFM.ON 123.00 PERMIT FEE $ 66.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X , � �% � T Date �'r�- Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE - TOTAL FEE $ .00 66.006 HAZ. D. FEES IMP FLOOD COF PARCEL Pp` S . This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above forwhich fees have bean pai . _ ,r, � 7 _/ Date f /� 11 PERMIT EXPIRES ON ~J e9' I" Date r7ReceiptNo. 264770 1 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT t, COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 -Telephone (916) 538-7541WPERRMMI No. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-360-009 1. ZONING AR BUILDING PERMIT °WNER MC CONNELL, RUSSELL TELEPHONE SO, Fr, OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1772 BIGGS AVENUE, OROVILLE CONTRACTOR'S NAME OWNER TELYPHQNE4484 �7 ��LL CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS ' Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE N0. —Fling Fee Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1772 BIGGS AVENUE, OROVILL•E Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF IX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RE TAG SERVICE FOR SHOP Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE _ ELECTRICAL PERMIT Fling Fee 20.00 Main Service zoos oa mss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWER License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. C] I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. -❑ 1 am exempt under Sec. Business and Professions Code for this reason66.00 Main Service 200A To 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( $ACC. IS.S. SO 3.50FT. CO No RES DT M�UILCTI.OUTLET 97.50 APPARATUS 8 SINGLE OUTLET CIR. OUTLET OR FOcruREs Ex. Occup.s„L 20 @ 1•00 @ .50 Ex. Occu .ovT, ,S'jRREslo.oen 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 INSPECTION PERMIT FEE _ WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: El I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) G1' i certify that in the performance of the work for which this permit is issued, I shallTOTAL ' not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. P y p C` X - 7/[�'�"�'_ Date `�' �� Sign ure of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE FEE $ HA2. 0. FEES IMP FLOOD coF P ggcEl .66.00 pp" MD I S UIr ` This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resglutions to do work indicated above hich fees have been pai . % Date _ PERMIT EXPIRES ON Dale Receipt No. 264770 WHITE •D.D.S.•B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERM NO. (Rev. 12'/96) APPLICATION AND PERMIT 99 ,AQP ASSESSOR PARCEL NUMBER �'1 �. .-^ D ® (� ZONING //`-//�W BUILDING PERMIT NER gWc-�o svv TELEPHONE SO. FT. OCC. BUILDING VALUATION OWN MAILING ADDRESS / � � CONTRA OR'B NAME © �� � TELEPHONE �t CONTRACTORS MAIUNO ADDRESS CONSTRUCTION LENDER LENDER'SMAILING ADDRESS ' Fireplace Total Valuation $ ARCHITECT OR ENGINEER - LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS ' Energy Plan Checking Fee $ PERMIT FEE $ •IDT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 Solar or heat'pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describ Work: �� L Ike (� C- Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 800V OR LESS Main Service zo.OR LEss 23.00 ,,13 '— I t ` l / V �v Main Service 200A TO I000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. S.`3•5QSO FT. NEW CONST. MULTI -OUTLET NON-RESID. 97.50 POWER APPARATUS b SINGLE OUTLET CIR. EX. Occup. OUTLET OR FORURES 1.00 BAL @ 50 Ex. Occup. o xur,t°Ts aEs,o °PITH 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PE MIT FEE : MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HA2. I D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. WHITE-D.D.S.-B.D. CANAR -ASS SS R PINK -INSPECTOR GOLDENROD -APPLICANT A OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signat, Please complete and return this information at your earliest opportunity to avoid unnecessary deyy 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 imp_ rovement : YES LSP NO D 'J 2. I HAVES HAVE NOT 13 signed an application for a building gn pp g permit for the proposed work; 3. I have contracted with the following person (firm) to provide the proposed construction:.-,, NAME• ADDRESS: CITY: PHONE: CONTRACTOR'S 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: ;T ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: `- ,(c,�/., a /-�,_�/•� SOCIAL SECURITY NUMBER: DATE:_ y- /�/- 19 NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property . improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible parry of jecord on such a permit.- Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should. be aware of the following information for your benefit and protection: ♦ if you emp y Zyou ag y persons other than your immediate family, and the work (including materials and other osmor for the entire project, and such persons are not licensed as contractors or subcontract . employer. If you are an must register with the State and Federal Governments as an employer and you are subject to several obligations. including state and.federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions.,. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information' about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit; erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contrac!qrs may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" bn the reverse side of this form so that we can confirm that you . are aware of these matters. The building permit will not be issued until the verification is returned. 4irely, l C. Vi iia, CB.O. r, Building Inspection NOTE: This Owner-Builder.Information is required by Section 19830 of the Californla Health and Safety Code- OVER oda OVER 30-36-09 3378-91B DAVIS,Harry 1772 Biggs Ave (reroof/sf) ORoville ! 77 1 J 1 1 l COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION ANWWRMIT ASSESSOR PARCEL NUMBER 030.-360-009 ZONING AR BUILDING PERMIT OWNER tiaDavin TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'Sl MAILING ADDRESS 1772 BiR a Ave. Orov311e 95955 26 L' 60 1, 560.00 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is 10560.W LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ 31,50 ARCHITECT OR ENGINEER ivQne LICENSE NO. Plan Checking Fee $ Ener Plan Checking Fee 9Y 9 $ EC ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 1+6.50 PLUMBING PERMIT Filing Fee 15.00 772 46 Ave oville Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF DA Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other © Describe work: Reroof W/COMPS Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 Main service 200A TO IOOOA, 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed ,under provisions of Chapt. 9, Div. 3 of the Business and Professions Code 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) El I, 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 OCCUPM 3.64 sq.ft. OR ACDNS. (ACC. BLDG S. NEW CONSTRESIO, RANCH TLET NON-RESID BRANCH CIRC ITS @ 5.00 CIRCUITS) POWER APPARATUS &) ( SINGLE OUTLET CIR. ) Ex. OCCUp(OUTLETS OR FIXTURES 20 @ 76 FIXED APPLNS. OR EX. I OCCUp. OUTLETS (RESID.) EA.) ! 3.00 Temporary service 15.00 Home Facilities 15.00 Misc. Wiring . g 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 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 15.00 Heating Cooling g Hood 6.50 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 conseq nce of the granting of this permit. %� 4-41 ' Z -4 • 3,03-�jj� Date 9� �� "'*� $ignature of Applicont — Owner IBJ ccntrccror ❑ Agent ❑ / An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 46.50 HAz 1 1) FEES I IMP I FLOOD CDF PARCEL I PO HD ISSUE j This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work in icatelYe for which fees have been paid. Dt b�TOR OF PUBLIC WORKS By �''✓fr�"� Date �/�-YI PERMIT EXPIRES Date q- Receipt No. 101124 WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle �Callf4ornla 95965 - Telephone: 916/538-7541 APPLICAN AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER - 030-360-009 ZONING ` . -AR BUILDING PERMIT OWNER Harry Davis TELEPHONE ,SQA FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS Oroville 95965 11140V 26 @ 60 1,560.00 As CONTRACMA Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 1,560.00 LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ 31.50 ARCHITECT OR ENGINEER Nonp LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 46.50 PLUMBING PERMIT Filing Fee 15.00 a 1772 ilip Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF [2 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other] Describe work: Reroof w/Corap. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OOR R LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code 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 Main service 200A TO 1000AI _37.50 NEW CONST.( DWELLING OCCUP.