HomeMy WebLinkAbout040-260-077.40-26-77
DAN IEBY (N 0
9384 Lot d, Durham
Building Cod Permit#1386 P,E(utjl,
'j e Violation MH)
"om ELEC 7— CO
Complaint
,to inspector 130 10, GAS _gl 30
30 day violation letter SUPPORT. -c, T-RUCTURE . Q.__._. #4q'jp1j0,0
l'O day violation letter COMPACTION TES EQ
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.bated or Closed
Contr:40-26-77
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Per ' #17', Paradise
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040- , 7 01-0495
ROBERTS, F S & ALICIJ.-Iw'
9384 LOTT RD. DU
CONT: CHICO MOBIL HOME
EX MH ON PERM FND
040-260-077 61-0888
ROBERTS, ALICE
9384 LOTT RD., DURHAM, -CA
CONT: CHICO MOBILE HOME
2 COVERED DECKS �t'AAL,
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Ce COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 P T NO.
(Rev. 12/96) APPLICATION AND PERMIT ��®
ASSESSOR PARCEL NUMBER
040-260-077
ZONING
A10 -
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
11
- OWNER'S MAILINGAD65144T
50 FAIRVIEW CIR. CHIM, CA 9599R
CONTRACTOR'S NAME
CHICO MORITE HOME
TELEPHONE
995-1774
CONTRACTORS MAILING ADDRESS
PO BOX 4191 CHICO, CA 95997
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ 99.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 64.35
BUILDINGADDRESS
Energy Plan Checking Fee
$
PERMIT FEE
$ 183.35
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome Ni 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 ❑ Other CC
Describe Work: 2 COVERED DECKS
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
(920.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
800V OR UE
Main Service 20.AORLESS
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 e- Lic. No./®�
OWNER -BUILDER D CLARATION
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.
My workers' compensation insurance carrier and policy number are:
Carrier
Main Service 200A TO f000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BLDS.
so
3.5¢FT:
NO R6ID MULTI.OUTLET
97,50
OWER APPARATUS
8 SINGLE OUTLET CIR.
EX. Occup. oLmEr OR FIXTURES
zo ®I 00
BAL @ .w
OR
Ex. Occup.Dnx�,E�°sA a�6.1Ek
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
$
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FET:
$
Policy Number
(fpe above sections need not be completed If the permit is for work of a valuation
�/�f 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
omply with those prow ' ns.
_ Date �� Z� ' �L _
Ic Owner Contractor ❑ Agent
is required for excavations over 5'0" deep and demolition or construction
3 stories in height.
fteceiptNo.,M=
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $183.35
HAZ•
D FE IMP
171
CDF C pD D SUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By -
PERMIT EXPIRES ON�
the applicable provisions
Resolutions to do work
been paid
D O fr
Date 4q�o
ate
183.35
CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
MI -a r, 'y r :. '��''7.+-^"*y:r`+ � `-"1✓'�� �\' 1 �"\r'1v - �►i�"`�i'hi ' 'i
TY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
y ;r 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 }
PERMIT APPLICATION DATA SHEET
OWNER: ASSESSOR PARCEL NUMBER: ~0
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
❑ PYot plans, 3/4 sets,��Complete sets, signed by the preparer of plans. ------
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! ---------
06. Energy Design Compliance and supporting documentation. ------ '; -----------------------------------
117. 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 ----------
0 10. Fees of $----------------------------------------------------------------------------
❑ 11. Impact fees as shown on the attached schedule. -------------------------------------------------------
❑ 12. California Department of Forestry plan approval/fees.-----------------------------------------------
P 13. Flood elevation certificate.-------------------------------�----------- ----- -- - --
------
tation and lot plan approval /C C� Health Department. ��-- -- -
---- Ott/
ell.tyof Chico plumbing permit.------------------------------------------------------------{----L--------- -----�N-- l
❑ 16. Plot plan and business license approval from the City of Biggs. ----------------------------------------------
❑ 17. Planning approval for (A) Use: (B) Parking: --------------------------
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. -----------------------
❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ----------------------------
❑20. Pre -inspection for required Request to Building Inspector on (Date)
❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------
❑22. Workers' Compensation carrier and policy number. -----------------------------------------------------------
023. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - --------------------------------------
024. Letter of signature authorization. --------------------------------------------------------------------------------
❑ 25. Recorded copy of Agricultural Acknowledgment Statement. --------------------------------------------------
❑ 26. Letter of intent on building use. -----------------------------------------------------------------------------------
❑ 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 $ .---------------
E130.
--------------
❑30. Other: -------
, er �u is ;e e pernut, process ollows ❑Mail to owner, ❑Mail t contractor.
v❑Teleph0 61: / 7 7 and hold for pickup at o ce. ❑ Deliver with ector.
aM`-�'(� Applican Date: L/' '—a C/
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air ol, ution Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By:
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, o Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, o Building Di ion counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buil ' i sion counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Sets of plans on hold in [],Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-754 T o.
(Rev.12/96-)_ .- APPLICATION AND PERMIT ZJ
ASSESSORPARC MBER ZONING
t19U --- I D BUILDING PERMIT
OWNER TELEPHONE
SQ. FT. OCC. BUILDING VALUAT N
OWNERS MAI ADDRESS �
S0 s
CONTRACTOR'SN.
CONTRALTO MAIUNG`AOARESS
.•CL//�LJJ
TELEPHONE
7
CONSTRU ON LENDER
LENDER'S MAILING ADDRESS
ARCHITECT OR ENGINEER
Fireplace
Total Valuation $
LICENSE NO.
Filin Fee $
20.00
--
ARCHITECT OR ENGINEER'S MAILING ADDRESS
BUILDING ADD7 //�� �
L -p '
Permit Fee $
oa--
Plan Checkin Fee $
Energy Plan Checking Fee $
PERMIT FEE S , 3 ,51
LAT NO.
SUBONSIONS NAMEPARCELMAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
sPELIFv
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00 ;
TYPE OF WORK
New 13 Addition O Remodel 13Utllities 13 Installation Oth
De/scribe Work:} n _
Each as water he or vent
15.00 -,- -
ts
Gas piping stem 1 - 5 outle—'15 .00Buildin
sewer 15.00
Mobile Home S W Q20.00
PERMIT FEE $
Filing Fee 20.00
ELECTRICAL PHFIXEDAPPLNS.OR
------ -----
r `
(/T''l.
1 ' I
,.
"PERMIT FEE PAID
SRA - -
SHERIFF
OTHER.
2)
AMOUNT RECEIVEC L
*RECEIPT NUMBER ���
" TO BE PVT INTO COMPUTER
Main Service R LESS
OAR LESS 23.00
Main Service O t000A 46.00
NEW CONST.
—OR ADDNS. ° ° .. 3:5¢F'T0.
N ONS O
NON-RESID.BRANCH CIRCU @7.50
PPARATUS
6 UTLET LIR.
Ex. Occup. OR FIXTURES
aAL SO
Ex. Occup. ORE�SID °EA. 5.00
Tem orar Servi23.00
Mobile Home Facs 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT g Fee 20.00
Heating
Cooling
Hood 6.50
ventilation
PERMIT FEt S
Mobile Home Installation Fee $
Energy Inspection Fee $
�°
LroN3T TYPE TOTAL.FEE $
HAZ.
0. FEES IMP
FLOOD
1 CDF
I PARCEL
Po
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.
ey Date
PERMIT EXPIRES ON
Pate)
T ' E.H. USE ONLY
Plot Plan Attached
Float PlanagMd
Sent to S.D.
TO: Building Department SSL➢ J
FRO11A: Environmental Health
SUBJECT: Sanitation Clearance S
Owner Location AP#
Plan Approved for: Sewage Disposal ✓ Water Supply: Public Private Well
Clearance for . dwelling. Other
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist Date
8/96
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NOTES A
RESIDENTIAL
040-260-077 ! 7° _ua {y
ROBERTS, ALICE �►i�
19384 LOTT RD. DURHAM, CA
CONT: CHICO MOBILE HOME
�2 COVERED DECKS T ��
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
s- c,
JOB FINALED (/D/ate) 1
s Signature
✓ = OK
0 = Not OK
= Not Applicable
*-= -Not Ready
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
DEC COV CARPORTS GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
ments-Setbacks-Easements
2.
Soils; Special MH Support Sketch
Footin�is-Size-De th-Spacing-Connectors-Stee
3.
Sewer; Location -Test -Fall -C/O -Concrete
ecks; Gir and/or Jois - ecking-Brac' Lairs -R '
4.
Water; Location -Test -Easement Needed (Sketch)
Wood Awn.; Posts-Beams-Rftrs.-Con nectors
Shlhg.•Frg-Bracing
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
Alum. Awn.; Columns•Connections-Splice- Decal- Enclosures
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or / P'L"ft./ PLPG
Carports; Windows -Doors
7.
Well Clearance & Disconnect
Electric
8.
Utility Clearance
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
-,),5'-61
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
1.
5.
Drain; MH Test -Fall -Flex Connector
.2.
6.
Water; MH Test -Regulator -Connector
3.
7.
Water and Sewer Connected -C/O to Grade -HD Approval
4.
8.
Gas and Electricity Tagged
5.
9.
Tie Downs -Type -Installation Cert.
6.
10.
Exits; Insp.-Sketch
7.
11.
Cert. of Occupancy
8.
12.
Permanent Foundation Only; License Decal
9.
Health. Department Approval
Date
Plumb.; Cir. Test -Water Supply Test
Card B-1 Date Card B-1
Date
Light Niche
Card B-1 Date Card B-1
C LLANEOUS
Date
DEC COV CARPORTS GARAGES (Plans) OK except #'s
ments-Setbacks-Easements
Footin�is-Size-De th-Spacing-Connectors-Stee
ecks; Gir and/or Jois - ecking-Brac' Lairs -R '
4.
Wood Awn.; Posts-Beams-Rftrs.-Con nectors
Shlhg.•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'
-,),5'-61
Card B-1yQ 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 Ready
RESIDENTIAL (E
Date
46.
Underfloor (Plans) OK except #'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-/ P' Ftg. Depth
5.
Stemwalls, Main; Steel-Blockouts-Wrapped
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
6a.
Hold Downs and Special Anchors
7.
Slab, Steel -Wrapped
8.
Piers -Fireplace Ftg.-Steel
9.
D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test
10.
UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11.
Water Pipe; Test -Anchors -Regulator -Service Test
12.
Electric Underground
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts -Joists- Vent s-Crippies
15.
Access & Ventilation
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
63.
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
70.
Fireplace or Stove, Clearance -Hearth
Date
71.
Card B-1 Date Card B-1
Date
72.
Card B-1 Date Card B-1
Date
73.
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 At
30.
Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or At
Insulated Neutral G Yes I] 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
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
Date
86.
Card B-1 Date Card B-1
Date
87.
Card B-1 Date Card B-1
Date
88.
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
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Comments at Final:
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
jingle & Duplex)
Date
FRAMING (Continued)
46.
Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rftr. Ties-Purlin-Roff Brac.-Truss -Shting.-Ring.
