HomeMy WebLinkAbout040-240-03340-_ 24-33
RALPH FERGUSON
2395 Service St, Durham 2
Contr : Park Sheet MEtal �3%(T I
Permit 1 7 -
# 3 5 87M(mech.duo pac) �
40-24-33 835-91E
MOFFITT, Roy
{
2395 Serviss St, Durham� 6 �� �' '. � =>�� -• =
Cont: Harry Baker Elec
. yrs r
.(2 elec services & gas meters)
p 4- -033 93-806 P,E
MOFFITT, RO KAY
2395' SERVISS S 'DURHAM
CONTR : MH CENTER
MHU
O0 600
GAS
ELEC '
GAS fi
COMPACTION TEST -RE '
SUPPORT STRUCT RE "
040-24-0-033 `93-dU7MH I
MOFFITT, ` ROY & K
2395 SERVISS S'�, DURHAM -
CONTR: MH CE ER-
MHI
N
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TLVE OFAPPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER INFORMATION
Last NameM Q�O o/�
First �ar�e
Mailing Address e) e) -,-)
Cityjo
State
Zi 9
Phone3
Fax 3 V ?_
E-mail
CONTRACTOR
Name
Address
City
State
Zip
Phone
Fax
E-mail
Lic. #
Class
ARCFI/TECT/ENGINEE
Name
Address
City State Zip
Phone Fax
E-mail State Li nse Number
APPLICANT SIQJVATURE
04
IF
PERMIT
NO. I�L�
BIN # .
PROJEqT LOCATION
AP#
Property Address
City ,\ , r/l r 1A.r01
WORKER'S COMPENSATION
Policy
Car 'e
Chiring anyone other than license contractors, a certificate of worker's
ompensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK:
I»GG
Scl FT- Living Garage Open Cov
❑ Structure Built without Permits 'I D
❑ Proposed Change of Occupancy
PL�'(Note previous use): �P
For office use only:
APPLICANT INF RMATION
Name
/
Address
1 /J
City
Type Const.
State n ZipaiI Q
/ V ON
Phone
Fax
E-mail
APPLICANT SIQJVATURE
04
IF
PERMIT
NO. I�L�
BIN # .
PROJEqT LOCATION
AP#
Property Address
City ,\ , r/l r 1A.r01
WORKER'S COMPENSATION
Policy
Car 'e
Chiring anyone other than license contractors, a certificate of worker's
ompensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK:
I»GG
Scl FT- Living Garage Open Cov
❑ Structure Built without Permits 'I D
❑ Proposed Change of Occupancy
PL�'(Note previous use): �P
For office use only:
Zoning
Flood Zone
SRA
Yes I No
Occ.
Type Const.
70; sT P�4
i
OFFICE COPY
Address_
zags
GAS /y
Meter By Date-,T-- Z�
+ ELECTRIC
Meter By
Date
OFFICE COPY
Address
I
3SS slaijiss
GAS
1
Meter By
Date
ELECTRIC
1
jMeter By
Date-S.
JOB FINALEO (Data).
Signature
V=OK
O = Not OK
Not = Not Reeaadyable MOBILE HOMES
Date/Initials MOBILE HOME UTILITIES (Plana) OK except #'a
�ning Requirements -Setbacks -Easements
oils; Special MH Support Sketch
ewer; Location -Test -Fall -C/O Concrete
"star; Location -Teat -Easement Needed (Sketch)
O!€lectricity; Location-Clearences-Grnd-/ /Amp -Concrete
"as; Location -Teat -Wrap: / /" L"ft.
/ "Nat. or/ P'L"ft./ /"LPG
Well Clearance & Disconnect
tility Clearance
S -\?. A13 — CT•G
Date/Initials MOBILE HOME INSTALLATION Plana OK except #'s
Zoning Requirements -Setbacks Easements
. F otings; Size -Spacing -Marriage Line i
..
tZ'Gas; MH Test-Demand-Valve—Connector
EI ctricity; MH Test -Crossovers -Breakers -Clearances
D n; MH Test -Fall -Flex Connector
. Wa1er; MH Teat -Regulator -Connector
7. ater and Sewer Connected -C/O to Grade -HD Approval
as and Electricity Tagged 1
9lE,�,ts; Insp.-Sketch
1p."Cert. of Occupancy
MISCELLANEOUS'
Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plana)OK exCapt #'a
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.; Posta-Beams-Rftrs.-Connectors
Shthg: Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Caroorts: 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/Initials POOLS (Plana) 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-Panelboarda-Ins. to Mein in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
V=OK
O = Not OK
- = Not Applicab%)
= Not Ready
RESIDENTIAL (Single & Duplex)
DatDat% UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd -/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date/Initials PLUMBING (Permit) OK except #'s
16. Water Htr.; Vent -Access -Combustion Air -Baffle
17. Water Pipe; Test & Anchor -Nail Protection
18. D.W.V.; Test -Fittings & Anchor -Neil Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower, Second Floor -Tub Access
21. Gas Pipe; Size & Anchors
Date/Initials ELECTRICAL (Permit) OK except #'a
22. Fixture & Transformer Clearance -Ins. Protection
23. Elec. Receptacles Spacing -Lights & Switches at Doors
24. Size Boxes & No. of Conductors -Stapled
25. Romex Installed Close to Edge of Studs & C.J.
26. Equip. Ground made up w/Mach. Fastners-Bond Gas & Water
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
30. Service -Riser Conductors & Ground -Main Disconnect
31. Equip. Clearances Panels -Motors -Mach. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
33. Smoke Detector
Date/Initials MECHANICAL (Permit) OK except #'a
34. A.C. Ducts Insulation & Support
35. Vent Fan; Exhaust above insulation
36. Condensate Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
Date/Initials FRAMING (Plans) OK except #'s
39. Sils, Proper Material & Anchors
40. Wells Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Wells over Girders & Floor Nailing
42. Draft Stop in Walls (rat proof)
43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
44. Headers & Beam -Size & Bearing
Date/Initials FRAMING (Continued)
41S� Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin=roof Bmc-Trues-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 Doom -Sill Hgt. & Dimensions
50. Garage Fire Protection Framing
51. Property Line Firewall & Openings
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls; Nailing -Bolts
59. I nsu lation-Walls-Ceilings
60. Infiltration -Walls -Windows
Date/Initials FINAL (Plans) OK except #'a
61. Ext. Steps -Door & Sidelight Protection -Landings
62. Smoke Detector
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Mach. Protection
64. Bedroom Exiting
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. Trim & Subpanel; Breaker Sizes & Labels