&\ 3.64 sq.ft. OR ADDNS. ACC. BLDGS. I/ NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS a\ SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 @ 76 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) I 3.00 Temporary service 15.00 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 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 15.00 Heating Cooling g Hood 6.50 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 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 conseq nce of the granting of this permit. X �� �� , Date ?— /% 4/ Signature of Applicant — Owner Contractor EJ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 06.50 HAz I DFEES I -I=F CDF PARCEL I PD I HD I ISSUE This permit is hereby issued under the applicable provi-. � sions of the Butte County Code and/or resolutions to do `^fork in ed a for which fees have been paid. D O F PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. 101124 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroviller California 95965 - Telephone: 916.'538-7541 APPLIC'10WAND PERMIT ASSESSOR PARCEL NUMBER - —1360-002 ZONI G. BUILDING PERMIT OWN r Y TELEPHONE SO. FT, OCC. BUILDING VALUATION RAI NG `RESS OW • '� 14 ZE 45 © I CONTRACTOR'S NAM TELEPHON CONTRACTOR'S MAILING ADDRESS Fireplace CON T UCTION LENOER /Up V7 UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS ARC I ECT QOORR ENGINEER LICENSE NO. Z Filing Fee $ 15.00 Permit Fee Plan Checking Fee $ ^ cJ $ ARCHITECT OR- ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee g'. Penalty $ 1 9U��rQIry�G DDRE55 11 ve- Permit fee $ 1 (O PLUMBING PERMIT- Filing Fe- I 15..0:0 Each Trap 5.001 Solar or heat pump water heater I 20.00 I LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 1 Each- qas water heater or vent 7-.00 USE OF STRUCTURE SF [X Duplex❑ MobilehomeC] Other SPECI FY Gas piping system 1 - 5 outlets , 5.00 I Building sewer 15.00) Mobile Home S ! G W @ 15.00 TYPE OF WORK New i Addition i Rem el L' lilies InJIlation Other Describe work: 1^O W� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200V OR LESS 00A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessPO,VER and Professions Code and my license is in full force and effect. License No. Classification I 1 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) [j I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) j I am exempt under Sec. , Business and Professions Code for this reason Main service 200AT01000AI I 37.50 NEW CONST. ( DwELLING OCCUP.s,` OR AODNS. l SCC. SLOGS. / i 3.6Gsa.rt.l 1Ew oohs -FL 'AUt_ LE- `ION-RESID. BR4NCi-+ CIRE-ITS I 1@ 5.001 AFOARATUSLtr (SINGLE OUTET =:R. j I ! Ex. Occup(ouTLETS OR=IA7',PES I AQO�,t^6a EX. Occup. OUTL TS 'PEISIC.;REA.) ! 3.00 Temporary service 15.00 Mobile Home Facilities 15.00Misc. Wiring g i 15.00 Permit Fee S — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): (� The permit is for 3100.00 (valuation) or less. C 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. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating I I Cooiing Hood 6.50 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. X Date Signoture of Applicant - OwnerC Contractor U C Agent An OSHA .on of structuresover39storaesoineheigvhattlons over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ „j Q MAL DFEES IMP I FLOOD coF PARCEL IPO ro ssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC BY _ DCRMIT G`l DIDCC !1 ..... the applicable provi- resolutions to do have been paid. WORKS i Date i Receipt No. 5 0 �o t rz�� �,6 0 r + vac NMIrC•D. P.'N., }[CLOW-A$$($$a q, PINK-1N9PCCT OP, :al, r:r,MRna•APPLICANr 1 COUNTY OF BUTTE - D64-art6ent of Public Works 7 County Center Driv-e,•OToville, 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 maj labor and materials for construction of the proposed property improvement ye or no) 2. I(have/ ave not) f4?v � signed an application for a building permit f proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. )I plan to provide portions of this work, but I have hired the following person to 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 . Phone Type of Work Signed: Property Owner 4 Social Security Number Date f — /l -.?/ 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. PERMIT NO. 6220-772 P,B PERMIT EXPIRES OWNER John Voorhees t CONTR. owner LOCATION (A.P. 30-36-9) 1772 Biggs Ave., Oroville } Temp. Power Pole Called PG&E Temp. Elec. Serv. 4 Called PG&E — Temp. Gas Serv. Called PG&E VB FINALED _ �U (Date) /J (Signature) 9. Electrical - A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes, No B. Is there proper clearances around panels? Yes41 No C. Is power supply cord,or feeder assembly properly fused? Yes No D. Is continuity test satisfactory as per the following procedure? YesNo 1. De -energize electrical wiring system of the mobilehome at the pe estal_ 2. Make sure that'the power supply cord or feeder assembly'conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to `the "on" position. 