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HomeMy WebLinkAbout030-461-03330-461-33 2344=90P,E O3O ." 1— O �. Mkt 'i � ° �� '" � 1:. ..��••��� ' .. r`` ,s : t•x7 ` STORM ` DAMAGE REPORT' HEN CK ON Carrie t 1863 h St, Ofoville ' r, '' t� � Contr. F lds Electric Y 37 �' "k� y,. '[('s- jx ° Y iT "°*r� 7.7'4 ; .l.`Ik�,,ti*. :iSf7, �;'' 1'{.i. ,+t'^x" 'f.�. (utilities ELEC v KS r ` GAS !'COMPACTION TEST -RE n_ J° `SUPPORT •STRUCTf REQ 30 -61-33 O� Permit#4084- 0 �w O !� ( install n/ ) ~ la '� V 113 d I��r�•\ fir. � �Vli��-}f! ��"r�� - / n.•xaaci Yi_ ii US�I�Is 30-Y6 33 DATE TIME . - W- 6 OCA ESTIMATED DAMAGE BY Cf. . (�t,�i`'� 3 0- PUBLIC INFORMATION OFFICER 538-6953 DAMAGE REPORT FOR INITIAL ASSESSMENT . FLOOD JANUARY 1995 P Name Reporting Partys-- Address/Location 1963 20 f:h SA - 1�596s Telephone Number 53(4 7Lq q7 City County Q Type of Damage (Note: Emergencies Refer to 911) Wao Building Description ( ] Commercial/Usage ( Residential Type and # Units [ ] Currently Occupied/Use [ ] AbandonedNacant Electric � .� Any electrical submerged Yes [ ] No Ki oN(XJ oma(( Obvious damage (failure, downed wires, arcing) Gas �r�plPrnnanP Obvious problems (odor, leaks, leaks, propane tank floating/submerged) On[X] Off( ] Structure /Off Foundation Floodin above belo loo /p G X y Obvious leaning, tilting .=ia-- Severe Damage/Collapse I Debris Hazard �� ll anitatiohv --Plumbing woi Running wate Well Flooded Obvious Sewage Problems Chemical/Fuel Wet, flooded, lost chemicals Type pesticide, fertilizer, other chemicals Amount Fuel tanks (above or below ground) Obvious hazards Agriculture Loss Crop Damage _ Livestock Lost _ Building Damage Roads (Public) Road Name Obvious Damage/Hazards Location/Landmarks Traversable (Sedan, 4 wheel) _ Involved Utilities (downed wires) Levees Public ( J Private Waterway Name Location of damage/problem Obvious hazards _ Nearest Landmarks Overflow/freeboard Covies: ( ( OES ( I Agriculture ( ( Health [ I Fire ( ( Building ( 1 Sheriff DATE 1— 13 -q TIME .ESTIM�T� E ,�C>O• �6 61000 BY t - DAMAGE REPORT FOR INITIAL ASSESSMENT FLOOD JANUARY 1995 . PUBLIC INFORMATION OFFICER -538-6953 Name Reporting Party IYN.& --b(.vvwS- - Address/Location 3565 Telephone Number 53 q -??q y? City County Type of Damage I c toti (t11-rn.c Q (Note: Emergencies Refer to 911) WCGO Building Descriotion [ ] Commercial/Usage r Residential Type and #-Units j ] Currently Occupied/Use ( ] Abandoned/Vacant A r e Electric Any electrical submerged Yes [ ] No Ki oN(X) QF'F•l ) Obvious damage (failure, downed wires, arcing) Gas ��oPropane Obvious problems (odor, leaks, leaks, propane tank floating/submerged) On[X] Off( l Structure • —(D/Off Foundation Flood in above belo loo /d X I, y Obvious leaning, tilting - Severe Damage/Collapse -(sY-- Debris Hazard ` alp. DATE 1— 13 -q TIME .ESTIM�T� E ,�C>O• �6 61000 BY t - DAMAGE REPORT FOR INITIAL ASSESSMENT FLOOD JANUARY 1995 . PUBLIC INFORMATION OFFICER -538-6953 Name Reporting Party IYN.& --b(.vvwS- - Address/Location 3565 Telephone Number 53 q -??q y? City County Type of Damage I c toti (t11-rn.c Q (Note: Emergencies Refer to 911) WCGO Building Descriotion [ ] Commercial/Usage r Residential Type and #-Units j ] Currently Occupied/Use ( ] Abandoned/Vacant A r e Electric Any electrical submerged Yes [ ] No Ki oN(X) QF'F•l ) Obvious damage (failure, downed wires, arcing) Gas ��oPropane Obvious problems (odor, leaks, leaks, propane tank floating/submerged) On[X] Off( l Structure • —(D/Off Foundation Flood in above belo loo /d X I, y Obvious leaning, tilting - Severe Damage/Collapse -(sY-- Debris Hazard BUTTE COUNTY BUILDING OFFICIALS JURISDICTION Block __ Parcel No. dt� Rapid Evaluation Suety Assessment Form BUIIDh`1G' DESCRI ON: OVERALL RATIN(Clceek One Name:' LNSPECTED (Green) ❑ Exterior only . Address: / g6 2q. S v6Yterior and Interior IJMITED ENTRY (Yellow) ❑ No. of stories: UNSAFE (Red) Basement: Yes ❑ No E Unknown ❑ I2NSPECTOF_ Primary Occupancy: Dwelling .. Inspector ID Other Residential❑ Commercial'❑ Office Affiliation Industrial ❑ Public ❑ School (] INSPECTION DATE: _ Government ❑ Emer. Serv. ❑ Historic ❑ Mo/day/year 1 �� Other Time Z : 0 3 ain Instructions: Review structure for the conditions listed below. A "yes" answer to -t, 2, 3, or 5 is grounds for posting entire structure UNSAFE. If more review.is needed, post I,ItiITI:1:D l°.�I'TR`�. A"yes" answer to 4 requires posting AREA UNSAFE and/or barricading around the hazard. Hazards such as a toxic spill or an asbestos release are covered by 6 and are to be posted and/or barricaded to indicate AREA UNSAFE. Ivrore Review Condition Yes No Needeci� -1. Collapse, partial collapse, or building off foundation ❑ ❑ 2: Building or story noticeably leaning ❑ '�1 ❑ 3. Sevice e racking of walls, obvious severe damage and�distress ❑ 'CJ 0. 4. Chimney,.parapet or other falling hazard ❑ ❑ 5. Severe ground or slope movement present ❑ ❑ 6. 