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058-200-076
a, 1 1 58-20-76 Ohl KEN ALLENA MATTOX - � U V' - 11595 Mi r Park Rd, Concow �g Permit#2914-98P,.,E(util, MH) io-to u ELEC. ZO 1�C9 M1'�- ZA Ew GAS '3114- 20 n SUPPORT STRUCTURE REQ. OMPACTI ON. • TEST - REQ.... 58-20-76 Contr: MolbileHome Center PErmit#3252-88MHI Issued u 58-20-76 �7 k1,1-� ' Permit#3821-88B(new stairs/NMHis 058-20-0-076 92-4185B _. MATTOX, Ken &.Helena u 9 11595 Miller Peak Rd, Oroville 1 open deck/mh 058-200-076', ` r,: t , '93=4043. ' MATTOX, I.EN-& :HELENA - r- -- ' - 11595'-MILLER, PEAK ,RD., ,OROVILLE'-' -.1ST RENEWAL BP#92-4185•!i/ f � I I . 1 1 PERMIT NO. 2914-88P,E(MH) PERMIT EXPIRES OWNER KEN & HALLENA MATTOX CONTR. unknown ASSESSOR PAR5C%L20-76 LOCATION 11595 Miller Park Rd, Concow Temp. Power Pole s Called PG&E Q Temp. Elec. Service iCl Called PGE Temp. Gas Sen Called PGE JOB FINALED + Signature to _= OK 0 = Not OK = Not Readyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Soils; Special MH Support -Sketch er; Location -Test -Fall -C/O -Concrete . Water; Location -Test -Easement Needed (Sketch) lectricity; Location- earances-Grnd.-JZV Amp -Concrete 6. Gas; Location -rap- / P1 ft. / /"Nat. or L"ft."LPG 7. Utilitv Clearance Card -B&// Date%� Card -B1 Date Card -B1 Dat Card -131 Date Date MOB LEHOME INSTALLATION (Plans) OK except #'s oning Requirements -Setbacks -Easements ootings; Size -Spacing -Marriage Line as;. MH Test -Demand -Valve -Connector ,Pctricity; MH Test -Crossovers -Breakers -Clearances r in; MH Test -Fall -Flex Connector LVW,arer; MH Test -Regulator -Connector at and Sewer Connected -C/O to Grade -HD Approval Gas and Electricity Tagged j9,11EVs; Insp.-Sketch ial—Cert. of Occupancy Card -131 eon Date//,,R Card -B1 Date Card -131 kj Date Card -B1 Date 2G wZ4,p, 7"' I i MISCELLANEOUS a, Date DECKS, COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking: Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beam s-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Card -131 Date Card -81 Date Card -131 _ Date Card -B1 Date 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 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panel boards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -61 Date G. Card -131 Date Card -81 Date 0 = OK 0 = Not OK - =Not Applicable RESIDENTIAL (Single and Duplex) Applicable ' = Not Ready e Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks; -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" 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 7. Slab; Steel -Wrapped 51, Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel 52. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 55. Siding -Nailing Veneer 12. Electric; Underground 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 57. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 58. Shear Walls; Nailing -Bolts 15. Insulation 59. Insulation-Walls-Clg. 60. Infiltration -Wal Is-Wndws Card -131 Date Card -B1 Date Card -131 Date Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Card -131 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchors -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test-Fttngs & Anchors -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-Mech. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels Card -131 Date Card -61 Date 67. Stairs & Rails Card -131 Date Card -131 Date 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. Date ELECTRICAL (Permit) OK except #'s 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 22. Fixture & Transformer Clearance -Ins. Protection 71. Elec. Outlets & Receptacles at Kit. Counter 23. Elec. Receptacles Spacing -Lights & Switches at Doors 72. Garage Fire Door; Swing -Landing -Closer 24. Size Boxes & No. of Conductors -Stapled 73. A.C. Duct in Garage -Damper 25. Romex Installed Close to Edge of Studs & C.J. 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 75. Plb., Elec. & Mech. Equip. Listed for Location 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 77. Insulation -Foam -Looked in Attic ❑Yes 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 78. Guard Rails & Deck Construction -Post Caps 30. Service -Riser Conductors & Ground -Main Disconnect 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 31. Equip. Clearances Panels-Motors-Mech. Equip. 80. Following instid.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑ No 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector 81. Stucco; Brown -Finish Card -131 Date Card -81 Date 82. A.C. Unit; Disconnect, Electrical, Plumbing Card -81 Date Card -131 Date 83. Vents Above Roof; PIbg.-Appliance-Firep I. -Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 84. Water Well; Disconnect, Electrical, Plumbing 34. A.C. Ducts Insulation & Support 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 35. Vent Fan; Exhaust above insulation 86. Ventilation throughout House 36. Condensate Drain & Overflow; Size & Grade 87. Glass Protection 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 88. Corrections from Previous Inpections 38. Attic Access & Platform if Furnace in Attic 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91, Energy Compliance Certificate -Other Certificates Card -B1 Date Card -61 Date 92. Roofing Certificate Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Card -B1 Date Card -81 Date Date FRAMING (Plans) OK except #'s Card -131 Date Card -61 Date 39. Sills, Proper Material & Anchors Comments at Final: 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit job site) ` .. + - .: ter..'., `� �'"'y'-j'=�3+. �-.s'-tlT�-'iii.'+-�`t,��" .cc`"S.`•-"` �'1' ^•v _ . �. .F�s.j COUNTY OF BUTTE " DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: -538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT 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 1-3— A —3— COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone:'538-7541 747 Elliott Road, Paradise— Phone.: 872-6307 CORRECTION NOTICE ER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector e / Date2/Z2 6 I COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville - Phone:'538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE iER I Pi(/ ERMIT 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. 