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 Roof 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
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 Instld./Drive D Yes J No/Walks J Yes J No/Planters J Yes J 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:
O p
C �
IN
lb
a
,� n
22
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ct
tj
00
LIN
22
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM'
ELEVATION CERTIFICATE
Read the Instructions on Daces 1 -
O.M.B. No. 3067-0077
Expires July 31, 2002
SECTION A- PROPERTY OWNER INFORMATION I. Fbr..Insurance.CompampUse;:
BUILDING OWNER'S NAME 1 Pollcy;•�lumberi
Q IV ?o B TS
BUILDING STREET AQDRESS (including Apt.,ft, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX N0. t CompanpNAIC:Numben
CITY if STATE ZIP CODE
0ufe ,gAM Ci9, 9s�38
PROPERTY DESCRIPTION (Lot an BI Numbqrs, Tax Parcel Number, Legal Description, etc.)
IWA O40-2-60-0-7:7
BUILDING USE (e.g., Residential, N n-residentlel, Addition, Accessory, etc. Use Comments section if necessary.)
lt DEN T i /rC-_
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: L -I GPS (Type):
( r/#• - ##' - ##.##- or ##.###W) LlkAD'1927 j --I NAD 1983 L -I USGS-Ouad Map Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAME & COMMUNITY NUMBER
B2. COUNTY NAME
B3. STATE
Q. 1 C4. A)cotP "-74
3u -r-=
c4 -e-, F,
MAP AND PANEL
85. SUFFIX
BB.. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
89.ASE FLOOD ELEVATIONS)
FB,,4.
NUMBER
00/ _ 32
C
DATE
145
EFFECTIVE/REVISED DATE
ZOWE(S)
A-4 '-7
(lone AO, use depth of flooding)
VNEB
S
U lu. u,uic,-dce u,e source or me mesa mood Elevation (6FE) data or base flood depth entered in By.
—I FIS Profile FIRM Community D Other (Describe):;,
B11. Indicate the elevaticf1i datum used for the BFE in B9: L& NGVD 1929 NAVD 1988 Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1,.-1 Yes No
Designation Date:
SECTION -C - BUILDING ELEVATION INFORMATION tSURVEY•REOUIREnt
C1. Building elevations are based on: I_IConstwcdon Drawings' IBuiiding Under Construction" I—IFinished Construction
'A new Elevation Certificate will be required when construction of thi§ building is complete.
C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate Is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3a-I below according to the building diagram specified in Iters C2. State the datum used. If the datum is different from
the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion.
Datum Conversion/Comments _
Elevation reference marts used IQ M 58 Does the elevation reference mark used appear on the FIRM? 1_1 No
❑ a) Top of bottom floor (including basement or enclosure) /S8 S ft en
❑ b) Top of next higher floor _ (') 12 rjfr ESS
IQ*
s �Q� QN
O c) Bottom of lowest horizontal structural member N zones only) _ /77 . IL fl.(
� �, •.•••""••. '�
❑ d) Attached garage (top of slab)
e) Lowest elevation of machinery and/or equipment m O t
servicing the building ft.(m)
❑ 0 Lowest adjacent grade (LAG)
Z- fQm) z .-
❑ g) Highest adjacent grade (HAG) 1 S4- N No. 7
❑ h No. of openings (flood ) Z fL y
permanent o sin s vents within 1 R above adjacent rade — � T •� �1V
❑ .I) Total area of all permanent opening" flood vents In C3h O 'a 1C.41 k .•
( ) ' sq. in. (sq. )
cn'I �n••o'
SECTION D - SURVEYOR ENGINEER, OR ARCHITECT CERTIFICATION
This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized b law certify ti
Y to rttfy elevation information.
1 cert#y that the Information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available.
/understand that any false statement mav be Punishable, by fine or imprisonment under 18 U.S.' Code, Section 1001,
CERTIFIER'S NAME , COMPANY NAME LICENSE NUMBER ^7 L
�
TITLE - gr -9z`6
�
Civis � iN��2 �i4. �EsT. �U 2vEY/N�'
ADDRESS / G L/✓E �� CITY 4 �/
•t :STATE ZIP CODES 6Q
SIGNATURE DATE 7
FLEPHONE 42 7-6 ZSS
Q
::NAA Froth A 11 AI Ir; QST CFF RF�/1=RCF CIr1F Fl1R r f1NT1Nt IATi(1N
RFPI 4r FC Al I PRFVIr11 IA r -nM lNlR
IMPORTANT: In these spaces, copy the corresponding information from Section A. N Forinsurance Company;Use:
CITY
No.) OR P.O. ROUTE AND BOX NO.
STATE - :ZIP CODE N Company;NAIC.Numbec
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation .Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
COMMENTS
Bc--n��rt- vY�2x
SC Co if CoIVCjLEs TE SGG G'
I_I Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO and ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E3. If the Elevation Certificate is intended for use as supporting
information for a LOMA or LOMR-F, Section C must be completed.
E1. Building Diagram Number (Select the building diagram most similar to the building for wtoich this certificate is being completed -
see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is 1-�_1 ft.(mt 1-I-1in.(cm) L-1 above or L-1 below
(check one) the highest adjacent grade.
E3. For Zone AO only:.If no flood depth number Is available, is the top of the bottom floor elevate in accordance with the community's
floodplain management ordinance? 1_1 Yes I_I No 1—I Unknown. The local official must certify this information in Section G.
• SECTION F - PROPERTY.OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or
community -issued BFE) or Zone AO must sign here.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE _ . ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
I I Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local offlcial who is authorized by law or ordinance to administer the community's floodplain msnagenrent ordinance can complete
Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable Item(s) and sirn below.
G1. 1-1 The Information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,
engineer, or architect who is authorized by state or local law to certify elevation Information. (Indicate the source and date of the
elevation data in the Comments area below.)
G2. j-1 A community official compfeted Section E for a building located in Zone A (without a FEMAyssued or community -issued BFE) or
Zone AO.
G3. j_1 The following information (Items G449) is provided for community floodplain management purposes.
G7. This permit has been issued for. [—I -New Construction 1_._j Substantial improvement
G8. Elevation of as -built lowest floor (including basement) of the building Is: _ fL(m) Datum:
G9. BFE or (in Zone AO) depth of flooding At the building site is: _ it (m) Datum:
LOCAL OFFICIAL'S NAME TiTLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
I_I Check here if attachments
;:=MA Form A9 11 Al Ir] 00 Rcoi n(`FC 41 I ooc�nni iC cn,Tt(�tJR
NOTES
F
RESIDENTIAL
040-260-077 }
01-0495
ROBERTS, FRANCIS &ALICE
19384 LOTT RD. DURHAM
yCONT: CHICO MOBIL HOME
IEX MH ON PERM FND
F.
fTHE HCD FORM 433A FOR THIS MH CANNOT
BE RECORDED UNTIL ONE OF THE FOLLOWING
HAVE BEEN TURNED IN TO THE BLDG DIV:
(1) LICENSE PLATE(S) or DECAL(THE
INSPECTOR MUST RETRIEVE)'
STA TEMENT OF FACTS(ONLY ON
NEW MH'�S_�
INSPECTOR 0 VERIFY SERIAL & LABEL #'S
ti
a
i
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
�Ck-IzSa
a 8 3
-JOB FINALED (Date)USignature
V= OK * '
0 = Not OK
- = Not Applicable = Not Ready MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1.
1. Zoning Requirements-Setbacks-Easements
2. Soils; Special MH Support Sketch
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Sewer; Location-Test-Fall-C/O-Concrete
3.
4. Water; Location-Test-Easement Needed (Sketch)
5. Electricity; Location-Clearances-Grnd-/ /Amp-Concrete
Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Frg-Bracing
6. Gas; Location-Test-Wrap;-/ /" L'ft.
/ P Nat. or / /"L"H./ PLPG
5.
7. Well Clearance & Disconnect
8. Utility Clearance
Carports; Windows -Doors
7.
Electric
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning quirements-Seib s-Ease nts
Roof; Shthg-Roofing
_Fod rings; Si -S g-M r ' ine
11.
T Gas; MH Test-Demand-Valve-Connector
ectricity; MH Test-Crossovers-Breakers-Clearances
Braced Wall Panels
'-'grain', MH Test-Fall-Flex Connector
Test-Regulator-Connector
Date
J
,rand Sewer Connected-C/O to Grade-HD Approval
Card B-1 Date Card B-1
Gas and Electricity Tagged
9
Date
1 nsp.-Sketch
FINAL (Plans) OK except #'s
11. Cert. of Occupancy
1.
1 ermanent Foundation Only; Licen cal
2..
Date
Card B-16/ �,"ate Card B-1
Date
Card B-1 Date Card B-1
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-Rftrs.-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
J=OK
0 = Not OK
- = Not Applicable
Not Ready
RESIDENTIAL (Single & Duplex)
Date
Underfloor (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth
4.
Ftg., Porches & Decks; Soils -Steel-/ f' Ftg. Depth
5.
Stemwalls, Main; Ste el- Blockouts-Wrapped
6.
Stemwalls, Garage; Stee l-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 -Anchors -Regulator -Service Test
12.
Electric Underground
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
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 #'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
69.
Stairs & Rails
Date
70.
Card B-1 Date Card B-1
Date
71.
Card B-1 Date Card B-1
Date
72.
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 At
30.
Range Circle / / ga Cu or AkOven Circ. / / ga Cu or At
Insulated Neutral U Yes C) 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
84.
A.C. Unit Disconnect, Electrical -Plumbing
Date
85.
Card B-1 Date Card B-1
Date
86.
Card B-1 Date Card B-1
Date
87.
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
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
FRAMING (Permit) OK except #'s
Date
40.
Sills Proper Materials & Anchors
Comments at Final:
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
r I . .
Date
FRAMING (Continued)
46.
Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rftr. Ties- Purlin-Rolf 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 Roof 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.
Inf iltration-Walls- Windows
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 -Mach. 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 O Yes
82.
Following Instld./Drive J Yes D No/Walks D Yes J No/Planters J Yes J 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:
BUILDING PERMIT NUMBER: 01-0495
Address or location of unit: 9384 LOTT ROAD, DURHAM, CA 95938
Legal Description of Real Property: A.P.#040-260-077
SEE ATTACHED
(x) Mobilehome/Manufactured Home
O Commercial Coach
Has been affixed to the real property above by installation on a foundation system
pursuant to Health and Safety Code Section 18551.
Owner's name: FRANCIS A. ROBERTS JR. & ALICE BURKART ROBERTS
Owner's address: 50 FAIRVIEW CIRCLE, CHICO, CA 95928
INSIGNIA OR HUD NUMBER: 320892/3
SERIAL NUMBER OR V.I.N.: 15700333A/BV
MANUFACTURER'S NAME: SKYLINE HOMES INC. YEAR- 19
OFFICIAL APPROVING INSTALLATION:
DATE: 4/25/01
PHONE: (530) 538-7541
H.C.D. 513C
P
BUILDING PERMIT NUMBER: 01-0495
Address or location of unit: 9384 LOTT ROAD, DURHAM, CA 95938
Legal Description of Real Property: A.P.#040-260-077
SEE ATTACHED
(x) Mobilehome/Manufactured Home
O Commercial Coach
Has been affixed to the real property above by installation on a foundation system
pursuant to Health and Safety Code Section 18551.
Owner's name: FRANCIS A. ROBERTS JR. & ALICE BURKART ROBERTS
Owner's address: 50 FAIRVIEW CIRCLE, CHICO, CA 95928
INSIGNIA OR HUD NUMBER: 320892/3
SERIAL NUMBER OR V.I.N.: 15700333A/BV
MANUFACTURER'S NAME: SKYLINE HOMES INC. YEAR- 19
OFFICIAL APPROVING INSTALLATION:
DATE: 4/25/01
PHONE: (530) 538-7541
H.C.D. 513C
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
COPY of Document Recorded
27 -Apr -2001 2001-0017303
Has not been compared with
original
BUTTE COUNTY RECORDER
SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code
Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit
described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document
shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as
to its contents to all persons thereafter dealing with the real property.
