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HomeMy WebLinkAbout030-461-020030-46-1-022 93-520 B LOSETH, KEN & ROMA 1909 20TH ST, OROVILLE CONV SF TO STORAGE BLDG 9,13 y3 030-461-022 PERMIT#95-2052 630-46-1-022 93-521 P,E LOSETH, Kenneth L. /y' 1907 20th St., Oroville 19 13 L909 2 KEN & ROMA Mobilehome Utilities(Replaces Demo SF) 1909 20TH ST, OROVILLE /3 P1HU ELECTRIC 1100 i% t` l" �f0 ELEC 200 GAS LINE / GAS n - FGE COMPACTION TEST REQ yc COMPACTION TEST REQ No , y SUPPORT STRUCT REQ No g-9 SUPPORT STRUCT REQ ---J 030-46-1-022 LOSETH, KEN & ROMA 1907 20TH ST, OROVILL ELEC SERV/SF- 030-46-1-022 LOSETH, KEN & ROMA 1909 20TH ST, OROVILLE ELEC SERV/SF 030-461-022 PERMIT#95-2373 LOSETH, Kenneth L. 1907 20th.St., Groville J Mobilehome Instailation /D p 030-46-1-022 LOSETH, KEN & ROMA 1909 20TH ST, OROVILLE MHI /I 14-� 93-640 E ? E J 93-641 E 93-522 9-/3-9:!!,, 030-461-022 PERMIT#94-2014 LOSETH,KENNETH & ROMA 9� 1911 20TH ST., OROVILLEg(2 CONV TO UNDERGROUND ELE & NEW GAS LINE TO MH & SF 030-461-022 PERMIT#95-1010 LOSETH, Kenneth & Roma 1911 20th St., Oroville Replace 2 Ele Ser/MH & SF �1 1s� 030-46-1-022 Permit#95-1891 B(demo SF) p yo -46) - LOSETH, KEN & ROMA 1911 20T1 -I ST, OROVILLE Cont: OWNER CABANA/Mli vov-4ol-022 03-20 LOSETH,KENNETH 1911 20TH STREET, OROVILLE Cont-. OWNER CARPORT 030-461-022 99-1143 LOSETH, Kenneth & Roma 1911 20th Street, Oroville Contr: Owner 2nd Renewal BP#98-1049 030461-022 #98-26 LOSETH, KENNETH 1909 20TH ST. OROVILLE D&DHONIES NIM EXISTING SITE ///yt6 030-46-1-022 96-1052 MHI LOSETH, Kenneth 4-r-o—a--- 1911 20th. St, Oroville (MHI/exist site) D & D MH�./ 1j" X030-461-022 PERMIT#97-062}2 LOSETH, Kenneth & Roma 1911 20th St., Oroville Open & Cov Decks/MH IJ 030-461-022 PERMIT#98-1049 LOSETH, Kenneth & Roma 1911 20th St., Oroville 1st Renewal BP#97-0622 2/:q_Y5AI i (his set o plans lans and specifications MUST b£ ' is I kept on the lob at all times and es on saline with ul te p changes or alter Department th make any out written Pe county from the GountY of Butte. Public Works. NC;_All Materials & Workmanship Shall Be h+ cordance with Recognized Good Practices an Ac escribed for the Specified use in and of a quality. pr Plumbing & I iec ical Codes Uniform Building' Fhe National Electrical Code* r t S i Location of structures & equipment shall be as shown . & clear of all easements. . s'sroFlec-�az sc Sd ���► Or-- ZOao. 15'Woose� .4',/907 30. A f # 630 01-0z' 22. X _.. WXS, Flo 1051 //111a6.JE 1911 BUTTE couN BUILIANG DEPARTMEI-10 APPR®VED I �e P f 02 ftft.� BUTTE COUNTY DEPARTMENT OF PUBLIC.WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name: ke n -I- po"d- I—OsEq`1 2. Installer's Name: ( l y1.16 3. Is the site currently under permit? Yes �. No F-1 (If yes, furnish permit number 9,� ) OR Is the site an existing site? Yes No (If yes, furnish two plot plans.) 4. Will the mobilehome-be-located at -leas -t 5 ft.. away from .septic -tank and leach 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- (ft.) g ---------------- // _ 12. What is the mobilehome as demand. �aX- l� Q� (BTU) *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) NEXT PAGE MUST BE COMPLETED TO PROCESS PERMIT APPLICATION. fields and clear of all setbacks and easements? Yes � No F (If no, clarify 5. What is 'the mobilehome electrical rating? --------------- / /O Amps '70O 6. What is the mobilehome site service rating? ----------- Amps 7. What is the mobilehome site circuit breaker rating? ----- to Q Amps 8. Is there any other electric load to be served by the a mobilehome site service? -------------------------------- Yes No (If yes, identify the load and size: (Load) (Amps) 9, What is the mobilehome site gas pipe size? -------------- Su//` (in.) 10., . What is . the .ty.pe of gas service? .------,----- --. _ Natural 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- (ft.) g ---------------- // _ 12. What is the mobilehome as demand. �aX- l� Q� (BTU) *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) NEXT PAGE MUST BE COMPLETED TO PROCESS PERMIT APPLICATION. MOBILEHOME SUPPORT DATA • ♦ wf If other than single wide, Mobilehome Mfr.. G(Je<S 1 IV t 0(i furnish Setup Model No. Year ' � 9 Width a "T (ft:} Box Length (ft.) Tagalong or Expaodo Size ft, x ft. On all mo-bilehomes 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)1. Wood -pressure treated or foundation grade.El2.' Other (specify) SUPPORTS (check one)1. Concrete.block.a 2.' Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Main Beams Line 2 _ _ _ _ _ _ Main Beams Tag or Triple Line Line 1 — Line 1 Piers: Line 1 Openings: Size -Min. ------ -- „ Size -Min. ^---------------- Spacing-Max. --- - Spacing -Max. - ------- , Each.Side of. Openings From Ends -Max. ------- '_ With Width Over --- - ----- Line 2 Piers: Line 3 Piers: (Under Bearing Wall Only) Size -Min- ------------ „x f7, Size -Min -------------------- Spacing-Max - --------- ------Spacing-Max. --- -- -- ,Q it _ Spacing -Max.--------------- 5 From Ends -Max.------- O " From Enda-Max.------------- Line 3 Roof loads: h J ---------- Size -Min. -- ' x "x 'k 'k "x "x "x 'k Location (From Front) -Line 4 Piers:: - _ _ Line 5 Piers: (Under Bearirg_Walls_Only)_ Size -Min.------------ Size -Min ------------------- Spacing-Max ---------- ------------------Spacing-Max.--------- „ Spacing -Max .--------------- „ From Ends -Max.------- _ „ From Ends -Max .------------- Line S Root loads: Size -Min ------------- x 11 „x „x „x „x „x 11 „x 1. Location (Prom Front) NOFTH: All Materials & Workmanship Shall Pe � Acoardartee with Recognized S gniz Good Practices and A of a Quality Prescribed for the 8teciiied use -in the Uniform Building; Plumbing & Mechanioal Codas and the National Electrioal Code. - - - - This set' of plans and epeci&ations M18T be kept on ttt0 job at X11 and it fe unlawful to make my changes. or altoratione.on same without written permission from the Department of Public Works.'County of Butte. ALL STRUCTUREBE CLEAR OF ALL EASEMENTS. - AND EQUIPMENT INCLUONG OVERHANGS SHALL . A SET BACK OF S FT. FROM THE SIDE AND FT. FROM THE REAR PROPERTY LINES AND FT'. FROM THE. ROAD CENTERLINE SHALL BE CLEAR OF STRUCTURES AND EQUIPMENT, EXCEPT - ,FOR A 2 FT. SAVE OVERHANG. r ,,2.11 Y60 BU17E COUNTY y BUILDING-DEPARTME ._A P, P R 0 V._ E D - 9s -2osz NOTES RESIDENTIAL . PERMIT N0'030- 41-022 - -f 04-0823. LOSETH, KEN & ROMA , 1911 20TH ST, OROVILLE f Cont: OWNER rr' r CABANA/MH f . i� •rf M . t 1 r a Sj i c 's 4ri i {ir3 JOB FINALED (Date) , dry— Signature J . i� •rf M . t a♦ c 's 4ri i {ir3 JOB FINALED (Date) , dry— Signature BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BP040823 LICENSED CONTRACTORS 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 Issued Date: 04/16/2004 APN' 030-461-022-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number Site Address: 1907 20TH ST ORO Date: Contractor. Map Index: Description: ADD ROOM TO EX MH 480 p OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a LOSETH KENNETH L 8r ROMA J permit to construct, alter, Improve, demolish, or repair any structure, prior Owner: to its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 1911 20TH ST the Contractor's Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95965 violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): )ZI, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who does . LOSETH KENNETH L &ROMA J Applicant. such work himself or herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -insure for License #: 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 Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 480 S.F. Policy #: X(' certify that in the performance of the work for which this permit is Valuation: $31,200.00 issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California. Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith 761y with t ose provisions. / Date: 'Re eetQe 1 • 3 Al97. i Applicant: 14rywun+ WARNING; Failure to secure workers' compensation coverage isd unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of �►niJu►ti���°CIV�C(: �/ os"1. compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This pe it is he s ued u er t licabi provisions of the Butte County ode and/or I hereby affirm that there is a construction lending agency for the Resol ions to r in dab v r hi fees have been paid. 4 �4O performance of the work for which this permit is issued (Sec 3097 Civ.) BY Date: 0 Name: PERMIT EXPIRE ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 2557 and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the wner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document o utte County. I hereby authorize represen fives of B Ile County to enter upon the above mentioned property for inspection purposes. Print Name: Signat 're: Date: Owner 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor J=OK 0 = Not OK = NotReadya°'e ' DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s MOBILE HOMES Date, MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test-Wrap; -/ P' L'ft. / P Nat. or / P' L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 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, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels 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, Distance-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- Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Si Date UNDE-RFLOOR (Plans) OK except #'s P!Ftg., Maim Soils-Elec. Grnd.-// " Ftg. Depth 3. Ftg., rage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. F ., Porches & Decks; Soils -Steel-/ /" Ftg. Depth SteruWalls, Main; Steel-Blockouts-Wrapped W. s oper Materials & Anchors II tuds-Nailing Spacing & Braces -Plates -Sound .Waring Walls over Girders & Floor Nailing Draft S.jdp in Walls (rat proof) 45. Fir tops, Furred Ceilings -Stairs -Chasers -Tubs 4 eaders & Beams -Size & Bearing ngle & Duplex) Date FR (Continued) angers -Post Caps -Anchors -Connectors Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exitinq Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. St Ys; Width -Headroom -Rise -Run -Landing -Fire Protection 56. ywood on Roof Overhang -Attic Vents -Rafter Outriggers . S' ing-Nailing Veneer 58./Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 56. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. lnfiltration-wiaoqws Date ti Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK eicept #'s xt. Steps -Door & Sidelight Protection -Landings moke Detector ­66--F�urnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection §7- edroom Exiting G.F.I. & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel, Breaker Sizes & Labels Stairs & Rails --71-fireplace or Stove, Clearance -Hearth Alec. Outlets at Wood Panel, Int. & Ext. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 4. Elec. Outlets & Receptacles at Kit. Counter -Z5-Gar-age Fire Door; Swing -Landing -Closure ,qC-*-G-Duct in Garage -Damper tr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. jK Garage; Above Floor-Mech. Protection Plb.; Elec. & Mech. Equip. Listed for Location 79,/Elec. Receptacles in Garage (F.F.I.)-Romex Protection �W Insulation -Foam -Looked in Attic ,_84 -Guard Rails & Deck Construction -Post Caps c8�' Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes -83 -'Following Instld./Drive O Yes O No/Walks O Yes O No/Planters O Yes O No Stucco Brown -Finish -e5-.A-.C. Unit Disconnect, Electrical -Plumbing W. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings ST. Water Well, Disconnect, Electrical, Plumbing TE terior Elec. Trim, G.F.I. Receptacle -Underground 8 . Ventilation Throughout House 9 . Mass Protection 9e Corrections from Previous Inspections 92/Gas Test -Meters Tagged, Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval 94-rn-ergy Compliance Certificate -Other Certificates Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date I ILCard B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: fp!Hold Downs and Special Anchors 7. Slab teel-Wrapped 8. P rs-Fireplace Ftg.-Steel W.V; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF as Pipe; Size Anchors -Yard Gas Piping; Size Test 1 ater Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation 117 Date r Card B-1 Date Card B-1 Date Date S and B-1 Date Card B-1 LU G (Permit) OK except #'s 1 . Htr.; Vent -Access -Combustion Air Baffle 1 ter Pipe; Test & Anchor -Nail Protection t9.41D.W.V; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Te ub & Shower, Second Floor -Tub Access 2 as Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date Card B-1 Date Card B-1 Date Card P4 Date Card B-1 Date ELE CAL (Permit) OK except #'s 2 . tur Transformer Clearance -Ins. Protection E ptacles Spacing -Lights & Switches at Doors Boxes & No. of Conductors Stapled 2 . Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 85. Smoke Detector Date Card B-1 Date Card B-1 Date Card B- Date Card B-1 Date ME N AL (Permit) OK except #'s isf.A. . Ducts Insulation & Support 37 ent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card 9,1 Date Card B-1 Date FRA C,/(P,ermit) OK except #'s W. s oper Materials & Anchors II tuds-Nailing Spacing & Braces -Plates -Sound .Waring Walls over Girders & Floor Nailing Draft S.jdp in Walls (rat proof) 45. Fir tops, Furred Ceilings -Stairs -Chasers -Tubs 4 eaders & Beams -Size & Bearing ngle & Duplex) Date FR (Continued) angers -Post Caps -Anchors -Connectors Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exitinq Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. St Ys; Width -Headroom -Rise -Run -Landing -Fire Protection 56. ywood on Roof Overhang -Attic Vents -Rafter Outriggers . S' ing-Nailing Veneer 58./Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 56. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. lnfiltration-wiaoqws Date ti Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK eicept #'s xt. Steps -Door & Sidelight Protection -Landings moke Detector ­66--F�urnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection §7- edroom Exiting G.F.I. & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel, Breaker Sizes & Labels Stairs & Rails --71-fireplace or Stove, Clearance -Hearth Alec. Outlets at Wood Panel, Int. & Ext. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 4. Elec. Outlets & Receptacles at Kit. Counter -Z5-Gar-age Fire Door; Swing -Landing -Closure ,qC-*-G-Duct in Garage -Damper tr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. jK Garage; Above Floor-Mech. Protection Plb.; Elec. & Mech. Equip. Listed for Location 79,/Elec. Receptacles in Garage (F.F.I.)-Romex Protection �W Insulation -Foam -Looked in Attic ,_84 -Guard Rails & Deck Construction -Post Caps c8�' Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes -83 -'Following Instld./Drive O Yes O No/Walks O Yes O No/Planters O Yes O No Stucco Brown -Finish -e5-.A-.C. Unit Disconnect, Electrical -Plumbing W. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings ST. Water Well, Disconnect, Electrical, Plumbing TE terior Elec. Trim, G.F.I. Receptacle -Underground 8 . Ventilation Throughout House 9 . Mass Protection 9e Corrections from Previous Inspections 92/Gas Test -Meters Tagged, Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval 94-rn-ergy Compliance Certificate -Other Certificates Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date I ILCard B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: _ � .� � r ..� ...r -.,._. ,�v�-.--rte-- «,r-... h :-[-Sr»�`-,rt..r.--,✓+-`."� r•-�-"."` , ^ , :CO.UNTYOFBUTTEf ,.�'�.f idi:t i l)h1a i. too i� t it: ::u9.{�fi BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street! Chico, CA • (530) 891-2751 .7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER 0(�-0S�23 PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address an should be corrected. Please notice this office when correction of work is completed. If yo have any question taining this matter, or need additional explanation, please cont a this office immedi y. COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 5 AV 41 1z;Y1 4z Date Inspector REV 10/92 IC . COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA,- (530) 538-7541 .t ! -''CORRECTION NOTICE OWNER PERMIT NC A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. ncr_v 1vivc COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE - 0 OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. LA + 5kVw) Date `� �f Inspector REV 10192 t - Date `� �f Inspector REV 10192 ..COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEV,,ELOPMENT SERVICES 411 Main Street - Chico, CA - (530) 891-2751 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE Z"o S/; rT/� 05(-6 �a OWNER PERMIT A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. &416 S . 929;AW-"/� REQUEST FOR INSPECTION Permit No. q --O �// Z LocaSon: 1 iii ZU S-7- 0 Owner: b L Call ❑ Phone: BLDG. PLUMB/MECH ELECTRIC M.H.I./M.H. . INSPECTION Form Rough Rough Fnd/Ftg Frame/Underfloor Top Out Temp. Service Jdb Status Stucco Lath Stucco Brown Woodstove Brace Panel Gas PipinglTest Temp. Gas Sewer Piping Water Piping Main Service Underground Well Circuit Corrections Final Permit Renewal Verify Utilities Ex Mobile Site POOL Insulation Shower Pan Nailing Gunite Demo Corrections Corrections Corrections Bonding Light Niche Ready for Final Final Final Corrections Final Inspec. on: Date: Comment: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BP040823 LICENSED CONTRACTORS 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 Issued Date' 04/16/2004 APN' 030-461-022-000 ' the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1907 20TH ST ORO Date: Contractor: Map Index: Description: ADD ROOM TO EX MH 480 p - OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' Stale License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a LOSETH KENNETH L &ROMA J permit to construct, alter, improve, demolish, or repair any structure, prior Owner: to its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 1911 20TH ST the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95965 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 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 (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: LOSETH KENNETH L 8r ROMA J such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with ; licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: Cl I have and will maintain a certificate of consent to self -insure for License #: 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 the Labor Code, for the performance of Architect: the work for which this permit Is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier. Total Square Ft: 480 S.F. Policy #: certify that in the performance of the work for which this permit is Valuation: $31,200.00 issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code' and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forth7ith6ly with t ose prov' ions. - LL .r, Date: ��(P T — %}I'nOUYI'4 �¢t'P_ltJ� : Al "7• '% c�. e I n F # 3 g s 1 q Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor 1►►'lrun��vl°GIVeC'(: code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This pe it is he s ued u er tlicabl provisions of the Butte County ode and/or . I hereby affirm that there is a construction lending agency for the Civ.) Resol tions to in d ab v r hi fees have been paid. performance of the work for which this permit is issued (Sec 3097 Date: Name: By. A PERMIT EXPIRE ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the Ca ifomia Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the wrier. I agree to comply with all county and state laws relating to building construction. I acknowledge It is unlawful to alter the substance of any official form or document o utte County. I hereby authorize represen lives of B tte County to enter upon the above mentioned property for inspection purposes. Print Name: Signal re: Date: Owner 13 Contractor ❑ Agent for Owner 13 Agent for Contractor April 14, 2004 While reviewing the plans of the addition to the mobile home (BPN 04-0823) I noticed there are three mobile homes located on the property. Searching how they got there I also noticed the permits were approved without the Planning'visions approval. ,,--�arr Painter Planning Technician II BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-754�"k) v! �/�^ ZONIN PERMIT NO. BP 6Y�jga� DATE: - 0 G �1 J • V APN: GJ OWNER'S LAST NAME:T �-65��� OWNER'S FIRST NAME: HONE. STREET ADDRESS: FAX CITY, ZIP: E-MAIL: SITE ADDRESS CITY, ZIP: 65140 NEAREST CROSS STREET: CTlLOT #: �r� 62-� APPLICANT NAME: z� PHONE: STREET ADDRESS: C ( " FAX CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER: E-MAIL:- DESCRIPTION OR SCOPE OF WORK: d ❑ Structure Built without p its ❑ Proposed Change of cup ncy (note pr ious use) YY� EXPIRATION OF APPLICATI Applications for which a permit has not been issued will expire one year after the date of a Iicati In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: -jAe.2mA u `rp T-QP6-f-PI C Notes: FL D-6'6', X� D17 � O z- 5 Application Received by: Date: Receipt number: �� Amount Received:�� P�COUNTY OF BUTTE -DEPARTMENT ENT OF DEVELOPMENT SERVICES -BUILDING DIVISION OCA 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 q C PERMIT APPLICATION DATA SHEET �n OWNER: �O JASSESSORPARCELNUMBER a Proposed Building Use: b T Counter Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order t pply. ' F1. Site plans, 3 or 4 sets, signed by the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. O 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans," and calcs in triplicate, (C) Elevations in triplicate. (D) Floor Plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑✓ 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health De artmentl ❑ Chico ❑ Oroville, as applicable -TL 16. Other -o A� �� --{- Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required .................................................... ❑ 20. Erosion Control Plan Required........................................................................ ....... 2r 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ fE;� 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. 24. Planning approval (A) Use: ol✓ (B)Parking: (C) Parcel Check: -1 - O t-) ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number ........ .....:...... ............. ......... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization ...................................... ............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance.........:..................................................... ❑ -35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index-pe�mit-app icatio�or t e above items numbered: ; Plan CheckLetter 2. Additional items reouiled, Al. Contractor, designer owner was advised of the above data by phone, ❑ mail, ❑ counter, by Date: '� 7 • ' Contractor, designer, ow er wa advised of the ab ve data by ❑phone, ❑mail, ❑count , by Date: Plans reviewed by: Date: Plans approved by: IF Date LLL �01 Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER PROP OSED BUILDING USE-AAa )p C� 11 � 1f• 1. BUILDING PERMIT FEES --- Balance Due ..................... $ Additional Fees Due........... --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES . 1 � t (paid at School District Office) (form available after Plan 3. SHERIFF FEES (paid at Building Division) v Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) A.P.#v ✓ ��— DATE RECEIPT # DATE RE . 6401 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Ftg. Amt. 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checkin cess. APPLICA DATE Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5; 6, 8, 9, and 10 above may have been imposed on your oject. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The req vements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM " (One form per Building) 1-10 Ischool District Building Department No.�v� A.P. N& ber Q—, Q ^ q& / — 0 D-DJJurisdiction: City County Property Owner A9&X"Q-(4 - 41-1.'1 Property Location/Address r Subdivision Lot No. :..........................................................:...........................' Residential Development t/ Sq. Footage No of Living MobileHomeAdditi�'Supplemen©tl 5Zp q: (Group R) Units Installation Conversion Permit # *(No foundation inspection) ..................................................................................................... i Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q I New Additior Department Sq. Footage (Including Exterior oofed Areas) Date p District Identification No. ` (kil l A4y 4 School District certifies that {. , J f. I (Applicant)__ 1c) 1A 20M 0 & 0 (Street Address) (Phone Number) 0youl I Cl 1;� � (:�- (City) (State) (Zip Code) has complied with the requirements of Resolution No. t osby payment of $ representing "t'()y square feet. JAB 2926 $ FULL MRIGATION $ School District Representativeate `— Paid by Check # Remarks: Nota: You may protest the Imposition of the fees Identified above by submitting a wrttten protest to the District, in compliance with Goverranud Code Section 66020(a), wttidn 90 days from the data fess are paid. Failure to submit a timely wrftien protest wtil'prohibtt you from challenging the Imposition of the fees In any court action. • M, subsequent to the School Dhdrict Representative signing this Butte County Schools Impact Fee certification Form, the school Dholct is rotted by the applicable Local Planning Agency that tide proJeet Is being reviewed render the California Environmental Gueiity Act (CEGA) this p al c may be sub)eet to additional school fees to hdiy its Impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) teeforrn.xis 00/03)dmm COUNTY OF • • 1 ' l, =i_ I — _ _ _ ♦ I t _ �I IriaU IRMO ■ BALANCE OF FEES SHEET DATE: ci '!l PERMIT: O135 a --y& / — ASSESSOR PARCEL #: z OWNER'S NAME: FEES: (Amount and Purpose): �� BALANCE OF FEES: $ ADDITIONAL FEES: $ REVISED PLAN CHECK $ SHERIFF FEE: $ SRA $ COPIES $ URBAN AREA FEES $ CSA 87 (North Chico Spec.) $ WATER TENDER FEE $ BATTALION # THERM DRAINAGE FEE $ OTHER $ OTHER $ VALUATION - IF BALANCE OF FEES OR ADDITIONAL FEES: TOTAL VALUATION: $ ADDITIONAL VAL: $ (Check one) COUN'T'Yy CITY OF BIGGS .(Check one) RESIDENTIAL COMMERCIAL RECEIPT NUMBERS: 34 j.,S62 `�S^ Building Permit Number: ® 1 0 9 2 3 Owner Name: I— OS e44-) Residential Construction Requirements IMPORTANT This set of plans and specifications MUST be kept on the job site at all times and it is unlawful to make any changes or alterations on same without written permission from the Building Division, County of Butte. All materials and workmanship shall be in accordance with recognized good practices and of a quality prescribed for the specific use in the 2001 California Building Code (2001 U.B.C), 2000 California Plumbing Code ( 2000 U.P.C.), 2000 California Mechanical Code (2000 U.M.C.) and the 1999 California Electrical Code (1999 N.E.C.) COMPLY WITH ITEMS CHECKED BELOW Your parcel lies within a designated 100 -year flood plain. Finish floor, electrical, H.V.A.C. equipment and services shall be a minimum of one foot above the elevation shown on the attached Flood Elevation Certificate. A Post Flood Elevation Certificate will also be required: Note: We will normally accept the following as compliance with the flood elevation requirements: 1. Building is anchored to concrete stemwall system with conventional anchor bolts. 2. Building plate on top of stemwall to be one foot or more above the 100 -year flood elevation. (Plate height less than 24" above grade, or engineered design required). 3. Electrical, heating, ventilation, plumbing and air conditioning equipment and facilities located above the plate. 4. At least 2 openings in exterior walls, located on opposite or adjacent walls with a total net area of not less than.1 square inch for every square foot of enclosed area. 5. The bottom of the openings shall be no higher than 1 foot above grade. 6. The openings may be screened or covered with other devices that will permit automatic entry and exit of floodwater. Page 2of 2 Building Permit Number: Q q- 0 Z 3 Owner Name: Loe,-e-� Ea Parcel lies within the State Responsibility Area (SRA). Comply with attached requirements. Fire sprinklers are required in this structure. IMThe following parcel map requirements shall be met: =-= All structures and equipment including overhangs shall be clear of all easements. A setback of — feet from the side and JE? feet from the rear property lines and 20 feet (25 feet if Federal Aid Route) from the edge of the right of way shall be clear of structures and equipment except for a 2 foot overhang. Expansive soil may be encountered on this site. This condition may require the foundation to be designed by a California registered engineer or licensed architect. .. CONTRACTOR/OWNER BUILDER. DECLARATIONS SEcnON i. - uNITINFORMATION Not re uired forSpecial Purpose [pose Commercial Coaches or , . ;• ' . I/We Are re'queshng services for the following unit(s)':"' : Recreational Vehicle's (Check Appropriate Box) 1. LICENSED CONTRACTORS DECLARATION �7. I hereby affirm under penalty of perjury that I am licensed under provisions P "" nufactured Home/Moblehome, 7 of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and O Mdriufoctured Home%Moblehome Component Struchire Professions; Code, ond.myylicense is in full force and effect. ❑ Commercial Coach (Occupancy Group_____j License ClossLic.,No.. 6 n. ❑ .: Special Purpose Commerc al Coach = ' .Exp. Date ? • Ciinfractor' Date Decal or License No: 2 OWNER -BUILDER DECLARATION Serial Number(st if-t>-11ieretiy(affum•underpendltyofperjurythat°I•om•ezerriptfrom the-'^.::-;,::; ,.,:.'::..:-••._.. `.... ...._. ........