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HomeMy WebLinkAbout039-270-143k f _ 3.9 -.2.7$. -fit NA CANFIELD ��?� [ � lUi" SW Third & Dayton West, Dayton I 19 a Contr; Irriga 'on Pump & ELe Permit#3688-86P, til, MH) ELEC 6ipi¢ GAS D ` 314o pl q•w� . ` ^OMPACTION. .TEST ,RE .tlb SUPPORT STR RE W 7 NoM : 0'D✓IOf+f. •x� 39-27-.K- /q-5 e -r -m -it... 3-87MHI- - - Iss 39-2786$-91MHI CANFIELD, Everett 3954 Cartwright St, Dayt (MHI EXISTING SITE) 39-27-.9,t -' T. 92=645NHI _ CANFIELD, Everett.'. 3954 Cartwright St, Dayton f * ♦.. _ •; '.. '{_. 1. •. � _ }: • R ID NTIAL 39-27-02 CANFIELD, Everett 3954 Cartwright Dayton (mhi) e ye- S JOB FINALE Signature 0 P, J=OK O = Not OK Nat Applicable MOBILE HOMES NotRead t Ready Date MOBILE HOME UTILITIES (Plans) OK except #'s w 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-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card 6-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s oninq Requirements -Setbacks Easements 4. Footings; Size -Spacing -Marriage Line . Gas; MH Test -Demand -Valve -Connector lectncity; MH Test -Crossovers -Breakers -Clearances k16rain; MH Test -Fall -Flex Connector Water; MH Test -Regulator -Connector Water and Sewer Connected -C/O to Grade -HD Approval & 8 and Electricity Tagged ,pelxits; Insp.-Sketch 1�ert. of Occupancy Date Y"? Card B-1 [�' y, 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; Griders and/or Joists -Decking -Bracing -Stairs -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-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes -Enclosures -Panel boards -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 ✓=OK O=Not OK = Not Applicable RESIDENTIAL (Single & Duplex) ' =Not Ready _ - Date UNDERFLOOR (Plans) OK except A's Date FRAMING (Continued) 1. Zoning -Setbacks -Easements -Flood -Slope' 45. Hangers -Post Caps -Anchors -Connectors 2 Flo Main& Soils-Elec Grnd -/ P' Ft De th -- ---- 9- P 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-Wra pped 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 ------------------ ---------------- - 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 A'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. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI - ------------------------------ ---'------------------------- 28. Subfeed Wire Size / r ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No ------------------------------ ------------ - --- --- 30. Service -Riser Conductors & Ground -Main Disconnect --------- --------------------------- ------- -------------------------- 31. Equip. Clearances Panels- Motors- Mech. Equip. ---------------------------------------------------------------------------------- 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector ------------------------------------------------------------------ Date Card B-1 Date Card B-1 -------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except A'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 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 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. 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 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,6-1 Date FINAL (Plans) OK except N's _ 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector ---------------------- 63. Furnace: Vents -Clearance -Comb. Air -Connector- -_ In Garage; Above Floor -Ducts -Meeh. Protection 64. Bedroom Exiting ---------------------------- -- 65. G.F.I. & Bath Fixtures & Tub Access -Spa -------------------------------- 66 Elec_ Trim & S_u_b_panel; Breaker Sizes & Labels ---------------- 67. Stairs & Rails 68. Fireplace or Stove: Clearances -Hearth --------- - ------------------ 69. Elec. Outlets at Wood Panel: Int. & Ext. 70. Kit Fixt_& Appliance_Grnd_Air Gap -Cooking Clearance -------------- 71. Elec. Outlets & Receptacles at Kit. Counter - 72. -Garage -Fire Door Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor-Mech. Protection 75. Plb.. Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic 0 Yes ----------------- ----------- ------- -- 78. Guard Rails & Deck Construction -Post Caps 79. Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ 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: MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT N0. Address or location of mobi lehome 3J- S 41 C A fZ i vJIZ!G t•I 7 I ,,Owner's name CAN F1 rt N Owner's address %�► '> 4 C A% r Uv k (r, q T Insignia or hud number IAIC I O LVC g6?1 Manufacturer's name UJ (- S i y all) R )n-ir_ S Cd 1z 1, 1f-" 2rJl� Serial number of V.I.N._ 431-7-&o 031 3� C:1 10t?„,l Year of manufacture 4— (Official Approving Installation) (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION AgpAPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE S MOB.�EHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White - Owner, Yellow - Installer, Pink - D.P.W. 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 • 39-27-2 ZONING' A 40 BUILDING PERMIT OWNER EVERETT CANFIELD TELEPHONE 589-3251 so• FT. occ. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. BOX 335 OROVILLE CONTRACTOR'S NAME UNKNO14N TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation is Filing Fee g $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 20.00 Ener Plan Checking Fee 9Y 9 $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGR CARRIGHT STREET DAYTON 95927 3954 TW Permit fee $ 3 ' 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❑ Mobilehome[3 Other SPECT FY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation EX Other ❑ Describe work: _M14 T _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200A TO 1o0OA1 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) �- I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUPM OR ADDNS. (ACC. BLDGS. 3.64 sq.ft. NEW CONSTR ULT' -OUTLET NON•RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS h\ I SINGLE OUTLET CIR. / Ex. Occup(OUTLETS OR FIXTURES 20 @ 76 FIXED APPLNS. R EX. Occup. OUT ETS (RESID )EA.� I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ,Fil 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 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 78'nce f the ting of this permit. G X Date /�� An OSHA permit is required For excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TO L E HAz I DFE I FLo C PARCEL H Issu This permit is hereby issued under the sions of the Butte County Code and/or work indicate ove f r which fees E F PUBLIC By .