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040-250-032
40-25-32 3311-91P,E ' COUNTS, Gladys 9213 'MdwaY� Durham rJ (nihu) / ---- l ELEC , GAS Yj g- COMPACTI N TEST REQ SUPPORT STRUCT .REQ , ' 0-25=32 Permit#3312-91MH (install mh �1 i I 1: '7 a i Y � a o � Or w m Q V QGo Or E.H. USE ONLY Plot Plan Attached Floor Plan Attached [�— Sent to B.D. TO: Building Department FROM: Environmental Health a W SUBJECT: Sanitation Clearance ga'p at'f q P /, kamo rni,,, I)kln - ;?-4;- - o3a Owner Location I AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwallinn nthar Final clearance O.K. for: NOTE: Cc110apnilC"p- I6P'If i. kaTI., w n 'i ►�, Environmental Heal Specialist Date if 45, I �® , -, 14?ld� �s000e 141 -32 3311-91P,E COUNTS, Gladys 9213 Midway, Durham (mhu) JOB FINALE Signature 1�12--92- ICE Copy Address a -z' GAS Datet18 Meter By—o�L— ELECTRIC Meter By Date 3AAIJI M CA I = OK O = Not OK Not = Not Readyable MOBILE HOMES - MISCELLANEOUS Date MOBILE HOME UTILITIES (Mans) OK except #'s Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s ,izoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements . Soils; Special MH Support Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel ,2"Sewer; Location -Test -Fall -C/O Concrete 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 011�Water; Location -Test -Easement Needed (Sketch) i 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Electricity; Location-Clearences-G.�d-`'6�YAmp-Concrete Shthg.-Rfg.-Bracing !d Gas; Location -Test -Wrap: , /"L"ft. 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures %%'Nat. or/ /" L"ft./ /"LPG 6. Carports; Windows -Doors 4 7. Well Clearance & Disconnect 7. Electric ,e Utility Clearance ) Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOIRCEHOME INSTALLATION (Plans) OK except #'s ning Requirement4,Setbacks E sements Footings Size- Ging-Marri a Line 3: a MH T errand V on r i EI tricity; MH Test-Crossov -Breakers-Clearances rain; MH Test -Fall- lex on or . Water; MH Test-Regulator-Connector W and Sewer Connected -C/O to Grade -HD Approval Gas and Electricity Tagged E ; Insp.-Sketch otic— art. of Occupancy Date 311 Card 8-1 S Date Card 8-1 Date 3 /tf �'(, Card B-1 L113 Date Card 1311 f 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O = Not OK = Not Applicable Not Ready RESIDENTIAL (� = Date UNDERFLOOR (Plans)' OK except ft's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wra pped 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. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except ti's 16. Water Htr.: Vent -Access -Combustion Air -Baffle 17. Water Pipe: Test & Anchor -Nail Protection -------- --- ---------------------------- 18. D.W.V.: Test -Fittings & Anchor -Nail Protection ----------- ------------------ -- --19. Shower Pan: Test. First Floor -Tub Access ---- - ---- 20. Test Tub & Shower, Second Floor -Tub Access ------------------------------------- 21. Gas Pipe: Size & Anchors Date Card B-1 Date Card B-1 ------------------------------------------ -- -- ------------------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ti's 22. Fixture & Transformer Clearance -Ins. Protection ---------------- ---- --------------------------------------------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors ---------- ------------------------------------------------------------ 24. Size Boxes & No. of Conductors -Stapled --------------------------------- -------------------- -------------- 25. Romex Installed Close to Edge of Studs & C.J. --------------------------------------------------------------- 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water ------------------------------------------------------------------------------ 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI -------------------------------------- ------------------------------- 28. Subfeed Wire Size r r ga. Cu or AI-A.C. Wire Size / ! ga. ---------- ------- Cu- ---AI ----------- ----------------------------------------------- 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No ------- ------------------------------------------------ 30. Service -Riser Conductors & Ground -Main Disconnect -------------- Equip Clearances Panels-Motors-Mech. Equip. ------------- - ------------------------------------------------- 32. Clothes Closet Light -Shower -Light -Spa Light 33. -.Smoke Detector ------------------------------- -- ------------------------------------------- Date Card B-1Date Card B-1 ------------------- --------------------------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except x's 34.