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HomeMy WebLinkAbout042-090-046COMPL:AINT TO INSPECTOR 10A -2-A y , _..--i _--_ �- "-__ .��« ._;a.. .�.�v-.—•-�-•-- __nr'_ _ -.tea-_._ � �A 42-09-46 Lloyd P. Jensen .� �Q !/��%- NW/S Hwy 32, app. 500 W.of Kennedy Ave., Chico Permi1t 1157 2- 8P E(util.,m) ELEC,'( o GAS47 41 SUPPOR STRUCTURE REQ: COMPACTIONTEST REQ.. 11%f42--09-46,; Pel mit #6467-78MHI Iss ed B07-2384 042-090-046 # " MISCELLANEOUS ;r'. Demolition'.,, � DEMO OLD MOBILE AND GARAGE 2684 HWY 32 ST ANTHONY FOUNDATIO,' B07-2579 042-090-046 MISCELLANEOUS Electrical 4, TEMP POWER -FUTURE LOT DEV, MI 2684 HWY 32 VADA LLC i : BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 2684 HWY 32 Owner: Permit No: B07-2579 APN: 042-090-046 1 VADA LLC Permit type: MISCELLANEOUS 1200 W EAST AVE Issued Date: 12/19/2007 By KCG Subtype: Electrical CHICO, CA 95926 Expiration Date: 12/18/2008 Description: TEMP POWER -FUTURE LOT DEV; (530) 891-0333 Occupancy: Zoning: C2 Contractor Applicant: Square Footage: BUILDRITE CONSTRUCTION & RESTO BUILDRITE CONSTRUCTIOP Building Garage Remdl/Addn 1200 W EAST AVENUE 1200 W EAST AVENUE CHICO, CA 95926 CHICO, CA 95926 Other Porch/Patio Total (530) 891-0333 (530) 891-0333 ff'".131F'' FEE INFORMATION DBE Temporary Service DBP Gas System (enter outlets) $58.00 $58.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires BUILDRITE CONSTRUCTION & 689238 / B C15 / 05/31/2008 I HEREBY AFFIRM UNDEFR PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with 70 of D... n 3 of the Business and Professions Code, and my license is in full force d X F. � 12/19/2007 Date l,lr,`',.�.v;�,:,WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. EPAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; P Carrier. GRANITE STATE IN:policy Number. WC1967"9 Exp. Dater (This section need not be completed if the permitis or ons a hundred dollars ($100) or less.) ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall n t employ any person in any manner so as to become subject to the Workers' Compensation la of California, and agree that if I should become subject to the workers' compensatiop pi visiorAof Section 3700 of the Labor Code, I shall forthwith comply with those X 12/19/2007 Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip Total Charged: $116.00 Fees Paid: Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: ❑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 (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: Owner's Signature 12/19/2007 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use oro panty of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte Cou ty a er lh above mentioned properly for inspection purposes. I hereby certify that I am the pr o er r m authorized ,t9 aq on the property owners behalf. i lffa .Jld, 12/19/2007 ❑ Owner ElContractor OR Agent for Owner RAgent for FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 o 110J:1% oA FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds c PLEASE PRINT CLEARLY PERMIT NO. "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County,is website for electronic access. 1 OWNER INFORMATION Last Name V♦ First Name LA V Mailing Address two W t—o-:�4— Ave City wILO State 6rxI Zip s Phone 1- c n 7 Fax E-mail APPLICANT INFORMATION ARCHITECT/ENGINEER CONTRACTOR Name Address Zip Address Fax City coState Phone Zip Phone r r7 3 State License Number Fax E-mail Lic. # G%9 23 �y Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail /.l ��Ifjj�JXJPAP�ICANT SIGNATURE r v PROJECT LOCATION AP#DSI-e_ogo_0q(O dS� Property Address City G L, Coy S Z WORKER'S COMPENSATION Policy Number 0KA �1 Carrier © lA fit'' lip Nhiring anyone other than licensed contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address I DESCRIPTION OR SCOPE OF WORK: e f Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA I Yes I No Occ. Type Const. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds ';. '°_; - PROJECT INFORMATION Site Address: 2684 HWY 32 Owner' Permit No: B07-2384 APN: 042-090-046 ST ANTHONY FOUNDATIO, Issued Date: 11/21/2007 By GLB Permit type: MISCELLANEOUS 121 GOLDEN GATE AVE Subtype: Demolition SAN FRANCISCO, CA 94102 Expiration Date: 11/20/2008 Description: DEMO OLD MOBILE AND GARAG (530) 591-0333 Occupancy: Zoning: C2 Contractor Applicant: Square Footage: BUILDRITE CONSTRUCTION & RESTO BUILDRITE CONSTRUCTIOr Building Garage Remdl/Addn 1200 W EAST AVENUE 1200 W EAST AVENUE CHICO, CA 95926 CHICO, CA 95926 Other Porch/Patio Total (530)891-0333 (530)891-0333 'c FEE INFORMATION DBMSC Demolition $58.00 Total Charged: $58.00 Fees Paid: $58.00 Balance Due: $0.00 Receipt No: B5393 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License BUILDRITE CONSTRUCTION & 689238 / B C15 / 5/31/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFF RM NDE PENAL71 OF PERJURY that I am licensed under provisions of Chapter 9 (commencin i ectio 00 f inion 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full for effe of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 11/21/2007 the applicant to a civil penalty of not more than five hundred dollars [$5001; Contr CI r•S ignature Date Please check one of the following: ❑ 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 : WORKERS' COMPENSATION DECLARATION .,_ OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the GRANITE STATE IN: WC1967449 3/1/2007 Carrier: Policy Number: Exp. Date: Contractors License Law.). (This section nee not a completed if the permit is or one undred dollars ($100) or less. ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation law of California, and a ree that if I should become subject to the workers' X 11/21/2007 compensation r inions of actio 7 0 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provision X11/21/2007 I hereby certify that I have read this application and state that the above information is correct. I agree Signature Date to comply with all City and County ordinances, rules, regulations, and State laws relating to building WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and roperty damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION, ( 1 hereby acknowledge that issuance of thispermit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND dewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY S FEES. "issuanofI mentio property for inspection purposes. I hereby certify that I am the ed to act on the property owners behalf. CONSTRUCTION LENDING AGENCY 11/21/2007 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for of arm ee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR. ElAgent for Owner ElAgent for Contractor FILE COPY Lender's Address City State zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name • 0 Gr /r P-- First Name v� Mailing Address V City �L�CO State/a Zip Phone �Iql O ?� Fax E-mail CONTRACTOR Name I�ff�.11 Fitt Address D ��Ae Address City , �� City State'a� Zip/, Z 0 Phone/_333 Phone Fax a E-mail E-mail Lic. # Class 3 APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail PROJECT// LOCATION API Property !Address City Ctsf'C0 Co-. PERMIT NO. ' �;a BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: cwto OU 14kr"Iie "cif el SS s oAl e Scl FT- Living Garage Open Cov • Structure Built without Permits O Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. 11 DEMOLITION PERMIT ASBESTOS NOTIFICATION STATEMENT Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form. "19827.5 A demolition permit shall not be issued by any city, county, city and county, or state or local agency which is authorized to issue demolition permits as to any building or other structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the,applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit application. Compliance with this section shall not be deemed to supersede any requirement of federal law." Attached is a copy of the Asbestos NESHAP Notification of Demolition and Renovation form for the project located at (Address) (City) (Zip Code) Assessor's Parcel Number Date Signature of Applicant I hereby declare that a written asbestos notification to the United States Environmental Agency is not applicable to this demolition project located at � �� 3z� C�►l�co c�- 95�� (Address) (City) (Zip Code) Date Signature of Applicant — I r DEMOLITION PERMIT ASBESTOS NOTIFICATION STATEMENT Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form. "19827.5 A demolition permit shall not be issued by any city, county, city and county, or state or local agency which is authorized to issue demolition permits as to any building or other structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the,applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit application. Compliance with this section shall not be deemed to supersede any requirement of federal law." Attached is a copy of the Asbestos NESHAP Notification of Demolition and Renovation form for the project located at (Address) (City) (Zip Code) Assessor's Parcel Number Date Signature of Applicant I hereby declare that a written asbestos notification to the