-. PERMI XPIRES Date applicable provi- resolutions to do have been paid. WORKS i ate /3- Receipt No. 110413 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 3 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE PER IT APPLIGkA�TION DATA SHEET OWNER Z Ue Q. 17_ cj2a t / Q 'Id Proposed Building Use /A �AT Building Inspector_ 916/538-7541 Permit No. / No. 3g`Z 7-z Date3 -9 9 2 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ............. ........................ 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. En i eered truss details and layout in duplicate (required prior to plan check) 0bilehome installation data including manufacturers insta`latio� instructions ....... sti ��..n� a,7etrr, a�� % (vlt�• . , . • ee t A. 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... Park fepaid ......................... 13. C 4to School District fees paid .............. �a — 14. Sanitation approval from f nHealth Department Q 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) ... Planning approval for (A) Use: (B) Parking: ...... ,444f- 4ft 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... `1 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Le ter signature authorization ........ i 26. �/iA 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. _ Telephone and hold for pickup at office. Deliver w/inspector. Other 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: Contractor, designer, owner, was advised of above required data byZphone___rnail—counter byov..date Contractor, designer, owner, was advised of above required data by_phone_mail co/unr by date Plans checked by Date Plans approved by Date — Sets of plans on hold in File cabinet AP folder Copy—DPW TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location ar# / Plan Approved for: Sewage Disposal Water Supply Hold final for: Final clearance O.R. for: Clearance for Z--bedroo mobile home NOTE * * * Other Water Supply Water Supply ,r ?- I. Date Sanitarian .`"�"•'; .ww...--.ra^� ",rears•^K^►';^.`-�ti-r.-.-+F"..-,-..:..-.+r......�nayg'+`'x%7*ta}iMM°"iYyj'wi "iK+xfi .v'+,.-,+...�y.w.i: k..:_.y. �-.. ,�. 1 TNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM UT E COU '(One'Form:per .Building) A.P. Number 39-;0- 2 Building Department No. School District �)j_kCAVY\ City Q County Jurisdiction Property Owner Project Location/Address335"' C'G fiwric,lz S�• /JO(vTOVI. Subdivision Lot Number cc , Re idj�ntial Development: # of Living.MHI Units Sq. Addition Footage L3 C)';7 (Group R Commercial/Industrial: Sq. Footage New Addition (Including Exterior Roofed Areas) Build ng De tment Representative Date (Floor Plans reviewed by School District Personnel) District�'=Idd"No. School District certifies that (Applicant Name)', (Phone Number) i .,(Street Addre s ) ( City) ,,,r �(State) } OZip Code) has complied with the requirements. -of Resolution No. � 7-L by the -payment of $ representing ,3 square feet. chool District Representative ,.-PAID BY CHECK NO. A BANK NO PAID BY CASH Date REMARKS: white -applicant, yellow -building department, -pink -school district SCHOOL.FEE (8/88) M COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovllle, California 95965 - Telephone: 916.'538-7541 ` APPLICATION AND PERMIT AS3E339R, PARCEL NUMBER ZONIN BUILDING PERMIT l OWNER / TELEPHONE� 3 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS Oro e CONTRACTOR'S NA ME ^r', ga OW TELEPHONE CONTR TOR S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee ,$, 15'5.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT O_ R ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ' ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS s arfiwrl �. LS - Permit fee $ S PLUMBING PERMIT Filing Fee 15.00 5 2 Each Trap 5.001 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[]Mobilehomel Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New ❑ Addition ❑f Remodel ❑ Uti litie Installation Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 2000AA OR LESS 20OR LESS 18.50 Main service 200A TO t000A1 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.&) OR ADONS. ACC. BLDGS. I 3.54sa.tt. NEW CONSTR. ULTI-OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS S (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20 76d FIXED EX. Occup. OUTLETS P(RESID )REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such Provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 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. X Date Signature Applicant ❑ Contractor ❑ Agent ❑ An OSHA ons over 5'0" deep and demolition or construct- ion of structures roverr/39stories inheight. 7 Mobile Home Installation Fee $ 707 Energy Inspection Fee $ occ 1 CONST TYPE I TOTAL FEES 00 HAz OFEES IMP I FLOOD COF PARCEL I PO HD ISSL•c 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. 110 % 1J wNITC•O. P. W., TCLL0W-A3eC330R, PINK -INSPECTOR, GOLDENROD -APPLICANT This set of plans' and specifications MUST be: kept on the job at all times and it is urilawfu'l'-ft-n- make any changes or alterations on same witty out written permission from the Department of" Public Works, Count/ of Butte. it VIVF�I ly - - 50 it. from the road centerline Shall be clear Of structures or equipment except jor-a 2 tt eave overhang -*V 0K-- NOTE:—AN K -- NOTE -,AN Materials & Workmanship Shoo Be In Accordance with Recognized Good Practices and of a qualify prescribed, far the Specified use in the Uniform Building. Plumbing & Mechanical Codes a ibe Natiormil Electrical Code. COUNTY f%r-n,&a-aAF-HT BUILDING. APPFt.OVED /IZ Cc" *Mmnff "stal e f { I � • i. wa r ti. J �•ti N C17 l i ... 1.1 ii (� � s e ti. J 3 ell X01: �y � •rw,( w.n � I.sfto ww. v� K/iaV. t./ oa • ik .ii iD e MOBILEHOME SUPPORT DATA If other than single wide, Mo'bilehome Mf � � � ���/ furnish Setup Model No. "2149 / Year VZ Width2 c/ (ft.) Box 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 (if not on file with the County of Butte). FOOTINGS (check one)o1. Wood -pressure treated or foundation grade. El 2. Other (specify) SUPPORTS (check one) 1:11. Concrete block. . Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Main Beams � �+ Line 2 —— — � Main Beams Tag or Triple — — — — — — — r� Linn L Line 1 Line 1 Piers: Line 1 Openings: Size-Min.------------ Spacing-Max - -----------Spacing-Max. --------- From Ends -Max. ------- Line 2 Piers: Size -Min. ------------ %Spacing -Max. ---------From Ends -Max.------- Line 3 Roof Loads: Size -Min - ------------"x3O.. Location (From Front) 7 _ Line 4 Piers: Size-Min------------- Spacing-Max ---------- From ------------Spacing-Max.