FRANCIS A. ROBERTS JR. &
ALICE BURKART ROBERTS
REAL PROPERTY OWNER/LESSOR
50 FAIRVIEW CIRCLE
MAILING ADDRESS
CHICO, BUTTE, CA 95928
CITY COUNTY STATE ZIP
9384 LOTT ROAD
INSTALLATION MAILING ADDRESS. IF DIFFERENT
DURHAM, BUTTE, CA 95938
CITY COUNTY STATE ZIP
SAME
UNIT OWNER (if also property owner, write'SAME')
MAILING ADDRESS
CITY COUNTY STATE ZIP
UNIT DESCRIPTION
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
(1R()V1T.T F� BUTTE CA 95965
CITY COUNTY STATE ZIP
01-0495 (530)538-7541
BU D G PERMIT NO. TELEPHONE NUMBER
4/25/01
IGGkf6ftOCAL AGEN 0 ICTAL DATE
NONE
DEALER NAME (if not a dealer sale, write "NONE")
NONE
DEALER LICENSE NO.
SKYLINE HOMES INC. 1986 GREENLEAF
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER
15700333A/BV 24'X 56' 320892/3
SERIAL NUMBER(S) LENGTH X WIDTHu - INSIGNIA/LABEL NUMBER(S)
AL DESCRIPTION
REAL PROPERTY LEGASSESSOR'S PARCEL NUMBER A.P. #040-260-077
SEE ATTACHED
HCD FORM 433(A) REV. 8/91
WHITE -County Recorder CANARY - HCD PINK -Applicant GOLDENROD - Building Dept.
DESCRIPTION
/ THE LAND REFERRED TO HEREIN IS SITUATED IN THE STATE OF CALIFORNIA,
COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS:
PARCEL I•
ALLOTMENT 22, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "SUBDIVISIONAL
PLAN OF THE DURHAM STATE LAND SETTLEMENT, BEING A PORTION OF THE
ESQUON RANCHO, SITUATED NEAR DURHAM BUTTE COUNTY, CALIFORNIA",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY
OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 17, 1918, IN BOOK 8 OF
MAPS, AT PAGE(S) 16, 17 AND 18.
EXCEPTING THEREFROM THE FOLLOWING PARCEL OF LAND:
BEGINNING AT THE SOUTHWEST CORNER OF SAID ALLOTMENT 22, WHICH POINT
IS THE INTERSECTION OF THE SOUTH LINE OF SAID ALLOTMENT WITH THE
CENTERLINE OF OAK LANE; THENCE ALONG SAID CENTERLINE NORTH 43 DEG.
0' EAST 74.2 FEET; THENCE NORTH 51 DEG. 24' EAST 100 FEET; THENCE
NORTH 61 DEG. 24' EAST 100 FEET; THENCE NORTH 43 DEG. 38' EAST 100
FEET; THENCE NORTH 28 DEG. 02' EAST 100 FEET; THENCE LEAVING SAID
CENTERLINE OF OAK LANE SOUTH 3 DEG. 22' EAST 325.8 FEET TO THE
SOUTH LINE OF SAID ALLOTMENT 22; THENCE WEST 351.6 FEET TO THE
POINT OF BEGINNING.
ALSO EXCEPTING THEREFROM THE EASTERLY 1159.26 FEET THEREOF. (AS
MEASURED ALONG THE SOUTH LINE OF SAID ALLOTMENT 22.)
ALSO EXCEPTING THEREFROM THE NORTH 320 FEET.
AP#: 040-260-077-000 (PORTION)
PARCEL II•
A PORTION OF ALLOTMENT 22., AS SHOWN ON THAT CERTAIN MAP ENTITLED,
"SUBDIVISIONAL PLAN OF THE DURHAM STATE LAND SETTLEMENT, BEING A
PORTION OF THE ESQUON RANCHO, SITUATED NEAR DURHAM BUTTE COUNTY,
CALIFORNIA", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER
OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 17, 1918,
IN BOOK 8 OF MAPS, AT PAGES) 16, 17 AND 18, MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
BEGINNING AT THE NORTHWEST CORNER OF SAID ALLOTMENT 22 AT THE
INTERSECTION OF THE CENTERLINE OF THE DURHAM-OROVILLE COUNTY ROAD
AND OAK LANE; THENCE SOUTH ALONG THE CENTERLINE OF OAK LANE, A
DISTANCE OF 160.0 FEET TO A POINT; THENCE EAST 160.77 FEET TO A
POINT IN THE WEST LINE OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN
DEED FROM JAMES D. STRIEBY, ET UX, TO GUS A. GORE,'ET UX, RECORDED
CONTINUED
DESCRIPTION - CONTINUED
PARCEL II - CONTINUED
FEBRUARY 15, 1963, IN BOOK 1227, PAGE 591, OFFICIAL RECORDS; THENCE
SOUTH ALONG THE WEST LINE OF SAID GUS A. GORE PARCEL, A DISTANCE OF
80.0 FEET TO THE TRUE POINT OF BEGINNING FOR THE PARCEL HEREIN
DESCRIBED; THENCE FROM SAID TRUE POINT OF BEGINNING, CONTINUING
SOUTH ALONG THE WEST LINE OF SAID GUS A. GORE PARCEL TO THE
NORTHEAST CORNER OF THE PARCEL OF LAND DESCRIBED IN DEED TO JAMES
D. STRIEBY, ET UX, RECORDED JULY 17, 1961, IN BOOK 1478, PAGE 631,
OFFICIAL RECORDS; THENCE WEST ALONG THE NORTH LINE OF SAID JAMES D.
STRIEBY PARCEL TO THE NORTHWEST CORNER- -OF---SAID 'PARCEL -AND THE -
CENTERLINE OF OAK LANE; THENCE NORTH TO THE SOUTHWEST CORNER OF THE
PARCEL OF LAND DESCRIBED IN DEED TO JAMES D. STRIEBY, RECORDED JULY
17, 1967, IN BOOK 1478, PAGE 632, OFFICIAL RECORDS; THENCE EAST
ALONG THE SOUTH LINE OF SAID STRIEBY PARCEL, A DISTANCE OF 160.77
FEET TO THE TRUE POINT OF BEGINNING.
DEPARTMENT USE ONLY STATE OF CALIFORNIA
TRANS CODS BUSINESS, TRANSPORTATION AND HOUSING AGENCY
C DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
Min !!ALLEY TI E ANOES �®� I CO. DIVISION OF CODES AND STANDARDS
G®RI"0 TI l�RTIF6E' RilE COPY REGISTRATION AND TITLING PROGRAM
t
slTusccAPPLICATION FOR DUPLICATE
CERTIFICATE OF TITLE
DEPARTMENTU$E ONLY
NEW DECAL #
STICKER #
OLD DECAL#
Name of Manufacturer
MFG 10 #
Trade Name
Model Name or#
Date of Manufacturer
Calif. Dealer License #
Date of Transfer to Dealer from MFG
ILT Exemption
Date First Sold New
DECALILICENSE #
MANUFACTURER SERIAL NUMBER(S)
HUD LABEL OR HCD INSIGNIA #
LENGTH
(Inches)
WIDTH
llnches
WEIGHT
(pounds)
DATE FIRST SOLD
If different than above
►-ASS17
15'70033'3 (3V
Sao 2ga
oo
D 2I
ADD UNITS
USE
CODE
EXPIRATION DATE TAX TYPE ORIG COST PRICE
CODE YR
SALE PRICE
PPF
DEPARTMENT
USE ONLY
ILT
EXT
LP
PT I
�%�
(/[/(/ —
RF
RECEIPT NUMBER(S)
RECEIPT DATE(S)
CLERK'S INITIALS
SALE DAZE
— 70 7
ILT
REGISTERED
OWNER(S)
(Print True
Name(s))—+�
Last First Middle
1. J A kin
MRF
2. J O V\
PEN 1
MAILING ADDRESS
Street_ / City State Zip
0
PEN 2
LOCATION ADDRESS
OF UNIT
Street �f City
Q State Zip
—1 Q l �O 11 ��AIJ� /il.►y�
LEGAL OWNER
(print true name)
TRF
TOD
MAILING ADDRESS
Street City State Zip
f
DUPT'
APPLICATION FOR TRANSFER BY NEW OWNERS
IA41e request that the new Certificate of Title and Registration Card to be issued as follows:
DUPR
REGISTERED
OWNER(S)
[Print true
Last First Middle
1. O t?
SUBD
CONF
name(s)]
2. Z
REPO
3
RREG
If applicable, check one of the following: ❑ TENCOM OR JTRS TENCOM AND ® COMPRO
RSF ,
MAILING ADDRESS
FUTURE MAILING
ADDRESS
Street City State Zip
' � re— e—
PLT
Street City (� State �j Zip
'�SIT
1 J C)Ox �t\(1�V1� t/A -lsg2>1O
UT
IlTP
IRT
LOCATION ADDRESS
OF UNIT
Street Q ity County State Zip
Laoa�CA -
ASF
LEGAL OWNER
(print true name)
MHP
CCP
If applicable, check one of the followin : TENCOM OR JTRS ❑ TENCOM AND E] COMPRO
MAILING ADDRESS
Street City State Zip
TOTAL
FIRST JUNIOR
LIENHOLDER
(print true name)
If applicable, check one of the following: TENCOM OR JTRS TENCOM AND El COMPRO
MAILING ADDRESS
Street CRY State Zip
ADD JR/LH
NOTE: SECTION I, "CERTIFICATION OF MISSING TITLE" ON THE REVERSE SIDE MUST BE COMPLETED, TO COMPLETE A TRANSFER OF
OWNERSHIP BOTH THE OLD AND NEW OWNERS MUST SIGN THE APPROPRIATE LINES ON THE REVERSE SIDE OF THIS FORM.
HCD 480.4 - Side 1 (REV 12/93) Reproduced by SMS, HCD Approved 11 -18-97
DECAL (LIG--NSE) NUMBER(S)
`
ti
TRADE NAME
SECTION 1. CERTIFICATION OF MISSING TITLE
The original HCD Certificate of Title or DMV Ownership Certificate (pink slip) was:
Lost, ❑ Stolen. If the title was lost or stolen after receiving it from a party other than the Department, enter
the party's name here:
❑ Illegible, ❑ Mutilated. A mutilated or illegible title must be surrendered to the Department.
❑ Not Received from the Department. This box can only be checked by the Legal Owner of Record (lienholder), or
if none, the Registered Owner of record.
I/We certify under penalty of perjury under the laws of the State of California that there are no liens against this unit other
than those shown on this application and the statements made on this application are true and correct.
I/We agree to indemnify and save harmless the Director of the Department of Housing and Community Development for
any loss suffered resulting from the issuance of said duplicate Certificate of Title.
/
,/n ,
Executed on at (��'�-,
Signatu
Printed Name of Person Completing Certification De r- ��L �'' � �-�.,q -
CGr_Tlnnl 9 RFI FASF OF nWNFRSHIP AND/OR INTEREST
1 A.
E SE OF REGISTERED OWNER
3 A.
RELEASE DATE
DEALER NUMBER
B.