--A.-C.- Ducts Insulation & Support ------------------------------------------------------------ 35. Vent Fan: Exhaust above insulation ------------------------------ ---------- ------ ------------ ------------ 36. Condensate Drain & Overflow: Size & Grade --------------------------------------------------------------- ------- ----------- 37. --- ----- 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet -- ---- ---- - ---------------------------------------------- - ---- 38. Attic Access & Platform if Furnance in Attic ----------------------------------------------------------------------------------- ------------------------------------- --------------------------------------------- Date Card _13- 1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except ti's 39. Sils. Proper Material & Anchors ------ ------- ------------------------------------------------------------------- 40. Walls -Studs -Nailing. Spacing & Bracing -Plates -Sound ------ ------------------------------------------------------- 41. Bearing Walls over Girders & Floor Nailing ------------ -- ----------1------------------------------------------------------- 42. Draft Stop in Walls (rat proof) ------------------------------------------------------ - ----------------------- 43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub - --------------------------- 44. Headers & Beam -Size & Bearing jingle & Duplex) Date FRAMING (Continued) ' 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing _ 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits ------------53.---Stairs: Width -Head room -Rise-Run-Landin 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. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows --------------------------- Date _ _ _Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except N's _ 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector ------------- _- 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor-Ducts-Mech. Protection ---------------- 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa ------------------------------- 66. Elec. Trim & Subpanel: Breaker Sizes & Labels -------____ ------------- 67. Stairs & Rails _ 68. Fireplace or Stove: Clearances -Hearth - ----- -------------------- 69. Elec. Outlets at Wood Panel: Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71 Elec. Outlets & Receptacles at Kit. Counter -------------------------- ---------- -- --- 72. Garage -Fire Door: Swing -Landing -Closer 73. A.C. Duct in Garage -Damper ------------------------------ ----------- ----- 74. Wtr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor-Mech. Protection 75. Plb.. Elec. & Mech. _Equip. Listed for Location -------------------- 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection ------------------------------------------------------- 77'. -Insulation -Foam -Looked in Attic 0 Yes ---------------------------- -------------- 78. -Guard -Rails Rails & Deck -Co nstruction-Post Caps ------------------------- - 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth _ _ _ __ Clearance Looked under Floor - 11 Yes _ 80. Following instld.: Drive D Yes 13 No: Walks 0 Yes 0 No; Planters D Yes 0 No -------------- --- 81. Stucco Brown -Finish --------- 82. -------------------------- --- 82. A.C. Unit: Disconnect. Electrical, Plumbing -------------------------------------- - 83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim: G.F.I. Receptacle -Underground - --------------------------- - 86. Ventilation Throughout House - ---------------------------------------- - 87. _Glass Protection 88. Corrections from Previous Inspections ------ ---- -- ------------------ ---------------- 89. Gas Test -Meters Tagged: d: Gas -Electric ---------------------------------- ------------- ------------------------------ --------- 90. Water -&-Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates ---------------------------------------- - Date Card B-1 Date Card B-1 ------------ -------------------------- ---- - - Date Card B-1 Date Card B-1 ------- --------------------------------- Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE 331< -91 OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. ZZ r •Ao��eu ��V�i/f/IAC.. ��.�_•. _.� � .�./�'I!