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HomeMy WebLinkAbout039-440-03339-44=33 �. Jackson 737 Skyway Ave. 39-44=33 L,>AALJACKSON �% Skyway Ave, Chicomit#2211-88B,E(new garage:/ .r °' t X39 44-33� } a. ContR Mike ,:Hart Constru:cti;ons Permit#T 28-90B(.new, roof structure.)SF 17 D i + f L iV P. 1 1' 1� r ++1 1' IF 1 jI 1 1' 1� r ++1 1' IF 1 y.._•s... _ _.. 'sa. N� .� 1 � A �% REqION IAL V 39-44-30 -` � 1528-90B JACKSON, u � A 11 737SkYwa Y �hico f ContR: Mike Hart Construction (new roof structure)SF JOB FINALE Signature J.= OK . O = Not OK Not Not Readyable 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-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L"ft. / /"Nat. or/ /"L"ft./ /"LPG 7. 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 1. Zoning Requirements -Setbacks Easements 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. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ' <0 - Datep. MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg.-Bracing 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-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 V'POK' ' 0 = Not OK r = Not Applicable Not Ready RESIDENTIAL (Single & Duplex) ' = Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -BI ockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. 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 #'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 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-Underfir. Access 57. Glazing Area -Glass Protection -Skylights -Plastic. 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ 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: 44. Headers & Beam -Size & Bearing ' (NOTE: An entry must be made each time you visit job site) ter-- • _ ._ �.- �� _ _ _-,-:. � � - .... - - , _ . dDEPARTMENT COUNTY OF BUTTE OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orollille — Phone: 538-7541 747 Elliott Road, Paradise — �Fi3ne: 872-630 ` CORRECTION NOTICE ASg - �� �4 NER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address a d should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter r need additional explanation, please contact this office immediately. -- J-4 li A .V_� 4A,uL., _ f4. A—, 1 /., -U'-. c7 Y.�1..�.. s Date �O ( y Inspector S COUNTY OF BUTTE -,DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, C,90orn4.95965 - Telephone: 916/538-7541 LZ APPLICATIOWAND PERMIT ASSESSOR PARCEL NUMBER 39-44-3Q S,S ZONING I BUILDING PERMIT IVI OWNER Al Jackson TELEPHONE 342-8489 S0. FT. OCC. BUILDING V LUA ION o tracto s Est 12,171.00 OWNER'S MAILING ADDRESS 739 Skyway Ave. Chico 95926 CONTRACTOR'S NAME Mike Hart Construction TELEPHONE 1891-5273 CONTRACTOR'S MAILING ADDRESS 1299 East Ave. Chico 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 12.171.00 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 98.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 49.25 Jl Energy Plan Checking n g Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty_2 X $ 197.00 BUILDING ADDRESS Permit fee $ 354.75 PLUMBING PERMIT Filing Fee 10.00 737 Skyway Ave., Chico Each Trap 2.00 Solar or heat pump water heater 20.00 LOT7. 11r1SION NAME PARCELM� 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 S G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ® Describe work: New Roof Structure _ L Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR01 OR LESS10.00 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.& New CONSTR.