RELEASE OF REREDD OWNER
B.
RELEASE DATE
RELEASE DATE
} % A
SECTION 4. NEW REGISTERED OWNER SIGNATURE(S)
C.
ELEASE OF REGISTERE - WNER
NEW REGISTERED OWNER SIGNATU
RELEASE DATE
If this transfer is the result
r
2 A.
RELEASE OF LEGAL OWNER (LIENHOLDER)
t`� / �1� cm
DATE
sale date must be entered
s
�1GG
B.
RETENTION OF LEGAL OWNER
NE TER DOWN TUR
DATE
}� HA RI E
C.
ASSIGNMENT OF LEGAL OWNER
NEW REGISTERED OWNER SIGNATURE
DATE
PURCHASE QR4GE
SECTION 3. DEALER'S RELEASE OF ACQUIRED UNIT
3 A.
NAME OF DEALER
DEALER NUMBER
B.
RELEASE OF DEALER
RELEASE DATE
SECTION 4. NEW REGISTERED OWNER SIGNATURE(S)
4 A.
NEW REGISTERED OWNER SIGNATU
If this transfer is the result
r
a sale ,the sale price and
t`� / �1� cm
sale date must be entered
s
�1GG
be ow.
B.
NE TER DOWN TUR
}� HA RI E
(�(J
C.
NEW REGISTERED OWNER SIGNATURE
PURCHASE QR4GE
--
HCD 480.4 - Side 2 (REV 12/93) Reproduced by SMS
RECORDING REQUESTED BY
MID VALLEY TITLE AND ESCROW CO.
AND WREN RECORDED MAIL TO:
FRANCIS A. ROBERTS, JR.
ALICE BURKART ROBERTS
50 FAIRVIEW CIRCLE
CHICO, CA 95928
A.P.N.: 040-260-077-000
Order No.: CHI/C
�..zr T% r•....,
Recorded
Official Records
CoBU-TTEOf
CANDACEllJJ. 6RUBBS
Recorder
ROSEMARY DICKSON
Assistant
09:00AM 03 -Jan -2001
REC FEE 13.00
TAX 156.75
Maureen
Page 1 of 3
Above This Line for Recorder's Use Only
Escrow No.: 184213DP \D5
GRANT DEED
THE UNDERSIGNED GRANTOR(s) DECLARE(s) THAT. DOCUMENTARY TRANSFER TAX IS: COUNTY L .156.75
)t computed on full value of property conveyed, or
computed on full value less value of liens or encumbrances remaining at time of sale,
] unincorporated area; [ ] City of _, and
FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged,
ROBERT A. HOLT and DEBBIE ANN HOLT,
WHO ACQUIRED TITLE AS DEBBIE ANN DUNCAN, Husband and Wife
hereby GRANT(S) to
FRANCIS A. ROBERTS JR. and ALICE BURKART ROBERTS, Husband and Wife as Community Property
the following described property in the City of UNINCORPORATED AREA, County .of BUTTE State of California;
See legal description attached hereto and made a part hereof.
Document Date: -December 27, 2000
STATE OF CALIFORNIA _ )SS
COUNTY OF BU1rS )
On DECEHM 27, 2000 re
personally appeared **ROBERT A. HOLT AND l
personally kno to me (or proved to me on the basis `f sa factory evidence) to be the person(s) whose names) is/are subscribed to the within .
instrument an wledged to me that he/she/they x the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s) on
the instrume th person(s) or the entity upon be f of the person(s) acted, executed the instrument.
WITNESS n c;el DEE PALMER ^
..... .111
Signature Comm. #1185035
m NOTARY PUBLIC CAUFORMA Q
BUTTE COUNTY —+
My Comm. Expims June 22, 2002
Mail Tax Statements to: SAME AS ABOVE or Address Noted Below
ROBERT A. OLT
DEBBIE HOLT
�, DEB PALMER, NOTARY PUBLIC
DESCRIPTION
THE LAND REFERRED TO HEREIN IS SITUATED IN THE STATE OF CALIFORNIA,
COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS:
PARCEL I:
ALLOTMENT 22, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "SUBDIVISIONAL
PLAN OF THE DURHAM STATE LAND SETTLEMENT, BEING A PORTION OF THE
ESQUON RANCHO, SITUATED NEAR DURHAM BUTTE COUNTY, CALIFORNIA",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY
OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER --17,-1918, IN BOOK 8 OF'
MAPS, AT PAGE(S) 16, -17 AND
EXCEPTING THEREFROM THE FOLLOWING PARCEL OF LAND:
BEGINNING AT THE SOUTHWEST CORNER OF SAID ALLOTMENT 22, WHICH POINT
IS THE INTERSECTION OF THE SOUTH LINE OF SAID ALLOTMENT WITH THE
CENTERLINE OF OAK LANE; THENCE ALONG SAID CENTERLINE NORTH 43 DEG.
0' EAST 74.2 FEET; THENCE NORTH 51 DEG. 24' EAST 100 FEET; THENCE
NORTH 61 DEG. 24' EAST 100 FEET;'THENCE NORTH 43 DEG. 38' EAST 100
FEET; THENCE NORTH 28 DEG. 02' EAST 100 FEET; THENCE LEAVING SAID
CENTERLINE OF OAK LANE SOUTH 3 DEG. 22' EAST 325.8 FEET TO THE
SOUTH LINE OF SAID ALLOTMENT 22; THENCE WEST 351.6 FEET TO THE
POINT OF BEGINNING.
ALSO EXCEPTING THEREFROM THE EASTERLY 1159.26 FEET THEREOF. (AS
MEASURED ALONG THE SOUTH LINE OF SAID ALLOTMENT 22.)
ALSO EXCEPTING THEREFROM THE NORTH 320 FEET.
AP#: 040-260-077-000 (PORTION)
PARCEL II•
A . P.ORTION. OF. ALLOTMENT 22,. -AS --SHOWN ON THAT CERTAIN MAP ENTITLED,
"SUBDIVISIONAL PLAN OF THE DURHAM STATE LAND --SETTLEMENT, BEING A
PORTION OF THE ESQUON RANCHO, SITUATED NEAR DURHAM BUTTE COUNTY,
CALIFORNIA", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER
OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 17, 1918,
IN BOOK 8 OF MAPS, AT PAGES) 16, 17 AND 18, MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
BEGINNING AT THE NORTHWEST CORNER OF SAID ALLOTMENT 22 AT THE
INTERSECTION OF THE CENTERLINE OF THE DURHAM-OROVILLE COUNTY ROAD
AND OAK LANE; THENCE SOUTH ALONG THE CENTERLINE OF OAK LANE, A
DISTANCE OF 160.0 FEET TO A POINT; THENCE EAST 160.77 FEET TO A
POINT IN THE WEST LINE OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN
DEED FROM JAMES D. STRIEBY, ET UX, TO GUS A. GORE, ET UX, RECORDED
CONTINUED
/DESCRIPTION - CONTINUED
RCEL II - CONTINUED
FEBRUARY 15, 1963, IN BOOK 1227, PAGE 591, OFFICIAL RECORDS; THENCE
SOUTH ALONG THE WEST LINE OF SAID GUS A. GORE PARCEL, A DISTANCE OF
80.0 FEET TO THE TRUE POINT OF BEGINNING FOR THE PARCEL HEREIN
DESCRIBED; THENCE FROM SAID TRUE POINT OF BEGINNING, CONTINUING
SOUTH ALONG THE WEST LINE OF SAID GUS A. GORE PARCEL TO THE
NORTHEAST CORNER OF THE PARCEL OF LAND DESCRIBED IN DEED TO JAMES
D. STRIEBY, ET UX, RECORDED JULY 17, 1961, IN BOOK 1478, PAGE 631,
OFFICIAL RECORDS; THENCE WEST ALONG THE NORTH LINE OF SAID JAMES D.
STRIEBY 'PARCEL TO THE---NORTHWEST--'CORNER-CrF-�SI�ID---PARCEL IND` -THE --
CENTERLINE OF OAK LANE; THENCE NORTH TO THE SOUTHWEST CORNER OF THE
PARCEL OF LAND DESCRIBED IN DEED TO JAMES D. STRIEBY, RECORDED JULY
17, 1967, IN BOOK 1478, PAGE 632, OFFICIAL RECORDS; THENCE EAST
ALONG THE SOUTH LINE OF SAID STRIEBY PARCEL, A DISTANCE OF 160.77
FEET TO THE TRUE POINT OF BEGINNING.
03/06/2001 T•UE 14:31 FAX
IM002/002
DEC -19-2000 07:27 ' HCD/HDQTRS/SACT0 916 323 9246 P.02i02
_ CALIFORNIA - BIIsINF_ss, TRARSPORTA11oN AND HoUBWG AGENCY
DEPARTMENT 4F HOUSING AND COMM NUI Y DEVELOPS
TNr cwar DAVIS, r>oven,or
Talon at Codes and Standards �l1T OF"
11tle Search •
Date Printed. I2119/2000 rf6�``~
Decal #t~:
LAJ5617
Manufacturer:
90002 SKYLM HM INC
Tradename:
GREENLW
Model:
GR F 1102
MaWactured Date: 01/09/1986
Registration Exp:
First Sold On:
07/15/1986
Serial Number
15700333BV
15700333AV
Registered owner:
HM Label / Insignia
320892
320893
Use Code: SFD
Original Price Code: AFQ
Rating Year:
Tax Type: LPT
Last ILT Amount:
Date ILT Fee Paid_
ILT Exemption: NONE
Length Width
56' IT
56' 12'
DEDSM ANN DUNCAN
JOHN DUNCAN
HELEN M I)MC AN (roint T==0 with Right of Survivorship)
9384 MATT RD
DURRAM, CA 95938
Last Title Date: 12/06/1993
Last Reg Caird: 12/06/1993
Sale/Transfer Info= Price $20,000.00
Situs Address: Ikanslerxed on 07/27/1993
9384 LOTT RD
S tussis Cou�ntyCH TrE
*** END OF TITLE SEARCH **�°
TOTAL P.02
G4� .3 3oz8S3
-
PACIFICrAj BELL.
�,QUNTY OF PUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUI ING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (53 ) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMITS
ASSESSOR PARCELNUMBER
040-260-077OWNER
ZOn '10
BUILDING PERMIT
ROBOWNERS
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
1344 R
72 576.00
MAILING DRESS
50 FAIRVIEW CIRCLE CHIM, CA 99922
CONTRACTOR'S NAME
C14TCO MORITE HOME
TELEPHONE
999-1774
CONTRACTORS MAILING ADDRESS
PQ ROX 4191 CHIC01 CA 95997
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation Is
ARCHITECT OR ENGINEER
UCENSE No.
Fee
$ 20.00
—Filing
Permit Fee 518/2
$ 259.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 23,00
BUILDINGADDRESS
Energy Plan Checking Fee
$
PERMIT FEE
$ 302,00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome EX Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00 15,00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
?C
Describe Work: EX MH ON PERM FOUNDATION
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00 15,00
Mobile Home S G W
920.00
PERMIT FEE
S 50.00
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 200AORLESS
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 io, full force and effect. ['—
License Class ` Lic. No. I'js/d
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:
❑ I 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.
❑ I 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
he 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
wor compensation provisions of section 3700 of the Labor Code, I shall
fo h c ply with those provisions.