_. ............"..- .....: .--:. Contractors License Law for the following reason (Sec. 7031.5), Business and ' '❑ Insignia Inspect[on COL No. .ri? [ 4 FEE RECD pt r DATE V AA NO. RT TO Professions Code Any city• or counly.whlch requites a permit to construct,.Y, alter Improve' demolish, ot, repac any structure: piiorto its gsuance; also ... _ y requires Jhe apphcanLfor such permit to flea signed statement that he or.. " �p ,• r State of Californnii Ho'Oia Business. Transportation-asing Agency ING �� Model Name DEPARTMENT OF'HOUSING AND COMMUNITY DEVELOPMENT Division Codes Standards aY 3 0. s Professions Code) orthat he or she is exempt herefrom'cind theb6iis for Jhe of and 3ory�e� F rallegedzempTion Any Jiolahon of Secfion.7031.5.by any applicant fora' g permrfsubjects the applicant to a crvl penalty:of not more than five hundred Yearof Manufacture APPLICATION1OR 'Y [ j I as owner of the property, or my employees wish wages as their[ sole SECTION 2 -OWNER/ APPLICANT. INF.ORMATION _• r ❑Alteration, Addition or Conversion; 'O ' Alternate Approval,, ❑ Technical Services,`' (Sec and Code: Contractors License, Law Owner 1� = . LAG' i :.'�: -�. Ste'. ' (SEE REVERSE SIDE OF FORM FOR INSTRUCTIONS AND ADDITIONAL INFORMATION] does not applyto arfownerof propertywho bulds or rmprovesthereon r ;and who does such work himself or herself.or through, ha;or her: own .. CONTRACTOR/OWNER BUILDER. DECLARATIONS SEcnON i. - uNITINFORMATION Not re uired forSpecial Purpose [pose Commercial Coaches or , . ;• ' . I/We Are re'queshng services for the following unit(s)':"' : Recreational Vehicle's (Check Appropriate Box) 1. LICENSED CONTRACTORS DECLARATION �7. I hereby affirm under penalty of perjury that I am licensed under provisions P "" nufactured Home/Moblehome, 7 of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and O Mdriufoctured Home%Moblehome Component Struchire Professions; Code, ond.myylicense is in full force and effect. ❑ Commercial Coach (Occupancy Group_____j License ClossLic.,No.. 6 n. ❑ .: Special Purpose Commerc al Coach = ' .Exp. Date ? • Ciinfractor' Date Decal or License No: 2 OWNER -BUILDER DECLARATION Serial Number(st if-t>-11ieretiy(affum•underpendltyofperjurythat°I•om•ezerriptfrom the-'^.::-;,::; ,.,:.'::..:-••._.. `.... ...._. ........_. ............"..- .....: .--:. Contractors License Law for the following reason (Sec. 7031.5), Business and ' '❑ Insignia Inspect[on COL No. .ri? [ 4 FEE RECD pt r DATE V AA NO. RT TO Professions Code Any city• or counly.whlch requites a permit to construct,.Y, alter Improve' demolish, ot, repac any structure: piiorto its gsuance; also ... _ y requires Jhe apphcanLfor such permit to flea signed statement that he or.. " •Manufacturer Name/ r- c�_ 3 RT BY "l she is 6cerued pursuant to the provisions of the Contractors License Law Model Name (Chapter 9:{commericing with_Sectiori7000) of.Di4ision 3 of the Business and ° w w Professions Code) orthat he or she is exempt herefrom'cind theb6iis for Jhe In'sigrna/HUDlabel Numbers ) rallegedzempTion Any Jiolahon of Secfion.7031.5.by any applicant fora' g permrfsubjects the applicant to a crvl penalty:of not more than five hundred Yearof Manufacture dollarsl$50011 [ j I as owner of the property, or my employees wish wages as their[ sole SECTION 2 -OWNER/ APPLICANT. INF.ORMATION _• „ compensahon will do„the work, and the structure is not intended of offered for 4ale 7044-:BusinessProfessions The __ . f_ �T 1 (Sec and Code: Contractors License, Law Owner 1� = . LAG' i :.'�: -�. Ste'. ' _. does not applyto arfownerof propertywho bulds or rmprovesthereon r ;and who does such work himself or herself.or through, ha;or her: own F -ernployee; provlded.that such unprovemenisdre noJmtended, or offered for_•"' 'Address r sale: it however the building or4m;56vement a sold within one year of "` the buldecwll have the burden that he '. i� �L G :- %G/+"%� I c v �Q "'c "6 ` / complehda owner of proving orshe' . did notbu�d or Improve -for the purpose of sale.). CityH Courity , Zlp . - [ j 1 as oivnerof the -property. am exclusively contracting with licensed contractors to edhsti cf the project(Sec. 7044, Business and.Professions.Code: Location Address —� fie Contractors ueer 6 Law does not apply to an owner.of property. who. Applicant bulds'orlmproves9hereon and wh(5'contracts for such projects with a licensed '. "' ' { "-' contradtor(s) pursuant to the Contractors License Law.). . Address / .f ...� j� I am exertlpT under Sec B & P.C. for this reason:, cityElephoneJ✓ in t 3 e z �� .- SECTION 3- CONiRACTOR, I+RCHITECT OR ENGINEER INFORMATION .OWger . iDate _ 3r;WORKERS CONiPENSATION.DECtARA bO._ r 1 hereby affrtm ander penalty of perjury one of the following declarations: } t t4,. - �I haveand wll maintain a certificate of consent to self4nsure for workers' compensation, as.provided for by Section 3700 of the Labor Code, for the ':performgnce of the fork fior which this permit is issued. . [ .] I have. and wll.moiniain workers' compensation insurance, as required by Section'3700 of the Labor Code, for the performance of the work for which -_ this permit aIssued.. M workers compensation insurance carrier and policy :Came[u ^ ^��Rohcy fJiiiriberr . d'.: � - ' :(This section need not be completed rf the permit is for one hundred dollars [ ]],,l_certify thdt in the perforriance of the workfor which4ha permd Ms;uecl !Lshgl plemploy'anyperson in -any mannerso.astobecornesubject;lo: ,_; ;:workers;compen-sation'laws of California;:anFJ agree that if I should become aubjecY-io workers compensation provisionS,of Section 3700 df the Labor' . ;:. ;Code 7sholl forthwith corn fily with those' roisions. .e.,.,r.-.,..r _ . .. if . ^t�, n.,ro , WAKNINty: rAILUKC IV 31tVUq CJ. WKF.CKJ k_VMrtN3AIIUN L.VVCKtkUt IJ UNLAWF,UL',-AND:SHALLSUBJECT ' EMPLOYER TO CRIMINAL PENALTIES:AND CIVILEINFS. UP:TOONE HUh{DRED THOUSAND DOLLARS($100,000), IN. AbblilbNT07HE COST OF(COMPENSATION.`bAMAGES AS...V,{tOVIDED FOR IN SECTIQN 3706 OF THE LABOR CODE, INTEREST, AND ATTOR EYY''S.FEES. 4.'CONSTRUCiION LENDING'AGENCY ''� ' (,glhoreby affirm underpenally of peijury that there a.o construction lending y -'agency for the Performance of4hework for which ilia pertnR a issued'•• • " r (Sec.3097, Crv. C) ' t, Ae..rid"ets Addre_ ss 5. -CERTIFICATION I certify that'] have.read this application and state Thai the above Y idformation-is:correct: 7:agree to comply with all city-ond county ordinances and state laws-reloting to building construction, and hereby authorize 'representatives of this county to enter upon the above-mentioned property `=for.inspection purposes. Signature of Applicant or Agent Date Contractor s Name n Address j: Architecl/Engineer Name License No.r Address _ rr �7'tt SECTION 4 j,DEStRiFTION OF WORK/ACTIVITY AND VALUATION Describe the proposed work/activity in detal.- Attach additional pages if necessary. Where; structural alterations orodd'rfions,are proposed, complete .plans;specificotions,,detals,and calculations are required -to be, attached,,. to this form.' Provide the make and model ofan9.appliance fo be` a:' lletl and provide complete electrical. calculations for any electricalm alteahons oraddrfions Indicate the Total Cost of the Work to be Performed SECTION -.SIGNATURE ANDCERTIRCATION:• I/We hereby make application for the services designated above., If applying for rep or label for the unit described in Item number 1 above; I%we certify that iheie`li&e'b additions,-,& Triodifications to the -unit which would affect compliance with'Cal'rfoinia and regulations of the Deportment. (Where alterations.or-modifications have been n be obtained.) �- ,• /.� DEPARTMENT USE ONLY :emenT of -a Lost nsigni n no altemahon ay federarlaw or the'rb'les ie, an inspechon-6iust CONDITIONS (see reverse side) ' Cl DISAPPROVED (see reverse side) of Department Repre'sentative 1 1 �"d �- , l � '1:• t'9 .-y . t Date HCD 415, Side 1 (Rev 05/99) DISTRIBUTION: YELLOW - DEPARTMENT, WHITE - AREA OFFICE, PINK - OWNER/APPLICANT .NOTES. 1. F00 TINGS TO BE EXCA VA TED INTO UNDISTURBED SOIL TO DEPTH D 2. ANCHOR BOLTS SHALL BE PER UBC SEC. 2907 (f) J. STEM HEIGHT OVER 32" REQUIRES REINFORCING (SEE STD 12.3) 4. SEE UBC SEC 2404 (f) 2 FOR CONCRETE BLOCK STEM WALL REDWOOD OR P. T. SILL .- FLOORS B D TW T ONE 12" 12" 6" 6" TWO 15 18" 8" 7" FLOORS REFERS TO NUMBER OF FLOORS PER USC TABLE 29—A, FOOTNOTE J. GIRDER 6" MIN 32" MAX TW (NOTE 3) D B RAISED FLOOR FOOTING 6" MIN D JOIST r18" MIN 12" MIN 7oe k� e SLAB ON GRADE FOOTING AS TYPICAL RESIDENTIAL FOUNDA TION DETAILS `; ; �` scnc. j14--r—o- DATE. 4/92 BUTTE COUNTY BUILDING DEPARTMENT I0WG: STDFTGI STD 12.1 May 1995 9.12 N07FS• 1. TYPICAL UNDERFLOOR F0077NGS ARE 140SQ X 6" THICK 2. FOORNGS OVER 16" SQ MUST BE 12" DEEP J. ALL F0077NGS ARE TO BE EXCA VA TED INTO UNDISTURBED PII SOIL. BL 4. MAINTAIN CLEARANCES SHOWN UNLESS APPROVED WOOD OF NATURAL RESISTANCE TO DECAY OR PRESSURE 7REA TED /S USED. 3" MIN S "THK S MAINTAIN REQUIRED CONCRETE COVER PER MANUFACTURER AT POST BASE INSTALLED /N CONCRETE PEDESTAL 1 TYPICAL UNDERFLOOR PIER11FOO77NG OR UNDER DECK PIER11FOO77NG P/1 BL VARIES P/ER/r"0077MG POST BASE PEDESTAL SEE NO c 5) (MONOUT 47C) " MIN 8" MIN '---' 2" MIN 12" MIN POST BASE SLAB FLOOR I" STANDOFF i i 12" MIN VARIES F0077NG WITH POST BASE do MONOLITHIC PEDESTAL REDWOOD OR P. T. POST POST BASE 12" MIN POST F0077NG ON SLAB FLOOR POST F0077NG — NO SLAB FLOOR EXPOSED TO WEATHER OR WATER SPLASH OR /N BASEMENTS RESIDENTIAL POST AND PIER FOOTING DETAILS REV10 91 . 1/7-1 =o" 1 DA TE. 4/92 BUTTE COUNTY BUILDING DEPARTMENT DWG: S7DFTG2 STD 12.2 fay 1995 9.13 lV LONGFELLow LUMBER CO. INC. Customer: Address: AP#: C•20E (Rev. 3/03) Quality Truss Design • Roof & Floor Systems 89 Loren Avenue • Chico, CA 95928-7434 Phone (530) 893-0112 o (800) 678-0112 Fax (530) 893-0140 E -Mail: trusses@longfellowlumber.com KEN LOSETH 533-0490 __ �' Job No: 24' X 20' ADDIT 20TH ST. sd �X% OROVILLE 3' -� ENGINEER Mitek Industries, Inc. Redong (Ray) Yu 7777 Greenback Lane, Suite 109 Citrus Heights, CA 95610 (916) 676-1900 APPROVED INSPECTION AGENCY Timber Products Inspection, Inc. P.O. Box 20455 Portland, OR 97220 (503) 254-0204 Ix4 GOVT BRACE AT BRACE MEMBERS LOWAR THAN 12' ATTACH AT MIDPOINT OF BRACE W/ 2-8d NAILS GABLE END STUD 2x4 HF STRONSBACK MAIL TO LEDGER W/ IOd o 12' OLJ — 2x4 HF LEIXAR MAIL TO VERTICAL W/ IOd NAILS) �—A35 BRACE TO FLAT �H-3 AT 48' O.C. NOTE: THIS DETAIL MAY BE USED FOR TRU55E5 WITH PITCHED BL. ALSO. (0) oPnoN To WEB PLATIN6. 16E (3) - 2' WIRE'STAKES 0.012 DIAA5 &A) TOENAILED TM CHORD INTO WEB i THRU WEB INTO CHORD ON ONE FACE FOR A TOTAL OF 6 STAPLES. (PI). (51) ! (H) MIST BE PLATED. 2xb PIA60NAL BRACE a 48' O.G. 3-10d NAILS EACIi END 6-10d COMMON NAILS ( MAX UNBRAGED LEN6TH OF &ABLE EW STUD. (2x4 FIR-LARGFU - STANDARD = 5' -II' - 01 AND BTR : l'-9' TG DL 15A PSF BG DL P5F NOTE: CABLE END DE516N BASED BC LL OA PSE ON 15 MPH WIN, EXPOSURE 'B' TOT. D. 50.0 P517 AT 0-25 FEET MEAN HEIGHT. DUR,FAC. 1.15 rrM of .M MTAIL Date: 10-18-02 Gary Hawkins JOB NAME LON6FELLOW LUM13m Drawn: AK ARCHITECT CITY 5TATE CHIGO CALIFORNIA 1530)8922700 r 1 Job no.: 02-116 1370wocew000Da..STE.tO F,ox:(530)893-0532 CH:co. CA 95973 garyatihOsbcglobalnet PAGE I Of _�9Z�—A T U�TERAI. C�ACE t�Gr i� I S VAti►� �2 RE P�Ac;QG c�N T . 0- (L AT Y2 0PL AT l/. mac, PC O.G. TYP• 2 SOWS � RAGl: WITH -lop Q 61' O. G. TYP. f,R AGE HAI.. YP. _ roK j?F_�4►Idq Pe—p1AuNy Vz OP, Y->, NOTE:,. TONT-5 6r2�, CURAGE HUST �,E i30 % THE LENGTH OP THE WEA.. THI'S DETAIL lb TO t,E: USED A0 AN PLT. r" -OP- ONE: CONTINUOUS LATERAL RAGE. TRU5��5 24" D.G.. TYP. NOTE: 2X3, 2X4, OR 1X4 GRADED LUMBER LATERAL BRACE PER TRUSS DESIGN WITH 2-1 OD PER WEB (TYP). MAR. 2 7 -2002 BRACE MAY BE ATTACHED TO EITHER NARROW FACE OF WEB. (SEE NOTE BELOW)' RESTRAINT XE:6LUIREI7 AT EAG- ENb OF t>RAGE: AH12 AT 20'-0" INTERNAL ✓. REFER TO HIES-aI SUHHARY SHEET FOR RE;GOHI-1ENpATIONE OP THE TRU55 FLATS INSTUTE tesTI2A► MA`( I3F_ rKcm mv �,Y-tEKMI 4 c- /r r PIAPHR��I.oK J�7 PC..l N IkEv Q Ia3 jqc 1,10TMITEI= it Ti�E��,,Ll�rrvi� ;�if1Y FcP•.acC a Job Truss Truss Type Qty Plyloseth in (loc) I/deft Ud TCLL 16.0 Plates Increase 1.25 R1166842 LOSE0322 Al SCISSORS 10 7 Lumber Increase 1.25 BC 0.55 Vert(TL) -0.54 9 >522 Job Reference o tional Longrenow t.umoer t,o., Inc., t,mco, t.a. yay�a-1434 �1 d 5.200 s Jan 16 2004 MiTek Industries, Inc. Mon Mar 22 16:13:41 2004 Page 1 -2-0-0 I 6-8-2 I 12-0A I 17-3-14 I 24-0-0 I 26-0.0 2-0.0 6.8-2 53-14 53-14 6.8-2 2-0.0 Scale = 1:46.1 4x4 = 6-8.2 2.0 3x8 = 0 12 5314 5-3-14 LOADING (psf) SPACING 2-0-0 CSI DEFL in (loc) I/deft Ud TCLL 16.0 Plates Increase 1.25 TC 0.62 Vert(LL) 0.28 , 9 >999 240 TCDL 10.0 Lumber Increase 1.25 BC 0.55 Vert(TL) -0.54 9 >522 180 BCLL 0.0 Rep Stress Incr YES WB 0.49 Horz(TL) 0.28 6 n/a n/a BCDL 7.0 Code UBC97/ANSI95 (Simplified) LUMBER TOP CHORD 2 X 4 DF No.18BtrG BOT CHORD 2 X 4 DF N0.18BtrG WEBS 2 X 4 DF Std G REACTIONS (Ib/size) 2=894/0-3-8,6=894/0-3-8 Max Horz2=10(load case 3) Max Uplift2=-48(load case 3), 6=-48(load case 4) 6-8-2 PLATES GRIP M1120 220/195 Weight 92 lb BRACING TOP CHORD Sheathed or 3-1-14 oc purlins. BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing. FORCES (lb) - Maximum Compression/Maximum Tension TOP CHORD 1-2=0/15, 2-3=3300/32, 3-4=-2355/0, 4-5=2355/0, 5-6=3300/22, 6-7=0/15 BOT CHORD 2-10=0/3159.9-10=0/3159,8-9=0/3159,6-8=0/3159 WEBS 4-9=-4/1213,3-10=17/202,5-8=17/202,3-9=903175.5-9=903f75 SkSZ' Dei j J NOTES 1) Unbalanced roof live loads have been considered for this design. 2) This truss has been designed for the wind loads generated by 75 mph winds at 25 It above ground level, using 10.0 psf top chord dead load and 7.0 psf bottom chord dead load, 100 mi from hurricane oceanline, on an occupancy category I, condition I enclosed building, of dimensions 20 ft by 24 ft with exposure B ASCE 7-93 per UBC97/ANSI95 If end verticals or cantilevers exist, they are exposed to wind. If porches exist, they are exposed to wind. The lumber DOL increase is 1.33, and the plate grip increase is 1.33 3) This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads per Table No. 16-B, UBC -97. 4) A plate rating reduction of 20% has been applied for the green lumber members. 5) Bearing atjoint(s) 2, 6 considers parallel to grain value using ANSI/TPI 1-1995 angle to grain formula. Building designer should verify capacity of bearing surface. LOAD CASE(S) Standard ® WARNING - 17er(fy design parameters and READ NOTES ON TIUS AND A'CLUDED MITES REFERENCE PAGE MU -7473 BEFORE USE Design valid for use only with Mlek connectors. This design's based only upon parameters shown, and 4 for an individual building component. Applicability of design poromenters and proper incorporation of component is responsibility of building designer - not truss designer. Bracing shown is for lateral support of individual web members only. Additional temporary bracing to insure stability during construction is the responsibillity, of the erecta. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding fabrication, quality control, storage, delivery, erection and bracing. consult ANSI/TPII quality Criteria, DSB-89 and BCSII Building Component Safety Information available from Truss Plate Institute. 583 D'Onohio Drive. Madison. WI 53719. /Q�pF ESS/ pti9l ANF F2 C 17180 zrn * EXP. 06/30/05 ,} gTFOF CA\-\ � March 23,2004 7777 Greenback Lane Suite 109 Citrus Heights, CA, 95610a%l a MiTek® 030-461-022 #98 -2690 RESIDEI MAL LOSETH, KENNETH 1909 20TH ST. OROVILLE D&DHOMES WR EXISTING SITE PERMIT NO. PERMIT EXPIRES U O I OWNER 1l'CONTR. 'ASSESSOR PARCEL t `LOCATION CHECKED SRA BY FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) Signature -�:y,%Xt�.;�,.,,yge4+s`^�..� h�y�Bw.Y�'V•. 1d)"$;"Ncyv�'-tifplYJb"ih•.p�'i', ....�;,..h;+�.--`vi, MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE j DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION --7 COUNTY CENTER DRIVE OROVILLE, CA 95965 --PHONE (916) 538-7541 APN: r, C PERMIT NO. Owners: Name: �`� l✓ J A / k c N� Owners: Address: ) (i/ iJ 10-7)``' <2t- fL �%�0 U ,y C___.0 Mobilehome r1^)� y�-� L"' u Year of �. Manufacturer i ' a ",, "' %Y Manufacture: Serial number y h 1�- l Insignia oref� or V.I.N.�,. !t'" HUD number. Officiiaal.appr&ing installation: 4� Date: If the mobile is moved of relocated, the mobilehome Installation acceptance shall become invalid. This form shall not be used when the mobilehome is installed on a foundation system. x, 513B White -Owner, Yellow -Installer, Pink -Bldg:, Gold -Assessor ar -.*- - Z'j.:i+.�zs+c�n»� �..=r�..,wc �ti2►%��'I';:..� ai,.sv �,.. ,..� `;'F' .!?Rt_� �1 -ter COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICE` 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE U S� OWNER PERMIT NO. t' T A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. r J Date Inspectq t REV 10/92 i • m*mxs 0 YLP 20 YM U OF MICE S&W10N E VAUIF iif"�:�'�•�`.`a't+yi�^ti•::"�^.'�!,?Z:•':�i�<)^G v.'.:c�r:��;�� aZ... p a1 •;+'v ,tt •a+> 1>: ,_v^ eat,.,1+y�J ,y`e:•` �_; Ve,.i ' i"{� Jl"•..�,, ;ir 'YJl"' ti Phone: (530) 532-3301 Fax: (530) 532-3304 •;�'�<< 'S'^�Y..',`,e.�l�n::'\( �Fi� :t- e-'� iY:• 'S:i%%''moi%:���'"-li: :: J �COn1� Phone: Fax: -5� - ar,4o Dates Total Z,yx _207±2�_ )- a Time: � <. 4- Nt c t, y -r. ti. A�•J!t i?�ft�.. Z .!c 2�� �} � �'i a r rx^Nr- A � 1. Y o NOT RECEIVE T ^. • • _IF ALL ' ^, • is FADES, PLEASE CALL US ! 2243 Feather River Boulevard Oroville. CA 95965 - (916) 532-3301 T00O SaKOH a V a 60CC ZCS OCS %V3 60=6T 66/TZ/TO • REG13111ATIUN 4JWIIlES 'IYVE •,LICENSE NUMnC11 TRAILER MAY 31 79 I •40 SJ8487 C OWNERSHIP CERTIF CA'TE _ A 00 NOT CANNY IN VEHICLE Mulct MO. L �Q, SoCa MRYHM HF F \. YEAR MODEL SHOWN IS BASED ON MANUFACWgSR AND DEALER REPRESENTATION nODT TYPE MODEL I CTL&. DATE FIRST SOLO IClAuS • YR t.l MV R CCHI9P 05/15/78 1CS I78 [�i1T N DATE I.^+SUED - AIf WC IwCIWITTAU NUMUER ``TOTAL 6EE5 n 06/28/78 I 1T4036921I $210 �= n SMITH CA•ROYL J G ON CAROLYN G -- i T RT 1 BX 573 7E 0 QLEVN CV,?5943 r` --IQ WON SALY-yLe --' BK AMER REGISTRATION wino TYPE, ~ LICENSE NUMBCR ' L '-- I E N 400 UROA C A o CHIj C0' ;'; OWNERSHIP CERTIFICATE ` WrI'Hol i 411M OF A _R� ;.2:. n1. i!e .. erri+A IAntr: Vf8 R(y QFTHAN AY 95926;'; i:' ''+ ,......, I•, II �II'��II A�- —�•�- If I '.ili V=OK O = Not OK ble Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements - Setbacks - Easements 2. Sols; Special MH Support Sketch 3. Sewer, Location -Test -Fall -CIO -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Locaticn-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap; / JUL / /Nat or/ A-* t./ /LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION(Plans) OK except #'s n9 Requirements- Setbacks Easements ngs; Size-Spacing-Morriage-Line st DerrtandVal6Connector tricity; MH TesW-rossovem-Breakers-Clearances S�ra+rr'M' IT Test -Fall -Flex Connector 6. WalmAH Test -Regulator -Connector �7yYYaterand Sewer Connected -C/O to Grade -HD Approval 9ged- ie Downs -Type -Installation Cert ts; Insp.-Sketch of Occupancy i 12. Permanent Foundation Only: License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-DepthSpacng-Connectors-Steel 3. Decks; Girders and/or Joists-Decking-BracingStairs-Rails 4. Wood Awn.; Posts-Beams-Rttrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns-ConnecbmsSplice-Decal-Encbsures 6. Carports; Windows -Doors 7. Electric 8. Fnng.; Sils-AnchorsStuds-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof;'Shthg-Roofing 11. Ext; Steps -Doors -Landings 12. Braced Wall Panels 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. Pod Structure; Steel -Connections -Thickness Dead Men -lining 4. Elec.; Receptacles and Lighting. Distance•GFI 5. Elec.; Pod Lighting; 15 Volts -GR 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Egiuip.+Ieater 8. Elec.; Grounding; Equip. w/5 Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards4ns. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. TestWater Supply Test 11. Light Nk;he Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ✓ = OK O = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. ZoningSetbacks-Easments-FloodSlope 2. Ftg., Main; Soils-Elec. Gmd :/ C Ftg. Depth 3. Ftg. Garage; Soils-Steel-Elec. Gmd/ /` Ftg. Depth 4. Ftg. Porches & Decks; SoilsSteel-/ /` Ftg. Depth S. Stemwalls, Main; Steel-Blockouts-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/0 -Sewer Test 10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Cdppies 15. Access & Ventilation Date 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #s 42. 17. Water Htr.; Vent Acoess-Combustion Air Baffle 43. 18. Water Pipe; Test & Anchor -Nail Protection 44. 19. D.W.V.; Test Fittings & Anchor -Nail Protection 45. 20. Shower Pan; Test, First Floor -Tub Access 51. 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Site & Anchors Property Line Firewall & Openings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 55. 23. Fixture & Transformer Clearance -Ins. Protection 24. Elec. Receptacles Spatxng-Lights & Switches at Doors Siding -Nailing Veneer 25. Size Boxes & No. of Conductors Stapled 57. 26. Romex kistalled Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water Glazing Area -Glass Protection -Skylights -Plastic 28. 2 Appliance Circuts in Kitchen & Conductor Size GFI 59. 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al 30. Range Circ. / / ga Cu or AI Oven Circ. / / ga Cu or AI Insulated Neutral 0 Yes Q No 31. Service -Riser Conductors & Ground -Main Disconect Insulation -Walls -Ceilings 32. Equip. Clearances Panels -Motors -Meth. Epuip. 62. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector Date Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation Ext Steps -Door & Sidelight Protection -Landings 37. Condensate Drain & Overflow, Size & Grade 64. 38. Fumance-Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #s 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Puriin-roff Brac.-Truss-Shfing: Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls: Nailing -Bolts 60. Brace Interior / Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. 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 63. Ext Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace; Vents -Clearance -Comb, Air-Conector- In Garage: Above Floor -Ducts -Meth. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int & Ext. 72. Kit. Fid. & Appliance; Ground. -Air Gap -Cooking Clearance 73. Elec. Outlets & Recepticales at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. In Garage; Above Floor -Meth. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (G.F.I.)-Romex Protection 79. Insulation -Foam -looked in Attic 80. Guard rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 82. Following Insdd./Drive 0 Yes 0 No/Walks Q Yes Q No/Planters Q Yes 0 No 83. Stucco Brown -Finish 84.A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throught House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. 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: V,& COUNTY OF BUTTE -,DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-46-1-022 ZONING AR BUILDING PERMIT ` OWNER LOSETH, KENNETH L. TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S T"fDTUTH ST. OROVILLE CA CONTRACT6R[ irMOmEs 7C�L}��p JJGMO O3 CGITRA0T 21TNF1f9.11L"R RIVER BLVD. OROV CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ' UU ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 1909 20TH ST. Ener Plan Checking Fee 9Y 9 $ $ OROVILLE PERMIT FEE S LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome 1p Other SPECIFY Each Trap 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 X] Other ❑ Describe Work: MHI EXISTING SITE Gas piping sy2tem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G 1 @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 a00R LE Main Service 2001 OR LESS 23.00 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 ful rce and effect. ^ License Class �� Lf / 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: ❑ 1, 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 Main Service TO 200ALICENSED 46.00 NEW CONST. DWEWNG OCCUCUP. WEE OR ADONS. ( & ACC. BLDS. SO 3.50FT. NEW CONSTMULTI-OUTLET @7,50 POWER APPARATUS a SINGLE OUTLET CIR OOUTLET OR FUTURES Ex, CCU .00 @ I50 BA 0 w Ex. Occup. DFlx s A- D DEA - 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 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 worker cgmpepation insurance carrier and policy number are: Carrier c�y�- Ucam--p Policy Number L101i $y; I S (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 workeffs' comp sation provisions of section 3700 of the Labor Code, I shall forthl/iith co ly it Be4provisions. X �.-� Date �/� Z,Q -.9C9 Signature of Ap lid nt - ❑Owner ❑Contractor ❑Agent An OSHA permWis required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE: $ Mobile Home Installation Fee $ 100.00 Energy Inspection Fee $ OCC CONST. TYPE TOTAL- FEE $ 143.,90' HA2. V. FE IMP FLOOD CDF PARC PD HD L This permit is hereby issued under of the Butte County Code and/or indica v for hich fees have B ---� y PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. �r Date I pate) Receipt No.z S/4U4 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 (530) 538-7541RM�r No. (Rev. 12/96) APPLICATION AND PERMIT Q �� M10 ASSESSOR PARCEL MJMBEA � 2-z-- - v- - v ZOM (2 -BUILDING PERMIT OWNER / TELEPMONE SO. FT, OCC. BUILDING VALUATION OWNER'S MALING ADDRESS COM R,sNAME aY1� TELEPHONE Z 3 3a CONTRACTORS MALING ADOFIESS L� CONSTRUCTION LENDER Fire lace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Feb S 20.00 Permit Fee $ a R cw ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee b BUILDING ADDRESS % s Energy Plan Checking Fee $ S d PERMIT FEE S LOT NO. OM6 SUB10NS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehomellk Other SP�`y Each Trn 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 ❑ U110des ❑ Installation '�I er ❑ Describe Work: �1i5'sL �Q� �1_i 7�e Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W Q20.00 PERMIT FEE t ELECTRICAL PERMIT Fling Fee 20.00 Main Service 20aL Don tLESS 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 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: ❑ 1, 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 ❑ I 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 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 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.) 13 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 Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over S0' deep and demolition or construction of structures over 3 stories in height c L Main Service zo TO +LING 48.00So NEW CONST. DWELLOCCUUP. SO OR ADONS. a ACC. BLDS. 3.5¢FT., T ea 7.50 NOWRtW ESID, I.BRANCH CIRCUITS POWER APPARATUS S SINGLE OUTLET d0. OUTLET OR FIXTURES Ex. ccu EOew �':w Ex. Occu . OUTLETssM�ESiU°E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE _ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee S Or), 60 Energy Inspection Fee S Occ CONST. TYPE �d al , ,1112 D. FEES FU700 CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. ro Receipt No.25f '3 f,D WHITE-D.D.S.-B.D. CA RY-ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT .. .. a .....�.� .. ..�, �,,, . �.. tt,�f: .,: .•< M.�!#+.i:: Sj, :�Pl� `�4�r:J' i rF.. ,,F, COUNTY OF BUTTE DEPARTMENT OF DEVELOPIIIENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: ,tel �,� �� ASSESSOR PARCEL NUMBER: _ � _ (14 1- a Z 2- Proposed Building Use: , Building Inspector: r Date:11/e gt At time of permit application, I was advise the following data must be submitted prior to pe processing and/or issuance: Date Received By ❑ 1. All iiems have been submitted --------------------------------------------------------------------------------------- 112. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ 03. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- ❑4. Engineered plans, 3/4 sets, with wet signature on plans. -All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ 0 6. Energy Design Compliance and supporting documentation. ---------------------------------------------------- El 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑ 9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------ ❑10/Fees of $ ------------------------------------------------------------------------------------- 4Y1'I . Impact fees as shown on the attached schedule. �� o, j----------------------------=--------------- ❑ 12. California Department of Forestry plan approval/fees- ----- ------------------------------- 0 13. Flood elevation certificate.