4222Inspector /. / � Date MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 (Offici I ing Installation) )- Ij - (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. PERMIT NO. Address or location of mobi lehome J i am, Owner's name Owner's address Insignia or hud number 1`7 L 5 2 L Manufacturer's name C Serial number of V.I.N. V Year of manufacture (Offici I ing Installation) )- Ij - (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT Off/ d �1 ASSESSOR PARCEL NUMBER �. Z 0 — 7 (p zo;�, /0 BUILDING PERMIT NER EIAs t� vA- TELEPHONE SO. FT. OCC. BUILDING VALUATION O ER'S MAILING AD RE S CONTR AC OR'S NA E u < TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 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 ADDRESSS LLE c Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Co NG W Each Trap 2.00 Solar or heat pump water heater 20.00 LOT N . SUBDIVISION NAME PARCEL MAP – V Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF F-1 Duplex EJ Mobilehomej� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home 10.00 ea 7& -- TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities Installation❑ Other ❑ Describe work: _ Permit Fee $ Dn Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Q a Main service EA. ADD'L 100 AMP 2.50 'z CONTRACTORS LICENSE LAW I declare under penalty of perjury (check.one): ❑ I am licensed under provisions Of Chapt. 9, Div. 3 of the BUSIneSS and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.l4 A New , �z�sgft CON5TR.( ULTBI-OUTLET NON•RES'D BRANCH CIRCUITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@50C eAL030 FIXED EX. OCCUp. OUTLETS P(RESID )LNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities o 15.00 ,— Misc. Wiring g 15.00 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 or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot r upon th above-mentioned property for inspection purposes. to save, indemnify and keep harmless the County of Butte against s, judg ents, cos s, and expenses which may in any way acc ue ysidCo Cy i o e e ce of granting of this ermiThis Date A t – Owner Contractor ❑ Agent ❑ Signature of Applic�r3 An OSHA permit isequired for ex vations over 5'0" deep a d: lition or construct- ion of structures ov in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ , OCCUP, CONST.TYPc JFrL PD MD s3u permit is hereby issued under sions of the Butte County. Code and/or work indica ed above for which /./DIR PUBLIC By-/ PERMIT EXPIRES Date Q the applicable provi- resolutions to do fees have been paid. WORKS a U 3 �� 3 Receipt No. v� �Z / ii� 000 WHITE-D.P.W.. YELLOW-ASBE330R, PINK -INS ECTOR. 60LDENR - PL A T h COUNTY OF BUTTE - DEPARTMENT OF;RUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVI LE,6CALIPORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET r Permit No. J OWNER }11C it/ l'TE Iv l�T�1a A. P. No.4 " 20 AN a g 8 Proposed BUIlding Use Building,lnspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and: /Or issuanc23 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. Plans with Energy Design Compliance Statement. . . . . . 1 6. School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ Letter of signature author*za ' ?. 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 ownerE]) _15. Improvements may be required. �. , , , , , . , , , 16. Mobilehome Installation Data. . . . . . . . . . Pre-Inspec. request to (Date) Pre -Inspection for Required, Building ins Recorded copy of Agricultural Acknowledgment Statement. X19. Driveway Permit. 20. Plot plan approval from city of 21. Engineered trusses in duplicate (required prior to plan check). 22. When you issue the permit, process as follows: Mail to owner, Mail to contractor.+ Telephone and hold for pickup at - office, Deliver w/inspector. Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to pmi i suance: (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_-nail counter by date Contractor, designer, owner, was advised of above required data by_phone_maII—coLun�terr by date Plans checked by Date Plans approved by/ Date Sets of plans on hold in • File cabinet AP folder o✓(i $ � l w 30.CTO j Copy—DPW. -- TO Building Department FROM: Environmental Health 1. SUBJECT: Sanitation Clearance /61t 0._� Owner Location w AP# Plan Approved for: Sewage Disposal Water Supply Hold final for:: Water Supply Final clearance O.R. for: Water Supply Clearance for -,bedroom mobile home. Other NOTE *** 4, Sanitarian Date Riturn to DPW AGRICULTURAL STATEM N'r O€ AOKN W�_CE.>EMr FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building -permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or'discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents with X said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. I All that real property situate in the County of Butte, State of California, described as follows: Date: f , SEE ATTACHED LEGAL DESCRIPTION �. 1 88-033732 _ Rec Fee ut7.00 Recorded Cash ' 7.00 official t Records County of { Butte Q'V V tCandace J. Grubbs 11' Recorder V 9:08am 3 -Oct -88 BG 2 ZA State of ) On this the day of SS. me, the undersigned Notary Public, It 1y_, before personally appeared Si ATE OF CALIFORNIA COUNTY OF BUTTE (ss. C EOn SEPT. ✓_�� 1988 before me, the undersigned, a Notary Public .n and for o V DAVID HOY personally knowto mesaid Stare, personally appeared - to me on the basis d to be the person whose name is subscribed to the within instrument, as a witness thereto, who being by me duly i= sworn, deposed and said: That he resides in sfactory evidence. that he was present and Saw KENNETH W. PKATTOX & HELENA_C_..