'Other hazard present ❑ ❑ Re co mendations: 7No further action required F1 Detailed Evaluation required (cycle one) Structural Geotechnical Other ❑ Barricades needed in the following areas: ❑ 0dier: Posted at this Assessment: ❑ Yes �No Comments: Dear Friends and Members of Magalia Community Church: First let me thank you for the care and concern that has brought our family of believers to the threshold of magnifying our effectiveness in reaching the Ridge for Christ. Our primary charge f is to witness to the Ridge, to Butte County, to California, and then to the World, the peace with God available through Christ Jesus our Lord (Acts 1:8), with the goal that all may know Him and the power of His resurrected life. You and I have been joined together as a body (1 Cor. 12:18) and a family (Psalm 68 :5) to help each other and extend God's love to our world. We have been positioned and empowered to make a difference. The gifts and abilities of our family have begun to reach our waiting world. Through our combined efforts (Rom. 12: 1-3) we can face any challenge. Many do not understand how a church is financed Biblically. The -X 4--- iH - 1-- g r a ; c F FSI®ENTIAL. i 30-461-33 2344-90P,E HENDRICKSON, Carrie 1863 20th St, Oroville Contr: Fields Electric (utilities/MH) d 'C h p r ' JOB FINALI Signature OFFICE COPY Address I � GAS Meter By Date: ELECTRIC Meter By ` �— Date l" i _ ... ••---...� ...-..�r.-�.r—•�...y..,..�.�.tir...._i..�,srtiasy."r'+v'�.`:."�,_..iii'!!"•.-•-•-..ti.'r-�.r:TF.. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541' 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE A�dn� ---� Z3 y — 9 - VN R PERMIT NO. 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. 3nM0.1- - 14 1 � 0 V Date w�+ Inspector COUNTY OF BUTTE• DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. 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. Date �` i J�� Inspector i�' re.,•..r {�. t .,, .'�•r �L.�s'yy-pct..i+.r--.rte--�-�'-^+.--�a�..., _ r .._ .. , . ?' COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 P 7 County Center Drive, Oroville — Phone: 538-7541' y' 747 Elliott Road, Paradise — Phone: 872-6307 M CORRECTION Ei3 - NOTICE 4 -'3q4 -4n - PERMIT NO. 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. Datj'�A —/v ^Cld Ins MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT N0 Address or location of mobi lehomew 7 Owner's name Owner's address Insignia or hud number—y4p !T2 Ca g: W Manufacturer's name ,ZF Serial number oJ V.I.N. Year of manufacture --` v '(OfFicial Papp oving Installation) (Date) IF.THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. J=OK t O=Not OKNot �� ? = Not Ready MOBILE MOBILE HOMES i Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements oils; Special MH Support Sketch ewer; Location -Test -Fall -C/O Concrete Location -Test -Easement Needed (Sketch) lectricity; Location-Clearences-GrndgV,Rmp-Concrete , Vis; ation-Test-Wrap: 1/_AwrNat. or/ /"L"ft./ /"LPG 7. Utility Clearance ' t Date�j� Card B-1 Date Card B-1 Dat �c. Card B-1 Date Card B-1 Date M ILE HOME INSTALLATION Plans OK except #'s 1. pning Requirements -Setbacks Easements I 2. Footings; Size -Spacing -Marriage Line I -,Z�Gas; MH Test-Demand-Valve—Connector I r'_-_.4-Erectricity: MH Test -Crossovers -Breakers -Clearances I C' Sin; MH Test -Fall -Flex Connector I C_-7—Water anaSewer Connected -C/O to Grade -HD Approval II MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs: Coonectors Shthg.-Rfg.-Bracing S. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 • Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater '8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboa rds-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 4 Date ! and B-1 /bate Card B-1 Date Card B-1 Date Card B-1 t lxlC� S%/cYc�� O� MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs: Coonectors Shthg.-Rfg.-Bracing S. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 • Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater '8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboa rds-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 l=OK a, O=Not OK - = Not Applicat�le RESIDENTIAL (c% = Not Rudy Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Fig., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel -Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B -1 - Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Fiirnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearinq e '- Ingle & Duplex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic. 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic 0 Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 80. Following instid.; Drive ❑ Yes ❑ No; Walks 13 Yes ❑ No; Planters 0 Yes O No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; PIbg.-Appliance-Firep lace. -Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California. 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT IN PERMIT NO. 2344- ASSESSOR PARCEL NUMBER 30-461-33 ZONING Ik' AR j BUILDING PERMIT OWNER Carrie Hendrickson TELEPHONE none SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS UroviB x lle 95965 TRACTOR'SN AMEO Fields, Flect-ric TELEPHONE 872-4557 CONTRACTOR'S MAILING ADDRESS 1491 Rov Tone, Paradise 95969 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 40-W LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1863 20th St. Permit fee $ 15.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2:00 Oroville 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 [:1Duplex❑ MobilehomeEN Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I -,G 10.00 ea 30.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities)M Installation❑ Other ❑ Describe work: TSU �dl mrest 0�� (7 a,Oprov-ej Permit Fee $ 40.