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040-280-078
040-28 -078 01-0179r�5 ANDERSO�INSTALLATION &DIANE9207 STANURHAMy�OCONTR: D MOBILE HOP RM FND 040-280-0 01-0489 ANDERSON, ART DIANEhS 9207 STANFORD DURHA CONT: BARKER ELECTRIC tae e1 RELOCATE MAIN PANEL 4 � � r FIRE DAMAGE REPORT OWNER: r<SO�J , G' L � �. , DATE: 7 J �y LOCATION: a rJ c�f,�lh`P-C� rill �� : �� �' �'1/�c✓V� J A.P. # CONTRACTOR: DATE TO INSPECTOR: Building Description: Commercial/Usage:�� :Uif of Units. Currently Occupied AbandonedNacant Electric: Yes No Gas: Condition of Electric PERMIT HISTORY:( ) NONE 1. ZONING: Ig -115 (1)/S FOLLOWS: BUILDING INSPECT'OR'S REPORT Electric currently On Off Natural Propane None Y Currently On Off Obvious Problems: Sanitation: Plumbing Working C d Well Working Potable Water Obvious SewageProblems i r7 Description of Damaged Estimate Valuation of Damaged Area: Condition of Foundation: J Mobile Home: Co i n of UtMies: Inspector. Y Date Sketch building on reverse and trate area of damage. 6 W -4;� 96 - 6 7K :DF/BUTTE COUNTY FIRE INCIDENT LO ♦ ♦ New Incident FC -4O ❑ DATE OF FC -40 INC AGENCY INC # INC P# FC -40 COMP DATE I FC -40 COMP BY County Notifications 0 EARS Hard Copy Recieved 0 EARS Checked Agenst EARS Computer ❑ 4 DATE 0211512002 INCIDENT NUMBER 1703 LOGGED B TGC REPORT TIME 8:43 LOCAL FIRE NUMBE 10108 ant �ra� Fim RO HAILE STATE FI=R ��*-crA�w F.... !z BI CASE NUMBER MEDICS LOCATION 9207STANDORD LANE PRA N3 ECC ❑ RP AURTHER PHONE NUMBER 898-1184 ( REPORT METHO 911 WILDLAND FIRES ❑ ESTIMATED ACRES FIRE INFORMATION STRUCTURE FIRE FIRE INFO SENT HO EMAIL BY TO 4� OTHER (OUTBUILDINGS EC OTHER FIRE' I 7 -DAY LOGGED INITIALS IMM MEDICAL AIDS INCIDENT NAME STANFORD v PSAIOTHER START DATE 02/15120021 START TIME 8:30 HAZ MAT DIAMOND # 5.0 COMMENTS CAUSE POWER BARN LAND USE JELECTRICAL FARM/RANCH FIRE ACRES 0TYPE OF ACRES DIAMOND 5 ONLY $ DAMAGE TYPE ALL OTHER DOLLAR DAMAGE r 40000.00 SAVE 10000.00 INJURIES/FATALITIES ❑ # CIVILIAN INJURIES # CIVILIAN FATALITIES 0 EMD ❑ OES ❑ # FF INJURIE �l # FF FATALITIES FC -40 INFORMATION ♦ ♦ New Incident FC -4O ❑ DATE OF FC -40 INC AGENCY INC # INC P# FC -40 COMP DATE I FC -40 COMP BY County Notifications 0 EARS Hard Copy Recieved 0 EARS Checked Agenst EARS Computer ❑ 4 040-280.:078 01-0179 4i r7e� ANDERSO , THUR & DIANE 9207 STANFORD N,.pURHAMy�O a1 CONTR: D & A CONST MOBILE HOME INSTALLATION PERM FND 040-280-078 01-0489 ANDERSON, ART R* DIANE� 9207 STANFORD DURHAM "L�a CONT: BARKER ELECTRIC °I RELOCATE MAIN PANEL 11 Lm 040-280-078 01-0489 • ANDERSON, ARTHUR & DIANE 9207 STANFORD DURHAM CONT: BARKER ELECTRIC ` RELOCATE MAIN PANEL • 1 LL. • � t i E F { i . a } i OFFICE COPY n Address - '7a,, )LjeJ1;,4 dAllW AS -- — Meter By Date ELECTRIC Meter. By Date — 2 -61 ,e� 0. � COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION U 7 County Center Drive • Oroville, California '95965 • Telephone (530) 538-7541 PERK41T NO. (Rev. 12/96) APPLICATION AND PERMIT 'I t/ .� `t ASSESSOR PARCEL NUMBER 0-7Y ZONI"O -/v BUILDING PERMIT OWNER r I''1 % 41 Al e T/E�L.EPHOf;E 7l ` / 71 SO. FT. OCC. BUILDING VALUATION OWNERS MAIUNG ADDRESS 0 r .14AJ r CONTRACTOR'S NAME T�7� 7 Jo /1 Gni �f CONTRACTORS 06 V VNG 3 /' ( 1 15 2 / CONSTRUCTION LENDER Fireplace LENDERS MAIUNO ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS e a A d Energy Plan Checking Fee $ $ y� V_ JA Jr in cs�w+ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMITFlin g Fee 20.00 USEOFSTRUCTURE �� SF ' Duplex ❑ Mobilehome ❑ Other G3 SPECIFY Each Trap 7.00 Solar or heat um 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 El n Describe Work: /1' e 40 C O 'I /P"ee / / y rl.w e / AJt o Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W (P20.00 ` PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 a00V OR LESS Main Service 20.AORLEs, X23.00 3r T 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. —, `L- 7 License Class C �- I r Lic. No. fn � �- ( OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) FITcertify 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 f workers' compensation laws of California, and agree that if I should become subject to the compensation provisions of section 3700 of the Labor Code, I shall �foahwifh•comp1i'Wkh those provisions. jj��" X WU/!� /1 Dete Signature of Applicant ,.❑ Owne—r6L Contractor ❑ Agent An OSHA permiltis required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service 200ATO 1000A 46.00 NEW CONST. DWELINNiOcc. SO EL OR ADDNS. ( 6 ACC. BLDS3.50FT. NMfFRE81p, � MuLTI.OUTLET @7,50 POWER APPARATUS 8 SINGLE 011r1.ET CIR. sc ®1.00 Ex. Occup. OUTLET OR FIXTURES BAL S0 Ex. Occup. pig pip°� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 0��• PERMIT FEE S n MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HA2. D. FEES IMP FLOOD A 0workers' CDF 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. By Date 3 PERMIT EXPIRES ONZ- -� ata I ReceiptNo. 3 C y y X WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 001 - r., ---v «rte_. �.---^, ..�.-.-ti.-.r----.,.A--''w---y--�r+-� •ti.r-----w�..-..,.ti�.p �-..,v... ����.,.-r•�r��✓�..•�-vey�,rvv.....-�....�-.-..�� ..'1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION lv// 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND -PERMIT ASSESSOR PARCEL NUMBER 010 0 - 0-7 F ZONING A-10 BUILDING PERMIT ; ER TELEPHONE SO. FT. OCC. BUILDING VALUATION .OWNERS AAIUNG ADDRESS p . N AA,I CONI CTOR' e TELEPHONE 3y.2- `f ?Ofa CO RACTORS MAILING AD KESS a ax / e, C L,i 2 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 0 —7 S r Energy Plan Checking Fee $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF 0' Duplex O Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK / New ❑ Addition O nRemodel O Utilities O Installation ❑ Other H Describe Work: /p e- a �>° ejPna %N t/ % G �P_ D Q -✓ e— 1 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ sem 0l /71 ELECTRICAL PERMIT Fling Fee 20.00 OLES Main Service 2OOOV00AORR LESSS 23.00 3, 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 fu force and effect. .�/ / '-^-� ZJ / / !`.,.- / License Class I Lic. No. l "`«<hh ( OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, army employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is Issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) O'%ertify that in the performance of the work for which this permit is issued, I shallTOTAL 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 o wl Orn h thos provisions. n —� X I . ,� (/ Date �—1 Signature of Applibant - Ownertractor O Agent An OSHA permilis required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service zooA To ,000A 46.00 NEW CONST. DWEWNG OCCUP. 3.5Q�. ( NRA CONS . MULWTI-ourLEsT NON RESID. @7.50 POWER APPARATus 8 SINGLE OUrLEr CIR. 20 Ex, Occup.OUTLET OR FS(TURER g':00 Ex. Occup. ounsED R� ,DE„ 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 073, PERMIT FEE MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE FEE $ HAZ. I D. FEES IMP I F1.00D CDP PARCEL PD HD ISSUE This permit is hereby Issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON3 f 'L provisions to do work paid. % D 0 Z to Receipt No. :30C14/,Fff WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT M ❑ APPROVED CONDI'RONALLY APPROVED �.. ❑ RESOLVE PROBLEMS PRIOR Tp APPROVAr` PERMIT CLEARANCE •• Permit a:2-2- Genera/Inlbrmadon AP#: Q O -CMCJ'- JO owners Name: -A TUVe Parcel Acreage: S-A . Owners Address: 20 % t.� l�y i� H�1i..