__NATTOX__. subscribed to m personally known to him to be the same person___ described hat a` ii. in and who executed rhe said within instrument, as � � � � ®®� � ®� � �� � ®®®9 � MOVE" thereto, sign, seal and deliver the same © tin contained. Ind and official seal. party ANGELA D. �JlAST�LOTI'® ;; w that the said—PERSONS n ® NOTARY PUBLIC -CALIFORNIA 3 Butte County nI+ Expires Sept. 7. 1990 My Commission It duly acknowledged in the presence of said ali'ant, that Isamu ®®®®®120S®©B®28®13 U®60®® Public o executed the same, and that he, the said affiant, thereupon try Erequest, subscribe his name as a witness thereto. WITNESS niy hand and offcia\al. Signatu7t1��^\ Name -(Typed or Printed) ,This area for official notarial seal` t 11L'INt, ,� E�c�r:t:�on e�C tlio ^c»r1;hwrraL cltiq s t:r>'."off. L•ion - 271 '!'owiiship • ').y No * 1-1i, Rnn(�0 •.4 i;.7st,..rY:l).11.. R. Ma 9: 'ariei lJr..l.)r<J rnor:e. 1�a%tifcuiar1y de ,cribed .7 r$ Coll-own: P,•orcel • 1 as Shown Oil that cort'll iv rar t.01 I-1p Filed in tho off I cc og the recar:clor, County t) f 11etk.LC, :1::ai:c)'og California" on 1'cbrn.lry 27,. 1907 An nook 1.05 %off ISL lin, a j�atje _93.- 121.:;.11111VING 11111; UTTIOt1'.4""1 non-exu'luz;lve. ea"acmen t, for road -rind publ.1C utiliity.pur:poucs.an shown oil t:he.,..tlan';r<Jrarreci to heral.n. AP # �d OWNER PERMIT "# M UT IL . CLEARANCE DATE INSPECTOR ELECTRIC GAS Support Struc. Compactioi Test -Req. Service Size Other Load Type__ Pipe Size Leri th YES NO YES NO f COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION -AND PERMIT ERMI4NO. OY ASSESSOR PARCEL NUMBER J ZONING BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNEV, M ILI Gr/R DDRESS ; CONTRACTORNAME // 5 TEL�PHONE CONTRACTOR•Sw1AILl ADDRESS n , l �7 /�(J Fireplace CONSTRUCT ON LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ S Q� Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS V/ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 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 USEOF ST SF ❑ Duplex❑ Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea' TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑ Describe work: 1� C;? V6 q%2lI Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 ✓ Main service eoov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declarnder penalty of perjury (check one): am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and mx license is in full force and effect. License No.Classification ❑ I, as the owner, or my employees with wages as their so 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.Ei OR ADONS. ACC. BLDGS. , /20sgft NEW CONSTR. TI -OUTLET 2.50 ea NON-RESID .BRANCH CIRC ITS POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES eA3030 Ex. Occup. OUTLETS IXED P(RESID ILINIS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 -::R Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ® 1 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 i Ventilation penult 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 Butte to enter upon the above-mentioned property for inspection purposes. t1also a ree to save, in emnify an keep harmless the County of Butte against iabiIitl s, j dgme s, costs, nd expenses which may in any way accrueinst s 'd C my ' onsequ ce of the granting of this permjt. Date /A _ � a �� Signature f Applicant - Owner❑ • Contraotor Agent ❑ An OSHA permit is required for excavations over 0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ q,5 &__0 Energy Inspection Fee $ TOTAL PERMIT FEE $ • o-t� OCCU P. CONST.TYPZJ SCHOOL Fyogo PARvL This permit is hereby issued under sions of the Butte County Code and/or work indicated above for w ich T R O69UI3LIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date ,� Receipt No. (-,-797 WHIT[-D.P.W.. YELLOW-ASSE,SOR. PINK -INSPECTOR. GOLDENROD-AP►LI CANT � a +-., p:�,�,..�`, •r,2� �y'��,!�t��l.+.�"'f`''+�j r" i�%'}'it.; i. COUNTY OF BUTTE - DEPARTMENT PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - ORO%% 11E,,_.CQ±a ,0111i41A 95965 - TELEPHONE: 916/538-7541 y- PERMIT APPLICATION DATA SHEET ( `� Pormit Mn OWNER /I e=A2 / Gt 7� f D A. P. No. �" O 6 Proposed Building Use iyl %� Building Inspector A. Date Zd— /V_ 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. Plans with Energy Design Compliance Statement. . . . . . 6. School District "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:- arking: 12. 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. . . . . . . . . . Pre 17 -In. Prespec. request to (Date -Inspection for Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of 21. Engineered trusses'in duplicate (required prior to plan check). 22. When you issue the permit, process as follows: Mail to owner,,.,—,') Mail to contractor. j '`�'�Telephone ��3 �� and hold for pickup AT)() o6ioe, Deliver w/inspector. j Other /—, t1 .4 Applicant ( a .v Date S I I�i Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit iss 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_phoneJnail—counter by date Contractor, designer, owner, was advised of above required data by_phone_mall_counte y date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder. Copy—DPW r. STATE OF CALIFORNIA ` BUTTE 55. >, COUNTY OF , r c On SEPT. 