67. Stairs & Rails
68. Fireplace or Stove; Clearances -Hearth
69. Elec. Outlets at Wood Panel; Int. & Ext.
70. KIt.Fixt. & Appliance; Grnd: Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
72. Garage Fire Door, Swing -Landing -Closer
73. A.C. Duct in Garage -Damper
74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor -Mach. Protection
75. Plb., Elec. & Mach. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic ❑ Yes
78. Guard Rails & Deck Construction -Post Caps
79. Fdn. Vents & Crawl Hole Door-Draina e & Wood -Earth
Clearance Looked under Floor Yes
80. Following Inatld.; 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: Appllance-Fireplace.-Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
85. Exterior Elec. Trim; G.F.I. Receptacle -Underground
86. Ventilation Throughout House
87. Glass Protection
88. Corrections from Previous Inspections
89. Gas Test -Meters Tagged; Gas -Electric
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
Comments at Final:
MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541
PERMIT N0. 93.807
Address or location of mobilehome 23915 SF,<V1SS ST
Owner's name /Y I o F f= r r
Owner's address 2395 S, E-f:YISS sr,
Insignia or hud number R,�%i �1J1 ;1 ZA,66 I I
Manufacturer's name
Serial number of V.I.N. Q-'-Aq1 -6633 v•Cilrr`1 Year of manufacture 73
l7 -13
(Official Approving Installation) (Date)
IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION
ACC PTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE
MWILEHOME IS INSTALLED ON A FOUNDATION SYSTEM.
5138 White - Owner, Yellow - Installer, Pink - D.P.W.
AP # CI
r
OWNER M o r T'C-
PERMIT `#- c13 - 8 O �o
MH UTIL.CLEARANCE DATE 5 1Lg3
INSPECTOR
ELECTRIC
GAS.
Support Compaction
Struc. Test -Rea.
Service
Other.
Pipe
YES
NO YES NO
Size
Load
Type
Size
Length
�kf .
-
mQ
i
COUNTY.OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
93-807
ASSESSOR PARCEL NUMBER
040-24-0-033
ZONING
R73 R3
BUILDING PERMIT
OWNER
ROY 9 KAY MOFFTTT
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
2395 SERVISS ST DURHAM
CONTRACTOR'S N AME
MH CENTER
TELEPHONE
33-4403
CONTRACTOR'S MAILING ADDRESS
1740 FEATHER RIVER BLVD OROVILLE
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $ 15.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $ 20.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
2395 SERVISS ST DURHAM
Permit fee $ •oo
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* Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home ISJGJWJ @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installatio4 Other ❑
Describe work: r rte, M f-�a _
H V D 9 Ea cmo -r—
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200A OR LESS 18.50
CONTRACTORS LICENSE LAW
I declapenalty perjury e under enalt of
y (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. f Q G
�.I 6i��--Classification
❑ 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ 1, as the owner, am exclusively contracting with licensed contract -
(Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service 200ATO10o0AI 37.50
NEW CONST. ( DWELLING OCCUP.E\ 3.6Q sq.ft.
OR ACDNS. l ACC. BLDGS. /
COSINSTR BRUANCH LTI.OUTCIRC ITS LET
NENOW RED @ 5.00
/POWER APPARATUS e)
\SINGLE OUTLET CIR.
Ex. OCcup� OUTLETS OR FIXTURES 20 76
FIXED APPLNS. ORL.
EX. Occup. OUTLETS (RESID.) EA.) 3.00
Temporary service 15.00
.00
Mobile Home Facilities 15ors.
Misc. Wiring -15.00
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT 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 Iiabiliti , judgments, costs, and expenses which may in any way accrue
againsVsa' o,unty in con uen of the granting of this permit.
X Date �3 �� 3
Signature of Applicant — Owner ❑ Contractor Agent ❑
An OSHA permit is req red for excavations over 5'0 ' deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $ 70.00
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 105.00
rlAz DFEES IMP FLOOD COF
PARCEL PD
IHoSSU
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
Work indicated above for which fees have been p id.
REC�OBLICchf WORKS
By ate S` ��
PERMIT EXPIRES Da
Receipt No. 135934
WHITE-D.P.W., YELLOW-ASSF3SOR. PINI( -INSPECTOR• GOLDENROD -APPLICANT
�sx�x+.'vK:j�i,i4!`��lyi��{7�ri��} �`P'y�4r ..�•.�rtr.��-w'r•��.r"!Tf"/yc`''s%t1�'tR'i'{�''yy.:F:.F� i.•.,=.�.+..._fyr.^`"Z°Mt•h+S�'*,.7'^1 _ .
s• ` l
COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION '
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 /
PERMIT APPLICATION DATA SHEET
OWNER d f i d A. P. No. r 0.33
Proposed Buildirfg Use /�%%�- -- Building Inspector Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECENED BY
1 . All items have been submitted. .• ........... .................... .
2. Plot plans, 3/4 sets, signed by preparer of plans. .......................... .
3_ Complete plans, 3/4 sets, signed by preparer of plans.
.4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form. .
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ . .........................%...
11. Impact fees as shown on attached schedule. .e5 .. °1?�.D.!�!• ...... • • • • • s' i
12. California Department of Forestry plan approval/fees. .................... ... .
13. Flood elevation letter (100 year flood) by California Engineer . ............... \
14. Sanitation and plot plan approval Health Department .
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements (B) Drainage. ...........
19. Driveway permit (construction approval required prior to occupancy). ... .
20. Pre -inspection for P`B'"�D�O"'eQe�-
required. . . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner . ...........
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use. .
.................:....................
Ael'S- 28. Mobilehome utility clearance . .......................................... j i• �-
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
WheXephone
ssue the permit,, process as follows: Mail to own r. Mail to contractor.
533- �J�/�3 and hold for pickup at office. Deliver with inspector./
Other
Parcel Creation
Acreage Applicant
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollu n Date
Copy of plans sent Health Dept. a Dept. Other Date By
The following data must be submitted p)V p)'o permit issuance: (Circle new item not checked above).
1. Index permiffor above items No.
2.,Additional items required:
Con actor, designer, owner, was advised of above required data by _ phone _ mail Counter by ate 3
Contractor, designer, o ner, was advised of above required data by _phone _mail Co nter b Date
Plans checked by Dat � Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
t
e4
• r.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541
7
OWNER �Iel'� A.P. NO. 04� 63rS
PROPOSED BUI DING USE //'/ /�'� DATE
REC. # DATE REC
School District Fees zow-�/sayI
(paid.at District Office) 2 l 3 3
�2. Sheriff Fees
(paid at Building. Department)
i
Residential.......... X _$
unit amt.
Commercial( per- sq . f t. ) X =$
sq.ft.. amt.
3.- Urban.Area Fees
(paid at•Building.Department
Residential (per unit) X _$
#-units amt..
Commerical(per-sq.ft.) X =$.
sq.ft. amt.
4. Recreation District Fees
(paid at District Office)
5. Drainage District Fees
(Contact Land Development) ........................
6. Other
7. Other
At time of permit application, I was advised the above fees are required to be paid prior
to issuance of the permit.
i
APPLICANT- DATE 3- C
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N0.
