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HomeMy WebLinkAbout040-250-026COMPLAINT TO INSPECTOR 2t1q ' r Comp AIN •TO' INSPECTOR ' Don 9.10 ;L 6cod aeJ, Dti r6tni `(set KJaiion apfrvvul) 040-250-026" 9`4�454B HENDERSON, ROBERT 9202 GOODSPEED AVE., DURHAM DEMOLISH SF ��. rril�, n 8cry ELECTRIC 2-dQ GASP( -,A yr AL � _ Qi COMPACTION TEST REQ._ SUPPORT STRUCTURE REQ. VO 040-250-026 - 0 -1830 WURM, ANITA �� /1a 9202 GOODSPEED DUPAM CONT: OW MH UTTL TI SR 9,' / y ' C / 040-250-026 _ ill -215 WURM, ANITA t[IRR(H'A(MI�j 902 GOODSPEED, MOBILEHOME INSTALLATION .. 040-250-026 02-1255 7; WORM, ANITA 9202 GOODSPEED, DURHA r23 NEW COVERED DECK 1 3 /b l 1AA/ Fw 2"q//e /t/H- m 's RMA, OVA- OVA Y't 040-250-026 V 2-1255'. WORM, ANITA 9202 GOODSPEED' DURHAM NEW COVERED DECK COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville; California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 07-19%% ASSESSOR PARCLN�IMEBEA2�26 26 �t1111�>a ZONING BUILDING PERMIT OWNER anrtn 894-1413 TELEPHONE FT. OCC. BUILDING VALUATION 596 C 7748.0 OWNERS MAILING ADDRESS po box 1066. durham ca 95938 CONTRACTORS NAME otmer TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAIUNG ADDRESS Total Valuation $ 7748.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ".00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 64.35 BUILDING ADDRESS 9202 G00DSPEED r DURHAM Energy Plan Checking Fee $ $ PERMIT FEE $ 183.35 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 1 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome EI Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK I New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑: C t Describe Work: NRt-I 00WRi?i1 TIME Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home ISI GI W1 1@20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. + License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING UP. OR ADDNS. ( 8 ACC. BLDS. SO 3.50FT. PION N•ReSID. MUL 1 CIROUTCUITS 97,50 FOWER APPARATUS 3 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES.501 Bn0 p 1.00 FIXED APPINS. OR Ex. Occup. OUTLETS RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION + 1 hereby affirm under penalty of perjury one of the following declarations: j ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation'insuran ce, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X LL UJ f.t t l Date S 1 7' p �•• Signature of Applicant -,tip Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE $ TOTAL Fp� H s""D Es IM FLOOD d// cEE PAR - PD HD+ ISSLO This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. ,L By _ Date PERMIT EXPIRES ON SA' 7_ Date Receipt No. 353651/$183,35 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT -COUNTY OF BUTTE......... . BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street - Chico, CA - (530) 891-2751 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE 1AA19Pz? 6a_ 5C- OWNER PERMIT NO. A routine inspection in Yates that the following violations of butte county Ordinances exist at the above address and s ould be corrected. Please notice this office when correction of work Is completed. If youpdve any questions pertaining to this matter, or need additional explanation, please contact Vt office immediately. _ &A?1vix 1 i AS czw'!G' Z��le �•i,•k.�Y �•, COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION it V 4 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 09-1995 ASSESSOR PARCT4k6T 250-026 ZONING BUILDING PERMIT OWNER anita wurm TELEPHONE 94-1413 SO. FT. OCC. BUILDING VALUATION 596 C 7748.00 OWNERS MAILING ADDRESS po box 1066, durham ca 95938 CONTRACTORS NAME owner TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAIUNG ADDRESS Total Valuation $ 7748.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 99.00 ARCHITECT CR ENGINEERS MAULING ADDRESS Plan Checking Fee $ 64.35 BUILDING ADDRESS 9202 GOODSPEED DURHAM Energy Plan Checking Fee $ $ PERMIT FEE $ 183.35 LAT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome 111 Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other EX Describe Work: UFW �yp)pn nECK Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200.' oR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A To 1000A 46.00 NEW CONST. DW LING OCCUP. OR ADDNS. ( a ACc. stns. SO 3.50FT. rN, .RESIST. MULTI.O11111 UTLET RCIrrS @7,50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occu OUTLET OR PDRUREs 209 1.00 aAL- o .w Ex. Occup. OFlxIATL rs PR DEA 5.00 , Temporary Service 23.00 Mobile Home Facilities 20.06 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X _ (� l t�fir✓� Date —111 O OL Signature of Applicant - ,�7 Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE 183.3 TOTAL FEE $ H D. IM PLOo CD PARC Po H ISS This permit is hereby issued under of the Butte County Code and/or indicated a ve for whi fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work een paid. Date > % �- Date ReceiptNo. X53651 �$18� i5 WHITE-D.D.S.-B.D. CANARY-A4SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT E.m. USE 04LY Plot Plan Artachod y Flow Plan AnacRod Sent to ®.D. — U TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwelling. Other - - Am �Le 4�� 11-11461 Hold final for: Final clearance O.K. for: NOTE: 1 Z Environmental Health Specialist Date 9/96 'i 1-�.,E.,,,.. U.P,;" c, b --- q /jp-o-,o i? load' uO X C,�m. !7 cx.r'% _ y - , - -fir r 1 - ---- --- - --- - - - - I 9 1 ' 1 may --jab �..- --- . -. - - - --; --- - - - — . -- ---- --- --- - - 4a0.0ln9 _ 96, o I Environmental -Health • ' MAY 1 3 2002 Chico, California 5,p 1Z oa d 1�— , T(G PLYWOOD CC EXT. 4'Y(o' DF'�2 2"xfo' DECKING (ALT) GIRDERS 17s' Ti G PLYWOOD CC EXT. / z r— GrUARPRAIL E 1-4 4"MAX. I .P�R�ECAA' CkZit i \ lo' ' 1 10 P i s 14 x 14 MIN. nrrr, vt►Ir- 4B" MAX. 7� 4'x V 1 ^' v Zo FRMd G. -- CLIP- _ = STAIRS RINGER. `TOP. VIEW:. H AUDQAIL . NOT SHOD) iJ FOR CLARITY. 3/g BOLT . MOBILE HOME "o Z OR DE(.m_ m �3 f . MAX.33 MTL. FRMW L- - — — `� rn CLIP (EA. RE 9'MIn 4% (o, �. 4'x4' POST 2,x12, x . I 02DF. 214" PRESSURE' �" -- (2) ale TVA TV) oR n e'MIW. DOLTS RFD WOOD P/.ATE GIRDER 9'� • i .