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056-320-014
z'I 56=32-14 Daniel J. Burgess 56-32-14 54-89A.. W/S 1 t pri.rd.,below gar and rd., .3 HORD, David 11 mi. E. Hwy 32,E 5326 Headwaters Rd., Forest Ranch ,. Permit ��2-76P,E(util;.,mh) A exemption ELEC..� =. w t_for 'stg of horse feed GAS supplies & hay truck stg SUPPO T MJCTURE REQ. a�� 5 COMPACTION TEST REQ. -32-14 (/ CONTR: Kentwood ile Home Sales, Chico Permit #2827 MHI Issued 2_ 56-32-14 1478-90B °HORD,.David 5300 Headwater ,r Forest Ranch (storage g)��y/U-,34-q(�` 56-32-14 3970-90E j HORD, David 5326'Headwaters Rd, Fores Ranc (split elec serv) 1,� ►- 056-320-014 PERMIT#94-1661 H6RD, DAVID 5326 HEADWATERS RD., FOREST RANCH � GAS LINE/MH (0/9 r f 1 I Ar , <1� 0 I i �;�3�j,F'.�,'�.1`l�►".•.,qi n'\'�.iri�i�.�:i�<,'sw+f�aw A'�'e�`�.s:`v�l'r'+�'��t+r��'�""�a"^Ht"1a "!"�y �".'..a��':. r.' -.r t.-ri-c�.'�/�;.x"'�%�+�q+'�"^,','r`y�.l4s`n'.a;.,ttaF""'t5 �•.:•.fswy,�j,._ri, N.,,�,� a lTl y i r �J 1 - • i I �, OFFICE COPY Address Aja `O GAS Meter By Date �G Meter By If j f, — COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT 0. APPLICATION AND PERMIT -- �� �h- �/ ASSESSOR PARCEL NUMBER 056-320-014 ZONING T'KS BUILDING PERMIT OWNER DAVIHORD TELEPHONED 894-3183 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS PO BOX 294 FOREST RANCH 95942 CONTRACTOR'S NAME UNKNOWN TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5326 HEADWATERS RD, FOREST RANCH PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF ❑ Duplex O Mobilehome Other SPEcIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S )3_ i W @20.00 20.00 TYPE OF WORK New ❑ Addition D Remodel D Utilities ❑ Installation O Other ❑ Describe Work: GAS LINE PERMIT FEE $ 40.00 Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( III OR LESS ) 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 6 ACC. BLOS. ) SD. 3.5C FT. CONTRACTORS LICENSE LAW( I declare under penalty of perjury (check one) 0 I am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification O I, as the owner, or my employees with wages as their sole compensation, will do ,the work, and the structure is not intended or offered for sale. (Sec 7044) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O I am exempt under Sec. Business and Professions Code forthis reason NEWCONST. MULTI -OUTLET -NON.RESID. ( BRANCH CIRCUITS ) @7.50 POWERAPPARATUS ) 6 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) B20AL. @ 1.00 Ex. Occup.FIXED APPLNS. OR ( OUTLETS (RESID.)EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. D I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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 CouRty_in consequence of the grant; of this permit. y� X l iW / Date b+ — / C Signature of Applicant - Owner D Contractor ❑Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structuresover 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 40.00 HAZ. 1 D. FEES I IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. %%e ate 7' BY % /� PI ON b /Dare/ tts Receipt Z ,J WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD-APPLIC ANT .D. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, Califprni, 95965 - Telephone (916) 538-7 ER IT No. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 056-320-014 ZONING TM5 BUILDING PERMIT OWNER DAVID HORD TELEPHONE 894-3183 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADOflESS PO BOX 294 FOREST RANCH 95942 CONTRACTOR'S NAME UNKNOWN TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5326 HEADWATERS RD FOREST RANCH PERMIT FEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SFO Duplex O Mobilehome INOther SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S $I W @20.00 20,00 TYPE OF WORK New O Addition ❑ Remodel O Utilities ❑ Installation ❑ Other O Describe Work: GAS LINE PERMIT FEE $ 40.00 Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 23.00 200A OR LESS Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. ) 3.50 FTD,. OR AODNS. ( a ACC. BLDS. S CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification O 1, as the owner, or my employees with wages as their sole compensation, will do �he work, and the structure is not intended or offered for sale. (Sec 7044) I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) O lam exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. p,.o o Ex. Occup. ( OUTLET OR FIXTURES 20 ) BAL.20 .00 Ex. Occup.FIXED APPLNS. OR ( OUTLETS I ) 5.00 EA. Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 deplare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. O I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a cIertificate of Consent to Self -insure. shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California 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 Coup in consequence of the gra ti of this permit. l X Z_ Date / Signature of Applicant Owner ❑ Contractor O Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 40.00 HAZ• D. FEES IMP F O PD I HD I U 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. 'e / ON /Date! Receipt No.1.0pBy WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD-APPLICANTpI /L ra.iy � COUNTYOF BUTTE -DEPARTMENT OF EfVELOPM ENT SERVICES - BUILDINPDIVISION 7COUNTYCENTERDRIVE -OROVILLE,CALIFORNIA95965 TELEPHONE(94) 538-7 OWNER PERMIT APPLICATION DATA SHEET A. P. No. .56 323 - Proposed Building Use /r'1 r/ C/r.S % "'V 117 Bu'ildirig Inspector Date o/y At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: v/ DATE RECEIVED BY 1. All items have been submitted . ....................................... . 2. Plot plans, 3/4 sets, signed by preparer of plans . ............................ 