X Date
Signature icant - ❑ Owner Contractor ❑ Agent
An OSH permit s required for excavations over 60" deep and demolition or construction
of struct res ov r 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP. 3.5Qf7.
OR (
EW coNST. MuicTlco
NON-RESID.
97.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
EX. OCCU OUTLET OR FIXTURES
20 Q Loo
BAL @ .50
Ex. Occup. OuT RES,,D.) E 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
PERMIT FEE S
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 FEEV" 199-00
HAZ.D.
..
FEES IMP
_ _
OD F
CD
PARC EL
PD
HD
ISSUE
This permit is hereby Issued under the
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
applicable provisions
Resolutions to do work
been paid.
ate
Defe
Receipt No. 2
WHITE-D.D.S.•B.D. S O PINK-GOLDENROD•APPLICANT
COF}NTY�DF BLIT E�- DEPARTMENT OF DEVELOPMENT SERVICES - UILDING DIVISION
` 7 COi�N F CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPH_ Q E (530) 538-7541
:.
y
PERMIT APPLICATION DATA SHEET
� ') /�
OWNER: ASSESSORPARC 15M
: "RJ �� '- O / /
Proposed BuildingUse: Building Inspector: Date: �31 011
At time of permit application, I as ad sed the following data must be submitted prior to permit roc swing and/or issuance:
Date Received By
❑ 1. All items have been submitted -------------------------
02. Plot plans, 3/4 sets, signed by the preparer of plans.
❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. -----------------------------4 -----== ---------------
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. ---------------------=----------
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------
❑ 8. Hazardous Material Form.-----------------------------------------------------------------------
anufactured Home data a d installation instructions including Tie Down Specifications .------------------
of:
f $ a-------------------------------------------------------------------------------------
11. Impact fees as shown on the attached schedule. -----------------------------------------------------------------
❑ V,�Cahfornia Department of Forestry plan approval/fees.---------------L---------------------------------------- �
Flood elevation certificate. ------ I ----------
❑ 14, Sanitation and plot plan approval Health Department.
❑ 15. City of Chico plumbing permit. ---------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs.
❑ 17. Planning approval for (A) Use: Q IC_ (B) Parking:
❑ 18. ntact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. -----------------------
El. ncroachment Permit for drivewayconstruction approval prior to occupancy) ------------------
( PP P P Y)• ----------
ftkPre -inspection for required. Request to Building Inspector on te)
021. Contractor's license information. (Number, Name Style, Classification). ------------------------------------
El 22. Worker's' Compensation carrier and policy number. -----------------------------------------------------------
❑23. Owner- Verification (Given to owner ❑, Mailed to owner ❑).--------------------------------------
❑ 24. Letter of signature authorization. ----------------------------------------- --
025. Recorded copy of Agricultural Acknowledgment Statement. -------------
❑26. Letter of intent on building use. -----------------------------------
❑27. Manufactured Home utility clearance. -----
028. Existing violations and/or expired permits.
❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $
ther:
en you issuee emit, o s o s ❑ Mail to owner,
Telephonef / and hod for pickup office. ❑ Deliver with inspector.
L/ APPht` Date: �3 -
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Pollution Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Departmen ❑ ttier: Date: By:
1. Index permit application for the above items numbered: ❑ Plan Check List
2. Additional items required: / �\
n actor esigner, owner, was advised of th above required data by one, ❑ mail, �A,13Uding°Division counter, byp-Z;0—Date: ,0.
on actor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, o'Building.Division counter, by Date:
Contractor, designer, owner, was advised of the above
gn required data by ❑ phonq\, o mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, w of the above r data by phone, ❑smail, ❑Building D, Ivv-i�s}"on counter, by Date: .
Plans reviewed by: c=%� Date: C9y�Plans approved by: �' : (J`— Date: o
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: ; ` l Date:
Yellow Copy - Department of Development Services, Building Division. t j
COUNTY 'OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7'County Center Drive a Oroville, California 95965 • Telephone (530) 538-7541 PERMIT No.
��,r 1 y96� APPUCATiON AND PERMIT -- �� dYq
sesaesoaamc�ra+ra�lt(_
aowa,�^1
BUILDING PERMIT
op+saVJ 1`�
Ck S
S
�`Q"0Na
SO. FT. OCC. BUIL 1170VALUATION
M-1 w 1 rc.��
i L,;D
«IAW i -e
l
-I�
UDOM rwim A000d"
Fireplace
Total Valuation =
Apce'wT°" 04=km
"°'
Filing Fee S
20.00
Permit Fee 1 =
p2
Aepst= an oronm►s warr+o woasa
Plan Checking Feet=
3 _
e"aa"0AD0"�
Energy Plan Checking Fee =
i
torwo eusoroec�rwrs
I ' 3i
►Acct wr
PERMIT FEE _
PLUMBING PERMIT Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF ❑ Duplex O hlobOehome P� Other
Solar or heat pump water heater
29.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
Now O Addition ❑ Remodel O L%Vee O Inst O other sk
Describe Work: �n ' \
Gas piping systern 1 -5 outlets
! 5.00
Buildin •ewer
1 s.o0
Mobile Home S G W
@20.00
PERMIT FEE =
S
ELECTRICAL PERMIT
Filing Fee 20.00
M 1
Main Service 001Lot
29.00
'PERMIT FEE PAID � �� � �
'SRA _ $
SHERIFF $
OTHER $
AMOUNT RECEIVED
�j
*RECEIPT NUMBER v\
* TO BE PUT INTO COMPUTER
Main Service tom To *wA I
4•.00
NEW C4004T. oweww occur. 3.Strt
Olt Aoora. a .ee. sue.
wwranro.' uvutiovnar @7.50
rowEta �v►AnTus
a
EX. Occu ounce ow PwrUm ewe p
o.rnrs. or♦
Ex. Occu ounF*s aro. u 5.00
Temporary Service 23.00
Moble Home Facilities 20.00
Msc. Wiring 23.00
PERMIT FEE :
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood e.so
Ventilation
PERMIT FEt S
Moble Home Installation Fee $
Energy Inspection Fee i
oce CONST. TTS TOT FE j
7
The permit Is hereby faaued under the applicable provisions
of the Butte County Code and/or Resolution• to do work
Indicated above for which fees have been paid.
By Date _----
PERMIT EXPIRES ON
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
't -r
OWNER / /HERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice 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.
Date Inspector Jr S
REV 110 2
PRE -INSPECTION REPORT
OWNER: �rau� � i s �- � � i cQ. � ��-s DATE: p
LOCATION:
CONTRACTOR:
PRE-INSPETION
DATE TO INSPECTOR:
Building Description: --
Electric
-
Commerci"sage:
Residential/# of Units:_
Currently Occupied 11� ,
t
AbandonedNacant r
Yes No Electric currently On Off
Condition of Electric
Gas:
Natural Propane None Currently On Off
Obvious Problems: /L n
Sanitation: t
Plumbing Working l�%C
Well Working! 5 Potable Water G
Obvious SewageProblems Al
-,- 0� Y7 -,I--p" r 4 c ke,
N
ACTION RECOMMENDED: ISSUE:
HOLD FOR.Ql,�i7�
..n..� ->
Inspector. '01,551 Date 0
r
Sketch buildings on reversb and indicate location on property
c�
1
'
�
.. �.
\e�-
_�
r '
"'COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT.SERVICES - BUILDING DIVISION
7 County.Center Drive a Orovillel California 95M ii Telephone (530) 538-7541 PERMIT NO.
(Rev,/2J'iIQ APPUCATION AND PERMIT
BUILDING PERMIT
ow"M CIS 1 ISO. FT. OCC. BUIL INt3 VALWITION
IIW 1 1� 1 -•e
tsioon 11111AAM 4000=8
-
Fireplace
Total Valuation S
4RCMffWf OR DOMME11
utast n0.
Firing Fee
i
20.00
4R4+ereer OR VOWS 11 wane 400at!141
Permit Fee f
i
Plan Checking Fee' $wqxi
3
0400me
Ener y Pian Chocking Fee
i
i
PERMIT FEE _
toTtla
eueorvsorriwus
�""`'� "'�
PLUMBING PERMIT
Flung Fee 20.00
SF O Duplex O
t USEOFSTRUCTURE
hbbdehome �X, Other.
~
Each Trap
7.00
Solar or heat pump water heater
29.00
Water piping
15.00
Each as water heater or vent
15.00
New O Addition
Describe Work:
TYPE OF WORK
O Remodel O L%W" O ineielation O Other C
A \
Gas pipintern i - 5 outlets
11S.00
Building sewer
15.00 '
Moble Home I S I G I W
®20.00
i v• + V r r PERMIT FEE s
ELECTRICAL PERMIT 1!!23.00
Fee
0
_ Main Service o. ttus'
Main Service ( 20" to root/ ) 40.00
*PERMIT FEE PAID
SRA
SHERIFF
OTHER
AMOUNT RECEIVED $
*RECEIPT NUMBER 4-79 �S
* TO BE PUT INTO COMPUTER
20.00 1
B Ex. Occuo. ( ouner oR nxn n 1 I I' a� +"2069se 1 i
w
Temporary Service 1 23.00
Mobile Home Faclities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Firing Fee 1 20.00
Heating
6.50
PERMIT FEE I S
r-Ewgy
Home Installation Fee t
Inspection Fee i
co- *r►c TOTAL FEE $ t�
RC Y► I (1000 I c01 I /;7ca. 1 r0 1flat
This permit Is hereby Imed under the appikable provisions
of the Butte County Code and/or Resolutions to do work
Indicated above for which fees have been paid.
By Date �—
PERMIT EXPIRES ON
([y�l
DAN EBY -71
40-26-77';;,.
9384 Lot d, DurhAm '
Permit#1386 P,E(util, MH) .1
ELEC
GAS �q 30 � C Z � •
r Z
n
- SUPPORT STRUCTURE
COMPACT '
ION TES EQ
Contr;- 40-26-77kC
Vrn StAvern, PAr+°ise
d '
_ Pe #17 86 WI y •�
Is ed
1
•
St' �
DAN EBY -71
40-26-77';;,.
9384 Lot d, DurhAm '
Permit#1386 P,E(util, MH) .1
ELEC
GAS �q 30 � C Z � •
r Z
n
- SUPPORT STRUCTURE
COMPACT '
ION TES EQ
Contr;- 40-26-77kC
Vrn StAvern, PAr+°ise
d '
_ Pe #17 86 WI y •�
Is ed
1
P1386-H6P.
PERMIT NO.
PERMIT EXPIRES—
DAN
XPIRES
OWNER
DAN STR'IEBY��
CONTR. owner
ASSESSOR PARCEL 40-26-77
LOCATION 9384 Lott Rd, Durham
OFFICE COPY
t
Address
GAS Dated
Meter BY
0-15
ELECTRI k Date,
Meter BY
a
1
I
Temp. Power Pole
Called PG&E
n
Temp. Elec. Service
Called P^O
Temp. Gas S
Called P
JOB FINALE
Signatur
= 0'K
0 = Not OK
— = Not Applicable MOBILEHOMES MISCELLANEOUS
* = Not Ready
Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1. Zoning Requirements—Setbacks—Easements
V. -.50-11s; Special MH Support—Sketch
_
2. Footings; Size—Depth—Spacing—Connectors
Sewer; Location—Test—Fall-C/0—Concrete
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
Water; Location—Test—Easement Needed (Sketch)
4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing
Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
GM; Location-Test—Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG
6. Carports; Windows—Doors
64"Utility clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBI OME INSTALLATION (Plans) OK except N's
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except #'s
Zo - g Requirements—Setbacks—Easements
1. Setbacks—Easements
ootings; Size—Spacing—Marriage Line
2. Soils: Compaction—Structure Stability
Ga"H Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
ctricity; MH Test—Crossovers—Breakers—Clearances
4. Elec.; Receptacles and Lighting; Distances—GFI
rai QMH Test—Fall—Flex Connector
5. Elec.; Pool Lighting; 15 volts—GFI
ater H Test—Regulator—Connector
7L.4,79er and Sewer Connected—C/0-to Grade—HD Approval
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
s and Electricity Tagged
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghig.