• %� r .;�,; : • . /?.yip � 4'X9" POSTMAN' - ADFQUATE' DIAL, ONA L RACING. TYPICAL RESiDzAvrl,41- srI'PS A9,17cA' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Orovllle. California 95965 Telenlinne- c-vo �r . NOTES RESIDENTIAL 4 040-}250-026 �" O1- 8 0 WURM, ANITA 9202 GOODSPEED DURHAM CONT: OWNER lMH UTILITIES' T _ r SPECIAL CONDITIONS l CHECKED t j BY r SRA ` FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. jp SPECIAL INSPECTION ITEMS VERIFY A a USE PERMIT CONDITIONS SUB-STANDARD HOUSING LETTER DETACH FOR SERVING UTILITY 1 Address t ! k� GAS Meter By Date � ELECTRIC Meter By DateO I 1 JOB FINALED (Date) 0 Signature V= OK 0 = Not OK - = Not Applicable MOBILE HOMES = Not Ready Date YOBI KOME UTILITIES (Plans) OK except #'s Require ments-Setbacks-Easements special MH Support Sketch Location -Test -Fall -C/O -Concrete Location -Test -Easement Needed (SI 6. Gas; Loc 'on -Test -Wrap; / �/" L'ft. at. r / /"L"ft./ /'LPG -WpILClearance & Disconnect Utility Clearance Date n Card B-1 Date Card B-1 Date CardJ3-t Card-tDate Card B-1 Date MOBILE)fOME INSTALLATION (Plans) OK except #'s Zoning Requirements -Setbacks -Easements 2. F Ings; Size -Spacing -Marriage Line Qa9'vlH Test -Demand -Valve -Connector tricity; MH Test -Crossovers -Breakers -Clearances DMH Test -Fall -Flex Connector " ; MH Test -Regulator -Connector 20"Ver and Sewer Connected -C/O to Grade -HD Approval G_aTknd Electricity Tagged D wns-Type-Installation Cert. its; Insp.-Sketch Cert. of Occupancy 12. Permanent Foundation Only; License Decal DateCard B-1 Date Card B-1 Date Card B-1 Date Card B-1 oc)-e a� ( 0/-19 CAL l(9' -?o( 4-.""7 6 Ar� � Qd. " MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rttrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (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, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 V= OK 0 = Not OK - = Not Applicable = Not Readv RESIDENTIAL (Single & Duplex) Date FRAMING (Continued) Underfloor (Plans) OK except #'s Hangers -Post Caps -Anchors -Connectors 1. Zoning -Setbacks -Easements -Flood -Slope 48. 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ f' Ftg. Depth 51. 4. Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth Property Line Firewall & Openings 5. Stemwalls, Main; Steel-Blockouts-Wrapped 54. 6. Stemwalls, Garage; Steel-Blockouts-Wrapped Plywood on Root Overhang -Attic Vents -Rafter Outriggers 6a. Hold Downs and Special Anchors 57. 7. Slab, Steel -Wrapped Glazing Area -Glass Protection -Skylights -Plastic 8. Piers -Fireplace Ftg.-Steel 60. 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test Insulation -Walls -Ceilings 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test Card B-1 Date Card B-1 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation Date 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19 D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 23. Fixture & Transformer Clearance -Ins. Protection 24. Elec. Receptacles Spacing -Lights & Switches at Doors 25. Size Boxes & No. of Conductors Stapled 26. Romex Installed Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al 30. Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or Al Insulated Neutral ID Yes O No 31. Service -Riser Conductors & Ground Main Disconnect 32. Equip. Clearances Panels-Motors-Mech. Equip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 40. Sills Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Root Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows 91. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 82. Following Insild./Drive J Yes J No/Walks D Yes J No/Planters D Yes D No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted 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: TO: FROM: DATE: 473 INTER -DEPARTMENTAL- MEMORANDUM BUILDING RELEASE OROVILLE ENVIR, HEALTH, CHICO HEALTH HOLD ON BUILDING FINAL FOR: SEPTIC: 'WELL: OWNAME: � L s J Comment: GUwAu &&/bold COUNTY QF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541/// �o 3� NO. (Rev. 12/96) , APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 040-250-026 ZONING BUILDING PERMIT OWNER WURM, ANITA TELEPHONE 824-.14 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS ' PO BOX 1066 DIRHAM, CA 9993 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ Permit Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 9202 GOODSPEED DURHAM Energy Plan Checking Fee $ $ PERMIT FEE $ 23.00 LOT NO. SUBDIVISIONS NAME 8_57 PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome )I Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities CX Installation ❑ Other ❑ Describe work: MH UTILITIES Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home 1 -11 j I vX .0060.00 PERMIT FEE S 80.00 ELECTRICAL PERMIT Fling Feel 20.00 Main Service 2�o.00R mUE ss 23.00 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.PSINOWGL License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ' I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X ,� Lam. Date 7 �' 01. Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavation eep and demolition or construction of structures over 3 stories in heigh Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCSO OR ADDNS. ( 8 ACC. BLDUP. S. 3.5¢FT: ONS =R.,DT' MULTI -OUTLET @7,50 TUS 8 E OUTLER APPARAET CIR. 20 ° ' 00 Ex. Occu ourLEr OR FIXTURES BAL @ •50 Ex. Occup.. ..ED .t%'.DE'w 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 20.00 Misc. Wirina 23.00 PERMIT FEE $ 63.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ D IMP I FLOOD I CDP PARCEL I PD I HD ASLJT This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By lka�Aa?4pate PERMIT EXPIRES ON d provisions to do work paid. (i Q� afe Receipt No. — WHITE-D.D.S.-B.D. CAN RY-ASSES IN -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPM-NT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 IRev.t2/96) APPLICATION AND PERMIT / /M�No. ASSESSOR PARCEL NUMBER DDNNe BUILDING PERMIT owNER Sa• Fr. OCC. BUILDING VALUATION 77 Mfv CONTRACTOR'S MAa1NO ADDRESS CONSTRUCTION LENDER L£NOER'S MAILMIO ADDRESS ARCHITECT OR ENGINEER ARCWMCT OR ENONEER'S MAJUM ADDRESS SULO oADDRESS ROT NO. SUEONDION'S NAME 60._ S 7 ►Ai10EL MAP i ii;i;EoFSTRUCTURE SF ❑ Duplex ❑ Mobilehome VOther aPecsv 6 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation ❑ Other ❑ Describe Work: *PERMIT FEE PAID SRA SHERIFF OTHER AMOUNT RECEIVED 'RECEIPT NUMBER �51 �"� " TO BE PVT INTO COMPUTER Fireplace Total Veluatlon b Flirt Fee S Permit Fee S Plan Checkln Fse S Energy Plan Checking Fee t S PERMIT FEE $ PLUMBING PERMIT Each Trap Solar or heat pum D water heater Water pIpIn Each gas water heater or vent Gas piping system 1 - 5 outlets Mobile Home 7.00 23.00 15.00 15.00 15.00 15.00 020.001 00 — PERMIT FEE t ELECTRICAL PERMIT Flin Fee 20.00 ::OR LESS MaiNFaciliMies 23.00 MaiaooA To I—A 48.00 NEW OWE]1/Jp OCCUP. OR ANEW a ACC. Erns. NON•MULTI.OunEr07.50 POWER APPARATUSa SPXME OUTLET CIREX. OtlT1ET OR FSRU. io O RRbEx. SEL o�"PP6 5.00 Temervice 23.00 MobFacilities qn nn I A77`1 PERMIT FEE f MECHANICAL PERMIT Filing Fee 20.00 I Hood I 16.501 1 { PERMIT FEE I S Mobile Home Installation Fee $ Energy Inspection Fee $ occ Ij coNT. re TO AL FEE �.UE P O. ES "ACS This permit is hereby Issued under the applicable provisions of the Butte County Code and/or Resolutlons to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON s .:,.