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Home My WebLink About040-221-01440-221-14 LESTER SAMUELSON 9353 Goodspeed St., Durham Cont: Diversified Electric Permit #3735-86E(repair fire damage ele/SF) f 1 � 1 � ` `4 1 JJ._... _ FIRE REPORT FC -18 (3/66) /1 ORIGIN LOCATION w KA N ac ORDER NUMBER REG. R.U. I INCIDENT NO. y7 rTA�TMO. DATE EACO!7 FIRE NUMBER FIRE NAME: REG.R.U. NO. ., thru ii - 1oL----1 SO Al MILES NRANGE Irl _ L--2ZSECTOWNSHIPg 2� ❑S — `L ❑W MILES DIRECTIONNATIONAL ❑ FROM SIN. FOREST, FIRE DIST., CITY & STREET NO., ETC. _ Number . - N 3eE DENT TYPE F FALSE ALARM—GO TO BLOCK 10 LAI4L7 Ubt (STARTS IN 6 DOMESTIC RANCH -FARM ❑ DUMP ❑ ROAD ❑ UTILITY, RAILROAD ❑ UTILITY, ELECTRIC n DAMAGE Al n n ❑ PLAY W/FIRE ❑ OTHER/MISC. j U V OR U ONLY) ❑ FOREST INDUSTRY ❑ RECREATION ❑ OTHER INDUSTRY-COMRCL. ❑ WILDLAND ❑ NON-WILDLAND ❑ OTHER OR 0 ONLY) % S DAMAGE" Number (Rwd off to Nearest 5100 1 2 8/or 8 5 TIMBER 8/0R "'c>•`:<''>`E YOUNG GROWTH •\ v`.:«;: WILDLAND VEGETATION•? :<"< (Other. than T;& 'Y G Otiy 14<4v AGRICULTURAL PROD Other than T& Y G DWELLINGS 8/OR CONTENTS hoc OTHER STRUCTURES d/OR CONTENTS VEHICLES & CONTENTS OTHER ..,i S .+ TOTALa ,. ACRES OF VEGETATION, BURNED ON ARRIVAL (O VEGETATION FIRES ONLY) SIZE DISTANCE (Origin to head) ACRES JHER ESTIMATE AT SCENE) SPEED (M.P.H.) DIRECTION (FROM) TEMPERATURE (°F) 1, PLEASE Cc ', . --"I . CDF 7540-130-0118 18 86 39852 ORDER! NUMBER 10 REG. R.U. INCIDENT NO. YEAR 1 —�LO 8 r\ FIRE RFCARn ..� MATO TIAAC FIRE STARTED OUTSIDE 1 F 5 OR 8 Enter 1ST. CD Dispatch PERSON AIRCRAFT CDF STATE & LOCAL GO CO TRA AN- HOURS FIT. HRS. CREW NAME 1 T ERSON HOURS AIRCRAFT FLT. HRS. INSIDE 1 I 12 4 5 OR 8 107 FIRE DISCOVERED. 5 ulr FIRST REPORT !2. 01 101,7`f' SECOND REPORT FIRST ATTACK BY CDF t "� V /JP --" ,OUP FIRE CONTAINED 17, 01 401 /1 CREW %AVFRIdFAn RFCARn I GO TO 12 • t LOOKOUT: If 1 ST. or 2ND. report made by Lookout r SITE NAME: SITE NAME: . It 1 . . 3 LOCAL GOVT. CONTRACT E ORGAN- RATION PERSON AIRCRAFT CDF STATE & LOCAL GO CO TRA AN- HOURS FIT. HRS. CREW NAME 1 T ERSON HOURS AIRCRAFT FLT. HRS. e FT WO"„ ■■■■ ■■NWMMM■ 5 ulr t-y1WjjV V /JP --" If I • F - CDF OVERHEAD TOTAL ON 1 2 8 FIRES. ENTER...::p;::.;,•: TOTALS BELOW !� <:•.... :'::v{,:>.:1.•::>:z::S::<,:r :,>:::.::;>;:: :f . ;S ,? ;;>:;.><,,;< U.S.F.S. (Incl. Overhead) TOTALI OTHER FEDERAL (Incl. Overhead) TOTAL I { f k,.k+ \.•, FIRE DIST. & OTHER LOCAL TOTAL :z:'•>`'•>f PAID HOURLY (E.F.F.) TOTAL VOLUNTEERS (Unpaid) TOTAL E] FC -18B (Additional crew activity) ATTACHED )3A MAP OnNNEENE ■'1REN"RE■■ TITLE I DATE ..G■ ■E■ESSNAMEN■ DATE, WO"„ ■■■■ ■■NWMMM■ /'1 COMMENTS Isn MAP IS: ONE SECTION ❑ FOUR SECTIONS ❑' MAP ATTACHED .t 1. I 1W n ORIGINAL REPORT BY: r APPRnVFn BY - t v RE TITLE I DATE INTI. DATE, f .. / �/ / � � �� /�� o ' �� ' �� d COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville,kalifonllia 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER n � - Z2 - --o ZONING BUILDING PERMIT OWNER _ HONE TELEP ,��-- SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS ` CONTRACTORS NAME �- T_EFHON J L44 CONTRACTOR'S MA1 LING ADDRI ' i ' 1 -�•,-/ Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee Energy Plan Checking Fee A$. $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING yADDRESS t Permit fee $ PLUMBING PERMIT Filing Fee 10.00 - ,Each Trap 2.00 t' r .,'Polar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME / f PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF' Duplex ❑ Mobilehome❑ Other I 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 -E], Remodel ❑ UW,lities ❑ Installation❑ Other ❑ Describe work: <<l.-- ,7 i il- &1.1.r % C.L-� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 :--%, / / - V Main service eoov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRAd/TORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professionisc�C-ode and ity license is in full force and effect. License No. 4.�T�lll Classification I.� �'Ex. ❑ 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 DWELLIN GS.CCUP.IL�� yZ¢sgft oR ADDNSCONST NEW CO o R' BRANCH CIRCTITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. OCCUp\( t OUTLETS OR FIXTURES eAL@ 0 Occup. our LETS (PLNS R ESID.IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 9 Permit Fee $ ate. Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. fy I have placed on file with the County of Butte Building Department 4� a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling 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. 