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047-190-030
T WFF OWFO �-�74 IRVIN SCHI AF _ s,/ s Bell Rd., 3/4 mi. E. of H 9 it ,� } Nord Cana Rd., Chico _�s \ I Permit# 3185-75P,E(util. , ). � L/ - ELEC. 'GAS u w SUPPORT 'STRUCTURE REV. COMPACTION TEST REQ. AP 47-19--EW,3b CONTR: Carrell Bros., Chi o Permit# 3585-754HI Issued. %— A..q -'l1S _ 47-19=$ # ` Permit #6157-76B(r-ew car ort/MH) ; 47-19-30 2170-91B PATTERSON, Julia �`•` 5219 Bell Rd, Chico cont: Tri County'Elec (replace power pole) -� ' 047-190-030 ~ 'PERMIT#97-0943 4 WOLFORD, Dean & Celynda 5219 Bell Rd., Chico i Cont: Executive Homes g/9� MH on Perm Fnd Ex Site i IL .. • . .� A� RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 -COUNTY CENTER DRIVE OROVILLE CA 95965 97-024999 I97-024999 I97-024999 97-0249991 :Rec Fee .00 I Total .00 Recorded I: Official Records I County of I Butte I Candace J. Grubbs I ; Recorder 1: 9:28am 8—Jul-97 1 COMS XX 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. DEAN S. AND CELYNDA WOFFORD MANUFACTURER'S NAME 1450 SPRINGFIELD DRIVE #101 MAILING ADDRESS CHICO, BUTTE, CA 95926 CITY COUNTY STATE 41r 5219 BELL ROAD CHICO, BUTTE, CA 95926 CITY COUNTY A ZIP SAME UNIT OWNER (it also property owner, write SAME STATECITY COUNTY BUTTE COUNTY BUILDING DIVISION LOCALAGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE, BUTTE, CA 95965 CITY COUNTY STATE ZIP 97-0943 . (916) 538-7541 BUILDING PERMIT NO. TELEPHONE NUMBER ,f., r , - C),jo,y 7/8/97 SIGNATURE OF LOCAL AGENCY OFFICIAL DATE EXECUTIVE HOMES DEALER NAME (if not a dealer sale, write 'NONE') 640583 DEALER LICENSE NO UNIT DESCRIPTION FLEETWOOD 1997 SUNCREST MANUFACI URt:K'b NAME DATE OF MANUFACI URI: MODEL NAMk:/NUM51:K CAFLV17A/B 19913SC12 60'X25'8" RAD 955326/955327 RIAL NUMBER(S) LENGTH X WIDTH INSIGNIAILABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A.P. # 047-190-030 THE LAND REFERRED TO IN THIS REPORT IS SITUATED IN THE STATE OF CALIFORNIA COUNTY OF B TTE, AND IS DESCRIBED AS FOLLOWS: PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OFT E COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JANUARY 29, 1988, IN BOOK 109 OF MAPS, AT PAGE(S) 85 AND 86. HCD FORM 433(A) REV. 8/91 WHITE - County Recorder CANARY - HCD PINK - Applicant GOLDENROD - Building Dept. Address or location of unit: Legal Description of Real Property: BUILDING PERMIT NUMBER: 97-0943 5219 BELL ROAD, CHICO ' A.P. #047-190-030 THE LAND REFERRED TO IN THIS REPORT IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS: PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JANUARY 29, 1988, IN BOOK 109 OF MAPS, AT PAGE(S) 85 AND 86. (x) Mobilehome/Manufactured Home O Commercial Coach Has been affixed to the real property above by installation on a foundation sytem pursuant to Health and Safety Code Section 18551. Owner's name: DEAN S. AND CELYNDA WOFFORD Owner's address: 1450 SPRINGFIELD DRIVE #101, CHICO CA 95926 INSIGNIA OR HUD NUMBER: RAD 955326/955327 SERIAL NUMBER OR V.I.N. CAFLVI7A/B 19913SC12 MANUFACTURER'S NAME: FLEETWOOD YEAR: 1997 OFFICIAL APPROVING INSTALLATION: DATE: 7/8/97 PHONE: (916) 538-7541 Record at the Request of M/d Valley TWO & Escrow Company Order N0. I Escrow No. 1570NDP Loan No. WHEN RECORDED MAIL TO: 97-0026931 Rao Few 9.00 1 DOC 214.30 DEAN S. WOFFORD Recorded I Check 223.50 CELYNDA WOFFORD Official Records 1 2500 Y.ANELLA NAY STE D-8 County of I CIIICU. CA 95928 Butts, I Candace J. Grubbs I Recorder I 411100ae 28 -Jan -97 I MVTC FM 2 wM rwra rrw� y.ra r.wr r�wrw.� w► MAIL TAX 8TATEMENTS TO: SAME AS ABOVE APN 047-190-070-000 I-) DOCUMENTARY TRANSFER TAX &ZJLp C07lW11114 an M aorut0erallon or nate of prepay aornayaat OR C`00" on tw aw wwadon of "etre bas hm or anaw6mitnea ranalnhp a orne of uta. The t'nAurgionart Grantor dfkf%larnu 11111flnakrre of Decannt or A em eaumlhhe ua . rk,,, 4vm GRANT DEED FOR A VALUABLE CONSIDERATION, receipt of which Is hereby acknowledged, CLARENCE E. MINNERLY and ANN T. MINNERLY, husband and wife hereby GRANT(S) t0 DEAN S. WOFFORD and CELYNDA WOFFORD, husband and wife, as joint tenants tho real property In the City of UNINCORPORATED AREA County of BUTTE as . State Of CalMomla, described SEE ATTACHED LEGAL DESCRIPTION Dated January 8, 1997 STATE OF CALIFORNIA ) COUNTY OF Santa Barbara )�• On January 8, 1997 ) bob. _ l.orie White Personalty appoarod Clarence E. Mi- ---and Ann T. Minnerly Personalty known to the (or proved to mo on the basis of satisfactory ovidenco) to be the persons) whose namo(s) baro aubscribod to the within instrument and acknow{odgoo to mo that he/shellhoy exoeulod the same In hls/horAholr authorized capeciypes), and that by h s/hor/lholr signaturo(s) on the Instrument the Persons) or the artily upon behalf of which the poroon(s) Adod, oxeculod the Instrument. WITNESS my hand and official anal. Signature__ '' lr u CaRENC X LORIE WHITE -114W.Comm 01020G73 D'111A!•AN111IPAfel111fY'A,/ .. . ......... IF, IF F,7717, h"" ; u ......... . }:'i-URUING REQUESTED BY MID VALLEY TITLE CHI/C Order No. Escrow No. 15 7 6 9 6 D P Loan No. WHEN RECORDED MAIL TO: MR- 6 MRS. CLARENCE MINNERLY 304 N. CABRILLO WAY DELANO. CA 93215 97-002694: Rec Fee 21.00 1 Check 21.00 Recorded I Official Records I County of 1 Butte I Candace J. Grubbs 1 Recorder 1 8100am 28 -Jan -97 1 MVTC FM 4 r%r 11 uv/—IVU-030-000 APACE AUOv[ THIS UNEfonnCConovs use ALL-INCLUSIVE DEED OF TRUST WITH ASSIGNMENT OF RENTS (LONG FORM) This ALL-INCLUSIVE DEED OF TRUST, made JANUARY 3, 1997 DEAN S. WOFFORD AND CELYNDA WOFFORD, HUSBAND AND WIFE botweon horoln callod TRUSTOR, whose address is 2500 ZANELLA WAY STE 0-8 CHICO CA 95928 (Number and 81rOOQ (City) (8lnW) MID VALLEY TITLE 6 ESCROW COMPANY 8 Ca)ifomla Corporation, herein Celled TRUSTEE, and CLARENCE E. MINNERLY AND ANN T. MINNERLY, HUSBAND AND WIFE, AS COMMUNITY PROPERTY WITNESSETH: That Trustor grants to Trustee In trust, with power of Salo, that property heroin called BENEFICIARY, UNINCORPORATED AREA County of P porty In the BUTTE ,State of California, described as: PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED 1N THE OFFICE OF THE RECORDER FO THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JANUARY 29, 1988, IN BOOK 109 OF MAPS, AT PACES 85 AND 86. logolhol with the ronts, issues and Profits thorool, subject, however, 10 the right, power and outhOnty horoinahur glvon to and conlurrod upon Bunuhclary 10 collect and apply ouch rents, Issues and profile lot the purpose of securing (t) payment of the sum of S 160,000.00 with intorolit then nun according to the forms of an all-Incluslv0 promissory note Of uvOn data herewith (hattimahor'the Secured Neill') mado by Tfuelor,peyi Ulu to otdor OI Uunuhciary, and extensions or fanowdle thereof, and (2) the PurfOnnllarlce of each agruomonl of Luster uKOrponulud Uy lulufuntcu Of Culltaulud huroin A. Sonior Doodfe) of Trusl: Thiti In nn All Inrlueivn nnnd of Tru-st, securing the Sueulud Notu and ie sublect m)d bUbowinnl0 to Iho lollOwelg umlulmunit, (1) A Doud of Trual rowrdod __ MAY 15 1 9 9 1 18 9 C 7 — in puck_ _ N_ / A ------- -----••-- . as Insuuniont No. B UTT_E------• Pngo ---- �� -- - -- . of Omeml Records of 0N_E__HUNDRE_D_TNENTY FIVF. THOUSAND AND Cuuoty,Cnhfomw.ellie onginnlprulegadsumot IS 125 000.00 - - ---L- -- - -----------Oclque ---- -L --------_-._-_ __--. in favor of S T A_k K_E K _S E k V I C L _CA_LIFOKNIA CORPOKAT_ION--BENEFICIAL INTEKES'f IS NOW RULDC � � -- 0nginat amount oft 1 2 5 0 0 0. 0 0 ti ti ne Puyoo, securing n note in the ---._..)_—_—_-.._•___8Y.-NE1.1,, C. SCIIWERTMAN_AND,MAR,CIA _I.,.__SCIIWE.RTMAN.,-. HUSBANDAND WIFE BY ASSIGNMENT RECORDED JULY 12, 1991, SERIAL. N0, 91-28276, (2) A Docd of Trust rocurdod _. . -. ... _.._.._. -----•-. as Inelrumonl No. Page _. . _. .._.-._ _...... _ ....—.-- .. . of Ofhcad Rucordo of —._----- - —__.._..... --------- Colutly, Cnldornol, in the onginnl pnncipnl num of IS '. .. .._- .. ... .._ _... _.. —_-. _... Dullais -... _ .• ... — ._.- •. _. - •.----_—.•— _ ns 1111yeu. suco nig n note In Iho I'. 