� _.. . " ._". 1t ,„ i r.1Lt. �. ia. .5- • 2 f -��: � � �.- � t k,;, �l ?:.s ,rte ik—k— COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: 1)jiv�nuASSESSOR PARC?sbmin Ur��C/69Proposed Building se: Building Inspector: Date:At time of permit application, I was advised the following data must etted prior to permit processing and/or issuance: Date Received By 1. All items have been submitted-------------------------------- ot plans, 3/4 sets, signed by the preparer of plans. ------ ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- ❑ 6. Energy Design Compliance and supporting documentation. ------------------------------------------- 07. Statement of Intent for Non -Heated and A/C Buildings. ------------------------------------------------ ❑ 8. Hazardous Material Form. --------------------------------------------------------------------------------- ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ---------- El10. Fees of $---------------------------------------------------------------------------- ❑Impact fees as shown on the attached schedule. --------------------- M1;California Department of Forestry plan approval/fees.-------------• ❑ 3. Flo elevation certificate. ---------/-- -- -------------- ----------------------------- F e and plot plan approval (� Health Department. 5. City of Chico plumbing permit. --------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. --- ❑ 17. Planning approval for (A) Use: CrJ< (B) Parking: _ ❑ 18. Contact Land Development about ❑ Improvements, ❑ Draina egal Parcel. ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). E120. Pre -inspection Pre -inspection for required. Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ 0 22. Workers' Compensation carrier and,policy number. ----------------------------------------------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- 1124. ------------------------------------- ❑24. Letter of signature authorization. '-------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- ❑26. Letter of intent on building use. i---------------------------------------------------------------------------------- ❑27. Manufactured Home utility, clearance. --------------------------------------------------------------------------- ❑28. Existing violations and/or expired permits.---------------------------------------------------------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ 030. Other: (Date) en you issuPom'Irl des follows ❑ Mail to owner,Mm:ffaice. . lephone � i and hold for pickup at ❑ Deliver with inspector. t Applicant: UJ ern^ Date: 7 a S__ Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, Other: Date: By: 1. Index permit application for the above items numbered: 11Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by phone, ❑ mail, ❑ Building Division counter, by /%k/ Date: 7 1iO Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Bmiilding i ' ion counter, by Dat : Plans reviewed by: Date: Plans approved by: Date: 3 Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Irl o?�rIA E.H. USE QNLY Plot Pian Attached Floor Plan Art h Sant to B.D. Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public r/ Private Well Clearance for dwelling. Other Hold final for: C,."�I n It fnv- y Environmental Health Specialist Date J w _ � ( Ct I Ca�� Cf 1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1 personally plan to provide the major labor and materials for construction of the proposed roperty improvement : YES NO ❑ HAVE HAVE NOT signed an application for a building permit for the proposed work. 3. I have co tacted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S 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 1 SIG _ ROPERTYOWNER: J; NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit OVER O R- I OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and,. if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. 4Micly, OK�CU� l C. Vi ira, C.B.O. r, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of Ilse Californla Health and Safety Code OVER 15 040-250-026 01 -2152 WURM, ANITA 9202 GOODSPEED, DURHAM MOBILEHOME INSTALLATION o q VA 0 CQMVY OF BUTTE - DEPARTMENT OF PEVELORMENT SERVICES - BUILDING DIVISION " 7iCounty Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) "' • APPLICATION AND PERMIT d, 01-2152 ASSESSOR PARAIJ-UMBSO-026 ZONING ' .", BUILDING PERMIT OWNER ANITA d• NTTA TELEPHONE 894-1413 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS PO BOX 1 CONTRACTOR'S NAME OWNER TELEPHONE TELEPHONE CONTRACTORS MAILING ADDRESS ,. CONSTRUCTION LENDER i Fireplace LENDER'S MAULING ADDRESS Total Valuation $ ARCHITECT OR ENGIGEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23,00 BUILDING ADDRESS 9202 GOODSPEED DURHAM Energy Plan Checking Fee $ $ PERMIT FEE $ 43.00 LOT NO. I SUBDNIS IONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 �'-A`a'1'wc,rrC AL>L-1"USEOFSTRUCTURE I~ �' L i U 1'v 0 \ + .r•- SF ❑ Duplex ❑ Mobilehome OXOther SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 - TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation E� Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W Q20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 a00VOR LESS Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.PSIow License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale.' ❑' I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. i My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. Jof X L wl yrn. Date Sr / p J _ Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in heigh . Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( a ACC. S.3.50FT. ppµqGIp MULTI -OUTLET �G 7.50 8 NGL E OVRET ER APPARATUCIR.S Ex. Occu OUTLET OR FDMRES BAL Q 1 .50 T Ex. Occup.oUMTlFDfS RE�SID.) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 1 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FET= $ Mobile Home Installation Fee $ 100,00 Energy Inspection Fee $ occ CONST.TYPE TOTAL FEE $ 143 OO }CDP HAz D FLo9 a EL HD ISSUE This permit is hereby issued under the applicable provisions the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON Date Receipt No. 3��rfll j(l'?. VE) WHITE-D.D.S.