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030-430-019
r A rvy L7 Vv� has .01 w. A -in man - %A COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTEFi DRIVE OROVILLE, CAIIF_-.',��34-4541 CERTIFICATE OF OCCUPANCY. This mobilehome has been installed in accordance W'ith'the re uIrements- of the California Administrative Code, Title 25, Chapter 5, unl'er permit 6 7 number for the follow'ing location: Owner— Owner's'Ad'dress Mo'bilehome Mig. Model Year p 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 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS BUILDING 1,,NSPECTION RECORD. - 'BUILDING BUILDING (Cont1d) PLUMBING Se 'ck Otewall Ski Piping IF For Par)tpets i loor Nt -�Mal Bldg. Ni Rest om Finish'- Floor Fo tings Windo 3rd Noor Stem al I Siding Jopout V Slab Root Shea"Iting Water Plp,)%g Piers Roofing Sewer Garage Fdn. Vents Fixtures Footincis Garage Vents Water Htr. Stemwa I I Insulation Heaters Slab Carport Footings Prov. for physical handicapped 7- Jr Conformance of ex. V structure V Appliances Gas�Plping & Test A Temp. Gas V Slab A Final Sanitation Patio REP ACE Final Footings Footing' EIACTRIdkl masonry alis N, Thr o*at -Roucih Reinf. Steel Final Fixtures Bond Beam/ ---/FIRE SPRINKLER$ Motors Framing T Test' Water Htr. S tucco F Final SubDanel Mesh MECHANICAL Grd. F!ot Prot. ScraVh HeatlA Servid Brg(vn CooJ(ng T p. Pole nish D ts nderground Inlerlor Uth Ventilation �Peffnanent 60 or Closer Inal Final MOBILEHOME UTILITIES 0%4 ---------- Elec- Service 3X15fZ1,117 ", -;N—ater Elec. Pedestal 4��7 Piping M . r t Sewer I Gas Piping 1� ---------- Supp7r, Elec. Continuity �? Water Pipin Drainage I/ or Gas Piping -DATE REMARKS OR CORRECTIONS 000;lo 10�� (NOTE: An entry -Must be made on this form each timd you visit the job site.) MOBT111"HOME, D4S1l`ALLATJ'0U INSPECTION CHECK'LIST Is the mob,ilehonit-_. located wii-h required separation from lot lines and buildings and generall�, conform to plot plan? Yes,,,yi. No 2, DocL; the mobilehome have require�d clearances above grounod? (Sec.'5085) Yes No 3. Are foothi,;s and supports properly -s-ized, spaced, and braced as, er approved plans? (Note possible. variation at spring shackles.) (Sec. 5082 & 5083) Y e No 4. Is the mobilehome leve'l.? (Sec. 5088) Yes.y No 5. IfqUn����jt _are c�ros nections properly installed? (Sec. -5088) Yes_ No - 5, Water A. Is il 'ble connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5�66) Ye sz�� No— B. Test Does water piping withstand working pressuretor 50 lbs. air test? Ye No s4 C. , Ba e_,__40_es 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! Ye No s 7 B.. Does it -'have minimum I," per foot slope and is it properly supported? Yes No xy— C". Are any leaks detected In drainage sy stem after running 3 -gallons of water through eac h fixture including washing machine standpipe? Yes N OX, D.. Ch is not State of Californiaap proved, does.station __ have required trap and vent?' Yes— N 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 mob*l *home gas line inlet without. reductions other than the mobilehome connector. YesyNo B. Test OK as per following . procedure? Yes No 1. Open all appliance connector valves!A 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 1011-14" 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. Are all appliance vents properly installed? Yes No 'Electrical A. IS Service ILUCJ�.O CVA)Hf',11 to PrOVidC adeqUZiP ' C 'amparage to mobilohome (must equal rating, of mobilehome' (vith j -,:z-inL,um of 100 amp) and other faciliti.E!,.