1 also lagree to save, indemfnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue againstlsaid County in consequence of the granting of this permit. %� /L,�E'1i� 1 ' ' r ---" Date — Signature of Applicant'— Owner Contractor M 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 $ TOTAL PERMIT FEE $ oc cup. CONST.TYPC FLOoo PARCEL PD ND ISSUE v 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. %'/I_/! WHITE-D.P.W., YELLOW-ASSES30R, PINK -INSPECTOR, GOLDENROD -APPLICANT JCOUNTY OF BUTTE - CEPA T NT -,OF PUBLIC WORKS PE MIT NO/ 7 County Center Drive - Oroville, Clifornis95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASSESSOR PAR NNER / _o/ D ZONING [/� i+ BUILDING PERMIT T LEPHONE OWNElEsi-75-r-rZ,apni:5 SQ SQ. FT. OCC. BUILDING VALUATION OWNER' MAIL !IG ADDSS C TRA TOR NA E ^ T O 7 CO T CTOR'S FAAI ING A OR Fireplace CONSTRUCTION LENDE UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER 7=S ICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDR�E;iS % \ RE: 9(— Permit fee $ PLUMBING PERMIT Filing Fee 10.00 ✓ U �,/ ach Trap 2,00 O �a ck 4,,-4-4nS O I ar 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 SFX Duplex❑ Mobilehome❑ 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 RemodeJ ❑ ities ❑ nstallation❑--Ott r ❑ Describe work: a y� _ �- s— r/ 2247 ��/ GG�..!!.!�" ` Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRA TORS LICENSE LAW I declare under penalty of perjury (check one): ElNON. l am licensed under provisions Of Chapt. 9, Div. 3 of the BUSIneSS and Professi0 s e' an a e My license is In full force ffect. 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- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.eI , ft OR ACDNS. ACC. BLDGS. /z¢sea NEW CONST R,MULTI-CUTLET 2,50 ea B RESID RANCH CIRCUITS) /POWER APPARATUS IS \SINGLE OUTLET CIR. EX. OCCU o 20050e Occup(OUTLETS OR FIXTURES eAL030 FI EX. Occup. OUTLETS (RESID )REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin g 15.00 £ / Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file.with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 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 abo mentioned property for inspection purposes. I also gree to save, in a fy and keep harmless the County of Butte against all Iia ilities, judgmen sts, and expenses which may in any way accrue agai t said County in h quence of the granting of this permit. Date Signature of Applicant — Owner ❑ Contractors Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures o er 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE OCCUP, CONST.TYPC FLOOD PARCEL P77u This permit is hereby issued under cions the Butte County Code and/or wor i icated a ove for which I C�QR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS 11 Date/e pse Receipt No. WHITE-D.P.W.. YELLOW-ASSCSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 9861 9 T 330 S1faOM onend .30 'ld30 110' -+O A NnOO COUNTY OF BUTTE - DEPARTMENT,;QF CRBLi£ WORKS - BUILDING DIVISION / 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET -- l% Permit No. OWNER 1 S TPS �G f'✓JUP(SO A. P. No PrnnncPH Ruilriinn IIsP �! if I e S Ruilrlinn IncnPr,.tnr 40 rlatc 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. 2. 3. 4. 5. 6. 7 8. 9. 10. 11. 12. 13. 14. —15. 1 17. All items have been submitted. . . . . . . . . . . . Plot plans in duplicate./triplicate, signed by preparer of plans. . Complete plans in duplicate. /triplicate, signed by preparer of plans. Complete engineered plans and calcs, with wet signature on plans. Plans with Energy Design Compliance Statement. . . . . . CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . . . Statement of Intent for Non -Heated and AC Buildings. Fees of $ , , , , , , .. Letter of signature authorization. . . . . . . . . . . Sanitation approval from Health Dept. . . Planning approval for (A) Use: (B) Parking: Certificate of Workmen's Compensation Insurance. . . . . . Contractor's License Information (no., name style, classif.) Owner -Builder Verification (Given to owner❑, Mail to ownerEJ). Improvements may be required. . . . . . . . . . . . Mobi lehome Installation D ta. . . . . . . . . Pre -Ins ec. re uest to (Date) Pre -Inspection for c� ✓ ► �— Required. Building Inspector ) 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of 21. 22. When you issue the permit, process as follows: Mail to owner, MX -1 to contractor. Telephone and hold for pickup at—off ice, Deliver w/inspector. Other_ Applicant of plans sent Health Dept., Fire Dept., Other The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: Date Date (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone ail_counter by date Contractor, designer, owner, was advised of above required data by_ph e_mall_counter by date Plans checked Copy—DPW Date Plansrdpproved by Sets of plans on hold in File cabinet AP folder Date — Flours: 10:00 a.m. - 3:00 p.m.