-B.D. CA ARY-AS ESSOR PINK -INSPECTOR GOLDENROD -APPLICANT R MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION — COUNTY CENTER DRIVE OROVILLE, CA 95965 — PHONE (530) 538-7541 APN: ,-I'd i �% ( ZIO 1... % �C.y► PERMIT NO.: o/—/(f3o Owneame: r s t1irArwt 0 a Owner's Address: X120 �Qo . `eta .OcA rAav, Mobilehome Manufacturer:,f Year of Manufacture: .� l Serial Number or V.I.N. / Ol �. 7 _ Insignia or HUD Number: � Official apProvin ' inDo.Date: /� / lJ 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. 5138 White -Owner, Yellow -Installer, Pink -Bldg, Gold -Assessor MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION - COUNTY CENTER DRIVE OROVILLE, CA 95965 - PHONE (530) 538-7541 APN: PERMIT NO.: 6 Owner's Name: J) Owner's Address: Mobilehome Manufacturer: Year of Manufacture: Serial Number or VI.Nj- Insignia or HUD Number: Official approving instanatioW,� p 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 While -Owner, Yellow- Installer, Pink -Bldg, Gold -Assessor r W (Rev. 12/96) �COUNTY,OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT G 01-2152 PERMIT NO. ASSESSORPaR�4r�UMBE�O-026 U L ZONING BUILDING PERMIT OWNER ANITA WURM TELEPHONE 894-1413 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS PO BOX 1066, DURHAM CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 9202 GOODSPEED DURHAM Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. I SUBDNISIONS NAME Q -7 V PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 72=' --r C- APD' USEOFSTRUCTURE `15 Ae. To ►>V 2t �iati-- SF ❑ Duplex ❑ Mobilehome ❑X Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation 13 Other ❑ Describe Work: MHI Gas piping system 1 - 5 outlets 15.00 Buildin sewer 15.00 Mobile Home IS I GI W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Feel 20.00 Main Service zoOA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.P License Class Lic. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑• I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service To 46.00so CCU000A NEW CONST. DWELLING OCCUP. DWE200ALLING OR ADDNS. ( a ACC. BUDS. SO 3.5¢FT, NONEW -RESID. T.MULTI.OUTLET @7,50 OWER APPARATUS 8 SINGLE OUTLET C IR. Ex. Occup. OUTLET OR FixURES �0 @ 1.00 Ex. Occup.ounETs AE�sID,DFn 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of e valuation of one hundred dollars ($100) or less.) 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X _AJ-&_ UJ Date di Lo % Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in heigh . MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ 100.00 Energy Inspection Fee $ Occ CONST. TYPE TO AL FE $ 1 14 .00 HA D. CDF EL or HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date/ / Q� PERMIT EXPIRES ON �l/ Z`4a Date Receipt No. (If , 00 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 1 ° I NTY OF BUTTE - DEPARTMENT OF DEVEh"OPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: [Okkm ASSESSOR PARCEL NUMBER:6e�& L/ , 6D-6 Proposed Building 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 Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- El 2. Plot plans, 3/4 sets, signed by the preparer of plans. ---------------- ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. --------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- %U � ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ ❑ 6. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ----------------------------------- Hazdous Material Form. ------------------------------------------------------------------------------------------ anufa tured Home data and installation instructions including Tie Down Specifications.------------------ ❑ s of $------------------------------------------=----------------------------------- ------ Impact fees as shown on the attached schedule. - ---------------------- t� �C ` P ------- �.�----------------i------------- ❑ 12. California Department of Forestry plan approval/fees.--------------; -----------=------------------------------ ❑ 13. Flood elevation certificate. --------------------------------------------- ------------------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. s ------------------------------------------ Ell 5. ----------------------------------------- ❑15. City of Chico plumbing permit ------------------------------------------------------ I ------------------------------ 0 ---------------------------------------------------=------------------------------ ❑ 16. Plot plan and business license approval from the City of Biggs. -----'------;' --------------------------------- ❑ 17. Planning approval for (A) Use: k- (B) Parking: r ----------------------- ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainags�egal Parcel. -------------=--------- ' 1 croachment Permit for driveway (construction approval prior to occupancy).--,-------------------------- -inspection -------`-=---------------inspection for required Request to Building Inspector on (Date) ❑21. Contractor's license information. (Number, Name -Style, Classification). ------------------------------------ 0 22. Workers' Compensation carrier and policy number. ------------------------------------------------------------ 02 1-owner-Buflder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- 1 1124. Letter of signature authorization. ------------------------------- ------------------------------------------------ 0 ❑ 25. Record -copy of Agricultural Acknowledgment Statement. ----------------------- ------------------------- 26. Letter of intent on building use. -----------------------------=------ ----- -------- --------------------------- Manufactured Dome utility clearance. -- - -�V�- ❑28. Existing violations and/or expired permits. ---------------------------- ----------------------------------------- E129. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .--------------- 1130. -------------- ❑30. Other: ------- en you issue pr ce llows ❑ Mail to owner,to tt elephone �/ and hold for pickup at rlcce. ❑ Deliver with inspector. 6pplicant: IN^^ Date: d` 9 Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date:,, 1. Index permit application for the above items numbered:❑Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Divisi n counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buildin Di 6 ion counter, by Da e: Plans reviewed by: Date: Plans approved by: Date: Q Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. Cn, v COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 OWNER PROPOSED BUILDING USE (V_"� SCHEDULE OF FEES DUE 1"'n- "VV _y 1. BUILDING PERMIT FEES --Balance Due ............................................ --Additional Fees Due.: .......................................... $ --Additional Fees Due ............................................ $ A.P. # DATE RECEIPT # DATE REC. --Revised Plan Checking Fee ..... .............'..... ..... $ 2. SCHOOL DISTRICT FEES (paid at District Office) _ 21 7 3. SHERIFF FEES (paid at Building Division) Residential .................................... x $360.00 = $ Units Commercial (sq. ft.) ...................... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES Residential ............................ it = $ # Units Amt. Commercial (Sq. ft.) ............. x = $ Sq. ft. Amt. 9 i__-5. , RECREATION DISTRICT FEES S 46 - ` 7 6 _ 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. 4 -APPLICANT irk 1 V \ . i (.t iliv� DATE d Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original - Building Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 6/00) OWNER -BUILDER ;VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary dela; in processing and issuing your building permit. No building permit will be issued until this verification is received. I." I personally plan to provide the major labor and materials for construction of the proposed property improvement : YES K - NO 2. I HAVE' HAVE NOT 0 signed an application for a building permit for the proposed work, 3. I have contracted with the following person.(firm) to.pmvio cproposed construction: NAME: ADDRESS: CITY:. PHONE: CONTRACTOR'S LICENJE NO. 4. I plan to provide portions of this work, but I have hired -the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CITY PHONE: CONTRACTOR'S LICENSE NO. S. I will provide some of the workbut I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: tt Y PROPERTYOWNER:mom SOCIAL SECURITY NUMBER: DATE: NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to Issue the permit. OVER OWNER BUILDER INFORMATION Dear Property Owner: An appikation for a building permit has been submitted in your name listing yourself as the builder of property improvements specified For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have'a bu sinws lkense from the city or county. They are also required by law to put their.license number on all permits for which they apply.., { If YOJ plad to drifyo oivn•woik, with the owepdon of various trades that you plan to subcontr i, you Aduld be aware of the following information for your benefit and protection: ' ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including' materials and other costs) is 5300 or mon for the entire.project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer,. you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ 'There may be financial risks for you ifyou do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are perforating their own work personalty. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can conium that you are aware of these matters. The building permit will not be issued until the verification is returned. rely, /SCA._, qMa' el C. Vi ira, C.B.O. ger,Building Inspection NOTE: rhlr Owner -Builder Information It required by Section 19830 of the CaWornia Heafth and Sajery Coda OVER • •-• —F vGVCLVI-Mar4I acnvlk;Fzs BUILDING DIVISION 7 County Center Drive Oroville California 95965 9 Telephone (530) 538-7541 (Rev. 12/96) PERMIT NC A..QLDRPARClL Nl1ADpI APPLICATION,AND PERMIT ' 6 IC3 I�j G ZONING BUILDING PERMIT owNlR (_t/�f)Y) Te�f1pNa SO. FT. VALU BUILDING OCC. On NG gq y_ � j 3 ATION owN I 6X l D(o CCc , CONTRACTOR'/ NAM! Tll2yNON! CON►RACTOR7 MATING ADDREII CONSTRUCTION LENDER LENDER'S MAILING ADDRESS ARCHRECT OR ENGINEER ARCWMCT OR ENONEIRV MATING ADDRESS BUILDING ADDRESS LOT NO. I SUBM80N8 NIM! USEOFSTRUCTURE SF O Duplex X Mobilehome O Other SPSCFY TYPE OF WORK New O Addition ❑ Remodel O Utilities O Installation ❑ Other O Describe Work: M 4 *PERMIT FEE PAID SRA '- SHERIFF OTHER AMOUNT RECEIVED s 1143 (01D *RECEIPT NVMSER 3 I i * TO k PVT INTO COMPVTFR Fireplace Total Valuation b Filing Fee S Permit Fee $ Plan Checking Fee $ Energy Plan Checking Fee S S PERMIT FEE _ PLUMBING PERMIT Each Trap Solar or heat Pimp water heater Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Building sewer Mobile Home SIG W PERMIT FEE I S 7.00 23.00 15.00 15.00 15.00 15.00 020.001 0.001 20.00 ELECTRICAL PERMIT Flln Fee 20.00 Main Service 800V OR LESS 23.00 Main Service 200A TO 1000A 46.00 NEW CONST. own I OCCVP. NI AOONS. M CONS a ACC. BIDS. 3.5QFT. No1FRESlo. MULTT.Oun.ET BRANCH (97.50 POWER APPARATus a SINOCE OIrRET Ci10. Ex. Occup. OUTLET OR FOCTUilE3 20 ® s•O0 I Bol .SO Ex. Occu DuTLM rR ) 5.00 I I Temporary Service 23.00 I Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 PERMIT FEt $ Mobile Home Installation Fee S / I Energy Inspection Fee S oc� OONST. �`� TOTAL FEE $ 143.OD KA2. D.fEEB IMP FLOOD COf PARCEL1 PO IND ISSUE This permit is hereby Issued under the applicable provisions o1 the Butte County Code and/or Resolutions to do work Indicated above for which fees have been paid. By Date PERMIT EXPIRES ON BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District DwAllaNy, Building Department No. A.P. Number &W—Dab Jurisdiction: City ®County Property Owner ' W",n Property Location/Address q a 0 a c�-8 Subdivision Lot No. Residential Development No of Living Mobile Home Addition/ 'Supplemental to Units Installation Conversion Permit # '(No foundation inspection); ................................................................................................................... Commercial/Industrial New Addition Building Department Representative Sq. Footage (Group R) Sq. Footage r moor rians reviewed oy acnooi uistnct rersonneu District Identification No. 61151 .DUP-#147-n UAI/F/8-0 School District certifies that AV, I* buUej,0 (Applicant) (Street Address) (Phone Number) (Including Exterior Roofed Areas) 2)v e -Hf" (f A- C? S- 2 9' (City) (State) (Zip Code) has complied with the requirements of Resolution No. 0 D representing 96,0 Q square feet. School District Representative Paid by Check # by payment of $ AB 2926 $ FULL MITIGATION $ .?- Ll -D/ Date Remarks: G8FS GtUg-) Y4!5:70 I P5LLZ� M9,9/48 #297"C Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. 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.xls (10/98)dmm �1'h'N'r+r"'`y��.y'"y"'�7""�"''`'�`r-'Y'���Y".�P✓��►�.`�'�1�,:.`*�,Y'�^$i '"(�,Y'����.t��Y.�.