-� on lot, i.e., water pumps, Zara,,L, cabana, (-�C. Yes No X B. is ther- proper cicarance3 around pane -Is? Yes No X assembly properly fused? Ye�v 1�O C. Is power suppiv cord or feeder D. Is continuity test. satisfactory as per the following procedure? Yes No I.- De -energize electrical wiring syste,,u of the mobilehome at the pe�esta.l.- 2. Make . surt� that t1he power supply cord or feeder assembly conductors, including neutral conductor, haVE�-been disconnected. 3. Switch all brealu-,rs and switches in the mobilehome. to the Pon" position. Connect one 1c. -id of a test ins�rurqent to the mobilehome grounding conductor and ilicludii-ig neuLral— apply tlie ouloic Jcaa to cta-ch rl-ioljileiLoffie SUPPLY COCIductUE, 5. All non-current, carrying metal parts of'the mobilehome (aluminum.s"id ing, gas line, water line), inclitding fixtures and appliances, shall be tested for continuity from such-oq�tjpment and the grounding conductor. Upon completio-n of the above procedure, the power supply cord or feeder assembly �conductors shall be connected. to* the site service equipment. A further continuity te.:-L shall then be rn.ade between 'che agrounding electrode and the chassis of the Mobilehome. Upon saLisfactor,' , completion of the(lect�tical tesL:s, the lot or site ser -vice oqijipment may be approved for energizing. 1� T, '-;ob card si-ned by 111calth DepartmeaL for water and sanitation? 11. If everything o3,ay) sign off card and ta- services. 'MOBILE-i'TOME DATA Mai)ufacturer �and/6r Narnestyle Length W i d t I Vehicle Serial No. State Identification No. I ILtional Infni-maticn or Comments: . d�, authorize representatives of the`_Couhty,of Butte',to enter upon the. �above-mentioned_propoirfy-f& i� , ti n purposes'.. �pec Da t e,—,.?, ow, - - ; . . - I— .' M -Signature ol"Per �itee or Ag t R�cei pt. No. White-D.P.W.. - Yellow -Assessor-- Pink-lnspe,ctor,� Gold�nrod-Applicont This permit,.is heeeby issued under the applicable provisions of the Butte Co , u , nty. 6,ode and/or resolutions to do. work indicated .:above for which fees -have been paid. PUBLI DIRECT01 C'WORKS .13, Date7 77 Zng -perm it. ex -3 7- -L(- 7 ilf4j pires�Daite, -BUILDING.' - Owner- A/A/t'ff �Y AZ flo SQ. FT.' OCC. BL)fLDING VALUATIO14 Mailing-Addre s s + 0 _q or,. No. -C 6y e, 6 iz 6 Fireplace - Contractor Total Valuation Mailing )�ddress, Permit Feb, �PlanChecki6d Fee&/orPenalty - T pl�one,1,16., - e.. � I . 'P&rnit�Fde $ W _f CA r 0-- 1 i 51 -,-M. �, . Bui.1di'66.Adde6ss 14 7 �L PLUMBING' NO. @ FEE, . - PERMIT F�ILNG FEE $3'00 3� 0 :G_ 12 Pf 0 0 V - C_ 6 OJ &A 5 t SWDU &F Each Trap 1..50 Repai�,dr6inage orIvent piping 1.50 water piping 1.'50 mow, ;it, 0+ G-61 di 5.1v 960LW k4" 'Each 'as -water* hbater 'or Vent 1.510 9 A. P. No..' das piping.system 1 '- 5 out'lets Each addi'tional outlet .30 F n F ire Depti. Fire Zone, Use Permij u 8 ilding sewer 15.00 10100 EQA� -1 Parking �Plans. Parcel Declaration Parc I M ap. 610' 'R/1W1. improvements Lawn'sprinkler system 2.00 Bld��Jans :Rec d uP"f-.-'.I�Approv.I -Permit Eee ni do NEW -AD*DITION F] UTI'Ll.-TIES:g OTHE14'E]' r-LECTRICAL No. @ FEE PERMIrT-.FILING FEE, $3.00' 600V OR,LESS' Main service �100 AMP,.OR..LFSS.r 5.00 Ma AD6'L '100 AMP I n- seFv ice EA 2.50. Main service OIER 600V - 25.00 1'00 AMP OR LESS S I n g'l'e Fami I y E] Duplex Mobi I Home_g].. .