7 County Center Drive - Orovllle,,Calllornla 95905 , Telephone; 918%538.7541
APPLICATION AND PERMIT '
Auk I ES Z tJ tJ
DO •'
0� /P-09410 _0212 �-u� BUILDING PERMIT
y_
O I D FF - I l\am' • T E E N H O 1•! F ".._"".. ...
%Nlr1 $0. FT. bCC,---BUI4DING VALUATION
�awn►C11' MAI INO ACORkee,•r!r_e!•!A
d' if 14 HONE
MA i � , Ali= r�u%7. �s
*ZQNTR ACTOR -6 MAILI-N6;0�;i7fi
_12Y-O--F._PQ/tE2 . .... &/kGe%Iropl
CONeTnUCT10N LkNOlin ..
UNtcNowr!
' ARCM t�T VM kN 01Nbk,K .. ••
TL'ItEiJ6E NO.
�
ARCHIftiCT OR EfJ01Nb@k'i MAILING AbbRE66 "'
-- - •-.._
BUILOING -
A13 ��15�v�S Frk! E'7
�l./K Jr� -----• /-"� •
t.OTNO, eUV0IV1elONNAME PAncGLmAf•
ao
c
....._ .......:......-on -•--
Total Val uati
37,50
'- "'•"'
yAlf �q.h`•
$---.._...--- ----''
----•..... _..._. _
- "'
$ - .._.... 15,00
Filing Foo
Perm{I Foe
--..__._. ...
Plan Checking Fee
.��,............-.. __..-.—__...._............. ...
Ener f'
gy.......lan Chocking Foo
b LOD
.-� _ ... _
Penalty
Permit fee
PLUMBING PERMIT
Fil
fly rcx
ti.U0
20.00
Y,UO
-- 7.0.0 0
5.00
15,00
--..-....-.�
Each Trap —
Solar or heal pump water hcator
Water piping
Each aas wotor heater or vont.-
GO$ piping system i - (i outlets
USE OF STRUCTURE
SF ❑ Duplex[] Mob!lehomeOther _
6Pr6CIFY
DtilldIng. sewer
1;.00
CO) 1 -•
�:00 .. ..........
$
Mobilo Horne � (j W
... ...._ ,... ._,....
TYPE OF WORK -_ z._. ...._..... ... __...
New Addltlon D Rernodel Ll Utilities u Installation Other ❑
describe work: �.._............�.._._.,_�. ✓D .... ._./
ertnit Fee
Contractor
ELECTRICAL, PERMIT
Mein service 1800g[fjss
FlhngFeo 15.00
18.50
CONTRACTORS LICENSE LAW
I deet under penalty of perjury (chock ono);
I am licensed under provisions of Chapt, 9, Div. 3 of the Businoss
and Professlon C,O06 and my license Is In fullll� fowo and effect.
License ;4o 19,OS _ Classification _
❑ I, as the owner, or my employees with wages as thou solo comp(,•
sallonI will do tbo work,and the structure is not intended or offered
for sale, (Sec, 7044)
❑ I, as the owner, am oxclusivoly contracting with licensed contract -
ore, (Sao, 7044)
[] 1 am exempt undo( Sec. , Business and Professions Code
- for this reason
Mall) .SCrVICC 2"ATO 1000/o
37,50
'- "'•"'
yAlf �q.h`•
tlFw COING CCUP�y'"
on APoN6. ACC. aLb0P, 1
_4EW coN
r F .n
•APPARATVS
PpwBR
_ �9+NCLR OUTLET CIR,
EX, �CCUp OVTLET& OR FIATURas
ie 717
Ex, OceupouTrlPrieaiDGl eA.
3,00
Temporary service
- -
1Ii,00
Mobile Horne Faellitles
_ -...._
15.00
-
Misc. 1Viring
_
Permit Fes
Cr7ntrer.Ior
WORKMEN'S COMPENSATION INSURANCE
I declare under penally of perjury (check one):
❑ The permit Is for $100,00 (valuation) or less,
I have placed on filo with the County 0f BullO Building UBpartmenl'-
a CONIfIcate of Workmen's Compensation Insurance or a Certllicale
of Consent to Self -Insure.
MECHANICAL PERMIT
FIIIryFee
15.00
Heating
-
Cooling
- --
-••-•-•-••••-
1 shall not employ any person In any mannor so as to become subject Hood 6.50
to the W. C. laws of California,
Notice to Applicant; If after making this statement, should you become subJect
CVentilatlun
to the W . provisions of life Labor Code, you ,just forlhwlUl Comply with such Permit Fee
- ------
provlelone or thle pem)Il shall be deemed revoked, — - --- - - $
Conlroctor ""-
1 certify that I have reed tells application arid stale that fife shove irlfotlnallon Mobilo Hofne Installation Fee
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 Energy Inspection Fee $
Butte to enter upon the above•menllonad property for Inspection purposes. occ LOw611vP1 TOTAL ��� $ QST
.:•1 also agree to save, Indemnify and keep harmless the County of Butte against _ I T—_
ail liabilities, judgments, COSTS, and expenses which may In any way accrue -- "' "" 4 'o Fees IMV FLOOD cor PAIIC[L Tut-i;� iss i"
against said County In consequence of the granting of this permit. I
Xpate -- This perrnit is 1loroby issuod under the applicable provi-
Slpnalute of Applleont •-o. ❑ Coni 1000'.1 Agent ❑ sions of the Butte County Cude wid/ui ltisolt711uns to do
An 06HA p*rmlr Is r.gvIrDd 1r, e.q,.acDn, Doer $� deep and demel;t,cm„co�.tru�l, work indicr7tod abovo for which foes have boon paid.
Ion of stryelures over 3 stories in keipkt. DIRECTOR OF PUBLIC WORKS
Reoelpt No. BY _ _.�_.� ..-...w..... Date ,.... ,.... `
ww,tt.p.►. w., T[44o W•Aee(e�oA, r,N�•tN�►ccr o,,. PERMIT EXPIRES pate -_
eOLPe N�OD•A►ILICANt - --
��59�/ 1993-03-30 15:03 PAGE - r;1
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA
PHONE: 538-7541
MOBILEHOME INSTALLATION SHEET
1. Owner's Name:
2. Installer's Name: f
3. Is the -site currently under permit? Yes a No
/_ €3 Q(
(If'yes, furnish permit number ) OR
Is -the siEe ;an existing site?.. Yes No a
'(If yes, furnish two plot plans,)
4.' Will the-mobilehome be located at least 5 ft, away fromseptic tank and leach
fields'and clear of all setbacks and easements?- Yea No
(If no, clarify
5. What is the mobilehome electrical rating? --------------- U Amps
.6. What is the mobilehome site service rating? ------------- - Amps
7. What is the mobilehome site circuit breaker rating? ----- U Amps r
.S. 'Is there any other electric load to be served by the
mobilehome site service? -------------------------------- Yes No'
(If yes, identify the load and size: ,(Load) C. (Amps)
./C
9. What is the mobilehome site gas pipe size? -------------- 3/ (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?--------------------------------------------- q (ft.)
