HomeMy WebLinkAbout056-120-005F��& PHYLIS WIKOFF 56-12-p5
V1,
`�4/S C� set, Rd ,, 4
3/�0 mi -N Maple L,�
Cohasset
Permi t��2825-85 �".
ELECSC
(util, MH) o-
GAS 4 3 cv.445111 — 8 /3 -
SUPPORT STRUCTURE REQ-/`
COMPACTION TEST RE p
56-12-05' . I-n��l
Cont: Ger c
Permit 42_86' Dremis/S/8� ,is D
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MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA — 534-4541
PERMIT N0. 2 825
Address or location of mobilehome IMIIJ &-a1v,L
Owner's name_ <!'
vOwner's address h n 3c3k` �iJ
E Insignia or hud number �'7 q 3 c � j 271362 2 2 9
i; Manufacturer's name
i 7 �q
Serial number of V.I N.! / �L� Year of manufacture
(Official Approving Installation) i(Dat°e)
�IF TH15•MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION
'EPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE
�LEHOME IS INSTALLED ON A FOUNDATION SYSTEM.
ti
513B White - Owner, Yellow - Installer, Pink - D.P.W.
w6 I 't
PERMIT NO. 2825-85P E MH
PERMIT EXPIRES A6w
OWNER _ FRED & PHYLIS WIKOFF
CONTR.. owner
ASSESSOR PARCEL 56-12-05
LOCATION W/S Cohasset Rd, 3/10 mi N Maple Ln,
Cohasset
• r
r OFFICE COPY
Address
e
GAS /
Meter By S Date 3 �p
ELECTRIC
Meter By Date
f�
1b
+1
1
Temp. Power Pole
Called PG&E _
Temp. Elec. Service
Called PG&E
Temp. Gas Service
CalledPG&E
JOB FINALED (Date)
r
r
Signature ,f��
S
J OK
0 = Not OK
— = Not Applicable
* = Not Ready
MOBILEHOMES
.....
MISCELLANEOUS
i'
Date
MOB16RMME UTILITIE (Plan OK except #'s
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s
1,00'Zo0ktg Requirements—Setbacks—Easements
1. Zoning Requirements—Setbacks—.Easements
of Special MH Support—Sketch
2. Footings; Size—Depth—Spacing—Connectors
Pllsiaw&; Location—Test—Fall-C/0—Concrete
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
at r; Location—Test—Easement Needed (Sketch)
4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing
Ele Tlcity; Location—Clearances—Grnd.—//:�cl/ Amp—Concrete
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
ocatiort—Test—Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft. "LPG
6. Carports; Windows—Doors
tility Clearance
7. Elec.
Card -BI
-Se Date 17 .b) Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date ) Card -BI Date
Card -BI
Date Card -BI Date
Date
!V!OrILEHO,& INSTALLATION (Plans) OK except #'s
Date
POOLS (Plans) OK except #'s
Of honing Requirements—Setbacks—Easements
1, Setbacks—Easements
ootings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
as; MH Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
1ectricity; MH Test—Crossovers—Breakers—Clearances
4. Elec.; Receptacles and Lighting; Distances—GFI
Drain; MH Test—Fall—Flex Connector
5. Elec.; Pool Lighting; 15 volts—GFI
Water; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
Water and Sewer Connected—C/0 to Grade—HD Approval
7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enclosures—Panel boards—Ins. to Main in Conduit
V'Exits; Insp.—Sketch
Cert. of Occupancy
g. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
Card B -I
Date 3 S �' Card -BI Date
Card -BI
Date Card -BI Date
Card B-1
Date / Card -BI Date
Card -BI
Date Card -BI Date
u
J = OK -
0 *Not OK �•,
= Not Applicable RESIDENTIAL -(Single and Duplex)
�lE _"Not Ready , ,
Date
UNDERFLOOR Plans OK exce t#'s
Date
FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings
2.
Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
51.
52.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers -
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts -Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7. Piers -Fireplace Ftg.-Steel
8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
54.
Glazing Area -Glass Protection -Skylights -Plastic
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Card -BI
Date Card -BI Date
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except #'s
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI
Date
Date Card -BI Date
PLUMBING (Permit) OK except #'s
14. Water Ht.; Vent -Access -Combustion Air
57.