-------------------------------------------------------------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. -------------------------- ----------------- 0 15. City of Chico plumbing permit. ----------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- ❑ 17. Planning approval for (A) Use: (B) Parking: -------------------------- ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------- ------ ❑ 1.9. Encroachment Permit for driveway (construction approval prior to occupancy) - ---------------------- ------ ❑20. Pre -inspection for required Request to Building Inspector on 021;: Contractor's license information. (Number, Name Style, Classification). ---------------------- ------ 0 X22. Workers' Compensation carrier and policy number. ---------------------------------------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). ❑ 24. Letter of signature authorization. ------------------------------------------ 025. Recorded copy of Agricultural Acknowledgment Statement. ----------- 026. Letter of intent on building use. -------------------------------------------- 0 27. Manufactured Home utility clearance. ------------------------------------- 028. Existing violations and/or expired permits. ------------------------------- El 29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ 030. Other: (Date) When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. ETelephoneS32- - 33 D? and hold for pickup at Qffice. ❑ De 'ver with inspector. Applicant: Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Avolflution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ p none -0 mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ B "lding i i n cora ter, by Date: Plans reviewed by: Date: Plans approved by: A Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. I��,,,..r�.- .,.,..:.�„1(�i�P„j�.M.crr.�N 4(4'v`hvTn'h1RM�F�j+rdM'y�ij.�-m31I �9f��l;,;i�,':1'�G:r�'rt^t��iN4`'.�t�'�v` ��'�"is'v^v .., �n._ , ..r. . , - `�• , t .. BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) IL 1 School District I' /rte iwl � Building Department No. A.P. Number(QZZ Jurisdiction: City County. Property Owner Property Location/Address 1!2 U 9 2 0 -11: '54, Subdivision Lot No. ................................................................................................................... Residential Development Sq. Footage No of Living Mobile al Home Units Installation` `Supplemental to Conversion* Conversiori Permit # r (Gr R) , `o-M•�,�,�,� o'. r_�,�✓jr-- ................................................................. '(No foundation inspection); .. ......................... Commercial/Industrial Sq, Footage New Addition (Including Exterior. Q,V1 -c _ Roofed Areas) / 8 Building Dep rtment Representative, Date (Floor Plans reviewed by School District Personnel) 990064 District Identification No. School District certifies that "= (Applicant). + X909 o9U` (Street Address) (Phone Number) :. (City) ' (State) / (Zip Code) I✓ n .. 't n A n nA it I. has complied with the requirements of Resolution No. representing /I� square feet > hill-- -/)I School District Representative Paid by.Check A Remarks: Of $ AB 2926 —S FULL MITIGATION Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this, -'Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Envirdnmental Quality Act (CEGA), this pioject may be subject to additional school fees to fully mitigate,its'impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls 110/98)dmm • J Cm iha joS of all Limas and i4 is unix-4ul "KAo my changos or alterations on samo witham p�rmisai of%Q Dai . �j 2-2r L�C7TIr: AQ t�'ctita:�raii �+ iMnr#�r►t�i�ip , i�^ a Shed' AcCOrdcAco wiih Recognized Goad Pracfwvr end of a qualiiY rr,�; rihc+o for f6 Specified tm ii, S Un'fcrm >rL►tding, Plumbing $ Mfacho";cQ! C,014" ' ' 6T) KIO+ orml 8--ac'rsr44 Clxfm Aof v4; A& ALL GTRUCTUR28 AYO ECJIPMEMI CS.Uat�!p OVER SI-Va � lr�j`{`irNCLUDW A gT BACK O:= 5 c SIOE T. I` F �" AND i EAR r i1CT U::_� I _. 'C �:.. _� ►L i_L HD GH. LL BE OF FOR A 2 PT. SAVE OVERHARG. `QUIPMENT "MPT '4-�190.7 1 3p 105 -3f 13 n '7' "TTE COUN� t v �Ij►_►1+`1S, �rP� 1 E K v �Z Mobilehome Manufacturer: IYUA-1-Y Manufacture Year: If other than single wide, furnish Setup Model Number: Width:_2 �_(ft.) Length:441�(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. FOOTINGS: Wood pressure treated or foundation grade[ ] Other: SUPPORTS: Concrete block[ ] Other: Provide Tie Down Specifications for all Mobilehomes: Pier Footings Sizes and Location SINGLE WIDE MMTI-WIDE Line 1 Line 2 ......................:......................................................................... Main Beanu Line 2.......................................................................................... Line 1 Main Beams ............................................... e s • Tag or Triple o4 ................................................. > ine 1 Line 1 Piers: Size minimum: r 1 x Spacing maximum: I t` From ends -maximum: I` Line 2 Piers: Size minimum: x [3 C . Spacing maximum: ` From ends-maximum:21 1` Line 3 Roof Loads: Size minimum Location (from front): Line 5 Roof Loads: Size minimum: Location (from front): Ano 1 Lino 2 .ino 2 Lino 3 Lino 2 Lino 2 Line 1 Line 1 Openings Size minimum: [ ] x [ ]. Each side of openings with width over: ` Line 4 Piers: Size minimum: [ ] x [ ]. Spacing maximum: I 1` From ends -maximum: ` NOW OVER -PA R I'M EN" 11 1. Owner's Name: Lc>�� 2. .,Assessor's Parcel Number: , D'S© --J4(,o) 3. Installer's Name: 4. Is the site currently under permit? Yes[ No[ j Permit No. 5. Is the site an existing site? YcsO No[ ] (Tfyes, furnish two plot plans). 6._ What is the electrical rating of the. mobilehome?j b d Amperes. 7. What is the mobilehome site circuit breaker rating? /a _p_Amperes. 8. What is the electrical rating of the mobilehome site? / d b Amperes. 9. Is the main service remote from the mobilehome site? Yes[ ] No[ j If it is, what is the rating? J o d Amperes. 10. Is there any other electric load to be served by the mobilehome site electric service (i.e. well, garage etc.)? Yes[ J No[ ] If yes, please identify the load and size: a) The mobile home site: Load- Amperes - b) The main service: Load- Amperes - 11. Type of gas service at mobilehome site: Natural[ ] Propane(/None[ J 12. Size of gas pipe at the mobilehome site from the meter or tank: ao inches. ' 13. What is the gas pipe length from the meter or tank to the mobilehome? ZC)(ft.). . 14. What is the mobilehome gas demand? B.T.U.* *(This information is not required if the pipe length is less than'6 feet on natural gas or less than 50 feet on propane). 'J'ME U't'HER SIDE OF THIS FORM MUST BE COMPLIETFA IN ORDER T PROCESS THIS PERMIT APPLICATION .10 QQ� �J May 1995 $ 5 ` OVAL IINEN ____ ; I i' +- nosEr I DINING AREA I 1 66'-B' Ort MASTER BEDROOM 12'-10•X74'-6' 4 SU/17/FE898 i Y1 I 66'-B' Ort 10"..0'MDIDIYD __� � OI '`- A DESK OR ;�LKRLHEN � I C! aROOM 1�4'X IO' -4' MY 7 _ST DEcoR DECOR SET GU44 GU44, _. _.."� ---------- DEN 15'-t0'x 12'-6' BEDROOM 12'-9"X 12'-0" EN r, PoRErtAL wDIV. State of Calif6mi67 4*4 _ t. k;L W__ Business. Tr6 nip'oirf 'a tion and Ha b sing Agency ING 4 DEPARTMENT OF HOUSING ANDCOMMUNITY DEVELOPMENT Division of Codes and Standards $Oy .' V. APPLICATION/FOR `0- 'Alteration, Addition or Coriversiori A!ternfote Approval,. 13 Technical SeM66i,z, ' '.O Inst nia Ins echos (SEE REVERSE SIDE OF FORM FOR INSTRUCTIONS AND ADDITIONAL INFORMATION) SECTION 1 - UNIT INFORMATION DECLARATIONS Not.requiredto Special Purpose -Commercial Coaches or I/We Are re­qu-e­siin-g s'e'i'v'O'es'fo� thefo'llow'ing- unit(s).:' COL NO. 1 .,-*�i)�'��-,RecreationolVehtcles (Check Appro;56afe Box) 1. LICENSED CONTRACTORS DECLARATION I hereby affirm unddr penalty of perjury that I'am Ii6ensed under provisions C 0 NO of Chapter 9 (commencing with Section 7000) of Division 3 of the Business Manufactured e/Mobilehome, and C]*-*M6,6U,I`octUi6d Hdriij�/Mobilehome Component Structure C.� Ptofessions'Code ,-and myjFep,e is in full force and effect. FEE RECD _ ! 0, Commerci6l Coach (Occupancy GroupJ n e.C1. C3 Special Purpose Commercial Coach Contractor" ctor Date Decal or License No: DATE 2.'OWNER-BUILDER DECLARATION Serial Numberfs) AA NO. *-614h'6eeby,offirm"tirider--pencilty of perjury-that'Vorn exempt from thet —4 Contracto;i License Low for the following reason (Sec. 7031.5). Business and a's co pep! Code:. -Any city or county -which requires a permit to construct, RT TO 44 A 7 v6,�.'cfeirfoiish, or iepair any structure,,pfior to its issuance;� also 'RT applicant.for such permit to flea signed statement that he or -` -Manufacturer No; &d.purivant,to the.,provisions of the Contractors License Law , . c6rhMeriding -Section Model Name .0 with 70D0)'of. Division 3'6f the Business and C&a_e�)76r:that he or the is'e�iiiffipt theiefroIrfi-drid the -basis for,the -mptionP,Any -violation of Sbdfion.7031 Z by any applicant fora, ,-cts-J jh' eappficantjo'6 civil penalty:of not more than five hundred I : vner ofthe-property, or my employees with wages as their sole S ECTION 2 - OWNE ion-,:will.do.thii work, and the structure,is not intended of offered ' ..-704,-BusiAess and Professions Code: ContractorsThdLicens P -� - 6i'6p-ply,t6bn'.6v�nbr'6f,propetty,-Y�hd.'b6ilds or improves 'himseIf ir )esiIsuff,work or herself or,through, his or her -own provided that such impidJemeritg"are not intended or offered for 'Address N.evi�r,'We b6ilding dr'irn�roviaiment is sold within one yeoF I 'a' the owner -builder will. have the burden of proving that he or'she, City ic _' J &Mj:�6(61orth I e purpose of sale.). finer of,,the -property, am exclusively contracting with licensed Location Address t665niyuct the project (Sec. 7044, Business and -Professions Code: _ t' ' t6sLic6nselaw does not apply yto an owneraf propertywho, .App-par,t I a )roves thefeon, and Who contracts for such projects with licensed pursuant to the Contractors LicenseLow.a 4C? ). 'Address p,,_�n ,,�.erspc;- B. I&, P.Q. for this reason: 57 City I -zip.5 -plephone I have and QlFm'� by Section WOO of ti�6 this permit is issued. My ,,��,.Policy; NG-rrii&�J_ kI, �is, sectioril',need �not -b v, t6otin-th6 6c employ Ziriy 40; ,:�::worker�.compentotion su __C bjec to workerll ;. co AP , plicont. WARNING: FAILURE TO S .. -�AND;SHALL ';UNIJkWFUL_ bV.iLfiF4ES..0 . P, T I O,0NE AbDIT1100"JO THE.COST SSE TI" N 3706 OF THE z`d�NSTRUCTION' LEN ,- 4�'ierebv affirm unde 1Date a ate AT`IdN76i�! �r penalty of perjury one of the following declarations: inloirrd'6brilificate of consent to self -insure for workers' ided for by Section 3700 of the Labor Code, for the )rk`f&r which this permit is issued. • '46in Ikorkers' compensation insurance, nsurance, as required Labor Code, for the performance of the work for which workers'compensation insurance carrier and policy o- r -1 4- e completed if.the.permh is for one hundred dollars P611torn.6riq6,of the "workJor which this perniff.,is--iss . Qed,�. person in -any m , annerso.as to,become subject to; 'laws of Cblff6jnia;:onp agree that If I should be -come ,pens.fign pr&lsionsef SWfion 3700 of the .Labor' ,am py with t oi�isions ;7 Date ECUqk,V4-0.RKERS' COMPENSATION COVERAGE IS SUBJRCT.AN EMPLOYER TO CRIMINAL PENALTIES AND HUND91EDTHOUSAND DOULARS- ($100,000) IN - : OF;'COMPENSATION,-DAMAGES A�..VOVI`61ED FOR IN LABOR CODE. DING AGENCY -r penalty of perjury =n lending ance,of -the,work for which'this oermft-is-issued­­-w,- lauu.juy/, %-rv. U.). ndees NaffibZ' '-Lender's Address t I certify that l have.read this application and state thofthe above Gr ;informarion,is:c,oftLict,,.�l.ogree" to comply with all city,ona county ordinan6bs and state laws,relating to building construction, and hereby:6uthorize •representpt;vesaf this county to enter upon the above-mentibned property n 'for I�spe fi� on purposes. Signature of Applicant or Agent Date SE - CTION 3 CONTRACTOR:AJZCHITECTbk ENGINEER INFOR"TION_ Contractor's ntroct6l5s Name % Address Architeci/Engino/er NameLicense Noi. Address SECTION 4 J DESCRIPTION OF WORK/ACTIVITY AND VALUATION Describe the proposed work/activity in detail. -Attach additional pages if oradditions. are proposed, complete plons, specifications, detolis,'and cc to this foffn.'Pr6vide the make "and -model-of an'�_6pplidnce to.b6'ii_st6lIc calculations for any electrical olt'6maii;n;'aFadd NwlS 'essary. Where. structural alterations. latrans are required to be attached Ind Orowde'comalete eler•trit•nl' 1`""' Indicate the Total Cost of the SECTION5- SIGNATURE AND. CERTIFICATION I/We hereby k6' 1 6pp ica� tion or the services cie' ri�bt6cf above., make : or label for the unit described in item number , above, I/we certify that th-er'e hay"e"be'e"n"'no &Vffiation, additions,-6irriodific6tionst6 the unit vvhich,%466fd-off66tcompliance 'witi'Cblgoinib orfedef6r&-6r,iha0ei­- and regulations of the Department. (Where olterations.or-modifications have beers made, an inipectio4•" ust Signature Date. DEPARTMENT USE ONLY 011ifi,100 CONDITIONS (see reverse side) CI DISAPPROVED (see reverse side) of Department Repre'sentatiw I t C JJ Date HLA) 4 1 Z), alae I (Rev ub/yy) DISTRIBUTION: YELLOW - DEPARTMENT, WHITE - AREA OFFICE, PINK - OWNER/APPLICANT RT TO 44 A 7 'RT F4Gmb&r(i)' 95 - 77.1 7 APPLICANT INFORMATION , _ 1p 7r'County 1911, )roves thefeon, and Who contracts for such projects with licensed pursuant to the Contractors LicenseLow.a 4C? ). 'Address p,,_�n ,,�.erspc;- B. I&, P.Q. for this reason: 57 City I -zip.5 -plephone I have and QlFm'� by Section WOO of ti�6 this permit is issued. My ,,��,.Policy; NG-rrii&�J_ kI, �is, sectioril',need �not -b v, t6otin-th6 6c employ Ziriy 40; ,:�::worker�.compentotion su __C bjec to workerll ;. co AP , plicont. WARNING: FAILURE TO S .. -�AND;SHALL ';UNIJkWFUL_ bV.iLfiF4ES..0 . P, T I O,0NE AbDIT1100"JO THE.COST SSE TI" N 3706 OF THE z`d�NSTRUCTION' LEN ,- 4�'ierebv affirm unde 1Date a ate AT`IdN76i�! �r penalty of perjury one of the following declarations: inloirrd'6brilificate of consent to self -insure for workers' ided for by Section 3700 of the Labor Code, for the )rk`f&r which this permit is issued. • '46in Ikorkers' compensation insurance, nsurance, as required Labor Code, for the performance of the work for which workers'compensation insurance carrier and policy o- r -1 4- e completed if.the.permh is for one hundred dollars P611torn.6riq6,of the "workJor which this perniff.,is--iss . Qed,�. person in -any m , annerso.as to,become subject to; 'laws of Cblff6jnia;:onp agree that If I should be -come ,pens.fign pr&lsionsef SWfion 3700 of the .Labor' ,am py with t oi�isions ;7 Date ECUqk,V4-0.RKERS' COMPENSATION COVERAGE IS SUBJRCT.AN EMPLOYER TO CRIMINAL PENALTIES AND HUND91EDTHOUSAND DOULARS- ($100,000) IN - : OF;'COMPENSATION,-DAMAGES A�..VOVI`61ED FOR IN LABOR CODE. DING AGENCY -r penalty of perjury =n lending ance,of -the,work for which'this oermft-is-issued­­-w,- lauu.juy/, %-rv. U.). ndees NaffibZ' '-Lender's Address t I certify that l have.read this application and state thofthe above Gr ;informarion,is:c,oftLict,,.�l.ogree" to comply with all city,ona county ordinan6bs and state laws,relating to building construction, and hereby:6uthorize •representpt;vesaf this county to enter upon the above-mentibned property n 'for I�spe fi� on purposes. Signature of Applicant or Agent Date SE - CTION 3 CONTRACTOR:AJZCHITECTbk ENGINEER INFOR"TION_ Contractor's ntroct6l5s Name % Address Architeci/Engino/er NameLicense Noi. Address SECTION 4 J DESCRIPTION OF WORK/ACTIVITY AND VALUATION Describe the proposed work/activity in detail. -Attach additional pages if oradditions. are proposed, complete plons, specifications, detolis,'and cc to this foffn.'Pr6vide the make "and -model-of an'�_6pplidnce to.b6'ii_st6lIc calculations for any electrical olt'6maii;n;'aFadd NwlS 'essary. Where. structural alterations. latrans are required to be attached Ind Orowde'comalete eler•trit•nl' 1`""' Indicate the Total Cost of the SECTION5- SIGNATURE AND. CERTIFICATION I/We hereby k6' 1 6pp ica� tion or the services cie' ri�bt6cf above., make : or label for the unit described in item number , above, I/we certify that th-er'e hay"e"be'e"n"'no &Vffiation, additions,-6irriodific6tionst6 the unit vvhich,%466fd-off66tcompliance 'witi'Cblgoinib orfedef6r&-6r,iha0ei­- and regulations of the Department. (Where olterations.or-modifications have beers made, an inipectio4•" ust Signature Date. DEPARTMENT USE ONLY 011ifi,100 CONDITIONS (see reverse side) CI DISAPPROVED (see reverse side) of Department Repre'sentatiw I t C JJ Date HLA) 4 1 Z), alae I (Rev ub/yy) DISTRIBUTION: YELLOW - DEPARTMENT, WHITE - AREA OFFICE, PINK - OWNER/APPLICANT O.. - OWNER -BUILDER VERITICATION 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. I personally plan to provide the jor labor and materials for construction of thero os ed property � rovement : YES NO ❑ P P im P I HAVE 13 HAVE NOT IS signed an application for a building permit for the proposed I have contracted with the following person (firm) to provide the proposed construction: work NAME• 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: ADDRESS: r.,.v. . PHONE: - CONTRACTOR'S LICENSE NO. 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 NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health. and Safety Coda This verification must be completed and returned to our office before we are permitted to issue the permit • ; I OWNER BUILDER INFORMATION 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 party ofrecord 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 ifthat 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you 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, ifyou 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 contractors 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" on 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. In iY!ic 1 C. Vi ira, C.B.O. L Building Inspection NOTE: This Owner Builder btfomw on is required by Section 19830 of the California Health and Safety Code OVER COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (13ev.;2/96) APPLICATION AND PERMIT 03-2010 ASSESSOR PARCEL NUMBER 030-461-022 ZONING BUILDING PERMIT OWNER v�7�7�77,�7+�� LOSEFH, L�ENNEM TELEPHONE TELEPHONE — SO, p7, OCC. BUILDING VALUATION "OWNERS MAILING ADDRESS OWNER 613 coy 7,969-00 CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee $ 99.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 64.35 BUILDING ADDRESS 1911 2 Energy Plan Checking Fee $ $ PERMIT FEE $ 183.35 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 1-4421 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other s5cIFv Each Trap 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 ❑ Describe Work: CARPORT Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service POOA OR LESS 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.P License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License LayFfor 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWEwNG OCCUP. OR ADDNS. ( 8 RAC. BLDS. SO 3.5¢x. N" �.RESD.T MULTI -OUTLET @7,50 OWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 @'.50 84L ta] .so OR Ex. Occup. oUriE°A_REESI6.) EEA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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 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.) ❑ 1 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 i h those rovisions. _ Date Signature of pplicant - Owner ❑ Contractor ❑ Agen An OSHA permit is require for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ COON"'TOTAL FEE $ X183.3 HAZ. __ I O FEES IMP ___ FLOOD I COF PAR EL I PD H ts-suf 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. By Date PERMIT EXPIRES ON P. Receipt No. 382387/$183.35 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �A COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754n IT 0. jReV.12/9b) APPLICATION AND PERMIT _AER ASSESSOR PARCEL NUMBERC.Z�o/- + ZONING n — BUILDING PERMIT OWNER/] �� L TELEPHONE -�3_��� 6 SO. FT. OCC. BUILDING VALUATION OWNERS Mau R ,1 CONTRACT] TELEPHONE cONTRACTO ADDRESS CONSTRUCTION LENDER LENDERS MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 62P ARCHITECT OR ENGINEERS "UNG ADDRESS Plan CheckingFee ¢� BUILDING ADDRESS '1 C 1 Energy Plan Checking Fee $ PERMIT FEE $ 35 LOT NO. SUBDIVISIONS NAME —`7 PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE tj `Z q SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump 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: ( /7 d- ("� Fl—DV, x , 0% 90 C-- T� f✓'aZ3re�A LiT� T 2� F -F9 C 1�2A1 IV A6� -�C �2� Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 800V R LES Main Service 200A OR LESS 23.00 • y _ Sey. �� � �Cooling �/ bc... �� 00� L4 t&M • ` -.gyp Q X Date _ Signature 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. Main Service 200A TO 1000A 46.00 NA CONST. DWELLING ACC. oCS. 3.50FT. OR ADONS. ( 8 ACC. ff FT. NEW CONS . MULTLOUTLET NON•RESID. 97.50 P0APCUIT PARATUS SINGLE OUTLEr CIS. EX. OCCLI OUTLET OR FDfTUREs 20 @ I•00 BAL � .50 Ex. Occup.DU Ao ° 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. ,TYPE TOT/L FEE $ ID.FEES HAZ. IMP FLO D CDF EL D SUE 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) rReceiptNo. HITE-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, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ��n /�] h Z, C.�,�''h ASSESSOR PARCEL NUMBER Proposed Building Use: (� Counter Technician: 7P Date: t7- Items required in orde_� to-a'pply for a permit. All boxes MUST be checked OR marked NA in order to apply. 4I. Plot plans, 3 or 4 sets, signed ty the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................:.. ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form ......................... _ . _ _ _ ... - ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the followinj items.) j1 Fees as shown on the attached Schedule of Fees Due Sheet ....................................... 5. Statement of Intent for Non -heated and A/C Buildings.............................16. Sanitation and plot plan approval from the Environmental Health Department in 17. City of Chico Plumbing permit.....................................................................: ❑ 18. California Department of Forestry plan approval ❑ paid. Sent. by: ...................... - ❑ 19. Planning approval for (A) Use: C) K (B)Parking: (C) Parcel Check: -x_22151 ❑ 20.. Contact Land Development about ❑ Improvements, ❑ Drainage .............................. ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier �ate, d Policy Number ..............:.............................. 25. Owner -Builder Verification (❑Viven to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance................................................................ ❑ 29. Existing violations and/or expired permits......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone - and hold for pickup. I have been informed of the above itemyand requirements for obtaining a building permit. 1. Index permit application for the above items numbered(: 2. Additional items required_ I Contractor, designer, owner, was advised cf the above data by Contractor, designer, owner, was advised of the above data by Plans reviewed by: Date: Structural reviewed by: Date: Note transfer by: Date: Check Letter ❑ phone, ❑ mail, ❑ counter, by Date: ❑ phone, ❑ mail, ❑ counter y Date: Plans approved by:Date: g7,1 _Structural approved by: Date: Yellow: Buildine Division O.B.- OWNER-BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit' will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property im rovement : YES NO O 2. I HAVE WHAVE NOT 0 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: ��- 4,� ADDRESS: Z�?& CITY: PHONE:, . — a CONTRACTOR'S LICENSE NO. --1-1 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: 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: PROPERTYO DATE: 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 a v 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 party of record 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 employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is •$300 or more for the entire project, and such persons are not licensed as contractors or subcontractors; then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to seveial 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 contractors 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" on 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. rely, d ` syr y i .pa.. � Sy. f6 7.: a14 •1'+w+b.f yk,,¢ � a •� � .Y`. Codi.= A P ,� /i.. l'G' Miclftel C. Vidira, C.B.O. Manhger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER Thermalito Inigation Dist 410 Grand Ave. Oroville, CA 95965 (916)533-740 Fax(916)533-9243 August 25, 2003 Kenneth Loseth 1909 20" Street Oroville, CA 95965 RE: 191120' Street address Mr. Kenneth Loseth I refer you to Thermalito Irrigation District's Improvement Standards for Water and Sewer Facilities number 3.09: A separate service line shall be installed to each residence or structure. A cleanout with plug and concrete sewer box similar and equal to Christy No. G-5 concrete box and cast iron traffic lid shall be installed for each service lateral and shall be brought to grade at the property line. The property owner is responsible for cleaning and maintaining the service lateral from the structure to the sewer main. Your service line from the house to TID's sewer main is approximately 160 feet long and it is imperative that you have the property line clean out raised before the concrete driveway is installed. It would be near impossible for you to service this line from the house if you should have a blockage with in the road easement. We have no objections to this construction project. If you have any questions concerning this matter please contact the office. Best Regards, Michael L. Edwards Compliance Supervisor Building Permit Number: Owner Name: Residential Construction Requirements IMPORTANT This set of plans and specifications MUST be kept on the job site at all times and it is unlawful to make any changes or alterations on same without written permission from the Building Division, County of Butte. All materials and workmanship shall be in accordance with recognized good practices and of a quality prescribed for the specific use in the 2001 California Building Code (2001 U.B.C), 2000 California Plumbing Code ( 2000 U.P.C.), 2000 California Mechanical Code (2000 U.M.C.) and the 1999 California Electrical Code (1999 N.E.C.) COMPLY WITH ITEMS CHECKED BELOW Your parcel lies within a designated 100 -year flood plain. Finish floor, electrical, : H.V.A.C. equipment and services shall be a minimum of one foot above the elevation shown on the attached Flood Elevation Certificate. A Post Flood Elevation Certificate will also be required Note: We will normally accept the following as compliance with the flood elevation requirements: 1. Building is anchored to concrete stemwall system with conventional anchor bolts. 2. Building plate on top of stemwall to be one foot or more above the 100 -year flood elevation. (Plate height less than 24" above grade, or engineered design required). 3. Electrical, heating, ventilation, plumbing and air conditioning equipment and facilities located above the plate. 4. At least 2 openings in exterior walls, located on opposite or adjacent walls with a total net area of not less than 1 square inch for every square foot of enclosed area. 5. The bottom of the openings shall be no higher than 1 foot above grade. 6. The openings may be screened or covered with other devices that will permit automatic entry and exit of floodwater. Page 2of 2 Building Permit Number: Owner Name: om Parcel lies within the State Responsibility Area (SRA). Comply with attached requirements. 