Boxes—Enclosures—Panel boards—Ins. to Main in Conduit
%its; Insp.—Sketch
1 Cert. of Occupancy
9. Health Department Approval
10, Plumb; Cir. Test—Water Supply Test
Card B-IXclf�Date
/0 Card -BI Date
Card -BI
Date Card -BI Date
Card B-1
Date Card -BI Date
Card -BI
Date Card -BI Date
T
0 = Not OK
= Not Applicable
�: = Not Ready RESIDENTIAL (Single and Duplex)
Date
UNDERFLOOR Plans OK except H's
Date
FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings
2.
Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Fig., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4.
Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
51.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
52.
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7.
Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
8.
D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9.
Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
Electric; Underground
-
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except N's
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI
Date
Date Card -BI Date
PLUMBING (Permit) OK except #'s
57.
Smoke Detector
14.
Water Ht.; Vent -Access -Combustion Air
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
Water Pipe; Test & Anchors -Nail Protection
___15..
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
_
17,
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
_
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
_
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
67.
Elec. Outlets & Receptacles at Kit. Counter
Garage Fire Door; Swing -Landing -Closer
Date
ELECTRICAL Perrr,it OK except q's
68.
A.C. Duct in Garage -Damper
--
20.
Fixture &Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
-
21.
22.
Elec, Receptacles Spacing -Lights & Switches at Doors
Size Boxes & No. of Conductors -Stapled
70.
Plb., Elec. & Mech. Equip. Listed for Location
23.
Romex Installed Close to Edge of Studs & C.J.
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
Insulation -Foam -Looked in Attic E] Yes
_
__28:;
25_ 2 Appliance Circuits in Kitchen &Conductor Size
26. Subfeed Wire Size_/ / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
27 Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated_ Neutral _,Yes ]No
Service -Riser Conductors & Ground -Main Disconnect
29. Equip. Clearances: Panels-Motors-Mech. Equip.
73.
Guard Rails & Deck Construction -Post Caps
74,
Fdn. Vents & Crawl !-tole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
75.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑Yes ❑No
76.
Stucco; Brown -Finish
77,
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
Card B -I
Card B -I
30.
Clothes Closet Light -Shower Light
-- -- --- -- -
-
Date _ Card -BI Date _
Date Card -BI Date
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
81.
Ventilation throughout House
82.
Glass Protection
Date
_
Card -BI
Card -BI
MECHANICAL (Permit) OK except N's
31. A.C. Ducts: Insulation & Support _
32. Vent -Fan: -Exhaust above Insulation _ _ _
33. Condensate Drain & Overflow; Size & Grade
34. Furnace -Vent Access -Comb. Air -Return Air Vent --115V outlet
35. Attic Access & Platform if Furnace in Attic
-
Date Card -BI _ Date _
Date Card -BI Date
83.
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
85.
Water & Sewer Connected -C/O to Grade -HD Approval
86,
Energy Compliance Certificate -Other Certificates
Card -BI
Card -BI
Date Card -BI Date
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRAMING(Plans) OK except p's
Comments at Final:
36.
37.
38.
39.
40.
Sills; Proper Material & Anchors _
Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof)
Fire Stops. Furred Ceilings -Stairs -Chases -Tub
41.
42.
43.
44.
45.
46.
47.
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -Connectors
Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
Fireplace Ties or Type A Flue -Fireplace Throat
Allic Access: Size & Romex Protection -Draft Stop -Ins. Baffles
Bdrm. Windows or Exiting Doors -Sill Hgl. & Dimensions
Garage Fire Protection Framing
(NOTE: An entry must be made each time you visit job site)
MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA — 534-4541
Address or location of mobilehome
Owner's name
Owner's address
Insignia or hud number
Manufacturer's name
Serial number of V.I.N.
PERMIT N0.
fficial Approving Installation)
Year of manufacture
(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
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville - Phone: 5344541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
r--
InspectorqX2—Date--7// 'Ioll S�T-
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected.. Please notify this office
when correction of work is completed. If you have any que tion pertaining to this
matter, or need additional explanation, please contact th s office immediately.
�-
Inspector
Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT
RECORDED IN OFFICIAL RECORDS
FOR RESIDENTIAL DEVEZOPNENT OF BUTTE COUNTY. CALIFORNIA
AT THE REOUESTOF
Section 26-8.1 of the Butte County Code requires this acknowledgement
-
I- d -1
be recor a prior to issuance of a buil ing permit.SG!®-17�
X986 JUN -- 5 ASI 9: 0
The property described herein is adjacent to land or included
within an area zoned for agricultural purposes, and residents of thiLSLEARQR KBECKtR
property may be subject to inconveniences or discomfort arising fromCLERK-RECORDER FEE
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, rz
smoke, noise, and odor. Butte County has established agricultural zones which have as a 6 z
priority use for productive agricultural purposes, and residents within said zones and on !!�®....
adjacent property should be prepared to accept such inconvenience or disconform from normal,
necessary farm operations..
All that real property situate in the County of Butte, State of California, described
as follows:
Date:
PROPERTY OWNERS:
AnJ
State of (_.G� ) On this the ? 7,e... day of-��L7���( , 19S6� , before
SS. me, the undersigned Notary Public p rsonally appeared
County \} r �,
rr
Personally known to me. d::7'Proved to me on the basis
of satisfactory evidence.
CAROL L.31RD q to be the person(s) whose names) subscribed to
Q =� NOTARY,PUBLIC-CALIFORNIAthe within instrument and .acknowledged that
...,
M
Butte County a executed the same for the purposes therein contained.
r?�• yCommissionExplrosSopt.18,1988 ® IN WITNESS WHEREOF, I hereunto set my hand and official seal.
4, -, L' e , __Z_ 4 �k _�� U
Notary Public
Present A. P. No. _'YO - 26-- 72
DESCRIPTION:.
t
h C t f Butte State
®:
All that certaig real property situate in t e oun.y o u ,
of California, described an follows:
PARCEL ONE:
Lot 22, as shown on that ce`ftain Map entitled,'"SUBDIVISIONAI PIAN OF THE
DURHAM STATE LAND SETTLEMENT, BEINGA PORTION OF THE.ES000N RANCHO,'SIIUAIEO
NEAR DURHAM BUTTE COUNT -V, CALIFORNIA", which Hap was filed in the Office of
the Recorder of Che County of Butte, State pf'California,.on September 17,
1918, in Book 8 of Maps,.st pages 16, 17 and 18..
EXCEPTING THEREFROM'the following parcel of lands
BEGINNING at.'the Southwest corner of said lot.22;'which point is the intersect-
ion or the. South line 'of said Lot with the centerline of. Oak Lane; thence
along said centerline North 43'.0' East 74.2 -feet; thence North Sl' 24' East
100 feet; thence North 61*24' East 100 .feet; thence North 43' 38' East 100
feet; thence North 28' 02' East 100 feet;'tlience leaving said centerline of
• Oak Lane South 3' 22' East 725.8 feet to the South line of said Lot 221
hence West 351.6 feet to the point of beginning.
ALSO EXCEPTING THEREFROM the Ea.terl77. 1159.26,feet thereof. (As measured
along the South line of said Lot 22.)
AL SO. EXCEPTING THEREFROM the North 320 feet.
PARCEL TWO:
A portion of Allotment-No.22, according to the Subdivision Plan of the
Durham State Land Settlement, recorded in the office of. the Recorder of ttie_.
County of Butte, State of California, on .Sept ember 17; 1918,..;;in Map Book -8,
at pages •16, 17,. snd 18, more" particuolry described a's' follo'voi"
BEGINNING it the Northwest corner of said Ahlotment No.;^'22 at the intersectiory
of the conte:line of the Durham-Oroville County Rosd)'jnd Oak -Lane; thence -
South along the centerline: of Oak Lane, a distence',gf'160.0 feet to a point;
thence Cast 160.77 feet to a point in the. West �ine�of that certain parcel of
land described in Deed from James 0. Strieby, let ux,.to Gus A. Gore, et ux,.
'recorded February 15, .1963, in Book 1227, at page. 591,' official Records -of -
Butte County; thence South along the'West line.of said Gus A. Core parcel$ a.
distance of 80.0 feet to the true point -of beginning" for the parcel herein
desc.ribed; thence from aai;d'true'point of beginning, continuing. South along
the West line of said Gua A. Gore parcel to,the Northeast corner of the
parcel of land described in Deed to James D..Strieby, et'u%.'recorded July ..
.17, 1961, in Book 1478, of Official Retords,,at page 6S1; thence West along
the North line of avid James D. Strieb'y parcel to the' Northwest corner of.
said parcel and the centerline of Oak Lane; thence North to Che' Southwest.
corner of the parcel of land described in Deed to James D. Strieby,-recorded
July' 17, 1967, in Book 1478, of Official Records, at page 632; thence East .
along.the South line of said Strieby parcel, a distance of 160.77 fast to floe'
true .point of beginning..
7'
ENDOf DOCUMENT
�& Gr0.y4MQs Wels
&on Hwq I!c-).`79
• y
t F
1 �.... h.a t
�tirh0.m...
A setback of 5 ft. f romihn. Ih lu i rl • ' `
property liines a d 'asetback
of 50ft. from the road
- centerline shall be clear of
structures or equipment ex;.6t
for a 2 ft. eave overhang!
Util y connecti ns shall be within
4 ft of the MOE ilel iome, either
dire tly behind x.vvithin the.rear
hal of the; i
A permit will required for the ��� g � Old r�'e'
6e
�ns#rill_ he mobileh
0'
���� �.
36'
h '
j
r
Materials & I�Vorkmanship Shall Ye M
with Rpre,--Practices ' ' ! Practiam
Aoetrdemce f � • '
a quality prescri� ^ Pd
use in
� i
the
Uniform Building, K" / _ "�l - -� -'
Ohs National Electricc;'
TITS no 6 and specifications MUST be
kep# on finejor at aA times and it is unlnw#ul +o y
make any c4ages or alterations on same without -
written permission from the Department of Public
iWorks, County of Butte.
iUi1
1 V'
iE ,
` WLDWG DEPARTMENT '
APPROVED
MH U� i
F
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California.95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
I
PERMIT NO.
ASSESSO PARCEL NUMBER
® _ ^�(� -.
ZO IN
-?
BUILDING PERMIT
OWNER
c.J
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
MAILING ADDRESS
OWNER'S MAILING
/3 i7 `V�✓
CONTRACTOR'SN ME
W
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
Ndrje—
UNKNOWN
I
Total Valuation is
FilingFee
$ 90
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
ENGINEER'S
LICENSE NO.