--------- From Ends -Max. ------- Line 5 Roof mads: Size -Min. - ----- ------ location (Prom Front) Size -Min. ------------------ , u x Each Side of Openings With Width over --------- = Line 3 Piers: (Under Bearing Wall Only) Size -Min .------------------ ,k , Spacing -Max.--------------- From Ends -Max -------------- e 5 Piers: (Under Bearing Walls Only) Size -Min .------------------ Spacing -Max.--------------- From Ends -Max .------------- '- BUTTE COUNT BUILDING DEPARTMENT APPR0VE.D._. BUTTE COUNTY DEPARTMENT OF PUBIC WOkkS 7 County Center Drive, ,Oroville;-�CA' PHONE: 538-7541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name: ( &)I/ -F Llo 2.. 3. Installer's Name:e5i- r" --a761Ze Is the site currently under permit? —S'ALEf Yes No (If yes, furnish permit number ) OR Is the site an existing site? - Yes No a' (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes E No 1:1 (If no, clarify 5. What is the mobilehome electrical rating? --------------- /00 amps 6. What is the mobilehome site service rating? ------------- toy Amps 7. What is the mobilehome site circuit breaker rating? ----- /00 Amps 8. Is there any other electric load to be served by the mobilehome site service? -------------------------------- Yes No (If yes, identify the load and size: IZ I. (Load) SSU (Amps) 9. What is the mobilehome site gas pipe size? -------------- 10. What is the type of gas service? ------------------- Natural 11. What is the gas pipe length from meter or tank to the 51Y (in.) F1 LPG I7 mobilehome?--------------------------------------------- /oZ (ft.) 12. What is the mobilehome gas demand? ---------------------- S3 6-w o (BTU) *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) Z/ -L CTI O Tempa Power Pole _ Called PG&E _ Temp. Elec. Service Called PG&E_ Temp. Gas Service Cal led PC JOB FINALEI Signature i y PERMIT NO. 3688-86P E MH) PERMIT EXPIRES OWNER NINA CANFIELD CONTR. Irrigation Pump & Ele ASSESSOR PARCEL 39-27-2 lot 19 LOCATION SW Cor Third & Dayton West, Dayton OFFICE COPY Address I GAS Meter By Date2 ELECTRIC j i Meter By Date � �! i Tempa Power Pole _ Called PG&E _ Temp. Elec. Service Called PG&E_ Temp. Gas Service Cal led PC JOB FINALEI Signature i J = OK O = Not OK — = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS Date OBIL OME UTILITIES (Plans) OK except q's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1 o ing Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—Easements .D So' s; Special MH Support—Sketch �� 2. Footings; Size—Depth—Spacing—Connectors Se er; Location—Test—Fall-C/0—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails r; Location—Test—Easement Needed (Sket h) / 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rig.—Bracing lectricity; Location—Clearances—Grnd.—/ Amp—Concrete _ 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location--Test—Wrap:/ /"L"ft./ /"Nat. or//40'L "LPG 6. Carports; Windows—Doors 7 ility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoni g Requirements—Setbacks—Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except #'s 1, Setbacks—Easements 2. F 'tin , Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability G , M, -Test— errand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining ctric' y; M Tes Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI Dr ; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI ater; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. W r an ewer Connected—C/O to Grade—HD Approval 7• Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater . Ga nd Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit U.Kxi; Insp.—Sketch 1 . ert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test D Card B -I ate Card—l Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK 0 = Not OK rf e = Not Applicable = Not Ready RE$IDENj�AI'(Sing•le and Duplex) 3k Date UNDERFLOOR Plans OK except N's Date.: FRAMING (Continued) Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits - 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Fig., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. _ Plywood on Root Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. _ Siding -Nailing -Veneer 6. Slemwalls, Garage: Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access ---1-18.- 7 Piers -Fireplace Ftg.-Steel D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test. 54. _ Glazing Area -Glass Protection -Skylights -Plastic 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10.. Water Pipe: Test -Anchors -Regulator -Service Test, 11. 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. _ ___ 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples _ Card -BI Card -BI Card -BI Date Card -BI Date Date Card -BI Date Date Card -BI Date Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings i ` 57. Smoke Detector Card -Bl Card -BI 14. 15. 16. 17. 18. 19. Water Ht.: Vent -Access -Combustion Air Water Pipe; Test & Anchors -Nail Protection D.W.V. Test-Fttngs & Anchors -Nail Protection Shower Pa_n: Test, First Floor -Tub Access Test Tub & Shower, 2nd Floor -Tub Access Gas Pipe: Size & Anchors T - Date _ Card -BI - Date Date Card -BI Date + 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 59. Bedroom Exiting 60. G.F.I. & Bath Fixtures & Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 1 62. Stairs & Rails (r 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. : 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter ' Date ELECTRICAL Permit OK except q's_ 'fir 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper Card B -I Card B -I 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. Fixture &Transformer Clearance -Ins. Protection Elec. Receptacles Spacing -Lights & Switches at Doors Size Boxes & No. of Conductors -Stapled Romex Installed -Close to Edge of Studs & C.J. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen &_Conductor Size Subfeed Wire_ Size / / ga. Cu or AI -A.C. Wire Size / / ga. Cu or At Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral _.Yes _)No _ _ Service -Riser Conductors &Ground-MainDisconnect __- Equip. Clearances: Panels-Motors-Mech_ Equip. Clothes Closet Light -Shower Light _ - - -- -..- Date CardT61 Date Date Card -BI Date 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 70. Plb., Elec. & Mech. Equip. Listed for Location 71. 72. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. Insulation -Foam -Looked in Attic ❑Yes 73. Guard Rails &Deck Construction -Post Caps 6 74. SP Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 75. 76. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No Stucco; Brown -Finish 77, A.C. Unit; Disconnect-ClrncesrBrkr. & Cond. Size -115V Outlet 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opn s. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House 82. Glass Protection Date MECHANICAL (Permit) OK except N's 83. Corrections from Previous Inspections 84. Gas -est-Meters Tagged; Gas -Electric Card -81 Card -BI 31. 32. 33. 34. 35. A.C. Ducts. Insulation & Support _ - -- Vent Fan: Exhaust above Insulationg6, Condensate Drain & Overflow: Size & Grade _ Furnace -Vent: Access -Comb. Air -Return Air__Ve__n_t-_11.5_V outlet Attic Access & Platform if Furnace in Attic - j- Date Card -81 Date Date Card -BI Date :f 85. Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates -"- Card -BI Date Card -BI Date Card -BI '),te Card -BI Date Card -BI G.ite Card -BI Date Date FRAMING(Plans) OK except Ws ? Com: ienls at Final: 36. 37. 38. 39. 40. 41 42. 43. 44. 45. 46. 47. Sills; Proper Material & Anchors Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fire Stops: Furred Ceilin s -Stairs -Chases -Tub Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rttr. Ties -Purl in - Roof Brac.-Truss-Shthng.-Rfng. { Fireplace Ties or Type A Flue -Fireplace Throat Artic Access: Size & Romex Protection -Draft Stop -Ins. Battles` Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing - _- _ - - y (NOTE' Anentry must be shade each time youvisit jobsite) MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 Address or location of mobilehome _ Owner's name Owner's address Insignia or hud number Manufacturer's name Serial number of V.I.N. (Official Approving Installation) PERMIT N0. Year of manufacture, (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE Cali OWNER PERMIT NO. A routine�:inspection indicates that the following violations of County Ordinance exist at the above''address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. clr UT d <u �idNS �U �Gu�CX coo Inspector—^� Date -'2 // COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway -and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector— Date—':Z7'--A0 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE37 OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. �� 'j'111 = I _ ' / � ' �/1.��' / ..� a .d► ,� 1/i fal G— 4925 Inspector "e ���, Date tl COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE V) 17-- A A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation„ _ pleasecontact this office immediately. - "J C V o,-, ' "ill— - / tQ �ie L// 7- Inspector COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California,95965 - Telephone 916/534-4541 APPLICATION AND PERMIT CXP M I T N 0 ASSESSOR PARCEL NUMBER j_ ZONING Y BUILDING PERMIT OWNER I C- , TELEPHONE Y9.1 -5 ,SQ. FT. OCC. BUILDING VALUATION OWN R'S MAILING ADDRESS ` O 1( T� 1 CONTRACTOR'S NAME ` 1 rJ r� 1 TELEPHONE CONTRACTOR'S M LING ADDRESS Fireplace CONSTRUCTI N LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ IS,UV Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS + W r>n�rr' 1 T Permit fee $ UQ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[]Mobilehome� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home 16110W 10.00 ea 36t0U TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities(R Installation❑ Other ❑ Describe work: ,f-rv%, Permit Fee $SjtV. C)L) Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V DR LESS 100 AMP OR LESS 10.00 lb, VO Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions Of Chapt. 9, Div. 3 of the BUslnesS and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason oR ADDNST ( DWELLIN GSCCUP tr) '/z¢sgft NEW CONSTR. ULTI.OUTLET 2.50 ea NON.RESID BRANCH CIRCUITS) POWER APPARATUS &) ' (SINGLE OUTLET CIR. ,Ocs Ex. Occup(OUTLETS OR FIXTURES 2ALI 30 eAL030 FIXED APPLNS. R Ex. Occup. OUTLETS ((RESID )EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 /$= Jo Misc. Wiring 15.00 Permit Fee $ $'p Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. i agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgm ts, colts, and expenses which may in any way accrue aga' t said Cou ' cons PCueQce qythe granting of this pe2rmi . Q/ V Date 4 Q U (O 1.sions Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is ryui d for ex . ions over 5'0" deep and demolition or construct- ion of structuress veer s ries in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ , occUP, CONST.TYPc JFLD D PARC P ND 1890E This permit is hereby issued under of the Butte County Code and/or work indicated above for which DIRECTO F PUBLIC BY PE IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS o p Date [ �f,Psd - - �' Receipt No. 6D -l�3 V WNITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT t' w . r... ti . k t •nom q r-r+�L � ;, ,, .'� '4.. •;staa� -• ..: , , f • � _• ... COUNTY OF BUTTE - DEPARTMENTvOF PUBLIC WORKS - BUILDING DIVISION r 7 COUNTYCENTER DRIVE - OROVILLE, GALI'FORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Permit No. �0 19 OWNER Cn--j t'f A. P No. 391— eZ7 —Qw Proposed Building Use I!v\ H lr(., Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing andJor issuance: DATE RECEIVED APPROVED 1 , All items have been submitted. . . . . . . . . . D �2. Plot plans in dupl"icate'/tripli_cat , signed by preparer of plans. 3. Complete plans in duplicate. /triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD ''Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . �9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from (f1; ,,,j Health Dept. . . ),�—y_ 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to owner (]•). _15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . . Pre-Inspec.request to _(Dote) 7. Pre -Inspection for Required. Building Inspector . 18. Recorded copy of Agricultural Acknowledgment Statement.Z%n 9. Driveway Permit. 20. Plot plan approval from city of 21. 22. When yogi.issue the permit, process as follows: Mail to owner, Mail -to contractor. Telephone 3ya sGa and hold for pickup at .k?—office, Deliver w/inspector. Other Copy of plans sent Health Dept., The following data must be submitted pri 1. Index permit for above items No. 2. Additional items required: Fire Dept., Other Date k it issuance: (Circle new item not checked above). i - r Contractor, designer, owner, was advised of above required data by_phone---nall—counter bye date Contractor, designer, owner, was advised of above required data by—phone —Mal l—counter by ;% date 12 Plans checked by Date Plans approved by �' ''Date r Sets of plans on hold in File cabinet AP folder f' — Flours: 10:00 a.m. - 3:00 P.M. Copy—DPW TO: Bui ldir - Deartment i FROM: Environmental Health, Chico e— . ' / 9 SUBJECT: Sanitation (Clearance �C%e-� C� .