3. Complete plans,,3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and'calcs, 3/4.sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ..................... . 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Developmental (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ..*cti. . Preanspeon request 20. Pre -inspection for required. .. to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner 1. .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ....................................... . 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . ........................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . .................................................... . J' 33. 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. eliver with inspector. Other Parcel Creation RV Acreage Applican Date 3; 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 must 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 _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on* 'holdJn File cabinet AP folder Copy - Department of Public VVorks COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF.DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE New OWNER PERMIT NO. A routine inspection indicates that -the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. I u have any questions pertaining to this matter, or need additional explanation, please co act this office immediately. _A - n 1 z (0 r Date 6 Inspector REV 10/92 _ ,hb."'sil•..'1T SP` }' �`v=•tiiw�rrpt'r.�N.'-. . ".rti'Vn.:;< t^"7+.tfv�i'fS,.re!.1:iy N41.4' i�q ,b•i,i, , " •,C'! 'f�'`i•. y .,;•.ft�t� .'1^ri: t•}••''�''^".-r�.;r.., - ,'t. .. �r "K 6-32-14 3970-90E •.__ • Yom. �HARD, David s 5326 Headwaters Rd, Forest Ranch (split elec serv) /2.0 I� r t • i 1 - 4 OFF C� E COPY Address 3 GAS r Meter By Date ELECTRIC r� Meter By %�/� Date�i2 r {• A 4L_.It4 COUNTY OF` BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 0. APPLICATION ANU PERMIT PERMIT NO. R- NUMBER 56-32-14 ZONING 1 BUILDING PERMIT OWNER DAVID HORD TELEPHONE � ;' SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. BOX 244, FOREST RANCH 95942 CONTRACTOR'S NAME 01�1\GR TEI,_EPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5326 HEADWATERS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 FOREST RANCH CA 95942 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 ELEC SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities X❑ Installation❑ Other ❑ Describe work: SPLIT MAIN SERVICE _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eoov OR LESS 100 AMP OR L ESS M 10.00 10.00 Main service EA. AOO'L 100 AMP 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business a Professions Code and my license is in full force and effect. icense 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 oa ADDNST ( DWEACCLLING GOCCUP.&) S. 21h ¢sq ft NEW CONSTR ULTI-OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS & (SINGLE OUTLET CIR. ) Ex. Occu p OUTLETS OR FIXTURES e20@50a ALO 301 FIXED PR Ex. Occup. OUTLETS IRESID IEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 PRE 1 Permit Fee $ Contractor 52.50 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. VI 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 pxoperty 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.aid Coun in consequence'of the granting of this permit. ` X J' Date l -o M, . ?f1 Signature of Applicant — P Owner ❑ C tractor ❑ Agent Ne An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee ol*'"� r $ .Energy Inspection Fee $ occ I CONST TYP__T E — TOTAL FEE $ 52.50 HAZ 1. CUA I PARK SCHL I FLD I PAR PD Ho I ISSUE This permit is nereby "issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PER EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date 't^'y" 4� Irl- y—_ I f Receipt No. 84067 WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovilr, California 95965 - Telephone: 916/538-7541 APPLICATION AND -PERMIT ' 1 eg FIM IT NO. \ A Xj 56-32-14 ZONING BUILDING, PERMIT OWNER DAVID HORD TELEPHONE SO. FT. OCC. BUILDING VALUATION - OWNER'S MAILING ADDRESS _ P.O: BOX 244 FOREST RANCH 95942. CONTRACTOR'S NAME, - OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER - UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS - Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS , 5326 HEADWATERS Permit fee $. PLUMBING PERMIT Filing Fee 10.00 FORESTEach 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 ELEC'- SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 1 1 110.0 e TYPE OF WORK New El Addition❑ Remodel❑ Utilities❑x Installation❑ Other ❑ Describe work: SPLIT MAIN SERVICE Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V OR LESS 100 AMP OR LESS 10.00 10.00 Main service EA. ADD -L 100 AMP 2.50 2.510 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): - ❑ I am licensed under provisions of Chapt. 9,.Div. 3 of the BuSlnesS a ' Professions Code and my license' is In full force and effect. icense No. Classification I, as the owner, or my employees with wages astheir 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) 1 ❑ I am exempt under Sec. , Business. and Professions Code for this reason . NEW CONST. DWELLING OCCUR.&` OR ADDN5. ACC. BLOGS. I 2/20sgft ;NEW CONSTR ULTI-OUTLET NON.R ESID BRANCH CIRC ITS 2.50 ea - /POWER APPARATUS & (SINGLE OUTLET CIR. Ex. p10UT LE TS OR FIXTURES Occu / 20130C BALO30 Ex. Occup. OUED ARPLNS. R TLETS RESID )EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00. Misc. Wiring 15.00 15.00 PRE INSP L5.001 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 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 52.50 MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g 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, Jud ents, costs, and expenses which may in any way accrue• agains. a'd Coun in copse e e of the granting of this permit. �' %� Date dtl d Signature of Applicant — Owner ElC tractor 1:1Agent An OSHA permit is required for excavations over 5'0'' deep and demolition or construct- ion of structures over 3 stories in height. t Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE AL E TOTAL FEE $ 52.50 HAz CUA PARK PAR PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By ' 'PER 'EXPIRES Date• the applicable provi- resolutions to do have been paid. WORKS Date /!'rte— !