/� _�/� -- U — . . .n.nn.,._ _ .,14 -- Date /i 2 Inspector 4.16�4 REV 11/91 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WOftKS 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE 3 3 11-'F1 OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the abov address and should be corrected. Please notify this office when correction of work is com eted. If you have any questions pertaining to this matter, or need additional explanation,. plea contact this office immediately. YJ ob f4 i n S 14 Werk 40 a nc CJS d r �•r / 3 hofe O n�l� /3 lil o� 4p17r01.?O� �yr' C C7 P P' C a.s i0i p/„ f — �s P [✓ (tiA 1 -er ,CJ ir- he&' 1�r4 rn ?z ni a -- 11.0 U. Gr ).M, - JAG Ir m(er 0'loo, Date Inspector REV 11/91 �°vs1NG ,q,ob STATE OF CALIFORNIA DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT 3 a,•4rd j:: IZu DIVISION OF CODES AND STANDARDS �41 Dev��° A9TIVITY REPORT AREA OFFICES Date , .[ Report by p� �� %% %5Q Q !//Q orthern Area � i600 Third Street _"� �_►�T�/ Sacramento, CA 95814 To: Name (�►�/ Gi N . /eS hiCi P.O. Box 1407 P G/O NP Sacr- Address-1407 ROOF ❑ FP ❑ O • ® THIRD -PARTY MONITORING: Tel. (916) 445-0135 Activity Site (If other than above) %/' DAA _ .Ho ❑. _ Southern Area 2038 Iowa Avenue .V 9�//� l�Q t( L. Bldg. 8, Suite 102 i / *COMPLY / Riverside, CA Owner (If other than above) 5g '!tne 92507.2435 • Tel. (714) 782-4420 Address PURPOSE OF REPORT: (Checked (,/) as appropriate) VONNSPECTION RECORD ONLY ❑ INFORMATION ONLY ❑ NOTICE OF VIOLATION AND RELATED INFORMATION: This report provides notice of violations of the California Health and Safety Code, Division 13 or the California Code of Regulations, Title 25, Part 1, Chapter , Sections indicated. Copies of the regulations may be obtained from the State of California, Office of Procurement, Publications Section, P.O. Box 1015, North Highlands, CA 95660-1015. w Violations indicated shall be corrected and a written rbquest for further inspection filed with the Area Office indicated above on or before The request for inspection shall be accompanied' by.mini(11um fee of $ A,-?ermit shall be obtained from the Area Office identified above for work to correct item(s) # K you believe this report has been issued in error or is factually incorrect, please contact the Area Supervisor ate Area Office indicated above. �MW MW INSPECTED UNff IDENTIFICATION: Type of Unit Box Overall Size AT Decal No./�/ Manufacturer, Year and Model_�/7 7 ( 00, (L _ZZ 400' / OA HUDIABEL or HCD Insignia No. OCD 7� 16— Serial No. or V. I. N. INSPECTION RESULTS OR INFORMATION: FILE IDENTIFICATION CPT # FAC. ID# ASSIGNMENT # LABOR DATA: 7 OR ID_ DATE O—[}-�.{ PCA/ACT COOE��e-4iG/ AREA CO LOC TR MILES TIME:INSP/ACT TR INSPECTION DATA ❑ TIME REPORT ONLY INITIAL INSPECT40N ❑ REINSPECTION # HOME/UNIT / # FLOORS / VIOLATION DATA: COL# -6 TOTAL MP TENANT INSPECTION S F E M P G/O NP MH ALTERATION TYPE: AC ❑ . ACC ❑ ROOF ❑ FP ❑ O THIRD -PARTY MONITORING: DAA _ .Ho ❑. _ aP—❑_— DL., 0---IS-0 -DAA #PLANS *COMPLY MP INSPECTION DATA BLG/FIX MH LOT RV LOT AS EH INSPECTION DATA: ❑ ACTIVE ❑ INACTIVE MAX CAP P CAP _ OCC SFD DORM MH/RV O. FEE ACCOUNTING: COL# -6 USED DUE I ATTACHED INSPECTION INSIGNIA OTHER ATTACHED FEE I.D. RECEIVED BY-1._T-„�0�/ "lam TITLE Fe? C ! �! , -a 7Ot EPARTMEN` AL USE ONLY: Action: Close File ❑ Reinspection Required ❑ Progress Inspection Required ❑ Enforcement Action Needed ❑ Other SEND COPIES TO: ❑ Recipient ❑ Owner ❑ SAA . ❑ OL ❑ Other SUPERVISOR REVIEW DATE COPIES SENT BY DATE HCD-61 (Rev.6/90) 89 55324 PAGE 1 of ` MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE 1 OROVILLE, CALIFORNIA — 534-4541 qPERMIT N0. iL Address or location of mobilehome 19 13 il Owner's name Owner's address Insignia or hud number ZOti 6 Manufacturer's name Serial umber of V.I.N. 1-17� T6 08 Year of manufacture (Official Approving Approving Installation) (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION :.ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 CountTCentiArive - Orovlller California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT N0. ASSESSOR PARCEL NUMBER '" 40-25-32 ZONING C2 BUILDING PERMIT OWNER rim.' GLADYS COUNTS TELEPHONE 343-4355 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 9205 MIDWAY DURHAM 95938 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS � MIDWAY DURHAM 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❑ Mobilehomefg Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer5.00 Mobile Home Sx X/ O.00ea 30.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities g Installation❑ Other ❑ Describe work: M1411 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 10000 AMP ORSLESS 10.00 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. I DWELLING OCCUP.E{ OR ADDNS. % ACC. BLDGS. , /2¢sgft NEW CONST R. U TI -OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS 6 SINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 20050Q eALeao FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 15.00 Misc. bVirin 9 15.00 Permit Fee $ 35.