�7Pd -1-4/,-� � Owner Location AP# Plan approved for: sewage disposal water supply Hold final for: water supply Final clearance O.K. for: water supply Clearance for 2— bedrodci@bile home. they Note*** Sanitarian Date 0 TO: Building Department FROM: Encroachment Permit Section RE: Driveway Clearance `I, 4 owner location / Driveway permit e 7 - 0.,2,. AP # has been issued for the above property. signa/pdre date X A,` , t phis sef of plans and specifications MUST be l kept on,thQ job' at all times and it is unlawful to i maker any- chpn$es or alterations on same without written permisson from the Department of Public t YVorks,; County ,of Butto, • ( � I � ! � �� � � , (moi - r �'� Q�dg�� '� Z a • i � � L i � � � � � � � � ti. p� N a arc Qd t -. � .,. _. � �• . _ _ ���q' . �' �,� � Got �,�y� •, �tt� � rv�, f , Y �� x 01L c�` \ , 17. ' Y Z, +.r Y LI#jlitI cone tions shall be within .' ;c! ft: the m bii-horns, either l cl.e ly be ii nd or vyitnin t } �, '-► I half of the ` { Cnbb leho e.64-1 A \eIt etba k of ft. from the tyilines a d a setback { # Y t.: qm the i ad r , ine hill be c .ar.of ItI j,44 rfs or �qui!�men except fi- ..� .. . t: save overhang. I �- 86.44205 Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT BUTTE COUNTY, OA. FOR RESIDENTIAL DEVELOPMENT R£ CORDER'S OFFlCI: Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. 19DEC 12 PH 12' 09 86-44205 The property described herein is adjacent to land or included RECO�RD 0 ATT REPEST Of within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herb es esticide� : and fertilizers; and from the pursuit of agricultural operations including,lbut not limited. to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on qpejs adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Lots 19 and 20 of Block 6 of the Town of Dayton, as the same appears of record on the Official Map of said Town, filed as of record in the Office of the County Recorder of the County of Butte, State of California. Date: PROPERTY OWNERS: State of ) On this SS. me, the County of ) 1411 the /( _ day of J 19141_, before undersigned Notary Public, personally appeared Personally known to me. JOS, Proved to me on the basis :NOTARY ONALD DRIVON of satisfactory evidence. -m BPUBLutte InALIFORNIA to be the person(s) whose names) subs ribed to tt mission Expires Sept. 16, 1989 the within instrument and acknowledged that executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public Present A. P. No. 0— OOJ --D END OF DOCUMENY COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville,jCalHornia.95965 - Telephone 916/534-4541 _ APPLICATION AND PERMIT ASSE SOR PARCEL NUMBER - a`7 oma- ZONING 4 BUILDING PERMIT Ow iER ✓�a. TELEPHONE S0. FT. OCC. BUILDING VALUATION WNER'S MAILING A DRESS C� CONTRALTO 'S NAME TELEPHONE 'CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10,00 LEND R'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS sPermit w fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 1 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL. MAP Water piping _ 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome)L Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S FG JW O.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installations Other ❑ Des ribe work: - Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 service 00V OR LESS Main 1 100 AMP OR LESS 10.00 Main Service EA. ADD'L 100 AMP 2.50 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) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.N S. , DDONIS. A ) /20sgft NEW UL•TBOUTLET NON.RESIO BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. Ex. Occup( 20®50s p OUTLETS OR FIXTURES SAL030 EX. Occup. OUTLETS P(RESID IRE A.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Virin 15.00 9 ++ 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. / LJ ' 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 10.00 Heating Cooling g Hood 3,00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and exp ses which may in any way accrue against said County in con quen not granting of this permit. %� Date / �`Z�% Signature of Applicant — _044, [ 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 $ 14 �51 Energy Inspection Fee $ TOTAL PERMIT FEE OCCUP, CONST*TYPEJ FF\D PARCEL PD I ND 39UE This permit is hereby issued under sions of the Butte County Code and/or work icate. a ove for which IR CTOFk OF PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS A Date�f2 �^ N Receipt No.—T7�7 4q WNIT!-D.P.W., YELLOW -Ase E99OR, PI K -INSPECTOR, GOLDENROD -APPLICANT .,,7-P:' •� ! ., .. -,_ �,y .. ., 3 s -,. .�- a� . , .,v ..a.s:..., .,., .,..�.-.r.;,., s.;>r fair viii dit T.+ . 'c. COUNTY OF BUTTE - DEPARTMENT -OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTEF$IDRIVE - OROVILLE,-CALIFOFTN''rA 95965 - TELEPHONE: 916/534-4541 w % ' --* PERMIT APPLICATION DATA SHEET OWNER Proposed Building Use Building Inspector At time of permit application, I was advised the following data must be submitted prior to permit processing and:/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate./triplicate, signed by preparer of plans. . 3. Complete plans in duplicate./triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) } 14. Owner -Builder Verification (Given to owner0, Mail to owner ❑.), Improvements may be required. . . . . 16. Mobi lehome Installation Data. . . . . . . . . . 17. Pre -Inspection for Required- Pre"Inng In request to (Date) p q Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. 21. Pjot plan approval fr m city of i(b d� �_ 22. �x-S When y_ou issue the permit, process as follows: Mail to owner, Mail to contractor. Telephone and hold for pickup at office, Deliver w/inspector. Other Applicant Date Copy of plans sent Health Dept., Fire Dept., Other Date 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---nail—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l_counter by date Plans checked Sets of plans on hold in Copy—DPW Date Plans File cabinet AP folder — Hours: 10:00 a.m. - 3:00 p.m. COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 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) 2. 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 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 Social Security Number 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. 1. Owner's Name 2. Installer's Nam 3. Is the site cur /_ (If yes, furnish permit number 60'009 - 'OR Is the site an existing site? Yes 19 No I Y ' w o BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes 1�1 No F] (If no, clarify E 5. What is the mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? --------------- ���(� Amps 7. What is the mobilehome site circuit breaker rating? ----- h �_ Amps 8. Is there any other electric load to be served by the . mobilehome site service? ---.