/r�! Receipt No. 84067 WNITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT- '�Mr 'Yi1.-:�11+ �`5.:+�i{S�n�.,T�+.:�c,y� .�a.s'�` , j-.- �,L, ,• -.�, � �... , i COUNTY OF BUTTE - DEPARTME T OF PUBLIC WORKS - BUILDING DIVISION 4 7 COUNTY CENTER DglVk jQI� VILLE, CALIFORNIA 95965 ,.TELEPHONE: 916/538-7541 PERMITAPPLICATION DATA SHEET Permit No. OWNER V 1 i7 1-i l% /1-I� A. P. N0 �- Z Proposed Building Use Ci�_-- 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 duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and,supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss 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 Area fees paid ....................................... 12. Park fees paid .................................................... 13. i School District fees paid .............. 14.,,'Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business 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 permit (constructiy ap�royal required prior to occupancy) --6,,,2T Pre -inspection for — :2:2�� C--� 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 ❑) ..... Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. Whe yo. issue the permit, process as follows: ail to owner. Mail to contractor. Zelephone and hold for pickup at office. Deliver w/inspector. Other Applicant ��, Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must 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 ---naiI unter by -date Contractor, designer, owner, was advised of above required data by—phone —mal I—counter by date Pand s`hecked by Date Plans approved by Date Sets of plans on hold in . File cabinet AP folder \ Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive = Orovf1'Ie, bal°rfornia 95965 - Telephone: 916/538-7541 J OPtICATION AND PERMIT ASSESSOR PA CEL NUMBER ZONING BUILDING PERMIT OWNER " IlJ TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNE�A LING DRESS M per)ccii Cif CONT �C TSO%R'S W TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDI RE s _ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 _ _ _V 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 (/L� SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W 10.002 TYPE OF WOR New ❑ Addition ❑ Remodel ❑ Utilities Installation❑ Other ❑ Describe work:. L G Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 211v oR LESS 100 AMP OR LESS 10.00 b Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification F-11, 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. ( DWELLINGoCCLIP.1k) OR A.D.S. ACC. OLOGS. l /zdsgft NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS 6 (SINGLE OUTLET CIR. Ex. Occup(ourLETs OR FIXTURES 20@030 SALO 30 E%. OCCUp. OUT LETS PIRESID IREA.J\\ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 �y"O Permit Fee $ 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 ora 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 Fi l 0.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the 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 agairlst-said County in consequ n of the granting of this permit. Date% ~ Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structuresover33 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee g occ CONST TYPE _ TOTAL FEE $ E HAZ CUA PARK SCHLr1I I PAR PD HD ISSUE This permit is hereby issued under sions or the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. ULf" ���% PRE INSPECTION OFINER:�l/lJ-(R"Q, DATE A/oL)- Jam, M� LOCATION: HQa& U.� A. P. # 57%r 3a - y CONTRACTORS ZONING TM PRE -INSPECTION FOR: PAIS _DATE TO INSPECTOR PERMIT HISTORY: NONE AS FOLLOWS: 0,CA s (4-7 _3 Q4) ,tom TYPE OF OCCUPANCY Q B=DING TENNANT: a FIELD - INFORMATION OCCUPIED Zh- HAS ELECTRIC F] HAS GAS _'ZLHAS SANITATION- FACILITIES 51 HEATED -COOLED PERSON CONTACTED 11k� YY�eac., Iia OTHER COMMENTS: D ACTION RECOMMENDED: ISSUE 0 HOLD FOR. P' OTHER: . BY (J DATE .R ENTIAL 56-32-14 1478=90B —�—` HORD, David 5300 Headwaters Rd, Forest Ranch (storage shed/MH) • - looe�-� �Sor~+i. �+�a� j�ar�5 %gip li g A, 3 'r I JOB FINALED (Date) ©� b Signature 0 ��� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — PWne: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 4,72-6307 CORRECTION NOTICE R ..rte. i,.. M A0 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 correc' n of work is completed. If you have any question pertainingjto this matter, need additional explanation, please contact this office immediately. m pKms+ Date � e /u, Inspector J=OK O = Not OKNot L = Not Ready abld MOBILE HOMES lg Date MOBILE HOME UTILITIES (Plans) OK except #a 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / P'L"ft. / P'Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance { Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test-Demand-Valve—Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances S. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 `{ MI�qELLANEOUS Date DECKS. rdVERS. CARPO lans)OK except #'s 5 S. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg: Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carpp&: Windows -Doors Trusses 9. ung; Nailing -Veneer -Stucco -Mesh_. S`h Ca — (,tee 9U Roof; Date -/(p yy Card B-1 (1 pate Card B-1 Date ft) - loll) Card B-1 h4, O Date/I;'30%t) 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, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 8. 