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte againstz. all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. %� Date Signature of plicant — Owner❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 6:.A CONST TYPE TOTAL FEE $ 90,/00 CUA PARK SCHL FL CDF PAR PD I H Issu ; 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 paid. D C OF P IC WORKS BY Daatee'//�/ �2 L PERMIT EXPIRES to Receipt No. 100869 WHITE-D.P.W., TELLOW-ASS ESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OFATTTE�- DEPARTMENT -OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENT$P,,P FES''- ROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 wwP��E''RMIT APPLICATION DATA SHEET `+ Permit No. OWNER «PF G Proposed Building Use A. P. 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 RECEIVED APPROVED II items have been submitted . .................................... 2.9Plot plans in duplicate/tri licate signed by preparer of plans........ 3. Complete plans in dup icate trlpllcate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans 5. Hazardous Material Form ......................................... . 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... ScolIct fees paid .............. C Sanitation approval from _ TT �-ol Health Department J (I — 15. City of Chico plumbing permit ..................................... t plan and business license approval from City of (see City for other requirements) Planning approval for (A) Use: (B) Parking: ...... .. Improvements may be required. Contact Land Development Section DPW 1 Z 19. Driveway permit (construction approval required prior to occupancy) 3 A20. Pre -Inspection for required Pre-Inspec. req est to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. Z;�VOwner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other -,-.—p-, Copy of l .az-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date r The following data must be.submitted prior to permit issuance: (Circle new -item not -checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_—mail—counter by Contractor, designer, owner, was advised of above required data by—phone—mall 9 coo/ter by Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder date date Date TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Plan Approved for: Hold final for: Location Sewaqe Disposal _-1.1� Final clearance O.K. for: Clearance for bedroo mobile ome. Other NOTE *** Water Supply Water Supply / Water Supply l� Z) S itarisn Date TO: Building Department FROM: Encroachment Permit Section RE: 'Driveway Clearance 'A :r LAny SyJIr owner location AP # Driveway permit / 911150 has been issued for the above property. n b date sign re COUNTY OF•BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Attention Property Owner: OWNER -BUILDER VERIFICATION Phone: 916-538-7541,'. An 'owner -builder" building permit has been applied for in your name and bearing your signature. 1 Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will b ssued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property i, rovement (yes or no) -.",/I (have/have not signed an appl cation for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. J plan to.provide portions of this work., but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: . Name Address . Phone Type of Work Signed: Property Owner Social Secur'ty umber Date NOTE: This Owner -Builder Verification is sent to you as required by Sections .19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center'Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSORPA CEL NUMBER — ^ ✓l` (�/"O, ZONINLN BUILDING PERMIT / OWNER/, • D I`� TEL P oNE SQ. FT. OCC. BUILDING VALUATION OWNER' AIS,I,NOG A�Q}i E55 41/ W1q u/f 7� (/J CORAS ON C TELEPHONE CO RACTOR•S MAIL -MG ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee Energy Plan Checking Fee E$. $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS � Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USkOFSTRUCTURE SF❑ Duplex❑ MobilehomOther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S W O.00ea TYPE OF WORK New ❑ Addition ❑ Re odel ❑ ii U ' lit ie Installation ❑ Other ❑ Describe work: �¢_I� / \\ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. ❑ 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.EI A New CONST , /20sq It R.( ULTB ODUTLET NON -.E BRANCH CIRC ITS .50 ea 2.50 ea POWER APPARATUS .