*'12. What is the mobilehome gas demand? ---------- --- BTU
*(This infoimation not required -if pipe length less than .6 ft. on �
natural gas or less than '50 ft.'on LPG.)
BUTTE COUNTY
U'ULD"N DEPARTMENT
%;
If other than single wide
Mobilehome Mfr. furnish Setup Model No.
Width r�_q 5_
(ft.) Box Length � (ft.) Tagalong or 'Elxp"ando Size Z/_&e KYear
-_X_ t.
'-On'.all mobilehomes manufactured after October 7, 1973, furnish_manufacturer's instailaticin
manual and structural --setup sheets (if not on file with.the County of Butte').
FOOTINGS (check one) 1. Wood -pressure treated or foundation grade. 2. other (specify)
SUPPORTS (check one)M 1. Concrete block. D 2. Other (speci.fy)
Pier Footing Sizes and Locations
S I NCLE -WIDE MULTI -WIDE
Line I
L,nc2_
Main Beams
2'
Main Beams
OF
line 2
Line I
i n:
n
Tag or Triple
Line
i4
L$ne I Piers: Line I Openinit:
Size -Min. ............ Size -Min. * ......
Spacing -Max. -•'..---- Lach Side of Opening$
From Enda-Max.-; ...... With Width Over' •-"-'"
e 2 Lint 3 Piers: (Under Bearing Wall'Only)
(Sfzn............. Size -Mia ...................
.......... Spacing-M&Z. ............
tfF�om Knds-Max ........ From Enda-Max..............
Cfn—e -3—Kou-i—
x
d q 3L)J12--� 01 'A
Line 4 Piurs: Line 5 Piero: (Under Bearing W&iI6 unly�
Size -Min. --- ....... Size -Min ...................
Spacing -Max .......... Spacing -Max. -•--•-......•
From Enda-Mex.--••••. From Enda-Max.•••••••••••••
.0 Line 5 Roof loads;
Size -Min ......
Location (From Front). .....
34
Mt
This set of plans arid specifications MUST be A e 711
kept on the job at all times and it is unlawful to
make any changes or alterations- on same without
Written permission from the Depar6nent of Public
Works, County of Butte.
5--33
ALL STRUCTURES AND EQUIPMENT INCLUr.)ING
OVERHANGS SMALL BE CL U-fR OF ALL EASEME NTS.
A SET BACK OF ,T- FT..FROM THE SID, E. srsl
Jr Fr. FROM THE REAP- 1. 1. - F" ' . T
PIR 0 P "
4-
/A
Q FT. FROM THE MVU ULF,"T
CLEAR OF'STRUCTURES AND EbU',Pi-v-,k1 'V.
FOR A 2 FT. EAVE OVERHANG.
s: -,K R U ( . SY-
I
'NOT All Aft
mals & Workmanship Shall Be in
Ac
Recognized Good Practices and
of a 4brescribed
for the Specified use in the
Uniform Building,
Plumbing & MechanicalVodes and
tj onal Elecftal
Code.
if
/I PO
eN
P
-j
DCO
W
Al 17mc ang
bow ON= %RV% fill.,
UILDING.DEPART MENT
v V E -D
ff
_D
x
Ir
LL!
as
Al 17mc ang
bow ON= %RV% fill.,
UILDING.DEPART MENT
v V E -D
ff
J��ry..—. . _��.�- �. .- �.,,•yt� t,'� �r -- r.T ..,,, .., ... _ - .., . x-....a.+srv4v�--� ��Y79^�+e'v�A"�'"'1"'�^'I�h"�•`s'""^a�'k►''rK"rK..,...v'err•--•--•r..11' i
BUTTE -COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One Form Per Building)
School District
A.P. Number 1y0 -'f133 Jurisdiction City
Property Owner
Building Department No.
�- County
Property LocatioAddress a3 C% �i ry�s s %f �l/✓�ff�
J
Subdivison of e.40 Lot No.
Residen �VOWment *gz sq. Footage
� ���i�
✓" Uk
Units ye Addition
Addition
Commercial/Industrial 0 Sq. Footage
New Addition
."' Building D
rtment Representative
0
(Floor Plans reviewed by School District Personnel)
423z,
(Group R)
(Including Exterior
Roofed Areas)
3 /Z�
Date
n %3
.� Qistrict Identification No. - -
:{•" (a72 N#A?n !/Nr Fd E� School District certifies that X90 y MOf�i t
"z (Applicant)
(Street Addiess) (Phone Number)
,.bue14,i7,, cg 9s9,3r
(City) (State) (Zip Code)
has complied with the requirements of Resolution No.
representing /oQ 3 A square feet.
School District Representative
'?I -S
by payment of $
Date
Paid by Check NPl� a L, umber Remarks: /i1.Uer' e i ST lire /N /iy
Bank Number, _ '
Paid by Cash F .C� /,u��
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to
additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.wkl (4/92)
A.
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
ZONING
040-240-033
R-3
BUILDING PERMIT
OWNER
Roy Moffitt
TELEPHONE
SO. FT. OCC. BUILDING VAL ION
OWNER'S MAILING ADDRESS
2395 Serviss St., Durham 95938
CONTRACTOR'S NAME
TELEPHONE
Mobile Home Center Inc.
533-4403
CONTRACTOR'S MAILING ADDRESS
1740 Feather River Blvd., Oroville
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 20,00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
FilingFee 15.00
9,199 OPrviqq St -rept, Durham
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SU/BJ(�I VIS/ION NAME //
�6-
PARRC_EL MAP
Water piping
7.00
Each qas water heater or vent
7.00
`
J
USE OF STRUCTURE
Gas piping system 1-- 5 outlets
5.00
SF ❑ Duplex[] Mobilehome Other
Building sewer
15.00
Mobile Home S I G I W
2@ 15.00 30,00
SPECIFY
TYPE OF WORK
New❑ Addition❑ Remodel❑ Utilities Installation❑ Other ❑
Permit Fee
$ 45.00
Describe work:
Contractor
Relocate Utilities for Existin Site for
ELECTRICAL PERMIT
FilingFee 15.00
T
Main service 600V OR LESS
200A OR LESS
1 18.50 18.50
Main service 200A TO 1000A)
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
NEW CONST. ( DWELLING OCCUPM
OR AODNS. ACC. BLDGS.
3.64sq.ft.
1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
-prand
NEW CONSTR. U TI.OUT LET
NON.RESID BRANCH CIRC11 ITS
@ 5.00
Professions Code and my license is in full force rand effect.
License No. �y6 �� Classification _ C _5/ /
(POWER APPARATUS e)
SINGLE, OUTLET CIR.
Ex. Occup(ouTLETs OR FIXTURES
20 76
❑ 1, as the owner, or my employees with wages as their sole compen-
FIXED APPLNS. OR
Ex. Occup. OUTLETS IRESIO.1 EA.)