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service SS 100 AMP O 1 01 R LESS 10.00 10.00 Main service EA. ADD'L 100 AMP 2.50 2.50 CONTRACTORS LICENSE LAW I declare under p y p i y (check one): penalty of perjury ) ❑ 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) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING & OCCUP. OR ..DNS. ACC. BLDGS. ) 2/20sgft NEW CONSTR ULTI-OUTLET NON -REBID BRANCH CIRC ITS 2.50 ea /POWER APPARATUS a (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES zo®soe SAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 15.00 Misc. Wiring g 15.00 Permit Fee $ 37.50 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. ����,�, ar X Date U �^ Signature of Applicant — caner Contra o r E] Agent ❑ An OSHA permit is require 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 $ 2.50 HAz CUA _ PARK _ SCHL F`D, ✓ PAR PD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees D OR PUBLIC By r� PERMIT EXPIRES ate the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 79934 WHITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovillts, California'95965 - Telephone: 916/538-7541 0_3 �4 y__9Q <„v-1 . APPLICATION AND PERMIT ASS ESSO ?ARCEL N MB I ZONI BUILDING PERMIT O, NER ��U 29;CS TELE SO. FT. OCC. BUILDING VALUATION O R'S IN G ADDRESS CO TRACTOR'S NAM 1C� Cv(`J Jam/ lj 072 ON� 57 _ O TRACTOR' MAIL I G ADDRES Fireplace CONSTRUCTION ENDER UNKNOWN Total Valuation Is Filing Fee $ 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 $ B IL.D G ADDRESS Permit fee $ / ,a PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Suplex❑ Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00e 0, TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UtiliesInstallation❑ Other ❑ Describe vivo Permit Fee $ Q. Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 ,�O Main service EA. AOO'L 100 AMP 2.50 a�s� CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business f and Professions Code and my license is in I force and effect. License No. Classification ❑ I, as the Owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUPM OR AODNS. ACC. SLOGS. 1 +/x¢sgft NEW CON5TR. -MULTI- OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea /POWER APPARATUS O (SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 18AL930 "`oc FIXED APP LNS. OR Ex. Occup. OUTLETS IRESID.I EA. 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring15.00 Permit Fee $ , Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 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 Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor Al certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in conseque ce of the granting of this permit. X Date Z /6 Signature of Applicant — w r antra.,., Age., An OSHA permit is required for ex ns 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 $ HAz I CUA I PARK I SCHL I FAD PAR PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date ��Receipt No. _ COUNTY OF BUTTE -"Department of Public Works 7 County Center Drive, Oryvillel, CA 95965 `OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-538-7541. An 'owner -builder" building permit has been applied fpr 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. 41. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) -� 2. I (have/have not) 4-1.e, signed an application for'a. building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: 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 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 Xs ig n ed : Property Owner Social Security Number _ 'Date ���Y,*/4% NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the-Cal.ifornia Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL'DEVELOPMENT Section,`�26-8.1 of the ;Butte requires this acknowledgement prior to issuance of a building County Code be recorded ' permit. 9 The property described, herein is adjacent O=�2g282 r= to land or included within an -area zoned for agricultural purposes, and residents JULof this ' property may be subject to incon- j 1990 veni.ences - or discomfort; • arising from the , U. se' a! 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 occasionally generate dust, stroke, 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 disconform from normal, necessary farm operations. All that 'real property situate in the County of Butte, State of California, described as follows: PARCEL 2, AS SHOWN ON THAT OFFICE OF THE RECORDER OF ON JULY 19, 1985, IN BOOK ,30-%0/- () 3.3 P Date:' JULY 10, 1990 CERTAIN PARCEL MAP, RECORDED THE COUNTY OF BUTTE, STATE OF 99 OF MAPS, AT PAGE 61. PROPERTY OWNERS: IN THE CALIFORNIA, '} STATEOF_CALIFORNIA lss. 19 , before me, ' COUNTY OFV��-' 1 red c r On - �`1 L.` \ �9 d before me, the undersigned, a Notary Public in and for said State, personalty appea4re� ' -1 S �'� ( - personally �r known to me wi�tame) to be the person whose name is subscribed to the within instrument, as a witness thereto, who being by me duly sworn, deposed and said: 1.r - v E That +helshe resides in © rOy ` • ` a thaHm/sheLZ r�r wags present and saw personally known to�hlm/her to die the same persons) described in and who OFFICIAL SEAL executed the.within instrument, as a party(ies) thereto, sign, seal SANDY A. STACK and deliver the same and that said party(ies) duly acknowledged NOTARY PUBLIC-CALMRNIA • in the presence of said affiant, that he/she/they executed the p .O(ryop In BUTTE County o same, and that said affiant, thereupon at the partys(ies') request, subscribed his/her name as a witness the 0 a l WITNSS my hart and offici eal. I,� i }t. (This area for official notarial seal) the basis evidence. '.0 aged that dined. IN WITNESS is THENALITO IRRI-GATION DISTRICT 00 