�, A 5 �� 3uilding Site Address: SCJ hr1 Prooertvinforn�aGion Permit Type: ❑ Agriculture Building ❑ Commercial ❑ Industrial Mobile Home ❑ 2nd Dwelling ❑ Muhl -Family >2 units per parcel ❑ Septic . ❑ Well '_cine District: Seneral Plan: Jse Permit: ?3rcel Is In: ❑ SM ❑ Resldentlal Aooessory ❑ Other - A-10- Zcnir. Ccde Date of Zoning Ordnance: Subdivision M an D� C-- Side 0 / Development Agreement: Variance: / S -`2.C) -.7 VH 2 To t -r? j � I 1 LD Side street Rear l HeiCh[ S /2C� APP2DVt�D land Conservation Agreement No ❑ Yes, check use Minimum Acreage: . Nitrate Action Plan No ❑ Yes Violation Area s® ® No ❑ Yes Specific Plan ❑ No Yes ❑ Chico J1 D2N ❑ Cohasset Enterprise Zone E No ❑ Yes, check use Floodplain ❑ No Yes Zone: A-0 Panel Number: Watershed Protection Zone No Yes ❑ 'rocosed Use Comclies With: ' General Plan 9 Zoning Irocosed Use Requires: ❑ Use Permit ❑ Minor Use Permit . - ❑ Administrative Permit commercial/Industrial/Multi-Family Ute• Parking: ❑ Panting Requirements are OK as Shown Landscaping: ❑ landscaping Requirements are OK as Shown Rcad and Orairage lmprovemerts Required: ❑ No ❑ Yes 'cclicabie Setbacks ❑ Other Other ❑ Accessory Buildng Use Zcnir. Ccde Street & Highways Fre Prevention Subdivision M an Front Side 0 / Side street Rear l HeiCh[ Iaaw D auoz Aq pojpn J az!s (awed paw of PPIL=o❑ (£Z abed slew jo LI 400B o0 JoPd paPJooa» sdew) a:)ueu!Pip I01 uDts.. P10 LAiM /4dwo:) ❑ '(I PPV auk IoVuoAeDuddd jaBaW a ion Iuawdo!anap PM an) M!uuad IOU s! sauti 40ftd ssoae uogonAsuco D •(uogM!dde Joh uo!swp bu!uueld aas) aouegdwo0 Jo aleoyq,a0 a u!gQ0 ❑ ata Joi !eAwdde jo suogpuoo jo 'ou uogpum tA!nn A!dwo0 ❑ Paa0 uogea13 aPNad D SSBOW !e5al lyuaq D !aged leSDI livap D ! Jed IDW aq 3snWIFLLUJu.!u: �• , �� :Ion 10 ale0 :RUO • MA ❑ oN D . :uopea p Paso -vi quepins Aunco Lw sWwo0 .. :: muieNpeoa'soA ❑ ON ❑ :mv Pouieiulew Apnvnd uo 85Vun+3 pWU Sok ❑ ON ❑ :P irfta ssav ler't :03uanjrd Paso SDA ❑ WJ ❑ :PaPMM SMOV 1&'! :uoAeao 10 ale0 SOA ❑ ON ❑ SPA ❑ oN ❑ SDA ❑ ON D OPW/Put'W*) ueld a5eu!eJp sols PM Pavu5m Pairam'a 4m!Puro aralvv dew m :M2M Iuauaopnao Puej :Mavaa Anwad Pm :m8M INLad DODS or INTER -DEPARTMENTAL MEMORANDUM BUILDING DIVISIO _ A FROM: ' - DATE: , OROVIL.LE ENVIR. HEALTH, CHICO RELEASE ENV HEALTH HOLD ON BUILDING FINAL FOR: OWNER NAME: % _i �a/i�/ SEPTIC: Z ---"WELL: AP#: ADDRESS/LOCATION: ��-�cU�-(c 'a '��� zwv Comments• GUmemos/creleasehold fioTFs Ls. ' t Y 1 0. �L-- _ THE 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 rr� INSPECTOR MUST RETRIEVE) (2) STATEMENT OF FACTS(ONLY ON NEW MH' S ) INSPECTOR TO VERIFY SERIAL & LABEL #'S ' RESIDgNTIAL • 040-280-078 01-0179 ANDERSON, ARTHUR & DIANE 9207 STANFORD LN., DURHAM CONTR: D & A CONST MOBILE HOME INSTALLATION PERM FND �r r 1 0. �L-- _ THE 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 rr� INSPECTOR MUST RETRIEVE) (2) STATEMENT OF FACTS(ONLY ON NEW MH' S ) INSPECTOR TO VERIFY SERIAL & LABEL #'S ' ISPECIAL CONDITIONS �A %, FLOOD CERTIFICATE REQ. Q FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDAR HOUSING LETTER ?'o. 52 lecd Elf -wino CHECKED BY r �p 1 30 111"b . i&3 7D Lq - I -LIZ JOB FINALED (Date) !�Q Signature • �A t t �r r ISPECIAL CONDITIONS �A %, FLOOD CERTIFICATE REQ. Q FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDAR HOUSING LETTER ?'o. 52 lecd Elf -wino CHECKED BY r �p 1 30 111"b . i&3 7D Lq - I -LIZ JOB FINALED (Date) !�Q Signature • �A /= 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.-/ P' 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/O -Sewer Test 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test "Anchors- Reg ulator-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 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 t 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 O Yes O No 31. Service -Riser Conductors & Ground Main Disconnect 32. Equip. Clearances Panels-Motors-Mech. Equip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector 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 'ingle & Duplex) Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on 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 -Botts 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 O Yes 82. Following Instld./Drive J Yes J No/Walks J Yes D 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: 0 = Not OK - = Not Applicable * = Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel 2. Soils; Special MH Support Sketch Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 3. Sewer; Location -Test -Fall -C/O -Concrete Wood Awn.; Posts- Beams- Rftrs.-Connectors Shthg.-Frg-Bracing 4. Water; Location -Test -Easement Needed (Sketch) Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete Carports; Windows -Doors 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /"L"ft./ /'LPG Electric 7. Well Clearance & Disconnect Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 8. Utility Clearance Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. 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 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 1. 4. Electricity; MH Test -Crossovers -Breakers -Clearances 2. 5. Drain; MH Test -Fall -Flex Connector 3. 6. Water; MH Test -Regulator -Connector 4. 7. Water and Sewer Connected -C/O to Grade -HD Approval 5. 8. Gas and Electricity Tagged 6. 9. Tie Downs -Type -Installation Cert. 7. 10. Exits; Insp.-Sketch 8. 11. Cert. of Occupancy 9. 12. Permanent Foundation Only; License Decal 10. Plumb.; Cir. Test -Water Supply Test Date Light Niche Card B-1 Date 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 FFMERAL EMERGENC`f MANAGEMENT AGEiNCY... . NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE O.M.B. No. 3067-0077 Expires July 31, 2002 Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATIONrlisurancmparijtsad ='_> BUILDING OWNER'S NAME n 1,4 BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. "Mparrykl K;ZNugi 2- 97 Si Nr= a L.a �. 'r� - _may �::- ; y , :y CITYp (, 2>�{iQ l`'1 CTATE CTS 93 S PROPERTY'DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etr-) ^ L4/,N --�o o►ei _,n -7Q, BUILDING USE (e g., Restdendal, Norrresidentlal, Addition, Accessory, ate. Use a. Comments are, if necessary.) .A.1 I r1 P i ,c' //1 /6-4 G - LATITUDEILONGITUDE (OPTIONAL) ( W - #iF - ##.#r or ##.# HORIZONTAL DATUM: SOURCE: LJ GPS (Type}: NAD 1927 L NAD 1983 LI USGS.Quad Map LI Other. SECTION 8 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 1 81. NFIP COMMUNITY NAME & COMMUNITY NUMBER I B2. COUNTY. NAME I I B3. STATE I B4, MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) DATE I EFFECTNE/REVISED DATE ZONE(S) (Zone ALO, use depth of flooding) XNUMBER 520 C 8 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 89. U FIS Profile FIRM " Community Determined L_1 Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: & NGVD 1929 LJ NAVD 1988 L f Other (Describe): 812 Is the building located in a Coas;aI Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? IJ Yes IX No Designation Date: WA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: j2,JConstrucdon Drawings* LJBuilding Under Construction* Finished Construction 'A new Elevation Certificate will be required when construction of the 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 SFE), VE, V1430, V (with SFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.a4 below according to the building diagram specified in Item C2_ State the datum used. If the datum is different tram the datum used forthe BFE in Section B, -convert the datum to that used forthe BFE. Show field measurements and datum conversion calculation. Use the space provided orthe Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum Corrversion/Comments Elevation reference marls used ✓`^- 8 Does the elevation 'reference mark used appear on the F No ❑ a) Top of bottom floor (induding basement or enclosure) 1 ✓�' 8 r-� ft(m) 9 b) Top of next higher door — ft (m) ❑ c) Bottom of lowest horizontal structural member (V zones only) — ft(m) c ��@ J�� Exp C•S•+ �� ❑ d) Attached garage (top of slab) — ft(m) E a C �' 6-3P-0 ❑ e) Lowest elevation of machinery and/or equipment m m Z;Ue 2 �: 303 servicing the building (Describe in a Comments area) Lowest adjacent (flnished) grade (LAG) 15 14y, Turn) Z2-9 \ rr ❑ g) Highest adjacent (finished) grade (HAG) - — ft(m) \ r ❑ h) No. of pemranent openings (flood vents) within 1 it above adjacent grade I /I >. CIV ❑ i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. crn) fi -\F SECTION D -SURVEYOR, ENGINEEF4 OR ARC�ITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the informadon in Sections A, B. and C on this cet6ficate renrese&s my best eftbrts to interpret the data available. 1 understand that anv false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. O{w / 3 -TITLE P2D � 5510 SIAL ��1�2b {� A c�tN� M.N4YKM /ls6csc.�.T� ADDRESS 136og7 AE4gat- L.IJ Cr`+i ^� Cf}� 95IM3 tila� �e 53o -3y2-171134/- fr " IMPORTANT: In these spaces, copy the corresponding Informpton *= tSecdon A. E suiaiicsi:Compeny BUILDING STREETADDRESS (Including Apt, Unit, Suite, andfor Bldg No.) OR P.O. ROUTE AND BOX NO. 'f�alliytiNUmberr r ' q 2 o7 5 221 451 CITY STATE ZIP CODE ,:CmpanlVArtCl�Eim15 SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community offtciai, (2) insurance agentfcompany, and (3) building owner. COMMENTS 1_1 Check hers if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOTREQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without 8FE), complete Items E1. through E4. 