3.00
sation, will do the work,and the structure is not intended or offered
Temporary service
15.00
for sale. (Sec. 7044)
ElI, as the owner, am exclusively contracting with licensed contract -
Mobile Home Facilities
1 15.00 15.00
ors. (Sec. 7044)
Misc. Wiring
-15.00
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Permit Fee
$ 48.50
WORKMEN'S COMPENSATION INSURANCE
Contractor
I declare under penalty of perjury (check one):
MECHANICAL PERMIT
Filing Fee 1 15.00
❑ The permit is for $100.00 (valuation) or less.
Heating
r -t-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.
Cooling
❑ I shall not employ any person in any manner so as to become subject
Hood
6.50
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
Ventilation
to the W. C. provisions of the Labor Code, you must forthwith comply with such
Permit Fee
$
provisions or this permit shall be deemed revoked.
Contractor
I certify that I have read this application and state that the above information
Mobile Home Installation Fee
S
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Energy Inspection Fee
$
Butte to enter upon the above-mentioned property for inspection purposes.
OCC CONST TYPE
I also agree to s e, indemnify and keep harmless the County of Butte against
TOTAL FEE
$ 113.50
all liabilities, ud'gments, costs, and expenses which may in any way accrue
HAz DFEES IMP FLOOD C6F
PARC PD H ISSUE
against said ou 4y -in consequ a of a granting of this permit.
— - —
i
X ate -3 31-"3F3
This permit is hereby issued under the applicable provi-
Signature of Applicant— ner ❑ Contractor Agent ❑
sions of the Butte County Code and/or
resolutions to do
An OSHAwork
permit is required or excavations over 5' deep and demolition or construct-
indicated above for which fees have been paid.
ion of structures over 3 stories in height.
ECTOR OF PUBLIC WORKS
Receipt No. 135934
By w-
Date -52- �
WNITC-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. f.OLDENROD-APPLICANT
P I PIRES Date
4. }�°�ZTy`,M"'r '�s-��':.t+"�,..y-N�r' i•YJr;'iry+�.-r.. }"1v'.i['/
COUNTYOF BUTTE-'DEPARTMENT�O-1:YP-VELOPMENTSERVICES --BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILL, CALIFORNIA 95965 -TELEPHONE (916) 538-7541
PC)
RMIT APPLICATION DATA SHEET
OWNER A. P. No. 6
Proposed Bui ding U44 Building Inspector A7 Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ........................................
2. Plot plans, 3/4 sets, signed by preparer of plans . ..........................
3_ Complete plans, 3/4 sets, signed by preparer of plans . ......................
.4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5.. Hazardous Material Form . .......................
6. Ener Design Compliance and supporting ...... .
Energy g p pporting documentation. .......... _
7. Statement of Intent for Non -Heated; 4nd"A/C Buildings . ..................... .
8. Engineered truss details and -Fayoufin'duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ............
10. Fees of $
.....................
11. Impact fees as shown on attached schedule.
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) y California Engineer. . .
--�'/ 14. Sanitation and plot plan approval _6W� Health Department . ............
15. City of Chico plumbing permit . ................... % ....................
16. Plot plan and business license approval from City of Bigg's/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: ........
18. Contact Land Development about (A) Improvements (B) Drainage. ......... .
,Ck!;q:L 19. Driveway permit (construction approval required prior to occupancy). .. . .
20. Pre -inspection for required. o Build g Inspector -Date
c )
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner Mail to owner _). ...........
tam 24. Recorded copy of Agricultural Acknowledgement Statement. , 3' s'
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone:113 and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant ate
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air PollutioK Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted pri o permit issuance: (Circle new item not checked above).
1. Index permiffor above items No.
2. Additional items required:
Cont ctor, designer, owner, was advised of above required data by phone _ mail Counter bttQ Date -Q -
Contractor, designer�ner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by :Zed Date Plans approved by Date
Sets of plans on hol in File cabinet AP folder
Copy - Department of Public Works
F.H. USE ONLY
Hot ri �, Atuc ,ca
— s ,o is. u.
TO: , Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Disposal Water Supply: Public 1 Private Well
Clearance for D— bedroom i o ile ome. Otheref) mb(0
Hold final for: �� - l s�nk-.
Final clearance O.K. for:
NOTE:
/
Enviro mental Health Specialist
8/92
5 -:jA3
. Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovllle, California 95985 • Telephone: 918!538.7541
APPI6ICATION AND PERMIT
PERMIT N0,
—
p�.�" BUILDING PERMIT
---
TEI05FIONF
rNE(a( j S0. FT, OCC. .BUILDING -VALUATION
�bwNCR' MAI NO AOtiRk
V elf
•� O A �••a `_r_•V,J, TELEPHONE ... .�... ... ......... .•. ...
•77 :yam -- _.......... . ............. _
N C OR M (LING AUUN�.Sd ; �� � � �
e�►*.eq...1� Ir. 1vc(
_.
CONSTRUCTION LkNutt� ... .. •-'---- $--...----- ........-_........_ ..
' VNKNOWrJ TOIaI Valuation ,
L6NPE SMA) FIIIng X00~may
.� --
Pern
�iicHlltCT 4k�iN01N66k —_Plan -- _—___.._. ...
t Foe $
�IC EN�6 NYEE'110, '���
Checking Fee a �O O� '.
_ ___ __ • .........._.�--
i ...._ ........... .._. _ i
ARCHITCT UR EtJO1NEEN'S A/AILING AbbRE65 ErC Flan Checking Foo
Ponalty s
�+
and ProleS
sslons Coue pend my license Is in lull fowo and Uffecl.
License No, GLfC Lq-(JS Classification _
❑ I, as the owner, or my employees with wages as their sole compon•
611110n, will do Ibo work,and the structure is not Intended or offered
for sale. (Sec, 7044)
❑ I, as the owner, am exclusively contracting with licensed contract.
ors. (Seo, 7044)
P em exempt under goo,_, Business and Prolesslons Code
I.. thl
Permit lee
5
L4F—VIA A 1`I •
1-il�tlyfetc - 15,00
___ pLUMBINQ PERMIT
Each Trap
_-__ _.......
5.00
LOT NO, N NAME PA MAO
Solar or heat pump water Itoator
Water piping
20.00
--
7.00
5.00
Each acs wolor hoator or vont
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF ❑ Duplex[] Mobilehome Other
f3tlildln sewer 1$,00
6PCfIFY --
---
Mobile Horne t, 1
... _.....,..._ _......-.........
--z._......._......_...._.---
TYPE OF WORK
�N
ewQ Addltlonn" rternodelF� "till't-- f•Il Installalfo^r Other ❑
.�eS'., J vx- -
6,)n:5y-(N S;te fay /�rre,,�et��o�/1%t�,Gl�;
Pertm Fee 3 4$•D0
ELECTRICAL.PERMIT ngFee 15,00
Main service 1800MR, His,
18.50
. S
_
Malt) scrvlce 20(.ATO1000,)
37.50
g•Cf sq.rt'
CONTRACTORS LICENSE LAW
I'deo,
are under penalty of perJury (chock one),
am licensed under provisions of Chapt 9 Div 3 of the Business'40
NEW CON T, OWELLINa
On ApON . ACC eLbGi
11 WRoN
C� 6,00
..--'
�� w
�+
and ProleS
sslons Coue pend my license Is in lull fowo and Uffecl.