410 GRAND AVENUE OROVILLE, CALIFONNIA 95965 • TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: 1869 20th Street Owner's Name: M. A. Sarni Date: 4/16/90 Address: P 0 Box X065 Acct. No: Paradise, CA 95967 30 461 A.P. No.: 099 Phone: No. Units: one Applicant/Agent: Agents Proof: Address: Fees: Phone: Application $ 30 00 Arrearage Preliminary Review By: Date: CSA 26 550 00 Remarks: SC -OR 900 00 *Connection fees payable in three (3) monthly 1st mo. S.C. payments, per agreement between SARNI & TID(Schmidt)Other TAP 75 00 1st payment in the amount of $803.00 M/0 #2200 rec.'d 4/16/90. Total Fees 1555 100 —T,ATERAT, TO CONNECT MAIN LINE TO SERVICE LINE Collected By: AT PROPERTY MUST BE INSTALLED BY OUTSIDE T Date: Field Review By: OF THIS AGREEMENT. Date: Refer s: 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). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID r*�f�t tizL `ivfi.tC.rlt ��Y�.t� �..L kms • COUNTY OF BUTTE - DEPARTMENT,OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET OWNER Cf 12-IZI`, h- 4IJ224/C/C Sy Proposed Building Use .41-1,71 (/ Building Inspector Permit No. _ A No _ Date / L9 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED All items have been submitted. .. Plot plans in dull_ 'c_ ate/triplicate, signed by preparer of plans ........T��� 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4.' Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 011l '' 15 16 S hp District fees paid .............. Sanitation approval from WlHealth Department90 City of Chico plumbing permit ..................................... Plot plan and business license approval from City of (see City for other requirements) Planning approval for (A) Use: (B) Parking: ...... Improvements may be required. Contact Land Development Section DPW Driveway permit (construction approval required prior to occupancy) Pre -Inspection for required...Pre-Inspec. request to IBuilding Inspector (Date) Contractor's license information (No., Name Style, Classifications ... Certificate of Workmans Compensation Insurance .................. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Recorded copy of Agricultural Acknowledgment Statement ......... f2 -4(—Q0 Letter of-sianc-4ure authorization...n .................... ...... _... �- When ,. r ......, .r. _ �.. .. Telephone Other and hold for pickup at office. Deliver w. /inspector. Applicant y✓JDate Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. _Fire Dept. Other Date By. The following data must be submitted prior to permit i 1. Index permit for above items No. 2. Additional items required: ce�(Circle new item not checked above). Contractor, designer owner as advised of above required data by_phone,2 Cmall—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —ma ll_ ounterb dater n Plans checked by Date Plans approved by Date / 7 Sets of plans on hold in File cabinet AP folder ,��-.✓�'` Copy—DPW nL No �o 5a4lt) RECEIPT TOTAL TENTATIVE CHOCK & STREET PUBLIC comp- FIRE OTHER APPLICANT RECEIVED FROM DATE NO. RUCE WE 0 MAPS KRIS SIGNS DOCUMENTS L.IANCa HYDRANT �/ /S� T OFFICIAL RECEIPT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS LAND DEVELOPMENT SECTION RECEIPT 11648 ISSUED I COUNTY OF BUTTE - DEPARTi'�ENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 Carrie Hendrickson- P.O. Box 228 Oroville, CA 95965-0228 With reference to the above subject: L1 Attached is: Application for permit Building Plans Engr. Calcs Owner -Builder Verification Form PHONE: 916-538-7.541 DATE�LI y 17. iggn RE: Building Permit Application for Mobilehome Utilities (#2344-90) A.P. # 30-461-33 .js . Mobilehome Utilities Installation Sheet Mobilehome Installation Information Sheet Typical Plan Sheet' List of Codes Enforced OTHER We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement.. Complete plans in including plot plans. Plot plans. in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 196 Memorial Way,' Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. XX.OTHER We need celarance from the TID for connection to sewer. Also this parcel is in an area where a Drainage Assessment fee of $250 00 must be paid to the Land Development Section of Public Works. Should you have any questions concerning the above, please contact this office. . JFG/aj Yours very truly, William Cheff Director of Public Works F. Glander Chief Building Inspector .'Af1 r •' /J,d:�_/S' 0/- /JEIJ1,C/iv6 .......,,. /Aw Cot lore (4 , ill! Ewe OP [ 07 0, g(OGK /� TAKFN /!!/NClN 'fie (e. 41-w'OY?e•u'eT'.L,/r.er) !rc[!o'- I /10/NrS [ 1A1 N°vGOTFO AI .VA9'gp%J OIIq (qf. b+ r%n'n[) z9o.oe nT,1 reo rJ• /"J NJ • S 1 `l7/5//No/0 lfLtlr w,[W ,. oyrxck[s[v/ w /O/ /a/Os 11 (ir/4[K Yr//lrY ; ar/O!!f TV C: rlri/Nr,7 4V OLlo! 1 —� 4 o ; PARCEL I ; ,i ti S7FbfrA/c� t� Z zI 2 $fE ACTA/L '4' / ex,lrema 10roor i wi°/ 1//•ff'io'r(MJ/�� 5 Ml �UsrM'"r/// rJII OI.II7 /sop* I oe•-- 'y.• `� ,� [L o°' s l!-- soD7!'.[•w/nsl z' 05,- - i J✓ 8 A!U[L/O/N/OJ s1N/� iOf MOOT IS 2154 aa. /47 I w Cat. Lor I o 467 Tt is set ofptan bye kept on the job 7ttitt,li make any changes or alteration on same without written permission from the D artment of Public Works, County of e /I7 'I W: w_ W NOTE: --ATI Materials &.-.:'- unship Shaft Be In Accordance "° quality pr X, practices and of a �scrty "•� 1, l�e�' i"6r a peeifled use in the Uniform Building, Plumbing & tunical Codes and , the:Nationlal El ' Nn. " 0) T/s00' L :;ul V/C/N/TY MAP S7FbfrA/c� t� Z zI d r """ ." vion of the rnobilehoMIL C y • C 8 LI/•O/'AY/(N),L OO• 2 ' $ Z (p)- 67A( 7/ (01 !ffI GI /I7 �d»•+`�. �ic.