(A , 2/z sq It ULTg OUTLET NO N.RESID BRANCH CIRC ITS 0ea 2.50 ea POWER APPARATUS o- (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 200605 BALI 30t FIXED PR EX. Occup. OUTLETS (RESIO )EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. bVirin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling 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 ag t id ty in consequence f the granting of this per it. c/ X Date /1 Signature of Applicant — wner' 4 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 $ Dcc CONST TYPE TOTAL FEE $ 354.75 HAz CUA PARK SCHL FL PAR D HD ISSUE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By 90��� PE EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. �-q y3Z WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Califbrnia"95965 - Telephone: 916/538-7541 . APPLICATION 'AND PERMIT PERMIT NO. ASSESSOR PARCEL UMBER - — 3 � ZONING BUILDING PERMIT OWNER A-S�`I/� TELEPHONE 3 V2 Y6-7' - SQ. FT. OCC. BUILDING VALUATION 2 �}0l�JCA/ OWNER' / ADDR�55 ��N ! IV�E n% G �•P- / / / Z CONTRACTOR�-NAME✓`�Y/ i /4/Lr C,-✓SO2JC,*rA.,- TF�LEPHONE 89/-5273 CONTRACTOR'S MAILING ADDRESS �✓ i ✓4 C4//4c, C� 5fS2iS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 111-71 Filing Fee - $ _ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ B ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 35 Y PLUMBING PERMIT Filing Fee 10.00 -2 3-7��y�� ,q✓� 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 S I G 10.00e TYPE OF WORK New❑ Addition❑�/ Remodel❑ Utilities[]installation❑ Other Describe work: / ve✓ yq!P-A . sr'licye, e 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): El 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 iritended 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 ADDNS. ACC. BLDGS. / I /20sgft NEw coNSTR uLTI_ouTLET2,50 NON.RESID BRANCH CIRC ITS ea /POWER APPARATUS tr -SINGLE OUTLET CIR. Ex. OCcup�OUTLETS OR FIXTURES 2ALO30@50C °Loo FIXED Ex. Occup. OUTLETS (RESINSR D )EAJ 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. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood -� 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, j dgments, and expenses which may in any way accrue agai t i Con in c sequ nce the granting of this permit. X Date / Signature of Applicant — /06.n., El Contractor C]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 414 occCONST TYPE TOTAL FEE / HAz CUA PARK SCHL FLD PAR PD HD ISSUE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 1 COUNTY OF BUTTE - DEPARTMENT '0 1 F PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE,.CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET � Permit No. l�t� OWNER—,AL- .�G� J'o A. P. No. 3 _ 1-4) — 3 j Proposed Building Use S& I-A.aG S7�',(je/-tj/t-`.Building Inspector C SJ 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..................................... ;Ft• . Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans . . omplete engineere�p ans and calcs, wlffi Tsignafure 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 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-Inspeoftn for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner-Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization . ' 26. 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. nthPr Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitte 1. Index permit for above items No. 2. Additional items required: r tofpe/-mit issuance: (Circle new item not checked above). Con tor, designer, owner, ;was advised of above required data by_!/phone___rnail—counter by._.&...date Contractor, designer, ownerwas advised of above required data by—phone —mall l—counter by date y Plans checked by Date Plans approved by '� /�% Date _Sets of plans on hold in . File cabinet AP folder Copy -DPW 9 i 4 ~OF COUNTY BUTTE DEPARTMENTQ F F PUBLIC WORKS r ' ,. -17�.196 Memo rial Way. Chico Phone 891-2751 ' vu,}a1 - tt r v� n° 7 Count Center Drive OroviIIe :Phone 538 7541 s r 1 Y +rx s . .. .. + 747 Elliott Road, Paradise Phone 872-6307 �n� d �Laa �.'