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 which 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. I I I fL(m) I I lin.(cm) (_ f above or U below (check one) the highest adjacent grade. (Use natural grade, if available.). E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is I I I fL(m) I I lin.(cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the communkys floodplain management ordinance? U Yes U No LJ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION T ne property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA -issued or community4ssued BFE), or Zone AO must sign here. The statements in Sections A, 8, C, and E are corset to the best of my knowledgm PROPERTY OWNERS OR OWNER'S AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS 1_I Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, 8, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. Lj 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 Lj A community official completed Section E for a building located in Zone A (without a FEMAnissued or community4ssued SFE) or Zone AO. G3. Lj The following information (Items G4 -G9) is provided for community floodplain management purposes. G7. This permit has been issued for. Ll New Construction " Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: _ ft(m) Datum: G9. SFE or (in Zone AO) depth,of flooding at the building site is: _ ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS 1_I Check here if attachments r COUNTY OF`BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7. County Center Drive • Oroville, California 95965 Y Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION ANUPERMIT el -&0f ASSESSOR PARCEL NUMBER 040-2k-078 ZONING A-10 BUILDING PERMIT OWNER ANDERSON ARTHUR AND DL4NE1320 TELEPHONE SO, FT, OCC. BUILDING VALUATION . OWNERS MAILING ADDRESS 9207 STANFORD LANE DURHAM r 71 280.00 CONTRACTORS NAME D AND ILA CONSTRUCTION TELEPHONE 533-9643 CONTRACTORS jlg(U4N� ADDRESS RIVER BLVD. DURHAM CA 95938 CONSTRUCTION LENDER LENDERS MAILING ADDRESS Fireplace Total Valuation $ 71.280.00 ARCHITECT OR ENGINEER LICENSENO. -Filing Fee $ 20.00 Permit Fee 513,50/2 $ 256.75 ARCHITECT OR ENGINEERS MAILING ADDRESS - Plan Checking Fee $ BUILDING ADDRESS 9207 STANFORD LANE DURHAM CA 95938 Energy Plan Checking Fee $ $ PERMIT FEE LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome 0 Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.0019-00 Each gas water heater or vent 15.00 TYPE OF WORK New J7 Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: MOBILE HOME INSTALLATION PERM. FOUNDATION Gas piping system 1 - 5 outlets 15.00 15 00 Building sewer 15.00 Mobile Home ISI GI W1 @20.00 PERMIT FEE $ 65.00 ELECTRICAL PERMIT Filing Fee 20.00 Main Service 0 E 200A OR LESS 23.00 3.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class C-4-1 Lic. No. L4 5 7 3 U OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. BLDS. SQ. 3.5¢FT. NEW CONST. MULTI.OUTLET NDN.RESID. 97.50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FD(TURES 200 1.00 BAL @ .50 LNS Ex. Occup. DUT FIXEDTS RESI6.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 0.00 Misc. Wiring 23.00 PERMIT FEE $ 63.00 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 in urance ca vier and policy number are: Carrier l Qti,. , i&- u� f MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number ! 'nAS7 O 1 09_ (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. a7 G' X _ Date , r " Q� Signature of pplican4 - ❑ Owner W Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 427.75 HAZ. D. FE IMP X FLOOD AO CDF `� PARCEL PD X HD X ISSUE X This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date f� I I � f PERMIT EXPIRES ON D De e ReceiptNo. 314529 /$83.00//314651/$344.75 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I� COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION =. 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT A/- x/79 ASSESSORP CELNUMSERZONIN _ a� BUILDING PERMIT OWNERPf r n, TELEPHONE SO. FT. OCC. BUILDING VALUATION OWN4S MAILING ADDRESS &M 5im rd Lp-rLL m qS 38 D CONTRACTOR'S NAMETELEPHONE 3-9641 CONTRACTORS MAILING ADDRESS 1740 Feather River Blvd. Oroville 95965 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee f $ ILDINGADDR-amESS n �c 7 (f L Energy Plan Checking Fee $ $ PERMIT FEE S , LOT NO. SUBDNMION'SNAME PARCEL MAP PLUMBING PERMIT Fling Fee .00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome IIA 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 Ilk Other ❑ Describe Work: m Gas piping system 1 - 5 outlets 15.00 6 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE _ &S, 06 I ELECTRICAL PERMIT Fling Fee 2C.00 OOOV OR LESS Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class _ C 4 7 Lic. No. 457364 O RENW BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. Xl 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 Atlantic Mutual Policy Number 400520192 (The above sections need not be completed 0 the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner XK Contractor ❑ Agent. An OSHA permit is required for excavations over 5'0° deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING UP. SO OR AODNS. ( 8 ACC. BLnS. 3.5¢FT. R° IDT' MULTI.OUTLET 97,50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. OCCU OUTLET OR FIXTURES SAL @ ';50 Ex. Occup. OFF'EE'A Aa oeA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 ,o� Misc. Wiring 23.00 PERMIT FEE $ 3 ' �b MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspegtion Fee $ Gcc TOTAL FEE $ CONNFE HA2.IMP D CDF pggC pD HD This permit is h issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. to Receipt No. ILI to WHITE-D.D.S.-B.D. CANARY-ASSESSO --PI-INSPECTOR GOLDENROD -APPLICANT y I E.H. USE�O�L—Y Plot Plan Aneched Floor Plan Attached Sent to TO: Building Department //\\ FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal !/ Water Supply: ' Public Private Well Clearance for dwelling. OSher ,4„ r-:z2ft Final clearance O.K. for: NOTE: Environmental Health Specialist 8/96 Date ;COUNTY OF BUTTE - DEPARTMENT,�OF DEVELOPMENT SERVICES - BUILDING DIVISION .� 7'COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 f, f PERMIT APPLICAT1101rDATA SHEET OWNER: 0��co),_5 t-.,-- ASSESSORPARCEL ER: D qn, �4 Proposed Building Use: �S L���,tt�, _ Building Inspector: Date: At time of permit application, I was advised the following data must b submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All iiems have been submitted -------------------------------- I -------------------------------------------------------- &10Z lot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 134. 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. --------------------------------------=--- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ----------------------------------------------- ❑ 8. Hazardous Material Form.------------------------------------------------------------- -------------------- ❑ 9. anufactured Home data and installation instructions including Tie Down Specifications. --------- ;of . pact fees as shown on tlie�attached schedule. ------------------------------------------------------- x 012. California Department of Forestry plan approvaUfees.---------------------------------------------- ❑ 13 . ood elevation certificate: -------------=-------------------------------------------------------------------------- '/ Sanitation and plot plan approval {�•�- / G OHealth Department. ------------------------------------------- o d ❑ 15. City of Chico plumbing perrnit- ----------------------------------------------------------------------------------- ❑ . Plot plan and business roval from the City of Biggs. -------------------- ---- --- --- -- 7. Planning approval f (A)/Use: (B) Parking: � s._ �J- I ~{ euelnp FOueiaerats--Hainag , arm. ----------------------- 019. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------- ❑2Q. Pre -inspection for required Request to Building Inspector on (Date) ❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ 022. Workers' Compeynsation carrier and policy number. ----------------------------------------------------------- 1123. Owner -Builder Verification (Given to owner ❑, Mailed to owner 11) - -------------------------------------- a---------------------------------------------------------------------- i 4 tter of signature authorizati\ on. --------=- `Yr � ecorded copy ,of Agricultural Acknowledgment Statement. -------------------------------------------------- 0 26. Letter of intent on building use`. ---------------------------------------------------------------------------------- 1127. Manufactured Home utility clearance. ------------------------------------------------- I Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .--------------- 030. -------------- ❑30. Other: Jl------- W�hen.you issue the permit process as follows C3 Mail to owner, ❑Mail to contractor.' QTelephone S 3-3- 14 3 r and hold for pickup at OdtQ J���office. ❑ Deliver with inspector r C9 ( Applicant: 4,ULLL%� UDate: Copy of Haz-Mat form sent o Health Departinent, ❑ Fire Department, o Air Pollution Date: By: Copy of plans sent ❑ Health Department, o Fire Department ❑ Other: ..By:, 1. Index permit application for the above items numbered: Cl Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by o phone, ❑ mail, o Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by o phone, o 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 ed of the aboveuired data by 1:1phone, o mail, ❑ Building,�Divi`si nn counter, by Date: Plans reviewed by: Dater •J� ' � Plans approved by: ^� "� Date: 1. 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) 538-7541 n _ _ SCHEDULE OF FEES DUEJ, OWNER (�y�" A.P. #0 PROOED BUILDING USE �-� C�/L�i DATE~�l RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --Balance Due ........................................................ $ --Additional Fees Due ............................................ $ --Additional Fees Due ............................................ $ Revised Plan Checking Fee ................................. $ ;2.. SCHOOL DISTRICT FEES aid at District Office) SHERIFF FEES (paid at Building Division) esidential.................................... x $360.00 = $ Units Commercial' (sq. ft.) ...................... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES Residential ............................ x = $ # Units Amt. Commercial (Sq. ft.) ............. x = $ Sq. ft. Amt. g --RECREATION DISTRICT FEES 446e%�— 9140-4f— 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. i " ,Q9 _ . , n Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original- Building Div. - 2nd Copy - Applicant 3rd Copy - Owner (Rev. 6/00) I " '-F.n—'-'I...�'._�Y�ro�•w m'�w:.r7f'n''y"�;d+v 5..( 'wP"'1tr` • - =it�tis y'"F`R-vin^-ss,�;,.+�"'FYI'"'.;.„., r COUNTY..OFF UTTE DEPARTMENT OF DEVELOPMENT4SERVICES -BUILDING DIVISION/-•• ^b 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 r SCHEDULE OF FEES DUE OWNER A.P. #a PROPO ED BUILDING USE W & ` 91-- AA DATE ii RECEIPT # DATE REC. C • 1. BUILDING PERMIT FEES $ � Cf Lf --Balance Due ...................................................... L --Additional Fees Due ............................. '.............. $ --Additional Fees Due ................... :........................ $ =Revised Plan Checking Fee ................................. $ ' 2. SCHOOL DISTRICT FEES t (paid at District Office) `� •�Qc'�ro , SHERIFF FEES (paid at Building Division)_' / D Residential .................................... x $360.00 = $ ,t Units Commercial (sq.:ft.) ...................... x $0.031= $ Sq: -ft..' 4- URBAN AREA`FEES ' t Residential':' .......................... / x t • Commercial (Sq. ft.) ............. x = $ Sq. ft. Amt. t 5:' RECREATION DISTRICT FEES 72A- (L 44*rx— 'Fet-5- G7! -t/ 0 6. THERMALITO DRAINAGE DISTRICT FEES l $510.00 (paid"at Building Division) r� 7. SRA FIRE INSPECTION AND PLAN CHECK $$9.00 (paid at Building Division) E f j 8. WATER TENDER,FEES (Battalion # ) y $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division 10. OTHER At time of permit application; .I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. � � t� r • 1 it r' j t I iti,! ... >��r '. r APPLICANT DATE Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from.the imposition of the above-mentioned items during which you may protest, The requirements for protest are specified in Government Code Section 66020(a). f Original - Building Div. 2nd Copy -Applicant 3rd Copy - O nety"(RiZ6/00) 1 February 5, 2001 Arthur and Diane Anderson 9207 Standford Lane Durham, CA 95938 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX Parcel Number: 040-280-078 Building Permit Number: 01-0179 This office reviewed building plans for the permit application referenced above. The plans examiner's comments are listed in Part I below. Please respond in writing to each comment in Part -I by completing and returning the enclosed PLAN REVIEW RESPONSE FORM. Indicate which detail, specification or calculation shows the requested information. Additional response information is included on the response form. Your complete and clear response will expedite the recheck and.approval of this project. If more than one party is responsible for plans, all party's must respond on the PLAN REVIEW RESPONSE FORM. PART -I Provide additional information and/or make revisions to plans, specifications and calculations as follows: Provide Planning Division approval for the use of this mobil home as ag worker housing. Building division will need ag worker's and owner's avidavit from the Planning Division. 2. finished floor of mobil is required to be located one foot above the base flood elevation which, to this case, is two feet above the lowest adjacent grade. Therefore the finish floor elevation is 157.8 not 157.4 shown on the elevation certificate. With the engineer's permission I will revise the certificate but his copy will also need to be revised. A post -construction elevation certificate will also be required. Plan check will continue upon receipt of all of the above items. Additional comments may be generated from your response above where the plan documents were incomplete, inconsistent or not adequate to depict code compliance.. If you wish to discuss any requirements, you may contact me at (530) 538-7541 between 1:00 P.M. and 4:00 P.M., Monday through Fridays. ,-PART-II ., 0 • The items identified below must be submitted prior to permit issuance. These items were noted at the time of permit application on the PERMIT APPLICATION DATA SHEET. 1. Complete and return your School Impact Fee form. 2. Complete and return your Park Impact Fee form 3. Provide Health Department Clearance. 4. Balance of building permit fees is $344.75 5.. Pay Sheriff fees of $360.00 Sincerely, Martha Whitney Plans Examiner cc: •D and A•. Construction 0 PRS 7ECT PROCESSING RFS :'ORD APPLICANT: OWNER: •. PERMIT #: A. P. WORK DESCRIPTION: DATE �,�y,.-�.,t..,,,.. `�'�+3"�"'+�u q'i`r.F"}"'i"yt`'81r:^?i^`4 r.S}St.'`tlWl�t�t�ii%1�+{kL�'►'+'�(^Mfi�,"«t'� BUTTE COUNTY PARK FACILITY FEE PAYMENT CERTIFICATION FORM DURHAM RECREATION AND PARK DISTRICT Assessor Parcel Number (s): Property Owner (s) : Project Location/Address: 1a 0 % S Subdivison Name: Type of Residential Development (check one): Assessable Square Footage:.. 13'z!0 U New Development Afteration/Addition Mobile Home (s) Non -Residential to Residential ,.,Comments: 2 rid �.. , S Building Di# on Represent ti �?-6.of Date Durham Recreation and Park District (DRPD) certifies that K chef l� . r'r-ee1 , 533 5(o`Y 3 Applicant Name Applicant Phone Number 1-740 ��eafhe� Rtve_.r -Blvd, Street Address OY-0 V 112, (J 95c/lo 6 City State Zip Code. has_comPlied with the requirem.e.nts of the Butte County Board .of Supervisors'. Resolution No:.: . 93 - 114 by payment for square feet at $ 1.04 per square foot for a total payment �U of$)a. s _ 9/o/ D PD Representative Date PAID BY CHECK No.: Remarks: BANK No.: 90_ 14 100 — /,;L � l PAID BY CASH: RECEIPT No.: y <` DISTRIBUTION: WHITE - APPLICANT PINK - DRPD YELLOW - BUTTE CO. BUILDING DIVISION t r 1w'�et �p;v�,�"e+`vRs?++,.���rsf„j,��{.� ,V+i.,�. I,...1(" s,',4.r^"S�Sfr��•�I'C J"� i`7:.,Y"t•rK .^. ^ ' -.. � BUTTE. COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per lI n School District ,• Ct %�i'�_ Building Department_ No. A.P: Number DC10 Jurisdiction: ' � City lCnunty t r� ^� i Property Owner A 1 `'t (,a u n ! (--- Property Location/Address C 7 67 S' g -z --II Janis -4,� l� /c in 1 �L 4-7-- Subdivision -7—_ Subdivision a Lot No. Residential Development Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to (Group R) i Units Installation Conversion Permit # ..................................................'