License No, GLfC Lq-(JS Classification _
❑ I, as the owner, or my employees with wages as their sole compon•
611110n, will do Ibo work,and the structure is not Intended or offered
for sale. (Sec, 7044)
❑ I, as the owner, am exclusively contracting with licensed contract.
ors. (Seo, 7044)
P em exempt under goo,_, Business and Prolesslons Code
I.. thl
/POWER APPARAT�156
_ 1 g'NOLG OUTLET CIR.
15.00
❑ The permit Is for 9100.00 (velualion) or less. Heating
EX. OCCUp OVTLETA OR FIXTURE•
r1olI have placed on file with the County Of ButtO Building Department ___
70 76
Ex, 000up) ovTLOET�PaeaioGl eA.
--• •-•-•--
3,00
Temporary 0rvIce
shall not employ an ysubject _.�........ ..:....5_......,._..�
p y y person In an manner s0 as to become NOOd 6 50
15,00
Mobile Homo facilities
-- -
15.00
_
Misc. 1Yirin —
g
_
•-•�
--
provisions or this permit shall be deemed revoked, l-- '-'--- -"' '
Controctor
s reaevn Permit t=ee $
' —
WORKMEN'S COMPENSATION INSURANCE r:gnlracl0r
I declare under penalty of Perjury (check one): MECHANICAL PERMIT FilrngFee
y� $
15.00
❑ The permit Is for 9100.00 (velualion) or less. Heating
r1olI have placed on file with the County Of ButtO Building Department ___
a Certificate of Workmen's Compensation Insurance or a Certificate -- -- - --
--• •-•-•--
of Consent to Self -Insure. Cooling
shall not employ an ysubject _.�........ ..:....5_......,._..�
p y y person In an manner s0 as to become NOOd 6 50
to the W. C. laws of California, -----
-- -
Notice to Applicant: If after making this statement, should you bocome subject Ventilbllun
to the W, C, provisions of Ilse Labor Oode, you must lotthwllh comply -with such Pemill Fee $
provisions or this permit shall be deemed revoked, l-- '-'--- -"' '
Controctor
I cattily that I have read 11118 appllcatlon and state that Ute auovG infonnatlon
la 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 properly for Inspection purposes.
1 also a99roe to save, Indemnity and keep harmless the County of Suite against
all Iiab11111es, judgments, Costs, and expenses whiCtt may in any way accrue
against sold County In consequence of the granting of this permit,
X,__...... Date_ .....-' -----
Slgnolvre of Appllconi - Owner ❑ Conlroctol� Agent.....,..._
An OSHA p*rmlt Is rogvlred fo• •,:cvwllen{ eve( 5'0" deep and demelil;en yr eonsfwel-
Ion of efrvcturos over 3 stories in height,
Rsoelpt No.
WNlif e•e. �.W„ T[44o W•A�et110 A, SIN I!•IN •►LC�011, OOLp{NAOO•AI�LIC ANT
• '' 135g3�
Mobilu 11011)o Installation Fee E
Energy Inspection Fee 8
OCC [ON6T Iver. TOTAL_ $
itA2 O Fi.E IMV 05 CO( T- 1i-eUU 1 H' i 65.0
This Per(T)it is horoby issued under the applicable provi-
sions of the Butte County Code and/ur (esulutluns to (lu
work indlcbtud above lot which foes have boon paid.
DIRECTOR OF PUBLIC WORKS
By Date
PERMIT EXPIRES Dots -
1993-03-30 15:03 PAGE = 01
y
APPROVED
0,/
ry- N
'This set of plans and specifications MUST"be
kept on the job at all times and it is unlawful to
make -any changes or alterations on same without
written permission from the Department of Public
Works, County of Butte.
<
'S 33
ALL STRUMRES AND EQUIPMENT INCLUDM
OVERHANGS SHALL BE CLEAR OF ALL EASEMENT
A SET BACK OF 5 FT. FROM THE SIDE AN
,5_ FT. FROM THE :REAR PROPERTY LINES h,'+
6ij�Q— FT. FROM THE ROAD CENTERLINE SHAi_a
CLEAR OF STRUCTURES AND EQUIPMENT EXCEP
FOR A 2 FT. SAVE OVERHANG. t
.S'Z(� U(sS-
! of a
3s
. '
tle National
�` 4
.`fC '
ials & "Workmanship Shall Be in
lecognized Good Practices and
jb0d for the Specified use in the
Plkmbing & Mechanical Codes and
Pical Code. .
C,
�iLpoL�.
1
Wl4]
R
iL S
BUTTE COUNTY
BUILDING DEPARTMENT\�
APPROVED.
o,;SC TY PE U 0.o
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ID V .E �✓
P!F I N TY.
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52
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I
STATE OF CALIFORNIA Butte Iss.
COUNTY OF 1
On Apr i L. 1, 1993 before me, the undersigned, a Notary Public in and for
said State, personally appeared Diana Johnson. personally
known to me xxxxxxXXXXXXXXXXXXXXXXXXXXXX'x
XbtgBffitg3dgdd�g4np6�i§3fld3GXQ5pb�¢to be the person whose name is subscribed tothewithin instrument,as
awitness thereto,who being by medulysworn, deposed and said:
ThatXii?(/she resides in 0 roy i 11 e , CA
that Wshe
was present and saw Roy E. Moffitt 0
and Catherine H. MoffittoFFICIAL SEAL •
personally MICHELLE A. MILLER
known to hWher to be the same person described in and who NP�nARY PUB�CI-�CB (F ERNIA •
executed the within instrument, as a party(ies) thereto, sign, seal M COttIR1. E7t UCf. I •
and deliver the same and that said party(ies) duly acknowledged 00000 0• •
in the presence of said affiant, that he/she/they executed the 000
same, and that said affiant, thereupon at the party's(ies') request,
subscribed his/her nameas a witness thereto.
WITNES y a I. d
ll
�Z&614�
END OF DOCUMEN
Signature (This area for�fficial notarial seal)
Return to DPW AGRICULTURAL STATF.MLNT OF ACKNOWLEDU MENT
00 .FOR RESIDF:NTIAL DEVCLOPMENT
93-13126
.Section 26-8.1 of the Butte County Code
requi.res this acknowledgement be recorded
prior to issuance of a building permit-.