58.
Smoke Detector
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels '
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Card -BI
Date Card -BI Date
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except #'s
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
20.
Fixture &Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
21.
Elec. Receptacles Spacing -Lights & Switches at Doors
70.
Plb., Elec. & Mech. Equip. Listed for Location
22.
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23. Romex Installed Close to Edge of Studs & C.J.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
Insulation -Foam -Looked in Attic E3 Yes
73.
Guard Rails & Deck Construction -Post Caps
25. 2 Appliance Circuits in Kitchen & Conductor Size
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
27.
Range Circ. ,/ / ga. Cu or AI -Oven Circ. / / ga. Cu or At,
Insulated Neutral ❑Yes ❑No
75.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters El Yes EJ No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish `
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
77.
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
79.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card BI Date
81.
82.
Ventilation throughout House
Glass Protection t
Card B -I Date Card -BI Date
Date
MECHANICAL (Permit) OK except #'s
83.
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
31.
A.C. Ducts; Insulation & Support
85. Water & Sewer Connected -C/O to Grade -HD Approval
32.
33.
Vent Fan; Exhaust above Insulation
Condensate Drain & Overflow; Size & Grade
86,
Energy Compliance Certificate -Other Certificates
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRAMING Plans OK except #'s
Comments at Final:
36.
Sills; Proper Material & Anchors
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
38.
Bearing Walls over Girders & Floor Nailing
39.
Draft Stop in Walls (rat proof)
40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
41.
42.
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -Connectors -
43.
44.
45.
Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfn_g_._
Fireplace Ties or Type A Flue -Fireplace Throat
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
46.
47.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
Garage Fire Protection Framing
,
1
(NOTE: An entry must be made each time youvisit jobsite)
COUNTY OF BUTTE
!, DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751,
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
Y,25 - 1?S
T NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector Date —?15191
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534A541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
(A), k0 FF a5fa S- �'K
OWN R 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 off c'e immediately.
IP_ 1. C4111Ii14-i uIi
r) LA. 1
V
/ s
�f e)J'Q -P /.N/V t r (' fca null — f n:uiw.r�w'—_ _ .ice._
0/,- 4,3 lever' -�r�Nches _.f G S
InspectorDate--"1 1 ' ifs _ _
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
2 8 r S
JFR IIII PFPRAIT Kin
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.
A
Inspector____ _ Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
P FSM ` NO,
ASSESSOR PARCEL NUMBER
?, —
ZONING
,A17 y
BUILDING PE
MIT
OWN
I !
GELEPHONE
7S�
SQ. FT. OCC. BUILDING VALUATION
OW R' M (LING AD SS
z
ONTRA/CTT OO /R -'SS NAME TELEPHONE
CON'TRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTIONLENDER
UNKNOWN
Total Valuation $
Filing Fee
$
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
Ale
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
LV
BUILDING ADDRESS 40
Permit fee
$ /JSS•
PLUMBING PERMIT
Filing Fee 10.00
r
a
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 ST URE
SF ❑ Duplex❑ Mobilehome Other
SPECIFY
Gas piping system 1 - 5 outlets
Building sewer
5.00
Mobile Home
Jt5.00
.00ea
TYPEOF WORK
New f-1 Add ition ❑ Remodel ❑ Utilitie /Installation[] Other ❑
Describe work:
Permit IFee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service ip0 AMP ORV OR SLESS
10.00 X00
Main service EA. ADO'L too AMP
2.50 j)
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
ElNON-RESID
I am licensed under provisions of Chapt. 9, Div. 3 of the BUSIneS$
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)
El 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.e
OR ACDNS. ( ACG. BLDGS.
,/a2$gft
NEW CONSTR. ULTI.OUTLET
BRANCH CIRCITS
2,50 ea
% POWER APPARATUS e�
C� SINGLE OUTLET CIR.
A-'
Ex. OCcup(OUTLETS OR FIXTURES
20
eALOAL030
FIXED APPLNS. OR
EX. Occup. OUTLETS (RESID.) EAJ
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the 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 liabilities, judgments, costs, and expenses which may in any way accrue
again sai County in consequence of the granting of this p it.
ate �,d9j
Signatu f Applicant — Owne Contractor Agent
An O$ A permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures o3 stories in height.
over
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FE �' a
OCCUP.