4. Connect one lead of 'a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including -neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for -continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length Width Vehicle Serial No. ( 03W e%f 4 - State Identification No. Additional Information or Comments: MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome locatedw'th required separation from lot lines and buildings and generally conform to plot plan? Yes No 2. Does the mobilehome have,required clearances above ground? (Sec.5085) Yes -4 No 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes4- No 4.* -Is the mobilehome level? (Sec. 5088) Yes No 5. Ifore than a single unit, are crossover connections properly installed? (Sec. 5088) Yes'T No 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes 4 No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes -V No C. Bac_ of California approved, does station have backflow device and pressure -relief valve? Yes_ No_ 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes_,X No B. Does it have minimum k" per foot slope and is it properly supported? Yes- No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes_ NoX- D. Ifis no roved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes4 No 1. Open all appliance connector valves. 2. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes No4 M Y MdW Bldg. !Fo tin s 'Ste all Slab . Piers Garage Footings Stemwa I I Slab Carport Footings Slab Patio Footings Masonry Walls Relnf. Steel Bond Beam Framing Stucco 7 1 S COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING FlIewall 4 S 1 Piping Pa pets t�Floor Rest om Finish • 2n Floor Windo4 3rd Xioor Sldin #'r` To out Roof Shea Ing Water Pi V Roofing Sewer Fdn. Vents Fixtures1 Garage Vents Insulation Water Htr. Heaters Prov. for ph sicall '' handicap ed 1/ Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Final Sanitation FLAEPLNACE Final 11471-, Final r/1 ,. MECHANICAL Heatin -,'* 1 erior Lath I V ntilation oor Closer Inal MOBILEHOMEUTI ITIES--- ---------------Elec. Service Water Piping 4/ ' " SewerAZIld-17;,71", MOBILEHOWE INS A TI - ------------Support Water Piping �a Drainage DATE REMARKS OR CORRECTIONS mo 9 M Grd. Fault rot. Service , Te4/.' Pole nal Elec. Pedestal Gas Piping I Elec. Continuity Gas Piping `r (NOTE: An entry must be made on this form each time you visit the job site.) kL .®ld c %im 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: f r, Owner Owner's Address Mobilehome Mfg. �"� �r�� 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 f By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ' 7 County Center Drive — Orovi Ile, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT - k ;_ �a V� O VMe uvuniy uI ouue to enter upon the above-mentioned property for inspection purposes. XX V Ar� Date Z 4---4 - 77 ig ature/oI`f_Permitee o gent Q Receipt No. W ite-D.*P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. IREC O,F_ fU IC WORKS By Date Q permit expires Date /�--� BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address go V v. V ( Telephone No. Fireplace Contractor I&e'r Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee Building AddressPLUMBING - t 2 No. @ FEE PERMIT FILING FEE J$3.00 ,00 Each Trap 1.50 _Water • "V t Repair drainage or vent piping 1.50 piping 1,50 6_0 _A071 Each gas water heater or vent 1.50 A. P. No. ZO" Gas piping system 1 - 5 outlets 1.50 b10 Each additional outlet .30 i n I Fire Dept. Fire Zone Use Permit Building sewer EOA ParkingPlans 4�I�RtI Parcel Map 60' R/W Improvements —� Lawn sprinkler system 22!.0Off Bldg. P46ns Rec'd Par pproval Plans - provaI Permit Fee $ 33, CO 3 FZ NEWADDITION ❑ ❑ UTILITIES 2 -'OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 () Main service 100 AMP OR01 OR LESS5.00 , Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ !Mobil Home Q�Others ❑ Main service OVER 00 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. OR ADDNS. ( ACCLBLDGLING OCCUP, &) 22sgft. NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEWCONSTR. /POWER APPARATUS & NON -RESID. %SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)@L Ag BAL�1 FIXED APLINIS Ex. Occup.(OUTLETSPRESID.)