�.`qthers 0 Main seNi�e :EA.. ADO'_L_ 106 AMP 1�.00 NEW CONST' ( DWELLING 0 C'(7.0 P.. OR AIDDNS.'- ACC.-BLDGS. 20sq ft NEW CONSTR. MULTI -OUTLET ITS) 2.50ea NON-RESID. ( BRANCH,CIRCU NEW-CONSTF;L POWER APPARATUS NON-RESID. SINGLE OUTLET CIR. dONTRACTORS LiCENSE'LAW I am lice ' rised-under the provisions, of Chapter 9, D i v'., 3, of the St r' t a e of Cial'ifornia Busine's�s & Professions Cod&,under the name style of: , @ 25t S RES Ex:�Occu (OUTLET OIR F I X'TU rBAL @ 101 X... OCCUp..(.F I I E D A PT LNS* OR I , ��00 OUTLE TS (RESID E A) -Temporary service 1'0.'00 Mobile Home acilities 15.PO Misc. Wiring 6.25 -License No. :,.,Classification I am exempt from the, Contractors License Laws of, the.Sta,te (of'Calif6rnia. Perfnit Fee 00. , 1.8 10 MECHANICAL. No.. FEE - WORKMEN'S'.COMPENSAT16N. 114SURAIIICE' I am awa , re of the.-provi,sions.of Sedtion3700 of the CbiIj forn ja. Labor Code which �eqiuires-every employer'to be�insuhe'd against iability for Workmen's�'Compensat ion.. I have placed on file with th ' e C66nt� of.B.utte 6 certificate of mion Ifisurance. Workmen!.s Compens� I",certify tfiat in the' �erformance of the Work for. Which this :permit -is. issued I :shall -not employ any person in any Tanner . so as to become subj6ct'to-the Workmen's Compensation Laws of —california. PERMIT FILING FEE '$3.66, Heating Cooling Ventilation Hood 2.bo Permit Fee $ $ I 'certifr that I:ha�e read thi's applJcation and state that the ab6ve 0 re c. y. -Ordinances' inf' rmation is,cor t.,-I'agree t6'coTply to al.1 Count an d �Stdte Laws' ird laiino to'.Jbuildina construction. and herebv J_ )y - C A d -Pevc-1660k,!�AA Ax TOTAL PERMIT FEE $ authorize representatives of the`_Couhty,of Butte',to enter upon the. �above-mentioned_propoirfy-f& i� , ti n purposes'.. �pec Da t e,—,.?, ow, - - ; . . - I— .' M -Signature ol"Per �itee or Ag t R�cei pt. 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Setback 'Shall be 5 ft. from the side property line and 50 ff. from the cenferrine of fhe rood. permiffing a moxi- mum of a 2 fl- efwo overhang but entirely ouf c" all easements. CD s. a, -CID co c- 0,0 focr,�Ie�- v!.*�,'-*r, tWd e +he rear secf ion of fr',.e mobile hoine on the left (road) -side of the mobile BUTTE COUNTY BUILDING DFPARTM�NT A.PPROVED CSA 26 SEWER SERVICE APPLICATION AND-CONNECTIbN PERMIT'-, Ser�vice,Aciclress: 2 Gwner's-Name: 'Date: 'Address: K) 45�- Acct. No: ;e A.'P. N o.: A� Phone: No. Unii�: Applicant/Agerit- Agents Proof: Address: Fees: Phone: Application $ Arrearage Preli minar y R evie By: k, w Date: 'Z 7 CSA 26 Remarks: 7— SC -0 R lst,mo., S.C. Qther F. Tota I Fees. Collected By: Date: ield.. Review By: Date: Remarks: MONTHLY- SERVICE CHARGES WILL'COMMENCE AUTOMATICALLY UPON:. 4' D Date of T I D, approval of completed bu i Id i ng sewer jearly connect ion). 30',days after.dafe above, or on date of D.P.W. approval of completed building sewer whic'h,ever c6 I mes . . f i rst ("ex isti ng c onstruct ion prior to Mar.'5, .1974). I 180'.days after date above, or bn-date of D ..P.W. approval of �bmple�ed.bu*ildi.ng.§e'wer,.Which ever:comes '.f,irsf�i��'new con'structi6n."