CONST.TYPEJ
FLooD PARC
PD ND ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIREC 0 OF PUBLIC
BY
PERW EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
to
p Q
Receipt No. '�C d P
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
OWNER
COUNTY OF BUTTE - DEPARTME14T-001 PUBLIC WORKS - BUILDING DIVISION %I
7 COUNTY CENTER DRIVE - OROVILLE,.�CA_L ,RNIA 95965 - TELEPHONE: 916 51' 44 541
PERMIT APPLICATION DATA SHEET
i dPermit No.
A. P. No.
Proposed Building Use Llk& 117,
PermiVF e Based Upon: Complete Contract Price DPW Valuation
Ot er ( xplain)
Building Inspector w Date /I--,
At time of permit application, I was advised the ollowing data must be submitted prior to permit processing
and./or issuance: DATE RECEIVED APPROVED
1. All items have been submitted..
2., Plot plans in duplicate/triplicate. . . . . . . . .
3. Complete plans in duplicate/triplicate.
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings'.
8. Fees of $ . . . . . . . .
Letter of signature authorization./
19z�..
Sanitation approval from G�7 G Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13-. Contractor's License Information (no., name style,..classif.)
14. Owner -Builder Verification (Given to owner , Mail to owner ❑)q.Tta-�,�
15. Improvements may be required. • . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . . . .
Pre-Insp7. Pre -Inspection for Required. Building
request to (Dote)
p q Building Inspector
1 ecorded copy of Agricultural Acknowledgment Statement .
19. Other Drivewa ermit & const. approvalreguired prior to occupancy
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other
Copy of plans sent Health wept., _rire wept., Uther uate
During the plan checking process, the following data
(For required items not checked above
1. Index permit for above Items No.
2. Additional items required:
ust be submitted prior to permit issuance:
timq 9� application, circle item.)
(Contractor, Designer, Owner) was advised of above required data by
By
r
Telephone Mail
r
Date
r
Plans checked by Date,
Plans approved by Date
Other
.
Copy—DPW
Other
r
TO:*Building Department
FROM: Environmental Health, Chico
SUBJECT: Sanitation Clearance
Owner Location IV, AAP#
Plan approved for: sewage disposal r� water supply
Hold final for:
Final clearance O.K. for:
Clearance for_ obile home Other
water supply
water supply
Note***
Sanitarian Date
I
Ql
APS#
OWNER W ► Imo ��
PERmrr �k .t Co — IfS
MEI UTIL. CLEARANCE DATE
INSPECTOR; `✓�!---
G
ELECTRIC
GAS
Support
Struc.
Compaction
Test Re .
Service
iize
Other
Load
Type
Pipe
Size
Length
YES NO
YES NO
30 A-0
LI .
4 ('
3�
s• i
V COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 959f5 - Telephone 916/534-454
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER ^
0BUILDING
ZO I
PERMIT
OWNER, ,.
TELEPHONE
,SQ. FT. OCC. BUILDING VALUATION
OWNER 'S MAIL G AD RES
CONTRAC T OR'S NAME
T LEPHONE
CT RACZ, MAILING ADDRESS
O
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
,$' I'
S
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS „^
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
�o�G ss fi
Each Trap
2.00
R C
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME f
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF TRUCTURE
SF ❑ Duplex obilehome Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G W
0.00 ea
TYPE OF WORK ,�-,�
New ❑ Addition R model ❑ Utilities ❑ lnstallationL`� Other ❑
Describe work: 14t` e rbl I f —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6001 OR LESS
100 AMP OR LESS
10,00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare er penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessPOWER
and Professions Code and my license is in full f rc and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.&
OR AODNS. ACC. BLDGS. , /20sgft
NEW CONSTR. ULT"OUTLET
NON-RESID BRANCH CIRCUITS) 2.50 ea
/ APPARATUS tr
(SINGLE OUTLET CIR.
Ex. OCcup�OUTLETS OR FIXTURES 20050Q
SALeao
Ex. Occup. OUTLETS FIXED P(RESID )REA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. byirin 9 15.00
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ Th rmit is for $100.00 (valuation) or less.
have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree t save, indemnify and keep harmless the County of Butte against
all liabil s, ju ments, costs, and expenses which may in any way accrue
inst i County 'n consequence of the granting of this permit.