'i ,, 1988 before me, the undersigned, a Notary Public in and for EDAVID HOY y v said State, personally appeared personally known to me v to be the person whose name is subscribed to the within instrument, as a witness thereto. who being by me duly i= sworn, deposed and said: That he resides in BUTTE CQUN` V that he was present and saw KENNETH W . MATTOX & HELENA C—_MATTOX_. E personally known to him to be the same person—_— described Q in and who executed the said within instrument, as party thereto, sign, seal and deliver the same V) that the said PERSON$ s ANGELA ®. �9iASIEL®TSO z ® NOTARY PUBLIC -CALIFORNIA In &b.. .. Butte County. P 3 ® My Commission Expires Sept. 7,1990 4" oduly acknowledged in the presence of said affiant, that executed the same, and that he, the said affiant, thereupon®®®®®®®®®®®®®®®Q®��®®®®®® E request, subscribe his name as a witness thereto. o WITN SS m�,hand and official seal. LL Signatu Name(Type dor Printed) ,This area for official notarial sear R' rn to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT p FOR RESIDEN;'IAL_DEEV,ELOPMENT 3 3 t 2 ' Section 26-8.1 of the Butte County Code 'r_er_uires.this acknowledgement j be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property maybe subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte 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. s� C� 4 All that real' property situate in the County of Butte, State of California, described as follows: Date: SEE ATTACHED LEGAL DESCRIPTION 88-033732 Rec Fee 7.00 Recorded Gash 7.00 Official Records County of Butte Candace J. Grubbs Recorder V (_L011am 3 -Oct -88 1 BG 2' State of ) SS. County of ) M On this the day of , i7 , before me, the undersigned Notary Public, personally appeared Ll Personally known to me. L/ Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) subscribed to the within instrument and acknowledged that executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A. P. No. 05- 9 - R0 -O -0 76 -0 Notary Public ' 88-33132 Itt*:IKIG ,1 u�r.l:ion cit* P.lic2..^,oiitlI c'st -(pmr-r, of rc�:L•ina. 2Z�. Toa�iist�ip .22 Nni tii, Hatuje '.4 i:ast,..At.11.tl.: &. M:;: ��iiicl Ur.l.ii<j :more txti ti.cularly de -cribod ars Col.l.owt3:. : Parcel • I as showl'i oil' tfill t car tnIn: Pn1*-COI •t`s;ip f i.l.ad In 1110 off tca of - the Recoi:clar, County of mit�.te, ,Lato'of Catiforntm, on tebcIIc 27,' 1907 in nook 1.05 of 4ta lm, -at j!atjc:..93.- 121:,,^ENIVING IrIl1:RX TI0H.a non-exclii:3ivo, eaacmont for, road and- public U t i l t t:y . ini V J)00C13 : ars shown ' on. thc..;-tlap ;'re>'a>: red to lie r.e.t n. END OF DOCUMENT r' PERMIT NO. 3821-88B PERMIT EXPIRES OWNER KEN MATTOX CONTR. owner ASSESSOR PARCEL 58-20-76 LOCATION 11595 Miller Peak Rd, Oroville i { a Temp. Pow Called Temp. Elec Called Temp. Gas Called JOB FINAL Signak = OK '0 = Not,OK - = Not Applicable = Not Ready MOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DEC ,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements-Setbacks-Easementsgoing Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch Vooli Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete ecks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Bea ms-Rftrs.-Connec.- 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete Shthg.-Rfg.-Bracing 6. Gas; Location -Test -Wrap: / PV ft. 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures / /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -B1 Date Card -81 Date Card -B1 Date Card -B1 Date Date MOBILEHOME 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 5. 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 Card -81 Date Card -B1 Date Card -B1 Date Card -B1 Date 1 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Card -B1 Date/�?- Card -B1 Date Card -B1 Date Card -B1 Date 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 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panel board s -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -B1 Date Card -Bt Date Card -B1 Date =OK o = NotOK RESIDENTIAL (Single and Duplex) - =Not Applicable Not Ready Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks; -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" 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 7. Slab; Steel -Wrapped 51. Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel 52. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 55. Siding -Nailing Veneer 12. Electric; Underground 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 57. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 58. Shear Walls; Nailing -Bolts 15. Insulation 59. Insulation-Walls-Clg. 60. Infiltration -Wal Is-Wndws Card -B1 Date Card -131 Date Card -B1 Date Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -131 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchors -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test-Fttngs & Anchors -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-Mech. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels Card -81 Date Card -B1 Date 67. Stairs &Rails Card -Bt Date Card -B1 Date 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 23. Elec. Receptacles Spacing -Lights & Switches at Doors 71. Elec. Outlets & Receptacles at Kit. Counter 24. Size Boxes & No. of Conductors -Stapled 72. Garage Fire Door; Swing-Landing-Closer73. 25. Romex Installed Close to Edge of Studs & C.J. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 27. 2 Appliance Circuts in Kitchen &Conductor Size/G.F.I. 75. Plb., Elec. & Mech. Equip. Listed for Location 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 78. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 30. Service -Riser Conductors & Ground -Main Disconnect 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters 11 Yes ❑ No 33. Smoke Detector 81. Stucco; Brown -Finish Card -61 Date Card -131 Date 82. A.C. Unit; Disconnect, Electrical, Plumbing Card -61 Date Card -B1 Date 83. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 84. Water Well; Disconnect, Electrical, Plumbing 34. A.C. Ducts Insulation & Support 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 35.'Vent Fan; Exhaust above insulation 86. Ventilation throughout House 36. Condensate Drain & Overflow; Size & Grade 87. Glass Protection 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 88. Corrections from Previous Inpections 38. Attic Access & Platform if Furnace in Attic 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Card -B1 Date Card -131 Date 92. Roofing Certificate Card -B1 Date Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Card -131 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors Card -131 Date Card -131 Date 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Comments at Final: 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE - DEPARYMENT OF PUBLIC WORKS M—ffir—W 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 �1PPLICATiUN Alb PERMIT ASSESSOR PARCEL NUMBER S $ 20 - ZONING /e / Q BUILDING PERMIT , - & OWNER !