(No.foundation inspection): Commercial/Industrial Sq. Footage New Addition (Including Exterior Roofed Areas) Building Department Representative Date r.. Irioor runs reviewea oy acnooi uistnct District Identification No. & // J/" - Du R 447h UN I F/ (_/) School District certifies that (Applicant) 9a07 .57 nf=o ff 44,V6 (Street Address) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. 00 by payment of $ representing Bozo square feet. AB 2926 $ FULL MITIGATION $ it T VAII School District Repre $ Remarks: Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written.protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is. notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls I10/99)dmm Q Environmental Health AGRICULTURAL AFFIDAVIT FEB - ) 2001 � Chico, CaliforniaEMPLOYER/EMPLOYEE Please read the following carefully before signing: Section 24-305.020 Agriculture Employer/ Employee FEB ) 5 2001 (Applicable only in zones A-5, A-10, A-15, A-20, A-40 and A-160phrvo, California An individual who verified, by personal affidavit and by affidavit of his employer, that he is, or will be, employed at least thirty-two (32) hours per week for at least sixteen (16) weeks per year, or that his primary source of annual income is, or is anticipated to be, derived from any of the following described occupations: (a) The preparation, care and treatment of farm land, pipelines or ditches, including leveling for agriculture purposes, plowing, discing and fertilizing 'the soil; (b) The sowing and planting of any agricultural or horticultural commodity; (c) The care of any agricultural or horticultural commodity. As used in this subdivision, "care" includes, but is not limited to, cultivation, irrigation, weed control, thinning, heating, pruning or tieing, fumigating, spraying and dusting; (d) The harvesting of any agricuiturai or horticultural commodity- inciuding, but not limited to, picking, cutting, threshing, field packing and placing in field containers or in the vehicle in which the commodity will be hauled on the farm or to the place of first processing; (e) The assembly and storage of any agricultural or horticultural commodity including but not limited to, loading, roadsiding, banking, stacking, binning and piling; (f) The raising, feeding and management of livestock, fur -bearing animals, bees, fish, frogs and other aquatic animals, including but not limited to, herding, housing, hatching, milking, shearing, handling eggs and extracting honey; (g) The operation, conservation, improvement or maintenance of such farm and its tools and equipment. This affidavit is valid only for the named employee. Any change of employee requires a new affidavit to be filed. Employer tax Signed: ', Dated: may be requested as emplo ment at a w RECEIVED FEB 2 2001 BUTTE COUNTY PLANNING DIVISION OROVILLE, CALIFORNIA ,�;�ra,�rr rfal Health FEB 1 5 2001 C�-co, Califomia AGRICULTURAL AFFIDAVIT EMPLOYEE Environmental Health FEB - 1 2001 Chico, California Employee Phone c� . gCt8 1 k?q Employee's Address (Present) 'P. O . -6bX1�6'f� U.r h am CC Cl'Eq'--,.F� Name of Property Owner rn-+V11nu _r �' D t -c Property Owner's Address Ian e- fur ham r Owner's Assessor's Parcel Number QLAC)- -C)gO- ul1 - ,�;�ra,�rr rfal Health FEB 1 5 2001 C�-co, Califomia AGRICULTURAL AFFIDAVIT EMPLOYEE Environmental Health FEB - 1 2001 Chico, California Employee Phone c� . gCt8 1 k?q Employee's Address (Present) 'P. O . -6bX1�6'f� U.r h am CC Cl'Eq'--,.F� Name of Property Owner rn-+V11nu _r �' D t -c Property Owner's Address Ian e- fur ham Owner's Assessor's Parcel Number QLAC)- -C)gO- ul1 - Parcel Size 5, Oo Ac.. do declare, subject to the penalty of perjury, that I am the employee of f UX' %Q nt NnJ eX'54F-n address (present) _Q`�)C-1 n-�ord 1 oLne- -i-N irham qcj-A3g and that 1 will be employee under Section 24-305.020 for at least thirty-two (32) hours per (a) to (g) week for at least sixteen (16) weeks per year on AP# ©t.lp - a �t - me Signed: Dated: 11 CD *************************************************************************************** Environmental Health Approval: Permit Description and Number Datelssued �1 Planning Approval: Date 2 11q o Zone - o Dwelling on AP# pyo- 2.8o - of e By Crop/Commodity Produced A,\„� o,, d s FA i Ufa; 4eaith 1 2001 AGRICULTURAL AFFIDAVIT r Callfomia EMPLOYER Environmental Health FEB - 1 2001 Chico, California Employer �011')&)S- -b\0.n e Qindef—,�:en Phone s3o - %g S - t\ 8 y Employer's Address Name of Property P rtY Owner vNonpk� L �) t Qrw— P.tit�O`QX'�Cl Property Owner's Address Owner's Assessor's Parcel Number ()c..j0 - ?0 - 07 $ Parcel Size S, o o Ac. I, hr�r �W—Qp % CAW- A f\AkJW . , do declare, subject to the penalty of perjury, that I am the employer of MCL( -Air me CbL address (present) gapl�� o� j.-C�n 0C ��� i and that I will be employer under Section 24-305.020 C. -I for at least thirty-two (32) hours per (a) to (g) week for at least sixteen (16) weeks per year on Signed:- FiM^ ated: rl r Dv Environmental Health Approval: Permit Description and Number Datelssued Planning Approval: Date ---2. Zone - t o Dwelling on AP# O 4 O- z 90- o ^( a By Crop/Commodity Produced p,1 V1^ o d s B4, MAP AND PANEL B5. SUFFIX FEBERAL. E—MERGENCY MANAGE1AE34T AGENC f O.M.S. No. 3067-0077 NATI®NAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Important-. Read the instructions on pages 1 - 7. EFFECTIVVREVISED DATE SECTION A - PROPERTY OWNER INFORMATION EorTi�iia BUILDING OWNER'S NAME Polli;}cNumts REriip Z/ BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX N0.oQipangriGNum CITYDy 2fiti4 J C A ATE CT 5 93 8 PROPERTY'DESCgIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 0 L/0 - 2,2Sa - a76 BUILDING USE (e g., Residerdial, Non-residential, AWN , Accessory, etc. Use a Comments are, if necessary;) Moe tL� . 01`12 ., LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: L__I GPS (Type): ##.#r or 1CMAD 1927 L__I NAD 1983 L_J USGS.Quad Map L1 Other. SECTION S - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2 COUNTY NAME B3 STATE B4, MAP AND PANEL B5. SUFFIX B8. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DA EFFECTIVVREVISED DATE ZONE(S) (Zone O, use depth of flooding) 0 C ! 8 B10. Indicate the source of tt a Base Flood Elevation (BFE) data or base flood depth entered in 89. LJ FIS Profile FIRM LJ Community Determined LJ Other (Describe): B11. Indicate the elevation datum used for the BRE in B9: & NGVD 1929 LJ NAVO 1988 I_1 Other (Describe): B12. Is the building Ionated in a Coaqal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Lj Yes JX No Designation Date: NIA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: jJConstruction Drawings' LBuilding Under Construction' �inished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Budding Diagram Number j(o (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 SIZE), VE, V1430, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.a4 below according to the building diagram specified in Item 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 forthe BFI=. 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/Commerits Elevation reference mark used Z�q r.JB Does the elevation reference mark used appear on the F No ❑ a) Top of bottom floor (including basement or enclosure) 1.58 r-� ft(m) ❑ b) Top of next higher floor � ❑ c) Bottom of lowest horizontal structural member (V zones only) _ lt(m) $3-2 Exp. ❑ d) Attached garage (top of slab) — ft(m) W CID s-30- ❑ e) Lowest elevation of machinery and/or equipment Z I t X303 servicing the building (Describe in a Comments area) ft(m) `j f) Lowest adjacent (finished) grade (LAG) 5 ft(m) z \ 7c ❑ g) Highest adjacent (finished) grade (HAG) _ t(m) ❑ h) No. of permanent openings (flood vents) within 1 tt above adjacent grade �q1, ` . j IY i ❑ i) Total area of ail permanent openings (flood vents) in C3.h sq. in. (sq. cm) F PA OF;Fq SECTION D -SURVEYOR, ENGINEER, ORARCj1ilITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation informatiom I certify that the kftmadon in Sections A, 8. and C on -this certificate represents my best effbrts to interpret the data avai/abla I understand that any false statement Tay be punishable by fine or imprisonment under- 18 U. S. Code, Section 1001. CERTIFIERS n.I'J, BA�MA . �C-1'S N/""EEto3 L=. F20ra 5510 ^lA L eA16/2p 13A c 1XrW % f7'r•?s��C.