+c 1a i�' t OBILE HOME MUST N'rYi I!(MJ Af111VZ1 t - 5lr"49 a41f [. f.4I10I INA," 1-40 0 - PO/Nr _ PCL z 011lfM/N!O LW[Y ERR H U n I ABEIIS —seYsa'ro e(i tTJ aea,c•— f= �pf fWN .-Ozo ?R(Y) PCI 1 Nr • /. 80rLJ P4.PCEC S A.ee SUR✓ECT TO 4 6 r wr w/OE EA5eA Nr OA .7/0l/r-CIS-TLSO✓ f ,v vada P/PpS, O/rcAles r FTG AS PIR /076 Oe. _11Z, Mf !,(.00r COCArlav OP [YN/C![/S NOr OEP/NEO /N SA/0 OOCU,NEN7: t. DeY&OPMENr aN P.ORlfO P IY/L( RfpU/RC' CRVNfCJ/ON M r. /. a w4ree Ir SeWE.P. i SURVEYOR'S CERTIFICATE SURvT r IN [ORrpRN VIIOLR Nr DIRECTION Amo's "SCO urON A II(LD •AD LOCAL ORDi•AN C�Yr TTM tNL'R(OOIR[ .(HIS 0/ THE 7000"171(1". MArACr • (AT TAE R[OU[ST OI [MAI- —Al. CON r'' _ ',17tR 1 HC'[tr 1I•It THAI 1NIS rMC(L Y+I SUOSIAN r14p All YGO�•O 1M1IIY r�[��b,N 1S��A r•ROr�bM CONOITION•L L" AP 0110 T(N /A i1Y( M+I 1[1M". LL ;:1 t i 1N0�11 NLALON-AAL 0[ IML CM•M AC a AMD OCCU" TM[ 1011 TION[ t "C110, MONW9417 Aft IV/rICILMi TO [N•fl[ THE tURV(" f0 0[ (/oMM o. cNAmwILR7 Ls..Lot 8? /{�1 � 7 A:setback of 5 ft. trom. the PARCEL � R� � � w ,tie�� Property Imes and a setback of 50ft. from the • road A-,C0RT/0N OF L OT 6, gL K. /2/, LT//ERUOL /TO centerline shah be clear of W.4L L Af4P N0.6, zma /N 5ECT/ON //, T/9/V, RSE, M. D. M, UN/NCORPORQTE0,4REA OF structures of uI ment f c—ul.f..°ff eq p "ceP' BUTTE COUNTY, C,4L/FORK/,4. i A. NAM, AI/E. �v a 1 �trrt�vf Ov�et'�awq `�y OR E.4 .L� BLQIR C�E'0.� OT all aS4W�e�![st NOT[: THE [OUNTA Ct,,j1R•S C(R TVICAT[ AND IN( ICL[RM Or THE SO•AO Of NOiI AN NIIOwII OI OWN(AS+II If S(rG CONCUR R(NTl" RECORD IN SVr[Rv150A7 CIAfi/ICAI[ ARC ev COMMAMrL" R(COROE N tN OVf IE COUNT" RECOROEA'S Orl10E I, 010 XAIAL NWSER _ THE O/rt( OI IK RV .It CCAINIv NCOM(A y.p(R $IAUI NVV![A COUNTY SURVEYOR'S CERTIFICATE — s L� ��-�S-�L3G0._. 7X17 Met CONrORMS "ITN iN[ RLORRLM(NT! 0/ TMt /IL[0 M 7RE 2RDERI 25RTIFICA_TE 1 SVSOIYISIOM Id" ACT AMD LOCAL OROIMnIICC. I OA" C, a. wfE, Dor Mars •T rA I +'iE71e dicuur LirA ENGINEERING DATED 7//7/d� L / Q SURVEYING IUTAL NO [i. m....- IM q,,. A. •1� PLANNING R �` n•i RIO CASH* AVE 0M."l, cAl Ir ORN1• rs[ISSS-[OSS OP/ 0/!•et BUILDING DEPARTMENT APPR0VEDYt C aE U �tt c CIS U E N U_ y a� Z I co N 0 0 o co I STATE OF CALIFORNIA Iss. COUNTY OF U-+ I On _7Q L� k0 N � q9 d , before me, the undersigned, a Notary Public in and for said State, personally appearedA • S Igr2Q 1 -,personally known to me to be the person whose name is subscribed tothe within instrument, as awitness thereto, who being by me duly sworn, deposed and said: That Wshe resides in V r0 ,J , It Q- Q,. A that-4+e/she wresent and saw 0_A4Z.� 4. present and Cc e_ I1� SO � , personally known to him/her to be the same person(s) described in and who executed the within instrument, as a party(ies) thereto, sign, seal and deliver the same and that said party(ies) duly acknowledged o in the presence of said affiant, that he/she/they executed the same, and that said affiant, thereupon at the party's(ies') request, subscribed his/her name as a witness the WITNESS my ha and offici eal. Signature PftIat.Ottp e N BUTTE County (This area for official notarial seal) END OF DQCUARPMT Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 90-29 1 82 FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County. Code requires this acknowledgement be recorded prior to issuance of a building permit.' The property described herein .is adjacent 90-4291.82 � 1 � Rec Fee 5.00 to land or included within an area zoned . 5 .'Cash'_ for agricultural purposes, and residents Recorded s of this property may be subject to incon- Official Records` veniences or discomfort arising from the. Couy of County w� use of agricultural chemicals, including, Butte but not limited to herbicides, pesticides, Candace J. Grubbs and fertilizers; and from the pursuit of agricultural operations including, 11:47amRecorder1"i>-Jv l =90 . �. CD i <� but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, -and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones. and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: PARCEL 2, AS SHOWN ON THAT CERTAIN PARCEL.MAP, RECORDED OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF ON JULY 19, 1985, IN BOOK 99 OF MAPS, AT PAGE 61. .. .�o - q (,/. 0 33 Date: JULY 10, 1990 State of ) SS. County of ) Present A.P. No. PROPERTY OWNERS: IN THE CALIFORNIA, On this the day of , 19 , before me, the undersigned Notary Public, personally appeared ® Personally known to me. ® Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) subscribed to the within instrbment and acknowledged that executed the same for the purposes therein contained. IN WITNESS' WHEREOF, I hereunto set my hand and official seal. Notary Public THERMALITO IRRIGATIONDISTRI(T 410 GRAND E OROVILLE, CALIFORNIA 90 � TELEPHONE 533-0740 a�,N 2 X991 CSA 26 SEWER SERVICE APPLICATION AND r,%Nl�YE����I�10PERMIT Service Address: 1863 20th Street Owner's Name- M • A. Sarni Date: 11/16/90 Address: P 0 Sox '065 Acct. No: Paradise, CA 95967 A.P. No.: 30 461 0-, Phone: No. Units: one Applicant/Agent: Agents Proof: Address: Fees: Phone:Application $ '0 n0 Arrearage Preliminary Review By: Date: CSA 26155x; 00 Remarks: SC -OR 900 00 OConnection fees payable in three (3) monthly 1st mo. S.C. payments, per ai~reement between SAR`JI F, TID(Schmidt)Other TAP 73,00 1st patj ent in the an.ou.nt of 1803-00 -NI/0 02200 ree' d 4f-1u/';rU. Total Fees 1`-'55 00 ?,A`.