/ to � TELEPHONE SQ. FT. OCC. B ILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE OWVe — CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation - $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ZD , 050 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ /^ J.-2 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee 5,5 OFV $ PLUMBING PERMIT Filing Fee 10.00 )e p / Each Trap 2,00 f (,041Solar le or heat pump water heater 20.00 LOTH . SUBDIVISION NAME PAMAP-MAP, Water piping Each qas water heater or vent 5.00 5.00 USE—OF ST UCTURE SF [I Duplex obilehome' ther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: -74Gt % (' Du�$)de Permit Fee s Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORLESS LESS 10.00 Main service EA. AOD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Bushes$ and Professions Code and my License is in full force and effect. License No. Classification Elas the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.5d , A )S. �Z¢sgft NEW OU CONSTR.� ULTI LET NO ESID BRANCHCIRC ITS 2.50 ea POWER APPARATUS e SINGLE OUTLET CIR. EX. OCCUp(OUTLETS OR FIXTURES 500500 eALeao FIXED Ex. OCCup. OUTLETS P(RESID )APLNS.REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 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 shal I 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 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 against sa C in copse u nce of the granting of this permit. X Date Signet re of Applicant— Owner Contractor ElAgent❑ An SHA permit is required for ex ovations over 5'0" deep and demolition or construct- ion of structures over 3 stories Mobile Home Installation Fee $ Energy Inspection Fee $ $ c, TOTAL PERMIT FEE �! occuP. CONST.TYPc SCHOOL Loop PARCEL \D ND SUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for Which BY /(�II E O PUBLIC PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS z J Date 'd �iin�height. 3-1 Receipt No. 92 —t WNITE-D.P.W.. YELLOW-A3etySSOR. P NK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF�PUBLIC WORKS - BUILDING DIVISION t 7 COUNTY CENTER DRIVE - OROVILLE,;&'AL`•FPORI,#IA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER J. Gt 7/ (1 7< A. P. No. ;;Z /) 6 Proposed Building Use 10% /.o -1a i r-4 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. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 12. School District fees paid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing. permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required ...... Pre-Inspec. request to Building Inspector 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... 25. 26. Date) 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 Applicant Date � C> - 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_—rtail—counter by date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Copy—DPW Date Plans approved Sets of plans on hold in File cabinet AP folder Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, 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)�. S= 2. I (have/have not) h4, (/ f signed an application for a building permit for the proposed work. 3. I have contracted with the /ffollowing 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 A 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: NameAddress Phone Type of Work Signed: Property Owner Social Securit N ber Date Z/- 2 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. eg This se+ a{ :NOTE:—All Materials $c `ll✓ortmanship ShI±11 B9 in KeNf is e+the •� ��, spe, *C�on5 M �' �,F Accordance w ;'t Pec ni.ed Good PracficFs and ,mav �� / ani�� iso �unie fill t" of a Clualrfy prt4t�16"4or �the'Specified use in the �`'' c� "�." "r!��" .•_:,ion Uniform Buii6ing, 1' um, ing & -Mechanical Codes and wri' � f„•� � �t;4 D i0 National ELc�ir-ical Code. lie Worn, ''�,f Of llui�. �'tnt�nc n' ° Pub- � setback of 5 ft. f� setback m the property lines and/ of 50:t. from the road j hall be clear of centerline s O , structures o' equipment except t; for a. eave overhang OF ej~cr�3s Ci ,m too 3*8' CorAt� ■`r Csw'..r �{Fa est . , VE LL Qd1 V _. Io Top. rail to be 36 in. high with IMOMediate rails to be rW ®vr 6 ire amrt. t w) Vie. 4 1 o C.� X, 0 RESIDENTIAL J — MATTOX, Ken & Helena 11595 Miller Peak Rd, Oroville j ojren deck/mh i 1 r j w> r JOB FINALED (Date) Signature J=OK O = Not OK = Not Ready,MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 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: / /" L" ft. / /"Nat. or/ /" L"ft./ /"LPG 7. Well Clearance & Disconnect 8. 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 5. 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 MISCELLANEOUS Date DEC S, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s Z ing Requirements -Setbacks -Easements Footin s; Soils -Size -Depth -Spacing -Connectors -Steel ecks; Griders and/or J s -Decking -Bracing irs- ails 4. Wood Awn.; Posts- Beam s-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes -Enclosures -Panel boards -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 J=OK O=Not OK = Not Applicable Not Ready RESIDENTIAL (Single & Duplex) ' =� � Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permil),OK except #'s 1E. Water Htr.: Vent -Access -Combustion Air -Baffle ------------------- ------------------------------- 17. Water Pipe: Test & Anchor -Nail Protection 18. D.W.V.: Test -Fittings & Anchor -Nail Protection ------------------- - ------------------- 19. Shower Pan: Test. First Floor -Tub Access 20. Test -Tub & Shower, Second Floor -Tub Access ------- -------------- ----------------- 21. --------------- 21. Gas Pipe: Size & Anchors Date - --Card B_1 --_ _ Date - Card B_1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection - ---------------------------- 23. E-lec. Receptacles Spacing -Lights & Switches at Doors - ----------- ---------------------------------------------- 24. Size Boxes & No. of Conductors-Stapled ---------------------------------------------------------- ---- - 25. Romex Installed Close to Edge of Studs & C.J. - - - - --- -------------------------------- 26. Equip. Ground made 'up w/Mech. Fastners-Bond Gas & Water -------------------------------- 2 Appliance Circuts in Kitchen & Conductor SizerGFI ------------------------------------------------- 28. Subfeed Wire Size r / ga. Cu or AI-A.C. Wire Size / ! ga. Cu or -Al- 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No - ------------------------------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect -------------- Equip Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light ------- -------------------- 33. Smoke Detector ---------------------------------------------------------------------------------- Date Card B-1 DateCard B-1 --------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34.- A. -C. -Ducts- Insulation & Sup port ------------------------------------------------------------------------------ 35. Vent Fan: Exhaust above insulation ----------------------------------------------------------- 36. Condensate Drain & Overflow; Size & Grade ---------------------------- --- ..- - -- 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet ---------------------------------------------------------------------------------- -------------- 38. -------------------------------------- 3a. Attic -Access-&- Platform if Furnance in Attic -------------------------------------------------------------------------------- Date ----------------------------------- Date Card B-1 Date Card B-1 ------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sils. Proper Material & Anchors ------- ------------------------------------------------------------------------- 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound ------ --------------------------------------------------41. Bearing Walls over Girders & Floor Nailing -- -- -- ---- -------------------------------------------- ------- 42. Draft Stop in Walls (rat proof) ---------------------------------------------------------- ------------------------ 43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub ---------------------------------------------------- 44. Headers & Beam -Size & Bearing 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties -Pu rlin-roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits ------------ ----------------------- 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection ----------- --54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers ---- --- 55. Siding -Nailing Veneer ------------ 56. ---- Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access -- -- _ _ 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows ------------------------------ Date _________Card B-1 _ _ _ Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings ----------------------- 62. Smoke Detector ------------- ------------ 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection ----------- ------------------- 64. Bedroom Exiting ----------------------- --- --- l 65. G.F.I. & Bath Fixtures & Tub Access -Spa - ---------- ---------------- 66. Elec. TrimP_& Sub anel; Breaker Sizes & Labels _ - ------------ 67. Stairs -&-Rai-Is _ 68. Fireplace or Stove: Clearances -Hearth ---------------- 69. Elec. Outlets at Wood Panel: Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance - --- .-. _ --------------------- - --- 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door_Swing-Landing-Closer 73. A.C. Duct in -Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. , In Garage; Above Floor-Mech. Protection 75. Plb__Elec_ & Mech. Equip. Listed for Location -------------- 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 7i. Insulation -Foam -Looked in Attic ❑ Yes ----------------------------------------- --- - 78._ Guard Rails & Deck -Co nst ruction- Post Caps 79 Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 1 80. Following instld. Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ID Yes E) No 81. StBrown-Finish -------------------------------- --- - 82. A.C. Unit: Disconnect. Electrical, Plumbing -------------------------------------- -- - 83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to Openings ------- ----------------------------------- --- 84. Water Well: Disconnect, Electrical, Plumbing ------------------------------ ___ ---- 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House -- --- -- ------------------------------- 87. Glass Protection - - --------- -- -- 88. Corrections from Previous Inspections -.-..----------------------------------------------- a9. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval ..--.-91.-Energy-Compliance-Certificate-Other Certificates - ----- ------------------------------------ - DCard B-1 Date Card B-1 --- ate --------------- -------------- ----- -- ------ Date Card B-1 Date Card B-1 - - ----- --------------------------- Date Card B-1 Date Card B-1 Comments at Final: IV COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION y 7 County Center Drive - Oroville,. aliforrlia 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT _4 Q� Q r ASSESSOR PARCEL NUMBER 958-200-076 ZONING FIR 10 BUILDING PERMIT & OWNER KEN & HELENA MATTOX Mo L812 SQ. FT. OCC. BUILDING VAULIN OWNER'S MAILING ADDRESS 11595 MILLER PEAK RD OROVILLE 95965 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee S 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 11595 MILLER PEAK RD PERMIT FEE $ SO OROVILLE 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 (R Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W ` 20'00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities O Installation O Other Describework: IST RENEWAL OF #92-4185 PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 260 0V OR LESS ) 23.00 20OA OR LESS Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. S0 OR ADONS. ( 8 ACC. BLDS. ) 3.50 FT.. 