�,�'T��len.l-.:i�f,nY -� � i .. BUTTE COUNTY PARK FACILITY"FEE PAYMENT CERTIFICATION FORM DURHAM RECREATION AND PARK DISTRICT • 4 Assessor Parcel Number (s): pyo - a ST1 — 0-a 6 Property Owner (s): (D1. m eh ; c -h ; J u r r►•� Project Location/Address: �l'aUZ q o ad so -e --.e cf t Subdivison Name: Assessable Square Footage: Type of Residential Development (check one): New Development Afteration/Addition Mobile Home (s) Non -Residential to Residential Comments: . T ruluoz &Q- Q 8 a9 ai Building Division, Representative Date .Durham Recreation and Park District (DRPD) certifies that t� �n'+a W Applicant Name Street Address Wr. sli(4- /(-//3 Applicant Phone Number Of 5938 City State Zip Code has complied with the requirements of the Butte County Board of Supervisors Resolution No. 93 -.114 by payment for square feet at $ 1.04 per square foot for a total payment Of $ .- 9 /4l� \,�P PD Representative Date PAI DtRy. C BANK No. PAID BY ( RECEIPT Remarks: tO fee—, C1 DISTRIBUTIONS WHITE APPLICANT PINK- DRPD YELLOW - BUTTE CO. BUILDING DIVISION \q: . . . . . . . b2 .. . . . �r del c-oow. . . .` . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �. . . . . . . . . 0 f 9 _ r o`� . . . . . . . . . ._ �.--- ;--- _ . . . - - - ------ - - 1. a es ; I : 1 �► - 1- 1 . . _ . . _ . .� : i , 4aoa -5sr�_ z Ceti—. 1 Mobilehome Manufacturer:C✓� m P; o r Manufacture Year: 9 o If other than single wide, furnish Setup Model Number: © ko , o / — DS ;�S! C/�- T / Width:ft.) Length: 5�0(ft.) Tagalong or Expando Size (ft.) On all mobilehomes manufactured • after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets. FOOTINGS: Wood pressure treated or foundation gradeN Other: SUPPORTS: Concrete block[A Other: Provide Tie Down Specifications for all..Mobilehomes: -op ...... p*... - .&.......0... ....A.... yip.........Mp - ...q�}....� Main Beams .r_aCVis ............................................... e 5 Tag or Triple e4 ,ine 1 Line 2 ,me 2 Line 3 Line 2 Line 2 Line 1 Line 1 Piers: Line 1 Openings Size minimum: r . /.I, x r,3 01. Size minimum: [ ] x [ ]. Spacing maximum:.,, s s� Each side of openings From ends-maximum:e;dd rs . T. with width over: . I` Line 2 Piers: Size minimum: [ aLJ x [ 30 ]. Spacing maximum: • ` b` From ends -maximum. d- ` Line 3 Roof Loads: Size minimum Location (from front) - Line 5 Roof Loads: Size minimum: Location (from front): 3O# Line 4 Piers: Size minimum: [ J x J. Spacing maximum: ` From ends -maximum: ` /aY3u 14Y30 izX3v /LX30 -27(30 I'd it 10,'H" 1 OVER Pier Footings Sizes and Location SINGLE WIDE S 1; @.- A MULTI -WIDE Line 1 Li.. Jbi Line s.....:jo Main .... ..... ...... �.......4W.. ®.:... _ . Line 1 -op ...... p*... - .&.......0... ....A.... yip.........Mp - ...q�}....� Main Beams .r_aCVis ............................................... e 5 Tag or Triple e4 ,ine 1 Line 2 ,me 2 Line 3 Line 2 Line 2 Line 1 Line 1 Piers: Line 1 Openings Size minimum: r . /.I, x r,3 01. Size minimum: [ ] x [ ]. Spacing maximum:.,, s s� Each side of openings From ends-maximum:e;dd rs . T. with width over: . I` Line 2 Piers: Size minimum: [ aLJ x [ 30 ]. Spacing maximum: • ` b` From ends -maximum. d- ` Line 3 Roof Loads: Size minimum Location (from front) - Line 5 Roof Loads: Size minimum: Location (from front): 3O# Line 4 Piers: Size minimum: [ J x J. Spacing maximum: ` From ends -maximum: ` /aY3u 14Y30 izX3v /LX30 -27(30 I'd it 10,'H" 1 OVER 1. Owner's Name: /L ' L VVI , W In r r-. . 2. Assessor's Parcel Number: 4 y0- c-0 - OZ -f- 3. ZfG 3. Installer's Name: Uj U 'r- ✓Y\ 4. Is the site currently under permit? Yes[A) No[ ] Permit No. 0/=,/� 5. Is the site an existing site? Yes[ No] (If yes, furnish two plot plans). 6._ What is the electrical rating of the mobilehonie?_Amperes. 7. What is the mobdehome site circuit breaker rating? 2O D Amperes. 8. What is the electrical rating of the mobilehome site? Amperes. 9. Is the main service remote from the mobilehome site? Yes] No[ ] If it is, what is the rating? ,2,00 Amperes. 10. Is there any other electric load to be serv6d by the mobilehome site electric service (i.e. well, garage etc.)? Yes[ ] No[X] If yes, please identify the load and size: a) The mobile home site: Load- Amperes - b) The main service: Load- Amperes - 11. Type of gas service at mobilehome site: Natural[A Propane[ ] None[ ] 12. Size of gas pipe at the mobilehome site from the meter or tank: / inches. 13. What is the gas pipe length from the meter or tank to the mobilehome?,0—(ft.). 14. What is the mobilehome gas demand? �,/� . _3 3 B.T.U.* *(This information is not required if the pipe length is less than 6 feet on natural gas or less than 50 feet on propane). THE OTHER SIDE OF THIS FORM MUST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION May 1995 8.5 F, G E -Z TIE"DOWN SYSTEM DESIGN LOADS' CHASSIS BEAM SUPPORT PIERS --! *WIND LOAD - 15 PSF SPACING AS RECOMMENDED BY THE HOME MANUFACTURER THIS 1 FAIRLYE DOWN LEVEL SITESTEM WITH IS DESIGNED NO EXISTING TSOIILE PROBLEMS. CONSTRUCTED ON A bUfTE GU' MINIMUM SOIL PARAMETERS: TYPE 5 COHESIVE SOIL, WITH MINIMUM tp SOIL BEARING CAPCAIFT OF 1000 PSF .�,y�e�...d. TNG DEP 2. CHASSIS BEAM SUPPORTS SHALL BE LOCATED AND SIZED FOR THE LOADS AS SHOWN IN THE "MANUFACTURED HOME INSTALLATION INSTRUCTIONS". 3. IN AREAS WHERE DIFFERENTIAL SETTLEMENT (DS) CAN OCCUR, MANUFACTURED HOME SHALL BE READJUSTED WHEN DS EXCEEDS 1/4", OR WHEN IT WILL ADVERSELY AFFECT MOBILE HOME UNIT. _ _ _ L'—Z TIE SUPPORT PAD 4. THIS .PLAN IS INTENDED TO BE USED FOR MANUfACTURI:D HOMES UP 10HSEE TYPICAL) 3 SECTIONS IN WIDTH. CONTACT THE DESIGN ENGINEER FOR NOTE N 10. DESIGNS FOR MANUFACTUED HOMES OVER 3 '3CCTIONS WIDE. 5. STRUCTURAL STEEL: FABRICATED ACCORDING TO RISC SPECIFICATION. WELD ACCORDING TO AWS SPECIFICATIONS. ELECTRODES -370 PLATED -ASTM A36. BOLTS=ASTM A307. 6. THE E -Z TIE ASSEMBLIES ARE CAPABLE OF THE FOLLOWING LOADS: HI HORIZ VERT UPLIFT 18" '2010 (lb) 6000 (lb) 891 (lb) 21" 1825 (lb) 6000 (Ib) 801 (lb) 28" 1419 (Ib) 6000 (lb) 629 (lb) 36" 867 (lb) 6000 (lb) 385 (lb) 7, ALL METAL COMPONENTS AND ATTACHMENT ITEMS SHALL BE PROTECTIVE COATED. 