United States Environmental Agency is not applicable to this demolition project located at � �� 3z� C�►l�co c�- 95�� (Address) (City) (Zip Code) Date Signature of Applicant — COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Fire all S I Piping orms Para is st Floor Main Bldg. RestroJ11V Finish Ad Floor Footings Windows 3rk Floor temwali Siding To ou S b Roof Sheath a Water P In Pie Roofing Sewer Gara 2A Fdn. Vents Fixtures Footin Garage Vents Water Htr. Stemwa I Insulation Heaters Slab Carport Footings Prov. for phslcally handicaped Conformance of ez. structure Appliances Gas PI in & Test Temp. as Slab V Final Sanitation i Patio FIREPL CE Final Footings Footing E`LECTR1141- Masonry Walls Throat Rou h Retnf. Steel Final Fixtures Bond Bea IFIRE SPRINKLERSN Motors Framing Test Water Htr_ Mesh / \ I / MECHANICAL I Grd. F�ilt Prot. arqwn x Co Iing x T mp. Pole F ish acts nder round Inferior Lath V fientilation Permanent oor Closer Final Final MOBILEHOME UTILITIES Elec_ Service .� �Q 7 Elec. Pedestal>� r� Water Piping Sewer /� �–,� Gas Piping c.i MOBILEHOME INSTAL ATI N - - - - - - - - - - - - - - Support _ Elec. ContinCty — 1 Water Pi in p P rainage Gas Piping. z-- 79ezzh t � DATE_ � REMA IfSbR &IICTIONS 31-7y /�reo�,���,rdd�c� ��C>rss T s7 a� y�f /i�F ✓ �o�.�l, ��� (NOTE: An entry must be made on this form each time you visit the job site.) { ! 5772-78P,E ` , --,V-P :RMIT NO. ` PERMIT EXPIRES. / Lloyd P.•Jensen OWNER CONTR. owner 42-09-46 LOCATION (A.P. '8 Hwy 32, app_.500'V of Kennedy Ave., �� N Chico iy • J Temp. Power Pole 3 Called PG&E { TemP"Elec. Serv. Called PG&E — — 7 • Temp. Gas Serv. 77 Called PG&E / JOB _ FINALED (Date) (Signature) MOBILEHOME INSTALLATION INSPECTION CHECK LIST �!V Is the mobilehome located withXequired separation from lot lines and buildings and generally conform to plot plan? 'Yes No Does the mobilehome have required clearances above ground? (Sec.5085) Yes_ZNo UAre footings and.supports properly sized spaced, and braced as per proved plans? (Note possible variation at spring shackles.) (Sec.. 5082 & 5083) Yes No Is the mobilehome level? (Sec. 5088) Yes No ,�. If more a single unit, are crossover connections properly installed? (Sec. 5088) Yes N or -Water A. Is f�to le connector of adequate size and properly installed.(1/2" ID min.)? (Sec. 5566) Yes B.' Test -.Does water piping withstand working pressure or 50 lbs. air test? Yes L> No Backfli -If coach is not State of California approved, does station have backflow device and pr ;Are -relief valve? Yes_ No Wastes and Drains ; A. Is connection made with Schedule 40 DWV and have flex connectors.at each end? Yes L,' No B. Does it have minimum " per foot slope and is it properly supported? Yes No C. Are any leaks detected in drainage system after running 3- allons of water through each fixture including washing machine standpipe?,.Yes No If co snot State of California approved; does station have required trap and vent? Yes_ 04a s Piping arid: Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector pot more than 6 ft, long? Note: All piping,is to be at least as - large as the mobile me gas line inlet without reductions other than the mobilehome connector. Yes Ll No Test OK as per following procedure? Yes !/ �No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. -without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, h soapy water. ' installed? Yes No C.. Are all appliance vents properly _ test connections with X -Electrical A. Is service large enough to.provide adequate ampex•age-to mobilehome (must equal rating°of., mobilehome with a minimum of W- amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes_ No I , B. Is there proper clearances around panels? Yes No_ C. Is power supply cord or feeder assembly properly fused? Yes 7/No Is continuity test satisfactory as per the following procedure? Yes 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4.. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for.\ continuity from such equipment and the grounding conductor. 0 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. Is job card signed by Health Department for water and sanitation? XV O 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length,_ Width /0-- Vehicle Serial No. State Identification No. Q,j~11; %Z__ Additional Information or Comments: 0100 C�,� SPll r/�_s A96> d& cere rt t o o � Anhf;� A/DT : LiJ4�.rt OLP/BEdouv lw�??.