-� - ------ Yes Dd No 0 (If yes, identify the load and size: Wad) - (Amps) 9. What is the mobilehome site gas pipe size? -------------- (in.) 10. What is the type of gas service ----- Natural LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- (ft.) * 12. What is the mobilehome gas demand? ---------------------- (BTU) *(This information not required if pipe.length less than 6 ft. on natural gas or less than 50 ft. on LPG.) w BUTTE COUVIII 4 BUILDING DE?ARTMEN? MOBILEHOHE_SUPPORT DATA If other than single wide, Mobilehome Mfr. /� furnish Setup Model No. Year l Width(ft.) Box Length_&jQ _(ft.) Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). FOOTINGS (check one)M1. Wood -pressure treated or foundation grade. 2. Other (specify) SUPPORTS (check one) R1. Concrete block. R2. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE Line 1 Piers: Size-Min.------------ Spacing-Max - -----------Spacing-Max. --------- From Ends -Max. ------- Line 2 Piers • /AX mj � Size -Min.------------ r •rz i �ff /� Spacing-Max.---------x From Ends _Max Line 3 Roof Loads: Size -Min. ---------- Location (From Front) Line 1 Openings: Size -Min. ------------------ 1 ax „ Each Side of Openings �• With Width Over ---""-- Line 3 Piers: _Wnder Bearing Wall Only) Size -Min .------------------ Spacing -Max._______________ From Ends -Max .------------- Line 4 Piers: Line 5 Piers: (Under Bearing Walls Only) Size -Min.------------ , „ Size -Min ------------------- Spacing-Max ---------- ------------------Spacing-Max.--------- ,_ Spacing -Max ----------------- From ------ ------From Ends -Max.------- ,_ „ From Ends -Max .------------- Line 5 Roof Loads: Size-Min------------- ux nx a „x a ux a ,k nx a nx a ,x u Location (From Front) 66il4r-e- SDS 2E.e, e,�= eount* •q' j OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: Everett Canfield ADDRESS: P.O. Box 335 CITY & STATE: Oroville, CA 95965 IMPORTANT: July 30, 1991 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) ' AMOUNT I Owner has decided not to do work. Permit #867-91 MHU & 868-91 MHI, AP#39-27-02 Receipt #88252 dated 4/l/91. Total Permit Fees Paid For BP 867-91---------------------$92.50 Retain Plan Checking Fee ------------------------ $15.00 Retain Plumbing Permit Filing Fee--------------- 10.00 Retain Electrical Permit Filing Fee------------- 10.00 i IotaIotal Permittees Retained -------------------------------J-5.00 TOTAL REFUND DUE ----------------------------------------- $57.50 Total Permit Fees Paid For BP#868-91--------------------- $70.00 Retain ' Total Permit Fees Retained------------------------------- 10.00 I I s I TOTAL REFUND DUE FOR BOTH PERMITS TOTAL $117.50 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or del' \ered, and that this claim is true and correct as stated. Dated this �%�.................... day of ..::::. SGC (;� 19 S j at � ;�7ri: ° Calif. .. t ��. �..'�� .........�. ...... :.....• �. ...t_ ................ — Signature of Claim aqt I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropriation ❑ or Specific Board Approval (Check one) for the same. _ GG_ 22 tIt 0—a Dated this ...........'.f . ................. day of ........u..tI 19,(,./. et / 1 Calif ' ........... :.. . ep'brtment Head or Authonzed Dep Dept. i �,/ �l _ Exp. I C' Code Gi �- Code Code �Q„-PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. �.ax 3,r ��-.�� e-C,0UNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS '.ji­7'County Center Drive - Orovllle, California 95985 - Telephone: 918/538.7541 APPLICATION AND PERMIT PERMIT NO. F f?6e�l —9/ A111111198111OPI PARCKL NUMBER ZONING _ BUILDING PERMIT wQNlSR TS—HONG 1 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAM TELEPHONE CONTRACTOR'S MAILING ADDRESS llnknnw Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee 19-00 Energy Plan Checking Fee E$. $ ARC I CT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 19 SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomeM( Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W O.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation Other ❑ Describe work: install mobile home 60-640 1 bath MHI Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eoov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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. ense No. Classification. I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLINGoCCUP.. ) New B , h2sgft CONSTFL UL OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. Ex. Occu Occup(OUTLETS OR FIXTURES 20®50e eAL@30 Ex. Occup. OUTLETS PRESID IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate Consent to Self -Insure. shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed.revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 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 Count in c qu c of the granting of this permit. X Date C Signature of Applicant — Owner❑ Contractor ElAgent 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 $ 45.00 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 70.00 HAz. CUA PARK SC f FLD CDF PAR PD ) HD ISSUE This permit is hereby issued unoer the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. 88252/4 7d, do WHITE-D.P.W., YELLOW-ASBF330R, PINK -INSPECTOR, GOLDENROD -APPLICANT W-15 " CO.EJ ,AAF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION ` 7 COUNTY CENTER DRIVE - OROVtL'I CALIFORNIA 95965 -TELEPHONE: 916/538-7541 PERMIT°APPLICATIOWDATA SHEET 671 Permit No. O OWNER e,91 A. P. No. Q A9-270-00?— Proposed Q0? -Proposed Building Use! l� �'' 7 d Building Inspector l Date / At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................ .......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park feesppai d 13. to Ui tHAA&- COO School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance ................. �3. Owner -Builder Verification (Given to owner ❑, Mail to owner } 2— 3 24. Recorded copy of Agricultural Acknowledgment Statement ..... 25. Letter of signature authorization ................................... If 27 A) IidQfQvtcP, When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans seht' Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: {Circe ne v 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_—naiI—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —Mai I—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW 40 .i . kf .�: `. � (�;t.y .-..:�.. . 