8• WHERE STAND IS PLACED ON EXISTING CONCRETE SLAB, 1/2" SLEEVE ANCHOR BOLTS MAY BE USED TO SECURE PIER BASE PAD. 9. ATTACHMENT METHODS FOR "C ' - do "J" BEAMS SHOWN ON SHT. 10. THE LONG DIRECTION OF THE E -Z TIE PAD (37") MUST BE. INSTALLED PERPENDICULAR TO THE CHASSIS BEAM. GUS GUARD COMPANY P.O. BOX 128 CATHEY'S VALLEY, CA 95306 PH 209-377-8354 • PH 8DO-322-2479 FAX 916-383-5207 SINGLE WIDE COACHES DOUBLE/MULTIPLE COACHES E= 2' MIN. / a' MAX. E= 2' MIN. / 11' MAX. VARIES 10'-70' EVENLY SPACED BETWEEN 1 I ilY'❑ O O Y t O O RIDGE BEAM SUPPORT AS REOVIRED BY MANUFACTURER (TYPICAL) O O O --9- O , ! I O O El LENGTH I NUMBER OF E -Z TIES AF HOME 18" HT 21" HT 28" HT 36" HT 40' 4 4 4 6 50' 4 4 4 6 60' 4 4 6 8 66' 4 4 6 8 70' 4 6 6 10 STATE APPROVAL ENGINEERED TIEDOWN SYSTEM APPROVED Isll18JECT TO CORRECTIONS NOTED Approval does not authorize or approve any omission or deviation from requirements of applicable State laws and regulations. State of Caglorola Department of Housing and Community Development ES AND STAN°iS Bygnslure DiSa i 3 -99 SPA NO C -77:S f� 2 _ This Plan Approval Expires _//- 4-'2-00f THIS TIE DOWN SYSTEM MEETS THE' REOUIREMENTS OF SECTION 1336.3 SUBSECTION (a). WAYNE T. POLVADO, PE -LISTING NO. 99001 SHEET 1 of r M t9 UJ C7 CL r m N to m m m m Lr) m CS) M N LD CD 00 CD 2"x2"x3/16" STL. ANGLE 3/8" CAD PLATED BOLT, NUT & WASHER COUNTER BORED FLUSH WITH BOTTOM (B) REOUIRED 1/4" STAND BASE ABESCO ABS PAD #503 3/4" DIA. x 18" LG. (4) REQUIRED DETAIL "A" CHASSIS FRAME 10.00 199/16 HOLE o (4) REQUIRED BENT PL (TYP) . TO.00 1"x1"x11 Go t 0 0 f STAND BASE—TOP VIEW 01 1/2" SCH 40 PIPE RISER WITH 01/2" ADJUSTER HOLES AND 3/8" THICK TOP PLATE 02" SCH 40 PIPE STAND WITH TWO 01/2" ADJUSTER HOLES ABESCO ASIS PAD #503 STEEL FRAME — SEE DETAIL "A"! 1/2" DIA. HOLE (8) PLACES ♦ $ 10.50 18.75 ♦ $ ♦ $ 30.00 STEEL FRAME TOP VIEW 30� 1" x 1"x 0.095 x 3" T.S. f5' (4) REQUIRED r4, PLCS 1/4" GRIPPER PLATE \SIDE VIEW (2) REQUIRED 1/4" GRIPPER BASE 1/2-13UNC-A307 x 4" BOLT WITH NUTS (4) REQUIRED —01/2"x 3" C.R. LOCK PIN WITH 01/8" BRIDGE PIN 2" CHANNE 1/4"xI-1/4 TEK STS 2) REQUIRE 1/4" GRIPPER BASE 1/2A307 BOL (4) REQUIRED COACH "C" FRAME COACH "J" FRAME 1/4"x1-1/4" TEK STS (4) REQUIRED 1/2" A307 BOLT (2) REQUIRED 1/4- GRIPPER BASE X1/2" A307 BOLT (2) REQUIRED C—BEAM J—BEAM = ATTACHMENT ATTACHMENT GROUND LEVEL E -Z TIE DOWN SYSTEM 122-2479 WAYNE T. POLVADO, PE—LISTING NO. 99001 SHEET 2 of 3 INSTALLATION INSTRUCTIONS E -Z TIE DOWN SYSTEM 1. PIERS MUST BE PLACED ON BEAM WITHIN 24" OF AN OUTRIGGER OR CROSSMEMBER, OTHERWISE INSTALL WEB STIFFENER ON CHASSIS BEAM. 2• MAKE LEVEL THE PLACE WHERE THE PAD WILL SET. DOWN TO UNDISTURBED SOIL. 3. THE PAD MUST BE CENTERED BELOW THE CHASSIS BEAM. 4. REMOVE THE FOUR (4) NUTS AND WASHERS FROM THE STUD BOLTS IN THE PAD AND PLACE THE PIER. THE HOLES IN THE BASE PLATE WILL LINE UP WITH THE STUD BOLTS. REPLACE THE NUTS AND WASHERS AND TIGHTEN DOWN. I -BEAM 5 REMOVE THE TWO (2) GRIPPER PLATES ON THE TOP OF THE PIER. START THE HEIGHT ADJUSTMENT BY REMOVING THE COTTER AND ADJUSTMENT PINS, PIER CAN THEN TELESCOPE. RAISE THE TOP OF THE PIER UNTIL THE PLATE IS AS CLOSE TO THE BOTTOM OF THE CHASSI`. BEAM AS POSSIBLE. PLACE ADJUSTMENT PIN THRU ADJUSTMENT HOLE AND SECURE WITH THE COTTER PIN, 6. RAISE THE TOP PLATE USING THE ADJUSTMENT NUTS UNTIL THE PIER TOP IS TIGHT AGAINST THE BOTTOM OF THE CHASSIS BEAM, 7. PLACE THE GRIPPER PLATES OVER THE FLANGE OF THE BEAM AND TIGHTEN DOWN FIRMLY .WITH THE TOP NUTS, C -BEAMS AND J -B AMS 8• HEAD OF PIER REOUIRES THAT TWO (2) TEK SCREWS BE PLACED THROUGH THE SIDE OF THE SIDE FO THE BEAM IN ADDITIN TO ONE GRIPPER PLATE. 9. FOUR (4) STEEL STAKES (SUPPLIED) ARE TO BE DRIVEN THROUGH GUIDES INTO SOIL UNTIL STOPS ARE FLUSH WITH. THE GUIDE. i ANGLE IRON lwmlwN4A ALTERNATIVE: (2) /12 S.Y.S. OR WELD .NoTE USE stlrrN[R Ir ounuc iR oil CROSS MEMICR 00 NOT OCCUR WITHIN 24" Or STANCHION (TTP) WEB STIFFENER GUS GUARD COMPANY DETAIL P.O. BOX 128 CATHEY'S VALLEY, CA 95306 PH 209-377-8354 • PH 800-322-2479 FAX 916-383-5207 WAYNE T. POLVADO, PE -LISTING NO. 99001 SHEET 3 of 3 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT Instructions for recording Agricultural Statement of Acknowledgment: Insert the legal description of the property in the space provided on the attached form. The legal description is the narrative description of the property - which will be on your deed. If you don't have access to the deed, the Recorders Office can provide this in- formation. (The description may be handwritten or typed in the space provided or attached on a separate sheet if more space is required.) 2. . Property owners must sign in the presence of a Notary Public and have the form notarized. 3. Make a copy of the form and then take the original and copy to the Recorder's Office at 25 County Center Drive, Oroville (the Administration Center building). The Recorder will record both the original and copy. They will keep the original and return the copy to you. Just bring the copy back to the Building Division at 7'County Center Drive. RECORDER'S FEES: $7.00 - 1st Page $3.00 - Each Additional Page RECORDER'S OFFICE HOURS: 9:00 a.m. - 5:00 p.m. MONDAY - FRIDAY 9:00 a.m. - 4:00 p.m. for Recording AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required thisacknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established 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 that real property situate in the County of ButteState of California, described/ as follows: 4O1 11 as 4i¢ C S. amis des ign n f4—e Qnd of e, 1;;)e-.,1-'-Jm74 .n.-4 rct00%r4-one,44c- A-aJI4ton Dwc6aw%j 6ti44e. 0, 4-1, Co. 1, {tom•..-la-a.�?iii mcg wks eC' of, dj p +--1.. o;S� o. 4' .- �Q¢o �..� �� �. .„(•Z e Sz (3 !-� S' ,fir ��' G,�tc�a�.,t IlnArc� 2), 192,1 , > n �oo k 8 0� »'10. pS� 0.,i- �A�- 37, Date 9 -c;113- 0/ PROPERTY OWNERS: State of California ) County of ) On �U before me personally appeared vly 7-W7 — personally (mown to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to we that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on 7se ent, the persons) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS and d officir :. C. WILDER COMM, 0 1188 9 Signatu Seal: ®� NOTARYC PU 0� BLl U iA comivi, Expires M816h 0,100 A.P. # :w.� `FTAR DER 296628 D li ® -CALIFORNIA - BUTTE y Comm. Expires March 9, 2005 r E.H. USE O LY Plot Plan Attached Floor Plan Atpwhed Sent to B.D. i TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner I Location Plan Approved for: Sewa a DisposalWater Supply: Public t-,' Private Well Clearance f dwelling. I r _r , Hold final foj Final rloaranro r) K fnr- Environmental Health Specialist Date TO , Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance Plan Approved for: Sewage Disposal Water Supply �-- Hold final for: Water Supply Final clearance O.R. for: Water Supply Clearance for bedroom mobile home. other I " �°�,YbOM LA NOTE * * * Date Sanitarian rt@AI19eai�i31 ;�a®3101CA 6'L o bit.- ubVr:L �a IseD p .- Lfkp udEs PLOT PLA FDp' -fR4Qt,6-X - q u 2- Sr AP o40-�60 -02to Leff I I MAR'(f1Jort RDDi� 'Co fl u R.I+Ar✓I PAWL. ALL gblI E_D SAA i3 igo)ti -1-0 A' LDPAPA ni q Ai90 Lw_ -Ton oG I-q1- _-Da.r IAUAKCFrF_L i 16.5 I —4-k I_ aaTtc MAA ---C Our ll Ari twig 011-r) �000�P �T (Aof R. o. W.) J iv ,: .. ,�� 1L�'". �OV1��, ► tliiD,�:� IO��D �A1'f�'i�K�; .'