�E COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY, This mobilehome has been installed in accordance with the requirements}. of the California Administrative Code, Title 25, Chapter 5, under permit number & °fit /- Z P for the ,foollowing,location: %fi. /r .,r_ i�Jl1 Ai,d��+.r � Al t F •`L fy1.�y �r� ��f / l � fry Vii„ Owner Owner's Address Mobilehome Mfg. >cf ����'� Model Year r �� Insignia No. �.� S %� _ Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of.Public )Workks Date ?/� �! By�3y'l/1 THIS CERTIFICATE IS VOID WHEN MOBILEHOME,IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE '' <DEF%ARTMENT OF PUBLIC WOR • 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT Owner tv Mailing Address Telephone No. Contractor �� C Mailing Address Telephone No. Building Address to v� Zgning Yprifi/cation QW4 G I A- A. P. No. a Q (p Zoning 711anning 4 -es I 61< S tion Fire Dept. Fire Zone Use Permit EQA Parking Parcel Parcel 60' R/W Improvements �+ Plans Declaration p p Bldg. anPT s Recd Parc Ap roval Pla Approval NEW ❑ ADDITION ❑ UTILITIES;& OTHER ❑ Single Family ❑ Duplex ❑ Mobil Home Others ❑ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: License No. Classification J0I am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 the Workmen's Compensation Laws of California. I certify that I have read this application and state that the above information is correct. I, agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. %( v Date Sign of Permite Or Agent Receipt No. � ,� l White-D.P.W. — Yellow -Assessor — PA -Inspector — Goldenrod -Applicant _ BUILDING SQ. F77 OCC. I BUILDING VALUATION Fireplace c.;7uvc Jt, J COUNTY OF BUTTE '' <DEF%ARTMENT OF PUBLIC WOR • 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT Owner tv Mailing Address Telephone No. Contractor �� C Mailing Address Telephone No. Building Address to v� Zgning Yprifi/cation QW4 G I A- A. P. No. a Q (p Zoning 711anning 4 -es I 61< S tion Fire Dept. Fire Zone Use Permit EQA Parking Parcel Parcel 60' R/W Improvements �+ Plans Declaration p p Bldg. anPT s Recd Parc Ap roval Pla Approval NEW ❑ ADDITION ❑ UTILITIES;& OTHER ❑ Single Family ❑ Duplex ❑ Mobil Home Others ❑ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: License No. Classification J0I am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 the Workmen's Compensation Laws of California. I certify that I have read this application and state that the above information is correct. I, agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. %( v Date Sign of Permite Or Agent Receipt No. � ,� l White-D.P.W. — Yellow -Assessor — PA -Inspector — Goldenrod -Applicant _ BUILDING SQ. F77 OCC. I BUILDING VALUATION Fireplace c.;7uvc s G Total Valuation @ FEE Permit Fee $3.00 �V Plan Checking Fee &/or Penalty 5.00 d Permit Fee 2.50 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Q Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50,/0& Each gas water heater or vent 1.50 Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Building sewer 5.00 Va 6 Lawn sprinkler system 2.00 Permit Fee c.;7uvc s G ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 �V Main service 610V OR LESS 100 AMP OR LESS 5.00 d Main service EA. ADD'L 100 AMP 2.50 Main service OVER soov 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. / DWELLING OCCUP. gill NON•RESID % BRANCH CIRCUITS/ c.;7uvc NEW CONSTR. (POWER APPARATUS 8i NON.RESID. SINGLE OUTLET CIR, Ex. Occup {OUTLETS OR FIXTIIRES SOL?SC BAL @ iC FIXED LNS.Ex. Occup.(OUTLETSP(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wirina 6.25 Permit Fee $ MECHANICAL No.1 @ PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 1 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE $ 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. DIREC R OF PUBLIC WORKS By Date/2- -f �ilng permit expires Date ��� `( Ay . �P ��- D G%-- C)wveR —LLcYa JE/vsEN Rour7 99: This set of lans and specifications MUST bt NOTE:—All Materials &Workmanshiph t� kept on the io at all times and it is unlawful to II B A make r^char ges or alterations on same without writrten permidion from the Department of Pub. "c Wor s, Co my of Bu#e. T• ft to� O r' UE 99 utility c nnec located within 4 ft. third section of * on. the left (ro id) si ,home. Uj 7 Q Q Septic Butte oL im shall be tside the rear mobile, home of the mobile a,;Y ccordance wrfh Recognized Good Practicese in and of a quality prescribed for the Specified use in the Uniform Building, Plumbing & Mechanical Coodes and the National Electrical Code. and location ef-�- - '� as per 3' S)&pt Re - The bldg. Setback shall b 5 ff, from the. side property line and 50 ft: from the centerline of the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely{` out of all easements. 