_ _
Sign ure of Ap (cont — Owner ❑ Contractor DAgent Elwork
An SHA per it is required For excavations over 5'0" deep and demolition or construct-
ion of struct es over 3 stories in height.
Mobile Home installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $ �0
OCCUP,
CONST.TYPC
�oaFLOODJPARCFLJ
PD
NO
ISS
This permit is hereby issued under
sions of the Butte County Code and/or
indicated above for which
DIRECTOR OF ELIC
r
BY
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Dat
Receipt N .4 _ 2315
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF- PU'BLI.0 WORKS - BUILDINGrDIVISION
7 COUNTY CENTER DRIVE - OROVILLEC'AIyfFJRNIA 95965 - TELEPHONE: {16/53541
PERMIT APPLICATION DATA SHEET`
Permit No.
OWNER �C'C` I �iDi�. A. P. No.
Proposed Building Use.
Permit Fee Based I Innn
('mmnlPtP C;nntrart Price
DPW Valuation
Building Inspector [/yr nate L-1/ Cni n (6�2
At time of permit application, I was advised the following data must be.submitted prior to permit processing
and./or is ance: DATE RECEIVED APPROVED
1. All items have been submitted. . . . . . . . . . . .
2., Plot plans in duplicate/triplicate. . . . . . . . . . .
3. Complete plans in duplicate/triplicate. . . . . . . . .
4. Complete engineered plans and calcs. . . . . . . . . .
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and''AC Buildings.
8. Fees of $
9. Letter of signature authorization. . . . . . . . .
10. Sanitation approval from Health Dept.
11. Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ )
15. Improvements may be required. . . . . . . . . . . .
16. Mobilehome Installation Data. . . . . . . ..
on
17. Pre -Inspection for Required..Pre-Inspec. request to (Date)
pBuilding Inspector
18. Recorde�Rc �X�A�.�q jr J, Acknowledgment Statement . .
19. Other �l�u""�i�l �c;onstruction approval required prior to occupancy)
When you issue t 'it, r as follows: Mai owner Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
Other P
ate 2
Applicant
Copy of plans sent Health Dept., Fire Dept.,
0 her. Date
During the plan checking process, the following data mus
(For required items not checked above at tie
1. Index permit for above Items No.
2. Additional items required:
e submitted prior to permit issuance:
of application, circle item.)
(Contractor, Designer, Owner) was advised of above required data by Telephone
By
Plans checked by -
Plans approved by
Other
Copy—DPW
4
Date
Date 3
r
-Mail Other
Date
� t e
� �.js tw •l}..: T � C,?�Cr. � �`" °fir "C3s.F y5i � ^t+ta;•,•�''.;`
BY FLEE7WCOD
64,-0,.
9.-4.,5,_4.'13'-0'/."�9._4.,�{-X13._4.,
0 cfl
r____l r____. �❑ �____ F DESK I O _________________
1
I I 2 1
1
0
UTILITY
= i YN ; KITCHEN 1
f OQJ 1
ovr ; BEDROOM
UTIL SINK
1
1
LINEN -------------
v ;
33'-4" I 'LIVING ROOM 1( 1I
MASTER
BEDROOM
DINING U =
AREA m BEDROOM
O
MODEL 7643C (approx. 1,819 sq. ff.)
AND
H "rf 1 141
�CLMFTCATRH OF CWUARM KIM
MME COMM ORDINANCE 2463
.1— nico Unified Sd of DI'BU t QWtifias that
/i%iy 11% ili��e%.ealrruar�. e
ZeGfilit pp iCallt Qne
Son' *P-- Z2,I4ey.'�,,,r.�r
C_ 0- e
P
'ied witha requirements of Ordinance 2463
_f i�.g t residential unit(s)
G.. , :::s:Dr Parcelby the
pay. .'o Jt of fees of A_ZGro or execution of a
School Impact Mitigation Agreemnt dated / /_.
. _ wed ���.
���,� ��
.���,
_� <<wd
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's Name: X21 fJp��
2. Installer's Name:
3. Is the site currently under permit? Yes No
_ (If yes,
furnish permit number
is
) OR
Is the site an
existing site? .