The property described herein is adjacent
93-0131261 Rec Fee
I Check
5.00
5.00
Lu land or Included within an area zoned
Recorded I
ror agricultural purposes, and residents
Official Records I
or Lhis property may be subject to incon-
County of I
veniences or discomfort arising from the
Butte I
use of agricultural chemicals, including,
Candace J. Grubbs I
.but not limited to herbicides, pesticides,
Recorder I
and. fertilizers; and from the pursuit
10::34am 2 -Apr -9:3 I PUSL
X 1
of • agricultural operations including,
but' not limited to cultivation, plowing,
_
1
spraying, pruning, and harvesting which
6tta.4ionally generate dust, smoke, noise, and odor. Butte County has establishcd ogric•ul-
aural zones. which have as a priority use for
productive agricultural purposes,
and resid('111 s
within said zones and on adjacent property
"de.-disconform
should be prepared to accept such
lnronveiiienco
from normal, necessary farm operations.
A11. that real property situate in the County of Butt.,F, State of Calif orni.u, (lcsc•ribcd
(ollows:
LOT 20, AS;_;SHOWN ON THAT CERTAIN MAP ENTITLED,."RICKETTS SUBDIVISION,.DURHAM,
CALIFORNIA", WHICH MAP WAS RECORDED IN THE OFFICE•OF THE RECORDER OF THE COUNTY
OE BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 17, 1947, IN BOOK 15 OF MAPS, AT
PAGE 19-
/A p# v yD -aW - 0 33
Date: A PROPERTY OWNERS: Foy E', MoFFiTl'°
3)iAKA o Soh
CAtNLcRl #, ftFPlrr
.SLute of ) On this the day of , 19 1)uforo mc,
SS. the undersigned Notary Public, personally appeared
Goun.ty of )
E] Personally known to me. 7 Proved Lo me on K basis
of s6tisfactory evidence,
Lo be the person(s) whose name(s).
subscribed to the within instrument and acknowledged Lh;ct
executed the same for the purposes Lherein conLni.ned., l.N WI'I'Nl,,SS
WHEREOF, I hereunto set my hand and official seal.- -'
d
8
Present A.P. No. _ Notary Public
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541
Roy E. Moffitt
2395 Serviss St.
Durham, CA 95938
With reference to the above subject:
/ / Attached is:
DATE April l' 19x1
RE: building permit application #835--91
A. P. # 040-240-033
Application for permit Mobilehome Utilities Installation Sheet
Building Plans Mobilehome Installation Information Sheet
Engr. Calcs Typical Plan Sheet
Owner -Builder Verification Form List of Codes Enforced
OTHER
We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in including plot plans.
Plot plans in
Structural details in
Complete plans and calcs in by registered engineer or architect.
Energy design including
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
Sanitation approval from Butte County Health Department at:
196 Memorial Way, Chico
7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise
Planning approval from Butte County Planning Department, 7 County Center Drive,
Oroville, for
Completed Owner -Builder Verification form.
Recorded copy of deed showing
Recorded copy of agricultural acknowledgement statement.
OTHER The mobile home on 'the above noted parcel appears to have been installed without
inspection or permits trom this office. The zoning ordinance requires a
approved and certitied unit. Your plumbing an electrical permits cannot be
issued until this matter is resolved.
Should you have any questions concerning the above, please contact
of this office.
Rod Taylor
Yours very truly,
William Cheff
Director of Public Works
J.F. Glander
JFG/aj Chief Building Inspector
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6626 1
COUNTY OF BUTTE - DEPARTMENT )F PUBLIC WORKS
7 County Center Drive - Oroville, California 959 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
040-240-033
ZONING
R-3
BUILDING PERMIT
OWNER _
tl
TELEPHONE
343-3404
SQA FT. OCC, BUILDING VALUATION
OWNER'S MA LING ADDRESS
CONTRACTOR'S NAME
TELEPHONE
11 I i
CONTRACTOR' MAILING ADDRESS
Vallombrosa Ave-
F NpIliace
CONSTRUCTION LENDER
UNKNOWN
Tota alU tion $
IIp'g Fe $
LENDER'S MAILING ADDRESS
mi! = e $
ARCHITECT OR L.J :INEFR
LICENSE NO.
Plan Check) g ee $
Ener P n Checking Fee
9 9 _ $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalt $
BUILDING ADDRESS
Permit fee $
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 pas water heater or vent 5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other House & MOUIP-Home
SPECIFY
Gas piping system 1 - 5 outlets 1 5.00 5.00
Building sewer 5.00
Mobile Home S I G I W r10-00 ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ® Installation[] Other ❑
Describe work: Install Power Pole and 200 AMP, 2 Meter
Service Replace Single Gas Meter with
Permit Fee $ 15.00
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
Main service 6000 V OR AMP LOR ESS 1 10.00 10.00
Main service EA. ADD'L 100 AMP 1 1 2.50 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.
FlI, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
® I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. / DWELLING OCCUP.yd ,
OR ACDNS. \ACC. BLDGS. h¢sgft
NEW N ON.RESID BRANCH CIRCUIT 2.50 ea CONSTR MULTI -OUTLET
S
POWER APPARATUS a
SINGLE OUTLET CIR.
Ex. OCcu 20e50t
Occup(OUTLETS OR FIXTURES eALO 30
FIXED
Ex. OCCup. OUT ETS IPRESID )APLNS.REA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. byirin g 15.00
Pre–Inspection 11 L5.00115.00
Permit Fee $ 37.50
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
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 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 sai ounty in f th granting of this permit.
X Date �—
Signature of pplicant — Ow er [�( 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
E
TOTAL FEE $52.50
HAz.
cuA-
PARK
SCHL
FLD
PAR
Po
I HD.
ISSUE
This permit is hereby issued unser 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. 83695
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE [DEPARTMENT OFPayS!IC WORKS -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OFLO•VILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER
Proposed Building Use
VA
Building Ins
At time of permit application, I was advised the following data must be subm, ed prior tc
1. All items have been submitted. .......
Date 7�
frht processing and/or issuance:
TE RECEIVED APPROVED
2. Plot plans in duplicate/triplicate, signed by prepareIgs
f�lans .....:../
3. Complete plans in duplicate/triplicate, signed by parer. of plan . .
4. Complete engineered plans and calcs, with wet sigure o plans . .
5. Hazardous Material Form ....................
6. Energy Design Compliance and supporting documation .........
7. Statement of Intent for Non -Heated and AC Buildi ..............
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) i
17. Planning approval for (A) Use: (B) Parkin : .
18. Improvements may be required. Contact Land Development Section DPW
19. Dom' way permit (con r44ct'o pprov q ire prior to occupancy)
207 Pre -Inspection for �- required Pre-Inspeo. request to
Building Inspector
21. Contractor's license information (N.., 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. Lepr of signature authorization ...................................
26.
27.
Date)
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
n+ko
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Healt. ept. Fire Dept. Other Date By
The following data must a submit ed �ior to permit issuance: (Circle new item not checked above).