9 r�: '�x/Fc7,�y,L'ygs'..:. r• iv .:r. � r4.,r- yRi'F'�..,. i., ,� BUTTE ;COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number q'��' ,.�y U ZBuilding Department No. / .+ » ... N School District pUPH/7-f City. F__j County L: Cj Jurisdiction Property Owner 'I/E&PE CA/I FIJ � F Project Location/Address E# Subdivision Lot Number tResidential Development: �Z kk,q r_ 564/4 Sq. F o`tage �7 R1ieeAJV e"t sf /N # of Living MHI Addition (Group R) Loi'/q 1'usrjyot!�r'u9 1�0 -�r Units mew 5?d 1 Commercial/Industrial: N. Sq. Footage New Addition (Including Exterior Roofed Areas) ,f• Building Department Representative qate .(Floor Plans reviewed by SchoolDistrict Perso nel) District Id No. School District -'certifies that 0 ;% Cys,- Z _ , (Applicant Name (Phone Number). (Street Address) (City) (State) (Zip Code) has complied with the requirements of Resolution,No`" _ v by eLy.ment*of $ representing square feet. Schoo District .Representative Date PAID BY CHECK' NO. - REMARKS: BANK NO PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) _ /STATE OF a /,COUNTY OF At, Yq t1 `( On this �� day of t County, personally appeared SS. (INDIVIDUAL) before me, the undersigned, a Notary Public in and for said 5 personally known to me, or prow d to me on the basis of satisfactory evidence W W to be the persons(.4whose nam*) is/afe subscribed to the within instrument, W and acknowledged to me that h C , executed the same. J Witness my hand and official seal. i 4 / otary blrctfn and for said County and State Name (Typed or Printed) 3403 (R9/87)2 i osis��•mi.6_®•m•••••• e GF�!QAL SEAL - LINDA HOFFMAN • NOTAR'y 1�19LIC-CALIFORNJA i n BUTTE County • h�v �c�r��:•,;•:.,::: _;.•giros JULY 1rJ,f994 0 (This area for official notarial seal) EBS® OF ®®CURRENT 4 Return to D.P.W. 91-013371 Rec Fee 5.00 Cash 5.00 - Recorded Official Records County of f Butte ` Candace J. Grubbs Recorder 12:57pm 8 -Apr -91 XX 1 NOTICE OF COMPLIANCE WITH COUNTY CODE SECTION 24-202 (A) (3) TO BE RECORDED BY OWNER (ADDITIONAL DWELLING IN SINGLE FAMILY RESIDENTIAL ZONES) Applicant �2l4J�,l Date Zone A-1-10 AP# �, Z Building Permit # I, do declare, that the dwelling (Building Permit # _ ��C ` ) at address (present)JD�;L Sw_on AP # �/ ".? �..-®2 is .01 intended for the sole occupancy of one adult or two adult persons who arE 60 years of age or over, and the area of floor space of the dwelling unit does not exceed 640 square feet. p crt I also understand that violations of these provisions are subject to the penalties provided in Section 24-63.1.of the Butte County Code. Signed Dated Attach Notarization Form m 3 ' NOTE: -All Materials & Workmanship Shall Be In Accordance with Recognized Good Practices and This set of plans and speciftcations MUST be of a Quality Prescribed for the SpeciSed uuso kept on tha,�ob at all times and Ais unlawflz' to In the Uniform Building, Plumbing & Mech��18� mq,ke any changes or altaraticns on same without � � � ona� � written permission from the Pepairtme o % I -Worker County of Butte. i e00V �°0 e� SOON es. o� ! �6 ©sem off' c� 0 00 0 RO\j App `7i L -S 4nlg"-� 4 Y COUNTY.OF BUTTS - 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 materials for construction of' the proposed property improvement (yes or no) 2. I (have/have not) signed an application for a building permit fof'Tt�e 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 Gni Social Security Number Date's 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 - DEPARTMENT OF PUBLIC WORKS `7 County Center Drlve - Orovllle, Callfornla 95985 - Telephone: 918/538-7541 APPLICATION AND PERMIT ERMIT NO. OR PAR ML N AaaE a27-02 39 - ZONINGBUILDING A40 PERMIT OWNER Everett Canfield TELEPHONE 589-3751 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. Box 335 Oroville 95965-335 CONTRACTOR'S NAME unknown TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER none UNKNOWN Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER none LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 3954 Cartwri ht St. Dayton Permit fee $ .PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 19 SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome[X Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home kS 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities U Installation❑ Other ❑ Describe work: MHTT 60/640 1BR Permit Fee $ 40.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS 10.00 1 Main service EA. ADD'L 100 AMP 2.50 2.50 CONTRACTORS LICENSE LAW of p i y (check one): I declare under penaltyperjury ❑ 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. �-,� Y�EA.) 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.Id) OR ADDNS. \ ACC. BLDGS. yz2sgft NEW CONSTR.MULTI-OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e SINGLE OUTLET CIR. EX, DCCUp OUTLETS OR FIXTURES 20 ®30t 9ALA 30 Ex. OCCUp. OUTLETS FIXED P(RESID LNS IK 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 1 9 -nn Misc. Wiring 15.00 P_ Permit Fee $ 37-50 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate onsent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed,revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, 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 againstHAz. all liabilities, judgments, costs, and expenses which may in any way accrue against s d County i con trUL-I a granting of this permit. ,� X Date Signature of Applicant — ner Contractor 11Agentwork An OSHA permit is required or excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ' occ CONST TYPE TOTAL FEE $ 92.50 I CUA I PARK I SCHL FL coF PAR I PD ) HD• ISSUE. This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt NO. 88252-92.50 WHITE-D.P.W.. YELLOW-ASeESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT ] ::^;Y .. •I '4' •.� :'� H•-��,j�...�-,C..:ir Y � .xi'�.nr-,["�.•:�.(,ir.�'ar``xy,,u.i..�}�.rt .t�}+r.'�rI'j..-,.f--1.. C(1V �Y OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION,( r' r 7 COUNTY CENTER DRIVE=PROOLLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 y / PERMIT APPLICATION DATA SHEET Permit No. �[/�7-� OWNER�... A. P. No. Proposed Building UseM V (0-40 y' - Building Inspector if Date�/—�"�� At time of permit -application, I was advised the following data must be submitted prior to`prmit processing and/or issuance: ZATE RECEIVED APPROVED 1. All items have been submitted . ........................ .......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .........:.... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Vi C,0 Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... i�K22. Certificate of Workmans Compensation Insurance ........ 