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 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) ❑ I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWERAPPARATUS ) B SINGLE OUTLET CIR. @ 1.0000 Ex. Occup. ( OUTLET OR FIXTURES ) BAL. 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 1 declare under penalty of perjury (check one): O This permit is for $100.00 (valuation) or less. ❑ 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 C t i c nseq f t granti g f this permit. d X Date �5 — % Sign tur 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 $ HAZ- I D. FEES IMP I FLOOD I COF PARCEL PO I HD Iss This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicaA above f r which fees have been paid. 1 TOR OF PUBLIC WORKS BY —Date?-Y2WC93 PERMrf EXPIRES ON (De tel ReceiptNo._ _154066 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - D•eo'artbent of Public Works . 7 County Center Drive, Oroville, CA 95965 Phone: OWNER -BUILDER VERIFICATION i. Attention' Property Owner: 916-538-7541 An 'owner -builder" building perait 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 them abor and materials for construction of the oposed property improvementKyens',rno) 2. I.( ave/ ave not) signed an application for.a building permit fo 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 Securityu ber Date .Z 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 toour office before we are per- mitted to issue the permit. i.•-1•,ri�, i•�.� �--�� •k ,,,,-�. � ..1.�.� A...�i�l7+r' [ I`��'� � ,�:�� , w ��1w } . v.:;rv.� ��..y^ � � ' qy,�'�'. -'f'•�'�'TI� ri/./� iLry "�V }""`, v' `r'•• �1"` ...^•'^�Y "� ri'«.� r�,,...�'1•s"aia� -,�'e. S.r:. COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER ) 0-yi A. P. No. Proposed Building Use '` Building Inspector Date A77per ' application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECENED BY 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 Development about (A) Improvements (B) Drainage. ......... . 19. Driveway permit (construction approval required prior to occupancy). ...Preanspe... reqs ---- 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 )............ 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 . ..................... 1 .................. 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 . ..................................................... 33. 34. When you issue the permit, process as follows:Mail to owner. Mail to contractor. Telephone and hold for *kat office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data 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 hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. N�• 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 J APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 058-200-076 ZONING FR10 BUILDING PERMIT OWNER KEN &HELENA MATTOX TELEPHONE 533-2812 SO. FT. OCC. BUILDING VALUATION-• OWNER'S MAILING ADDRESS 11595 MILLER PARK RD OROVILLE 95965 320 0 2240 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 155.00 Permit Fee Plan Checking Fee $ 45.00 $ 22.50 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 11595 MILLER PARK RD OROVILLE Permit fee $ 82.50 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome®X Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition Pgr, Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: OPEN DECK Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service LESS 2000A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑I am licensed under p provisions of Cha t. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification VV 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 Main service 200A TO 1000A) 37.50 NEW CONST. DWELLING OCCUP.&) OR ADDNS. ACC. BLDGS. 3.64 sq.ft. NEW CONST R ULT' -OUTLET NO N.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS e\ SINGLE OUTLET CIR. / EX. OCCU p(OUTLETS OR FIXTURES 20 76 AL Q 46 FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 1 1 -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 15.00 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 County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agai st sai ounty in consequence of the granting of this permit. X Date �t7� z- Signature Applicant — Owner [f Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or consrru�r- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE TOTAL F . $ 82.50 HAz I DFEES IMP I FLOOD CDF PAflCEL PD HD ISSU This permit is hereby issued under the sions of the Bu Cou Code and/or `^fork indica ab a or which fees OF PUBLIC By P EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date/Z-� — Receipt No. Z��$ WNITE-O.P.W., •ELLOW-ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT 1 .,COU.NTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVIAN—�' 7COUNTY CENTER DRIVE -OROVILLE*CALIFORNIA95965- TELEPHONE (916)538-7541 a PERMITAPP`IICATION DATA SHEET OWNER'S Proposed Building Use Building Inspector A. P. No/') o�fD %f At time of p rmit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY All items have been submitted : ....................................... . 2. Plot planso)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 $........................................ . V11Impact fees as shown on attached schedule. ............................. . California Department of Forestry plan approval/fees. ....................... . . Flood elevation letter (100 year flood) by California Engineer. .. ..... . . Sanitation and plot plan approval O 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 Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ..... st 20. Pre -inspection for required. .. � B.i,e �g �spe� (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 ............ 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 . ..................................................... . 