Yes
Amps
6.
No
N
(If yes, furnish two plot plans.)
4. Will the mobilehome be located at least 5 ft. away from septic. ank and leach
fields and clear of all setbacks and easements? Yes No F-1
(If no, clarify
5.
What
is
the
mobilehome
electrical rating? ---------------
11670
Amps
6.
What
is
the
mobilehome
site service
rating? -------------
20—D
Amps
7.
What
is
the
mobilehome
site circuit
breaker rating?
Amps
8.
Is there
any
other electric
load to
be served by the
mobilehome
site service?
--------------------------------
Yes
No
F
(If
yes,
identify
the load and
size:
(Load)
(Amps)
9.
What
is
the
mobilehome
site gas pipe
size? --------------
10.
What
is
the
type of gas
service? --=----------------
Natural
LPG
11. What is the gas pipe length from meter or tank to the P< '
mobilehome? ---------------------------------------------
* 12. What is the mobilehome gas demand? ---------------------- (BTU)
*(This information not required if pipe length less than 6 ft, on
natural gas or less than.50 ft. on LPG.) 4 ft vn__4?L
BUTTE COUNTY
BUILDING DEPARTMEN11
APPROVE M
�d-
MOBILEHOME SUPPORT DATA
�- Mother. than single wide
Mobilehome Mfr. ,lc /V/00)0 furnish Setup Model No. -3 Year_, q '�
Width 3L (ft.) Box Length1U."L(ft.) Tagalong or Expando Size ft. x ft.
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
FOOTINGS (check one)0. Wood -pressure treated or foundation grade. 2. Other (specify)
SUPPORTS (check one) 1. Concrete block. 2. Other (specify)
Pier Footing Sizes and Locations
SINGLE -WIDE MULTI -WIDE
r
Main Beams —
Line
Line 1 Piers:
Size-Min.------------
Spacing-Max -
-----------
Spacing-Max. ---------
From Ends -Max. -------
Line 2 Piers:
Size -Min.------------
Spacing -Max. ---------
,_6 „
From Ends -Max.-------
1,-o,,
Line 3 Roof Loads: ,
Size -Min .----------
Location (From Front)
Main Beams — — — — — — —
-Line 4
Tag or Triple
i Line 1
Line 1 Openings:
Size -Min. ------------------
ux u
Each Side of Openings
With Width Over ---------
Line 3 Piers: (Under Bearing Wall Only)
Size -Min -------------------
Spacing-Max ----------------
------------------
Spacing-Max.--------------- ,- „
From Ends -Max .------------- r_ n
Lne 4 Piers:
Size -Min.------------
Spacing -Max. ---• ---
From Ends -Max .-------
Size -Min. ------------------
'k "
Spacing -Max.--------------- •_ „
From Ends -Max .-------------
Line 7 Noor Loaa9:
Site -Min. ------------ 6 ,,x3 x „x
(5u 2h .. ou na r,x n a nx a ux n
Location (From Front) /G l xJ „ 17 ,_ , O „ , „ „ ,
( .d
J os_
, D r -v A 4 - 7 � --,,z o � A, o -� �e
NOTE—All Materials & Workmanship Shah Be in
Accordance with Recognized Good Practices and
of a quality prescribed for theSpecified use in the
Uniform Building, Plumbing & Mechanical Codes and
+he National Electrical Code.
This set of plans and specificnItions MUST be
kept on the job at all times and it is unlawful to
make any changes or alterations on same without ,
written permission from the Department of Public
�1Norkc,
County Pf 8 d
'
A
M
stn-.e
tn
for
AID
BUTTE COU N
BUILDING DEPA
Utility connections shall be wit) 11
4 ft. of the mobilehome, eithef-, r
directly behind or within the real
half of the roadside (left) of the
' mobilehome.
47 IV
back ofYft. from the
arty lines an a setback
ft. from thLoad
dine shall �clearof
,ures or eg4ipment except
2 ft. eave 7�rhang.
C�
e�G� ,,b.C�rOX :� �l/G � �
"Ad
T
Y:
MENT . 1
APPROV D
All that realr
p operty situa[e in the County of Butte, State of California, described
as follows: A portion of the North half of the Southeast quarter of the Northeast quarter
of the Southeast Quarter of Section 22, Townshin 24 North, Range 2 Fast, M.D.B.&.M.
