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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 oo K ID V .E �✓ P!F I N TY. f�A 1�(l,Ae � 52 N L -- -ittL�LL` 'L I'i i CL"` -E �` DIN �• rd ` <<W D- ! f < <t `�.%Ltt��H[HHILIT.lr t r -rc" RE"DROG14t H t. f .. FfS. o,;SC TY PE U 0.o oo K ID V .E �✓ P!F I N TY. f�A 1�(l,Ae � 52 N L -- -ittL�LL` 'L I'i i CL"` -E �` DIN �• rd ` <<W D- ! f < <t `�.%Ltt��H[HHILIT.lr t r -rc" RE"DROG14t 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 `ib - 2Yb - 631 - / Z/ z21f ..: jq, t�, ( CJGt t re C (' Cf, lCA� r -�-� S a . C. S Y p l o P l CL j does rvo+ S�.ow hou.s e o"lY 0. Sem �.%S%o� —•\�!-ger ca9. y�7.0/7 Z- �'N 54. r 47. //Z o / 7 s - J J 0.N — `� l•t p ,,,1 r ('� 1 Q iit a V� 1. 4.L(.i'1j/ c S p � t G'OYvCer� abe�,..'r V tv tct+eci J LAVA PFAM 71 �� ��.,: , � �',S� l � 1.33C,6�,,, is ' ,2�4 ��� o" 31 M oU Rum 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 / _ , .. ... r . ..,c..-� ^^--n --•• ..-.-. �.,... .,.:.. p.nR".wV��+v..{ _�.,. „ i...,,,� .. p,� ..'x• w t *s • .. r ...R .. ,. � 5 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. wr- i w "o 2�- j C3 o0 b -I wr- i w "o 2�- j lzi o0 BRIAN MOFFITT 2395 SERVISS ST. DURHAM, CA 95938 ,5r30 -3L'3- X 04 f o? i/L%u? - 6, o %t 12- 0 �t. S '? P ro � \�"l