Plan Checking Fee
$ S, d0
Energy Plan Checking Fee
ARCHITECT ORMAILING ADDRESS
Penalty
$
BUILDING ADDRESS ))
�jr
D 40
Permit fee
$ , O
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex[]Mobilehome� Other SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home
0.00 ea 0,00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities &L Installation[—] Other ❑
Describe work: .r
Permit Fee
$ 10,60
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
1 OR
Main service 100 AMP ORSLESS
10.00 /Q, bo
Main service EA. ADD'L 100 AMP
2.50 2. SO
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑NON.RESI0
I am licensed under provisions of Chapt. 9, Div. 3 of the BuslneSS
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.,
hd ) hlCsgft
New CONSTAC
CONSTR. TBI.OUTLET
BRANCH CIRC ITS 2.50 ea
/POWER APPARATUS e
(SINGLE OUTLET CIR. I
/
Ex. Occup\OUTLETS OR FIXTURES 2AL030
eAL030
FIXED APPLNS. R
Ex. Occup. OUTLETS IIRESID,)EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00 %Sroo
Misc. Iyirin 15.00
9
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.
ETI,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
Hood
3.00
Ventilation
permit Fee
;
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
agaty in consequence of the granting of this perMiitt.
X in said Coun- Date s :( 8
Signature of AppIn, — 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 $
TOTAL PERMIT FEE $ 9 ZILS 0
occuP.
CONST.TYPc
F LO 0_91T
PARC
PD
HD 590E
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
B
P IT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
� d
- Date
Receipt No. s ra q 7
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMEfNT.OF, PUBLId WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIF6,' 95965 - TELEPHONE: 916/534-4541
a�
PERMIT APPLICATION DATA SHEET
Permit No
OWNER �qN si-A. P. No. 'r?�0 — aG- 77
Proposed Building Use M
Permit Fee Based Upon: Complete Contract PriceyDPW Valuation
Other (Explain)
Building Inspector i�J Date
S-/ -;t 7 �$ b
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. . . . . . . . . . .
3. Complete plans in duplicate/triplicate. . . . . . . . .
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ . . . . . .
69�
9. Letter of signature authorization. .
Sanitation approval from Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name ssty�, classif.)
4. Owner -Builder Verification (Given to owner& Mail to owner ❑,)�
15. Improvements may be required. . . . . . . . . . .
16. Mobi lehome Installation Data. . . . . . . . . .
17. Pre -Inspection for Required,
In request to (Datel
p q Building Inspector _
Recorded copy of Agricultural Acknowledgment Statement. _
. Other Driveway permit (const. approval required
Wh n you issue the permit, process as follows: Mail to owner. Mail to contractor. -
Telephone and hold for pickup at office. Deliver w/inspector,.
Other
Copy of plans sent Health Dept., Fire Dept., Other Date
During the plan checking process, the following data must be submitted prior to permit issuance:
(For required items not checked above a me f ap lic tion, ircle item.)
1. Index permit for above Items No. /.�1
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone Mail
By Date
Plans checked by z Date
Plans approved by Date2g soh
Other:
Copy—DPW
Other
Ye htia i h as
a ve�J' 2c
G
TO:. Building Department
FROM: Environmental Health, Chico
SUBJECT: Sanitation Clearance
Owner, Location AP#
Plan approved for: sewage disposal water supply L—�
Hold final.for: water supply
Final clearance O.K. for: water supply 4----
-V
' Clearance fo� _bed om mohi�homOther
Note***"
+ Sanitarian
Date
TO: Building Department
FROM: Driveway Permit Section
RF: Driveway Clearance
019-A/ ST2 i /S y
owner
Driveway permit 8 %
number
signature
38-� /--VT� &Z,
location
4d- z -
AP#
has been issued for the above property.
date _
AP #
OWNER JyI&I
PERMIT 9k
MH UTIL.CLEARANCE DATE %
INSPECTOR
ELECTRIC
ttAS
Support
Struc.
Compaction
Test eq.
iervice
iize
Other
Load
Tvpe
Pipe
Size
Len th
YES NO
YES NO
ta
s
V/, - COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCELAN BER
ZON G�
BUILDING PERMIT
OWIJEV
th)
TELEPH E
pa/ , "�.1, /
OO II 6T1�
SO. FT. OCC. BUILDING VALUA ION
O 8MAILIN V DDRESS �/� `
(�J( Y
CONT CTO 'S N ME
PFIONE
(n/
CO RA TOR'S I ING ADf�E S
`nro Ir 4 17 �
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
$ D
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 67 _12
Permit fee
$ no
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❑ MobilehomeOther
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00eF
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installations Other ❑
Describe work: _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 10.00
Main service 500V 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.
P `I
License No. ! 1 ® Classification C� i�
EJ 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)
❑ 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. C DWELLING OCCUP.ad ,
h¢sgft
New CONSTR.A
ULTBI.OUTLET
NON-RESID BRANCH CIRCUITS 2.50 ea
POWER APPARATUS tr
SINGLE OUTLET CIR. I
. 20 ® 500
ExOccu p OUTLETS OR FIXTURES IsALO 30
FIXED APLNS.
Ex. OCCUp. OUTLETS P(R ESID )REA.I 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. �yirin 15.00
g
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑Che permit is for $100.00 (valuation) or less.
have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
Xyn^� Date 6 _ LO - 9 C
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 height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ //)
OCCUP.
CO.ST.TYPE
I
IFLOODIPARCVLI
PD
I NO I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for whi h
DIRECTOR OF P BLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date — —el
Receipt No.
WHITE-O.P.W., YELLOW-ASSF350R, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMIENT,-_ PUBLIC WORKS - BUILDING DIVISION 1
7 COUNTY CENTER DRIVE - OROVILLE'a GALL -.&NIA 95965 - TELEPHONE: 916/34-4541 /
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER D� Yl sty';04IV A. P. No.
Proposed Building Use MY)
Permit Fee Based Upon: Complete Contract Price DPW Valuation
Building Inspector J//.r/"/ (./ /l Date 421421L'i62w
At time of permit application, I was advised the following data must be submitted prior to permit processing
and./or 'ssuance: DATE RECEIVED APPROVED
1. All items.have been submitted.
2., Plot plans in duplicate/triplicate. . . . . . . . . . .
3. Complete plans in duplicate/triplicate. . . . . . . . .
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans wrth Energy Design Compliance Statement. . . . . .
6. CUSD ''Fees Paid'' Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ j . . . . . . . .
9. Letter of signature authorization. . . . . . . .
10. Sanitation approval from Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no..,,name style, classif.)
14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ )
15. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . ..
• Pre-Inspec. request to (Date)
17. Pre -Inspection for Required- Building Inspector
18. Record d f A r'Itu al Acknowledgment Statement.
19. Other �RIWA�' PE�R�Ic T trConstruction approval required prior to occupancy)
Whe you issue theit r9cess as follows: Mail to owner. Mail to contractor.
Telephone -d � and hold for pickup at LZ office. Deliver w/inspector.
Other
Applicant Date jL 2 a' C
Copy of plans sent Health Dept., Fire Dept.,Other Date
During the pl
.nw"checking process, the following data must be submitted prior to permit issuance:
For required items not checked above at time of application, circle item-)
1. Index permit for above Items No.
2. Additional items required:
(Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other
Plans checked by
Plans approved b,
Other
Copy—DPW
By
0
Date --�-
Date _L2
Date
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS.
7 County Center Drive, Oroville, CA
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's Name: D 0.-V—
2. Installer's Name: 4y�,
3. Is the site currently under permit? Yes No FI
_ (If yes, furnish permit number 1 3 S'(. '" 8 C ) OR
Is the site an existing site? . Yes F] 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 r-1
(If no, clarify
5. What is the mobilehome electrical rating? --------------- to 0 Amps
6. What is the mobilehome site service rating? --------.---= 2 m Amps
1 -
7. What is the mobilehome site circuit breaker rating? ----- Amps
8. Is there any other electric load to be served by the
-
------------- ---------------
mobilehome site service. --- Yes No
(If yes, identify the load and size: _(Load) (Amps)
9. What is the mobilehome site gas pipe -size? -------------- 3/� (in.)
10. What is the type of as'service. -------------- Natural LPG
11. What is the gas pipe length from meter or tank to the
mobilehome?
--------------------------------------------- t.)
* 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.)
BUM COU
BUILDING DEPARTMEt,
APPROVED �a-
MOBILEHOME SUPPORT DATA
12 'other •than single wide,
Mobilehome Mfr. furnish Setup Model No. i-�d 2 — F Year /1f E -G
Width 4 (ft.) Box Length SG (ft.) Tagalong or Expando Size ft. x I ft.
On all mobilehomes manufactured after Oc7taber-7, 1973, furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
FOOTINGS (check one)ET. Wood -pressure treated or foundation grade. 2. Other (specify)
SUPPORTS (check one)�1. Concrete block. F1 2:. Other (specify)
tPier Footing Sizes and Locations
SINGLE -WIDE MULTI -WIDE
Main Beame—N\ —
.._ie 2 _ tine 2
Main Beams —
-- — — — — — -- =1.
Tag or Triple
Line 1 Piers:
Size-Min.-------------
Spacing-Max -
-----------Spacing-Max. ---------
From Ends -Max'. -------
Line 2 Piers -
Size -Min -------------
Spacing-Max.---------
Prom Ends -Max .-------
Line 3 Roof Loads:
Size -Min. ----------
Location (From Front)
Line 1 Openings:
Size -Min. ------------------ „x
Bach Side of Openings
With Width Over--------- '�
Line 3 Piers: (Under Bearing Wall Only)
Size -Min .------------------
u
Spacing -Max----------------
From Ends -Max --------------
IZ„x3b" .14"x.36" 34 ,k30 -1 3G„x 3o„ y„x3o„ Z`r„x3o„ iZ "x3oI, k
o - 0 7 - (�,- Y ” 32-'-o ” fo-.0 d 5G '-o „ ,
e % riers•
Size -Min. ------------
'k ”
Spacing -Max:-=-------
From Ends -Maio. =------ �_
Size -Min .------------------
Spacing -Max.--------------- r_ u
From Ends -Max .------------- '-
Line 5 Roof Loads:
Size -Min -------------
„x a ax a ux n „K
Location (From Front), -
Q
�1
0
AJ,
Q
�1
0
C<
r4
x
k7 A
V
Pl.-,INNING DIVISION—BUILDING PLAN APPROVAL.
n
Date:
1 G)
,--aar ing: _- Landscaping:
Ofly
CO
ZLL� /6 , � 1 � p'°• J
9)D
t y
k �� �. ff� 4
1
SLIsNic Prt:hs
6 FOUND P ane
OUTLINE
or NOBIU
WACH
j
V •�1j'
MAX TUBE HEIGHT i0l T&/g 11rALi+I<YitiLQ0 IATUALIMLOAD slowsidca ,
B' SHORT TUDE •y��ak '" y t ✓ 1Y17�% zon
14' LONG TUBE :z>
T`T" 2' D1A � .
_ /� SID PIPE �w .y..,yo-
BDL. T S V : i{ 31bp�tl n* a �Y �'T� Y" g 9 r'.. �.' .
1�1TIGHTEN 3/16,' PLATO. ✓�.:,'c. 4NO
..