23. Owner -Builder Verification (Given to owner ❑, Mail to owner 7, 3 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. _L.et;_'1elephone and hold for pickup at office. Deliver w/inspector. Other Applicant r �.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. o. 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone _lnail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Date Plans approved by Date 1_4 7� Sets of plans on hold in Copy—DPW File cabinet AP folder V 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 materials for construction of the proposed property improvement (yes or no) 2. 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 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 Social Security Number 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. CLAIMANT: ADDRESS: c J3& OROVILLE, CALIFORNIA GENERAL CLAIM Everett Canfield P.O. Box 335 CITY & STATE: Oroville, CA 95965 IMPORTANT: DATE OF CLAIM: July 30, 1991 SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Owner has decided not to do work. ermi - , AP#39-27-02, Receipt #88252, dated 4/1/91. Total Permit Fees Paid ----------------------------------- $70.00 Retain Building Permit Filing Fee ---------- $10.00 I i I Total Permit Fees Retained------------------------------- 10.00 TOTAL REFUND DUE ----------------------------------------- $60.00 I I i j i i i TOTAL $60100 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this ' claim is true and correct as stated. X Dated this day o[ C4et ..... . - %lt:'.y Calif. �.�:L.;........ ' Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropriation O or Specific Board Approval E] (Check one) for same, j Dated this Nth ,day or ....July . 19 91 at Oroville Calif.i ....... ........... ........... . ...... ... .... ........f�- .................................Ien,uthorized Deputy e, Code 440-002 ...............„ cads 4210500 PAYABLE FROM „Cons ermltS . FUND ................ DO NOT WRITE BELOW THIS LINE — AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. COUNTY OF BUTTE a DEPARTMENT OF PUBLIC WORKS PERMIT NO, 7 County Center Drive e Cr®ville, California 050a$ a Tolo1hone: 010/638.7641 Z�2 6 _ p / APPLICATION AND PERMIT _ _ 1AV A-40BUILDING PERMIT owN RTICLMPHONC 589— 31 1 SQ, FT, OCC, BUILDING VALUATION MA NA OWNER'S G DDRB38 P.O. Box Oroville CONTRACTOR' S NAME Unknown TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER Nnnp UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER Nonp LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 3954 Cnrtwright St., Dayton 27 Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 19 SUBDIVISION NAME PARCEL MAP Water piping - 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF❑ Duplex❑ MobilehomeMK Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ installationa Other ❑ Describe work: MUT exi st;i ids site 2 BR for utility permit #3688-86 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 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. 2,1, 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.8d OR ADDNS. ( ACC. BLOGS. , /20sgft NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20®506 RALO 90 FIXED APLNS. Ex. OCCUp. OUTLETS (RESID.)REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Ensure. W5—F shal I 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 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs and xpenses which may in any way accrue against S ' Coun ' c eq nce the granting of this permit. C/ X� ?t Date����/ Signature of Applicant — 164r ❑ 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 $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ E Zn HAz. CUA PARK SCHL FLD PA PD ) ISSUE, This permit is hereby issued unaer the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date FR,ecelpt No. 88252/'-92 070 I TE-O.P.W., YELLOW-ASSE350R, PINK -INSPECTOR. GOLDENROD -APPLICANT ave.. ti �� �.r, �r. ^,,rrt'i'-1 ik . r'+r�►.c1; ws..s �:"ci�•r �'.t'n, �f^•►v iyrti^ .r. exN T COUNTY OF BUTTE - DEPARTMENT, OF PUBLIC WORKS - BUILDING DIVISION t t w 7,NTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 ' PERMIT APP,L-46ATION DATA SHEET V (��� FI'e/d Permit No.� OWNER CAN t fV/ [.� ,v A. P. No. 3�j ".27®' 00?--• Proposed Building Use Building, Inspector o Date ^ At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ....................... _ ......... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) — 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... TH&4 Co. School District fees paid .............. 14. Sanitation approval from CIA i d_^ Health Department 15. City of Chico plumbing permit .................................. 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance ........... 23. Owner -Builder Verification (Given to owner ❑, Mail to owner Recorded copy of Agricultural Acknowledgment Statement ......... L 25. Letter of signature authorization ................................... 27. When yIssue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other A p p I i c a n t d 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---nail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder r` Copy—DPW `T7t- ` ��f c''r� i., , �,11�„rrAy7: `�,, ter r. +w a�c� ,� ,may” rrxYr �r;^s: y xa p�:..x F!✓ a i;t': a n{; F`:v a BUTTE COUNtYi SCHOOLS DEVELOPMENT,FEE CERTIFICATION FORM (one Form per Building) A.P. Number D3CIa�o-l�Z Building Department No. School District �(J I'f���1 City ,County In— Jurisdiction Property Owner; 4r114!51 17` C'ANFe/ ``"" Project Location/Address ✓ 9;,- 7,--tp Subdivision Lot Number 47 Residential -Development:,1� ,/ /„ q-iq ElgSq. Fort,age rr /� ��// 7700- # of Living, MHr Addition (Group R) I, Units Commercial/Industrial: a Sq. Footage New Addition (Including Exterior i Roofed Areas) Building Department Representative Date (Floor Plans reviewed by School -,District Personel).-j- District Id No. School District certifies that (Applicant Name) (Phone Number) (" f (Street Address) (City) (State) (Zip Code) has complied with the requirements of Resolution No. r- by the payment of $ representing �$o�� square feet. School—District Representative Date + PAID BY CHECK:NO. REMARKS: BANK NO PAID BY CASH white -applicant, yellow -building department,,pink-school district \ SCHOOL -.FEE (8/88) z �=-C6UNTY 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 materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) 4z&G 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 ze, Social Security Number Date 44 -3 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. ra7ty-w-R, -k-