&) SINGLE OUTLET CIR . ( OUTLETS OR FIXTURES EO x. ccup\ 20060C eAL03o FIXED APLNS Ex. Occup. OUTLETS P(RESID )REA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 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. Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in heigh Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 6I HALcuA PARK scHL FLD cDF PAR PD i HD. ISSUE. This permit is hereby issued unaer the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. 1494 5E 6 V WNITC-D.P.W., YEL OW -ASSESSOR, PINK-YMPECTOR. GOLDENROD -APPLICANT }� pp ``Return to DPW AGRICULTURAL STATEIMNT OF ACKNOWLEDGEMENT - FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 ofNhe Butte .County Code requires this acknowledgement be recorded prior.to issuance of a building permit. The property described herein is adjace-, to land or included within an area zon 91-044498 1 Rec Fee 7.00 for agricultural purposes, and residen =; I STF 1.00 of this property may be subject to inco. Recorded I Check 8.00 veniences or discomfort arising from t',<, Official Recorde use of agricultural chemicals, includin County of but not limited to herbicides, pesticide.- Butte and fertilizers; and from the pursu'' Candace J. Grubbs of agricultural operations includin :, Recorder but not limited to cultivation, plowin-: 8a02am 22 -Oct -91 I JJ 2 spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have. as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal., necessary farm operations. All ttrat real :property.. situate in the County of Butte, State of California, described as follows: See Exhibit "A" attached and made a part hereof. Date: October 16, 1991 PROPERTY Ot1NERS : Glady F. unts State of California) On this the 16thday of October , 1991 , before me, the ) SS. undersigned Notary Public, personally appeared County of Butte ) Gladys F. Counts -------- Personally known to me. ] Proved to me on the basis of satisfactory evidence. a to be the person(s) whose name(s) is aTA,_,,,4��:1 subscribed to the within instrument and acknowledged that she ... g,,g NOTARY!-s!.cc}'•!e?+�� vexecuted the same for the purposes therein contained. IN WITNESS • ; ;`� 'nExpi es J :WHEREOF, I hereunto set my hand E; `_;,"r<»>' dyC mmi�si.^,ncx�iresJuna30,1992 a al seal a Present A.P. No. D. Koenig ;Notary Pu Exhibit "A" 9 1-44498 !r ORDER NO. BU -116208 DP ' y.a DESCRIPTION ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: A PORTION OF LOT 19, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "FRANKLIN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON OCTOBER 3, 1900, IN BOOK 2 OF MAPS, AT PAGE(S) 143, MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT A POINT ON THE NORTHERLY LINE OF SAID LOT 19, BEING THE POINT OF INTERSECTION OF SAID HIGHWAY LINE AS DESCRIBED IN THAT CERTAIN DEED EXECUTED BY CHARLES A. THOMPSON,. ET AL, TO THE STATE OF CALIFORNIA, DATED MAY 22, 1929 AND RECORDED SEPTEMBER 18, 1929, IN BOOK 217 OF DEEDS, PAGE 368, BUTTE COUNTY RECORDS, SAID POINT BEING ALSO THE MOST NORTHERLY CORNER OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN THE DEED EXECUTED BY JOE LITINSKY AND ROSIE LITINSKY, HUSBAND AND WIFE, TO O. L. OFFUTT AND ALTA A. OFFUTT, HUSBAND AND WIFE, AS JOINT TENANTS, DATED OCTOBER 4,-.1951 AND RECORDED OCTOBER 30, 1951, IN VOLUME 606, PAGE 453, OFFICIAL RECORDS OF BUTTE.COUNTY; THENCE ALONG SAID HIGHWAY LINE, SOUTH 30 DEG. 35' 30" .EAST- A DISTANCE OF 45.45 FEET TO AN ANGLE POINT IN THE EASTERLY LINE OF SAID OFFUTT PARCEL, SAID ANGLE POINT BEING THE TRUE POINT OF BEGINNING FOR THE PARCEL OF LAND HEREIN DESCRIBED; THENCE FROM SAID TRUE POINT OF BEGINNING, LEAVING SAID HIGHWAY GOING THE FOLLOWING �MUTH D DISTANCES: SOUTH 8 DEG. 21' 00" WEST, 47.77 FEET; 18 DEG.�2?91WEST, 95.0 ; ;SOUTH 89 DEG. 41' 00" EAST, 91.60 EORTH 69 DEG. 24' 30" EAST, 40.99 FEET TO A POINT IN SAID WESTERLY LINE OF SAID HIGHWAY; THENCE ALONG SAID WESTERLY LINE, NORTH 30 DEG. 35' 30" WEST A DISTANCE OF 108.98 FEET TO THE TRUE POINT OF BEGINNING. PAGE 4 - - - -- - -- - END OF ®MMENT a ` Owner r Telephone No. -3 y 3 - 4/3 S's' Permit No. A. P. No. _ya --25--27— Date -.S'-3Z Date '7— 7 0 44 1. Parcel creation Map Book Z Page Legal Parcel Creation date 60' R/W Certificate of Compliance Other (Specify) 2. Parcel created by subdivision map prior to July 1, 1949 17-23 Parcel size is less than S acres Parcel exempt from items 3, 4, and S and improvement requirements 3. Minimum Parcel Size (must meet zone or) `-'--� " -'"' C. - C' Z' ✓Parcel meets frontage and area requirements of zone Parcel does not meet frontage and area requirements of zone or