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 e A _,V OK 0 U-ev M O - Not OK - = Not Applicable ' =Not Ready RESIDENTIAL (Single & Duplex) ' ' Date UNDE OOR (Plan K except #'s Date FRAMING (Continued) X,Zo'n-Setb s -Ease men ts-Flo -Slope tg., ' ; Soils-Elec. Grnd.- /' Ftg. Depth 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. g., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel-Blockouts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel- Blockouts-Wrapped 50. Garage Fire Protection Framing 6a. Hold Downs and Special Anchors 51. Property Line Firewall & Openings 7. Slab; Steel -Wrapped , 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 8. Piers -Fireplace Ftg.-Steel 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. Gas Pipe; Size -Anchors 55. Siding -Nailing Veneer 11. Water Pipe; Test -Anchor -Regulator -Service Test 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric; Underground 57. Glazing Area -Glass Protection -Skylights -Plastic, 13. Pienums & Ducts; Clearance -Material -Support -Ins. 58. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 59. Insulation -Walls -Ceilings 15. Insulation 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Date Card B-1 Date Card B-1 16. Water Htr.; Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchor -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa Date Card B-1 Date Card B-1 66. Elec. Trim & Subpanel; Breaker Sizes & Labels Date Card B-1 Date Card B-1 67. Stairs & Rails Date ELECTRICAL (Permit) OK except #'s 68. Fireplace or Stove; Clearances -Hearth 22. Fixture & Transformer Clearance -Ins. Protection 69. Elec. Outlets at Wood Panel; Int. & Ext. 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 24. Size Boxes & No. of Conductors -Stapled 71. Elec. Outlets & Receptacles at Kit. Counter 25. Romex Installed Close to Edge of Studs & C.J. 72. Garage Fire Door; Swing -Landing -Closer 26. Equip. Ground made up w/Mech. Fastners-Bond Gas Water 73. A.C. Duct in Garage -Damper -& 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 75. Plb., Elec. & Mech. Equip. Listed for Location 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic Yes 30. Service -Riser Conductors & Ground -Main Disconnect 78. Guard Rails & Deck Construction -Post Caps 31. Equip. Clearances Panels-Motors-Mech. Equip. 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector 80. Following instld.; Drive 0 Yes ❑ No; Walks ❑ Yes 0 No; Planters ❑ Yes 0 No Date Card B-1 Date Card B-1 81. Stucco; Brown -Finish Date Card B-1 Date Card B-1 82. A.C. Unit; Disconnect, Electrical, Plumbing Date MECHANICAL (Permit) OK except #'s 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 34. A.C. Ducts Insulation & Support 84. Water Well; Disconnect, Electrical, Plumbing 35. Vent Fan; Exhaust above insulation 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 36. Condensate Drain & Overflow; Size & Grade 86. Ventilation Throughout House 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Glass Protection 38. Attic Access & Platform if Furnance in Attic 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card 8-1 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s Date Card B-1 Date Card 8-1- 39. Sils, Proper Material & Anchors Date Card B-1 Date Card B-1 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Date Card B-1 Date Card B-1 41. Bearing Walls over Girders & Floor Nailing Comments at Final: 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing each time you visit job site) (NOTE: An entry must be made V COUNTY OF BUTTE —DEPARTMENT .OF .PUBLIC WORKS " 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 --" APFICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 56-32-14 v ZONING _ BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VAL N David Hord (Ask for Mirki 1891-1137 OWNER'S MAILING ADDRESS 351 M 4,914.00 P.O. Box 244 Forest CONTRACTOR'S NAME TELEPHONE Owner CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation 1$4,914.00 LENDER'S MAILING ADDRESS Filing Fee $ 10,00 Permit Fee $ 50.5)0 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 25.25 Energy ecg ' Ener Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS M $ Penalty $ BUILDING ADDRESS Permit fee $ $5.75 PLUMBING PERMIT �aHPadwaters ! Each Trap Filing Fee 10.00 2.00 Solar or heat pump water heater 20.00 L T NO.2 Is UBDIVISION NAME - PARCEL MAP 45-88 Water piping Each qas water heater or vent 5.00 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex[]Mobilehome❑ Other Private Storage Building sewer 5.00 Mobile Home S I G I W 10.00 e SPECIFY TYPE OF WORK New l Addition ❑ Remodel ElUtilities ❑ Installation[]Other ❑ Permit Fee $ Describe work: Tool Storage Shed _ 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 under penalty of perjury (check one): ElI 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 1, as the owner, Or my employees with wages as their sole compen- NEW CONST. DWELLING OCCUP.& OR ACDNS. ( ACC. BLDGS. , 2/20sgit NEW CONSTR.MULTI-OUTLET NON•RESID BRANCH CIRCUITS) 2,50 ea POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@30¢ BAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) Mobile Home Facilities 15.00 Misc. byirin g 15.00 ❑ I am exempt under Sec. , Business and Professions Code Permit Fee $ for this reason Contractor WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT Filing Fee 10.00 I declare under penalty of perjury (check one): ❑+ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling g Hood 3.00 00 I shall not employ any person in any manner so as to become subject Y�l` 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. Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information : Mobile Home Installation Fee $ Energy Inspection Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrueL occ CONST TYPE TOTAL FEE $ 85.75 HAZ CUA PARK SCHL FLD P. PO HD IssuE against said C unty in consequence of the granting of this permit. - T—i X Date ` d Signature of Applico r - Owner Contractor ❑ -Agent [�, 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 paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 storiesin height. DI EC,PR PUBLIC WORKS ' Date `%/ Receipt No.) 5 / 2 0BY WMITC-O.P.W.. YELLOW -ASS f 590 R, PINR•INSPECTOR, GOLDENROD -APPLICANT PERMIT E'VI'RE'S Date & _1 COUNTY OF BUTTE - DEPARTME% ,ONTF PUBLIC WORKS - BUILDING DIVISION .. . 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 r� - PERMIT APPLICATION DATA SHEET i. / Permit No. OWNER �B ✓/A Ae2 4 A. P. No. 5-(- r 32 / V Proposed Building Use /`107, Owtj!c .S<i419 Bui-Iding Inspector C5 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 duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss 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 Area fees paid ....................................... 12. Park fees paid .................................................... School District fees paid .............. Sanitation approval from C, 0 I c_ � Health Department �---�=,�J 15. City of Chico plumbing permit ..................................... 16. Plot plan and business 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 permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... Certificate of Workmans Compensation Insurance ........ Owner -Builder Verification (Given to owner ❑, Mail to owner..—�L,�� Recorded copy of Agricultural Acknowledgment Statement ......... Letter of 'signature authorization ................................... 26. 27. When ou issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone O 'F?- 3 and hold for pickup at office. Deliver w/inspector. Other ? -,4-;rP_ Ge , Copy of plans sent Health Dept., The following data must be submitted prior 1. Index permit for above items No. 2. Additional items required: Appl ica Fire Dept., . permit, issua Date�"r Other Date (Circle new item not checked above). b Contractor, designer, owner, was advised of above required data by�fione�aiI —counter by- gfi�ate �— Contractor, designer, owner, was advised of above required data by phone_mall_cou ter by date Q Plans checked by Date Plans approved by Date Sets of plans on hold in . File cabinet Y AP folder Copy—DPW I TO Buildinc,,Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner. Location AP# Plan :Approved for: Sewaqe Disposal Water Supply .Hold final for:,Water Supply I Final clearance O.K. for: Clearance for bedroom mobile home.. Other o ' NOTE Water Supply Date Sanitarian 60 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orelli;e, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMB R ZONI G BUILDING PERMIT OWNER ( 1//Q 6a /�lexf, Ey, �EONE �73- PHlJ3%- SO. FT. OCC. VALUATION �BUILDING OWN SMAILING ADORE 5 1. o, 6� .`/�1,4Ck 6f CONTRACfTO,R'5 NAME ow dC-4— TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWNT otal Valuation $ 4 / Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ra ,s'�3 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Zr Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 7f PLUMBING PERMIT Filing Fee 10.00 N�t�V �GGf�T Xv �-,� Each Trap 2,00 oot�f� / d R' ty�X /oDv. �ie$� b� fiHif A5 A,0 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP C' Water piping 5,00 Each qas water heater or ven 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome❑ t_50bAiS SPECIFY Gas piping system 1 - 5 out ets 5.00 Building sewer Mobile Home S W 5.00 0.00e TYPE OF WORK Newl5r Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: foa StioA*'C- SYf Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 1 10.00 Main service jp0 AMP O 1 OR RSLESS 10.00 Main service EA. AOD'L too AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- 3 sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ..DNS. ACC. BLOGS. , /20sgft NEW CONSTR AULTI.OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR _TURES eALO 30 FIXED APP 5. OR Ex. Occup. OUTLETS 1 EsID.> EA.) 2:00 Temporary service 10.00 Mobile Home Faci ies 15.00 Misc. Wiring g 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 g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot 1 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 Co my 1onsequ nce of the granting of this permit. ` /Q /G 70 %� ^ Date Signature of Applic nt - Owner❑ tractor ❑ Agent [ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3Cstoeriiees in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST PE �^ TOTFEE $ 91D>^ 2 AL � AL E HAZ CUA PARK PAR PD HD ISSUE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC BY PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. �/ l2*� A/I I �t ��h l PI I� 1 �I F Z�( �I :\ -� } �� ' f- a � \. � ` 4 � I _ - —��_�_ .ter � � � �_� — ' .. � - � r ����� -----r- � �...�.,, t - -+ s -.- 1 £ U �v�D f-�►21� Head uja COUNTY OF BUTTE - Depa"rtment of Public Works 7 County Center Drive, Orovil,le, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement '(yes or no) 2. Iav" have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner Social Security umber Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831.and 19832 of the California Health and.Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. NOTE: All Materials & Workman A. ship S ali.Be in Accordance cordance with Recognized Good PradCes and of d quality prescribed for the Specified use in the Uniform Building; Plumbing & Mechanical Codes and the` National. Electrical Code. Thi$ SO of plans and specifications MUST be - kept on the job at all times and it is unlawful to z make any changes or alterations on same with= I �� out written permission from the Department of ublic Works, Countv of DuttPp"` . 