�ai S t :�"i •-:'x ,.i': .., ..... s .. .Y 1 t• 4j_ Sa,Jr,. s CORRECTION NOTICEfl Vim. 33 ` C.Soni A -K - PERMIT -NO.,:', _._'«.:.OWNER `following p that theviolations of County Ordinance A routine inspection indicates exist at the'above address and should be corrected Piease`nobfy=this office _c to this t''when correction of work is completed.:if you have-any'.question pertaining matter, fice immediately or need additional explanation, please contact this ofDa XA a 1... 4 b r+ . s '.. . e` Y pa•p 5- �Ll - (� Inspector_ PERMIT NO. 2211-$$B,E i PERMIT EXPIRES /9 OWNER AL JACKSON CONTR. owner ASSESSOR PARCEL 39-44-33 f 'E LOCATION 737 Skyway Ave., Chico 1 a i 1 I 1 t L .r. ' L t° Temp. Power Pole 7. Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) ' Signature v OK 0 = Not OK Not Not Readyiable MOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date. DE ,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements teVning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch . Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/0 -Concrete /or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 00 osts-Beams-Rftrs.-Connec.- 5. Electricity; Location-Clearances-Grnd; / / Amp -Concrete SftITIT7Rftj7BrMng 6. Gas; Location -Test -Wrap: / /"L" ft.T.mns-Connections-Splice-Decal-Enclosures / /"Nat. or/ /"L"ft./ P'LPG s -Doors 7. Utility Clearance Card -81 Date Card -131 Date Card -B1 Date Card -B1 Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 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/0 to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10.. Cert. of Occupancy Card -B1 Date Card -B1 Date Card -131 Date Card -131 Date t.; Steps -Doors -Landings f r L �, Card -131 _ Card -131,I±42 Date Card -B1 _) Dat@ Card -131 Date 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 Card -61 Date Card -131 Date Card -61 Date Card -131 Date i s = OK 0 = Not - =Not Applicable RESIDENTIAL (Single and Duplex) ' = Not-R-,ady I. Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks; -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ P' Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main ee -BI uts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. &Dimensions 6. Stemwalls, G age( e B kouts-Wrapped 50. Garage Fire Protection Framing 7. Sla , S el ppe 51. Property Line Firewall & Openings 8. PieWrbolice Ftg.-Steel 52. Ext. Doors -One T -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 vmy C/O -Sewer Test 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 55. Siding -Nailing Veneer 12. Electric; Underground 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 57. Glazing Area -Glass Protection -Skylights -Plastic . 14. Girders -Sills -Anchor Bolts-Joists-Ve s -Cripples 15. Insulation A8. S e r i -Bolts ul ion- Is-Clg. . Infiltratio- alls-Wndws Card -B1 Date qqdA D Card -131 DateC 1 ate Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date PLUMBING (Pe4it)k0K except #'s 16. Water Ht. V t -Access -Combustion Air- Baffle Date FINAL (Plans) OK except #'s 17. Water Pip Test & Anchors -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; T„st-Fttngs & Anchors -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels Card -131 Date Card -B1 Date 67. Stairs &Rails Card -131 Date Card -B1 Date 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 23. Elec. Receptacles Spacing -Lights & Switches at Doors 71. Elec. Outlets & Receptacles at Kit. Counter 24. Size Boxes & No. of Conductors -Stapled 72. Garage Fire Door; Swing -Landing -Closer 25. Romex Installed Close to Edge of Studs & C.J. 73. A.C. Duct in Garage -Damper 26. Equip. Ground made upw/Mech. Fasteners -Bond Gas &Water 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 75. Plb., Elec. & Mech. Equip. Listed for Location 28. SubfeedWire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu of AI 76 Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 30. Service -Riser Conductors & Ground -Main Disconnect 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 33. Smoke Detector 81. Stucco; Brown -Finish Card -131 Date Card -131 Date 82. A.C. Unit; Disconnect, Electrical, Plumbing Card -131 Date Card -B1 Date 83. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 84. Water Well; Disconnect, Electrical, Plumbing 34. A.C. Ducts Insulation & Support 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 35. Vent Fan; Exhaust above insulation 86. Ventilation throughout House 36. Condensate Drain & Overflow; Size & Grade 87. Glass Protection 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 88. Corrections from Previous Inpections 38. Attic Access & Platform if Furnace in Attic 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Card -61 Date Card -61 Date 92. Roofing Certificate Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Date FRAMING (Plans) OK except #'s Card -81 Date Card -B1 Date 39. Sills, Proper Material & Anchors Card -131 Date Card -B1 Date 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Comments at Final: 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 89 -2751: 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OW R PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matte need additional explanation, please contact this office immediately. t/ h Inspector Date 4 <! a y . d C4 ! / br • Y•/� i., •'tet , 3 r J Inspector Date J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N0. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND -PERMIT QQQ ASSESSOR 3 PARCE N3UMBER z0N N� BUILDING P RMIT O NER 6641 TELEPHONE � � a SQ. FT. OCC.1 BUILDING VALUATION 541 OWNER'S MAILING ADDRESS �7.3 7 Sit',, LoisCo- a , CONTRACTOR'S AME TELEPHONE ©GAN e CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENOER ova N� UNKNOWN Total Valuation 1 $ CEJ I Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ a ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS - Permit fee $ D '79 PLUMBING PERMIT Filing Fee 10.00 -'73-7' Each Trap 2.00 Of C 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 CTURE ��ryry SF ❑ Duplex[] Mobilehome❑ell Other 54 D Ep ECI FY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK New E5 Addition ❑ Remod Iyties ❑ Installation❑ Other ❑ 1 Describe work: ' ' c >-o a Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 600V OR LESS Main service 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) ❑ 1, 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.y` , OR AODNS. ACC. BLDGS. / /20sgit 1 NEW CONSTR. TI -OUTLET NON.RESID BRANCH CIRCUITS) 2,50 ea POWER APPARATUS 11 (SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES .200930 FIXED EX. OCCUp. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00. Permit Fee $ 3, 0 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. �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 FiIirig 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 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 ounty i onseq nce of the granting of this permit. X Date !�2 Signature of Applican - Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over,! stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ �� t S occuP. l CONST. rac ISCHOOLIFLOODJPARCIILI PD �- No �- ISsu This permit -is hereby issued under sions of the Butte County Code and/or work Indicated above for which DIRECTOR OF PUBLIC / By PE T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 7-1 t-" —1 Receipt No. 1-73 0 9 WNITE-O.P.W-. YELLOW-AS6E3 SOR. PINK -INSPECTOR. GOLDENROD -APPLICANT -.,,.. .-,..,-.. -, . -.... �, .. .. . .,. ... .-.. -.-.. ..-•�•.'^+7"",a•vf-•"'^.^+y.�,,1..*+h+V,-^_`�'"ti".yf':iii-^t`..",q".�-tii^.�y''`r'�I7f-. •.^�` . COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION � f / 1 i:r �+r 7 COUNTY CENTER DRIVE - OROVILLE?'CALi'bOIA 95965 - TELEPHONE: 916/538-754;1 " PERMIT APPLICATION DATA SHEET Permit No. OWNER Al J Ac k6QA.1 A. Proposed Building Use J bra ✓2-I .e Building Inspector Daae 7—/3-59 _., .