111 STATE OF CALIFORNIA �s DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT �►.,e DIVISION OF CODES AND STANDARDS REGISTRATION AND TITLING SECTION STATEMENT OF FACTS This unit is a: Mobilehome [] Commercial. Coach Floating Home a Truck Camper Decal (License) No. (s) Tradq Name Serial. No.(s) I/We,- the undersigned, hereby state that the unit described above: THIS UNIT IS BEING PLACID ON A FOUNDATION SYSTEM IN ACCORDANCE WITH SECTION 18551 OF THE HEALTH AND SAFETY CODE. 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, or from issuance of a California certificate of title covering the same. I/We certify and r ` malty of perjury that/the foregoing is true and correct. Executed on Cl 0? at �l�ll Ld , (Date) (City) (State) Signature of each affiant Printed name of each affiant J "or Address s-oti, city �.�� (� State lei a HCD 476.6 (Rev 11/86) 'RESIMENTIAL 047-190-030 PERMIT#97-0943 WOLFORD, Dean & Celynda ' 5219 Bell Rd., Chico Cont: Executive Homes MH on Perm Fnd Ex Site THE HCD FORM 433A FOR THIS MH CANNU= RECORDED UNTIL ONE OF THE FOLLOWING HAV BEEN TURNED IN TO THE BLDG DIV: (2) STATEMENT OF FACTS(ONLY ON NEW MH -S) INSPECTOR MUST VERIFY SERIAL & LABEL #' ti v Fe''5' o .4'--5,"h OFFICE COPY Address -57U,7 2 7F&t4 GAS Meter By Date ELECTRIC Meter By Date l:3B FINALED (Date) 19,9 Signature VAO cry cam) V=OK 0 = Not OK I •=Not t able NoReady MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements - Setbacks - Easements 2. Footings; Soils-Size-DepthSpacing-ConnectorsSteel 2. Soils; Special MH Support Sketch 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg: Rfg.-Bracing 4. Water, Location -Test -Easement Needed (Sketch) 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Carports; Windows -Doors 6. Gas; Location-TestANrap; / jVfL / /Nat or/ M ftJ /LPG 7. Electric 7. Well Clearance & Disconnect S. Fnng.; Sils-AnchorsStuds-Rftrs-Trusses 8. Utility Clearance 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Setbacks Easements 1 -Marriage Line 6!GieiniJAH Test -Fall -Flex Connector , &.-Water; M st-Regulator-Connector er and Sewer Connected -C/O to Grade -HD Approval . Gas an lectrici Tagged ----9—'1ie D- pe -Installation Cert. r. ts; Insp.-Sketch 11. Cert of Occupancy n ' Date a.A�Card B-1 Date Card B-1 Date Card B-1 ' Date Card 8-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-DepthSpacing-ConnectorsSteel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric S. Fnng.; Sils-AnchorsStuds-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, 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 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ✓ = OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s Date 1. ZoningSetbacks-Easments-FloodSlope Date 2. Ftg., Main; Soils-Elec. Gmd. / i Ftg. Depth FINAL (Plans) OK except #'s 3. Ftg. Garage; Soils-Steel-Elec. Gmd/ /`.Ftg. Depth Ext Steps -Door & Sidelight Protection -Landings 4. Ftg. Porches & Decks; Soils -Steel-/ /" Ftg. Depth Smoke Detector 5. Stemwalls, Main; Steel-Blockouts-Wrapped Furnace; Vents -Clearance -Comb, Air-Conector- In Garage; Above Floor-Ducts-Mech. Protection 6. Stemwalls, Garage; Steel-Blockouts-Wrapped Bedroom Exiting 6a. Hold Downs and Special Anchors G.F.I. & Bath Fixtures & Tub Access -Spa 7. Slab, Steel -Wrapped Elec. Trim & Subpanel, Breaker Sizes & Labels 8. Piers -Fireplace Ftg.-Steel 69. 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Pienums & Ducts; Clearance-Mater:al-Support-Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation 77. Plb., Elec. & Mech. Equip. Listed for Location Date 78. Card B-1 Date Card B-1 Date 79. Card B-1 Date Card E-1 Date 80. PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 18. Water Pipe; Test & Anchor -Nail Protection . Following Instld./Drive 0 Yes Q No/Walks ❑ Yes ❑ No/Planters Q Yes 0 No 19. D.W.V.; Test Fittings & Anchor -Nail Protection Stucco Brown -Finish 20. Shower Pan; Test, First Floor -Tub Access A.C. Unit Disconnect, Electrical -Plumbing 21. Test Tub & Shower, Second Floor -Tub Access Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 22. Gas Pipe; Sixe & Anchors Water Well, Disconnect, Electrical, Plumbing 87. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Corrections from Previous Inspections 23. Fixture & Transformer Clearance -Ins. Protection Gas Test -Meters Tagged, Gas -Electric 24. Elec. Receptacles Spacing -Lights & Switches at Doors Water & Sewer Connected -C/O to Grade -HD Approval 25. Size Boxes & No. of Conductors Stapled Energy Compliance Certificate -Other Certificates 26. Romex Installed Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water 28. 2 Appliance Circuts in Kitchen & Conductor Size GFI Card B-1 Date Card B-1 29. Suhfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al Card B-1 Date Card B-1 30. Ranje Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or AI Insulated Neutral Q Yes ❑ No Card B-1 Date Card B-1 31. Service -Riser Conductors & Ground -Main Disconect 32. Equip. Clearances Panels-Motors-Mech. Epuip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Furnance Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-roff 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 Hgt. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3 -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace 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-Conector- 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 & Recepticales 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 (G.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 82. Following Instld./Drive 0 Yes Q No/Walks ❑ Yes ❑ No/Planters Q Yes 0 No W. 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 Throught 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 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: COUNTYV OF BUTTE- DEPARTMENT OF'DEVEtOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California -95965 - Telephone (916) 538-75410. 1 NO. (Rev. 12/96) APPLICATION AND PERMIT � V - ASSESSOR PARCEL NUMBER , 047-19-0-030 ZONING BUILDING PERMIT OWNER 404 E SO. FT. OCC. BUILDING VALUATION -7516� OWNERS MAILING ADDRESS 342 0786 R, co-&415@36YRINGFIELD DR 101, CHICO TELEPHONE EXE 3042 R214 ANAD- CONTRACTOR'S MAILING ADDRESS S -PI-6992 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. -Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS BUILDING ADDRESS 52,1,9 BELL ROAD, CHICO Permit Fee $ 286.00 Plan Checking Fee Energy Plan Checking Fee $ 23.00 $ \ $ PERMIT FEE $ 329.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome EIX Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: MH/PERM FDN Each as water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ 65.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Serviceeoov OR Less 200A OR IESS 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 'n full force and effect. % License Class Lic. No. _19 110 S j 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 /000A J 46.00 NEW CONST. DWELLING UP. OR ADDNS. ( 8 ACC. BLD S. So 3.50FT. NEW CONST. MULTI.N1LLET NON-RESID. @7,50 POWER APPARATUS d SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 Q 1,00 BAL Q .50 Ex. Occup. nXED APPWS. OR oLIrtETS RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.0 01 _no PERMIT FEE S43.00 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' mpensation in a e car( ier and policy number are: Carrier Swtw1nr, a\ MECHANICAL PERMIT Fling Fee 20.00 Heating Coolin g Hood 6.50 Ventilation PERMIT FEE $ Policy Number R 34 % Lk -d-. (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 fo h ith co ply with those provisions. >>> U� X Date 1 SI at e o pp Icant - ❑Owner Contractor ❑Agent An OSHA permit is required for excavations over 60" deep and emolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE 437.00 HAZ• 1 0. FEES IMP 1.41) JADF `CEL PD HD This permit is hereby issued under the of the Butte County Code and/or Resolutions indicated above for which fees have PERMIT EXPIRES ON _ applicable provisions to do work been paid. Date .97" '" Z< Date ReceiptNo. /R919 WHITE-D.D.S.