Parcel is merged pursuant to Section 20-180.2 Parcel has vested right to develop /Lar .,.J 4. Legal Access Parcel fronts on publicly maintained road (Road ame) Parcel does not front on public maintained road (Road Name) Documentation on legal access required (must be by Title Co. or licensed engineer or surveyor) Documentation on legal access submitted and accepted. �. Copy of form sent to Land Development for improvement requirements q - Z o-9/ by �= (Date) Copy of form sent to Building Department Road Improvements not Required U Road Improvements Completed and Approved for Buil 'n ",Permi Issuance i 7 Date Z By J 7/26/91 / COLyJ,I'1OF.BUTTE -DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California -95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. Al- AS.'CESSOR PARCEL NUMBER "40-25-32 ZONING -C2 BUILDING PERMIT7 OWNER GLADYS COUNTS TELEPHONE 343-4355 SQ. FT. OCC. BUILDING VALU TION OWNER'S MAILING ADDRESS 9205 MIDWAY DURHAM 95938 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15.79 - Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS MIDWAY DURHAM, 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❑ Mobilehomen Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Instal lationER Other ❑ Describe work: MHI 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 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. 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,a (Sec owner, am exclusively contracting with licensed contract- 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.0 AUC New , t CONST'( TBI ODUTLET NON-RESID BRANCH CIRC ITS 2.50 ea .50e POWER APPARATUS e) SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES AL05AL00 3 FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed,revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the 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 agains said County in c nse ence oft granting of this permit. X Dateq I S_ ?/ L6- Signature of Alplicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ 45.00 Energy Inspection Fee $ occ CONST TYPE TO AL FEE $ 70.00 Az. HAL CUA PARK sc L F1E PAR '— PD i HE). Issu This permit is hereby issued unoer the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIR.EA'�TOF PUBLIC WORKS �Zr By Date /2- 9� Z PERMIT EXPIRES Date /— /Z '- /F" -Z_ Receipt Nc,. 100869 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT AP # o - z5 — 3E! OWNER PERMIT`# MH UTIL.CLEARANCE DATE k2-kk-Qbl INSPECTOR_ ELECTRIC GAS Support Struc. Compaction iTest.Req. Service Size Other. Load 'Type Pipe Size Len th YES NOI YES NO. 6 T4odC i h T T s rim BUTTE COUNTY bEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name: _r 2. Installer's Name: r' Ca lgp 3. Is the site currently under permit? Yes No 1 (If yes, furnish permit number ) OR Is the site an.existing site? Yes No (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft, away from septic tank and leach fields and clear of all setbacks and easements? Yes No (If no, clarify 5. What is the mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? ---------- -- /� Amps 7. What is the mobilehome site circuit breaker rating? ----- 20 Amps 8. Is there any other electric load to be served by the n 1� mobilehome site service?------------------------=� ---- Yes I No 1� (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? -------------- <;_=� (in.) i 10. What is the type of gas service? ---=--------------- Natural LPG `J 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- �� (ft.) * 12. What is the mobilehome gas demand? --------- ------------- (BTU) ; *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) 1V —`!2 00 l BUTTE COUNTY BUILDING DEPARTMEN ' APPRC`?VEDi ./t.h, PIOBILEHOME SUPPORT DATA • y If other than single wide, Mobi.lehome Mfr. �% ( fµrnish Setup Model No. Year Width % 2— (ft.) Box Length (ft.) Tagalong or Expando Size ft. x ft. On all mobil.ehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of fButte). FOOTINGS (check one) 1. Wood -pressure treated or foundation grade. U 2. Other (specify) SUPPORTS (check one)rX 1. Concrete block -F] 2. Other,(specify) Pier Footing Sizes and Locations SINGLE -WIDE Line 1 Piers: Line 1 Openings: Size -Min. ------------ k „ Size -Min. ------------------ Spacing -Max. --------- ,_ „ Each Side of Openings From Ends -Max. ------- _ " With Width Over --------- Line 2 Piers: Size-Min.------------ J� Spacing -Max.--------- ' \ From Ends -Max. ------- Line 3 Roof loads: Size -Min. ------------ Location (FromfFront) i Line 3 Piers: (Under Bearing Wall Only) Size -Min .