Tp' 180 LLAHP ? ..: i
IN -POUNDS
e T .2. 'THt1DOW 11GNM3Mi IIHAU 88 CONil>rMT WITH R10OP U%% LOAD, WIND 1.OAA AND 45MW ZONE AS
3/4' THREADED 3/16' PLATE LEGS OTAX.*Mi%? *n&WWiiWA ifCLOCAI+A A
*vxmwTYP Or 4
RDD �, T=1l MDA'1"! 160MIMW TO CWW 1T M A MMAtXRN'i' M)NDATKIN.
MLK5/16' PLATE
4 f p p% 10* W JW4 LnAUNDWUMDCOHWVIK BOLL FOOTU" ARE
1 � An COAt!'ATU" YVil .LOCAL'lltlil.
i 5/e' X 1 1/4• 11a.7 CMC>iiLlflX Ili. eu
WITH HARDENEq WASHER' 3. �riiJClllitALB`rill: M
a UTALI, OOiNiNFORM TO MUNI AM IT • 34 KSI,MMtMUM. o �
N SEISMIC PIER Not to Sc.a 1 e D, mmil rm FA9�1CAT8D r�o�clw> ro .rl�u�ICATMS.
j C.P. SEISMIC PIER#] PATENT PENDING SEISMIC
N��
AUIAwaINC�iCA'r,0i c
1 i.;: ELI4C! iDt7DLrs id71D aMo
ii, IK �1'iirc : MM AM
1 1 Nf)TE iii. ANCHORamm.. AM AM,
iaOL'1E; ga (3_41wA{"Fid A4 9TAMW A325
160 IN -POUNDS IS EGUIVAL€NT TD 15 rT-POUNDS w. TI AD1i1DRQD OWEURAWNLOW CARBON WUDAilS r�M v i3 �
ALL.IwiBiAi.t7 iil ONl 1I1 DaNC u INO NAJU A SCUWS SM ARS TO 88 MOTI'FiCI M COA1 ED° C ig �
6. 7H8 PIER AM#IOQE=AM S11hMT Al SUOL M IIHAt.i: BS COA"1 W WrM $HE> MANI WMUAMS Z6i4tC2 OR � � V �
c' - 3/8' x 1' BOLTS $ AP?ItOVSD IIQUiVAlxt+il' AND KLALL 89 USMAND LAXII& i% BY C2II'flF1ED `T1at"1 M AND OONSUUTINO W
ES s"ViCSS (Cm to r4 i"Oi.�+i1KVINa U1u1C� .
I ' FIELD DR
OPTION ILL LOF
o LAT'UAL- 1700 b& MriX �..I
4 - 414 TEX STSGgaCH G k 131A0 "MAXCA u
OR J BEAM A FOUNIiATiQNi IS (4
y. THI
k* K.4rC +KN MANMAe UR o BUIU)ftio nOQ+InVIX70 WM 1+oNaMJMAL OR
{ j 04 x 3' CR,Dw JOINti . ,
1/4'x2'x4' -
Loi L+j ANGLE 3' WIDE PLATE
a• TMFOUNDATION ftm it DP,9iGM TO i9 CONSIRUL' M ON A FAIRLY LBVL. SITU WrM NO EXATINO 901L
sclerae 1'tER3
• FOUNDAPADON1 \ I ' ►RaOlii.J►�, IF i>3I"lrLN1tiT Oi t�tlE 7+a KTWt Roil, tt N17CE 1. .
4 1/2' _ R. IN AAEAfl wiMMI owpi Imnu sirrmameNT (D•r.) cAN . MMUFAG•TURSD t1Wt871 ii11A11. 118 ^p`
BOLTS SCISMIC IIBAfl;R.lA•X'ED ! D,>>k EXCJ1BDi 1M•., 09 WHIiN IT WW. MNVERRBLX AFPY�CT IMLWOF M03W; in
PIER . MANUFACTURW HIOIAL
E
OU7l1ilB
10. THIS RIfTIEW IS AMAF'I'AW TO STANUA" MX44W MASONRY HLOCK DIEM.
(W IdOBILE
C"CH W .
TYPICAL BEAM
SINGLE WIDE 'TYPICAL �
OR IS
CONNECTIONS '
.. 2044 . , 28 OR r.0
_ 1. nMFOUM MTWN I PAD SHOWN ON `1= FLAN W A P1iR,CUT CMCRET6 K"D ATM RAD• TW PLY WOW
LAN N O t to Scale
P011NAATION >rA1) I MAY H$ U� AN ALTSIINA'1$•
JOUBLE WIDE MOBILE COACH SINGLE WIDE MOBILE COACH
Scale: 1" . .10' scoie: 1" i 101• :' i r0uNOXI'OWt1'M1+MJii Atlas LAY•Dfwum, uNDtR'iVltBi mxL
le SD 41 Dv1RSIit Rti1-em"IMG
NOT£• AMD,rx t(J 11 IR��K+yT,: -
-:. — _ _
.�'.�'
STANDARD PIER .k PC!►T11Vt,'; 3PAClIJO � . . ,:. , . „... -- - ,-;
FOS? MORE THAN TRIPLE WIDE UNITS, SUBWIT - x ►
LAYOUT TO 7NARP .k ASSOC.,�YOR -APPROVAL.
PER 1i0BILE .1..NE HANUfMC'fURER'S _$' a 3W FAt AT
?i DAYS A$ YBFWL ATPD MANWAC'MIaMISY STAAt iY'ie wFJMff C0WDt8i'8. <
... ,, INSTALLATION MANUAL -. -
b. PitEFIIMIilIID1PADaItIBN1'ATi+Ott WHERB IIOSAiBU n THAT Ti1a LtWO DNU81NSION Oi' Tf1R PAD Std - -
;)TANDARD PIEN k I'0011?JC SPACING
PER 'MOBILE HOME HANUPACTURER'8
. � 11RlBripMX1.IBJ!T07tt6COACH b"� (AS SHOWN QN'tH8l1.AN')
INSTAUAT1ON MANUAL.
IHstar r = a WHBRB Fig" COQ S REtjUM PAD RWATION. NO 11"E nM NMY OF TW PAN IN A
a.o . r 1/41 rl a. 2 4 TUMISS IUNR CM RX 1110TATlu1 tl 0 THAT TO � 00901 ao� Of PAN ARTS IIAftAI�L 1'A
1W COACH OLM
4. _.
4W Wff= rt ! S.isD W. TUJpOEU, NU • QA M. M-100
L+- ---- 36 112, .
sir° >i 1 3:s• rtma
stomwEss sr(ej 1. • MAX15"LNINOTHIOFOR+ifILIIWIi 004" 6AFm. '
3.5' w1XtNIJAt 1JWTHI CP DODUa+u611 COACH • 70 MT.
1 • .J i x'
4.4-4.4 var
31. tA�tl.1lSi At1'RUY1dD � 8Y?HA#a'A�;Af/OC., PIS TD LID1Ki11 IISIIn1iT Nm' r0 iIJtL`B$Dr
L t !Sb'1i' PM *?I" *m C1pA+CNW
11. 101'1 M" Ma *WtMU W=COACHES .�
PRECAST CONCRETE. #Rnt>iI;TFOD3I'.20, i2 MW *=00ACH8t
FOUNDATION PAD .• Ka umWm1t Fouow �s�l' rA,-rslw As u�wN ONT1ua wwra moo" �U
SCALE: V = 1.5' J. WR ANDY COACH sUU O HBII THAN A$ OHO" ON TINS K -4N Oft 1teFUI!NCBD ABOVE, "M nU ANQ PAD - r-
IAYalf l' Ski" 291tt1~Yt8V W AM A"ROM BY DONAW M, '1li+W Ik ASSOCiATU 0% C�
00 `�►
3/4' F'LYW(3i1D SHE.t:IS
SCREWED 10GEIHER WITH
30'x32•x3/4 8 M8 x" 1 1/2' FHWS 1. 8?ACtN0 SHOWN O)N THX PLAN Alta FOUR COACHES WM 1011dCtI ANI) 13 WJJ Olt Il INCH PACO H (j
Pl. Y W [1[] D .: OORRu0AT1tD 14"
A ANY OTHRIt = INCH 1ANDSPAa OOr � �
Bk40 IS NOT TO CAN nUVU MOR13 THAN 6.0 M&T ON LWA UND OF UNIT
- SB111it1IC P'CBRR CANNO? R70G:R0 I'.
N
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SEISMIC PIER AND
FOUNDATION PAD `` eA
APPROVED
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FLEVATION,
IY Develc, r:.�ni ri1 OIAM XT
NOT TO'SCALE
Q17. Job 95-36
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f''A "FPAD pATE N•L # .559 53b6
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ALL.IwiBiAi.t7 iil ONl 1I1 DaNC u INO NAJU A SCUWS SM ARS TO 88 MOTI'FiCI M COA1 ED° C ig �
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sclerae 1'tER3
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OR IS
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LAN N O t to Scale
P011NAATION >rA1) I MAY H$ U� AN ALTSIINA'1$•
JOUBLE WIDE MOBILE COACH SINGLE WIDE MOBILE COACH
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le SD 41 Dv1RSIit Rti1-em"IMG
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LAYOUT TO 7NARP .k ASSOC.,�YOR -APPROVAL.
PER 1i0BILE .1..NE HANUfMC'fURER'S _$' a 3W FAt AT
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b. PitEFIIMIilIID1PADaItIBN1'ATi+Ott WHERB IIOSAiBU n THAT Ti1a LtWO DNU81NSION Oi' Tf1R PAD Std - -
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PER 'MOBILE HOME HANUPACTURER'8
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INSTAUAT1ON MANUAL.
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a.o . r 1/41 rl a. 2 4 TUMISS IUNR CM RX 1110TATlu1 tl 0 THAT TO � 00901 ao� Of PAN ARTS IIAftAI�L 1'A
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sir° >i 1 3:s• rtma
stomwEss sr(ej 1. • MAX15"LNINOTHIOFOR+ifILIIWIi 004" 6AFm. '
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1 • .J i x'
4.4-4.4 var
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IAYalf l' Ski" 291tt1~Yt8V W AM A"ROM BY DONAW M, '1li+W Ik ASSOCiATU 0% C�
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Pl. Y W [1[] D .: OORRu0AT1tD 14"
A ANY OTHRIt = INCH 1ANDSPAa OOr � �
Bk40 IS NOT TO CAN nUVU MOR13 THAN 6.0 M&T ON LWA UND OF UNIT
- SB111it1IC P'CBRR CANNO? R70G:R0 I'.
N
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I ICS• X C� 1Itr° 1. B. \ M X x . BEL= An $AMY COM V,MM Mul
SEISMIC PIER AND
FOUNDATION PAD `` eA
APPROVED
18'xi'4'x:3/4° x� �R %
PLL Y W UQ D Shane To CORP... � iG�'S NQ'TP�[i, hlo. Oft"Dow . OW007
y
pppvx K x ` + ArPROVALDONIS NOTAiTlHORth,: GF APPROYEANY �A CIij11. T
Ol► oft DB'VV0Xw Fk0M ItEQUiRF.MENIS OP :CW As ShownSTA7B {.Aws AND REGULATIONS CP�
FLEVATION,
IY Develc, r:.�ni ri1 OIAM XT
NOT TO'SCALE
Q17. Job 95-36
, T141A L a7 L Iti N A 'PIV l.� .P LY W r) t) 1)
f''A "FPAD pATE N•L # .559 53b6
M 1 .�i lllrgA M ,rY � 1��.'r�AL Of
SCAIL F, 1 X1.5
..°"-7-77
lfi� € ,� � • `� t ,.
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