-B.D. CANARY -ASS SSO PINK-INSPECTO GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OFTJE1LO?,VENT SERVICES -BUILDING DIVISI IN 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: / o r-r,� ASSESSOR PARCEL NUMBER: L G% — O 6 Proposed Building Use: P4_A- Building Inspector: Date: At time of permit application, I was ad iced the following data must be submitted prior to pe it rocessing and/or issuance: C>k ��h �1- Date Received By ❑ 1. All items have been submitted. ❑ 2. Plot plans, 3/4 sets, signed by the preparer of plans. ---------------------- ------------------------------ ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. --------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. 1:15. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- ❑6. Energy Design Compliance and supporting documentation. ------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ---- 1:18. --- ❑8. Hazardous Material Form.------------------------------------- E19. ------------------------------------ ❑ . Manufactured Home data and installation instructions including Tie Down Specifications. 3' � p•G ees of S J,5 _,�-- ------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ----------------------------------------------- lifornia Department of Forestry plan approval/fees. --------------------------------------- t� ood elevation certificate. ---------------------------------------------------------------------- Sanitation and plot plan approval O ,I (n Health Department. ------------------------- ❑ 15. City of Chico plumbing permit. --------------------------------- '-------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- • ❑ 17. Planning approval for (A) Use: (B) Parking: -------------------------- ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- ❑ 19. Encroachment Permit for driveway (construction approval prior to occuprancy). ---------------------------- El 20. Pre -inspection for required. Request to Building Inspector on (Date) 021. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ 0 22. -----------------------------------❑22. Workers' Compensation carrier and policy number. ----------------------------------------------------------- 023. Owner -Budder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- E124. ------------------------------------- ❑24. Letter of signature authorization. -------------------------------------------------------------------------------- ❑ 25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- ❑ 26. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑27. Manufactured Home utility clearance.-------------------------------------------------------------------- ------ ❑28. E ' ing vi ations and/or a pired permits. ------------- - OUO3 A, ant Deed> ��//,,�� , ,% ✓.--------------- vI.H. Title, R�l�fieck to H.C.D $ _1 f" 030. Other: -____-- When you issue the1permj�ocess as follows ❑ Mail to owner, ❑Mail to contractor. e hone 6 and hold for pickup at office. ❑ Deliver with inspector. p can : r. Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Dep t, ❑ ' Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Otj)er: Date: 1. Index permit application for the above items numbered: ` / ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by,0 phone, ❑ mail, ❑ Building Division counter, by ID te: Contractor, designer, owner, was advised of the above required data by 11 phone, 11 mail, ❑ Building Division counter, by -^ ' Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer; owAner, was advised of the above data by ❑ phone, ❑ mail, ❑ Building Div' ' counter, by D te: . Plans reviewed by: c e&- Date: uired Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. E.H. USE 1 Plot Plan Attached Floor Plan Attac e w� Sent to B.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance o r 156 Z 17 t _.. 7! -.3o Owner Location AP# Plan Approved for: Sewage Disposal ✓ Water Supply: Public Private Well Clearance for Other. %x/,)00^ `M0inI/Q— Hold final for: &I Olt r Final clearance O.K. for: NOTE: Environme 8/96 I Health Specialist /7 Date ' .. ... .. ` ...•i! :'cif; .. And when recorded mail to: Building Division I #7 County Center Drive APR i997 Oroville, Ca. 95965 i _97-014266 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code requires this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited -to herbicides. -pesticides, and fertilizers, and from the pursuit of agricultural operations including, but_not limited to cultivation. plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte Countv has established agricultural purposes and residents within said zones and on adjacent propem, should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the Count}• of Butte, State of California, described as follows: Pte,tet. X4 1 Cts shVL-00,on A-ha_� ,)ay `�-Q mCL-P t rho rd e'0 l r� "e Dq -�-hg V -eco r de.r ®( 4-k, CCoLt.lnA--i o -'l3 t Sdee,- o� Cal; -�oy r %eZ I o tom, Z" LLa-r .-i i n b oo i< k09 oi�_ ma - Qs , cc "'o- C)e (-s) 8,V5 ar"A <8b Date: AI IC% / PROPERTY OWNERS: State of California ) County of —B>LO- o ) On O t before me, personally appeared personulh known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. Irxouuunurul►Iluluunlrnllurunmuouuunuauuunulo WITNESS my hand and official seal. _ OFFICIAL SEAL 0 1010978 > �+ '0 WENDY M. AUER iW 1 li NOTARY PUBLIC - CALIFORNIAN SI natur ,v COUNTY OF BUTTE i; SCdI: uMY I ;ommission Expires February 13, 1998= • Ytrr1111111111111111111IrrlililrllilnlEIIIIIIIIIIIr111u111Urr111pWA • A.P.# '-1 1 "- I I " .. ELEVATION CERTIFICATE O.M.B. No. 3067-0077 FEDERAL EMERGENCY MANAGEMENT AGENCY M` Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I BUILDING L )WNER'SA NAME WO �-�o� � I POLICY NUMBER STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBERI COMPANY NAIC NUMBER 5-25-2-15 PJ LZi20 IL ,+V0, OTHER DESCRIPTION (Lot and Block Numbers, etc.) CITY �STATECI Z�IP C i,L�l'- SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION 0600/7 FSO 1j _57 T5 (in AO Zones, use depth) 1 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 ❑ Other (describe on back) 8. For Zones A or V, where nE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: IL I!!4! 4�.Li feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level I 2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of I__I__L�J.I� feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of ! ! ! I ! ' ._ feet NGVD (or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is LVIMF above ❑ or below*heck one) the highest grade adjacent to the building. (d). FIRM Zoe AO. The floor used as the reference level from the selected diagram is I.J feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: NGVD '29 .❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes No (See Instructions on Page 4) 5. The reference level elevation is based on: K.actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: i I 4i3!.�El feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is:!! I I I I LJ feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement---- FEMA mprovement__ FEMA Form 81-31, AUG 96 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al -A30, AE, AH, A (with BFE),V1-V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features -If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. / certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. _ /4013G:7�7 ft!�Ft Jt2, /fty Z 747 CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal) TITLETIL L�i1i 01111 �c lZ - �/(_i�l✓1/g -- W � S T �(} l�V L—T //� � --- n 7COMPANY NAME q T4 3 7 l� L�� OLItiC /012, ADD CITY STATE ZIP SIGNATURE ea U /_� % —IT DATE PHONE Copies should be made of this ior: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: ON SLAB A V ZONES ZONES --�— -, ur WITH ON PILES, BASEMENT PIERS, OR COLUMNS A A V ZONES ZONES ZONES REFERENCEBASE LEVEL LEVEL REFERENCE LEVEL FLOOD ELEVATION "sl T FLOOD u . 