3/ A permit will be required for installation of the mobilehome.. ILL F w S5, S. S..L__ .t •4' w to a BUTTE COUNTY BUILDING DEPARTMEW, COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 -County Center Drive ,4 _..OroviIle, California 95965 _ �P Telephone: 534-4541 yid APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property fo 'nspection purposes. Date e�- ignat at Perm r../ or Agent Receipt No. v 0 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated 11NA f above r which fees have been paid. OF LIC WORK S iSDate Building permit expires Date /! 2 f h BUILDING Owner 41- SQ. FT. OCC. BUILDING VAL TION Mailing Address Telephone No. Contractor O C�9 Jar` Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address Wv 5 Plan Checking Fee&/or Penalty_ Permit Fee p PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each-TraD 1.50 Repair drainage or vent piping 1.50 ` A. P. No. _ Y (o �}/� `' Zonin & Planning Water piping 1.50 Each gas water heater or vent 1.50 WLe- S=Ltatwn Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel on Declarati Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 d I P,arcelurgroval Plan proval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER 5? Permit Fee $ $ hj —79 ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 600V OR LESS Main service 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. AOD'L 100 AMP 2.50 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. AOD'L 100 AMP 1.00 NEW CONST. DWELLING OCCUP. &1 22sgft OR ADONS. ACC. BLOGS. // CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name st le of: y NEW CONSTRES'.. -OUTLET NON -REBID BRANCH CIRCUITS) 12.50ea NEW CON ST R. (POWER APPARATUS & NON.RESID. `SINGLE OUTLET CIR. EX. OCCUD{OUTLETS OR FIXTIIRES BAL@1 Ex. OCCU FIXED APPLNS. OR p•�OUTLETS (RES ID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. LMA SA. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL N0.1 @ FEE PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby $ �. TOTAL PERMIT FEE $ �C authorize representatives of the County of Butte to enter upon the above-mentioned property fo 'nspection purposes. Date e�- ignat at Perm r../ or Agent Receipt No. v 0 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated 11NA f above r which fees have been paid. OF LIC WORK S iSDate Building permit expires Date /! 2 f h BUTTE'`COUNT-Y'DEPARTMENT OF .PUBLIC WORKS 7 County Center Drive, Oroville, CA. , PHONE: 534-4541 MOB ILEHOME INSTALLATION SHEET 1. Owner's name : D �/ I� - � j1/S E 4,1 2. Installer's name: ZfZ7::41 ,Qv 1L�/��S 3. Is the site currently under permit? Yes 77777 No / / (If yes, furnish permit numbers77� et ) OR Is,the site an existing site? Yes No (If,yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes / / No ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- / D D Amps 6. What is the mobilehome site service rating? --------------------- le9 64 Amps 7. What is the mobilehome site circuit.breaker rating? ------------ Amps 8. Is there any other electric load to -be served by the mobilehome site service? --------------=------------------------------------ Yes / / No 777- (If 7%(If yes, identify the load and size: (Load) (Amps) �r 9. What is the mobilehome site'gas pipe size? ------=--------------- �in. 10. What is.the type of gas service? ------------------------------Natural /,T-/ LPG -651 i 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand?"--=------------------------- (BTU). (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) MOBILEHOME SUPPORT DATA Ifother'than single wide, Mobilehome Mfr.2 �r(ii'%2� furnish Setup -Model No. Year , Width -(ft.) Box Length 6 o (ft.) Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installa�Ion manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from -front of mobilehome unless otherwise specified. Footings (check one) Single 1. Wood either A Pq A pressure treated or foundation grade. (ft.)(in:) (in.) (in.). 2. Other (specify) Center support Center support locations* footing sizes Supports (check one) (in.) 1. Concrete block.. E] 2. Other (specify) (ft.)(in.) (in.) (in.) <---Tagalong or Expando, show support details. (in.) (in.) Typical Support (in.) (in.) Footing Size (in.) (in.) - Max. Pier Spacing (ft.)(in.) O -v " -- Max. Overhang (ft.)I(in.) (in.) (in.) jj (ft.)(in.) BUTTE COUNTY BUILDING DEPARTMENT *If center piers are other than drawn above, APPROVED P P R ® v E D draw in locations, spacing, and dimensions. /� �` �-/ 9-64M