3- Sr 161 _.� q'g C of 9 ft. from the Pr�� lits and a sett 50 ft. from the road centerline shall be clear of J structures or equipment exert l for a2 it. Gave ovsrh". � r^ () Qu- ESE' � �` IBU E COUNN- • �UILQ�NO DEPARTMENT A PFI ov dV :gh61,q0 /� rr . SI �'rrJ w r7� UAP 66�pv CSR �UMOasii7o �/ SrAJfLc 7ff ,2X?X1C5oe, 8PEC4►L ROOF COVERING REQUIRED_ . - ME BUTTE COUNTY BUILDING DEPARTMENT --APPRROVED �o CmOOH CXIA (YO I f- # I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (916) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place- used by the public. ASSESSOR PARCEL NO. FLOOD ZONINGg::�2 Z'6 g/V xz-�� P4n OW PHONE NO. I A � OWNER'S ADDRESS Po LOCATION OF BUILDING 5 Z2 USE OF BUILDING u C ©- 00P SIZE OF STRUCTURE X �' .- (/ li(J SQ. FT. TYPE OF CONSTRUCTION: WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE SIN�C ROS OV���U FLOOj. T ao d ESTIMATEDS &F CONSTRUCTION to AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as folio s:, / "^ > FRONT SIDES REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date Permit Fee - $25.00 Receipt No. TV u a � Signature of Owner The above described AG Building is exempt from a building permit. White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant Director of Public Works By Date FLOOD PARCEL P.D. ROOFING ISSUE I I Director of Public Works By Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been. installed in accordance with the requirements of. the California Ad inistratve Code, Title 25, C apter 5, under ermit nuummbee��' Z;�for the following location S �� Owner's Address Mobilehome Mfg.2*L0—J / 44W ^4- Ae0BAMode1 5#4*'1y9J'9 Year Insignia No. _.2— --,2- 2! Serial No&!�/,-2&0 9 It is hereby certified for occupancy at the above described location and may be occupied. Director of Pu lic Works Date By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of� the Cq,�for Ad 'nistrative Code, Title 25, apter 5 u E permit numbeg R-T��-7rllfor the following 1pcatio 157 Al�,/ -ec-4 P. Owner, fV1674- d Owner's Address 'Allo, .43ox —1/61 Mobilehome Mfg.A`A"v��VAAI -i-Aen odel 5-#-HAJ?k'4 YearZV.5 25L C Insignia No. 1 2 Serial No�1.-2662!2 - It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED Q) util.,MH '2035-76P,E �} PERMIT NO. X20 �'`-' ✓� ' PERMIT EXPIRES. OWNER Daniel J. Burgess CONTR. owner LOCATION (A.P. 56-32-14 W/S 1st pri.rd.,below Garland Rd., .3 mi. E.of Hwy RK 32. Te/CallePG&E Pole +eerv. &E ��`-7 `n �/S�Tev. &E ' JFOINALED Q`'' (Date) (Signature) 6101) 9. Electrical OA Is service large enough to provide adequate amperage to mobilehome. (must equal rating of mobilehome with a minimum of 1 amp) and other faciliti.e,� gn ,lot i. water pump garage, cabana, etc.? Yes No_ �� � v�� �=/1/07, B. Is there proper clearances around panels? Yesx No 6 Is power supply cord, or feeder assembly properly fused? Yes No Is continuiiytest Ssatisfactory as per the following procedure? Yes_ No 1. De-enexgize electrical wiring system of the mobilehome at the pedestal. CY Malce sure that the power supply cord or feeder assembly conductors, including neutral Xoiductor',-have been disconnected, wch 1 breakers and switches in the mobilehome to the "on" position. 4. C ect one lead of a test.instrument to the mobilehome grounding conductor and apply o 'Ler 'Lead to each mobileiiorne supply conductor, including neutral. 3. 5. non-current., carrying metal parts of the mobilehome (aluminum siding,,gas line, water line),. including fixtures and appliances, shall be tested for continuity from suc equipment and the grounding conductor. ,f 6Upon 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"s.hall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card•Ysigned by Health Department for water and sanitation? 11. If everythng:okay, sign off card and tag services. A00 go7' HOME DATA Manufa anufacturer and/or Namestyle Lergt--,h��� Width e�ial No. </ �, �° "1��-�%` )�_• , Identification No. �� d % U�t5� Addition 1.Informati.on or Comments: , 74 a MOBIL EHOME INSTALLATION INSPECTION CHECK LIST 1: Is the mobilehome located with required separation from lot lines and buildings and generally ,conform to . plot plan? •-Ye.No 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes No 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No C Is the mobilehome level? (Sec. 5088) Yes \ /No� 5. If m tha single unit, are crossover connections properly installed? (Sec. 5088) Yes 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes4 No Q) Test - Does water piping withstand working pressure or.50 lbs. air test? Yes �Io C. Bacow - coach is not State of California approved, does station have backflow device and pr re -relief valve? Yes No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes[ No B. Does it have minimum k" per foot slope and is it properly supported? Yes-X-No Are any leaks detected in drainage system after running 3- ons of water through each fixture including washing machine standpipe? Yes No D. If coat s not State of .California approved, does station have required trap and vent? Yes o 8. Gas Piping and Gas Ven s A. Connector - Is mo ilehome connected to the gas supply with an approved 3/4" minimum obilehome tonne for not more than 6 ft. long? Note: All piping is to be at least as rge as the mo ilehome gas line inlet without reductions other than the mobilehome co nector. Ye No B. Test\Shut p following procedure? Yes No 1. l appliance connector valves. 2.. f appliance burner and pilot valves. 