�,.fp ADDRESS 1-3 (p 7 p �f &�- I.ZIP C �CO Ci+� 9 S qz S %� /e 1 s3a-3y2-y%3� F IMPORTANT: In these spaces, copy the corresponding Infiornation from Section A. EccC:omparijtle<Y'_" BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. J?cI IVU 7b, 207 S eDE CITY STATE ZIP CODE yCiuopa w.gA=..Ntimti6r-,q Mn r D (� � 593 c`3Ate.>- SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. COMMENTS I_I Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WrTHOUT BFE) For Zone AO and Zone A (without SFE), complete Items E1, through E4. 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 which this certificate is being completed — see pages 6 and 7. If no diagram accurately represents the building, prouide a sketch or photograph.) E2 The top of the bottom floor (including basement or enclosure) of the building is. I I I ft(m) I I )in.(cm) Lj above or I_( below (check one) the highest adjacent grade. (Use natural grade, if available.) E3. For. Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is I I I ft(m) I I lin.(cm) above the highest adjacent grade. Complete Items C3.h and CW an front of forth. E4, For Zone AO only: if no flood depth number is available, is the top of the bottom floor elevated in accordance with the communitys floodplain management ordinance? LJ Yes LJ No U 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, C (Items C3.h and C3.i only), and E for Zone A (without a FEMArissued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are carred to the best of my knowledge_ PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATNE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS J-1 Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. "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 "A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued SFE) or Zone AO. G3. L j The following information (Items G4-Gg) is provided for community floodplain management purposes. PERMIT G5. DATE PERMIT ISSU ISSUED G7. This permit has been issued for. (J New Construction " Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: _ t(m) Datum: G9. SFE or (in Zone AO) depth -of flooding at the building site is: _ t(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS 1_1 Check here if attachments RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 26 -Apr -2001 2001-0017030 Has not been compared rith 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. ARTHUR C. ANDERSEN & DIANE MCCOY ANDERSEN REAL PROPERTY OWNER/LESSOR 9207 STANFORD LANE MAILING ADDRESS DURHAM, BUTTE, CA 95938 CITY COUNTY STATE ZIP SAME INSTALLATION MAILING ADDRESS. IF DIFFERENT CITY COUNTY STATE ZIP SAME UNIT OWNER (iralso 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 OROVILLE, BUTTE, CA 95965 CITY COUNTY STATE ZIP 01-0179 (530)538-7541 BUIL G ERMIT NO. TELEPHONE NUMBER ILI"4/20/01 StP14ATM OF LOCAL AGENC I IAL DATE NONE DEALER NAME (if not a dealer sale. write "NONE") NONE DEALER LICENSE NO. CHAMPION 2001 SOUTHWOOD MANUFACTURERS NAME DATE OF MANUFACTURE MODEL NAMUNUNMER 0901-524-12495A/B 24'X 56' FAD1304369/70 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A.P. #040-280-078 SEE ATTACHED HCD FORM 433(AI REV. 8/91 WHITE -County Recorder CANARY - HCD PINK -Applicant GOLDENROD -Building Dept. LEGAL DESCRIPTION A.P. #040-280-078 All that certain real property situate in the County of Butte, State of California, described as follows: PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JUNE 27, 1977, IN BOOK 62 OF MAPS, AT PAGE 27. EXCEPTING THEREFROM ALL MINERALS, OIL, GAS, GEOTHERMAL AND OTHER HYDROCARBON SUBSTANCES BELOW A DEPTH OF 100 FEET OF SAID REAL PROPERTY WITHOUT THE RIGHT OF SURFACE ENTRY, AS RESERVED IN GRANT DEED RECORDED DECEMBER 5, 1978, IN BOOK 2350, PAGE 365, OFFICIAL RECORDS. 4 'r. ~r n S:. '�.�!"".r {t:+.r,E, 4iP 4"a k3''%'ro,c'"`✓"� ;-mss. e` ` ri' . 9w*1 iH f mm i�ia3 s ins Nr %1A vC C,t ra S' �pi "'v4 °�' a 1114- Y4 -� BUILDING PERMIT NUMBER: 01-0179 Address or location of unit: 9207 STANFORD LANE, DURHAM, CA 95938 Legal Description of Real Property: A.P.#040-280-078 SEE ATTACHED '(x) Mobilehome/Manufactured Home OCommercial 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: ARTHUR C. ANDERSEN & DIANE MCCOY ANDERSEN Owner's address 9207 -STANFORD LANE, DURHAM, CA 95938 INSIGNIA OR HUD NUMBER: RAD1304369/70 SERIAL NUMBER OR V.I.N. 0901-524-12495A/B MANUFACTURER'S NAME: CHAMPION YEAR: 2001 OFFICIAL APPROVING INSTALLATION: DATE: 4/20/01 PHONE: (530) 538-7541 H.C.D. 513C „U I Dr,� STATE OF CALIFORNIA OUSINE55. TRANSPOATAnON AND HOUSING AGENCY NUMBER; CEPAITMENT OF MCU'.LVG A.`C COIAA LK—" DEVELOPMENT r� DIVISION OF t00l5'ANO STANOAROS A - MANUFACTUAEO HOUSING pRQCRAM MANUFACTURER CERTIFICATE OF ORIGIN I� CNE:CK IF TM(c R A OUPLIc TE SICO*0s7'R ORIGINAL NCO No bdaNUFn • REO HOME ORM _TI•UNIT IPANUFACTUREiTZQJSING L.Et SFO (SINGLE FANCILY DWELLING) ❑ MUMIA (MULTI-UN)T MANUFACTURED MOUSING yUMBER OF TRANSPORTABLE SEGTtOrlg �^ OCCUPAN& GROUP ANUFACTUAER NAIAE: i Charnpion FOme Builders CO. MANUFACTURER LI ENSE NUMBER: I.NUFACTUAER ADDRESS: _ 90086 reeq P.O. Box 423 :.lnd3dy CA 93247 SUGGESTEp RETAIL PRICE. !AMIUFACTURER T.C/+DE ruVdE; (Ci 1 (Stale Iol 53, 127 00 MOD L NAMZ ANDIOR NUMBER: JO:IfF�W00D DATE OF SMNUFACTURE; NAME OF LER OR TRANSFEREE foww RSHIP 7RgNSFERREO '01. 50524N2 12-19'00 Oupar And Angel, TnC. DSA/Integrity Homes, CALIF DEALER NUMBER OR TRANSFEREE DESIGNATION DATE OF ;R4N5F Inc. DEALER OR NSFEREE ADDRESS. I 91096 12-27-00 (slreeq -1740 Feather River Blvd. ' -NVeNTORY C --- NAME: ;C ov_li 0 (Stile) a %R65 Deutsche Financial Services INVENTURY 01TQRAD ESS: MARYVILLE CEJ. PRE DP.IVE - Si. LOUIS MO 63141-5832 (C1n1 _ (SIa(et fLal SEC^CN AIAYUPa�TURpA BER SEAML NUIK (1 bl NCO INSIGNIA 011000 kABEt. NUMBER -'- 1l HGF( 11NCNES? WIOTN WRIGHT IINCNESI (POuNos 1 0901-524-.124958 - i 2 0901-524-12495A - RAD1304370 672 140 21582 (, ra nod CJTTEc' f�-±• .r..e o ]'. n fi1G rGTZCG,Cti;Ta— r ~ r yr TMNSPORTER NAlM� �� D&RTans r � t TgAIISPORTEA AOORE$S: _. _.._ (sve.n P.O. Box 179 iT.;rhalr: CA OESTINAnnR AOR un/TOESCaaco.LOVE: icily] ISlare ---.95938 I cener rmaa. P~i at a",n -aa.1V 8.al JaSa.cC�IOTY 1Na _ --� aapq 4aI an � • .ro oo+.a 12-27-00. Lindsca iVlare, CA rc Ica_ tsu:cl SIGNATVAE OF AUTN0RI2ED.AGENT: O(STAIBUTIDN; OR1Gn+Al WINK) iONWARD TO THE MVENTORY CRECITOR. U S THERE IS NONE. MEN FORWAAD TO THE PURCHASER (OSALEA OR TgANSFenre) COPY I (WHITE 'ORWARO .O THE OE-AJirkgWT AT P 0. BOR 1920, SAGRANENTO. CA 93x12., COPY 2 (YELL" OELPAR 70 INE TRANSPORTER TO ACC04:PANY rNE UNIT TO ITS rA 25M 2-I &N 'A 'Hw FIVE (SI DAYS Ow AEL45E COPY 2 (00I.XNROO) TO BE RETAINED er THE MANUFACTURER {+CO 447.0. Stdo T • (719 T) 100'd 6000N 101d .40 80':1 i1HI)00.8Z 030 z'd ZEEEEbEOES S3610H A1I8931Wl e9j,c80 10 92 jdH Cw to t� b ��6rm STATE OF CALIFORNIA DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS REGISTRATION AND TITLING SECTION STATEMENT OF FACTS This unit is a: Mobilehome Commerical Coach Floating Home Truck Camper Decal (License) No. (s). Trade Name Sou. oo Serial No. (s) Ookb 1- fbaN, -i aH,PVS A -I 3 I/ We, the undersigned, hereby state that the unit described above: P _C V dd Affiant further agrees to indemnify and save harmless the Director of Housing and Community Development, -State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above- described unit in California, of from issuance of a California certificate of title covering the same. I / We certify under penalty of perjury that the foregoing is true and correct. Executed on A • pa a - at: Oroville ,California (Date) (City) (State) Signature of each affiant Printed name of each affiant (Michelle Freel, Office Manager Address 1740 Feather River Blvd. City Oroville , State California HCD 476.6 (Rev 11/86) 12/14/00. 09:2? BIDWELL TITLE CUSTOMER SERVICE 4 5305330125 NO.260 P005 R.00b.o tl Nfra RaNlsfeai d � yrrN nd. � Ceurtpanlr : . � S 8.18 g S O /... .r Order Nes �. V Lom No79 93-0189501 Rec Fee 5.00 WHEN RECOROEO MNL TO: I DOC 196.90 Recorded I Check 201.90 ARTIiUR C. ANDERSEN andOIfWE MC Y ANOEAg! OffLetal Records I County of 1 P-0) BOX 206 Butte 1 VANILTON CITY CA 95951 Candace J. Grubb• I Recorder I B:00ae 13 -flay -93 I NVTC VS 1 i MAIL TAX STATEMENTS TO: OOCUMMARY TRANSFER TAX:Sffi8Q Plyd ha aorxd ar wua a olauablvt OR SAME AS ABOVE Dollq� a, iM r011fNM90a s wr Im MM N umminma Ww Tib IM/��bIA_y�I /1. --ate- J�-I�bG 61904- d ddMrlll �0 AM$ -4kg kx - Finn ftl oao.