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 '00 License No. Classification Misc. Wiring 6.25 'El am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby nnfL.n.'-ie ... 'W,� >��E TOTAL PERMIT F E $ �a V� O VMe uvuniy uI ouue to enter upon the above-mentioned property for inspection purposes. XX V Ar� Date Z 4---4 - 77 ig ature/oI`f_Permitee o gent Q Receipt No. W ite-D.*P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. IREC O,F_ fU IC WORKS By Date Q permit expires Date /�--� 3. 3I . - NOTE: A c orda II ce n• Materials with—Recogn'I 'ibPd r ..�. & V17orkmans ed--Good�Prctilcesan�d for th'e Specified ip 5ha11- use I es a in the ;ae y � U ifor buil in.. . plrm inq Gode. anica� - s i,e the !`�'`-;ondl E1Prical All Located utility -vi -thin conn - actions outside shall -the -rear be aS —� third section o_fi, he mobile) home on h the m left (roai ide of the ro.l ilp t441�1 I 73tv, �Np_ -e.) L`e�G� - ��rw y0 T14s fe- A instafle_m^fh'! per -it will-, a require for the i Bldg) I k La 5 f+� frorm t r5 The s dry (proper#�y Seibu line ,mull andl 50I ftp I fro /� t I his set of plans and specitications T—�--!—TT-mum MUS] i, cle111 nterlme of`a of�the'road, 2 ft.-eaveloverhang-bvt permitting a emir- m4l-Y Iy i ��� L cept tneke .__ n the I ...... ny lob chaflges a# l ....l all .. orlalterations times I . and it u , ..I on untewfttl ....:L....I same without to ..I _. alut. Qf aA easements......___.. -, �_ - --- BUl' DI%iV PA RTM1N r `7✓- written works[ -pe County. miIlsson of -fro No m-fFie-Depalrtment-of-Q to _ - _ _ _ lli 2, 2.z Y_j �./x� a � �. � �� � i •a. � - � .. i 1 . _ _� i r �. i M �r --- � � ! � 4 ', I i � _ _ w � i i � . � i � I i I i - �- - - - - --- - COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — proville, California 95965 Tele0hone: 534-4541 APPLICATION AND PERMIT �VOwner R Mailing Address 0 7 BUILDING SO. FT. OCC. BUILDING VALUATION ! / �A ���� r\ Te p one Co. Fireplace Contractor c A) >D1_N Total Valuation Mailing Address (91& //VCoil /tN t -UD Permit Fee Plan Checking Fee &/or Penalty n P,0 U f LL �0.- '7 S Telephone No. Permit Fee $ Building�fA"ddre/ss_ / 66 ✓� PLUMBING No. @ FEE PERMIT FILING FEE $3.00 n (� n SAti 1 Yl L1J7�a) /• 16.5 ,ry U r hzt Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. N D �. r — iv Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 eesC. I Sanrtatiorf FireDept. Fire Zone Use Permit Building sewer 5.00 EOA Parking Plans Parcel Declaration Parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. Plans Recd Parcel royal Plan pproval Permit Fee ,$ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 A1500V 7 47n a p, av-- J_L,••K,,% a - 7 OR LE Main service 100 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L too AMP 1.00 NEW CONST. DWELINGOR ADDNS. ( ACCLBL GS CCUP. &1 .20 sq ft // NEW CONSTR. MULTI -OUTLET NON-RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON•RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the nbme style of Y // r���r r�� �) / �/C�II V C� k nl fJ / t-/-1� ,-DE ///QB/1�� %i OM .s Ex. Occup(OUTLETS OR FIXTURES) 50 BAL�1 FIXED APPLNS. OR EX. Occup. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 ,CF7,�� /�INCO1.IiJ BL U� f //Q�(fICL� Mobile Home Facilities 15.00 License No. .�;�� -3�%'� Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. • MECHANICAL No. @ FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I•agree to comply to all County Ordinances and S aws relating to building construction, and hereby Z4 U. 0 0-C TOTAL PERMIT FEE Is 3Q 1 ex au rize rep esentatives of the County of Butte to enter upon the a ove-mentio ed property for inspection purposes. X Date —2 Sig ature of P rmitee or Agent Receipt No. O ;D_ White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIREC-iOEPOF PUBLIC WORKS BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS 7 County Center,Drive_, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET O(hN UOORHEES 1. owner's name: .a + © R r" 2. Installer's name: Ne-01,fV 14(oF /iJ061L 1`O!D F_.5 3. Is the site currently under permit? Yes / / No / ( If yes, furnish permit number j,/ 'Z Z D -7 ) OR Is the site an existing site? Yes / / No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes W/ No / / ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- a = 100 Amps 6. What is the mobilehome site service rating? ----- - ---- Amps 7. What is the mobilehome site circuit breaker rating? ------------- a d Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes / / No TU (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? -- - --- ----- � .