-,, afte*r.'Mar.'5; 19.74)., DI . ST RiBUTION:' WHI_�.E`TID, YELLOW:- APPLI*CANT", PIN DPW,' K GOLDENROD DPW to TID authorize representatives of.the County of Butte to enter, upoq,the bnd6r the applicable Orovisio . ns of This permit, is hereby. issue abo�e-menfioned -property for.inspecitkolh p'urposes. '6tie' Couhty Code arfd/or resolutions -to do work indicated the, Bi above fo(which fees hav6 6een paid. D TOR LIC WORKS' IREC ate., D .'Si niiure of Permitee or Agent 7�- ate - JA - 10 g Receipt No. 13 ing perTit,6 White-D.P.W. rZ�'�ink'-In'sp6cto'r Goldenrod-Applicon't expires Date'-. B01LDING Owner SQ. FT. OCC. B U I L DO N d V A L 0 10 N Mailing Addre§r�_A 01 Co"ZZwl CC' a.,) Tel n'6 Contracioi 'A) 5 & Tota I'Valuatio1 M,ailling Address Pe rmit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ .7 Building Addres 6Aj PLUMBING No.1 FEE FILING F=EE $3.00' _PERMIT CY-AA io, A 0& 0 AJ 4�5 f', Eachtrap.-1.50: Rep�i,r-,drainage or vent piping .1.50 4. Water piping, 1.50 Jr 35 r i L&CA Each.gas water heater or vent 1.�o I A. P. No.'.. Zoning & Planning s m' Uitl e*ts '1. Oas,piping yste 1 - 5 o 50 Each additional outlet .30 F4<1�dl_ aftmtit� FireDept. Fire�Zone U�e Permit. Building'sew6r- 5.00 Q A Parking P _[an s Parcel. Dec rcel�M�p '60'JR/W ImRroveme�� Lawn sprinkler system 2.00 F�� �sApproval Permit'Fee. �i- $ $ NEW ADD�TIQN 0 T H E _.PERMIT ELECTRICAL N0.1 @ FEE F(LNG FEE �3.00 -ESS 600V OR L '00 Mai n, servi6e 100 AMP OR LESS 5. A" Main service 0 AM P EA. ADD' 'L 10 2.50 OVER 600V S 25X0 Main service 100 AMP OR LES -Dup -Mobil Home Single Family Others Main service' EA -460"L. 100 AMP 1.00 7 NEW CONST. I OWELL.ING-OCCUP. . & 20sllft OR ADONS. % ACC.BLDGS. ... NEW.CONSTR. (MUL�TI-OUTLETI 'S) 2.50ea NON RESID, BRANCH CIRCU T 'NEW CONSTR. 4POWER APPARATU S NON-RESID. % SINGLE OUTUET CIR. CONTRACTORS LICENSE- LAW I am licensed under the pr�yisions' of Chapter 9, DJ y. *3; of the State of California Business & Pr6f6ssions Cod6 under the' name style of, 50 @ 251 Ex. -Occup(OUTLETS..qR FIXTURES) SAL@ 101 (FIXED APPLNS. OR ) s Ex. Occup. 2iOO OUTLETS (RESID.)'EA Temporary seryice .10.00 Mob i I e� Home Fa6.ilitie's. 15.00 License No. Classi,fication Misc. WJring 6.25 I. am exempt from the Contractors L 1 cense+ Laws of the State of Cal i f ornia. erm t Fee Permit Fee $ "ng $ MECHANICAL No. -FEE MECHANICAL @ WORKMEN'S COMPENSATION 114SURANCE + . - . I . I -1 am aware of'theL provisions of Section3700 of -the California Labor Code' %�h i ch requ i res every emp I oyer to be insu�ed against liability for Workmen's Compensation. " I have placed on file with the County of Butte"a certificate of:� 'Workmen's Compensation'Insurance.. I c tify that fn the performance V er of the -work for whi6h this permit 'is issued I shall riot employ any person in any'.manner so as to become subject to the'Workmen's Comoen.satiod, Laws, of -California. PERMIT'FILING FEE $3. ob PERM I T'' F I L ING FE rHe a t Heating, Coollilng... I veriti I ati 6n Hood 2.00 -PermifFee 1+ bertify that I have read -thi�, appl'ication' an . d. state, that. the above information is'-cohrem',l agree.to comply.to all County.,Ordinances and State�La%�is relatina to buildinq 'Construction, -and � hereby, 14--h -'TOTAL PERMIT FE - E $ 3106/ authorize representatives of.the County of Butte to enter, upoq,the bnd6r the applicable Orovisio . ns of This permit, is hereby. issue abo�e-menfioned -property for.inspecitkolh p'urposes. '6tie' Couhty Code arfd/or resolutions -to do work indicated the, Bi above fo(which fees hav6 6een paid. D TOR LIC WORKS' IREC ate., D .'Si niiure of Permitee or Agent 7�- ate - JA - 10 g Receipt No. 13 ing perTit,6 White-D.P.W. rZ�'�ink'-In'sp6cto'r Goldenrod-Applicon't expires Date'-. 