�eo-Ota-000 _ GRANT DEEP FOR A VAIAPAU CONBfAERAT". rftto of whkh a WeM aeblp, edW, RICHARD DOUGLAS BRIGHAM, 0k an unman Ns NIRA, IIs hb "10 wid aeparab properly hor" WANT(% to ARTHUR C. ANDERSEN and DIANE MCCOV ANDERSEN, huabhrtd and wfh Ow f0d POP" 1" Vn CEY of U14CORPORATED AREA Of BIRTE of C ATA% do" PARCEL 1. AS SHOWN ON THAT CERTAIN PARCEL. MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, am dUNE 27, 1977, IN BOOK B2 OF MAP% AT PAGE 27. EXCEPTING THEREFROM ALL MINERALS, OIL, GAS, GEOTHERMAL AND OTHER HYDROCARBON SUBSTANCES BELOW A DEPTH OF 100 FEET OF SAID REAL. PROPERTY WITHW THE RIGHT OF �- SURFACE ENTRY, AS RESERVED IN GRANT DEED RECORD6.0 DECEMBER 5, 1978, IN BOOK 2M.PAGE W OFFICIAL RECORDS. ` DatedXMax A 190 at- . UMPJW 09 STATE OF CALWORMA QoUwn'CF BUTTE ► 011 h NIM TAMI SAILLOW Ppb bOm to ny W orawd b on 11a ear of lWkkdwy aafl.otj b be en Smola ailNm fwwq wm admbw to v* V" bwA" W ad a*ftwbcbsd b me and howsyllry *=Aid IN Maya b N"Atrh Wnoba akmoVfmo. ud oW PY M&t*A * abmIYl" all fM hub=" en Wm*) a dry w" UM bee d ~ Wi PMdl 6014 mmw tM M u tt WMRBa,nr h" and am" ad aw.aw au.: *Irai �iw i►v.. D /�rep,°ei Turn ��~ Y�� t >-4 cc W M > 11? nL O M cz w u' O Z O '1' _ �o o. V Lr) Z L Q � t�6 cz 00 ARTHUR & DIANE ANDERSEN 9207 STANFORD LANE DURHAM, CA 95938 •AP# 040-280-078 �vfi�cwf� pie�uirecf INSTALL MANUFACTURED HOME AS AG WORKER 24' x 56' dee a,�e Mood eleva ori Cea' Cad e, 5E�-rc�TM►K �6 , U �e �—�CsAb•M�TBR. doLa�O� �1C1517i�1� N • W E �Kd�E�AY Oq A ro E Southwood Opt Glamour Bath (Opt. P¢t"Widows Replace 1 a' Wddow) Model #524 1,283 Square feet 23'-4"x56'/54' Built By ScHampion HOME BUILDERS CO. Lindsay, California Opt Den 14'-3" (Replaces Bedroom a2) 'PRO , `sMO,BILEH ME INSTALLATION.TA r 1) Owners Name: r'�'{'1(,( (' �' D ► G YI2 (- to je_t� 2) Assessors Parcel Number: Q Li OR-) _ 0-1 3) Installers Name: INTEGRITY HOMES, INC. 4) Is the site currently under permit? Yes [ J No Permit No. 5) Is the site an existing site? Yes [?c] No[ ] (If yes, furnish two plot plans). 64P--CN-e_ Pg" LL 6) What is the electrical rating of the mobilehome? 100 Amperes. 7) What is the mobilehome site circuit breaker rating? 000 Amperes. 8) What is the electrical rating of -the mobilehome site? a 00 Amperes. 9) Is the main service remote from the mobilehome site? Yes [ ] No [ k] If it is, what is the rating? Amperes. 10) Is there any other electrical load to be served by the mobilehome site electric service (ie well, garage, etc.)? Yes [ 3c] No[ ] If yes, please identify the load and size: a) The mobilehome site: Load- W 40—L ( —Amperes- b) mperes-b) The main service: Load- Amperes - 11) Type of gas service at mobilehome site: Natural [ ] Propane [)d None[ j 12) Size of gas pipe at the mobilehome site from the meter or tank: 3/4". 13) What is the gas pipe length from the meter or tank to the mobilehome? &S- (ft.) 14) What is the mobilehome gas demand? B.T.U. * *(This information is not required if the pipe length is less than 6 feet on natural gas or less then 50 feet on propane). THE OTHER SIDE OF THIS FORM MUST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION A1RPPR0VF_:P_', u -a r - � r r�- .: u.•,MOBI LEHOMESI RPP0Rv T �DAT�A Mobile Manufacturer: C'lgarr I a►l Manufacture Year. o'?C)o I • If other then single wide, fumishSetup Model Number. 6"00-? Y Width: 5� T -f ftLength: a3 ftTagalong or Expando Size X On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets. FOOTINGS: Wood pressure treated or foundation grade [,c] Other: SUPPORTS: Concrete block [p] Other. _ Provide Tie Down Specifications for all Mobilehomes: Pier Footings Sizes and Location SINGLE WIDE MULTI WIDE Line 1 1 Line 2 Line 2 . Main Beanu Line2.........................................................................�... e 2 Line 1 Line 3 Line 2 ................................................................................................ Main Beams ................................................................................................ Line 2 Line 1 ............................................. e S Tag or Triple e 4 in 1 1 Line 1 Piers: Line 1 Openings Size minimum: I 1x[Size minimum:]XI I Spacing maximum: Each side of openings " From ends -max: with width over: " Line 2 Piers: Line 4 Piers: Size minimum:' Uhl x W Size minimum:]XI I Spacing maximum: I$ v Spacing maximum: " From ends -max: F ;rYO " From ends -max: " Line 3 Roof Loads: Size minimum Location (from rear): Line 5 Roof Loads: Size minimum Location (from rear): ,WjVG AlIp,4. �� 0 C= CL: nJtu et 51D[h8ll � I -OCMI • I-11EMI e SIM1116 tlhC I I-6EAN , I-e[M4 • 5111WLI t S•: 5'-11' J 16'-p• 6' s 114•. fir:ne. .rr e„I. 1a -n 1r4• I -451rD••�-••45M-------r-49/1580-•--t----'•4598-t'--- ._4988-.-.---.-r•-45dd------<.-- 4 5p--wJ —• ! 23'-6 lea• �1 _•'��,. n -1588••--'•4588---"-- -4508-----�-1588-. .-t-----_-..1588-s.---•--•-4588-----'- --4508--'---"�._--- .l ------------.--J4Ad---------------31854-------------------- -�-- r 45":.10V-------4588•-r---�. •-1`diB•-t- -!---1589-•'�--•-'---4988------�-4'BB--•---�� -45N- -- f 1 23'-e u8 i Y + �-1588-4=-Ad-•---'---4588--�-'•--t--•--1=-A9•---•-•-1599-•j--•-_---4508-•----•-•-a---4508-•-----�L— I L_J�_J �_J r—tet _r-- t_J L —1-651111— -1 .. ..__.___.__. ___..__. ___—___—_.1 l I—J L--- 1e' -z 3rei l E{'-2 SlbS NPIbN HOME BUILDERS CO, IOIEi 0 PRLH AYE, P.O. 807( 429, LINEM, CA 9324 - PW plr/.Et4tf CORAL MOTES 1. flit Flit lee leen raltelsted .ith a 28 p".d reel lead. Y. All I-eltn piers Feet • Alms. tpaclry or 96 intlet ole .ith end plcrt 14uted ae mre till 2-tl fren each end of tit I-0een. 3. Sta Ital Utrl. MA -111 tyle 14, 15 and 16 it' Fig' art l4er at ivnt. 1. AI nLernatt [tmio at faeetstr4t end tie tett nntrastiae nil it used it lieu 0 the Chatplon IMlalltlla.t Yena1 pre.ite/ tit neliiJ hat I: at bsipsd std ttenjtA lY A registered Architect or Eylaerr alt tet tntWJ melt local eelfer elect Ivi U:y gran. 5. All dirtmiont lakan Fran sur 4J1; 41' flnr. Nu4nuoaa I—��_��� — Curtis Id8• = 1'-0• flu F-2 N-17 PIER FOUNDATION FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION For. Insurance-Companjr, Use B ILDING OW E1V'S NAJ�AE :policy, -Number : ' ;. > ; ., : ; + ° ;•; ;- �L� RCI BUILDING STRtE i AD ESS (Including Apt., Unit, SQrte, and/or Bid . No.) OR P.O. ROUTE AND BOX NO. Company: MAIC Wumber 3-10-7 S`24zVA--:'o L -4 -- CITY CITY rA E DUJ11-4AA1 ZIP P 4 E 8 PAP- TY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Ig 01117- 0 -o71:�N BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) L�btU l La '410 LATITUDE/LONGITUDE (OPTIONAL) �/ HORIZONTAL DATUM: SOURCE:GPS (Type): ( ##*-#V -##.W or ##.� 11`1'(1 NAD 1927 LI NAD 1983 k USGS Quad Map U Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITYME 8 COMMUNITY NUMBER B2. COUNTY NAME B3. STATE C ("0C, *7 e-a-/C.G5ZO Ui e v0 r' CA B4. MAP AND PANEL 85. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD 89. BASE FLOOD ELEVATIONS) ,,NUMBER aDATF n I EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) U ! –1 2 B10. Indicate the source of t(ie Base Flood Elevation (BFE) data or base flood depth entered in B9. U FIS Profile FIRM " Community Determined . L Other (Describe): B11. Indicate the elevation datum used for the BFE in B90 NGVD 1929 LJ NAVD 1988 U Other (Describe): B12. Is the building located in a Coa��I Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? LJ Yes No Designation Date: AYA SECTION.0 - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: Construction Drawings* LJBuilding Under Construction* "Finished Construction *A new Elevation Certificate will be required when construction of the 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, V1430, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.a-i below according to the building diagram specified in Item 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 forthe 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 mark used M .5 g Does the elevation reference m1rk used appear on the LJ No ❑ a) Top of bottom floor (including basement or enclosure) 157'90 115/7 fL(m) Q 9 ❑ b) Top of next higher floor ?e G� �'� _ fL(m) H O ❑ c) Bottom of lowest horizontal structural member (V zones only) _ ft.(m) �Q� �� W SAC A, e- ❑ d) Attached garage (top of slab)_ ft.(m) v Exl?- '-I G� ❑ e) Lowest elevation of machinery and/or equipment y tl l 7 Z servicing the building (Describe in a Comments area.)_ ft.(m) g 4 W N 168 V Z m ❑ f) Lowest adjacent (finished) grade (LAG). % 5 ft.(m) z' N ,t ❑ g) Highest adjacent (finished) grade (HAG) _ ft.