1..:. ADJACENT '` REFERENCE FLOOD ELEVATION REFERENCE ADJACENT GRADE ��` LEVEL ELEVA7I0N LEVEL GRADE ADJACENT:, GRADE ' The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. _ Page 2 �� e. �� �� -►- �" ��- 0��3 v / ������ ELEVATION* CERTIFICATE " l`/O.M.B. No. 3067-0077 July l FEDERAL EMERGENCY MANAGEMENT AGENCY Expires y 31 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE BUILDING QWNER'S NAME I POLICY NUMBER STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBERI COMPANY NAIC NUMBER SZl 'iP LZ.L V_nArO, OTHER DESCRIPTION (Lot and Block Numbers, etc.) 412A) C1 -0 3 o CITY 9 STATE r ZC., j Z6 SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION 060017 do c� (in AO Zones, use depth) 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 ❑ Other (describe on back) 8. For Zones A or V, where no E is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: 1 I 1/1-0 31 feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level 2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of l 1 1/141-3 .1-31 feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of! 1 1 1 1 I,_i feet NGVD (or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is LV.% .1freet above ❑ or belo heck one) the highest grade adjacent to the building. (d). FIRM Zo a AO. The floor used as the reference level from the selected diagram is W .1J feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: L�5 NGVD '29 I_I Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes ' I No (See Instructions, on Page 4) 5. The reference level elevation is based on: X,actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: 3 . feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I I I I I .L1 feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31, AUG 96 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. / certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 100 I. 120 t5 T ja,, ddb 7,74 47 CERTIFIERS NAME LICENSE NUMBER (or Affix Seal) _ i(_Y29.4 -- UJ S T S'U ie -V &__'7',1A1 _ TITLE COMPANY NAME -- S4 37 c.#4 -cis /2, _ (�,4(� /��J � s � _C �, � l'y 619 ADDRESS CITYr STATE ZIP KLL-i_1± A.- , J!P �/ 7_ 87�-10 Zr7 eiz` S3 3_—S GU" SIGN DATE PHONE Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: ON SLAB A V ZONES ZONES REFERENCE FLOOD A41 1..... ADJACENT ELEVATION REFERENCE ADJACENT GRADE LEVEL GRADE Imo' No. 2 / 647 _303f/ ie 1.7 WITH ON PILES, BASEMENT PIERS, OR COLUMNS A A V ZONES ZONES REFERENCE BASE LEVEL REFERENT ZONES FLOOD LEVEL RE`EREcL KI R E'_EV�ON ADJACENT:,. �}1 `. •::;::.•.::?::!: i.:'.??;:4: :i"..i GRADE The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 E.H. USE ONLY ,f)e6c)k, on1 \ Plot Plan Attached _{�._Jj,�-J� 1 Floor Plan Attached Sent to B.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance IAD&bacA sail I� Owner r . ' i� ,, -� , Location 'TF 97-t''c3 AP# Plan Approved for: Sewage Disposal' ' _ Water. Supply: Public Private Well Clearance for dwelling. Other, tl `- !_ u =;s•, Hold final for: Final clearance O.K. for: NOTE: Enflironmental Health Specialist Mi. w Date ....:_ .. � PERMIT#97-0943 047-190-030 e .J. Dean & Chico WOLFO$e11 Rd. , Chico 5219 Homes Cont: Executive Site �3f5 rgI on Perm Fnd F .S N.w'.... a 1 BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE• CALIFORNIA 95965-3397 TELEPHONE: (916) 538-7541 FAX: (916) 538-2140 DEAN WOFFORD 5219 BELL ROAD CHICO, CA 95926 Re: B.P.#97-0943 A.P.# 47-19-030 With reference to the above subject, attached is: [ ] Plan Check List [ ] Red Marked Calculations [ ] Red Marked Plans [XX] Other Action Required: [ ] Comply with Plan Check List [ ] Resubmit Plans with Revisions As Required [ ] Return All Original Materials and Revised Plans to the Building Department kX] Other Should you have any questions, please contact this office at the address or phone number listed above. Sincerely, LINDA SEXTON CC: ROBERT G. AGEE JR 0,/ PERMIT APPLICANT WOLFORD ASSESSOR PARCEL NO. 47-19-030 PERMIT N0. 97-0943 DATE 6/3/97 The above referenced building plans were reviewed by this office. Provide additional information and/or make appropriate revisions to plans, specifications,, and calculations as follows: I AM RETURNING YOUR FLOOD CERTIFICATE SO THAT YOU CAN FILL IT OUT PROPERLY. I CIRCLED THE ITEMS THAT ARE WRONG AND'AM SENDING A COPY OF OUR INSTRUCTIONS. PLEASE SEND THE ORIGINAL OF YOUR REVISED CERTIFICATE. THANK YOU LINDA SEXTON P.S. I TRIED TO"CALL YOU, BUT THERE WAS NO ANSWER AND NO MACHINE. If you wish to 3iscuss any requirements, you may contact me at (916) 538-7541 between 1:00p.m. and 4:00 p.m., Monday through Thursday. CC: ROBERT G. AGEE JR 5437 BLACK OLIVE DR PARADISE, CA 95969 ELEVATION CERTIFICATE O.M.B. No. 3067-0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. ` SECTION A PROPERTY INFORMATION I FOR INSURANCE • COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER Gllo —ori io STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 5 4!�_r /. r� c= 1✓ 1` Kofrr- I I OTHER DESCRIPTION (Lot and Block Numbers, etc.) CITY STATE ZIP CODE SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION 060017 ®o �.s- 73 se--?oZ 9 6 9 (in AO Zones, use depth) 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 ❑ Other (describe on back) 8. For Zones A or V, where no E is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: 4 U feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level I 2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of I I I/141-3l.[3� feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of �J.0 feet NGVD (or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is et above ❑ or belOwWheck one) the highest grade adjacent to the building. iP1 (d). FIRM Zoe AO. The floor used as the reference level from the selected diagram is L I .0 feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: 54GVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes )< No (See Instructions on Page 4) 5. The reference level elevation is based on: actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: uL3 .L41 feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: l l l l l l.H feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31, AUG 96 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. If certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. 2013r47 '4�E� J2, /19 Z--: - Z7647 CERTIFIER'S NAME LICENSE NUMBER (or Affix Seat) TITLESS44 COMPANY NAME ADDRESS 3 7 Li/i cr OLI(I C' //%J/L CITY STATE ZIP 8 T� ?_ S-6 Ir SIGNATURE oDATE PHONE Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: ADJACENT GRADE The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 X CS — -- No. 2 647 0 ON WITH ON PILES, SLAB BASEMENT PIERS, OR COLUMNS A V A A V ZONES ZONES ZONES ZONES ZONES REFERENCE LEVEL BASE FLOOD REFERENCE LEVEL REFERENCE LEVEL ELEVATION BASE FLOOD ELEVATION REFERENCE "' ADJACENT ADJACENT :;:•,t�:�., GRADE REFERENCE LEVEL BAS[ FLOOD ELEVATION LEVEL GRADE ADJACENT GRADE The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 /q- 3 o 6vl-eo rl_ 9�9aa6 O 666 0. . APPROVED & d 00 Dog, o6 • Environmental Health MAY 1 2 1997 Chico, California N F1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 • Telephone: 916/538-7541 1 APPLICATION AN&PERMIT r •' PERMIT N0. SSES OR PARCEL NUMBER y 47-190-030 r { ZONING, A -4Q,. BUILDING PERMIT. OWNER Julia Patterson/Golden Gem Alm TELEPHONE 345-8233 SO. FV.' OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 5219 Bell Rd., Chico 95926 CONTRACTOR'S NAME Tri County Electric TELEPHONE 891-5821 CONTRACTOR'S MAILING ADDRESS 9554 Cummins Rd., Durham 95938 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is -• Filing Fee $ '0.00 LENDER'S MAILING ADDRESS ARCH!