------------------ x ' Spacing -Max.--------------- From Ends -Max -------------- e 4 Piers: Size -Min.--------=- -- „x , Spacing -Max. -- ------ „ From Ends -Max. ------- Line 5 Roof Loads: Size -Min. ------------ Location (From Front) Line 5 Piers: (Undar Bearing Walls Only Size -Min ------------------- Spacing-Max ---------------- From ------------------Spacing-Max.--------------- From Ends -Max .------------- " "x "x "x "x "r Main Beams Main Beams — — — — — — — — — — — ... � _Line Tag or Triple • —• — — — — — -- — — r i n Line 1 Line 1 Piers: Line 1 Openings: Size -Min. ------------ k „ Size -Min. ------------------ Spacing -Max. --------- ,_ „ Each Side of Openings From Ends -Max. ------- _ " With Width Over --------- Line 2 Piers: Size-Min.------------ J� Spacing -Max.--------- ' \ From Ends -Max. ------- Line 3 Roof loads: Size -Min. ------------ Location (FromfFront) i Line 3 Piers: (Under Bearing Wall Only) Size -Min .------------------ x ' Spacing -Max.--------------- From Ends -Max -------------- e 4 Piers: Size -Min.--------=- -- „x , Spacing -Max. -- ------ „ From Ends -Max. ------- Line 5 Roof Loads: Size -Min. ------------ Location (From Front) Line 5 Piers: (Undar Bearing Walls Only Size -Min ------------------- Spacing-Max ---------------- From ------------------Spacing-Max.--------------- From Ends -Max .------------- " "x "x "x "x "r OWNER COUNTY OF BUTTE - DEPARTMEN'T OKF�UBL,It W(41KS - BUILDING DIVISION •. 7 COUNTY CENTER DRIVE : OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 4 PERMIT APPLICATF DATA SHEET Permit No. Proposed Building Use Building lifspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ..................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans . . 5. Hazardous Material Form .......................................... 6. Energy Design Compi nce and supporting �d©curnentation ......... C 7: Statement otXt@rVioor Non -Heated acid AC 6' ildings .............. 11 ngineered truss details and layout in duplicate (regitir6d prior to plan check) qZ(?L Mobilehome installation data including manufacturer's installation / instructions .....................2s, oc 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park feesop Id --3• 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) + 1t7. Plan nind"approyalifor (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW ' 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required ... Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 2 Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 4. Recorded copy of Agricultural Acknowledgment Statement ......... When you issue the permit, process as follows Telephone Other i I to owner. and hold for pickup at office. Applicant Mail to contractor. _Deliver w/inspector. Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior t ,per �_t is ance: (Circle new -item not checked above). 1. Index permit for above items No. l-' 2. Additional items -r ii`ed: Contractor, designer, owner, was advised of above required data by_phone---nail—counter by Contractor, designer, owner, was advised of above required date-by_phone_mali_ inter by Plans checked by Date Pllans approved by Sets of-pl' Id in File cabinet AP folder Copy—DPW / date date Ar Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive,,Oroville, CA 95965 OWNER -BUILDER VERIFICATION Phone: 916-538-7541 s^ Attention Property Owner: _ An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of /the proposed property i provement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. )1 plan to provide portions of this work, but I have hired the following person to coordinate, supervise, 'and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner , Social Security um r Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF _BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California,95965 - Telephone: 916/538-7541 v APPLICATION AND PERMIT PERMIT NO. ASSESSOR PA E NUMB R Z2/ ZONI BUILDING PERMIT OWNER V DN/G T E 3oK SO. FT. OCC. BUILDING VALUATION OWNERAILING ADDRESS CONTR TOR'S NAM TELEPHONE CONT AC OR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 1000 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ C O J Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ 21 BUILDING AWW / ������ 112 ('/fA// Permit fee $ PLUMBING PERMIT Filing Fee 10.00 3 5S 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[]MobilehomeLCl Other /� SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti Iities ❑ Instal lationGkr Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V DR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. Eli, 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.51 OR ADONS. ACC. BLDGS. , /z¢sgft NEW CONSTRES'..MULTI-OUTLETNCHC NO N•R ESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS &) SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 20050 eALO 300 FIXED Ex. OCCup. OUT ETS (RESID.)APLNS.REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. lyirin g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the 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. Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures qve,3 It9wiesinIAMight. Mobile Home Installation Fee $ Energy Inspection Fee ' Occ CONST TYPE TOTAL FEE $ (� HAz. I CUA- PARK SCHL I FLD I coF I PM PD I HD. ISSUE, 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 paid. DIRECTOR OF PUBLIC WORKS Date PERMIT EXPIRES Date Receipt No.By WHITE-D.P.W., YELLOW-ASeESSOR. PI -INSPECTOR. GOLDENROD -APPLICANT 1,r-•li"lot; as1 '!`Yt, :', fjj��; +w:if�4..�a13?1hJ' . 'i -i -"'k •""'"r.*fire✓-7%��;'`''1`+�r^'i�.Y%'�-�r::-`�i+Y� is k's;.;�,. p,.:�t..-sf=:iE"%*'r"', r l^ -� BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Fofm per Building) A.P.' Number ( �p� £j Z-�Bunding Dep�arttment No. School District �fj� City County >�jurisdiction Property Owner-�l�G/��'` Project Location/Address- ,/fel /D'wA% J D()9 /T/6744 Subdivision Lot Number Residential Development: a Sq. Footage # of Living MHI Addition (Group R) Units Commercial/Industrial: DSq. Footage New Addition (Including Exterior Roofed Areas) Building Department Representative Da e (Floor Plans reviewed by School District Personnel) District Id No. 64412.A School District certifies that (Applicant Namej (Phone Number,) 1.5 1"Iaa v Street Address City cl�__ State) p Uo has complied with the requirements of Resolution No. by the payment of $ Scholl District Represents r� U PAID BY CHIE,CK-nO. •�'� BANK NO PAID BY CASH representing q d-rJ square feet. ive Date r white -applicant, yellow -building department, pink -=school district SCHOOL . FE•E•. , (8/88) PARCEL CHECK LIST AND REQUIREMENTS Owner Cn/CL& -y Gowans Permit No. 33/ I-ct A. P. No. yd -• Z S-- 3 'Z Telephone No. 3 y3 - y3 SS' Date 47— Z p 4 f 1. Parcel creation Map Book Z Page Legal Parcel Creation date 60' R/W Certificate of Compliance Other (Specify) 2. V Parcel created by subdivision map prior to July 1, 1949 17-23 ✓Parcel size is less than 5 acres Parcel exempt from items 3, 4, and 5 and improvement requirements 3. Minimum Parcel Size (must meet zone or) rLo Ne>Cc _ C- Z. ✓Parcel meets frontage and area requirements of zone Parcel does not meet frontage and area requirements of zone or Parcel is merged pursuant to Section 20-180.2 Parcel has vested right to develop 4. Legal Access Parcel fronts on publicly maintained road 171, &,,j (Road ame) Parcel does not front on public maintained road (Road Name) Documentation on legal_ access required (must be by Title Co. or licensed engineer or surveyor) Documentation on legal access submitted and accepted. .�. Copy of form sent to Land Development for improvement requirements q. -.z o -q/ by **� per_ (Date) Copy of form sent to Building Department 0 Road Improvements not Required U Road Improvements Completed and Approved for Building Permit Issuance Date By 7/26/91 iSG-/ <14AMPICA 1',2. -� (, 6 ff .. -.»,.._._�_.,...a.-.,-._._..._..�:...___-..-,::_w-.,__......:_,.,......"_...,.-._._:-.�.._,.,—.._,.:._:.,.,.m.....«,,.�..�,.z .:.,.,.....mom. �. { i N It This set of pians and specifications MUST be kept on the job at all times and it is unlawful to y� make any changes or alterations on same with - /Z b ti � out written permission from the Department of 1 Public Works, County of Butte. F; orkma�nship Shall Be in l �e X11 Materials & WC ood Practices and - /1 i , oTfi., with Rev the ecified use in the ,:.. far the 5p ,� uaht prescr+'ombing z o;r a q y Plu & Mechgnic'd1 Codes '*qo , - kJniform Building , the isatioeal 61eEtrical Code. , < , r , 5 l - i a 61- ,a I p�rianif wilt l5� rg%eg for go / of Ow A, aetl?* di 5 ft • from themobi i property tines aridasetback of _ i 5(0 ft.. from the road centerline shall be clear of ., i —> sttructures or equipment excepi foar a 2 ft. eave overhang. A.r i BUTTE COUNTY „ NG DEPARTMENT BUILIV _ ED i. AP if 4At- 7 77 , r_ Rtt.��r i , F- �.. - .. _. _..•....a+.--�'sn,."^_--.xa,w-c-y, --s:..•a_.+.... _ ..: _:�- V. .v._ .,. .d; y�.' � ��-t`i,�' .:. . , . _. ..,. .. +,. . ,.uzwr.,.:.....•-•..+ +,♦o•a.,a+rrv..::rr+.ry.r.+,u_....rx+,. 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