0 Fire sprinklers are required in this structure.. MThe following Parcel map requirements shall be met: All structures and equipment including overhangs shall be clear of all easements. A setback of 5- feet from the side and 5- feet from the rear property lines and 20 feet (25 feet if Federal Aid Route) from the edge of the right of way shall be clear of structures and equipment except for a 2 foot overhang. Expansive soil may be encountered on this site. This condition may require the P k, foundation to be designed by a California registered engineer or licensed architect. AJD r P/Z� lo I 1 S -1171A, a4-) 46 AA7 9L SIM? - Alp" Iq BUTTE COUWI-7f-- tj!LDING DEPARTME. A. P P R 0v Co� E RTME.. PA 4 ROVF , p p APRIL 25, 2000 KENNETH LOSETH 1911 20TH STREET OROVILLE, CA 95965 BEAUTY 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7541 FAX: (530)538-2140 RE: Building Permit # 99-1143 Expiration Date: 4/29/00 A P # 030-46-1-022 With reference to the above subject, our records indicate that your building permit expires on the above date and your permit falls into one of the categories marked below: [ ] Permit work started, but not completed. Permit may be renewed for 1/2 the original building permit fee (plus a $20.00 filing fee). The renewal permit will extend the building permit for an additional year from the original expiration date. Should you not renew your permit within 30 days of the expiration date, all work must cease until a new building permit has been issued. For your convenience, we are enclosing a renewal application form and owner -builder form to be completed and signed by you where indicated and returned to this office together with the fee shown. Please return all copies of the application form. [ kXX No inspections have been made on permit work. Inspections are required to verify code compliance. We are unable to renew a permit where the work has not been started and inspected prior to permit expiration. After expiration of your permit, no work may be started until a new permit has been issued. [ ] A final inspection has not been made on permit work. Final inspection approval is required before occupancy. Our field inspector has verified that the building is occupied. Occupancy must cease until a final inspection can be made and final approval given. You have 30 days to voluntarily cease occupancy or to present an acceptable plan for abatement or corrective actions to be taken by you. If our records are in error or should you have any questions concerning this matter, please contact the OROVILLE office. Thank you for your prompt attention concerning this matter. MCV:ahb Attachments, Chico Office - 1469 Humboldt Rd/891-2751 Yours very truly, 4elC. V ira, C.B.O. Manager, Building Inspection Paradise Office - 747 Elliott Rd/872-6307 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 y�1 PERMIT N R IIT O. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-461-022 ZONING BUILDING PERMIT OWNER LOSETH, KENNETH &ROMA TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 1911 20TH ST., OROVILLE, CA 95965 CO S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1911 20TH ST., OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE $ A,7 nn LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other OPEN & COVERED DECK SPECIFY Each Trap 7.00 Solar or heat pump 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: 2ND RENEWAL RP#97-n699 (1ST RENEWAL BP#98-1049) Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 "OOVMain Service zo.A OR IESS 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 La`wfX 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 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 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 provisio s of section 3700 of the Labor Code, I shall forth 'th comply with 111ose pr isions. p Date 7 Signa ure O 6 licant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO +oOOA 46.00 NEW CONST. DWE UNG OCCUP. s0 OR ADONS. ( 8 ACC. BLDS. 3.50FT. NEW CONS . MULTI -OUTLET NON-RESID. @7.50 APPARATUS a sINGLE oLmEr cIR. 00 Ex. Occup. OUTLET OR FIXTURES BAL @':50 Ex. Occup. GLIT>Frs PID °� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirino 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 47.00 HAz. o. FEES IMP I FLOOD COF I PARCEL I PD I HD SSUE 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. By Date , .-1 1 PERMIT E PIKE ON Z 6� Date Receipt No. M WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT - utte Co, ^-� LAND -OF NATURAL WEALTH AND BEAUTY April 23, 1999 BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7541 KENNETH AND ROMA LOSETH FAX: (530) 538-2140 1911 20TH STREET Re: Building Permit # 98-1049 OROVILLE, CA 95965 Expiration Date: 4/23/99 A.P.# 030-461-022 With reference to the above subject, our records indicate that your building permit expires on the above date and your permit falls into one of the category marked below: [X] Permit work started, but not completed. Permit may be renewed for 1/2 the original building permit fee (plus a $20.00 filing fee). The renewal permit will extend the building permit for an additional year from the original expiration date. Should you not renew your permit within 30 days of the expiration date, all work must cease until a new building permit has been issued. For your convenience, we are enclosing a renewal application form and owner -builder form to be completed and signed by you where indicated and returned to this office together with the fee shown. Please return all copies of the application form. [ ] No inspections have been made on permit work. Inspections are required to verify code compliance. We are unable to renew a permit where the work has not been started and inspected prior to permit expiration. After expiration of your permit, no work may be started until a new permit has been issued. [ ] A final inspection has not been made on permit work. Final inspection approval is required before occupancy. Our field inspector has verified that the building is occupied. Occupancy must cease until a final inspection can be made and final approval given. You have 30 days to voluntarily cease occupancy or to present an acceptable plan for abatement or corrective actions to be taken by you. If our records are ' error or should you have any questions concerning this matter, please contact the Xeo office. %�#J ` /i3 Thank you for your prompt attention concerning this matter. YWrs very truly, C. Vieira, C.B.O. Building Inspection MCV:lt Attachments Chico Office - 411 Main Street, Chico / 891-2751. (Rev. 12/96) ►, 7 county center unve • Uroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. AS SESSOR PARCEL NUMBER 010-461-099 ZONING AR BUILDING PERMIT OWNER KENNETH AND ROMA LOSETH TELEPHONE SO, FT, OCC. BUILDING VALUATION owns, i"O ES§TREET OROVILLE CA 95965 COtOp1G LT NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAULING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 1911 90TU STREET 0V0V11 IFs Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other 'SPECIFY Each Trap 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 IN; Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: X 2ND RENEWAL OF PERMIT #N9X 97-0622 Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service zRooAY 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. License Class Lic. No. OWNER -BUILDER DECLARATION 1 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. ❑ 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 Main Service sooA TO I000A 46.00 NEW CONST. DWEILNO OCCUP. OR ADDNS. ( a Acc. a CC. SO 3.5¢FT: NEW RES,p ' MULTI.OUTLET 97.50 POWER APPARATUS 8 SINGLE OUTLET CAR. Ex. Occu oLmtTORFocruREs 200 1.00 aAL @ .50 Ex. Occup. OUTLETSRESID.) OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 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 the performance of the work for which this permit is issued. ❑ I 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 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.) ❑ 1 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. Date_ __ Yatture 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. 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 HAZ D FEES IMP FLOOD COF PARCEL PD HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date EXPIRES ON provisions to do work paid. to Receipt No.PERMIT WHITE-D.D.S.-B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT C COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDINGDIVI N 7 County Center Drive - Oroville,. CalifAiia 95965 - Telephone (916) 538-75 PERMIT N . (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-461-022 ZONING AR B U I I NG P ER M I T OWNER LOSETH, KENNETH &ROMA TELEPHONE SO, Fr, OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS 1911 20TH STREE, OROVILLE, CA 95965 CONTRACTOR'S NAME OWNER TELEPHONE ' CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING 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 1911 20TH STREET, OROVILLE Energy Plan Checking Fee $ PERMIT FEE S Inn LOT NO.SUBDNIS IONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 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 .LAy New ❑ Addition 0 Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: OPEN DECK AND COVERED DECK MENEWAL OF PERMIT # 97-0622 Gas piping system 1- 5 outlets 15.00 Building sewer 15.0 -0 - 5.00Describe Mobile Home ISI GI W1 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 UE Main Service A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm nder 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.POWEPPARATUS License Class LIC. No. OWNER -BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from the Contractors License w or the following reason: I, as owner of the property, or my employees with wages as their sole compensation, Bwill 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 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 Main Service Zoog TO 46.00 CCU000A NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( s ACC. sLOs. 3.52'7. NON-RESNDT MANLCTI OUTLET 97.50 b SINGLR AE OUTLET LIR. Ex. Occup. OUTLET OR FIXTURES 20 @ E00 BAIL p .so Ex. Occup. Gr.E I'S 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing 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 orth ' h comp) 1�p thos provisions. Date atu App can 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 $ 47. n0 HAZ. D. FEES IMP I FLOOD I COF PARCEL I PD HD ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated bove for which fees have been paid. ' B �� Date ES PERMIT EXPIRES ON ��b�� / afe Receipt No. WHITE-D.D.S.-B.D. CANARY-ASSESSO PINK -INSPECTOR GOLDENROD -APPLICANT 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 major labor and materials for construction of the proposed property un rovement : YES NO D Q2. I HAVE HAVE NOT D signed an application for a building permit for the proposed work. 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: 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: N TE: PROPERTYO SOCIA DATE: -This Owner -Builder Verification is required by Section 198.31 and 19832 of &e. California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit OVER 4 , OWNER BUILDER INFORMATION . I Dear Property Owner: An applicarion 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 record 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 employ or otherwise enrage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer.. ♦ if you are an employer, you 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 contrac9rs 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" on 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. +trely, Vi ira, C.B.O.,uilding Inspection NOTE. This Owner-Builder,lnformation is required by Section 19830 of the California Health and Safety Code- OVER ode OVER Y RESIDENTIAL 030146-17022 _93-5 2 -1 P,E I I LOSETH, KEN & ROMA - - 1909 20TH ST, OROVILLE MHU q .y OFFICE COPY w { Address I � GAS Meter By Date p ELECTRIC j I Meter By Date ) V=OK O=Not OK =NotReadyable MOBILE HOMES Date/Initials MOBILE HOME UTILITIES Plans OK except #'s Zo�R eq u i rements-Setbacks-Easements MH Support Sketch La—Seyter; Location -Test -Fall -C/O Concrete -L.4!VNater•-L66ation-Test-Easement Needed (Sketch) gl:trtLrify; Location-Clearences-Grnd-/ /Amp -Concrete Gaon -Teat -Wrap: / /" L" ft. r/ P'L"ft./ /"LPG _ ? Blue nce & Disconnect tility Clearance Date/Initials MOBILE HOME INSTALLATION (Plana) OK except #'a 1. Zoning Requirements -Setbacks Easements 2 Footings; Size-Spacing-Marrlage Line 3.. Gas; MH Test-Demand-Valve—Connector 4. Electricity; MH Teat -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector r 6. Water; MH Test -Regulator -Connector 1 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch j 10. Cert. of Occupancy MISCELLANEOUS Date/Initial 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 -Rolls 4. Wood Awn.; Posts-Beams-Rftrs: Connectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columna -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sila-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date/Initials POOLS (Plans) OK except #'a 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-Panel boa rds-Ins. to Mein in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test V=OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date/Initials UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-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. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance -Materiel -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16, Insulation Date/Initials 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/initials ELECTRICAL (Permit) OK except #'a 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/Meth. 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 -Mach. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date/Initials MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date/Initials FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Wells 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 & Bearing Date/Initials FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties- Puri ln-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 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation-Walls-Ceilinas 60. Infiltration -Walls -Windows Date/Initials FINAL (Plans) OK except #'a 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. 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 -Mach. Protection 75. Plb., Elec. & Mach. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg: Appliance -Fireplace. -Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Comments at Final: �,.-� p1Snnl�g 0e4ertneent AUG � g �g93 0(OV1118, Cfl11�tOC�11a THERMALITO IRRIGATION, DISTRICT 410 GRAND AVENUE OROVILLE, CALIFORNIA 95965 TELEPHONE 533-0740 C,eV �i<oPev, .. . CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT r`y 3 Service Address: Owner's Name: Date: Address: Acct. No: A.P. No.: Phone: - No. Units: Applicant/Agent: Agents Proof: Address: Fees: Phone: Application $ Arrearage Preliminary Review By: Date: CSA 26 Remarks: ' ' SC -OR 1st mo. S.C. Other Total Fees Collected By: — Date: Field Review By: Date: Remarks: 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 Ift INT —OOUIWTY OF BUTTE - DEPARTMENT OF,PUBL4(,- WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541.��� APPLICATION AND PERMIT / ASSESSOR PARCEL NUMBER — ZONING AR BUILDING PERMI OWNER h TELEPHONE 33-0490 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1660 e Oroville 95965 CONTRACTOR 'S NAME nwnpr TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 15,00 Permit Fee Plan Checking Fee $/20.00—) $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $35.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomef] 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 ❑ Utilities ❑ Installation[ Other ❑ Describe work: MHI _ Z Permit Fee $ Contractor ELECTRICAL PERMIT FiIingFee 15.00 Main service 200AORLESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p J y (check one): ElNON•RESID I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and ef fect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 200ATO1000AI 37.50 NEW CONST. / DWELLING OCCUP.&) OR ADONS. l ACC. BLDGS. // 3.64 sq.ft. NEW CONSTRU MULTI -OUTLET BRANCH C IRC ITS @ 5•�0 POWER APPARATUS tr SINGLE OUTLET CIR. Ex. Occu P OUTLETS OR FIXTURES 20 �6 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 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 FilingFce 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. 1 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 liabilit jes, judgme s, co s, and expenses which may in any y accrue agai st s id Count n ons uence of the granting of this per It. Date `✓ $ignoture o Applicant —� owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee %S 70.00 Energy Inspection Fee OCC CONST TYPE TOTAL FEES 105.00 HAz DFEES IMP �- FLOOD COF PARCEL PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees r By PERMIT EXPIRES D the applicable provi- resolutions to do have been id. i WORKS Da 135704 Receipt No. WHITE-O.P.W.. TELLOW-ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT ."Y. ".<ir' .., '`'�r'l.{-"r�t�i ..v«`� rA"��,.-4 „\.I'-�.n.�.(�..�. r�Yi�-w"f'!-r/^r1'•�.�.,(� U{ud �`ti ..Yu/��Ar-1ti"•w.'-'f.- -�-� • � r ��+ COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMEATSEFcVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHONE(916)538-75410 ELEPHONE(916)538-7541 OWNER PERMIT jQAPPLICATION DATA SHEET APNo Proposed Building Use Building Inspector 0 3p -4/ l -o ZZ _ Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECENED BY 1. All items have been submitted......................................... 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3, Complete plans, 3/4 sets, signed by preparer of plans . ...................... A. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ........................................... . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........ . 10. Fees of $ ............. 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit. ....................................... . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ......... ' 20. Pre -inspection for l Inspection reques- required. . to Building Inspector , (Date) 21. Contractor's license information. (No., Name Style, Classification) . ............... 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use. . 28. Mobilehome utility clearance . ........................................ 111-93 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. When ou issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone v Z,3-600and hold for pickup at ®Gp office. Deliver with inspector. Other Parcel Creation Acreage Applican Date -3 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 issuance: (Circle new item not checked above). 1. Index permiffor above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail C unter by -Date Plans checked by Date Plans approved by tZ lL Date 19-) %3_S Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works L COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CZENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541 V- d�R A.P. NO . 10POSc-D BUILDING USE �r( DATE zs REC . • : DATL_ Rr-c l School Distr_c Fees (pa=d.at District Office) ........................ 3 2. Shen Fees -Bu-f (paid. at lding Department) Residential ......... Z 4 uni t amt. Commercial( per sq . f t .) x =$ 3. sq. ft. Urban Area Fees amt. fiell,�Eolio (paid at Building Department Residential (per unit) X =$ `SQ 7 � a units amt. Commeric--?(per sq.ft.) X =3 sq.=-,-. amt. 4. Recreation Distrtct Fees (paid at District Off'_ce) .......................... 5. Drainage Distr_c= Fees (Contac= Land Development) 6. Other 7. Other .= -t = - appl4caton, was advised the above fareees are recuired to be pa=" t=me O= perm :o issuance of the permit. DA's "' 3 �/3 COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Pleas -e 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 ma' labor ar`d mat rials for construction of the proposed property improvement((yes or no) 2. I <av have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name 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 , D Social Sec r,,*ty N ber > — — Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Heal-th ..and Safety.. Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. �Olal(J�'1 COUNTY OF BUTTE - DEPARTMENT OF. PUBLIC WORKS PERMIT NO. r` 7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 0_30— v61- 62.L ZONING nn A 9 BUILDING PERMIT OWNERTELEPHONE Com✓✓ d�1/1 �ll — 9d SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS _— CONTRACTOR'S /�// LI (MAAII/LING TELEPHONE CONTRACTOR'S ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $' 15.00 Permit Fee $),mo ARCHITECT OR ENGINEER LICENSE NO. Pian Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ DBUILDING ADDRESS -{� Permit fee $ 35.00 PLUMBING PERMIT Filing Fee 15.00 �d�l�lr f a Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE STRUCTURE SF ❑ Duplex[] Mobilehome)6 Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW I @ 15.00 TYPE OF WORK New ❑ Addition[][ emodel ❑ Utilities ❑ I'n//stallation Other ❑ Describe work: IN /�uST 6 + 111W : Permit Fee $ Contractor ELECTRICAL. PERMIT Filing Fee 15.00 Main service 200AORLESS 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 F1APPIXED 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 Main service 200A TO 1000A1 37.50 DWELLING OCCUP.tk\ NEW CONST.OR AODNS. ( ACC. SLOGS. II 3.6d sq.ft. NEW CONSTRMULTI-OUTLET NON-RESID BRANCH CIRCUITS) @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 20 7619 NS EX. Occup. OUTLETS iRESID )gEAJ I 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 consequence of the granting of this permit. X Date Signature of Applicant — Owner❑ Contractor ❑ Agent ❑ An OSHA ion of structures tover 39stories oinehe ght Ions over 5'0" deep and demolition or construct- Mobile Home Installation Fee S %O`er= �. Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES 5 HAz I DFEES I IMP J fL COF I PARC L I PD I HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 35 '70 WHITE-D.P.W.. YELLOW-ASeE350R. PINK -INSPECTOR. GOLDENROD -APPLICANT Retur,;, to DPW AGRICULTURQ, STATEI�NT OF AC�iOWLEDG�EMENT ,... FOR RESIDENTIAL DEVELOPMENT � Section 26-8.1 of the Butte County Code og� o\O oE,9 requires—this acknowledgement be recorded G v 9� prior to issuance of a building permit. �Q► The property described herein is adjacent 93-008906'1 to land or included within an area zoned Rec Fee I Cash 8.00 8.00 for --agricultural purposes, and residents Recorded I of this property may be subject to incon- Official Records 1 veniences or discomfort arising from the County of - I use of agricultural chemicals, including, _Butte I but not- limited to herbicides, pesticides;- i Candace J. . Grubbs I and fertilizers; and from the pursuit I Recorder I of agricultural operations _including-, '— =g:44am -- 4 -Mar -93 -1- PURL XX 2 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 discomfort from normal, necessary farm operations. All that real.. -property., -situate in.the County of Butte, State of California, described as follows: See Attached Date: 3/3/93 PROPERTY OWNERS: / Ex! Ze5ICF r ff State of Calif. ) On this the 3rd day of March , 19 93 , before me, the SS. undersigned Notary Public, personally appeared County of Butte ) Ken Loseth & Roma Loseth ®Personally known to me. [3 Proved to me .on the basis RBARA EDGAR ■ BA �. of satisfactory evidence. a WTAW� be the persons) whose names ) are MyCO,,, ,E*mMam,27:-,051bscribed to the within instrument and acknowledged that -,hey ecuted the same for the purposes therein contained.. IN WITNESS_ Deem■■■■o■■■o■■■■■■oo■■oIEREOF, I hereunto set my hand and official seal. Present A.P. 030-461-022 o. Notar ' u lic 'Order No. V-11169 -CW Page 5 S C H E D U L E C The land referred to herein is described as follows: All that certain real property situate in the County of Butte, Unincorporated, State of California, described as follows: The South 213.0 feet of the East half of Lot 2 in Block 121, as shown on that certain Map entitled, "Map of Thermalito, Butte County, Cala", which Map was recorded in the office of the Recorder of the County of Butte, State of California, June 8, 1887. Said property is also known as Parcel 2, as shown on that certain Parcel Map, recorded in the office of the Recorder of the County of Butte on September 23, 1977 in Book 62 of Maps at Page 71. 1 TNERMALITO IRRIGATION DISTRICT 100 410 GRAND AVENUE OROVILLE, CALIFORNIA 95965 TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: Owner's Name: Date: Address: 1 Acct. No: A.P. No.: Phone: - No. Units: Applicant/Agent: Agents Proof: Address: F ees: Phone: Application $ L " Arrearage Preliminary Review By: Date: CSA 26 Remarks: SC OR . .. - 1 st mo. S.C. Other Total Fees ` Collected By: Date: Field Review By: Date: Remarks: 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 i'�v"q�}a�!�js�+�y.p•�r71�"4��7N �eCSr�"-r/17'7v.�7.Z+'hR�'<'"'.`�'y�^#M�'�j�'r,,•i��✓�71?w5j'�'`'~�.1E��rrT$.R+!thy'},�:�._.,rnYT.+...+!{.n+"i_.^-r:Yr."�+`'„^..r•.....r+..:.�:wr fi BUTTE COUNTY SCHOOLS' WPACT FEE CERTIFICATION FORM ' (One'Form Per Building) �Y�Ca/ •_� School District llV � Building Department No. A.P. Number 4Z�- Jurisdiction 0 City ®^County Property Owner X 05 eia--- Property Location/Address _ Subdivison x Residential Development .Commercial/Industrial • / // / 11.1 ,,2014* S-tree, Lot No. 0 Sq. Footage A ZAO No. of Living - - - Addition (Group R) Units 0., 0 Sq. Footage New Addition (Including Exterior Roofed Areas) Building Department Representative Date fy (Floor Plans reviewed by School District Personnel) District Identfication No. 0.0 .� 8P-0,V;1&School District certifies that cry �• ` (Applicant) 0 (Phone Number) (CRY) (State) Zi Code),415 % �,. has complied with the requirements of Resolution No. Q Jr —910 by payment of $ representing square feet. School District Representative Paid by Check Number Bank Number Paid by Cash � 'Date• Remarks: /t-2.tEL�"Ulf / /C00 , .1 t If,'subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality,Act (CEQA), this,project may be subject to additional school fees to fully_ miti-gate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.wkl (4/92)- ,« COUNTY,OF BUTTE BUIL0146 DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE Los i3 '.j'6 oral Si PERMIT NO. Arou6mbspecdon irdcates that the following violations of Butte County Ordinances exist at the chose a ftem and should be corrected. Please notify this office when correction of work --scow4doeeil-Ifyouhmn any questions pertaining to this matter, or need additional explanation, pieaoe commact tis office immediately. Date ( — / 3 ` ;F Inspector REV low O 'C7 ,; 9 r X3'/3�7 , 9:00 AM At No. JUDGE: HON. S. HOWELL To No. CLERK: M/F OFFENSE DEFENDANT/COUNSEL/CU F 23152a W/3 Prs., 23152b W/3 Prs. SALISBURY, Ronald Ar F 11378 H&S WALLACE, Louis Winfr (110'E to C F 23152a W/4 prs., 23152b W/4 prs., 14601a W/3 prs., CVC ✓WILKINS, Floyd Leroy F 23152a W/3 prs., 14601a W/3 Prs. WILKINS, Floyd Leroy F 2899.3, 14601.1a, 4000a 16028a VC ALLEN, Jeffrey Josep F 11377a H&S ,/ BACKUS, Mitchael Ant r .......................... Inspector must draw a plot plan with all building locations: Additional comments from Inspector: i MCor& All Materials WorkmanShip shall Be in. A000rdeace with Recognized Good Practices and , ✓ `'/ of a qualiV.preeoribed for the 9peomed use in the Uniform Buildings Plumbing &f Mechanical _ Codas and the National Eiectrioal Code. — :- Tis set o.fplans and speciftccatione MUST be . kept on the job at all times and it is unlevrM to make wxy o#anges. or a atarwone .on sine without - a vritten'permiesion from the Department of Public Works, County of Butte. X GO - do ALL STRUCTtR� AND E R OF A �EME�• - OVERHANGS SHALL BE FROM HE SIDE AND A SET BACK of _5 M . FROM THE REAR PROPERTY LINES AND 5 FTCENTERLIN .--- F -(,.FROM THEO AND EQUIPMENT. EXCEPT CLEAR OF STRUCTURtS fbR A 2 FT. EAVE OVERHANG. z Y60 llle4 - / 5- / BU R8 COUNTY y BUILDING DEPARTME AFPR01 ED . 9.S'-2OSZ Y 030-461-022 PERMIT#95-2052 LOSETH, Kenneth L.3 1907 20th St., Oroville Mobilehome Utilities(Replaces Demo SF)' ELECTRIC I00 GAS LINE L! V l Cl COMPACTION TEST REQ. /(i, SUPPORT STRUCT'REQ 030-461-022 PERMIT#95-2373 LOSETH, Kenneth L. 1907 20th•St., Oroville �f Mobilehome Insta`'ilation : /D/3 I �� 030-46-1-02293-5201 LOSETH, LOSETH, KEN & ROMA 93-520 B 1909 20TH ST, OROVILLE" q CONV SF TO STORAGE BLDG J�W' 3 / r- 030-46-1-022 93-521 P,E LOSETH, KEN & ROMA 1909 20TH ST, OROVILLE MHU , .y� ELEC Z d 0 �� � GAS YI - PO 9 (9-1-7-q3 COMPACTION TEST REQ 1.90 SUPPORT STRUCT REQ 030-46-1-022 93-640 E 19072 LOSETH, KEN & ROMA 2 1907 20TH ST, OROVILLE ilka. 7ELEC SERV/SF' 030-46-1-022 93-641 E LOSETH, KEN & ROMA 1909 20TH ST, OROVILLE u3 ELEC SERV/SF 030-46-1-022 93-522 LOSETH, KEN & ROMA 1909 20TH ST, OROVILLE DIHI 030-461-022 PERMIT#94-2014 LOSETH,KENNETH & ROMA 1911 20TH ST., OROVILLE$�2 CONV TO UNDERGROUND ELE & NEW GAS LINE TO MH & SF 030-461-022 PERMIT#951010 LOSETH, Kenneth & Roma 1911 20th.St., Oroville Replace 2 Ele Ser/MH & SF I 030-46-1-022 Permit#95-1891 B(demo SF) �I iq� t 50--- q6) �. D . r RESIDENTIAL 030-46-1-022 96-1052 MHI LOSETH, Kenneth { 1911 20th. St, Oroville I I (PRII/exist site) D & D MH 8 OFFICE COPY =- Address GAS Meter gy ELECT Date t Meter g Date / JOB FINALED (Date) — Signature V=OK DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 0 =Not OK 1. Zoning Requirements -Setbacks -Easements :=NotApplicable MOBILE HOMES eady Date MOBILE HOME UTILITIES (Plans) OK except #'s 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg: Rfg: Bracing 1. Zoning Requirements - Setbacks - Easements 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 2. Soils; Special MH Support Sketch 6. Carports; Windows -Doors 3. Sewer, Location -Test -Fall -CYO -Concrete 7. Electric 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap; / lVit. / /Nat. or/ /'L°ft./ /LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILEHOME INSTALLATION(Plans) OK except #'s oning•Requirements- Setbacks Easements tjpis'$ize.Spacinq-Marriage Line Z4:,EI'ectri 'ty; MH Test -Crossovers -Breakers -Clearances ain:.MH Test -Fall -Flex Connector 49 --Water and Sewer Connected -C/O to Grade -HD Approval as d Electricity Tagged ie Downs -Type -Installation Cert. of Occupancy Date Card B-1 Date Card B-1 Date / --7' Card B Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-DepthSpacing-ConnectorsSteel 3. Decks; Girders and/or Joists-Decking-BracingStairs-Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg: Rfg: Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sils-AnchorsStuds-Rttrs-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, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFl 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtq. Boxes-Enclosures-Panelboards-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 _J OK O=Not OK = Not Applicable Not Ready RESIDENTIAL (; ' = Date UNDERFLOOR (Plans) OK except It's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel -Bloc kouts-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. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 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. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except a'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 n's 22. Fixture & Transformer Clearance -Ins. Protection ----------------------------------------------------------------------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors --------- - ---- ------ - ------ -- ----------------------------- ---------- 24. Size Boxes & No. of Conductors-Stapled ------------------------------------------------------------ --- --- -- ___---------- 25. Rome 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 S ze,GFI ------------------------------------------------------------------- 28. Subfeed Wire Size r r ga. Cu or AI -A.0 Wire Size , ga ___________ Cu or AI 29. Range Circ r , ga. Cu or AI -Oven Circ. I I 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 ------------------------ ...... .......... I ............ ... .. . _ .... . Date Card B-1Date Card B-1 - ............... --............... .. ......-----.-... .. ... ... ... Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except rr's 34. A.C. Ducts Insulation & Support ------ -- - - ..... ........ 35. Vent Fan: Exhaust above insulation -------------------- ---I— .... _. _..... ... _._ 36. Condensate Drain & Overflow: Size. &. Grade ------ - -- .. .... ....... ... ... ........... .. 37 Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet --------- ------ 38 Attic Access & Platform if Furnance in Attic ------------- --- ._. .. Date Card B-1 Date Card B-1 - .. ... . ... . ..... . Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except n's 39 S Is. 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 & Bearing >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 3=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 t+'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector ------------- ---------- ___ ----------- --- - - 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection -------------------------------------------- 64. ....------ ---------------------------64. Bedroom Exiting ------------------------------ 65 --- ----------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. Wir Htr.. Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection ... . - - - ----------------------------- ---- 75. Plb.. Elec. & Mech. Equip. Listed for Location ------------------------------------------ - 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection - --- -------------------------------------------------- 7; Insulation -Foam -Looked in Attic ❑ Yes ----------------------------------------------------------- 78. Guard Rails & Deck Construction -Post Caps --- -------------------------------------- 79 ------------------------------------79 Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes_ 80. Following instld� Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No: Planters ❑ Yes ❑ No - - - -- - - - - - - - - - -- - - - -- - -- - -- --------------------------- 81. Stucco. Brown -Finish - - - - - -- - - - - - - -- - - -------------------------------------- 82 A C Unit: Disconnect. Electrical, Plumbing --------------------------------- -- ----- 83. Vents Above Roof. Plbg.-Appliance-Fireplace.-Clearance to Openings 84 Water Well: Disconnect, Electrical. Plumbing 85 Exterior Elec Trim. G F.I. Receptacle -Underground - - ----------------- 86 ---- ----------86 Ventilation Throughout House 87 Glass Protection - ------------------------------ 88 Corrections from Previous Inspections - -- -- ----------------- 89 Gas Test -Meters Tagged: Gas -Electric - ------------------------------------- 90 Water & Sewer Connected-CrO 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: 1 �rvci%''�-ivh�`9'c%r'N°'1�u'°',,.�'�w'.'"�'"��.a�,-•yN`:�'i����'E"y�`�t��'�� y�tr�^w�.-w,nYrc.�'i�,'.:"�,'w..—:-.��+..y;=:r�l9��m MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION --7 COUNTY CENTER DRIVE OROVILLE, CA 95965 --PHONE (916) 538-7541 . A�%�v PERMIT NO/y�-- Owners: �'�' f�✓�-'sal, Name: S4-'f/I i r?� _ Owners: Address: /6/,// `- 1'1 '1 / Mobilehome S� Year of Manufacturer y�i �`� Manufacture: / Serial number Insignia or k l %5,i/ 94D / orV.I.NC&/ Official approving installation: =ate If thetmobilehome is moved or relocated, the mobilehome installation acceptance shallbecome in alid. This form shall not be used when the mobilehome is installed`on a foundation system. „ -.5l 3B. White -Owner, Yellow -Installer; Pink -Bldg., Gold -Assessor 030 1POUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541PERMIT N RZ O. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 2 ZONING AR BUILDING PERMIT OWNER KENNETH >♦933-0490 TELEPHONE SO. FT. OCC. BUILDING VALUATIO OWNERS MAILING ADDRESS 1911 20TH ST.. F CONTRACTOR'S NAME D & D HONERS TELEPHONE 532-3303 CONTRACTORS MAILING ADDRESS 22 43 I, Fireplace CONSTRUCTION LENDER UNI(NOWN Total Valuation is Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 1911 20TH ST., OROVILLE PERMITFEE $ 43-00 PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome IAX Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑ Describe Work: SII EX SITE — Mobile Home I S I G W 1 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20.'00 Main Service000V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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 L" Lic. No. / za-,q� OWNER -BUILDER DECLARATION 1 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. ❑ 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 NEW CONST. DWELLING OCCUR \ OR ADDNS. ( & ACC. BIDS. / So. 3.5¢ FT. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS ( & SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 sAL Ex. Occup. ( OUTLETS (RLNS.OR ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ! PERMITFEE ; Contractor WORKERS' COMPENSATION DECLARATION I 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 the performance of the work for which this permit is issued. �f I 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 'z_R)/7f4 MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE S Contractor Policy Number/V, .3 f13 (The above sections need notbe competed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 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. Date -/.� Signature of Applicant - ❑ Owner contractor ❑ Agent An OSHA permit is required for excavat o1 ns over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ 100.00 Energy Inspection Fee $ OCC CONST. TYPE I TOTAL FEE $ HAZ. I D. FE IMP I FLOOD I COF PARCEL I FV I HD I ISSUE This permit is hereby issued under of the Butte County Code and/or indica bove for whipp fees ha % '( PERMITEXPIRESON the applicable provisions Resolutions to do work e b n paid. Date S s ��5 Z9 (Date) Receipt No. 195573 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT y COUNT:YOF BUTTE - DEPARTMENTOF0-D 1%ELOPMENTSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET / l V OWNER it tie f r'+ / 10se f A. P. �(� ri� Proposed Building Use ng Inspector CPCJ Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ....................................... . 2. Plot plans, 3/4 sets, signed by preparer of plans . ........................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . ................... 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... ` 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ . ........... r . . . . 0401 ................. Impact fees as'�hown-O atYche sc te.�..1? (. 9� 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year floo�bv-Oalifornia Engineer . ................. . 14. Sanitation and plot plan approval ;1q Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. .17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. . . st 20. Pre -inspection for P��"�e�O" actor required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ....................................... . . Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... �s 27 Letter of intent on building use . ...:...::............................ . A Mobilehome utility clearance. ... .. ........... .... . . 29. Documentation of legal access... . 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . .................................................... 33. 34. W e you issue the?e mit, process as follows: Mail to wrier. Mail to contractor. Telephone � � ZCX3 and hold for pickup at V i^O V i office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date 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 ermit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: ;Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by(,. i t; P, aI Date Sets of plans on hold in File cabinet Z AP folder Copy - Department of Public Works DEIs'A' . 'ENT OF HOUSING AND COMMUNITY; DEVELOPMENT DIVISION OF CODES AND STANDARDS P.O BOX 1407 SACRAMENTO, CA 95812-1407 (916) 255-2501 ". •9 b Tai`. TIEDOWN SYSTEM CERTIFICATION (To be completed bby'the ^mobilehome installation permittee or their representative) R*%r �® (Print Name and Title) hereby certify under penalty of perjury and in accordance with the provisions of the California Code of Regulations, Title 25, Division 1, Chapter 2, Section 1326 that the portions of the tiedown system installed at 1I 2QT�, ST S 6s (Address) (Lot No.) (City) y) (Zip Code) below grade were not damaged prior to or as a result of the installation, were not modified prior to or during the installation, and were installed in accordance with the terms of the listing/or in accordance with plans and specifications of an engineered tiedown system. S - 94 - Z 3, (Signature) (Date) f Note to Installers: - Pursuant to the CCR, T25, Section 1326(d) upon completion of the installation, of the home, they home` manufacturer's installation instruction, the approved plot plan, a copy of the plans and specifications for an engineered tie down system if used, and a copy of any maintenance requirements for the tiedown system, strap be placed within the home for retention by the homeowner. Permit # Dbpartment Use Only District Representative HCD-NAO.21 (9/94) � ... � �a �� �..�. ._ � ������ ter( ----- ----*-�,-�_=--4-�--- � ... � �a �� �..�. ._ � ������ ter( } Mobilehome Manufacturer: FL £.T w 66 s _ Manufacture Year: 9S If other than single wide, furnish Setup Model Number: Width: 26 (ft.) Length:_ (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. FOOTINGS: Wood pressure treated or foundation grade[X] Other: SUPPORTS: ,Concrete block[ x] Other: Provide Tie Down Specifications for all Mobilehomes: G Ro u pjb Loc S y STEms Pier Footings Sizes and Location SINGLE WIDE MULTI -WIDE Line 1 Line 1 Line 2 Line 2 Main Beams Line.............................................................................. '--Line2 Line 1 Line 3 Line 2 ................................................................................................ Main Beams ................................................................................................ Line 2 Line 1 ................................................. ine S Tag'or Triple ine4 F:ine 1 Line 1 Piers: Size minimum: r 1 x Spacing maximum: I From ends -maximum] Line 2 Piers: Size minimum: [ le ] x [30 ]. Spacing maximum: 1 5 ` O` From ends -maximum: 1 ` p ` Line 3 Roof Loads: Size minimum Location (from front): Line 5 Roof Loads: Size minimum: Location (from front): Line 1 Openings Size minimum: 12Y ] x [ 2y.]. Each side of openings with width over: I q ` O ` Line 4 Piers: Size minimum: [ ] x [ ]. Spacing maximum: ` From ends -maximum: ` 2 2y 2 2y x 36 2 XZ 2x36 x3o 2x2. a 111'10" 121Y' A p PAQ, � E UFiLE COPY 96 - lose 1. Owner's Name: KF -W) E r A Lo S E R 2. Assessor's Parcel Number: ()30- 4 6►- 022 3. Installer's Name: 'b + 1 a rA q- 4. 4. Is the site currently under permit? Yes[ ] Nok] Permit No. 5. Is the site an existing site? Yes[x] No[ ] (If yes, furnish two plot plans). 6. What is the electrical rating of the mobilehome? b0 Amperes. 7. What is the mobilehome site circuit breaker rating? 2 00 Amperes. S. What is the electrical rating of the mobilehome site? 2. o O Amperes. 9. Is the main service remote from the mobilehome site? Yes[ ] No[x] If it is, what is -the rating? Amperes. 10. Is there any other electric load to be served by the mobilehome site electric service (i.e. well, garage etc.)? Yes[ ] NoM If yes, please identify the load and size: a) The mobile home site: Load- Amperes - b) The main service: Load- Amperes - 11. Type of gas service at mobilehome site: Natural(x] Propane[ ] None[ ] 12. Size of gas pipe at the mobilehome site from the meter or tank: ► inches. 13. What is the gas pipe length from the meter or tank to the mobilehome? 30 (ft.). 14. What is the mobilehome gas demand? B.T.U.* *(This information is not required if the pipe length is less than:.6 feet on natural gas or less than 50 feet on propane). THE OTHER SIDE OF THIS FORM MUST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION r May 1995 r 8.5 - ad _ .b "►�► 313 yi mer. WA -r Tent wdAff cal YIt011Am6 eF Cttct 4Fl I 1 r- akAL U,1.1't.4d(t4h AO FA �e.Sl� � en—' -Amt. �P� Rfi. 1 , APT1f�Y fAA ITr 94MLLS \ 19.9'14 ir Pat VON - Co. CAAMT Bag nnrtAc� l ly(►IL1 RmFs . gE_i Imp. 4m.Z sa*T• • i . vo.4 30Lor \. _ \ MIN. 2011.1.. fOaD.l- t „ER 114 -MAX. 1DAM.aa wn WZ1 ® O ® 7t i7ft off. " 1 t1YO ® .32 ya/1 g�lq. r+• 1'+� •� - 1 'fir //1 E200 1 A B'.It• 92 a � . 1 IIID 11 1700 2 B / Q (EMRAL MANUFACIURED v r ,1 a sw.3 B 11 e 4 HOUSING CONSIRUCTION dd y 6 SAFEN S(ANDAROS � 3�1r 811 3800 4A e a 9 JAN 30 1995. C 3g'bfl 4,DD sA a'4• 4 CBIVIA/1 « A t(128 fI.00R DIJI1 %AT ed GUILT, 17 0 8100 e B 114'-Q' 31 III AN 6IAt= MIRROR MACS XWOT J - 0 ✓3 f �s•!ME LEMM AND/OR WIM AXIS.. [ / j1 rar yz gym, �S1. '�� SSDO 7 8 e -a-0 n rc cored WINDOW I30ORSCHEDULE Tm; �yAyp — 1'l r LEGEND: m —^ svf'm 'p AEETIYOOD SHT 1 yui vexr p W BICC. o'lI PISCS . p V.P-T �111ar.MAL W r.lutrrin 4c qD It: 4 FLOG PLAN , OF 1 a1At carr Ro. ma'^1O1 — _ :1 AM F1ALr � [pR/oeT/11 ® Ci11t110RR31![Rt watlwc pulwrRr 2•-/i 5D`e(AIC�iy1i1LL� o oowe7 a an 1w ' v � "!� wTc 1 S%(o3 A A . CD D wOb onee'ren ttuO" R(rU1MAl11 tilltli eCM& YK . V -r fV • vo" 8= woXFORM" � _ BUTTE COUNTY.SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Pei Building) School District Oro M-1),-04 ` `� � Building Department No. A.P. Number Q)y' �}�%rt��o� Jurisdiction: 0 City (] County Property Owner Property Location/Address /14/1 4014 Subdivison Lot No. Residential Development 0 Sq. Footage (..o,No. of Living �HC I Addition (Group R) Units JOlac FS co n Citi Commercial/Industrial ' 0 Sq. Footage New Addition (Including Exterior Roofed Areas) Building Depa ent Representative Date (Floor Plans reviewed by School District Personnel) dentificati n No. 960135 District certifies that M Z (•p (Street s��)yy� -� - (Phone Number) (City) (State) _ (Zip Code) has complied with the requirements of Resolution No. ��� �® by payment of $ representing, School Distri t Rep Paid by .Check # Bank Number Paid by Cash squa Remarks: Date If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the. applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink- (school district) feeformmkl (t 1/sa)dmm ri March 17, 1998 Kenneth & Roma Loseth 1911 20th St., Oroville, CA 95965 �.,.ffu tte co, LAN D OF NATURAL WEALTH AN D BEAUTY BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE. CALIFORNIA 95965-3397 TELEPHONE: 1916) 538-7541 FAX: 1916) 538.2140 RE: Building Permit # 97-0622 Expiration D to • 4/29/98 A. P. # 030-461-022 With reference to the above subject, our records. indicate that your building permit expires on the above date and your permit falls into the category marked below: [ ] Permit work started, but not completed. Permit may be renewed for 1/2 the original building permit fee (plus a $20.00 filing fee). The renewal permit will extend the building permit for an additional year from the original expiration date. Should you not renew your permit within 30 days of the expiration date, all work must cease until a new building permit has been issued. For your convenience, we are enclosing a renewal application form and owner -builder form to be completed and signed by you where indicated and returned to this office together with the fee' shown. Please return all copies of the application form. [X] No inspections have been made on permit work. Inspections are required to verify code compliance.. We are unable to renew a permit where the work has not been started and inspected prior to permit expiration. After expiration of your permit, no work may be started until a new permit has been issued. If our records are in error or should you have any questions concerning this matter, please contact the Oroville office. Thank you for your prompt attention concerning this matter. Yours very truly, Michfael C.1 Vieira, C.B.O. MCV:ahb Manager, Building Inspection Attachments Chico Office - 1469 Humboldt Rd/891-2751 1 RESIDENTIAL C75 x.373 __4 030-461-022 PERMIT#95-2052 LOSETH, Kenneth L. 1907 20th St., Oroville Mobilehome Utilities(Replaces Demo SF) OFFICE COPY Address • 1 GAS Meter By Date ELECTRI Meter By - Date JOB FINALED (D� %,lgnature r J=OK O = Not' Ok NotApplicable MOBILE HOMES Date MOBILE HOME UTILITIES Plans OK except #'s Date -DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s Z ing Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements So' ,"Special MH Support Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel L.SA-er; Location -Test -Fall -C/O Concrete 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails . Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors . ctricity- Location-Clearences-Grnd-/ /Amp -Concrete Shthg.-Rfg.-Bracing . A. Gas;ation-Test-W a 'L" ft. 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures p: , / Nat. or/ /"L"fI /"LPG 6. Carports; Windows -Doors ell Clearance & Disconnect 7. Electric 8. Utility Clearance 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings i 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-Panelboards-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 I a • 4 MISCELLANEOUS Date 7ZTCard B-1 /Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE OME INSTALLATION (Plans) OK except #'s onin ..Requirements -Setbacks Easements ootin s; Size -Spacing -Marriage Line a� Test-Demand-Valve—Connector lec ity; MH Test -Crossovers -Breakers -Clearances Drain; MH Test -Fall -Flex Connector er; MH Test -Regulator -Connector 7 and Sewer Connected -C/O to Grade -HD Approval sad Electricity Tagged xits; p. -Sketch ert. of OccuWcy Date Card B-1 Date Card B-1 Date Card B-1 Date Card 13-1 ✓=OK O = Not OK -=Not Applicable Not Ready RESIDENTIAL (: = Date UNDERFLOOR (Plans) OK except ff'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. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-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. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 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. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except ft'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 fr'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 Sizer ! ga. - Cu or At - - ------------------------ 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. 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 n's 34.- A. -C.- Ducts Insulation & Support ------------------------------------------------------------------------- 35. Vent Fan: Exhaust above insulation --------- - - ------------------------------------------ 36. -------------------36. Condensate Drain & Overflow: Size & Grade -------------------------------------- ------ ...-.. - 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic ---------------------------- ---------------------------------------- ------------------------------------ Date Card B-1 Date Card -B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except H'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 & Bearing c '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 3' -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 ff's 61. Ext. Steps -Door & Sidelight Protection -Landings 62 Smoke Detector -------------------- 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. 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 -Doo -r: Swing -Landing -Closer --------------------- - 73. A.C. Duct in Garage -Damper -- ---------------------------- __ 74. - -----74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection ----------------------------------------- - 75. Plb.. Elec. &Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection ------------ -------------- 7;-.- Insulation -Foam -Looked in Attic ❑ Yes ------------ 78. - Guard -Rails & Deck -Const ruction- Post Caps ---------------------- ----- 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.: Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No: Planters ❑ Yes ❑ No -------------------------- ------------------------ 81. Stucco: Brown -Finish --------------- --- - 82. A.C. Unit: Disconnect. Electrical, Plumbing ------ ---- ---------------------------- -- - 83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to Openings - - - - - - -- -- ----------------------------------- --- 84. Water Well: Disconnect, Electrical, Plumbing - -- - ----------------------- - ----- ____ -- - 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House -- -- ----------------------------------------- 87. Glass Protection -. .................. --------------------- --------------------- 88. Corrections from Previous Inspections .. - --------------------- ------ --------------------- 89. Gas Test -Meters Tagged: Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates - --- ----------------------- --------------- --------- Date Card B-1 Date Card B-1 --------- -- - - ---------------- Date Card B-1 _ _ Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754 PERMIT PERMIT NO. APPLICATION AND PERMIT 7R145--JaM;2 ASSESSOR PARCEL NUMBER 030-461-022 ZONING AR BUILDING PERMIT OWNER KENNETH L. LOSETH TELEPHONE SO, Fr, OCC. BUILDING VALUATIO OWNER'S MAILING ADDRESS 1911 20TH ST OROVILLE, 95966 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER ATONE 1\ 1� UN -OWN Total Valuation $ - LENDER'S MAILING ADDRESS Fling Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER NONE23.00 LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ' ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 1907 20TH ST PERMITFEE $ OROVILLE PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23,00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome 6 Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities d Installation ❑ Other ❑ Describe Work: REPLACES DEMO HOUSE x95-1891 Mobile Home @20.00 60-00 PERMITFEE Y 80.00 Contractor ELECTRICAL PERMIT Filino Fee 20:00 Main Service E00V OR LESS ( 20.A OR LESS ) 23.00 P Main Service ( 200A TO 1000A ) 46.00 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 1 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. ❑ 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 NEW CONST. DWELLING OCCUR OR ( 8 ACC. BUDS. ) SO. 3.SQ FT. NEW CNS. CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( OWER APPA—Us ) 8 PSINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) BA2L 0 I•50 L .SO EX. Occup. (OFIXED UTLETS(RESS OR S.00 Temporary Service 23.00 Mobile Home Facilities 20.00 20.00 Misc. Wiring 23.00 PERMITFEE $ 40.00 Contractor 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 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 Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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.) `0 1 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 Date ��� 4Signature o Applicant - ❑Owner ❑ AContractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or constructions of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 143.00 HAZ. _ I D. FEES IMP FLOOD CDF PARCEL PD HD tSSU This permit is hereby issued under the of the Butte County Code and/or indic d o e for hich fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. .� • �S _ QDate (Date) Receipt No.185249 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT VG COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILL; CAU`FORIA95965 -TELEPHONE (916) 538-7541 PERMIT_ APPLICATION DATA SHEET OWNER Ke nn 4 O O l '' 1 A. P. No. O ' "�! r O�oC Proposed Building Use Building Inspector Date g a At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. 2. All items h e been submitted. . Plot plans& 4 sets, signed by preparer of plans . ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form. ........... ............................ . 6. Energy Design Compliance and supporting documentation . ................. . 7. Statement of Intent for Non -Heated and A/C Buildings. .................... . 8. Engineered truss details and layout in duplicate (required prior to plan check). .... / 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11.• Impact fees as shown on attached schedule . ......................:....... . 12. California Department of Forestry plan approval/fees......................... 14. Flood elevation letter (100 year floodllbaG ornia Engineer. ............ . Sanitation and plot plan approval Health Department . ............ 1 City of Chico plumbing permit. ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............ . 17. Planning approval for'(A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 04 Driveway permit (construction approval required prior to occupancy). ... . . Preanspectionrequ� LLLUUU Pre -inspection for required. ; :,. to Building lnspedor (Date) 21. Contractor's license information. (No., Name Style, Classification). .....:-1-1: 22. Certificate of Workmans Compensation Insurance. ...................�.•... 4� 23. Owner -Builder Verification (Given to owner , Mail to owner _). ........... ESM+ 4. Recorded copy of Agricultural Acknowledgement Statement. .................. N. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... �^ 27. Letter of intent on building use . .......................t .................. T 28. Mobilehome utility clearance. 29. Documentation of legal access . ..................... ; .................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... c ' 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. M 34. When you issue the,permit, proc ss as follows: Mail to owner. Mail to contractor. e Telephones and hold for pickup at /r`�rvot�i //P office. Deliver with inspector. Other V Parcel Creation //��� Acreage ApplicantDate 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 issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: S Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by 113 Ba ✓ c . Date Jm 9j Sets of plans on hold in File cabinet 3 AP folder Copy - Department of Public Works y THERMALITO IRRIGATION DISTRICT y 410 GRAND AVENUE OROVILLE, CALIFORNIA 95965 + TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT MONTHLY SERVICE CHARGES WILL COMM ENCE,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 Service Address: Owner's Name: J Date: Address: (: Acct. No:),/ A.P.No.:�, Phone: s" No. Units:i'�,—I'-' t 'It Applicant/Agent: Agents Proof: Address: Fees: Phone: Application $ Arrearage Preliminary Review By: Date: CSA 26 00 Remarks: _ - . , , ,.: t,1 . SC -OR -1st mo.'S.C. aAk kt; a . , - _!.A . • Other Crj . A Total Fees Collected By: + C; M AAJ ?... �•: r _ rx..V. s L J A.•, Date: Field Review By: Date: Remarks: MONTHLY SERVICE CHARGES WILL COMM ENCE,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 Attention Property Owner: - - An "owner -builder" building permit has been applied for in .your name and bearing your _ - - - signature_ _ = - Please complete and return -this -information at your earliest 'opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. . 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement :.YES[A NO[ J. - 2. I HAVE[X] . HAVE NOT[ J 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: 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: 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: PROPERTY OWNER: SOCIAL SECURITY NUMBER: DATE: 9 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. 