`ECT OR L.v-.INEEP — L_ICE.":SE r,o• T� Perm;;, Permit Fae $ Plan Che:;King Fee $ Energy Plan Checking Fee $_ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 5219 Bell Rd., Chico Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping r 5.00 Each gas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other Electric SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S .I G I W 10.00 ea TYPE OF WORKt� New ❑ Addition [1Remodel [JUti lities r' 1 Installation ❑ Other ❑ Describe work: Replace Power Pole _ Fire Damage Permit Fee $ Contractor _ ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 1 10.00 10 00 Main service EA. ADD'L 100 AMP 1 2.50 2.50 CONTRACTORS LICENSE LAW 1 I declare under penaltyiof perjury (Check One): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code nd my license IS In full force and effect. License No. I Classification. IA -ZQ ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.yi) OR ADDNS. ACC. BLDGS. l '/20sgIt NEWCONSTR ULT' -OUTLET NON.RES'D BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES\ eA 030 FIXED ARLNS. Ex. Occup.OUTLETS P(RESID )REA.J 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 25.00 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate Of Consent to Self -Insure. �" I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County ' consequence of the granting of this permit. X .T� L 1 �l/ 1 ate li ,-- v, v I ; Signature of A licant — 0 g pp � ❑ Contractor Agent ❑ An OSHA permit is req ' ed for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE _ TOTAL FEE $?5.00 HAz I CUA I PARK I SCHL FLD I CD F PAR PD I HD• ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been aid. � p DIRE TOR F• UBLIC WORKS r Bye ! Date PERMIT EXPIRES`/Date —q7 _ Receipt No. 94328 WHITE-a.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR. GOLDENROD -APPLICANT i COUNTY OF BUTTE DEPARTMENT OF PUBLIC -WORKS 196 Memorial Way, Chico — Phon : 891-2751 o 7 County Center Drive, Orovi Ile —.Phone: 538-A41' '47 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE MI I ta, tom- C -,-r, 50A i'70 -91 OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at -the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. ave. n Of 4 l A/ W S Q n A r\ C7 ( t a.S I sa r.. y D �1 JJ � %LIQ ✓ lePG/.I/"e61 or Date 7—�—y% Inspector 1 t COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICAT�I,ON AND PERMIT PERMIT NO. r, SSESSOR PARCEL NUMBER 47-190-030 NING A-40 BUILDING PERMIT OWNER Julia Patterson/Golden Gem Alm TELEPHONE 345-8233 S0. FT. OCC. BUILDING VALUA.71ION OWNER'S MAILING ADDRESS 5219 Bell Rd., Chico 95926 CONTRACTOR'S NAME Tri County Electric TELEPHONE 891-5821 CONTRACTOR'S MAILING ADDRESS 9554 Cummins Rd., Durham 95938 Fireolace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ '0.00 LENDER'S MAILING ADDRESS Perm:' Fae $ ARCHITECT OR U-� ,INEERT LICENSE No• Plan Che -;King Fee $ Energy Plan Checking Fee n $ ARCHITECT OR ENGINEER'S MAILING ADDRESS _ Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 5219 Bell Rd. Chico Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other Electric SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W O.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities KI Installation❑ Other ❑ Describe work: Replace Power Pole Fire Damage Permit Fee $ Contractor _ ELECTRICAL PERMIT Filing Fee 10.00 00V OR L Main service 100 AMP ORSLESS 1 10.00 10.00 Main service EA. ADD'L 100 AMP 1 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ET I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code nd my license is in full force and effect. n /. License No Classification. 6 Fl 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.et OR ACDNS. ACC. BLDGS. , /zQsgft NEW CONST R. U OUTLET NON.R ESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex.Occu o p OUTLETS OR FIXTURES 0@50e e2ALO 30 FIXED APPLNS. Ex. Occup. OUTLETS ((RESID )REA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ 25.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. �I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g I Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabili ' s, judgments, costs, and expenses which may in any way accrue against County ' equence of the granting of this permit. ate �$ Signature of Applicant — O er❑ Contractor Agent An OSHA permit is req ' ed for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE t-5.00 HAL CUA PARK SCHL FLo coF PAR PD I Ho. )ssuE This permit is hereby issued unaer the sions of the Butte County. Code and/or work indicated abo for which fees ;DI rEORUBLIC 110 B PERMIT EXPIRE` Date_'_ �T' applicable provi- resolutions to do have been paid. WORKS Da e Receipt No. 94328 WNITE-D.P.W., YELLOW-ASSE350R, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DERARTMENT OF PUBLIC WORKS - BUILDING DIVISION �y 's T COUNTY CENTER DRIVE - OROVIjl.E,.CA+E'IFORNIA 95965 - TELEPHONE: 916/538-7541 PL �ERMIT APPLICATION DATA SHEET _ Permit No. OWNER �i>OG��� �tG//� A. P. uO. Proposed Building Use ��� 'Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in diplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engi-ieered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ........................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Irtent for Non -Heated and AC Buildings .............. 8. Engineered trusc, details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban A -ea fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico p umbing permit ..................................... 16. Plot plan and bisiness license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19,.,,Driveway permi- (construction ap o al re a for to occupancy) 91T . Pre -Inspection for �_/2 �1� o�required . Pre-inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy -: f Agricultural Acknowledgment Statement ......... 25. Letter of signati re authorization ................................... 26. 11 27. When you is ue the per mit Rrocess fol lows: Mai t w er. ail to contractor. eIephone _ nd hold for pickup at=office. Deliver w/inspector. Other Applicant ti Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data mu3t be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone__mail counter by .date Contractor, designer, owner, was advised of above required data by—phone —mal i_counter by date Plans checked by Date Plans approved by ` Date 01 Sets of plans on hold in File cabinet AP folder Copy—DPW ASSESSOR,PARCE O WNI- VIIC OWNER'S MAILINI 59-1 CONTRAC.TOR'S CONTRACTOR'S CONSTRUCTION COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916,538-7541 4 APPLICATION AND PERMIT • 6 • LENDER'S MA!LIN: ADDRESS A RCHITE_T OR L :I:;E_? ARCHITECT OR ENGINEER'S MAILING ADDRESS BUILDING ADDRESS LOT NO. I SUBDIVISION NAME 1 Q59 Z( I TELEPHONE UNKNOWN _..._._7L'CE'7SE of O. PARCEL MA USE OF STRUCTURE SF ❑ Duplex ❑ Mobi Iehome ❑ Other SPECIFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities _ Installation❑ Other ❑ Describe work: PL -A t fl(.yr--.,le— VoL_9 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ Ishall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Receipt No. WHITE-D.P.W.. 7(LLOW-ASe E990 INN -INSPECTOR, GOLD ENROO-APPLICANT PERMIT NO. BUILDING PERMIT S0. FT. I OCC. I BUILDING VALUATION Fireplace j i Total Valuation $ —� Filing ;'ae $ 10.00 Main service BOOV OR LESS 100 AMP OR LESS $ U.O Plan Che:. -:,ng Fee $ Energy Plan Checking Fee $ Penalty $ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap FIXED APLNS. Ex. Occup. OUTLETS (RESID.)REA.7 2.00 Solar or heat pump water heater Temporary service _ 20.00 Water piping Mobile Home Facilities 5.00 Each qas water heater or vent Misc. Wiring 5.00 Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W X10.00 ea Permit Fee Contractor —� ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV OR LESS 100 AMP OR LESS 10.00 U.O Main service EA. ADD'L 100 AMP 2.50 NEW CONST. / DWELLING OCCUP.&) OR ADONS. \ ACC. BLDGS. '/2QSgft NEW CONSTR. ULTI.OUTLET NO N.