`•LPAL TO COANECT .LkI`I LINE m0 SERVICF LINE Collected By: AT PROPLRTY *ILST BE INSTALLED DY OTY1'SIDE Date: .,y........_..:, mow: .......r.,,.. ......,. �....�..-..._...__ .....y . d. .. ,._.. Field Review By: Or' T4IJ APRE11"hilT. Date: Remarks: / % / I rte" >� [ %/� _mss- �i. � / / � CI .t_• � % � / /� • . - i:• i r 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). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS j. 7 -Bounty Center Drive-'Oroville,'L`alifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. 4084-90 ASSESSOR PARCEL NUMBER 30-461-33 ZONING AR BUILDING PERMIT OWNER Carrie Hendrickson TELEPHONE 534-8947 S0. FT. OCC. BUILDING VALU OW"MAILING ADDRESS 186320thSt, Oroville CONTRACTOR'S NAME Executive Homes TELEPHONE 891-6992 `O" 842T spiana"cfe;DWSS 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1863 20th St, Oroville Permit fee $ 25,00 PLUMBING PERMIT Filing Fee 10.00 Each Trap. 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeQ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home JSFG W 0.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Instal lation EX Other ❑ Describe work: MHT (MHU #2344-90) _ Permit Fee $ Contractor . ELECTRICAL PERMIT Filing Fee 10.00 Main service SS 1000V OR 0 AMP OR LESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): p7� f� 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. 1116 ice -/L Classification �` �%� ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD -L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.ad OR ADDNS. ( ACC. BLDGS. ) , 2/2Qsgft NEW NLET CONSTR ULTI-OUT NON•RESID BRANCH CIRC ITS 2.SOea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURESBA 20) 030 Ex. Occup. our ETS (RESID )D APPLNS. KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin 9 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 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, judgments, costs, and penses which may in any way accrue against sa�uncseq en the granting of this permit. //, % X Date / Signature of ppli nt — Owner, ❑ Contractor ® Agent ❑ An OSHA permit isrequired for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ !!4.57 Qd Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ E p , 45 -@@' HAz CUA PARK SCHL PAR t� PD PD HDi Issu /HD This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRE JOR OF PUBLIC / BY / P IT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date iZ-- 6- 9% Receipt No. 84619 WNITC-D.P.W., YELLOW-A88L880R, PINK-INBPECTOR, GOLDENROD -APPLICANT COUNTY OF•BUTTE : DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovi9le, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PAR,L'�EL NUMBER - ZONING f�P fl -- L! (o 1 --3 3 BUILDING PERMIT OWNER 1 TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS S5 b 3 Z� A- (0'"V) CONTRACTOR'5 NAME TELEPHONE (5_� f,=, c v n v-,67 i+o 9-YA iES I -X992 CONTRACTOR'S MAILING ADDRESS , -gVIA Z &S P'L f1,r1 A be Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation cu Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ /5(00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING DDRESS 1W W Permit fee $ o O PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets . 5.00 Building sewer 5.00 SF ❑ Duplex[] Mobilehorie_t2Q Other SPECIFY Mobile Home S G W O.00e TYPE OF WORK New[—] Addition[] Remodel[] Utilities Installation Other Permit Fee $ Describe work: 16t Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service e00V OR LESS 10.00 100 AMP OR LESS Main service EA. ADO'L 100 AMP J 1 2.50 CONTRACTORS LICENSE LAW NEW CONST./'/2QSQftDWELLING OCCUP.&\ OR ADONS. -( ACC. BLDGS. // ' 1 declare under penalty of perjury (check one): NEW CONSTR. ULT I.OUTLET 2,50 ea `� NON.RESID BRANCH CIRC ITS �. I am licensed under provisions of Chapt. 9, Div. 3 of the Business POWER APPARATUS e and Profess* ns Code and my license is in full force and effect. / SINGLE OUTLET CIR. I 20050C U—!1 Ex.00cup\OUTLETS OR FIXTURES 5AL030 License No. Classification G� a OAL930 EX. Occup. OUTLETS IPRESID.>FIXED APLNS REA.) 2.00 ❑ 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 Temporary service 10.00 for sale. (Sec. 7044) Mobile Home Facilities 15.00 ❑ I, as the owner, am exclusively contracting with licensed contract- Misc. Wiring 15.00 ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): " MECHANICAL PERMIT FiIingFee 10.00 ❑ The permit is for 5100.00 (valuation) or less. Heating gZ>I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a.Certificate Cooling of Consent to Self-Insure. ❑ I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, should you become subject Permit Fee $ to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may, in any way accrue against said County in consequence of the granting of this permit. X Date 1 Signature of Applicant — Owner ❑ Contractor Agent ❑ Mobile Home Installation Fee $O Energy Inspection Fee S occ CONST TYPE TOTAL FEE $ 0 Q 4 HAz CUA I PARK I SCHL I FLD I PAR I PD Ho I ISSUE This permit is nereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. • . An OSHA permit is required for excavations over S'tdeep and demolition or construct. ion of structures over 3 stories in height. DIRECTOR OF PUBLIC WORKS Receipt No. �b / 7 /�, ... - - ., .._. -... -...-, -. ..,o..- --• --.,. - .. BY Date I.PE911,411T C)(PtAFc r�ara-------------- COUNTY OF BUTTE -,DEPARTMENT-OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE; 918/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER �. �� A2rc/� sa,,� A. P. No. Proposed Building Use Building Inspector S G s Date //-2-g —?