` r _ w 60 flu i�slk I I 040-250-026DEMOLISH 040-250�-026 94-0454B S HENDERSON ROBER-r 9 20 0( 9202 GOODSPEED'AVE., DURHAM, SF 7J COUNTY OF BUTTE - DEPA ME O DlVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION- AND PERMIT ASSESSOR PAR=1!2� �26 1- ZONING BUILDING PERMIT OWNERROBERTHENDERSON TELEPHONE SO. FT, OCC. BUILDING VALUATION OWNER'S 16INW;1 ,779 Durham 95938 (�(� Eat 5013 CONTR J5;;Ruu ;rEE TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $.� ARCHIT T OR ENGINEER done ucENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BuaDIN R ss Goode d Avenue, Durham PERMfT FEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF ❑ xDuplex O Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 020.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑X Demolish i Describe Work: PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 23.00 200A OR LESS Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. SO. OR ADDNS. ( & ACC. BLDS. ) 3.5C FT, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, 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 contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET •NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) A. OUTLET CIR. -SINGLE Ex. Occup. ( OUTLET OR FIXTURES ) BAL. @ 1.50 Ex. Occup.FIXED APPWS. OR (OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20,00 Misc. Wiring 23,00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 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 Butte County Ordinances and California 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. 1 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 Countyin consequence of the granting of this permit. X /, ,( J^ ,.- , .._.._ �- Date .2 7 / Signature of Applicant- Owner _ElContractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 35.00 HAZ. 1 D. FEES IMP 1 FLOOD I CDF PARCEL PD I ND I ISS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By -O I% Date 2 /7y L PERMIT EXPIRES ON (Date) Receipt N0. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEALOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT qq- D 4S`�`�' ASSESSOR P MB�-0-026 `+`� R ZONING —3 BUILDING PERMIT OWNERROBERTHENDERSON TELEPHONE SQ. FT. OCC. BUILDING VALUATION GWNEMSMAOINrxESS 6 999, Durham 95938 Est 500 CONTR TOR'S NAME � wner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDERUN KNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGADDRESS 9202 Goods eed Avenue Durham PERMIT FEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO.SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF O XDuplex O Mobilehome ❑ Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W ` 20'00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ElOther ❑j{ Describe Work: Demolish PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 600V OR LESS ) 200A OR LESS 23.00 Main Service ( 200A To 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. OLDS. I 3.50 FST.p, CONTRACTORS LICENSE LAW( I declare under penalty of perjury (check one) O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and P P 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 compensation, 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 contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW NON R SLID. ( BRANCH C ST. MULTI -OUTLET RCU TS I @7.50 POWER APPARATUS I & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) @ ,.00 BALL.. .so Ex. Occup.FIXED APPLNS. OR ( OUTLETS (RESID.) EA. I 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. O 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. A[shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE S Contractor MECHANICAL PERMIT Filing Fee 20.00 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 Butte County Ordinances and California 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. 1 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 co/nsequenceof the grayngthis permit. X� _ � Date Signature of Applicant Owner ❑ Contractor ❑ Agent An OSHA permit is re uired for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 35.00 HAZ. 1 D. FEES I IMP F100D COF PARCEL PD I Ho I ISStV This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By 4Date ' PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. a Dete) 156174 Receipt No. WHITE-C.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT . ^ n COUNTYOF BUTTE - DEPARTMENTOF.D.EVOPMENTKSERVICES - 6UILDING DIVISION 7 COUNTYCENTER DRIVE - OROVILLE, CALIFORNIA95965-TELEPHONE (916) 538-7541 � PERMIT APPLICATION DATASHE-FET OWNERv���l�S�/C/ A. P. No.���� Proposed Building Use %D (7 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 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. 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 required . .. ;B ";II 9 �Wea;� (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 . ......................................... 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: l Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation a3 Acreage Applicant Date _19Y 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 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 _ Date Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone: 916-538=7541 An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) signed 'an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name `��� 2 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 Ad�ress Phone Type of Work Signed: Property Owner c��� Social Security Number Date 2-z -9 V 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. 3/0. ?- ?S134- T7,9 .x'1.34- q7, �em -f . Ix A., t- yr Pe -post - dew /�ov zl-�) c ja"n /C v 2x APPROVEU SM Countyy � lywi ental Loh '.} v 44. -i`n`lirenmentai Health J U L 2 5 2001 Chico, Califomia �d I fl T �•�T JUG' �i S,pt� a C/.3 -<7e /,tvOl✓i�ie <<f CA t_ i n; crr. - 4 X';/O W v 13 PLANNING DIVISION -BUILDING PLAN APPROVAL ALL STRUCTURES AND EQUIPMENT INCLUDIAIG OVERHANGS SHALL BE CLEAR OF ALL EASEMENTS. A SET BACK OF,&SAFT. FROM THE SIDE AND FT. FROM THE REAR PROPERTY LINES AND .SD FT. FROM THE ROAD CENTERLINE SHALL BE CLEAR OF'STRUCTURES AND EQUIPMENT Edi' FOR A2 FT. EWE OV AM s cl " r.. zr- i It �rcn �c. new t�acfrici^� h¢., Cam/c� 4�1,P%,i ) w" i, vt8'--. Cj Q S I Yn c t r 4.a. i+o a6 G � x •,g) r Y � Po •a, u �, l e:, : ,) 0 DEP APP.R ,-- Nor4A 9 � � i Environmental Health AUG 1 6 2001 Chico, CA d/- AeR 1H,� 14�y N^ n n �6eSQr-oc> r� y/3 11086--j. 1066 P'O /d0 ,C c �• c.G- 1. , ..� V. i P'O /d0 ,C c �• c.G- 1. , ..� V. m ° J 0 a T 5 �l N 4 : u _ 2 s I � w co Ie SS eo S • ovo �o-oas OUTTECOlq�iiv APPROVED