BEGINNING at a point on the Section line between Sections 22 and 23, said point bein^ 792.0
feet South of the quarter corner common to said Sections 22 and 23; thence South on said
Section line 198.0 feet to the Southeast corner of a pavgel of land dgcribed in Deed to
Ray F. Coker, et us, recorded August 11, 1942, in Book 301 pf Butte CI3> ty Official Records
at nage 307; thence along the Southerly boundary line of said parcel of land, West, 660 fee
to the Southwest corner of said parcel of land;'thence along the'Westerly boundary line of..
said parcel of land, Nortn, 198 feet to a point; thence East 660 feet to the true -point of
beginning.
III t)8 11042 qifbacmhoW A dchotcM
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PrlWio"� fmlolillu
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10 .7t))Uj-Ujj;;
!3Vo 1") , * t's r. '!G1
TMA noi-111--iew bele 10,01q 10 fez MT
16 to doj
v -4-1-11y) loamp"
InA2,Lmn 015m
0-
9 q
Cl
YOUR RECEIPT
THANK YOU
10/17/85D0055,
11:56AM TERI
THU
BUTTE CO RECD.
33227#
ALLOTHER
FEE PAID.
5.00
CASH 1 5.DO
CCORDEd ;ii OFFICIAL RECORDS
Return to DPW ACR.' CtUXURAI, STA'1'i IAENT OF ACKNOW1,EDGS KLN`f_OF BUTTE COUNTY. CALIFORNIA
FOR RESIDENTIAL t)FVELOPMENT _ AT THE REQUEST OF Page
Section 26-8.1 of the Butte County Code requires this acknowledgement PARTY SI'OWN
be recorded prior to issuance of a building permit. 1985 OCT 17 AM !I: 55
The property described herein is adjacent to land or includegLEAROR M.BRXER
within an area zoned for agricultural purposes, and residents of Ct5M$-RECORDER FEE ✓✓✓
property may be subject to inconveniences or discomfort arising from 85_33227
the use of agricultural chemicals, including, but not limited to herbicides, pesticides,
and fertilizers; and from the pursuit of: agricultural operations in;:luding, but not limited
to culti.vation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural zones which have as a
priority use for productive agricultural purposes, and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or disconform from normal,
necessary farm operations.
All that real property situate in the County of Butte, State of California, described
as follows: A portion of the North half of the Southeast Quarter of the Northeast nuarter
of the Southeast Quarter of Section 22, Township 24 North, Range 2 East, M.D.B.&.M.
BEGINNING at a point on the Section line between Sections 22 and 23, said point beim 792.0
feet South of the quarter corner common to said Sections 22 and 23; thence South on said
Section line 198.0 feet to the Southeast corner of a parcel of land described in Deed to
Ray F. Coker, et us; recorded August 11, 1942, in Book 301 of Butte Countv Official Records,
at nage 307; thence along the Southerly boundary line of said parcel of land, West, 660 feet
to the Southwest corner of said parcel of land; thence along the Westerly boundary line of
said parcel of land, Nortel, 198 feet to a point; thence East 660 feet to the true point of
beginning.
Date: l0—/�— ,
es—
PROPERTY OWNERS:
NO AMPARFD
WIC
OR/G
�oCUME
Nr
State of
SS
County of )
(' kern fZ lY)
a, J +0
l�3
'2-
-1- (:- 04 6?S��
Present A.P. No,
On this the _I day of Q,��A c
me, the undersigned Notary Public, personally
I
19-, before
appeared
/ Personally known to me.
Z'/,Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose name(s) Gi.,1J'-_ subscribed to
the within instrument and acknowledged that '
executed the same for the purposes therein contain
1N WITNESS WHEREOF, I hereunto set my hand and official seal.
Ynna¢¢ierrtuauuatnuaUA/
auaiunanaauuAjQr Public
OFFICIAL SEAL
VICTORIA A. DUVAL
c,.4. "•�NOTARY
9 PUBLIC — CALIFORNIA :,
COUNTY--Oi BUT7f
�. Comm. Ex P. 1lams 29, 1988
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