9 !\Itrr,T 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 awire that as "owner -builder" you are the responsible party of record 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you 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. 0 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. 0 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 "ownerbuilder" 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 contractors 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" on 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. Sinccrel` r. j mac„ Micha4l C. Vierra, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OWNER PERMIT_�� .MH UTIL.CLEARANCE DATE. _ INSPECTOR ELECTRIC GAS Support Struc. Compaction Test Re . .vice Other Pipe YES NO Y -S. NO re Load. Type Size Length /�,, /UST; : N c/ H.I.- 2 Mobilehome Manufacturer: (,11)°n P7ui`( Manufacture Year: If other than single wide, furnish Setup Model Number: Width:-q(ft.) Length: ,, (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. . . FOOTINGS: .:Wood-,.pressure..treat_eo,.or- foundation grade[) _ Other y � . r .., ,..._ , SUPPORTS: Concrete block] C)ther: r , Provide Tie Down Specifications for alf �v. Mobilehomes: I 1 C -4,7 y IZ j J TR r srA T-£ TEsrr j V M 94 M 66 cc � Pier Footings Sizes and Location SINGLE WIDE MULTI -WIDE Line 1 Line 1 Line 2 Line 2 Main Beams Line2................................................................................................ ine 2 Line 1 Line 3 Line 2 ................................................................................................ Main Beams ................................................................................................ Line 2 Line 1 ................................................. Line S Tag or Triple ine 4 ine 1 Line 1 Piers: Line 1 Openings Size minimum: r 1 x 3d . Size minimum: [ ] x [ ]. Spacing maximum: Each side of openings From ends-maximum:1 ON with width over: ` Line 2 Piers: Line 4 Piers: Size minimum: [) �] x [ ]. Size minimum: [ ] x [ ]. Spacing maximum: 4 '6'' Spacing maximum: ` From ends -maximum: I D From ends -maximum: ` Line 3 Roof Loads: Size minimum Location (from front): Line 5 Roof Loads: Size minimum: Location (from front): OVER FILE COP"vY 2 1. Owner's Name: 2. Assessor's Parcel Number: 2 Tne*ellaea r'e Noma- ` `4, 4.- Is tlie��site carrently under.permiV -Yes No( ] PermitNo.,t', 5. Is the site an existing site? Yes[ ] No (If yes, furnish two plot plans). 6. What is the electrical rating of the mobilehome?© Amperes. 7. What is the mobilehome site circuit breaker rating?Amperes. 8. What is the electrical rating of the mobilehome site? 106 Amperes. 9. Is the main service remote from the mobilehome site? Yes[41 No[ ] If it is, what is the rating? W a Amperes. 10. Is there any other electric load to be served by the mobilehome site electric service (i.e. well, garage etc.)? Yes[ ] No[)� If yes, please identify the load and size: a) The mobile home site: Load- Amperes - b) The main service: Load- Amperes - 11. Type of gas service at mobilehome site: Natural[] Propane[ ] None[ ] 12. Size of gas � pipe at the mobilehome site ` from the meter or tank: r inches. 13. What is the gas pipe length from the meter or tank to the mobilehome?3� (ft.). 14. What is the mobilehome gas demand? Q� ((� B.T.U.* *(This information is not required if the pipe leng is less than 6 feet on natural gas or less than 50 feet on propane). THE OTHER SIDE OF THIS FORM MUST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION May 1995 8.5 t .. .. .�` tr..•w.;�,.�a„..,.�.�b,-:.��fr�Qa[i>"1�.'.'`�:`�q�tk"4"� �'��iR P �[l Z' .fiT h r.:e:a�f{•r•'i'Y%.3�.dp�wi-...arr•.�i���h..�...�,CY.•. ...:�'r.. ;N. '.40 .. ' BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM 1 .(One Form Per Building) School District �►^p rti �,� n ; p r j. Building Department No. A.P. Number i Jurisdiction: City [ County Property Owner Property Location/Address Subdivison Residential Development 0ITV No. of Living MHI Units Commercial/Industrial 0 New f 6 Lot No. Sq. Footage e j' o Addition (Group R) Addition (Group demo sg-� r Sq. Footage Addition (Including Exterior Roofed Areas) g -h /9, Building DepartmentlTepresentative — Date (Floor Plans reviewed by School District Personnel) District Identification No. 960037 ,iil� lU. School District certifies that - ,(Appli ant) (Street Address) ai�u'111� (City) (fie) has complied with the requirements of Resolution No. S'kD by pay representin^� square feet. As 2926 A)i I t-" FULL MITIGATION r Paid by Check # Bank Number Paid by Cash (Phone Number) (Zip Code), , nento $ Date Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the -California Environmental Quality Act (CEQA), this project may be+subject to additional school fees to fully miticiate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) , feeform.wkt (11/94)dmm i • a T' _ ... ,. :... - ...-%a;.e:-"1'^ •''��-r`�u"�+•'i,, ?"`�"4.i'7°i?�:,�;�9tY��.'�'#"};�`'���� ...,`'z; "u`.,...yq„r; :, �i:�w��t�.r^�'�, ' .. ��•. � � Tial �j, e-+� .�' , v��, , • � t . `, "arm:' � d%,i��!'�' f�� }fs✓ �. s i . `, "arm:' � d%,i��!'�' f�� }fs✓ �. 4 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Cglifornia 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT p ASSESSOR PARCEL NUMBER 030-461-022 ZONING BUILDING PERMIT OWNER KENNEIEH & ROMA LOSETH T53 N3-0490 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1911 20TH ST OROVILLE, 95965 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAIUNG ADDRESS ' Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAIUNG ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGADDRESS 1911 20TH ST PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 OROVILLE Each Trap 7.00 LOT NO. SUBDNIS ION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome EY Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 01 Installation ❑ Other ❑ Describe Work:PERMITFEE — To 41 Mobile Home Tfl-dT TS—dW @20.00 $ Contractor ELECTRICAL PERMIT Filina Fee 20.'00 REPLACE 2 MAIN SERVICE RE:94-2014 Main Service ( 800VOR LEss ) 2 23.00 • 200A OR Main Service ( 200A TO IOOOA ) 46.00 LICENSED CONTRACTOR'S DECLARATION f 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 1 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, army 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 NEW CONST. DWELLING OCCUR SD. OR ADDNS. ( 8 ACC. UDS.) 3.52 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER SINGLE APPAOUTLETIRATUCS ) 8 R. EX. Occup. ( OUTLET OR FIXTURES ) 20 @° I.- BAL 0 .50 Ex. Occup. FIXED . OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring CREDIT 23.00 23.00 PERMITFEE $ 43.00 Contractor 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 the performance of the work for which this permit is issued. 1 ❑ 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 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 pr isions. X ____ Date l _ Signatu a of Applicant - Owner ❑ Contractor ❑ Agent An OSHA permit is require for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee Is Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ 43.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL PO HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated ab a for which es have been paid. , f q c�C/ Dat PERM ITEXPIRESON (D e) Receipt No. 176082 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDI DIVISION 7 County Center Drive - Oroville, California -95965 - Telephone (916 38-7541 PERMIT No. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-461-022 ZONING BUILDING PERMIT OWNER KENNETH &ROMA LOSETH TELEPHONE0490 SQ. Fr. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1911 20TH ST OROVILLE, 95965 CONTRACTORS NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNW40WN Total Valuation $ LENDERS MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 1911 20TH ST PERMITFEE S OROVILLE PLUMBINGPERMIT Fling Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome EX Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities IX Installation ❑ Other ❑ Describe Work: Mobile Home S G W 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20:00 REPLACE 2 MAIN SERVICE R r. e 94-2014 Main Service ( e00v OR LESS 2 200A OR LESS 23.00 23.00 Main Service ( 200A TO 1000A 46.00 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law or the following reason: 1, 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. ❑ 1, 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 NEW CONST. DWELLING OCCUP. OR ( 8 ACC. BLDS. SO. 3.50 FT. CNS. NEW CONST. MULTI.OUTLET NON-RESIO. ( BRANCH CIRCUITS 97.50 ( POWER APPARATUS & SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) 20 Q 1.00 BAL .00 Ex. Occup. (oFFIXED LET3 E ISIS D.OR / 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin gCREDIT 23.00 23.00 PERMITFEE S 43.00 Contractor WORKERS' COMPENSATION DECLARATION I 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 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 Filing 9 Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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 forthwi comply wi ose pr sions. / Date ! 9rj_ Signatu, a of A plicant- Owner ❑ Contractor ❑ Agent An OSHA permit is require 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 $ 43.00 HAZ. I D. FEES I IMP I FLOOD I DF PARCEL PD HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated a ve for whi ch es have been . /2� i� Dat L PERMITEXPIRESON L I (&e) provisions to do work paid. / (D Receipt No. 176082 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvemerdr=Y ] NO[ ]. 2. L(�] HAVE NOT[ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: 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: 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: PROPERTY OW. SOCIAL SECURJTY NUMBER: DATE: 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 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 party of record 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you 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. 0 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. 0 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 "ownerbuilder" 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 contractors 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" on 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. Sincerel , Michael C. Vie6a, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER I i PERMIT#94-2014 f i ` ( .•_ a� r eLOSETH , KENNETH '& ROMA' :, . , � x 20TH .ST,. ; OROVILLE CONV TO UNDERGROUND ELE & NEW GAS. LINE TO MH & SF r �0;71� . ,A COUNTY PF BUTTz - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION _ 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 �/ ..,PERMIT N ; �' •. ' APPLICATION AND PERMIT ,>)r ASSESSOR PARCEL NUMBER +-, / ��� i /a -I—n22 I" ZONING wSOTLDING PERMIT OWNERy r ,G� I 0-MTH & Rnm uwpn4 TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS " r 1011 1 21M SI, 01ROUTU�LE,$ GA Q59fi CONTRACTOR'S NAME , 1,T►,TI~ TELEPHONE CONTRACTOR'S MAILING ADDRESS ' Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS ' Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE'NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS 3. • Penalty $ BUILDING ADDRESS j 1911 ion ST.,OROViz PERMIT FEE $ 4 ' PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. , ^ SUBDIVISION'S NAME S PARCEUMAP Solar or heat pump water heater 23.00 Water piping 15,00 Each gas water heater or vent 15.00 USE OF STRUCTURE t _ SF El Duplex O Mobilehome 5 Other � �� SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00, ' TYPE OF WORK- "+ New O Addition O Remodel ❑ Utilities ® Installation. ❑ Other O ��, 111 r Describe Work: C01W TO WDERMUND & NEW GAS d PERMIT FEE $ `3 • UV Contractor ELECTRICAL PERMIT Filing Fee 20.00 TO IM 0 GSL+ J.V CiEl a �7.0 Main Service 6OOV OR LESS ( 200A 0R LESS ) 23.00 i Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OR ADDNS.( BACCBDS. ) T. 3.50 Frk.., CONTRACTORS LICENSE LAWr/JI I declare uider penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ' I I, as the owner, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec -7044) D I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) B SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. 50 . Ex. Occup. FIXED APPWS. OR p' ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O 1 have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith-eomply with such provisions or this permit will be revoked. PERMIT FEE 43. Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor 1 certify that 1 have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the Countyof 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 in conseuence of the granting oti t is permit. �- unt�of XDate nt - O'OvOner Con ractor ❑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 TOTAL FEE $ 71 HA2. I D. FEES I IMP I FLOOD I CDF PARCEL PD HD ISSU 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. BY ' Dat I// PERMIT EXPIRES ON /Date Receipt WHITE-D.D.S.-B.D. CANARY -A ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Galifornis 95965 - Telephone (916) 538-7541PERMIT N APPLICATfON AND PERMIT % ASSESSOR PARCEL NUMBER 030-461-02,21 ZONING DING PERMIT ' OWNER ° G �Q SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1911 -I 20TH, ST OR011ITTE, CA 9596S , CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 1911 20TH ST., OROVILLE PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Water piping 15.00 Each gas water heater or vent 15.00 USE OF STRUCTURE SF ❑ Duplex Cl Mobilehome IN Other SPECIFY Gas piping system 1 - 5 outlets 2 15.00 Building sewer Mobile Home S G W K TYPE OF WORK New O Addition O Remodel O Utilities MInstallation ❑ Other O Describework: CONY TO UNDERGROUND & NEW GAS LINE PERMIT FEE $ 5 Contractor ELECTRICAL PERMIT Filing Fee 20.00 TO MH & SF OR LE Main Service ( OOA O100VR LESS ) 23.00. Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. ) S°. 3.50 FT, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. 1, as the owner, or my employees with wages as their sole compensation, 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 contractors. (Sec 7044) 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET •NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. 1@ .50 FIXED APPWS. OR Ex. Occup. UTLETS (flESID.I EA. ) (O 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiiing, 23.00 I 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 43.00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood H 6.50 Ventilation PERMIT FEE $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said unty ' consequence of the P ranting o tis permit. X Date ature of Applicant - CYOWner ZI Con ractor O 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 I TOTAL FEE $ -ISSU HAZ• I D. FEES I IMP I F100D CDF PARCEL PD NO 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 h ve been paid. r B Dat PER MIT EXPIRES ON IDer Receipt No. WHITE-D.D.S.-B. CANARY -A ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYIOF BUTTE ' BUILDING. DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road "C oCA (916) 891-2751 7 County Center Drive, Oroville, CA - (916).538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please cont ,#ct this office immediately. Date Inspector��/ REV 10/92 COUNTY OF'BUTTE Departmentro Development Services Building Division • " " ' Oroville: 7 County Center Dr:, Oroville.CA 95965 Ph: 916-538-7541 Chico: 1469 Humboldt Rd., Chico 'CA 95928 Ph: 916-891-2751 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building .permit. No building permit will be issued until this verification is received. 1. I.personally plan to provide the major labor and materials for construction of the proposed property improvement - (yes or no) fir -ems . I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name 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 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- 4 1 Property Owner_�1/ Social Security Number Date 7 20 —174-1 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 permitted to issue the permit. - UN- Y OF BUTTE - DEPARTMENT OF'PUBLIC WORKS 6ERMIT NO. / 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 (V/ APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-461-022 OWNER ZONING AR BUILDING PERMIT Ken & Roma Loseth TELEPHONE 533-0490 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1660 Leta Lane Oroville 95965 CONTRACTOR' 5 N AME nwnpT- TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 0\, . LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE No. Filing Fee $,•� � �� ' Permit Fee Plan Checking Fee $ � 20.00 $ �----' ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $'20. 00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION �� NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex[] MobiiehomeK] Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W 3 @ 15.00 45.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ® Installation Other ❑ ❑ Describe work: MHU Permit Fee $ 60.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service OR LESS 200AORLESS 18.50 m CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑I am licensed under p prOVISIOnS Of Cha t. 9, Div. 3 of the BUSIneSS and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, Or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 200A TO 1000A,. 37.50 NEW CONST. / DWELLING OCCUP.&) OR ADDNS. l ACC. SLOGS. // 3.64 sq.ft. NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 /POWER APPARATUS 6) (SINGLE OUTLET CIR. Ex. OCcup(OUTLETs OR FIXTURES20 @ 75 FIXED APPLNS. OR Ex. OCCUp. OUTLETS IRESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 1 15.00 15.00 Misc. Wiring -15.00 Permit Fee $ 30.00 46, 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 I 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. Not ce 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 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 IIabIIiti s, judgment costs and expenses which may in any way accrue ag t s 'd County i o seq nce of the granting of this per it. - Da e Signature of Ap icant — OwneContractor ❑ Agent An OSHA permit is required for exations over 5' " deep and demoliti or construct- ion of structures over 3 stories in h,? ht. �� Mobile Home Installation Fee S Energy Inspection Fee $ occ - - - CONST TYPE TOTAL FEE $ HAZ OFEE IMP FLOODi s�11 CDF PARCEL HD ISSUE This permit is hereby issued under the sions of the Butte Count ode and/or work indicat ab ve which fees T OF PUBLIC By PER XPIRE Date / applicable provi- resolutions to do have been paid. WORKS to 3 Sri Receipt No. 135704 3Jrvp��� �8� WHITE-D.P.W.. T LLOW-A96(9SOR. INK -INSPECTOR. GOLDENROD -APPLICANT OOUNTYOF BUTTE - DEPARTMEN�DEVELOPMENT SEI VICES - BUILDI IVISION f 7COUNTY CENTER DRIVE - OROVILLE CALIORNIA95965 -TELEPHONE (916) 538-7541 PERMIT PPLICATION DATASHEET OWNER e 9,a, C US2 l A. P. No. 630' Proposed Building Use �� - !J ' Building Inspector Date 3 3 �3 At time of permit,application, I was advised the following .data must be submitted prior to permit processing and/or issuance: ' l I DATE RECEIVED BY qi%Allitems-have been submitted. Plot'plansj3 4 sets, signed by preparer of plans . .................. Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans. ........� ... . 5. Hazardous Material Form. ......... ,............................. ...... . 6. Energy Design Compliance and supporting documentation . ................. . 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout' in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ ...................................... . 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year floodd) b_y California Engineer . ................. k, 6L�14. Sanitation and plot plan approval / Health Department . ............ zts 15. City of Chico plumbing permit. ........ .......................... . Plot plan and business license approval rom City of Biggs/Gridley. ............ . 1 Planning approval for (A) Use: - (B) Parking: ` .E 6 t t7 ........ 3 i Contact Land Development about (A) Improvements (B) Drainage. ........... :5 rl 19. briveway permit (construction approval required prior to occupancy). .. .. .. . v Pre-Inspecb.n request 20. Pre -inspection for, required. .. to Building Inspector. (Date) 21. Contractor's license information. (No., Name Style, Classification) . ........... 22. Certificate of Workmans Compensation Insurance . ......................... . 23. Owner -Builder Verification (Given to owner , Mail to owner ............ k 4. Recorded copy of Agricultural Acknowledgement Statement . ................. „y� 25. Letter of signature authorization . ..................................... v>. 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use. ......... 28. Mobilehome utilityclearance. t ... . 29. Documentation of legal access . ..................... :........... .... . 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. ..........r. • .. . 31. Existing violations/expired permits . ....................................... In j32.3. Pip check list. .... ....... . faz 33. Py�tfi ?a �iUNI��' f' ('�f'6iN .1� STo �i44( 3 3 34. . Wheq you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone5,B- Qq'?Q and hold for pickup at office. Deliver with inspector. Other ZZ Parcel Creation -;73 Acreage Applican Date 7& Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept.. 9ther Date By The•following data must be submitted prior to1ppirmit is uanc . (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by phone _.mail C /inter by Date Contractor, designer, owner, was advised of above required data by _ phone _ mail ounter by _ Date Plans checked by Date Plans approved by Date l g3 Sets of plans on hold in File cabinet AP folder Copy - Department¢r5y�IigWorks COUNTY OF BUTTE - Department of Public Works. 7 County Center Drive, Oroville, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-538-7541 An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return. this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will 'be issued until this verification is received. 1. I personally plan to provide the major labor and / -materials for construction of the proposed property improvement yes r no) 2. I ave have not) \ signed an application for -a building. permit fol -proposed '%Tork. 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: . po 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 Owne Social Se rit, NGmbAf�— Date. NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and - 19832 of the California_Health--and-.Safety Code: - This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DF_PARTMENT OF- PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER QSO , Z Z ZONING - %2 BUILDING PERMIT OWNER C�i�fvl �oS�� TELEPHONE �33royya SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS d /_ e 4-er Liv e�aoie 5, s CONTRALTO 'S NAME _ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ —I_C_0A— Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS " Permit fee $ p,(0bYY� PLUMBING PERMIT Filing Fee 15.00 IneVM�,L� o Each Trap I 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 1 7.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeM Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 Building sewer 1 15.00 Mobile Home S W 015.00 �a TYPE OF WORK New ❑ Addition ❑ Re�mnod/el ❑ Uti litiesa Installation❑ Other ❑ Describe work: /V/ /�' V Permit Fee $ d CD.5� Contractor ELECTRICAL PERMIT Filing Fee 15.00 00V OR LESS Main service 200A01LESS 18.50 Main service 200A TO 1000AI 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.SINGLE 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) ❑ 1 am exempt under Sec. Business and Professions Code for this reason OCCUP.01 NEW CONST. DWELLING OR ADDNS. ACC. BLDGS. // 3.6Qsq.ft. NEW CONSTR. ULTI.OUTLET NON•RES10 BRANCH CIRCUIT @ 5.00 POWER APPARATUS tr OUTLET CIR. EX. OCCUp(OUTLETS OR FIXTURES 20 @ 76FIXED ALNS,d EX. Occup. OUTLETS PIRESID IREA.� j 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 5. ba Misc. Wiring g 15.00 Permit Fee $ 3O 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 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 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 consequence of the granting of this permit. X Date Si nature A Applicant of g pp — Owner❑ Contractor ❑ Agent ❑ An OSHA ion of structures tover 39storiesoinehe excavations over 5'0" deep and demolition or construct- Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $90 HAz 1 0FEES I IMP I FLOOD I COF I PARCEL PD HD 1 ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 1,3570V WNITE"D.P.W., TCLLOW-ABBE»OR, PINK -INSPECTOR, GOLD ENROO-APOL I CANT THERMALITO IRRIGATION DISTRICT • 410 GRAND AVENUE OROVILLE. CALIFORNIA 95965 TELEPHONE 533-0740 Sloe - N° 968-- M- Z11, CSA 26 SERVICE APPLICATION AND CONNECTION PERMIT -SEWER / 0 Service Address: " i Owner's Name: Date: Address: 1267, .2Q/ �r Acct. No: A.P. No. Phone: No. Units: Applicant/Agent: `r " A. s roo Agent /:f r� �/ Address: / , � \�� f \ Fees: Phone: Application $ Arrearage Preliminary Review Bir Date: CSA 26 Remarks: SC -OR 1st mo. S.C. Other Total Fees Av Collected By: Date: - — Field Review By:0:, r Date: — .o91f d i C' MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON: ate 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 - TIO, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID THERMALITO IRRIGATION DISTRICT ., 410 GRAND AVENUES V OROVILLE, CALIFORNIA 95965 -TELEPHONE 533-0740 CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: 7 i'; - �•1 " t. Owner's Name: r,r,-. rI. L,,,.. _.1. Date: Address: 1 1 - Acct. No: "rv2�' U4 A.P. No.: Phone: No. Units: Applicant/Agent: Agents Proof: Address: Fees: Phone: Application $ = u Arrearage Preliminary Review By: Date: CSA 26 Remarks: rl� ! t� , , , ,r_c :. �, SC -OR i st mo. S Other Total Fees �/ Jf= '7r r.��.�' f0' -- Collected By: Date: Field Review By: Date: Remarks: 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, 1.974). DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW -to TID COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, Califoelia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030-461-022 ZONING AR BUILDING PERMIT OWNER Ken & Roma Loseth TELEPHONE 533-0490 S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1909 20th St. Oroville 95965 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT FiIingFee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF EJ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW 1 615.00 TYPE OF WORK New❑ Addition❑ Remodel[-] Utilities❑ Installation❑ Other E] Describe work: New Main Service Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AOR ORLESS 18.50 18.50 CONTRACTORS LICENSE LAW I declare under penalty of ur p y perjury f y (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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason Main service 200A TO 1000A). 37.50 NEW CONST. DWELLING OCCUPM OR ADDNS. ACC. BLDGS. / 3.64sq.ft. NEW CONSTR. MULTI. OUTLET NON.RESID BRANCH CIRCUITS)POWER 5.00 APPARATUS 61 ( SINGLE OUTLET CIR. / EX. OCcU OUTLETS OR FIXTURES P 20 76 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 1 -15.0015.00 Permit Fee $ 48.50 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. Notce 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 1 15.00 Heating Cooling 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 es, judgments, ts, d expenses which may in any way accrue 'County in c se uen of the granting of this per t.Date 4ns Applicant — Owner Contractor ❑ Agent An OSHA ion of structures tover 39storiesoineheighttions over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ Occ CONST TYPE TOTAL FEE $ 48.50 HAZ 11 FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte u Code and/or work indica 0 or which fees I OF PUBLIC By PE MI EXPIRES Date applicable provi- resolutions to do have been paid. WORKS ate S� 9 101 Receipt No. WHITE-D.P.W., YELLOW -ASS ;OR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your. signature. Please complete and return this iriformation at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I .(have/have not signed' ari ' 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. �ovide- ortions.of-this work but I have hired the folr6win person .'..�:�. I� plan ---to p~ p- � g P ' 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 Social SecAirit}umber Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832. of the California Health. and .Safety- Code.. This verification must be completed and returned to our office before we are per- mitted to issue the permit. od�15�1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville,Salifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 030- -'161, Z7i ZONING BUILDING PERMIT OWNERTEL �y O�vt,G} p Se PHONE s3 - 6Yq a SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS I y a 1 26 Y`? l/& //,e CONTRACTOR'5NAME o cJNC TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS D 7 .G/ S o• Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME - PARCEL MAP Water piping 7.00 - Each qas water heater or vent 7.00 USE OF STRUCTURE SIX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WOR , New ❑ Addition Remodel ❑ Uti l I ies Installation ❑ Other ❑ Describe work: W B ,' Permit Fee $ - Contractor ELECTRICAL, PERMIT Filing Fee 15.00 Main service 2000A OR LESS 18.50 19. S-6 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 200ATO1000A, 37.50 NEW CONST. OR AODNS, l ( DWELLING OC CUP"') ACC. BLDGS. 