3. Air s* Faith manometer to 10"-14" water column, or test with slope gauge (minimum 6oz. max um 8 oz.) calibrated in tenth pound increments. Test for 10 min. without dro . 4. Co ect gas ter to mobilehome with connector, turn on gas, test connections with so py water. C. Are a 1 appliance ven s, properly installed? Yes No 4 Col. No. RI A FTS CPT CPT No. DOM �Sl7i Insp. Fee $ Insig. Fee $ ti Alt. Fee $ S PROGRAM HOURS M/H Mfr. E M P M/H Dlr. Insignia M/H Other No. Voided R/V Mfr. 7d l <1 1,ov a l,fJb h/ /Y ,// b"r1-i.� 7',r�iJ,na R/V" Dir. rn // S R/V Other FBH Mfr. �. �/r :/ FBH Other yy�r! , •4 DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS ACTIVITIES REPORT ,Q NORTH AREA OFFICE 1:1 SOUTH AREA OFFICE 700 L, ROOM 300 28 CIVIC CENTER PLAZA SACRAMENTO, CA ROOM 639 95814 SANTA ANA, CA. 92701 Date �� +� G Inspected by Z'4r e r I. r Firm/Person �� R - % e Location P 0. R,y FV I; s/ %/', CA 9 SW 2 - Owner Owner and Address if other than a Page one of PSN No. ID No. - 0 , /� . PI RI A FTS CPT CPT No. DOM �Sl7i DOP 17 t, Legal C/NA # Insp. / # Comp) Violations S E M P Insignia No. Issued / No. Voided NOTICE: Items indicating corrections are violations of the California Administrative Code, Title 25, Chapter ❑ 3 ❑ 4, Sections indicated. Copies of these regulations may be obtained" from the State of California, Documents Section, P.O. Box 20191,. Sacramento, CA 95820. It is unlawful to sell, offer for sale, rent, or lease any noncomplying mobilehome, recreational vehicle, or commercial coach, or to sell or offer -for sale any noncomplying factory -built housing unit or component system thereof. Upon receipt of a notice of violations, the person served shall notify the department in writing within 10 days of the action taken. to correct the violations. A person so served shall not move or cause to be moved said vehicle, unit, or component system until the department has been notified of its destination and disposition. A person served with the notice of violation contained in this activities report has the right to request, and shall be granted, a hearing on the matter before Oe Director of the Department or his authorized, representative. A request for such hearing shall be in writing and shall set forth a brief statement as to the grounds erefor. Requests for such hearing must be presented to the Department by mail or in person at 1807 13th Street, Sacramento, CA 95814. VIOLATIONS INDICATED SHALL BE CORRECTED AND A REQUEST FOR FURTHER INSPECTION FILED WITH THE AREA OFFICE INDICATED ABOVE ON OR BEFORE . THE REQUEST FOR INSPECTION SHALL BE ACCOMPANIED BY MINUALIM FEES OF $ 4 P/A No. Manufacturer—Model—Location Type of Occupancy Insignia No. Serial No. �Sl7i /ln� +n.t s.. ci.r.� I3rl)anl �ri lz.f. , 6/209 A r ,-. r, O C A 7d l <1 1,ov a l,fJb h/ /Y ,// b"r1-i.� 7',r�iJ,na nli3G% rn // S C A /.'.l f)!T<r� /d ,� <f" � C /:S � cf .rr ,i,J K. �"'.�,r �. �/r :/ .�i• G� .>r. yy�r! , Vo c{ r { L / r! C, r, .r. 3,/� �? ,.,.0 .2 4'1 A , .1-1 H 9 Received CC: ❑ Mfr. Ej Dlr. Plant CSI ❑ CC's Mailed ❑ Other H C]D * 412 ( (:REV .; 5-75 ) asp COUNTY OF BUTTE — DEPARTMEf T OF PUBLIC -WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firew I Soil Piping Forms ParapetsN, Parapetslist Floor Main BI Restroom FNRh 2nd Floor Footinqx Windows 3rd Floor Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Footin s Prov. for ph Cally handicappV Conform ce of ex- x. struct a Appliances Gas Piping &Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Ste Footings Footinq ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Stucco Final % Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service - -5 ^- 'f Brown Cooling Temp. Pole ---- Finish Ducts Underground " Interior L th Ventilation Permanent Door Clo er Final Final C, •^- --3 — —7 DATE —REMARKS OR CORRECTIONS a' i 0tv - , - 1 Af t � QT • .. 'Po -y f- -D -.,Yw s /-(Y) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drjve — &oville, California 95965 l - Telephone: 534-4541 APPLICATION AND PERMIT �r•�•-�....... .., .. •n a. Vvaa .ay — UUl lV 611 UP11 mu abov m tioned property for inspection purposes. X Date J7 10C r l� Signature of ermitee Agent Receipt No. White-D.P.W. - Ye low -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR aF U LIC WORKS BY Dat(e�T _3 h — / —� a ' 7 �Jb B ilding permit expires Date z : •, BUILDING Owner O SQ. FT. OCC. BUILDING VALUATION Mailing Address .- 3elephone Fireplace Contractor AigTotal Valuation Mai I i ng Address " 1 Permit Fee PI an Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Addresff ZA PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 ,Q * — Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping L6T• 2� Each gas water heater or vent 1.50 A. P. No. �� '�j?— g °n' n Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fos�J-C-rSaAC Fire Dept. Fire Zone Use Permit Building sewer &Cn, EQA IParking Plans Parcel Decl ation�,� arcel 60' R/W P Im r p ovements Lawn sprinkler system 2.00 %Plans Recd Parce Ap�al e�iPlans pproval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES OTHER [:] ELECTRICAL No.1 @ FEE PERMIT FILING FEE J$3.00 Main service iOOV OR 00 AMP ORLESS5.00 Main service EA. ADD -L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ OVER Main service 1100 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 NEW CONST. DWELING OR ADDNS. ( ACCLBLDGSCCUP. &) 2¢sgft NEW CONMULTI-OUTLET NON-RESID.STR. (BRANCH CIRCUITS) 12.50ea NEW CONSTPOWER APPARATUS & NON- R. RESID. (SINGLE OUTLET CIR. 