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR, OUTLETS OR FIXTURES Ex. Occup(2AL9 eL030 FIXED APLNS. Ex. Occup. OUTLETS (RESID.)REA.7 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 Heatino P ooling ood 3.00 enti Iation Permit Fee $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ OCC I CONST TYPE TOTAL FEE HA2 I CUA I PARK I SCHL I FLO i CDF I PAR I PD , HD•IISSUE This permit is hereby issued unser the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By PERMIT EXPIRES Date Date r 'C t PERMIT NO.,, �1�7KP�E P +; E t �_ MH UTIL. PERMIT NO. PERMIT_EXPIRES �' -7L "OWNER ZYM Irvin Schlaf ,CONTR. — LOCATION (A.P. 47-19-09 ) s1s Bell Rd., app. 31. mi. E. of Hamilton Nord Cana, Hwy, Chico y , f, Temp. Power Pole Called PG&E Temp. Elec. Serv. ^�s 5 Called PG&E ! �� 7-7 5/ Temp. Gas Serv. Called PG&E FOB INALED —z �� J (Date) i (Sin tura) s- y 9 'MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located wit equired separation from lot lines and buildings and generally conform to plot plan? Yes No ,� 2. Does the mobilehome havb 'required clearances above ground? (Sec.5085) YeR No 3. Are footings and supports properly sized, spaced, and braced aXN pproved plans? (Note possible variation at spring shackles.) (S.e 5082 & 5083) Yes Yes_ V No 4. Is the mobilehome level. (Sec. 5088) . Ye 5. ore than a single unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is fle ble connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No B. T st - Does water piping withstand working pressure or 50 lbs, air test? Yes /1,0 ckflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at.each end? YesNo B. Does it have minimum k" per foot slope and is it properly supported? Yeses No C. Are any leaks detected in drainage system after running 3-ga lons of water through each F..."" fixture including washing machine standpipe?,.Yes' No D is not State of California approved; does station.have required trap and vent? N o 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/.4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobi ome gas line inlet without reductions other than the mobilehome connector. Yes No � B. Test OK as per following procedure? YesNo . 1. Open, all appliance connector valves. 2. Shuoff appliance burner and pilot valves. 3. it 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. V/nnect gas meter to mobilehome.with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes V No- 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of��amp) and other facilities on lot, �., water pumps, garage, cabana, etc.? Yes a' No 0 Q &moi V C B. Is there proper clearances around panels? Yes INO C. Is power supply cord or feeder assembly properly fused? Yes NO D. Isntinuity test satisfactory as per the following procedure? Yes'► No 1. e -energize electrical wiring system of the mobilehome at the pedestal. 2. M ke sure that the power supply cord or feeder assembly conductors, including neutral c nductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. onnect one lead of a test instrument to the mobilehome grounding conductor and app y the other lead to each mobilehome supply conductor, including neutral. 5. 11 non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, w'ter line), including fixtures and appliances, shall be tested for continuity from uch equipment and the grounding conductor. 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 theelectrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA ` ! Manufacturer and/or Namestyle l� Length 6 4 Width 2., Vehicle Serial No. d / State Identification No. % a 10 � �p Additional Information or Comments: TO: Building Department c.. FROM: Environmental Health 3 RE: Sewage and/or.Water.Clearance GinMER BLOC TT Oi/4 / A . P;Y- Has been approved for: s,JAGE DISP vIATER ILY ' Sanitarian 7 Da t'e 895-775 rraIII Intl Stucco i est Final Water Htr. Subpanels Mesh MECHANICJL Grd. Fault Prot. Scratch Heating Service Brown � Temp. Pole • T.� Interior Lath Lath Ventilation Permanent 'yam ` � � Final 'A COUNTY OF BUTTE — DEPARTMENT OF PAJBLIC WORKS' B� _ BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback — JS Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor !� Footings Windows 3rd Floor / Stemwall Siding To out Slab Roof Sheathing Water Pi in -1 . Piers Roofing Sewer �.- Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwall Prov. for physically Heaters Slab handicapped Appliances r Carport Conformance of ex. Gas Piping & Test Footings structure Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam _ FIRE SPRIM S I Motors rraIII Intl Stucco i est Final Water Htr. Subpanels Mesh MECHANICJL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Lath Ventilation Permanent Door Closer Final Final / DATE J REMARKS OR CORRECTIO B� � t/V ' � s 4/�E 2; 0 90'4 �� � 5��ci:lZ. 14 00/C Cf 'at< S -o;/ 14 fAvt Itvs r 4 krl W 'bE o f d 0 190000 PU ice® ! � /)10 �/Z UA171 t� P. 5 77® A, e t Owner w Mailing Address Contractor Mai I i ng Address Building COUNTY OF BUTTE — tEPAIRTMENT OF PUBLIC W,• 'R ' ` ;Oc— �J 7 County Center Drive — Oroville, California 95965 Tel ephone:,1534-4541 APPLICATION AND PERMIT Telephone No. e imo. A. P. No.,_5f --- ©^ 99 Zoning Sa t ' n ire Dept. FireZo_ne Use Permit EQA Parking Parcel parcel Ma 60' R/W Imp Plans Declaration p pro ments .P1h Plans d Par & Approval P Planvpproval NEW n ADDITION n UTILITIESX • OTHER n 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 BUILDING N\ SO. FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee P I an Checki ng Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter' Additional meters, each Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven Water Heater or Space Heater Light fixtures Receps„ switches & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. disp. or D.W. Air conditioner or heat pump Water pump _J, � Mobil Home Facilities Temp. Power Pole Misc. wirina @ FEE $3.00 1.50 1.50 1.50 Q� 1.50 1.50 D, .30 5.00 2.00 @ FEE $3.00-5-0 1.00 1.00 1.00 1.00 1.00 5.00 5.00 I am exempt from the Contractors License Laws of the State of California. Permit Fee SAO $ S MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE PERMIT FILING FEE '$3.00 1 am aware of the provisions of Section3700 of the California Labor Heating 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 Cooling Workmen's Compensation Insurance. I certify that in the performance of the work for which this Ventilation 7` J� permit .is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of Hood 2.00 California. ' - Permit Fee $ $ 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 relatin to building construction, and hereby , auth ' e representativ of the County of Butte to enter upon the ab e- ntioned el .for insp ction purposes. J 15� aUDate Si ature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant TOTAL PERMIT FEE 1$ SSIS(� 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. DIRECTOR OF PUBOC WORKS By ate RdZ;rernmit expires Date 7'"e 2 41 COUNTY OF BUTTE —-+DEP,<RTMENT OF PUBLIC W S� ' - w K 7 County Center Drive - Oroville, California 95965�v Teltephone:1534-4541 APPLICATION AND PERMIT ' BUILDING a T Owner 'SQ. FT. OCC. BUILDING VALUATION Mailing Address ��, / C� ` �p Telephone No. � Fireplace Contractor J Total Valuation Mailing Address f Up- Permit Fee -Plan Checking Fee&/or Penalty - ' �' Tel epbone ry �} oL Permit Fee Building Address ► PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 w Each Trap 1.50 3 Repair drainage or vent piping 1.50 Water piping 1.50 �IiLKG�- Each gas water heater or vent 1.50 A. P. No. — Zoning & Planning Gas piping system 1 - 5 outlets. 