3.64 sq.ft. NEW CONSTR UL '.OUTLET NON.RESID BRANCH CIRCITS @ 5•00 POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED APPLNS. OR EX. Occup. OUTLETS (RESID.) EA.J 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 15, QO 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 Pernit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Si nature of Applicant — Owner g pp ❑ Contractor ❑ Agent ❑ An OSHA ion of structures tover 3Q stories ineheight Ions over 5'0" deep and demolition or construct- Mobile Home Installation Fee $ Ener Inspection Fee $ Energy P occ CONST TYPE TOTAL FEES HAz 1 DFEES I IMP I FLOOD I COF PARCEL PD IID ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. .NITE•D.P.W.. YELLOW-ASSE»OR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT,OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 030-461-022 ZONING AR BUILDING PERMIT OWNER Keri. & Roma . �Loseth TELEPHONE 533-0490 SO. FT. OCC. BUILDING VALUATION` OWNER'S MAILING ADDRESS 1909 20th St. Oroville 95965 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 191717 9nth St, Qroville PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF E1 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 Ek Installation❑ Other ❑ Describe work: New Main Service Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 1 18.50 18.50 CONTRACTORS LICENSE LAW 1 declare under penalty of p y perjury y (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Buses $ 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 1000A). 37.50 NEW CONST. / DWELLING OCCUP.y!\ OR ADONS. l ACC. BLDGS. II 3.64 sq.ft. NEW CONSTR. U TI -OUTLET NON•RESID BRANCH CIRC ITS @ 5.00 /POWER APPARATUS 6\ (SINGLE OUTLET CIR. I EX. OCCUp(OUTLETS OR FIXTURES 20 @ 76 FIXED APPLNS. OR Ex. Occup. UTLETS (RESID.) EA.) O 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 1 -15.00 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 shal I be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling 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 County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify a d keep harmless the County of Butte a ainst all liabili es, judgme cost , and expenses which may in a y way ccrue a st id Count n c se nce of the granting of this permi . O A Date $igna ure of Applicant — Owner contractor ❑ Agent - An OSHA ion of structures tover 39storiesaineheighj Ions over S'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEES 48.50 HAz DFEES IMP FLOOD COF PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte Count ode and/or work indica d a v r which fees I C OF PUBLIC By PEffAff WiRtS Date / applicable provi- resolutions to do have been paid. WORKS to 3 5111 Receipt No. �WHITC-D.P.W., YELLOW-ASSC390R, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing, your signature. Please complete and return this information. at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and,nIAterials for construction of the proposed property improvement (yes or no). 2. 1 -(ha * ve/have not) signed an application for a building permit for te 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 Owned Social Sec rity umber Date/r15 NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and =--..19832 .of the Ca-lifornia .Heal-th and Safety Code-- This ode: This verification must be completed and returned to our office.before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATM AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 030-116�� lit Z4_,J ZONING _ BUILDING PERMIT OWNER &2 oya TELEP oNE 533 - oja SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING DOR SS CONTRACTOR'S NAM TELEPHONE CONTRA MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS ! Permit fee $ PLUMBING PERMIT Filing Fee 15.00 0 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF�< Duplex❑ MobilehomeO 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❑ Remod 10 Utilities Installation❑ Other ❑ Describe work:T�/il/ '.5��� r Permit Fee - Contractor ELECTRICAL PERMIT' Filing Fee 15.00 Main service 00V OR LESS 200AORLESS 18.50 'p CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification El1, 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) EJI, 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 200ATO 1000A1 37.50 NEW CONSTOR ADDNS. . / DWELLING OCCUP.kACC. SLOGS. I l ) 3.64 sq.ft. NEW CONSTR.U TI -OUTLET NON.RESID BRANCH CIRCUITS) @ 5.00 POWER APPARATUS &) SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 20 @ 764 FIXED APPLNS. OR Ex. Occup. OUTLETS IRESID.1 EA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 �s 05 Permit Fee $ sx) 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 Pernit 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 Si nature of Applicant — Owner g pp ❑ Contractor ❑ Agent ❑ An OSHA ion of structures rtover 3Qstories oin height.Ions over S'0" deep and demolition or construct. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ i I HAz OFEES IMP 1 11.000 COF I PARCEL I PD I HD I ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date _ Receipt No. WHITE-O.P.W.. YELLOW•ASSE330R• PINK -INSPECTOR. GOLDENROD -APPLICANT ' MOBILE HOME. INSTALLATION ACCEPTANCE C ' COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES r= BUILDING DIVISION ---7 COUNTY CENTER DRIVE OROVILLE, CA 95965 --PHONE (916) 538-7541 APN(9 .•► /� t''—V z - PERMIT NO.: Owners: t% COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLIC-ATIONAND PERMIT �S��n ASSESSOR PARCEL NUMBER 030-461-022 ZONING AR BUILDING PERMIT OWNER KENNETH L. LOSETH TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1911 20TH ST -OROVILLE, 95966 CONTRACTOR'S NAME OWNERTELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER NON. E UNIRIOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 23 Q Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS HARING ADDRESS Penalty $ BUILDINGADDRESS 1907 20TH ST PERMITFEE $ 43.00 OROVILLE, 95966 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23,00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome Ii Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation X] Other ❑ Describe Work: Mobile Home I S I G W 1 920.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 2 0:0 0 Main Service OOOV OR LESS ( 2ooA oR LEss ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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. re 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. 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 NEW CONST. DWELLING OCCUR \ OR ADDNS. ( & ACC. BUDS. / SO. 3.5¢ FT. NEW CONST. MULTI -OUTLET NON•RESID. ( BRANCH CIRCUITS ) 97.50 'POWER ( POWER APPARATUS ) OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) 20 BAL a 1.00 SO Ex. Occup. ouTLETS RESID.oEA ( ) 5.00, Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 ' PERMITFEE $ Contractor 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 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 Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor -100.0O Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the orkers' compen ion provisions of section 3700 of the Labor Code, I shall orthwith comp wi t se provisions. �� Date -- -- � — 4SignreApplicant - Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee 7T$ Energy Inspection Fee $ OCC CONST. TYPE I TOTAL FEE $ 143.00 HA2. D. FEES — IMP FLOOD MP COF PARCEL PD HD ISS — — This permit is hereby issued under the applicable provisions in the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. BY Da i�4 PERMITEXPIRESON 76- (Date) Receipt No. 185912 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT CERTIFICATE OF ANCHOR INSTALLATION - Title 25 CCR Moblehome .Parks Act Section 1326 (W) I certify those. portions of the tiedown system installed below grade were not damaged prior to or as a result of the installation, were not modified prior to or during the installation,- and were installed in accordance with the manufacturer's installation instructions, plans and specifications of the engineered tiedown system referenced on this certificate. Tiedown System: Manufacturer: 71—oczoq 9 � Model: F pow Installed_- by: l Date: . /Q a Contr./Owner. f`� License No.: _ - - ,', .T' � -. .u.�..- ..-��+'�-^r'..^r-spY..�y.:w.lYF'Ynw.+�+..�+:*.i•,.�'y:i`ry"�s..t..-�+�;i«�w.Z+f.�n:y.�:.:.i�:,,.,,:.,,a+Niv.,f'� t,..r-'" ... �,_rr,, .,y+:i ,�.... ,:7; .- - _ - , . h T� Jam. J OUNTYOF BUTTE - DEPARTMENT OF DEVELOL3,MENTSERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVttLE; CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATASHEET OWNER © S 6L A P. o. Proposed Building Use Building Inspector, Date r At time of permit application, I was advised the following data must 6e submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . .............. f 1....................... . 2. Plot plans, 3/4 sets, signed by preparer of plans. ..x..... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 04 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form..................J........................... 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings. �: ................... . 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... Fees of $ i if 3 ......................................... . Impact fees as shown on attached schedule.,. . . . ......... 12. California Department of Forestry plan approval/fees. ..... .................. 13. Flood elevation letter (100 year flood) by California Engineer... ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . I......... 18. Contact Land De`v�elopment about (A) Improvements (B) Drainage. .......... . 19.. Driveway permit (construction approval required prior to occupancy). .. .. ... . 1,1"spedion requeis 20. Pre -inspection for required. .. to Building inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance. ........'°+................ . 23. Owner -Builder Verification (Given to owner , Mail to owner _). .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature a0fhorization......................................... 26. Copy of recorded deed of pa crl creation and 60 right of way to a public road. . 27. Letter of intent on building use . ...:.:::: .::::::::::::::::::::::.. . 28. Mobilehome utility clearance. . 29. Documentation of legal access. ...................:.......... . 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. .. ................ Existing violations/expired permits. ........................................ 32. Plan cj�eclelist. �) OI.c� N ... �.�.PCS ............................... . 34.=40 33. jj . ,. Wen u issue thee ermit, rocess as follows: Mail to owner. Mail to contractor. Telephonand hold for pickup at h i► office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date 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 issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data,by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date• Plans approved by G I a(3a.45 Date q-27,� Sets of plans on hold in File cabinet Z AP folder Copy - Department of Public Works > a r COUNTY OF BUTTE — DEPAR'Il11EN'T OF DEVELOPMENT SERVICES — B I LIMING DIVISION _ 7 COUNTY -CENTER DRIVE, OROVILLE CA 95965 — TELEPHONE (916) 538-7541 OWNER .. /'S r► n C- i` 't�1 © S el �"l� ! A.P. PROPOSED BUILDING USE DATE REC . - # DATE REC 1. SCHOOL DISTRICT FEES r) '0 rA (paid at District Office). 6�2. SHERIFF FEES (paid at Building Department)/ � ►tet o Residential...... x = unit amt. Commercial (sgft) x _$ sq.ft'. amt. -4p�3. URBAN AREA FEES (paid at Building Department) Residential (per unit) x G =$ # units amt. Commercial (per sq.ft) x =$ sq.ft. amt. 4. RECREATION DISTRICT FEES (paid at District Office) ......................... 5. DRAINAGE DISTRICT FEES (Contact Land Development Division) .............. 6. SRA FIRE INSPECTION AND PLAN CHECK = $89.00...... (paid at Building Department) 7. OTHER 8. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. APPLICANT DATE. COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7_ County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 en, (Rev.12/96) L,. ' APPLICATION AND PERMIT g`7 --to (n a ASSESSOR PARCEL NUMBER 030-461-099 ZONING AR BUILDING PERMIT OWNER TELEPHONE SO, FT, OCC. BUILDING OWNERS MAILING ADDRESS 88 C 1144. 2 0 1064. CONTRACTOR'S NAME TELEPHONE ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER , LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 54.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 10 BUILDING ADDRESS 1911 20TH ST_ OROVIT-LE Energy Plan Checking Fee $ $ PERMIT FEE $ 10 9.10 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome QX Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition RX Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: E)PEN & 60V DECK Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service .IA OR LESS 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.PowEL License Class LIC. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: '4( 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. ADDNS. ( a ACC. BLOB. SO 3.5QFT: NEW CONS.OR NON-RESIDT gq�Cl Cull',f @7.50 APPARATUS 8 SINGLE OUTLET C1 R. Ex. Occup. OUTLET OR FIXTURES 00 BAL zp ,. Q .5050 ED Ex. Occup. OuxTrs AESIo.DFRa 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 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 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 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.) It 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 Date . Y Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agen An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 109.10 HAZ. D. FEES IMP FLOOD CDF _ PARCEL PD -- HD ISSU This permit is hereby issued under Of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON zf the applicable provisions Resolutions to do work been paid. ate � Kq p 7 7 0 (J Dete Receipt No. 210360 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ''7�"y'^+.rr- �,..fTa�r ,m�. .�'^ � , :: , � .a-•+rnr+t"�'� cr'�Zt, ji y.. ems. ;. , «. � L �i- •r COUNTY OF UTIE DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION SCO iY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIaT A1'LCAT18N DATA SHEET OWNER: ASSESSOR PARCEL.�/ Proposed Building Use: Building Inspector: Date: 6� 14119"1 At time of permit application, I was advised t e following data must be submitted prior to permit processing and/or issuance: Date Received By ❑. All items have been submitted.------------------------------------------------------------------------------------- 02. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑3 . Complete plans, 3/4 sets, signed by the preparer of plans. --------------------------------------------- 114. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. 05. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- ❑ 6. Energy Design Compliance and supporting documentation. ------------------------------------------- 117. ------------------------------------------ ❑7. Statement of Intent for Non -Heated and A/C Buildings. ------------------------------------------------ 118. ----------------------------------------------- ❑8. Hazardous Material Form. --------------------------------------------------------------------------------- ❑9. Manufactured Home data and installation instructions including Tie Down Specifications .--------- ❑ 10. Fees of $ ----------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ------- ❑ 12. California Department of Forestry plan approval/fees. ❑ 13. Flood elevation certificate. ------------------------------ ❑ 14. Sanitation and plot plan approval Health Department. ------------------------ ❑ 15. City of Chico plumbing peimit.-----:'---------------------------------------------------------- ❑ 16. Plot plan an&business license approval from the City of Biggs. ❑ 17. Planning approval for (A) Use: (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------- ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). --------------------- 020. Pre -inspection for required.. Request to Building Inspector on 021. Contractor's license information. (Number, Name Style, Classification). ----------------------------- 0 22. Workers' Compensation carrier and policy number. ---------------------------------------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - ------------------------------- 024. Letter of signature authorization 025. Recorded copy of Agricultural Acknowledgment Statement. ------------------------------------- 026. -----------------------------------❑26. Letter of intent on building use. ---------------------------------------------------------------------- ❑ 27. Manufactured Home utility clearance. --------------------------------------------------------------- ❑28. Existing violations and/or expired permits.--------------------------------------------------------- 9/0e 33 A, ❑Grant Deed, ❑ M..H. Title, ❑ Check to H.C.D $r: 0 .i%r. c,� G'T� �i�,'� - jivjfi( icy (Date) ,r When you issue tWepzenui t, proces ollows ❑ Mail to owner, �❑ Mail totractor. Telephone �� and hold for pickup at C/�/'O V l //C office. ❑ Deliver with inspector. Applican•ZDate: / 7 Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution, y Date:_ By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date. By: 1. Index permit application for the above items numbered:& ElPlan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: 4 Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the aboverequir�rl data by 11 phone, ❑ mail, 11 Building Diyasion counter, by Date: glans reviewed by: �� Date: �f- Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. OWNER -BUILDER _,VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES 50 NO ❑ , -2. I HAVE A HAVE NOT ❑ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the'proposed construction: NAME: 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: 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:�— SOCIAL SECURITY NUMBER: DATE: 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 Dear Property Owner: .B.-1 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 record 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 employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you 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 contractors 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" on 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. i rely, Mic el C. Vi ira, C.B.O. Ma ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER I I COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. Rev. 12/96) APPLICATION AND PERMIT ASSESS^��I1aCEL NUMB_¢I� / ^O�� ZONING BUILDING PERMIT TELEPHONE SO. FT. OCC. BUILDING VALUATION /j ow .1911 MNO DORES O �� 9 Z — •6- a 0 o!p :CON! CTOR•S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS :C0r1TROCTTQN_(FNOER . Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCNRECj Or ENGINEER ./ U y., e' L10EfiSE NO. Ellin Fee $ 20.00 Permit Fee $ S Y1OD ARCHITECT OR ENOWEERS MALLLNG ADDRESS Plan Checking Fee $ SULDINGADDREss lqll Energy Plan Checking Fee $ PERMIT FEE $ /(J IAT NO. SUSONISIONSUWE PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome,!>il' Other SPECIFY 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 1!�r Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: (OA, ✓� �� i/ DL'C Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2�oon oa mss 23.00 LICENSED CONTRACTOR'S DECLAR•A-TION. 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 I am exempt from the Contractors License Law fouthe following reason: ❑ 1, 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 the performance of the work for which this permit is issued. Q 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 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 _ ___ Date 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. Main Service 200A TO t000A 46.00 NEW CONST. oWEUINc OCG1/P. s0 OR ADONS. ( a Acc. ells. 3.52 FT. NEW CONS MUITI.OUTLEr . @7.50 NONREstO. POWER APPARATus A SINGLE OUTLET C. OUTLET OR FIXTURES 20 (g 1.00 Ex. Occup.SAL Q .so FU EO APPINS. OR 5.00 Ex. Occup. ouTLETs Resio. EA Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ coNST. TYPE TOTAL FEE $ HAZ. 1 O. FEES IMP I FLOOD I COF PARCEL PO 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 ��' ReceiptNo. - _ w"TE•D.O.S.•B.D. CANARV•ASScSSOR PINK -INSPECTOR GOLDENROD•APPLICANT ffiLl-i /707 :w C= ALL C*tumU"Eg Aft 1OWNT INCLUDING OVE HA��4 NGS ALL B, - OF ALL ItEASEMENTS. A Sl-- SA-i.� la t, 1 - -� . FROM THE SIDE AND -1 THF .Gi� REAR PROPERTY LIKES -MI) FT. FROM THE ROAD CSHALL Fr' CLEAR OF STRUCTURES ANDf LQUIPMENT EXC:4, FM j k 2 FT. EAVE OVERHANG.' I 431 y I 0 cb 31 Z) .uz\ I CJ 95 HE -:4:1W. �Cl� -I- CIL -V1 VL tr V) t=77 C- �V-Sy �- 9- 1004 fh ---------- B..bf,TE ObUNTY BUILDI, G DEPARTMEN1 .A p R 0 V E r 51":Zl Ago �sv.._.Couni Eat$ - LAND OF NATURAL WEALTH AND 8EAUT� BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE. CALIFORNIA 95965-3397 TELEPHONE: (916) 538.7541 FAX: (916) 538-2140 4/3/97 KENNETH & ROMA LOSETH 1911 20TH ST ' OROVILLE, CA 95965 Re: B,p,#97-0622 A.P.# .030-461-022 With reference -to the above subject, attached is: [X] Plan Check List [ ] Red Marked Calculations [ } Red Marked Plans . [ ] Other - Action Required! [X] Comply With Plan Check List [ ] Resubmit Plans with Revisions As Required . [ ] Return All Original Materials and Revised Plans to the Building Department [ ] Other Should you have any questions, please contact this office at the address or phone number listed above. Sincerely, LINDA SEXTON PERMIT APPLICANT KENNETH LOSETH-PERMIT 97-0622 . N0: ASSESSOR PARCEL N0. 030-461-022 DATE 4/3/97 The above referenced building plans were reviewed by this-office. Prrovide additional information and/or make revisions to plans, specific ns calculations as follows: WE DO NOT APPROVE*JOB-BUILT TRUSSES UNLESS THEY ARE DESIGNED BY AN ARCHITECT OR ENGINEER AND APPROVED BY OUR PLAN CHECK ENGINEER. PLEASE PROVIDE THIS DESIGN OR REVISE YOUR PLANS TO FACTORY BUILT TRUSSES OR RAFTERS. LINDA SEXTON If you wish to discuss any requirements, you may contact me at (916) 538.7541 between 1:00 P.M. and 4:00 P.M., Monday through Thursday. AP # PWNER OS -7 PERMIT MH UTIL.CLEARANCE DATE INSPECTOR ELECTRIC GAS Support Struc. Compaction Test -Req. Service Other Pipe YES! NO YES NO Size Load Type Size Lenq:th COUNTY OF BUTTE DEPARTMENT OF.P._UBLIC WORKS ' 7 County Center Drive, Oroville, CA 95965 PHONE: 916=538-7541 KPn & Roma Loseth DATE March 12. 1993 1660 Leta Iane Oroville. CA 95965 RE: Building Permit #93-521. Dear Mr. & Mrs. Loseth: A.P. # 030-461-022 With reference to the above subject: Attached is: Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical.Plan Sheet Owner -Builder Verification Form List of -Codes Enforced. OTHER' XX 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:.. 1469 Humboldt Road, Chico 7 County Center -Dr., Oroville Skyway & Elliott -Rd., Paradise XXX Planning.approval from Butte County Planning.Department, 7.County Center Drive, Oroville, for Usfor Ird dualling Completed Owner -Builder Verification form. Recorded.copy of deed showing Recorded..copy of.agricultural..acknowledgement.statement._ OTHER' Should you have any questions concerning the above, please contact Dave Wasney of this office., between 3:00 and._5:00 pm weekdays. Yours very%truly, William Cheff Director of Public Works ,,J.F. Glander - JFG/aj COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 DATE��3 RE :.QPA�` SZ/ A.P. # With reference to the above subject: / / Attached is: Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form 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 -Sect -ion (DPW;: :.- sets'of plans in accordance with the changes marked in red. - Sanitation approval from Butte County Health Department at: 1469 Humboldt Road, 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.. OTHER Should you have any questions concerning the above, please contact of this office._ Yo6rs very truly, William Gheff Director -of Public*Works J.F. Glander JFG/aj 'I---,- '41-T - - -- - - - � COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Californi6 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ��" �Y9 ASSESSOR PARCEL NUMBER 030-•461-022 ZONING '_AR Y BUILDINGPERMIT OWNER ROMA LOSEM 133:b490 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS V 17 !All 20TH ST OROY lI LE, 95966 CONTRACTOR'S NAME -__N iy � TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNW40WN Total Valuation Is LENDER'S MAILING ADDRESS Fling Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS ST 190% 20THPLUMBING PERMITFEE $ �g OROVILU PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNIS ION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF a Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑N Describe Work: DEW Mobile Home I S I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20.'00 7V Id1d ' Main Service 20000AA OR LESS ( 2OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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 I am exempt from the Contractors License Law for the following reason: Q 1, 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. ❑ 1, 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 NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. BLDS. ) SO. 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS d SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES ) 20 Q 1.00 BAL .00 EX. Occup. (oFIXEEDrs RESID.OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc . Wiring 23.00 PERMITFEE $ Contractor 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 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 Filing Fee 20.00 g Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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.) 13 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in -any manner sous to'.become subject to workers' compensation laws of California—: -a -6d agree that if I should become subject to the1. workers' compensation provisions of section 3700, of the Labor Code, I shall forthwith comply with those provisions. /-~ X /____�Y-CDate 5=�;7 _ Signature of Applicant - Q Owner ❑ Coltraotor ❑ 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 Is Occ CONST. TYPE TOTAL FEE $ 35+00 HA2. D. FEES IMP FLOOD CDF PARCEL PD HD ISSUE 11.0 This permit is hereby issued under the applicable provision of the Butte County Code and/or Resolutions to do work indicated ove for which fees have eek paid. l By Date �/ PERMITEXPIRESON (Date) Receipt No. 180928 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) 538-754 � /`J ERMIT NO. APPCiCATION AND PERMIT jf ASSESSOR PARCEL NUMBER 030-461-022 AR ZONING BUILDING PERMIT OWNER ROMA LOSETH TELEPHONE 3N 0�s90 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 1911 20TH ST OROVILLE, 95966 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Fling Fee $ 20.00 Permit Fee $ 19-00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 1907 20TH ST PERMITTEE $ OROVILLE PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNISIONS NAME PARCEL MAP Solar or heat pump water heater 23,00 USE OF STRUCTURE SF 11 Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other OX Describe Work: DEMO Mobile Home I S I G W 1 920.00 PERMITTEE S Contractor ELECTRICAL PERMIT Filina Fee 20.'00 Main Service600V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 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 IL No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 1p'. 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 NEW CONST. DWELLING OCCUP. OR ACDNS. ( 8 ACC. BUDS. ) SO. 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES) 20 Q 1.00 BAL .50 Ex. Occup. OUTLEEDTS j COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBERQ3O r7" I r 2DN1NO BUILDING PERMIT OWNER 77/ ;Igf TELEPHONESO. FT. OCC. BUILDING VALUATION OWN 5 MAILING ADORES!?,, CONTAA�OR'3 NAM �• - .' . _ TELEPHONE CONTRACTORS MAILING ADDRESS - _ - - Fireplace - CONSTRUCTION LENDER UNKNOWN - Total Valuation $ _ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ / Q ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Penalty $ BUILDINGADDRESS /10 _20 S —r PERMITFEE $ Q PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ulilibes ❑ Installation ❑ Othe Describe Work: Mobile Home S G W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main ServiceOOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION 1 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 I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, army 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 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 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.) ❑ 1 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, ►shall forthwith comply with those provisions. X ____ Date' __ 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. NEW CONST. DWELLING OCCUR R ADONS. 