1 41 , -, ,: A'. , -, � - J" - qv 1 1 ,; ",I P , , - '.- " , '.' � f. . ,.'.� I - - , , - ..�� . '. . 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'. � , ,�*` - � ,- I. 1� ,� , , - , , ,4- �. - � . i -, i, -'. ��, � -," ,,,,-,i , , ; 4 I- -I. ,,'t, . , -, , - . - � . , - , `i�_�_ � ��+, " . . �, , �- : , - - , _% . , ork If— -, " - � is - , ,_ " , � - I � i. ". , " . , � ., �*, - � �5;, . , ,t,: , , L ,�: % : . . . 4, . I . � , � , . , "t, , � , � .. � - , : - �-- - -.', � - - , IF , , - � ,�,+ �"� * -,�,,,� �: ., �, -,,� �-t, � t, ,�, ,,,, ;o"A� 1'1_,�'�v ". _� , , � - - -,, -�,. -',, "A"WIT, _-,:,��:._.�,��`,�; __,. :_,iA - . " .. -,- ,-- , � , :�:�, ,`��,,,� ,,�;: , " - ," .i, :� ", ; , � I , . ,F. , , � , , . .,,X", �, . � V p , .-, ."",� �, ; . J. �� � �� , - I .; !, !.- -,. ,� . I , " ", : ,��L' �� - �qj 'I ,i, , �,r �i . . � , �� ., � , � , , - i" BUTTE COUNTY DEPARTMENT OF PUBLIC'WORKS -7 County Center Drive, Oroville:, CA. PHONE: 534-4541 r MOBILEHONE INSTALtAT ION SHEET 1. Owner s name: 2.* Installer's name: DJ -Q& 3. Is.the site currently under permit? Yes No .(If Yes :--furnish, permit number 805--r77 OR I 'the site a' 7 7 s n,existing site? Yes No /X (If yes, furnish two (2) plot 'planis.)' 4.' s Will the' mobil-ehome be.located at lea't 5 ft. away from septic tank.and leach fields.and., clear of alls-etbacks and easements? Yes No (If no,'clarify 5. What is* the mobilehome electrical rating? -------------------------- 50. Amps., 6. What is the- mobilehomO site service rating? ----- ------------- 100 Anps 7. What is the mobilehome site circuit breaker rating? --------------- 50 Amps 8. Is there any other electric load to be served by the mobilehome site servic*e? --------- I ----------- ----------------------- I --------------- Yes No (If_yes,'ident'ify the load,and,sit"e': (Load) (Amps) 9. What is the �.,mobilehome site gas pipf..'size? ----------------------- 10. --------- -------------------- _77: What is the, type of gas service? Natural 7 �LPG T ll.,.What is the g'as, pipe length from meter. .or tank to the:mobilehome?. (ft.) 12. What is the mobilehome gas demand? ---------- --------------------- -- (BTU) (This information -not required if.pipe length les's than 6'.ft. on natural�g4s or less -than 50 -ft. dnLPG.-) MOBILEHOME SUPPORT DATA kaHAMPION HoME BUILUERS Mobil ehome Mfr. Setup Model No. 701 Year 1976 Width 12 (ft.) Length 57 (ft.)_ Expand&Size ft.x ft. (Draw suppor� details -below) On all mobilehomes manufactured -after October 1, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). S I Footings (check.one) /X/ 1. Wood either I pressure treated or Center Centex. Suppor ort fdn. grade .,Support Footing Sizes Locationsl (in.) 2. Concrete pad. X (in. -(in-. 3. Other,, specify' k Supports (check one) Concrete' -,block .1. X 2. Concrete piers ('ft n (in. 1(in.) j j 3�.Steel piers. 4. Other, specify X (in.) (in.) in.) _X i in.) *If center riers are other than:drawn.above, :.,draw in locations, spacing, and dimensions. / .8-0- 1 Typical Support 4 (I ifi---) : ( _in�_.J) Footing Size Max Pier (f Sp* ac ing 4" M=e�hang 'ft-- _iV. ,, i n—, ..in._. - BUTTE COUNTY BUILDING DPARTMENT APPROVED