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 preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and caics, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ................ °...................... Park ees paid 6% l��`f 4-Af i0 School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 27. When you issue the permit, pr cess as follows: Mail � tQoo owner. Mail to contractor. ,, —1� Telephone �,� and hold for pickup at office. Deliver w. /inspector. Other —• -e2 l Applicant Date Copy of Haz-Mat form sent Health Dept. FiryDeptr. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit issua 1. Index permit for above items No. 2. Additional items required: (Circle new item not checked above). ) Contractor, designer, owner, was advised of above required data by-if—phone—nail counter bVv_. ..date Contractor, designer, owner, was advised of above required data by_phone_ma11 ounter by date P4,ans checked by Date Pans approved by Date — Q_Sets of plans on hold in File cabinet ___VAP folder t Copy—DPW E' h ✓�� ` �7'. CITY ------------- AccR O ----------- CFS( I AF;•. i. 2:i ;: ' :'�'•.�'{ ;`_ ;Y. {� CXNCCAAL ..::.{. a .. • } i-•.> f•- > . LIVING ROOM BEDROOM tY•. t. , . . { AR �"'. {:.:•f''v'-i. }.'.. •i-;•nY{ri-.. Mme.`. {4�. -y+ ® - ININGta} }< { 04R CA , a: :> .• r CGT. _-' USX .J ENTRANCE OPT. Alk -IN BAY. t BEDROOM BEDROOM MODEL 26636 9'-8"X7'5" 7'-8'X10',-2" • ® 3 BEDROOMS, 2 BATHS EATH APPROX. 879 SQ. FT. EXECUTIVE IFIOMES tim- 3042 EspLanade Chico, C . ' ° s'Z:76 Contractor's -Lic. # 289506 ..916 -;891-6992 arC. k . rA S'l • � �y •Y 9rEy t BY Fwk COD' s• SP/17/MAY88 MODEL 2662A Chi. �A 13.4 _ O x: acccs MASTER 2 BEDROOMS, 2 BATHS Q:'`: BEDROOM '. APPROX. 879 SQ. FT. •; 12'-b'xla -a• 4 - RCM.AN COT.un .. ✓�� ` �7'. CITY ------------- AccR O ----------- CFS( I AF;•. i. 2:i ;: ' :'�'•.�'{ ;`_ ;Y. {� CXNCCAAL ..::.{. a .. • } i-•.> f•- > . LIVING ROOM BEDROOM tY•. t. , . . { AR �"'. {:.:•f''v'-i. }.'.. •i-;•nY{ri-.. Mme.`. {4�. -y+ ® - ININGta} }< { 04R CA , a: :> .• r CGT. _-' USX .J ENTRANCE OPT. Alk -IN BAY. t BEDROOM BEDROOM MODEL 26636 9'-8"X7'5" 7'-8'X10',-2" • ® 3 BEDROOMS, 2 BATHS EATH APPROX. 879 SQ. FT. EXECUTIVE IFIOMES tim- 3042 EspLanade Chico, C . ' ° s'Z:76 Contractor's -Lic. # 289506 ..916 -;891-6992 arC. k . rA S'l • � �y •Y 9rEy t BY Fwk COD' s• SP/17/MAY88 . Q� - Wi - // k STANDARD. New tri -color exterior 100 AMP service with cable New kitchen cabinets Washer & dryer hook ups New bath cabinets 30 gallon electric water heater 17 x 17 vent w/5 way switch Removable hitch RO.S. vent system Front Box Bay window in all B models Walk -A -Bay windows on front kitchen models Full accent walls in living room and both bedrooms Cathedral ceilings in living room and kitchen High pitch metal roof 16" 'plank ceiling Standard carpet in living room and both bedrooms with pad PRICES AND SPECIFICATIONS SUBJECT TO CHANGE WITHOUT NOTICE OR OBLIGATION. PP Note that square footage is measured on the basis of exterior wall to exterior wall, and is an approximate figure. Length indicated in floor plans is floor length only. Add four feet to arrive at overall length when hitch must be included in your calculations. Prices and specifications are subject to change without notice. Renderings and diagrams shown here are meant to be representative and, in keeping with Fleetwood's policy of constant updating and improvement, may vary from the actual home. All dimensions are nominal. Ask your dealer for specifics. OPTIONS Shingle roof Dishwasher/disposal Ceiling fans Upgrade carpets and pad Skylights (shingle roof only) OTHER OPTIONS AND FEATURES MAYBE AVAILABLE. BE SURE TO ASK YOUR DEALER. smigpoiti9rEBY FIEEMOOD° Sandpointe Homes are built by: FLEETWOOD HOMES OF CALIFORNIA, INC. a subsidiary of Fleetwood Enterprises, Inc. 18 North County Road 101, P.O. Box 1308 Woodland, California 95695 (916) 662-3223 SP/17/MAY88 00 BUTTE COUNT-'DEPARTMENr�OF PUBLICWORKS-' 7 County Center Drive, Oroville, CA '.PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: 2. Installer's- Name :. 3. Is the site currently under permit? Yes,9 No. .(If yes, furnish permit p..umber ) OR Is the site an existing site? Yes No (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No -[ (If no, clarify 5. What is the mobilehome electrical rating? -------0----- -- Amps 6. What is the mobilehome site service rating? - ------- .�� Amps 7. What is the mobilehome site circuit breaker rating? ----- I O� Amps 8.' Is there any other electric load to be served by the mobilehome site service? -------------------------------- Yes El No (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 gaspipe length from meter or tank to the mobilehome?i------------------------------------------ (ft.) * 12. What is the mobilehome gas demand? ---------------------- (BTU) *(Th`is"information not required if pipe length less than 6 ft..on natural gas or less than_50 ft. on LPG.) MOBIL$HOME SUPPORT -DATA If other than single wide, _._:N_1_uh.il,eh:ome-..Mfx-.o-l;i,__C_1_..r,:..,.:=-;furnish:.Setu Model -.No: p:. Year �...•. '� Width___,Z'44_(ft.) Box Len th g--4562—(ft.) Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on.file with the:. -County of Butte). FOOTINGS (check one) �a, Wood -pressure LLQ treated or foundationgrade-E]2. Other (specify) SUPPORTS (check one)�1. Concrete block' 2. Other (sp.ecify) Pier'Footing Sizes and Locations S I N(.ILE -WI DE Line MULTI -WIDE _ _ �. _ _ • Line 1 ' o .in 2 — _ — — — — Main Beams_ ne 2 ' Lie 7 _ L1W i 1 ---- Line 2 Maio Beamef.ine 2 Line • _ — '-"'.. _ -+-Line Tag or Triple -- Lina 4 - Line 1 Ling l_P/=re; 1� Line 1_ OceninRa; Size -Min. 1 'k3�" Size -Min. ------------------ ''+-- -- �--1 Spacing -Max. -•-•----- _ Each Side of Openings With Width Over-------- =] L1no 2 t'iere: Line 3 Piers: (Under Bearing Wall Only) Z „x3� . Size -Min ...--____ ..-' Spacing -Max.------.^ Spacing -Max.-____._-_ From F.nds-Max- ------- From Ends -Max .---•--------- , I_1ne. 7 k.oC loads: - Size -Min .----------._ "x Lncation (From Front) bine 4 Pler_s; SIXe-Min.------------ 'k SFdclog-Max.--------. u From Enda-Max.------- , I_Inc_ 5 Koof Loads: Size-Mio.------------ Linc 5 Plera: (Under Bearing Walla only) Size -Min.------------------ Spis 7E cow �x From Ends -Max .------------- BUILDING DEPARTMENT location (From Front)I x * `4 -AL- i 4i '1 "x " ' , 'F B T1 I ' PROPOSAL and CONTRACT propose to furnish all materials and perform all labor necessary to complete the following: TD -- S/Th' /}�G 5'O 1 /Y ST/21- L Gv/�-T� /7 L� �/� l�"2 d �`7 /'y �i�i� /V/7 Fo 4 SAll �o L Gam' S"AEC,Z Z_ -'Y G I7 -J P^1 All of the above work to be completed in a substantial and workmanlike manner according to standard practices for the sum of Dollars ($ 00 Progress payments to be made �P/? 14 /7- -y .-Q 2 auv as the work progresses to the value of 7— per cent ( 9b) of all work completed. The entire amount of contract to be paid within / 19 All days after completion. Any alteration or deviation from the above specifications involving extra cost of material or labor will only be executed upon written orders for same, and will become an extra charge over the sum mentioned in this contract. All agreements must be made in writing. Name'and Registration Number of any salesperson who solicited or negotiated this contract: submitted, By Namey 5 lf(1����/ No. tl-e-1211 2y Gj Contractors are required by law to be licensed c Address and regulated by the Contractor's State License l 777 Telephone Board. Any questions concerning a contractor may Contractor's State License No. Z yZ L be referred to the registrar of the board whose address is: You, the buyer, may cancel this transaction at Contractor's State License Board, any time prior to midnight of the third business day 3132 Bradshaw Rd. after the date of this transaction. Sacramento, California 95826 ACCEPTANCE You are hereby authorized to furnish all materials and labor required to complete the work mentioned in the above proposal, for which _ and according the terms agree to pay the amount mentioned in said proposal, NOTICE TO OWNER Under the Mechanics' Lien Law, any contractor, subcontractor, laborer, materialman or other person who helps to improve your property and is not paid for his labor, services or material, has a right to enforce his claim against your property. Under the law, you may protect yourself against such claims by filing, before commencing such work of improvement, an original contract for the work of improve- Date // —26 , 19 ment or a modification thereof, in the office of the county recorder of the county where the property is situated and requiring that a contractor's payment bond be recorded in such office. Said bond shall be in an amount not less than fifty percent (50%) of the contract price and shall, in addition to any conditions for the performance of the contract, be conditioned for the payment in full of the claims of all persons furnishing labor, services, equipment or materials for the work described in said contract. AIGNER FORM NO. 55-037CAL rwInTeo IN USA � r _.+"R�.T 6„vy..w.c,yy..wN'•.-.o.•r+r_.,,•.. ..a�;pr�y�- .w-••,,,y.::-,.sw.t.w..•y,.. BUTTE COUNTY SCHOOLS DEWELO15NENT'FEE CERTIFICATION FORM (One Form per Building) h A.P. Number Building- Dep'artment ,No. School District ORO'�0 City .n 'County Jurisdiction +�4 Property Owner /,� k-: Azle 9.0^7 Project Location/Address ` .. ' Subdivision Lot Number Residential Development: / Sq. Footage �7 f # of Living 'MHI Addition (Group R) U- its . 'Commercial`/Industrial: ° Sq'* Footage, New Addition •.(Including Exterior '* } Roofed Areas) 01 Bui-ldng,Department.Representative;. Date ' (Floor Plans reviewed ,.by School .District .Personnel). . rDi�`strict._'Id No.� 1 V �D D(n/' • r ' . a y"fir, ` iK,�i�1lJ „L School• District certifies that,. (A plicant Aame) (Phone Number) (Street Address) "6"(City) (State).' (Zip Code) `AV 6 �C / has complied with-the-requirements of Resolution No. by e payment of $ /,194 representing, F square feet. �`�Schoo District ffepresentative Date PAID BY CHECK NO. REMARKS ;d&tA& BANK NO r PAI BY CASH write app cant, yellow-building department, pink-school district SCHOOL.FEE (8/88) AP !o ✓L '✓ � + OWNER )&e_ . . PERMIT -# � v MH UTIL.CLEARANCE DATE INSPECTOR ELECTRIC GAS' Support Struc: Compaction Test Re . ervice Other -' Pipe YES NO ES NO ize Load Type Size Length • .j 1 i COUNTY OF BUTTE Department of Public %4'0r ks ';. AN INSPECTOR CALLED ON WAS UNABLE TO GAIN ADMISSION, PLEASE, NOTIFY UNDERSIGNED INSPECTOR AS TO WHEN N INSP TION CAN BE MADE. _ BUILDING INSPECTOR ..E K d COUNTY OF BUTTE Department of Public Vorks • AN INSPECTOR CALLED ON AND WAS UNABLE TO GAIN ADMISSION. PLEASE NOTIFY UNDERSIGNED INSPECTOR AS TO WHEN AN INSPECTION CAN BE MADE. BUILDING INSPECTOR