(m) Q. 13h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade CJP4 CIV0. ��� ❑ i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm) F n p r at A SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify 'el'evat6-6;in rmation. 4 14 I certify that the information in Sections A, 8, and C on this certifrcate represents my best efforts to,interpnst_ the data available. I understand that an false statement may be ' "r ii" " y y punishable by fine or imprisonment under. 18 U.S. Code. "Seclldrr 1001®twvx �9�t F -51 )A L 5l10 ��YQ/L �:VM NY NA 103 Q " i ,Q 4,-JSSoC. r I—a titer ezp• t co DATE TELEPHONE '�. 5,2�� 53�-3yz-y�6 IMPORTANT:.,In these spaces, copy the corresponding information from Section A. For Insurance.Company Use::; BUILDI STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. ;;Polley Number:.:': �0 `7 s % A /Y 9-6 � C - - CITY � CA � „ZIP�O�,-Company.,NA1CNumber`�:�,�..-; 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 - 1-1 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 E4. 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 which 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. I I I fL(m) I I lin.(cm) LJ above or U below (check one) the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is LLI ft(m) I I lin.(cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form. E4. For Zone AO only. If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? LJ Yes LI No LJ 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, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community4ssued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best Toff my knowledge. PROPERTY 2TN 0 E?'S r�OWNMAUTHORIZEDgAo�P��E-% W_ 'S NAME /7 S =:,A I /1Y1./RCJJ 7-0 -7- S IV URP 41 D;)ZHA C "ATE IP CO 415 IF a NATURE/ /� D DATE TELEPHONE�� �A1 D (A., t I YA? k i 1 w b �.' i__ I.- /_7 _ t'. i _P4 7- J I Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable dem(s) and sign below. G1. U 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. "A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. U The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBERI G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for. L New Construction LI Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: _ ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE��� DATE ati 1-1 Check here if attachments / ENVIROWENTAL-IfALTH e� pG� , s\ wa DEC 2'� 2000 Chico, Califomia So uthwoo-d A Oiv(slon of Champion Hage SLCdem Co. - Undtay. C.-W=ia J Or 40 � Room _ Bdmt �3 I F 5'• Master Bd m 'WngRoom 6dm2 16-C 14-3" • i r• CAPP x ButteNOV�O � Env!Fonmel al h W%W6 Orc cLvnocx Bath Opt Dcn c I • Model #524 1.283 Std =Feet 33'-4'x54'/S6' 600 OCCOhl 70C 400'n9t 35 'an ENVIRONMEWALHEALT14 DEC 21 ago Chico, CaIWOM'a APPROVED Butte County Envimnn*ml 149Wth li� 7 IWM�9-2 07 5-C (RAS V) /) '30,4LE AGRICULTURAL AFFIDAVIT EMPLOYER/EMPLOYEE Please read the following carefully before signing: Environmental Health FEB - 12001 Chico, Califomia ifti�u. j i"emsafth FEB 15 2001 Section 24-305.020 Agriculture Employer/Employee (Applicable only in zones A-5, A-10, A-15, A-20, A-40 and A-160phIoo, Califomia An individual who verified, by personal affidavit and by affidavit of his employer, that he is, or will be, employed at least thirty-two (32) hours per week for at least sixteen (16). weeks per year, or that his primary source of annual income is, or is anticipated to be, derived from any of the following described occupations: (a) The preparation, care and treatment of farm land, pipelines or ditches, including leveling for agriculture purposes, plowing, discing and fertilizing the soil; (b) The sowing and planting of any agricultural or horticultural commodity; (c) The care of any agricultural or horticultural commodity. As used in this subdivision, care Includes, but is not limited to, cultivation, irrigation, weed control, thinning, heating, pruning or tieing, fumigating, spraying and dusting; (d) .The harvesting of any agricultural or horticultural commodity including, but not limited to, picking, cutting, threshing, field packing and placing in field containers or in the vehicle in which the commodity will be hauled on the farm or to the place of first processing; (e) The assembly and storage of any agricultural or horticultural commodity including but not limited to, loading, roadsiding, banking, stacking, binning and piling; (f) The raising, feeding and management of livestock, fur -bearing animals, bees, fish, frogs and other aquatic animals, including but not limited to, herding, housing, hatching, milking, shearing, handling eggs and extracting honey; (g) The operation, conservation, improvement or maintenance of such farm and its tools and equipment. This affidavit is valid only for the named employee. Any change of employee requires a new affidavit to be filed. Employer tax Signed: Dated: may be requested as proo of emplo ment at RECEIVED FEB 2 2001 BUTTE COUNTY PLANNING DIVISION OROVILLE, CALIFORNIA 77 Health AGRICULTURAL AFFIDAVIT FEB 1 5 2001 Ch;c,o, Califomia EMPLOYEE Environmental Health FEB - 12001 Chico, Califomia Employee mo -C -k n (Y1C. CUUU Phone �� • g�1� I l8y Employee's Address (Present) '�P O - -;F�,bX �b'f� u r h Qnn cc,_ q��g Name of Property Owner 4={ C`7j1ht a r �' _ L) k 0 Property Owner's Address g2ko-1 (acyl (- n P I uo hQm a q5Hffi Owner's Assessor's Parcel Number nLAp - 01 g Parcel Size Oo Ac._ 11 ma -V- (1 ' "C L j , do declare, subject to the penalty of perjury, that I am the employee of R('iln r f la, n , PwiJeXse�n address (present) Qc)0-1n�c 1.�r1P �rhQm q 8 and that I will be employee under Section 24-305.020 for at least thirty-two (32) hours per (a) to (g) week for at least sixteen (16) weeks per year on AP# ©LAO - of 2C) - 6l8 Signed: Dated. *************************************************************************************** Environmental Health Approval: Permit Description and Number Datelssued �* V Planning Approval: Date 2 1 o Zone A, -\o Dwelling on AP# o y o- 2..8o - ori 8 M Crop/Commodity Produced A�,,,,� ord s r � �v 1 ' • Health AGRICULTURAL AFFIDAVIT FEB 1 5 2001 Ch;c,o, Califomia EMPLOYEE Environmental Health FEB - 12001 Chico, Califomia Employee mo -C -k n (Y1C. CUUU Phone �� • g�1� I l8y Employee's Address (Present) '�P O - -;F�,bX �b'f� u r h Qnn cc,_ q��g Name of Property Owner 4={ C`7j1ht a r �' _ L) k 0 Property Owner's Address g2ko-1 (acyl (- n P I uo hQm a q5Hffi Owner's Assessor's Parcel Number nLAp - 01 g Parcel Size Oo Ac._ 11 ma -V- (1 ' "C L j , do declare, subject to the penalty of perjury, that I am the employee of R('iln r f la, n , PwiJeXse�n address (present) Qc)0-1n�c 1.�r1P �rhQm q 8 and that I will be employee under Section 24-305.020 for at least thirty-two (32) hours per (a) to (g) week for at least sixteen (16) weeks per year on AP# ©LAO - of 2C) - 6l8 Signed: Dated. *************************************************************************************** Environmental Health Approval: Permit Description and Number Datelssued �* V Planning Approval: Date 2 1 o Zone A, -\o Dwelling on AP# o y o- 2..8o - ori 8 M Crop/Commodity Produced A�,,,,� ord s Environmental Health `' tai �eatth FEB - 1 2001 t 5 2001 AGRICULTURAL AFFIDAVIT Chico, California California EMPLOYER Employer �r~�\l.C' �0.C\e lc�e� .1'l Phone S3o-%Qg-k\8y Employer's Address �`�"� f .�n�c a ZALr 1\Q-rn �jCjm Name of Property Owner C Property Owner's Address q�,p-1 fin( - ed � uc ham - � q5q� Owner's Assessor's Parcel Number f)(4 O - 9 80 - 07 3 Parcel Size S, o o Ac. do declare, subject to the penalty of perjury, that I am the employer of address (present) 920-1 c�-} Lr\ -C J �-�fl ,� 0, -jn� LOOLA and that I will be employer under Section 24-305.020 C." for at least thirty-two (32) hours per (a) to (g) week for at least sixteen (16) weeks per ye -'sr on r s.AW4MIN= Signed: *************************************************************************************** Environmental Health Approval: Permit Description and Number Datelssued Planning Approval: Date -Iztqlnl Zone A-(0 Dwelling on AP# pyo -'Z 9c) -0,1S By Crop/Commodity Produced 4, ..09/13/2000 05:20 .3835207 c rn ►�� AZ �' _ � ._ .0 x T 5�ci S >> y ABESM. I 2A.. i I` 112 �7 r x�L' A ��O Q�y r--• � a � � • og b 1r{Al( 3( y 1 'c 5N `cg �'0� �"g- =KA. ex Q00 In. ma 0 a a 0 e , , cc cc 0- ui0 iii rj..�5.. �. ... .. �} r�J) ✓ 09/13/2000 05:20 3835207 ABESCO PAGE 03, o t � A {� r . (7,11_• rn u ni U 5 Jr ..vv I b " rn Fa O � aam �Nm oso ANm V'r, ).� IA IA pay a g o °0 a ISM •� • �- w CL 0 a cc All