8 ACC. ) O ( SO. FT. UTLE NEW CONST. MULTI -OUTLET NOWRESID. ( BRANCH CIRCUITS / @7.50 @?7. POWER APPARATUS (8 SINGLE OUTLET CIR. ) Ex. Occup. (OUTLET OR FIXTURES) 20 Q 1'00 BAL FIXED APPLNS. OR EX. Occup. (OUTLETS (REBID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee Is Occ CONST. TYPE �^ TOTAL FEE $ 3S 00 HAZ. I D. FEES I IMP I FLOOD CDF PARCEL PD HO ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above- for which fees have By PERMITEXPIRESON the applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. WHITE-D.D.S.-B.D. CANARY -A ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT w ;3y Demolition Permits Asbestos Notification Statement Date AP# Pursuant to section 19827.5 of the California Health and Safety Code., all demolition permit applicants are required to fill out this form. "19827.5. A demolition permit shall not be issued by any city, county, city and county, or state and local agency which is authorized to issue demolition permits as to any building or structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or, both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The.permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit appli- cation." Attached is a copy of my written asbestos notification to the United States Environmental Protection Agency for the demolition project located at Signature of Applicant 6R I hereby declare that a written asbestos notification to the United States Environmental Protection Agency is not applicable to this demolition project. Signature of Applicant 2/19/91 MAIL TO ASBESTOS NOTIFICATION EPA/NESHAPS Region IX 1235 Mission St. A-3-3 San Francisco, Ca. 94103 DATE: PROJECT JOB # (Please see reverse side) Agancios &= Notified: ❑ 10C.1 ❑ caiiforni- Air PAsouzeaa Board ❑ cal 0 BmUding Dw=t= ant INSTRUCTIONS ON REVERSE ASBESTOS- DEMOLITION/RENOVATION NOTIFICATION Please check one: Renovation Demolition requiring 10 day notice Demolition requiring 20 day notice Revision of Original (Form on reverse side) IDE—PLEASE READ BEFORE USING THIS EPA USE ONLY DateRec Pstmrk School Dei/ND ADQUTE? Code#: Doc#: FORM 1. OPERATOR: 3. FACILITY NAME: (Contractor) ADDRESS STREET ADDRESS CITY STATE CITY STATE ZIP PHONE( ) COUNTY ZIP 2. OWNER 4. FACILITY DESCRIPTION ADDRESS CITY STATE AGE SIZE ZIP PHONE( ) PRIOR USE 5. Project Start Date: Completion Date: 6. Estimate of Friable Asbestos: ON PIPE: Linear Feet SURFACE OF OTHER COMPONENTS: Square Feet Nature of Materials: 7. DESCRIBE METHODS OF REMOVAL: 8. PROCEDURES USED TO COMPLY WITH 40 CFR 61.147 6.152: 9. NAME 6 LOCATION OF DISPOSAL SITE: ANY FURTHER PERTINENT INFO CAN BE INCLUDED BY ATTACHING ADDITIONAL SHEETS QUESTIONS??? FOR FURTHER INFORMATION CALL (415) 556-6415 8am/4pm M -F INSTRUCTIONS FOR USE OF ASBEBTOS DEMOLITION /UNOVATTON NOTIFICATION rn�u � RENOVATION: means altering in any way one or more facility components. NOTICE MUST BE POSTMARKED AS EARLY AS POSSIBLEBEFORE PROJECT DEMOLITION: means the wrecking or taking out -of load -supporting structural members. of a facility together with any related handling' operations 10 Day notice for MORE than 160 sq.ft.or 260 linear ft. asbestos 20 Day notice for LESS than 160 sq.ft.or 260 linear ft. asbestos, includes facilities which contain no asbestos. FACILITY: means any institutional, commercial -or industrial structure, installation; or building. Renovations on single family residences and apartment buildings with 4 units or fewer are exempt from notification to EPA. PROJECT JOB #: Your OWN IN -HOOSE I.D. for a specific jobsite. Optional, but expedites communication -concerning notifications. LOCAL AGENCY: Most areas in Region 9.have local NESHAP delegated agencies. In these areas notice must be provided to both EPA and the local agency. . 1. OPERATOR/CONTRACTOR: Full.information concerning person doing the work. 2. PROPERTY OWNER: Complete in full. 3. FACILITY NAME: Must have complete address OR directions to the jobsite. 4. FACILITY DESCRIPTION: Current use of building. Project location in the facility. Other descriptive information as necessary. 5. START AND COMPLETION DATE: Provide month, day and year. Must be revised if dates -change. -(see revision form below) 6. Estimate of amount to be removed (must be in square or linear feet). Revisions(see form below) must be made for additional amounts uncovered. 7. Examples of methods: glovebag, scrape, remove in sections, etc. 8. Examples: Adequate wetting prior to and during work, double bag, etc. DRY REMOVAL MUST RECEIVE PRIOR WRITTEN APPROVAL FROM EPA .OR THE LOCAL DELEGATED AGENCY IF MORE SPACE IS NEEDED THAN PROVIDED, ADDITIONAL SHEETS SHOULD BE ATTACHED TO REVISE A NOTIFICATION ALREADY ON FILE WITH EPA, USE FORM PROVIDED BELOW PROJECT NAME PROJECT JOB I ORIGINAL NOTIFICATION DATE Revision Notice #1 2 3 4 5 please circle This is to advise that the above referenced notification presently on file has been revised. Please note the revised portion listed. CHANGES FOR THIS REVISION: 1. NEW Location 2. NEW Scope of Work 3. ADDITIONAL Quantity of Asbestos 4. -NEW Start Date 5. NEW Completion Date 6. NEW Disposal Site PROJECT ( ) CANCELLATION - - Attention Property Owner:. _ An "owner -builder" building -permit has been applied for in -your name and bearing your - signature. — i 7 Please complete -and return this information at -your. earliest opportunity to avoid unnecessary delay -in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement : YES [VI NO[ ]. 2. I HAVEtVf HAVE NOT[ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: ;�:_.:.. _..-v „_ CONTRA_ CTOR' 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: r 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: ME ; NAADDRESS PHONE TYPE OF WORK SIGNED: ' .PROP'ERTY OWNER: SO DATE: 7 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 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 party of -record 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: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you 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. 0 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. 0 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 "ownerbuilder" 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 contractors 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" on 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. SInIc rel 1 Michail C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830. of the California Health and Safety Code. OYER COUNTY- OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATIQN-ANQ PERMIT ASSESSOR PARCEL NUMBER 030-461 922 �^ ZONI NG 1 AR - BUILDING PERMIT OWNER Ken & Roma Loaeth TELEPHONE 533-0490 SQ. FT. OCC. BUILDING VALUATION Est. 500• OWNER'S MAILING ADDRESS 1660 Leta Lane, Oroville 95965 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is • 00 LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee s 30.00 PLUMBING PERMIT Filing Fee 15.00 1909 20th St., Oroville Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDI VISION NAME PARCEL MAP Water piping 7.00 Each pas water heater or vent 7.00 USE OF STRUCTURE SF EI Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W 1 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other n Describe work: Convert SF — Cabin to Storage Only Bldg. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 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 I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason Main service 200A TO 1000A) 37.50 NEW CONST. ( M DWELLING OCCUP3.64 sq.ft. OR ADDNS. \ ACC. BLDGS. / NEW CONSTR. U TI.OUT LET NON BRANCH CIRC ITS @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. EX. OCcup(OUTLETS OR FIXTURES 20 @ 76 FIXED APPLNS. OR EX. Occup. OUTLETS (RESID.) EA.) 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. �❑j 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 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. J X _4- �_ ^ -� Date-' S of Applicant — Owner cDnrrDcrDr ❑ Agent ❑ o An OSHA permit is required For excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories. i.n-hp�ght. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEES 30 0() HAz 1 0FEES I IMP I FLOOD I CDF PARCEL PD I HD ISS This permit is hereby issued under the applicable provi- sions sions of the Butte County, Code and/or resolutions to do work inch sled above for which fees have been paid, G DIRECTO PVF PUBLIC WORKS WI By .� ,_(amu ® ,�-.. � iIi �h,'' �/�` . Dat PERMIT EXPIRES Date `: / - Receipt No. WHITE-O.P.W.. YELLOW-ASBESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION ;AN0 PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 030-461-022 ZONING AR BUILDING PERMIT OWNER Ken & Roma Loseth TELEPHONE 533-0490 SO. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 1660 Leta Lane, Oroville 95965 Est. 500,00 CONTRACTOR'SNAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 300.00 LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 30,00 1 0 20th St. Oroville PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF [I Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G J W= @ 15.00 TYPE OF WORK New Addition❑ Remodel E] Utilities❑ Installation❑ Other® Describe work:_ Convert SF — Cabin to Storage Only Bldg. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 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. 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 200A TO 1000AI 37.50 DWELLING OCCUP.&) NEW OR ADDNS. CONST. ( / ACC. BLDGS. II 3.6Q sq.f[. NEW CONSTR. ULTI.OUTLE T .RESID B NONRANCH CIRCITS @ 5.00 (POWER APPARATUS e) \SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20.iI 76 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 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. Notl a 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 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 liabilit' s, judgments, costs, and expenses which may in aany way accrue ag • t Id County i rise ence of the granting of this per ft. Dat 7� Signature of Applicant — Owner Contractor ❑ Agent An OSHA permit is required for exc vations 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 FEES 30.00 HAz DFEES IMP FLOOD CDF PARCEL PD HD Iss This permit is hereby issued under the sions of a Butte County Code and/or work 1 di ted a f which f DIR F PUB By PE EXPI• S Date applicable provi- solutions to do ave been paid RKS Da r , Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT :-I ^"�,'r+�"Y'. 11Yt4h�v.-.s«I�-..Y...._'.`yri'h'"wn.�ihy.� wypi�sw:�y,l-)N;wj}�'i�^.7: "� �.pv►�'��r'�,-•..C'.ni+'"'.,"nr.f`ars^'1'�,�:G.^ii''��Y.-�--..�,�,.. i_ fCOUNTYOF BUTTE - DEPARTMENTOPDEVE111iiiLOPMENTSERVICES - BUILDING DIVISION ( 7 COUNTY CENTER DRIVE - OROVILLE; 6-IF:SRNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHE ET OWNER -eom V A. P. No. `g) OZ Z_ Proposed Building Use r.11A)` (6i6AJ o�'C-AL_'a -C� Building Inspector /� Date 5-r-oc ha At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: 1. DATE RECEIVED BY All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... . 3_ Complete plans, 3/4 sets, signed by preparer'of plans . ............- .4. ......... Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form. .......................................... 6. Energy Design Compliance and supporting documentation . .................. it 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ........................ . 13. Flood elevation letter (100,year flood) by California Engineer ................... 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: .„ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. 20. Pre -inspection for P�a"eaedio; quest required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . ............ . . 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner 124. _)............ Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................:. 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... _ 27. Letter of intent on building use . ......................................... A- 5 28. Mobilehome utility clearance. T 29. Documentation of legal access . ....................................... . *� 30. Documentation of 50% subdivision developed or (A) Road improvements completed , and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ..................................... . 32. Plan check list . ..................................................... 33. 34. y When ou issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone 533-6y90 and hold for pickup at C1,ec�c�; r(C�_ office. Deliver with inspector. Other -Parcel Creation/` Acreage Applican �_U Date 3 3/ s 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 issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by -Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER L ZONIN BUILDING PERMIT OWNER N �vse TELEPHONE 533—c���a SO. FT. OCC. BUILDING VALUATION OWNER'S M��G ADDRESS (!o �, r/� �5 9� � 5 O CONTRACTO 'S NAAM`E /V TELEPHONE CONTRACT R'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS G t ljj_ ���e U 7//C/ permit fee $ PLUMBING PERMIT Filing Fee 15.00 h Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFtZ 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 ❑ Utilities[] Inst_a/llation ❑ Other Describe work: ���1(��f G5 /1:7,— il— e,4h%N Ta Penult Fee $ Contractor ELECTRICAL PERMIT .Filing Fee 15.00 Main service 200V OR LESS 00AORLESS 18.50 Main service 200A TO 1000A1 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjuryOR (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification ❑ 1, as the owner, or my employees with wages as their Sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.yd\ ADON.S. ACC. BLDGS. I 1 3.64 sq.ft. NEwCONSTR ULT' -OUTLET NON.RESIO BRANCH CIRC ITS @ 5 00 POWER APPARATUS h (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20 76q At 116) 4F;J4 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESIO.) EA.) j 3.00 Temporary service 15.00 Mobile 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 1 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 Countyof 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 Si nature of Applicant - Owner 9 PP ❑ Contractor ❑ Agent ❑ An OSHA ion of structures tover 39storiesoin height.ons over 5'0" deep and demolition or construct- Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEES HAz 1 0FEES I IMP I FLOOD COF I PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. /3570 y WHITC-D.P.W.. YELLOW-ASDC3300. PINK -INSPECTOR. GOLDENROD -APPLICANT l COUNTY OF BUTTE - Departmant! of Public Works 7.County Center Drive, Oroville, CA 95965 014NER-BUILDER VERIFICATION Attention Property Owner: Phone: 916-538-7541 An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit. will be issued until this verification is received. 1. I personally plan to provide the major labor a d atrials for construction of the proposed property improvement (yes or no 2. I (have/have not) l= signed an application for a building permit for the proposed wo k. 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 Owne Social Secu ity NuLbe — Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and . . . --_19532 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. • PTN SEC. I i �., - _ TNERMAL.ITO. 'T. 19 N. 3 M. D. B. B M. R. - ` PL UMASAVENUE o.. r .00 75.00 75.00 014000.200.00 189.9 1899 580.00 0.31AC $ 00.46AC. I 28 29 3 4 0 I if 0 O a a . , 0.84ACE � 0.84Af. 0.34 34 r I 27 ACA a a3/AC 1Q 2 2 I 1 �� o 1 PM 73 4 w x140.0 �! 2 ? I O 1 s.00AC x35.00 25 155 o NO0.52AC ��l M 23 O . I lLJ �22 00.84 00.84A o 24 o Lij 20 .j I pw 290 23 m to00.31AC. 189.E a "-1700 o L2 .. �_ 1.21 Ar - 290. C J j� 790.1 9 N2 r _ o I!ti 0 4 3 W) p �z •, o /9yo _i 1.42 AC. I g �o �'� p -337.19 _L 2.9719 T4�3�5.08 - •155.01 1 / 6D118O '� 86 Ac/V � /A 10 1 f I I. 2 12 3 O 30-46 W E_ _ 19 °^- 75.09 1.22AC. I.BAC. co 2.94 AC 145.00, 6 ° I 5 tn 7 i 2 215:02 p _ ON PM99-61 305.08 PM62a = BO ► 195. 1 - 7.I _ 8730 87.50 -115.00 30 72.50 145.00 16; 5.04 = f -484.09 143.0$ I r7 p = I ' 35 .y15m�1.61 AC 39AC. 145.03 . II n Ypoy O 00 0.32Ac 2 12 14. 0.34AC. aZj 33 78500 445W' 3418 20. G 4 a is 44AC 0.44A .44AGrQ3ASAC I%m /6 • III F4 `'- 91.30 0 89-67 A A176- 3 91.30 L - 4 TEHAMA AVENUE f NOTE geese parcels aro for assessment purposes Assessdr' s " Mop No. 30-46 ✓ Q4iy and may not constitute legal parcels. WAL_ MAW NL,. � County of Butte, Calif. vd LX c" J - C.4 -01A lvq VOL ZN � � ga, I 0 ca t03'5) toL ct" EL D C��zz 0 PLANNING DIVISION - BUILDING PLAN APPROVA I Use. c> � — Date: Z)-/ Parking:_ Landscaping: Other. Signature: .0 4 All AV CV7 5r/\ lzo DID 51 C&Jl� Pe,►r CIE ELECTRICAL, MECHANICAL, AND PLUMBING CONSTRUCTION ( NOT PLAN CHECKED SHAIL COMPLY WITH CURRENT EDITION OF NEC, UMC AND UPC. -"oo the sfusched o Pages ro BME COUNflr ...RUILDING DEPARTMI'll.- A* P. lu 2-Qa BME COUNflr ...RUILDING DEPARTMI'll.- A* P. EA J117.w IT. [: sty e 'Ito " o • C. 1" t pp BSE COON -i RVIL®ING DE1 ARTM417-,h 1 � sty e 'Ito " o • C. 1" t pp BSE COON -i RVIL®ING DE1 ARTM417-,h ti f SG- p %��lCtf ; 7"o I �oa�' L IVIO C ogr I rfr.4o9 D Fro P BUTTE COU q I Lit qUILDING DER RTME.�,,. 4 P P R C Zvi 01 3 11WaEK92@9 ch 0 r�c7 ", 4 BCSII-B►1 SUMMARY SHEET -GUIDE FOR HANDLING, INSTALLING AND BRACING OF METAL PLATE CONNECTED WOOD TRUSSES � 1 GENERAL NOTES NOTAS GENERALES Trusses are not marked in any way to identify Los trusses no estan marcados de ningtin modo que the frequency or location of temporary bracing. identifique la frecuencia o localizaci6n de los arriostres Follow the recommendations for handling, (bracing) temporales. Use las recomendaciones de manejo, installing and temporary bracing of trusses. instalaci6n y arriostre temporal de los trusses. Vea el folieto Refer to BCSI 1-03 Guide to Good Practice for gC511-03 Gu(a de Buena Practira nary el Manejo. Instals& Handling Installino & Bracing y. of Metal Plate Arriostre de los Trusses de Madera Connertados con Connected Wood Trusses for more detailed Placas de Metaloara para mayor informad6n. information. Los dibujos de diseno de los trusses pueden especificar Truss Design Drawings may specify locations of permanent bracing on individual compression las loralizaciones de los arriostres permanentes en los 83 Summary miembros individuales en compresi6n. Vea la hoja members. Refer to the BCS! 133 tQSumEO Sheet -Web Member Permanent Bracing/Web rm I -B3 para los amostres permanentes y refuerzos de los Reinforcement for more information. All other miembros secundarios (webs) para mayor informad6n. EI permanent bracing design is the responsibility resto de arriostres permanentes son la responsabilidad del of the Building Designer. Disenador del Edifido. ® The consequences of Improper handling, installing and bracing may be a collapse of the structure, or worse, serious personal injury or death. EI resultado de un manejo, instalaci6n y arriostre inadecuados, puede ser la caida de Is estructura o a6n peor, muertos o heridos. Banding and truss plates have sharp edges. Wear ® gloves when handling and safety glasses when ?�o cutting banding. Empaques y placas de metal tienen bordes m afilados. Use guantes y lentes protectores cuando R Corte los empaques. HANDLING - MANEJO QAllow no more No permita mas than 3" of defiec- de 3 pulgadas de tion for every 10' pandeo por cada 10 of span. pies de tramo. 10, 1a 6'mex. _ _ ' _ ���1tw• to T 1a IT QPick up vertical Levante de la cuerda bundles at the superior los grupos top chord. verticales de trusses. ONE WEEK OR LESS MORE THAN ONE WEEK �rwfl_ r QBundles stored on the ground for one week or more should be raised by blocking at 8' to 10' on center. Los paquetes almacenados en la Berra por una semana o mas deben ser elevados con bloques a cada 8 0 10 pies. QFor long term storage, cover bundles to pre- vent moisture gain but allow for ventilation. Para al(pacen-af0laniq por mayor tieril , cubra los paquetes para prevenir aumento de humedad pero permita ventilaci6n. Q Use special care in Utilice cuidado windy weather or especial en dias near power lines ventosos o cerca de and airports. cables elddricos o de aeropuertos. HAND ERECTION — LEVANTAMIENTO A MANO BRACING FOR THREE PLANES OF ROOF Q Trusses 20' or r7f Trusses 30' or EL ARRIOSTRE EN TRES PLANOS DE TECHO LI t less, support \� ' less, support at t , at peak. quarter points. r Levante Levante de This bracing method is for all trusses except 3x2 and 4x2 parallel chord trusses. del pico los los cuartos Este metodo de arriostre es para todo trusses excepto trusses de cuerdas paralelas 3x2 y 4x2. trusses de 20 de tramo los 1, pies o menos. trusses de 30 1 1) TOP CHORD — CUERDA SUPERIOR Trusses up to 20' pies o menos. Trusses up to 30' I� Trusses hasta 20' Trusses hasty 30' HOISTING — LEVANTAMIENTO Hold each truss in position with the erection equipment until temporary bracing is installed and truss is fastened to the bearing points. Sostenga cada truss en posici6n con la gr6a hasta que el arriostre temporal est@ instalado y el truss asegurado en los soportes. r Do not lift trusses over 30' by the peak. No levante del plco los trusses de mas de 30 pies. Greater than 30' Mas de 30 pies HOISTING RECOMMENDATIONS BY TRUSS SPAN RECOMMENDACIONES DE LEVANTAMIENTO POR LONGIRID DEL TRUSS Spreader bar for truss bundles 9 Ta line e���'e _ O O GDo not store No almacene unbraced bundles vertical mente los upright. trusses sueltos. Do not store on No almacene en uneven ground. tierra desigual. 60' or less Approx. 1/2 __j, truss length Tagline TRUSSES UP TO 30' TRUSSES HASTA 30' Toe -in TO oe-in Spreader bar 1/2 to j� 2/3 truss length TRUSSES UP TO 60' TRUSSES HASTA 60' Locate Spreaderbar Attach above or stiffback 1max. m mid-height (� F Spreader bar Im to 3/4 truss length —►jl Tagline TRUSSES UP TO AND OVER 60' TRUSSES HASTA Y SOBRE 60' Truss Span Top Chord Temporary Lateral Brace (TCTLB) Spacing Longitud de Tramo Es aciamiento del Arriostre Temporal de la Cuerda Superior Up to 30' 10' o.c. max. Hasta 30 pies SO pies m3ximo 30' to 45' 8' o.c. max. 30 a 45 pies 8 pies maximo 45' t0 60' 6' o.c. max. 45 a 60 pies 6 pies maximo 60' to 80'* 4' o.c. max. 60 a 80pies* 4 pies maximo -Consult a Professional Engineer for trusses longer than 60'. *Consulte a un ingeniero para trusses de mas de 60 pies. { C 7f See BCSI-B2 for TCTLB options. LJ Vea el BCSI-B2 para las opciones de TCTLB. 1+ ® Refer to 0L2 -B6 I Summary Sheet - y' Gable End Frame 1 11 Bracing. 1-7f Repeat diagonal braces. Vea el restimen IJ I SCSI -66 -Arriostre Repita los arriostres del truss terminal diagonales. i de un techo a dos aquas. f= if Set first five trusses with spacer pieces, then add diagonals. Repeat IJ process on groups of four trusses until all trusses are set. Instale los cinco primeros trusses con espaciadores, luego los arriostres diagonales. Repita Este procedimiento en grupos de cuatro trusses ii hasta que todos los trusses estan instalados. i 2) BOTTOM CHORD — CUERDA INFERIOR Lateral braces 11 2x4x12' length lapped t' over two trusses. t ' f 4,onal braces every 710trus�s spaces (20' max.) + 10'-15' max. F Some chord and web members not shown for clarity. BRACING - ARRIOSTRE © Refer to BCSI-B2 Summary Sheet - Truss Installa-3) WEB MEMBER PLANE — PLANO DE LOS MIEMBROS SECUNDARIOS 7 r tion and Temoorary Bracing for more information. t Vea el res6men BCSI-B2 - Instalacl6n de Trusses y Arriostre Temporal para mayor informaci6n. *1 . Web members Do not walk on unbraced trusses. n No camine en trusses sueltos. QLocate ground braces for first truss directly in line with all rows of top chord temporary lateral bracing. Coloque los arriostres de tierra para el primer truss directamente en linea Con cada una de las filas de arriostres laterales temporales de la cuerda superior. Brace first truss well �— before erection of additional trusses. Top Chord Temporary Lateral Bracing (TCTLB) 10'-15' max. same spacing as bottom chord lateral bracing r Diagonal braces every 10 truss spaces (20' max.) Some chord and web members not shown for clarity. 46 DIAGONAL BRACING IS VERY IMPORTANT iEL ARRIOSTRE DIAGONAL ES MUY IMPORTANTE11 BRACING FOR 3x2 AND 4x2 PARALLEL CHORD TRUSSES EL ARRIOSTRE PARA TRUSSES DE CUERDAS PARALELAS 3x2 Y 4x2 ®Refer to SCSI -B7 Maximum lateral brace spacing Summary Sheet 10 o.c. for 3x2 chords - Temoo� and 15' o.c. for 4x2 chords Diagonal braces Permanent Bracino 10' 011`' every 15 truss for Parallel Chord spaces (30' max.) Trriccac for more Gypsum Board information. Tolerances for Out -of -Plane. — Tolerancias para Fuera-de-Plano. Vea el mcGmen Asphalt Shingles BCSI-87 - Arriostre Max. Bow F'�' 'r temporal v Permanente de The end diagonal trusses de cuerdas brace for cantilevered paLalela5 pat mayor trusses must be placed Lateral braces Informad6n. on vertical webs in line 2x4x12' length lapped 14.6' with the support. over two trusses. INSTALLING - INSTALACION Gypsum Board 12" Tolerances for Out -of -Plane. — Tolerancias para Fuera-de-Plano. 16" Asphalt Shingles Q Max. Bow Max. Bow Length Max. Bow Truss Length Clay Tile fl �--•y •-•-- - -------------------- II �— Length --► II 3/4" 12.5' Mex. Bow Length —► 7/8° 14.6' Q Tolerances forT1 D/50 D (ft.) 1 ° 16.7' Out -of -Plumb. I ; 1/4" 1' 1-1/8" 18.8' Tolerancias para ' 0 1/2" 2' 1-1/4" 20.8' Fuera-de-Plomada. a1_3/8" 2P g o Plumb 3/4" 3' bob 1° 4' D/50 max -- s CONSTRUCTION LOADING — CARGA DE CONSTRUCCION ® Do not proceed with construction until all bracing is securely Maximum Stack Height and properly In place. for Materials on Trusses No proceda Con la construcci6n hasta que todos los arriostres est6n colocados en forma apropiada y Segura. Do not exceed maximum stack heights. Refer to BCSI-B4 Summary Sheet - Construction Loading for more information. No exceda las m6ximas alturas recomendadas. Vea el res6men BCSI-B4 Carga de Construcci6n para mayor informacf6n. Material Height (h) Gypsum Board 12" Plywood or OSB 16" Asphalt Shingles 2 bundles Concrete Bloat 8" Clay Tile 3-4 tiles high I i Do not overload small groups or single trusses. No sobrecargue pequehos grupos o trusses individuales. QPlace loads over as many trusses as possible. Coloque las cargas sobre tantos trusses tomo sea posible. QPosition loads over load bearing walls. Coloque las cargas sobre las paredes soportantes. ALTERATIONS — ALTERACIONES / ® Refer to SCSI -85 Summary Sheet - Truss Damage ]obsite Modifications and Installation Errors.' Vea el resumen BCSI-B5 Dafios de trusses Modificaciones en la Obra y Errores de Instalad6n. Do not cut, alter, or drill any structural member of a truss unless specifically permitted by the Truss Design Drawing. No torte, altere o perfore ning6n miembro estructural de los trusses, a menos que est@ especificamente permitido en el dibujo -- – del diseno del truss. ® Trusses that have been overloaded during construction or altered without the Truss Manufacturer's prior approval may render the Truss Manufacturer's limited warranty null and void. Trusses que se han sobrecargado durante la Construcci6n o han sido alterados sin una autorizaci6n previa del Fabricante de Trusses, pueden reducir o eliminar la garanda del Fabricante de Trusses. NOTE: The Truss Manufacturer and Truss Designer must rely on the fact that the Contractor and cane operator (if applicable) are ca- pable to undertake the work they have agreed to do on a particular project. The contractor should seek any required assistance regarding construction practices from a competent party The methods and procedures outlined are Intended to ensure that the overall construction techniques employed will put floor and roof trusses Into place SAFELY. These recommendations for handling, Installing and bracing wood trusses are baud upon the collective expedenco of leading technical personnel In the wood buss Industry, but must, due to the nature of responsibilities Involved, be presented only as a GUIDE for use by a qualified Building Designer or ErecdoNlnstalladon Contractor. It Is not Intended that these recommendations be Interpreted as superior to any design specification (provided by either an Architect, Engineer, NeBuilding Designer, the Erection/Installation Contractor or otherwise) for handling, Installing and bracing wood trusses and it does not preclude the use of other equivalent methods for bracing and providing stability for the walls and columns as may be determined by the truss Erection/installation Contractor. Thus, the wood Truss council of America and the Truss Plate Institute expressly disclaim any responsibility for damages arisingfromthe use, application, or reliance on the recommendations and Information contained herein. 1711.17 WOOD TRUSS COUNCIL OF AMERICA TRUSS PLATE INSTITUTE One WTCA Center • 6300 Enterprise lane • Madison, WI 53719 583 D'Onofrlo Drive • Madison, WI 53719 608/274.4849 • www.woodtruss.com 608/833.5900 • www.tpinst.org BIWARN11x17 031125 M� I TEN HOJA RESUMEN DE LA GUTA DE BUENA PRAC-TIGA PARA EL MANEJO, INSTALACION Y ARRIOSTRE DE Lr--I­­ .TRUSSES L?E MADERA GONEGTADOS CON PLACAS DE METAL J