`v At time of permit application, I was advised the following data must be submitted prior to permit processing and1or issuance: DATE RECEIVED ) APPROVED 1. All items.have been submitted. 2. Plot plans in duplicate. triplicate, signed by preparer of plans. �� r 3. Complete plans in duplicate./triplicate, signed by preparer of plans. <r k 4. Complete engineered plans and calcs, with wet signature,onr:'pfans.-,f1 5. Plans with Energy Design Compliance Statement. 6. School District "Fees Paid" Stamp on.Floor Plan. 7 Statement°of Intent "for Non -Heated and AC Buildings. 8. Fees of $' . . . . , , , , u. 9. Letter of signature authorization. 10. Sanitation approval from HealthDept. .� . 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation'lnsurance. 13. Cont.rad tor's License Information (no., name style, classif.) ' 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑•) _15. Improvements may be required . . . . . . + . i ,,�6 Mob,ilehpme Installa on Data: .` . Pre -Ins ec. request to (Date) 17. Pre' lns ection for 76CL41 AY �i/ e' i5 �i�t� g q p equired. Building Inspector - 18. Recorded Jcopy of Agricultural Acknowledgmen tatement. 19. Driveway'Permit. 20. Plot plan'approval from city of 21. Engineered'trusses iritduplicate (required prior -to plan check). 22. 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 /_3�- st 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 permitIfor 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 —mal l—counter by date Plans checked by Date Plans approved bye Date Sets of plans on hold in File cabinet AP folder Copv—DPW COUNTY OF BUTTE - Departmelnt 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 wor . 3. I.have contracted with the following person (firm) to provide the proposed construction: Name SEL; 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 0"MeAL_ Social ecurity 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. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PAR NUMB R _ ZON N BUILDING PERMIT O NER TELEPHONE NZ a 1 $ SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 737 S r4 W '(_ 9_5F.4?, CONTRACTOR'S AM TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER /✓1.✓ C_ UNKNOWN Total Valuation 1 $ FilingFee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee = ARCHITECT OR ENGINEER LICENSE NO. Pian Checking Fee $ S Energy Plan Checking Fee S ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty s BUILDING ADDRESS Permit fee = •'7S PLUMBING PERMIT FllingFee 10.00 7 3 ° Each Trap 2.00 C 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 _ CTURE �-y SF ❑ Duplex ❑ ❑ MobilehomeOther Jh 0 o ECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.00 ea TYPE OF WORK New aAddition ❑ Remode Lt 'fes ❑ Installation ❑ Other ❑ Describe work: N • nJQ e Ag Pernit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 a Main service ?00 AMP ORSLESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 1 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. / =¢soft a I-OTBLDG W CONSTR. U NO-RESID BRANCHU ILET 2.50 ea POWER APPARATUS S\ SINGLE OUTLET CIR. ! ' j�Lsjp Ex. OCCUp OUTLETS OR FIXTURESFIXED APLN5. OR Ex. Occup. OUTLETS P(RESID ) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00. Permit Fee S 3, 0 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. Lij-1- 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. 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 Btte against all liabilities, judgments, costs, and expenses which may in any .way accrue agairtst said aunty i onsequence of the granting of this permit. ////��%% V , Z. —�, X lam_ l Date Signature of 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. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee = Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCYP. CONST.TYPE scllooL .Loon .ANeEL .n J NO I ISSUE This permit is hereby Issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. 1 Z, 0 9 WNITE-O.P.W.. YELLOW -ASSESSOR. !PINx-INSPECTOR. GOLDENROD -APPLICANT r'd �• �� l� � �-��- ;�c. � ' .,�,��� �, �� � � �� 0 F I _R1 E REPORT FC -IS (3/86) eN ORIGIN LOCATION D-, --6-,-DE-R,-- RANGE E &/or!& <5> N'UMPcl--R TIMBER 8/OR RflEG­Ii.U. INCIDENT 140. START MO. DATE COUNTY YOUNG GROWTH QQ ppPEAR FIRE NUMBER FIRE NAME: ?EG. I -L- R.U. -L I NO. thru (other than. 7 & Y G). SEC. TOVkfNSHIPZ N RANGE E &/or!& <5> Ds TIMBER 8/OR MILES DIRECTION I [I FROM 9 IN. tINCID T TYPE FIRE 0 FALSE ALARM --GO TO BLOCK 10 4A RESPONSIBILITY \/-STATE ZONE STATUTORY WILDLAND BURNED 0R.THREATENED 30 C] RESPONSIBILITY CDF LOCAL GOVT. CONTRACT AT ORIGIN) O w 0 UNPROTECTED 1 0 STATE OC] ASSIST OTHER AGENCY (Not Chy) 0 U.S.F.S. LOCAL ZONE 0 B.L.M. 5 J§j CDF LOCAL GOVT. CONTRACT E] B.I.A. ASSIST OTHER AGENCY (Not City) ❑ OTHER FEDERAL FEDERAL ZONE t E] OTHER ❑ ASSIST FED. AGENCY (Not Mil.) '0 CDF LOCAL GOVT. CON. -TRACT MISC. AND OTHER O0 ASSIST ary, CONTRACT CO., MIL, OTHER 5 CAU (STARTS IN OR ONLY) 0 LIGHTNING ❑ DEBRIS 0. PLAY W/FIRE ❑ CAMPFIRE C] ARSON OTHER/MISC. ❑ SMOKING ❑ EQUIPMENT rLAND USE (STARTS IN OR ONLY] 6 DOMESTIC ❑FOREST INDUSTRY DOME. El RA ❑ RECREATION, - RANCH -FARM E] DUMP E] OTHER INDUSTRY-COMRCL C] ROAD ❑ WILDLAND - I 0 UTILITY, RAILROAD ❑ NON-WILDLAND ❑ UTILITY, ELECTRIC ❑ OTHER 'wl DAMAGE (1 2 OR 8 ONLY) 7 S DANAGE Number (Ro..d off t. Nw,.o f100) &/or!& <5> TIMBER 8/OR YOUNG GROWTH WILDLAND VEGETATION (other than. 7 & Y G). AGRICULTURAL PROD - (Other than T & Y G) DWELLINGS 8/OR CONTENTS OTHER I STRUCTURES &/OR CONTENTS VEHICLES & CONTENTS OTHER TOTAL NATIONAL FOREST, FIRE DIST., CITY & STREET NO., ETC. ACRES OF VEGETATION BURNED ON ARRIVAL (0 VEGETATION FIRES ONLY) SIZE IDISTANCE (Origin to head) ACRES FEET WEATHER (ESTIMATE AT SCENE) WIND SPEED (M.P.H.) DIRECTION (FROM) TEMPERATURE ('9 4J -D �z 10 OVER PLEAS CDF 7S40-130-011 66 398.' 12 CREW OVERHEAD RECORD atch :EG. R.U. 114GDENT NO. YEAR ORGAN-- IZATION PERSON HOURS S: FIRE RECORD MO. DATE TIME OUTSIDE �IC �©O8'FIRE FIRST REPORT fi g } GO TO 12 SECOND REPORT ' STARTEDErrter 1STD Di'Pi FIRST ATTACK BY CDF 12 CREW OVERHEAD RECORD atch ORGAN- IZATION PERSON HOURS' AIRCRAFT FLT. HRS. INSIDE l0 02 OR ORGAN-- IZATION PERSON HOURS AIRCRAFT FLT. HRS. FIRE DISCOVERED r,e� FIRST REPORT fi g /Z B SECOND REPORT ' liivv FIRST ATTACK BY CDF FIRE CONTAINED 12 CREW OVERHEAD RECORD CDF .STATE 8 LOCAL GOVT. CONTRACT CREW NAME ORGAN- IZATION PERSON HOURS' AIRCRAFT FLT. HRS. CDF STATE 8 LOCAL GOVT. CONTRACT CREW NAME ORGAN-- IZATION PERSON HOURS AIRCRAFT FLT. HRS. 1 ST: ATK s CDF CREW o�j / liivv Co 5 , Q /o'er CDF OVERHEAD TOTAL ON 1 2 8 FIRES, ENTER TOTALS BELOW US.F.S. (Incl Overhead) TOTAL OTHER FEDERAL (Ind. Overhead) TOTAL FIRE DIST. 8 OTHER LOCAL TOTAL PAID HOURLY (E.F.F.) TOTAL VOLUNTEERS (Unpaid) TOTAL 3A MAP I ❑ FC -18B (Additional crew activity) ATTACHED 13B %.%.f1.►r.116_r.9.7 . MAP IS: ONE SECTION ❑ FOUR SECTIONS ❑ MAP ATTACHED fid . 4t�✓r` d; ' L I 1 I . I t � . - • 4 ORIGINAL REPORT BY: SIGNATURE �■ APPROVED BY: DA INTL DATE ylav��yAAP.) ("'AriAll Q J- CA ',.-v 46�a hd\\ 5 d QcaC, JS •`o 06 nd\� o s`�ea\`e S G�dc`Gd e / G° �e0 01 -41 a V,G n o d 5 Ot 172 tr -`° 0C.� STW-AG 54 -C. -K-1 req 'i s � bu1� � II A tl ,rk of 5 ft. from the pro erty lines and a setback e r^r+ 4rnm t1le road .__1:-- hall he clear o cn111Q,--- _.- structures or equipment except for .s 2 ft. eave overhang. '4 ,�;" U 90So f�9 }zt� b C ' "Z�kA n IiC;� o. NJ ` l 1- �Tl J^ ' "Z�kA n o NJ ` l ' fi �F f j k d t � r AMY n e 4 r + puts Q r t 2s r } F t 5x All OVA nymm NASA? l S 160 SIN wo s a: c t � a� i PINTO aid J? Me Y Sy oil { F. r r t- F t 5x 01,10 �yc � I t � 3 i 7 N 61 t"IMPI �fr'V 9l