1. Index permit for ab ve items No.
2. Additional items r Quired:
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 _mall—counter by date
Plans checked by
Sets of plans on hold in
Copy—DPW
Date Plans approved by
File cabinet AP folder
Date
PRE -INSPECTION
r Q
OWNER: B /l4 ` DATE
LOCATION: 02 �J' .Se jn w'ts fir. r7�N� . A. P. m d 0 r 2 -Li O - 03
CONTRACTOR: ZONING
PRE -INSPECTION FOR:
DATE TO INSPECTOR
PERMIT HISTORY: NONE f-( AS FOLLOWS:
TYPE OF OCCUPANCY
FIELD - INFORMATION .
BUILDING USAGE:
TENNANT:*
FV7.00CUPIED HAS ELECTRIC Q H�1S GAS HAS SANITATION -FACILITIES
Q HEATED -COOLED PERSON CONTACTED
OTHER COMMENTS : w 06 Mo MLL la oma I� t�h S I nIG�� FAm r t1 -
i n!y CA U Vt, A96 tir
'I Ci `IP
ACTION RECOMMENDED:
E] ISSUE
HOLD FOR_�o3i�-�
_ {
AFEE Aics r0
fl'\ ; 22
uoe�-� ,
R� C517!
Iior1S� �O/JI�G P, Ca
OTHER: MaS+(_ E
(-} �� m �.
AMA2s i'o
W6
�Ny InlSPPC�Io.✓s
AN�
%2 %e�ST2.reT�6�/,c
BY ;�� .a,�;_ . DATE
t
- COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS , PERMIT NO.
a 7 County Center Drive - Oroville, California E15965 - Telephone: 916/538-7541 J _�`%
APPLICATIAN AND PERMIT r
ASSESSOR PARCEL NUMBER
ZONING
BUILDING PERMIT
OWNER + ^^
dll..J -"Gf' 4 nN
TELEPHONE
SQ.FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
a3� seg .� a
CONTRA OR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
CT ,o . (, ; 0, -.. /,/ -� C_ It
Fireplace
CONSTRUCTION LENDER
)v /�
UNKNOWN
Total Valuation $
'
FilingFee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
_,y
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
._.L_
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
SFN 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 ❑ Remodel ❑ Uti lities ❑ InstallationEl Other ❑
Describe work: M r c v\ ?' ,r • + �or' �y .-•
� i
{rJ�L
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I de [a 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.
ry� T/_
License No. 1331 y Classification i i
❑ 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 ADDNS. ACC. BLDGS. , /Z0sgft
NEW CONSTR.MULTI-OUTLET 2,50 ea
NON-RESID BRANCH CIRC ITS
POWER APPARATUS e�
SINGLE OUTLET CIR.
20e60e
EX. OCcup(OUTLETS OR FIXTURES eAL@30
Ex. Occup. OUTLETS ((RESID.)REA.) 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
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 c3
Cooling
U,
Hood
3.00
Ventilation
permit Fee
$ S r�
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
nA / 4
X ����rl f+r^t�/ Date
Signature of Applicant — Owner ❑ Contractor ❑ Agenrwork
LXJ
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 $
OCCUP,
CONST.TYPE
FLOOD
PARCEL
PD
ND
139UE
This permit is hereby issued under
sions-of the Butte County Code and/or
indicated above for which
I/
/'DIREC'�OR OF PUBLIC
T�r�))
By. 1 r� /, f
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date �- R'f.
' ��'
i
Receipt No. � � G %
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
' COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
' 196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-45'41
Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57
CORRECTION NOTICE'
s
A routine inspection_ indicates that the following violations of County Ordinance
exist at the�ab'address and should be corrected. Please notify this office
when correcwork is completed. If you have any question pertaining to this
matter, o ditional explanation, please contact this office immediately.
�v0LI1
1/o &-�J� IMt &*,o cat, f4,v 1? 15'
Inspector—(4"V Date ^ CJ
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION ANTYPERMIT
PERMIT NO,/
ASSESSOR PARCEL NUMBER
_. -/ ! 3 3
ZONING
BUILDING PERMIT
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'SMAILI G ADDRESS
V 3q Se r « S4. r) UL cL
CONTR OR'S NAME /
r .f S�Ce /
TELEPHONE
3ya - /37/
CONTR TOR'S MA ING ADDRESS I
-S. Wax C 1%ICo
Fireplace
CONSTRUC�TIO LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MVILI G ADDRESS
Permit Fee
$
ARCHITECT O ENGINEER
Ig
LICENSE NO.
I
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECTIR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
S r V lrLt S �•
Permit fee
$
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 S G W
10.00ea
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation( Other ❑
Describe work: M'ec� /Jp rw,.} �r l>�o _
�ac
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I de la under penalty of perjury (check.one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Profession1
s Cod and my license is in full force and effect.
License No. Classification ��
Fl 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.d ,
OR ADDNS. C ACC. BLDGS. / h2sgft
NEW CONSTR MULTI -OUTLET
NON.R ESID BRANCH CIRC ITS 2.50 ea
/POWER APPARATUS e
(SINGLE OUTLET CIS.
0050C
EX. OCCUp�OUTLETS OR FIXTURES ewL030
zALO30
Ex. Occup. OUTLETS ED AP(RESID )SEA.) 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
V 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 d ',pc3z� j
po
Cooling
UO
Hood
3.00
Ventilation 1,
Permit Fee
$ S" v�
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit. `./
X�A�I�1��1/±tRif'!L'J 4q f ,
Date
Signature of Applicant — Owner El ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structuresover3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ ou
OCCUP.
CONST.TYPEJ
PLOOD
PARCEL
PD
ND
ISSUE
This permit is hereby issued under
sion f the Butte County. Code and/or
wor i dicated h bove for which
I CTOR OF PUBLIC
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. 0 3O 1 %
WHITE-O.P.W.. TELLOW-ASBE330R. PINK -INSPECTOR. 60LDENROD-APPLICANT
/
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COUNTY OF BUTTE - DEPARTMENT OFt POBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916%53444-4541
-- PERMIT APPUtArIN DATA SHEET
Permit No.
OWNER A. . No. y0 - � ti — 33
Mr��. ���^ Building Inspector A.
Date
Proposed Building Use �9
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. . .
A� I.anning approval for (A) Use: (B) Parking:
J.2. 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. . . . . . . . . .
17. Pre -Inspection for Required. Pre-Inspec. request to (Date)
Building Inspector
18. Recorded copy of Agricultural Acknowledgment Statement.
19. Driveway Permit.
20. Plot plan approval from city of r
21.
22. f
When you issue the permit, process as follows: Mail to owner, I M ii to contractor.
Telephone and hold for pickup at—off ice, Deliver w/inspector.
Other r'
- I
Applicant IL 1114960c -_Date o�
Copy of plans sent Health Dept., Fire Dept., Other Date
The following data must besubmittedprior 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 _maiI—counter by date
Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy—DPW
— Flours: 10:00 a.m. - 3:00 p.m.
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BRIAN MOFFITT
2395 SERVISS ST.
DURHAM, CA 95938
,5r30 -3L'3- X 04
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