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: ' Ex. Occup(OUTLETS OR FIXTURES)@�` BAL@1 Ex. OCCU FIXED APPLNS. OR P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.000 License No. Classification Misc. Wiring 6.25 am exempt from the Contractors License Laws of the State of California. A�tl Permit Fee $ U$ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. Elhave placed on file with the County of Butte a certificate of 'workmen's Compensation Insurance. RI certify that in the performance of the work for which this E --"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 1 1 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ �r•�•-�....... .., .. •n a. Vvaa .ay — UUl lV 611 UP11 mu abov m tioned property for inspection purposes. X Date J7 10C r l� Signature of ermitee Agent Receipt No. White-D.P.W. - Ye low -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR aF U LIC WORKS BY Dat(e�T _3 h — / —� a ' 7 �Jb B ilding permit expires Date z COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - �Orov°i'lle, California 95965 t Telephone: 534-4541 APPLICATION AND PERMIT autnonze representatives or the uounty or tsutte to enter upon ine above-mentioned property for inspection purposes. x0ka,"Date ��LL $ig ature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECT -OR OF PUBLIC WORKS By , Date _4117-19 6 Building permit expires Date .Z- BUILDING '•`� Owner SQ. FT. OCC. BUILDING VALUATION Mai I ing Address Telephone No. Fireplace Contractor�� (tivp 7A Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty " Telephone No. 3 f Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 / 3 [a / C �I dvY� SrY o r�eu 3 Z Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No , -SC,,- Z Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fed W ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im ovements Lawn sprinkler system 2.00 Bldg. P I a eced Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 d 7— 4e." d 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 bo (0 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:_ � %wU6s mba L S 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 -/ y License No.,,?2,S1 Classification <2'�/ 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 for Workmen's Compensation. 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.1 @ I FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 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 relating to building construction, and hereby chtlz 2446 TOTAL PERMIT FEE autnonze representatives or the uounty or tsutte to enter upon ine above-mentioned property for inspection purposes. x0ka,"Date ��LL $ig ature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECT -OR OF PUBLIC WORKS By , Date _4117-19 6 Building permit expires Date .Z- . --: V BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 53,4-4541 , MOBILEHOHE INSTALLATION SHEET 1. Owner's name: J2 PtA&e-s5 2. Installer's name: %�o6i ��`� SI`/%PS 3. Is the site currentlyunder permit? Yes / No (If yes, furnish permit number _ ) OR Is the site an existing site? Yes / / No (If yes, furnish two (2) plot pans.) r 4. Will the mobilehome be located at least 5 ft., away From septic tank and leach fields a-nd clear of all setbacks and easements? `les No / / (If no, clarify S. What is the mobilehome eZ�r_tri.cal rat:=ing?-_______ __... _-_.__.__, `Zoo Amps. 6. What is the mobilehome site sei:vi.•e rating? ---•-•-----.._-_-.___.-__ n?ps 7. . What is the mobilehome site circuit bre.,k.Evr rat:i.np------------ 2Go Amps 8. Is there any other elec.:tric .load to be seri eu iffy 'the mobilehome site service? - Yes % / No (If yes, identify the load and size: _(Load) —_� (Amps) 9. What is the mobilehome site gas pipe size? ______._...--•--- ___.-___-- (in.) 10. What 'is the type of gas sera ic:e? - ,-- _.W....____--- _- - Natura / .. ! I.PG 7 11. What is the gas 'pipe' length from meter ta.r�ri. to tie n�b:ilei�.ome: _ ('ft!) 12. ' 12. What is the mo"D leho,ne gas demand? ------ - --- __.____._____.____.:__ (BTU). - (This information not. required if pipe. length less than 6 ft. on natural gas or less Chan 50 ft. on LPG,) ' e �i. °�•.MOBILEHOME SUPPORT DATA SR�aRCL !Zx 76 'Z�2 Mobilehome Mfr: kac&'�n Setup Model No, o7X 2 )( Year Width (ft.) Length's (ft.) -Expando Size _ ft.x GO ft. (Draw support details below) . 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). _ ®tee Single. — �� ,!y® Footings— (check. one) _ `1 / 1. Wood e_ ither pressure treated or . .Center Center Support fdn, grade.:' Support Footing Sizes Locations (in.) / 2.'.Concrete pad. 3. Other,`specify (�"t•Jlu►•J in. in. Su ' orts (check one) 4 / 1. Concrete block ( / / 2. Concrete piers (f7�3.n� 3. Steel piers 4. Other, specify I i1a Tyupport 71k. x 3GFooting Size in.) is *If -center piers are other than drawn above, drawin locations, spacing, arcl. diunensions. qMgpjierng BUTTE COUNTY BUILDING DEPARTMENT APPROVED fhis set of Alam aw r MeeNes MU6T be • , 1W- kept on the job at all times and it is unlawful to make any changss or alterations on -same wilhalui wrH, to permisson from the Departnwt* of 'ltalo,rlrs, County of 0uft 164' .: i � d-� � • � _ permit will -b 9 required for f16 r , installation of he mobilehome, J JJ 0,10 The Bldg, Se+�ack shall 6e 5 ft. from `` 1 the side; property line and 50 ft: from' � a pnterlirie`of the road, permitting ,= T ',a maximum -of a 2 ft. eave overhang.- _ 11 MIRCIC s9pf 111f A, - All -utility connect ons shall be located within 4 ft.-o(atside the rear third section of the mobile home on the left (road) sideof the mobile NOTE:—All Materials & -Workmanship Shell Be'_ in �'- Accordance 'with Recogniaed-� Good Practices and is of a- quality -prescribed -d"Cp. -S pecified`�,ise-`�in the _ !• Uniform `Building, Plumbing? &: Machcnical,C�des an ` - th®• National Electrical! Cade.{ '.4 tiU C UNTY ,off, - • _ , . � -. -.. BUILDING D ARTMENT �_ . ..� � gib_ � Z_-l._��,_ ._ _.__ . _ �-e .. _... -_:._ • _.: -�A�-P P ROV E D a 4e'' So= 140'- a