^ - (in.) 10. What is the type of gas service? ---------=------------------- Natural/ LPG 11. What is the gas pipe length from meter or tank to the mobilehome? TU (ft.) 12. What is the mobilehome gas demand? ----------------------- - Odd (BTU) (This. informationtno,t required if pipe length les � a 6 f on natural gas or, , less 'than 'S0 ` ft`: on LPG.) { MOBILEHOME SUPPORT DATA c• Mobilehome Mfr. 1) /U Al2 CJA Setup Model No. --Year Width Ll (ft.) Length. _.. (ft.) Expando Size -rq--ft.x eft. (Draw support details..belDw) . 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). *If center piers are other than drawn above, draw in locations, spacing, and dimensions. Footings (check one) 1. Wood.either . pressure treated or fdn. grade. 2. Concrete pad. 3. Other,: specify Supports (check one) 1. Concrete block 2. Concrete piers 3. Steel piers 4. Other, specify Typical Support Footing Size Max. Pier Spacing Max. - O Overhang BUTTE COUNTY BUILDING DEPARTMEN APPR(DVEj) r NOT COMPARED WITH - DECLARATION REGARDING LOTS OR PARCELS bRIGINAL DOCUMENT I certify that as owner of the property acquired by deed in Volume Page f -� Official Records of Butte County, (AP# n30�.� I am requesting permission to build or install an additional living unit on this property. I will not divide the aforementioned property for sale, lease, rent, or financing unless all applicable land division laws and map requirements are com- plied with. I am conversant with the present zoning regulations affecting the aforementioned property, and declare that I shall not violate same. I represent that the proposed use of.the afdditional living unit is�� and that further I shall not change this proposed use of the additional living unit unless and until I receive written approval therefor from the County of Butte. kk I fully understand that pursuant to Chapter 20 of the Butte County Code and §11535 et seq of the Business and Professions Code that if I, in the future, sell, lease or finance the area on or adjacent to said improvement without fully complying with : the applicable laws and ordinances, that I shall be guilty of a misdemeanor and therefore, subject to the aforesaid penalties and imprisonment pursuant to law. Further, this statement shall be properly acknowledged and recorded at the request of the County of Butte. OFFICIAL RECORDS BUTTE COUNTY -CALIF. collas R�our_s 44 6 30 Iso A� 19T7 COUNTY RECO FEE MIA Owner / 7 2 2 !3,�4s v `e Address ► Date 4 ` -------------- STATE OF CALIFORNIA j ss COUNTY OF Butt e On this 30th day of November 1977 , .before me, Linda F. Wilson —, Z. a Notary Public in and for the County of Butt a State of California residing therein, duly commis- sioned and sworn, personally appeared S. John Voorhees known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same. IN WITNESS WHEREOF I have hereunto set my hand and affixed my official seal in the County of Butte the day and year in this certificate first above written. S96 -1275 - OFFICIAL SEAL . ' pts T V,IILSON LINDA F '= a o NOTARY PUBLIC - CAUFORN1A BUTTE COUNTY �ai� aN a P MY COMt,11S1JON EXPIRES OCT. 17, 1978 Notary Public , T1 PI MA 01 6 ,,1 L . i"-'# . sA YTrJi s33 ��^:. • *goo-.., r �I:oY, THERMALITO IRRIGATION DISTRICT 410 GRAND AVENUE N2 891 OROVII-I-E. CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE. APPLICATION AND CONNECTION PERMIT 77 2— 7 . 10-2-0-77 "1 410 rr Service Address: g - ,6 — 7 Owner's Name: Date: Address: 7 7-- Acct. No: .17 A. P. No.: 39— Phone: 2— le No. Units: Applicant/Agent: 7 Agents Proof: Address: Fees: Phone: Application Arrearage Preliminary Review By: ---,Z./, Date- CSA 26 Remarks: — g 4Z" 74 SC -OR 12- 7 &-a 1st Mo. S.C. Other t Total Fees Collected By: Date: C/o Field Review By: Date: Remarks: -e MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: Date of TID approval of completed building sewer (early connection). 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("existing construction", prior to Mar. 5, 1974). 180 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes first ("new construction", after Mar. 5, 1974). DIS MIPUTION; V.1HITE -TID. - AIPLICANIT, P;f,.K - OPY4. (IOLDE.NP100 - DPW to TID PRE—INSPECTION 9_/ / OWNER: C' DATE `—C LOCATION: / `7 `7 lyd A.P. # C� �j�-34060 Q/ CONTRACTOR: ZONING -Tr-p PRE—INSPECTION FOR: PERMIT HISTORY: NONE M TYPE OF OCCUPANCY BUILDING USAGE: TENNANT: [� OCCUPIED �J [� HEATED.—COOLED OTHER COMMENTS: DATE TO INSPECTOR FOLLOWS: FIELD — INFORMATION c HAS ELECTRIC FD HAS GAS Q HAS SANITATION FACILITIES ED PERSON CONTACTED ACTIO ECOMMENDED: 21 ISSUE 0 HOLD FOR OTHER: BY