1.50 Each additional outlet .30 Fli Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma 60' R/W Im rovents p m Lawn sprinkler system 2.00 Bldg. P16rtsrRec'd Parcel pproval Planspproval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER D& ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 P Main service incl. 1 meter ' Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) _ Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 _Water Heater or Space Heater 1.00 Light fixtures 4 (d2 Receps.., switches & fix outlets 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring ❑ 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 or Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑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 No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fpe _ $ 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 ;abomenti ed propert for i spection purposes.Ivor Date 1 Signature of Permitee or Agent Receipt No. � � 2 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant i C_J e TOTAL'PERMIT FEE Is_W 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. , DIRECTOR OF PUBLIC WORKS By 1 Date 2- 7 -1 " ilding permit expires Date -7 -'91-1 --7-(., NOTE. --All Materials & Accordance with q orkmanship Shall Be in RpCO ^1z d Good Practices and of a qualify. prescribed for Me S lDec Uniform use in* f he Buildinq, Plurnhin9 Machan 'I Codes and Nafional Electrical Cod �a Phis set of plan � °n t. a iab At all. Nrwe's r+iake any chang" or altars w►Mten .perm. from the Worh, county QVINUft. .... „ MUST be am it is :unlawful to ons. on Sam* wI;*qut "of PufAc ?ePtic system and location �`�' X300 Butte Coun to bLS j�L qu'Per Irements. fi' Health pept. �00 The 8ft Setback shall be 5 #, frorn fhe side property line and 5o ff. from ffie.cenferlihe of Me road, perrnitfing am�rimum of a 2 IT, eave.:overhang. ' 'p, Per, °! f•' Will be re (All °^ All utility connections Shall located _ be t. outside the rear third section of the mobile hoe on the left (road) side of them bile home. ZUTTE COUNTy ING bEPAR71`'1ENfi A-PP.R.OVED s C 17 �_ Lot Facilities Length = o MOBILEHOME INSTALLATION INFORMATION - 5 Mobilehome Data H 1. Plot plan dimensioned, location of mobile 1. Length w 7 Width and utility connections? Manufacturer x Yes__K No Vehicle Serial N ...5�� d i/ y 2. Electrical service equipment ampacityAo Insignia Control Circuit breaker ampacity /©� ': 2. Feeder assembly an1pa ty /p -o Permanent Wiring Connection Conduit sizeG Ampacity. /0-b Power supply cor am Receptacle j "opacity 3. Gas inlet size 3. Gas: Natural -� LPG Mobilehone connector size _ � Gas riser size 3/� Capacity 4. Drain inlet size 4. Drain connector: 'describe on reverse side 5. Fater riser size 5. Plater connector: describe on reverse side 6. Are utility COLIiectiong located outside 6. Designed loads: the rear 1/3 of the .nobilei.ome• within Roof'.:;live load !30 ____psf 4 feet of the left' wall.? Yes No Wind load /;L psf. . If not, show di.nensions. above;e (only for robilehomes manufactured after 7. Is the mobileho•ne••clear of septic tank, -October 7,'1973) leach fields and located outside public 7. rIanuf.acturer's installation instructio's? utility casements? Yes_ No ye, c`"`_ No j. 8. Do you propose to-do other work on the -- property other than the mobilehome 8. Pill the mobile home be installed on a installation ich will require a permits :separate support structure? Yes No Yes No_� If so, specify' *For plans -and specifications of support system, see other side. w COUNTY OF BUTTE vnpartnLent 01 VubloqworKS 7 County Center Drive, Oroville, Cali rnia PHONE: 534-4541 In I T+ s� v utility 20' th � d G) m • _ to 1 5' N. rt Pi N n K M M i o r mr d p• _ �� �� � wry � �� � �� � .� a (g_-...�.� �. ..�. � �� ,i n w m m w . Lot Facilities Length = o MOBILEHOME INSTALLATION INFORMATION - 5 Mobilehome Data H 1. Plot plan dimensioned, location of mobile 1. Length w 7 Width and utility connections? Manufacturer x Yes__K No Vehicle Serial N ...5�� d i/ y 2. Electrical service equipment ampacityAo Insignia Control Circuit breaker ampacity /©� ': 2. Feeder assembly an1pa ty /p -o Permanent Wiring Connection Conduit sizeG Ampacity. /0-b Power supply cor am Receptacle j "opacity 3. Gas inlet size 3. Gas: Natural -� LPG Mobilehone connector size _ � Gas riser size 3/� Capacity 4. Drain inlet size 4. Drain connector: 'describe on reverse side 5. Fater riser size 5. Plater connector: describe on reverse side 6. Are utility COLIiectiong located outside 6. Designed loads: the rear 1/3 of the .nobilei.ome• within Roof'.:;live load !30 ____psf 4 feet of the left' wall.? Yes No Wind load /;L psf. . If not, show di.nensions. above;e (only for robilehomes manufactured after 7. Is the mobileho•ne••clear of septic tank, -October 7,'1973) leach fields and located outside public 7. rIanuf.acturer's installation instructio's? utility casements? Yes_ No ye, c`"`_ No j. 8. Do you propose to-do other work on the -- property other than the mobilehome 8. Pill the mobile home be installed on a installation ich will require a permits :separate support structure? Yes No Yes No_� If so, specify' *For plans -and specifications of support system, see other side. w In Lot Facilities Length = o MOBILEHOME INSTALLATION INFORMATION - 5 Mobilehome Data H 1. Plot plan dimensioned, location of mobile 1. Length w 7 Width and utility connections? Manufacturer x Yes__K No Vehicle Serial N ...5�� d i/ y 2. Electrical service equipment ampacityAo Insignia Control Circuit breaker ampacity /©� ': 2. Feeder assembly an1pa ty /p -o Permanent Wiring Connection Conduit sizeG Ampacity. /0-b Power supply cor am Receptacle j "opacity 3. Gas inlet size 3. Gas: Natural -� LPG Mobilehone connector size _ � Gas riser size 3/� Capacity 4. Drain inlet size 4. Drain connector: 'describe on reverse side 5. Fater riser size 5. Plater connector: describe on reverse side 6. Are utility COLIiectiong located outside 6. Designed loads: the rear 1/3 of the .nobilei.ome• within Roof'.:;live load !30 ____psf 4 feet of the left' wall.? Yes No Wind load /;L psf. . If not, show di.nensions. above;e (only for robilehomes manufactured after 7. Is the mobileho•ne••clear of septic tank, -October 7,'1973) leach fields and located outside public 7. rIanuf.acturer's installation instructio's? utility casements? Yes_ No ye, c`"`_ No j. 8. Do you propose to-do other work on the -- property other than the mobilehome 8. Pill the mobile home be installed on a installation ich will require a permits :separate support structure? Yes No Yes No_� If so, specify' *For plans -and specifications of support system, see other side. w r LOAD BEARING SuPPOR TS ADDITIONAL CCNL\'7'_;TS Drain Conn/`/pr tor, Describe C---? Water Connector, Describe LO,\D BEARING SUPPORT AIND i'OOTING INFOR',-.ATION Pier Spacing Used Maximum Pier Load Maximum Column Load (multi; --units only) u is Soil Bearing Capacity / 7T Footing Dimension Used et'j\ TYPE OF PIER USED 1� - b Steel Concrete Coacrete B1ecK ` Other / TYPE OF FOOTING MATIERIAL USED Pressure Treated Wood Concrete en Redwood (Grade) Other Approved Type BUTTE COUNTY BUILDING DEPARTMENT APPROVED j,0 PERMIT NO. 6157-76B PERMIT EXPIRES OWNER Irvin D. Schlaf ;CONTR. owner LOCATION (A.P. 47-19-9 S/S Bell Rd., 3/4.mi.E.of Hamilton Nord Cana Rd., Chico Temp. Power Pole Called. PG&E Temp: Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E ` /.� B NA l (Date (Signature) ; r j i COUNTY OF BUTTE - DEPARTMENT OF PU;1PLIC VORKS �� 1 BUILDING INSPECTION -RECORD ` BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms — Parapets 1st Floor r Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor ' Stemwall Siding To out Slab. Roof Sheathing Water Piping Piers Roofing %% Sewer. Garage Fdn. Vents Fixtures Footings StemwaI l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handicapped Conformance *of ex. - structure Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation ' Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls z Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Z,� Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE. 1-131' 77 REMARKS OR CORRECTIONS C� d r/,'Q1E ��/�� /� s7�a�� G- 6 UIT J d: dv7 m� � `;►' � `' ��'�� s ` ���o�,��• lv `' �� //G�t!\ �£T �� GVDo C'�R/s�izCla r/4CiF 9 77 STI/ A/',�r-c✓ /V' ,,� G loo vC I r f (NOTE: An entry must be made on this form each time you visit the job site.) _C(5UNTY'OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Driver Urov�le, California 95965 / 7776 �f/ Telephone: 534-4541 " / / `/lJ-, APPLICATION AND PERMIT U1 t11' vVUIIty vI pUttc tV CIItCI UPVII t11v abo a -me tioned property for inspection purposes. ignature of Permitee or Agent Aj Receipt No. —' White-D.P.W. — Yel6 . vm— Pin -Inspector — Goldenrod -Applicant 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. DIRECTOR OF PUBLIC WORKS By— 'F7 ' P'7 DateZ,VZ Building permit expires Date 3/e?:7 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION 00 Mailing Address 25;<7_7__ ('C> el phone N Fireplace 1/0 Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ 0 C) o Building Address �/C Li ELEVATION CERTIFICATE O.M.B. No. 3067.0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a,waiver of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to supporta request for a Letter of Map Amendment'or Revision (LOMA or LOMR).You are not =required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME MJQ _FFQ re0 POLICY 04FWSTREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER OTHER DESCRIPTION (Lot and Block Numbers, etc.) 0 3 0 CITY ATE ZIP CODE ZI / l,7i 6 SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): I. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX5. FIRM ZONE 6. BASE FLOOD ELEVATION 'KJ 1 8 (in AO Zones, use depth) t. Inaicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE):, L NGVD '29 ❑ Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: /' feet NGVD (or other FIRM datum -see Section B, Item 7) foo 16 SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level L`- _ 2(a). FIRM Zones Al -A30, AE,AK'and A (with bl E). The top of the reference level floor from the selected diagram is at an elevation of Ll�. 3 feet NGVD'(or other FIRM'datum-see. Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with BFE)IT he bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of feet NGVD (or other FIRM datum -see Section B, Item 7). (c). FIRM Zo e A (without BFE). The floor used'as the reference level from the selected diagram isL-W feet abov or below(check one) the hi'gh'est gracie,adjacent to the building. (d). FIRM Zone AO. The floor used as the reference' level from the selected diagram is, �_1_�:� feet above E] or below (check one) the highest grado adjacent to the building. If no flood depth number is available, is the building's.lowest floor (reference level) elevated in accordance with the community's floodplain, management -ordinance? Ell Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level`elevations: GV6'29 ! I Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevatio s is ifferent than that used on the FIRM [see Section B, Item 71, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes 9-4\1 o (See Instructions on Page 4) 5. The reference level elevation is based on: a actual construction i construction drawings (NOTE: Use of construction drawings is only valid if the building dos not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A ost-construction Elevation Certificate will be required once construction is complete.) 3 6. The elevation of the lowest grade immediately adjacent to the building is: feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the comm pity's floodplain management ordinance, the elevation of,the building's "lowest floor" as defined by the ordinance is: i I feet NGVD (or other FIRM datum -see Section B, Item 7). 2. Date of the start of construction or substantial improvement -LAP FEMA Form 81-31, AUG 96 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION I SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation Information when the elevation information for Zones Al–A30, AE; AH, A (with BFE),V1-V30,VE, and V (with BFE) is required., 'Community officials ,who are authorized by local, law or"ordinance to provide floodplain management information, may also sign, the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8` Distinguishing Features–If'the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings; or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. / certify that the information in Sections B and C on this certificate represents my best efforts to'interpret:the data available. t understand that any false statement may be punishable by fine or imprisonment under, 18 U.S. Code, Section 1001. 2 7 J (2,c C- a764 -7 CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal) TITLE Y _ _—S'/ 12H -- Gy 6� -% y 2 V C 1ti1 COMPANY NAME ADORES CITY — STATE ZIP SIGNATURE DAT PHONE— Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. 2 f/ COMMENTS: 7 ►J%I — NA / L i Alis 6 _po U RST a F i k,"I LJSfn�' ON 1 WITH rOfJ#ILES. . 7 ^ rpt SEMENT SLAB No. 27647 647 r .�i:R,SInOR COLUMNS /4 r A V g A ZONES Z 3/�// / �•. A A N t' ZONES -' ' ZONES ZONES REFERENCE PREFERENCE - LEVEL \ ' ' r ,,/ :\� BASE LEVEL REFERENCE �� i r- •` r '�`/ FLOOD LEVEL ELEVATION Oj BASE BASE FLOOD `...._ ADJACENT REFERENCE FLOOD EiE YA•ION REFERENCE ADJACENT GRADE LEVEL ELEVATION LEVEL GRADE AD.'AC ENT;... GRADE The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 SA of" opaoyAoations MMT be ke7pt on thejob aft, 3-11 t-1--mes amid it iisunla�full to allY I iii3c-S Or on sama -withaut WIPM8.n -Delr73siol'! f'-"Gnl the Department of Publio wor43�p' coun4y oi- Butte. AU ovr. , RH440 - AND A &HALL, a- CL CQU PJWEIV-r 0,P ALL t A TH"' 0 '91DE AN.r AZOF "04t A a -TRUC-ru CLZN-rr-' C-oUll:)MC Vr- OA 0 19.- :UUNI� 6*IALL Ive J40TE.- All ITa' & owicie. ppary -511 lot -11- s and ccordsnCo -TvI0tv of "Ort us 6 ;7 rTi,,.3c-r-u3,jd,(o 3 S DSAb & &nll uae Ooale. Cc H6'. 8 V/t- a IN & tv ELL it V% Q I 3 wF-11- d�)e6o xG N LNI 181Yfi1#7$ d � 1Jsuull at, I , k1 sa, a ,i « IL e I 7 a n REcen ON �{ F-(3 pe 1J /�) uiFi it i`L�IOERai------------------ CE FE(OR tG> V �1{ fi� _ yrGGGYf. 05 r �� � 1 •1FI , � �EC7249v1 f3�71iaG�M _ t"'JI' 6 Ari%,q x •� WfF� : _,' � 6 t 3.1 0�2 F-. is rro sa. f o s,. , I— R ! `� 1- Fl -� ,OG !N .:"�3Sian at �`j' '. '"`i �•-'k-L= 7 ' _.�1 .-•'""-•` —' I Grp 6. t Tl..Orr ! f � r 72. PLEA 114" hM , i t uu2� 2 'T r 2 5 1 I tfz �Tt2 EIA -T '7L.1 SCL P7 ii SIM 1 A S8' 32 3 o �o m 5 b iAl.L L7J �j AaG / V sato z A ,c -S r 23 N �-- � � A �7 A 1sXr r 2001`'1 _ a� L�! 5; r0 7 e23 F t � 4) U " �✓__ c - l r _ f' /j—� I S5t0 :A ,Y.10::s' 0 3 L, �� e Fad+F1# �Pr pp/ FIY�PL. c E--. i'.1Gc5 fid- FT 4r -TRY- � o 11tiIC3'.C9 .�.' B+ar`"!C<i32 uired ;pITTt4 T 's.c,Fl- OPT. 4112 ROOF PIER 120' 2.1AX. Loj%as 0 -49 mss: w-zj A v-a j €II 1 r B I p rn FEDERALUA4J:AC1WQC A 10912' Z23c 2 . p ).Yyjs;Nc Ci 'TpAkTiG + I'111? 4 a; to z e tb ut SAFETY3iJNDdWtiS = u> a , r A ,moo' c 1� � � 5700 3 23 r �. 1•- �1 8 V D i} i hb #lmr piat rt�Y be blit+t t G�iocti`rt¢t rt7r � To v.l o K. F E 1 ,� j J � LSC ro s A IC -301.4- 6 p (r&W Avut the tatgth awor Wktth wo z 1. Q.. 1900 3 A 11'4• 3 WINDOWIDOOR SCHEDULE 25G0 6 A SJ ,a` 32 NO. 812E 0£5C4REPTt0M -;tAL VENT N6. I BILE f1E$CAI,Y'ru:,4 GL.aZ vEtiT (r&cau 2' Dearr'y is requircd 61.1 CJ•11LEGEND: ® MAINDISTRIeUTFON P"AOXEL FLEETWOOD 1ITLE t ..A SEE ELECT CIA SPIC:. N 1f 1 av7faltrSfS *.c iiD �CdF7C".-:'7tli �,.l+tD �. X510.✓^ SUPPI.Y.tkRGRIiLE�FECa �J�"T-1 swlrcN 14 TVP Fi.O{3f 01 AN �.A IQ }•1 vL+'r7 . 0 '1..:+ '' 'ib :Yc X Q ' ~ tC _` y ItCHY FIMUHE AIA SI: c PPLY A 12'IG'0Fx taU%O �2.1Qj17[ Err: 1 OG� 6E b TH£RMOSTAt ® CEILMGREGISTEA SALES LINE 1•{.,�ji.T• �. �. �'j-'D F` rt� DRANN 6Y G[l4 EXHAUSFd%EILF1N 5+E.aaw�LL p�t� SMOKE O ETE ;TOR D SUPPORT P --ST DATE iCo"X H.$S�fie fy. 3. F] fa-O"�cF-&'F MGD 5IRET�.gNARGaeuE xIt£ ]r16-.r'r ����'L TY Z. D 000R eE1L TRANUOPItE 4AG4 ..{siHAla iJB) KE�i+i'T Gtr WA "LF Ac 0 7TFAk c" Lij 191997 cc C.. 4 TITLE. t' ® MAIN DISTRIBUTION PANE` FLEE' WOOD V ��� � 1 $1/PPtY AIR GAlLLEiOECi fk►r�vrrls>=� fxc FLOG 2LAN 4 x 10 TYpfel-'-4C�1t SHT OF MIN. PIER 114•' MAX. LOADS TM5 �sT WZJ ILBSI E] �--J XAD .o u�r Cj 3100 A 6'-8- 1 3Z tNs1 A i 0'-9 V2- 2 Z3 1 `4, 1 x700 b a A 17-0- 2 �o r 5700 3 A 147-10 1:4' b tai's z fjsCO q 2t 4900 s t 25006 A S 1, a' 32 1 9 # ` OPT. 4112 SOOT" MIN. 2a$It_.L.. 1r_.so L- PIER 1-4Q" N1nX, �• / /•� LOADS a:c1 wzi 3100 1 A 5..a. 32 0 a m M A,a .2- z 47 00 2 5700 A 17, C) 23 3 U y, B rM —F 4 A 14' 191.A' 6 6-5 00B R 1 r•a- 4900 S IS a. jp ,,..F �'� �k c t S s y,n _ aae SIN TITLE. t' ® MAIN DISTRIBUTION PANE` FLEE' WOOD V ��� � 1 $1/PPtY AIR GAlLLEiOECi fk►r�vrrls>=� fxc FLOG 2LAN 4 x 10 TYpfel-'-4C�1t SHT OF m the mnhilehome`site? Yesf 1 " Nof I If it is, what is ,'Line 5 moot Loaas: Size Minimum Location (from front)