33. 34. When yo issue the permit, process as follows: Mail to owgqer. Mail to contractor. !/Telephone _a and hold for pickup at Ol 0 office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz�Mat form sent Health Dept. Fire Dept. Aif 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 fog 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 Cou ter by _ Date Plans checked by Date Plans approved by ) Date 1�'3 Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works i:. ii.li.s Hot Han AUached ,~ 1' Floor Plan Auad d ` Sent to B.U. TO: Building Department � r ; +� (COUNTY OF BUTTE BU!LDItVG DEP"r FROM: Environmental Health SUBJECT: Sanitation Clearance DEC 0 1 1992 Kg�,<- Me,( 'IT- lz,,,- P(IZHO 4�,-Q - Owner Location AP# Plan Approved for: Sewage Disposal ✓ Water Suppl --y: Public Private Well ar e m ne Other ��dnn� K a Hold final for: Final clearance O.K. for: NOTE: Environmental 8/92 Sp�alist Date COUNTY OF BUTTE - DEPART(AENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 9161538-7541 APPLICATION AND PERMIT ASSESSOR PA C L NUMBER Za O ZONING %Z� BUILDING PERMIT OWN TELEPHONE 32 fir/ 2 SO. FT. OCC. BUILDING VALUATION OWNER'S MA ING ADDRESS Al,e-z ElL CON TOR'S NAME Gl/il/ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Is LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 15.00 Permit Fee Plan Checking Fee $ 1=0 O $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS k722 Permit fee $ 0/1- D PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF [:1 DuplDuplex[]Buildin Mobilehom Other SPECIFY Gas piping system 1 - 5 outlets 5.00 9 sewer 15.00 Mobile Home S I G I W 1 15.00 TYPE OF WORK New ❑ Additio Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR OR LESS 18.50 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.SINGLE 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason Main service 2oGATOI000A1 37.50 NEW CONST./ DWELLING OCCUP.&\ OR ADDNS. 1 ACC. BLDGS. // 3.64 sq.ft. OUTLET NEW CONSTR.ULTI.H CIRCITS NON-RESID BRANC @ 5.00 POWER APPARATUS 6 OUTLET CIR. Ex. Occu P OUTLETS OR FIXTURES 20 76d FIXED APPLNS, OR Ex. Occup. OUTLETS IRESID.1 EA.T 3.00 Temporary service 15.00 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 15.00 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 County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in an way accrue agai Sts i Coun in co s quence of the granting of this permit X Date S.gneture of Applicant — OWner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'11" deep and demolition or construct - ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ ��, S0 HAz DFEES 1!77D CDF PARCEL PD MD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date / Receipt No. / 7 W HITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, COLD ENROD-APPLICANT 4L 0 an Location of structures & equipmant small be as shown & clear of all easements.. f iv 1( -t- rear �aC,I's �a . op r®aEC APPROVED Butte County I Environmental Health --_ L� -- gate I ------- Sign t, re 9 101, TO eCNtf► i 4/' Toe ZOo`O7(� NWWAU 61 9` cftl^i1B1 P Shall Be 1n IAcCoi^ciance with ReC09MZ-,d Good PT arm' and" ot: & QualV P. -MSC -TI :sQ3i1 fr:T the s"S,pacr` d UBS in the Uli oA' n Bll!?dinL, MuMbing & McChantw Codes and the IUUM610 I r 4 I ' I mWCA LLD 8 �} r— Z �o �m V Q CM 7�77 .4 a 6' t - � ' 00 cQ o 7�77 .4 s m 7 s 1 C BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: AYA 77-e r, 2. lh, _1 Installer's Name: /i/G%�i�� /7M AfjL El 3. Is the site currently under permit? Yes D- No (If yes, furnish permit number Is the site an existing site? - I Yes ) OR No (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic nk and leach fields and clear of all setbacks and easements? Yes No (If no, clarify E 5. What is the mobilehome electrical rating? --------------- /G G Amps 6. What is the mobilehome site service rating?-------------� 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 L—I 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 service? --El --'-------------- Natural LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- (ft.) 12. What is the,mobilehome gas demand? ---------------------- (BTU, *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG:) ?: T �` MOBILEHOME SUPPORT DATA If other than single wide, > Mobilehome Mfr. furnish Setup Model No. �/ Year pZ8 Width �O (ft.) Box Length (ft.) Tagalong or Expando Size ft, x — ft. On all mobilehomes manufactured after October manual and structural setup sheets (if not on 7, 1973, furnish manufacturer's installation file with the County of Butte). FOOTINGS (check one) 1. Wood -pressure treated SUPPORTS (check one)©1: Concrete block. 2. or foundation grade. 1-12. Other (specify) Other (specify) Pier Footing Sizes and Locations SJNCLE-WIDE MULTI -WIDE Llne 1 Piers: Size -Min- ------------ Spacing -Max._._____-- , From finds -Max. ------- Uite_ 1 Piece: -- SJzc-Min.------------ SpacJog-Max.--------- From Ends -Max. ------- Line 3 FZrot loads: Size -Min. ------------ Location (From FronL) . Line 1 Line 1 Openings: Size -Min. ------------------� "x Each Side of Openings With Width Over --------- Line 3 Piers: (Under Bearing Wall Only) Size -Min------------------- 1x Spqcing-Max ---------------- From Ends -Max --------------- 1:7., , ------------- Line 4 Piers: Line 5 Piers: (Under Bearing Walls Only) SJz,.!-Min.------------ ,k Size -Min .------------------ x Spa, Jog -Max.--------- „ Spacing -Max .--------------- From Ends -Max.------- From Ends -Max.------------- " I_inl Koof mads: -5 � —. 11 _TC COUN Size -Mil .------------ I,ocaLion (From Front) .,, o ., ,,L3o „ X A". on, 1-9 d HI -8 9q. -Cl .1,50. Rr 1A, - 8 .. I - Line 4 Piers: Line 5 Piers: (Under Bearing Walls Only) SJz,.!-Min.------------ ,k Size -Min .------------------ x Spa, Jog -Max.--------- „ Spacing -Max .--------------- From Ends -Max.------- From Ends -Max.------------- " I_inl Koof mads: -5 � —. 11 _TC COUN Size -Mil .------------ I,ocaLion (From Front) APPRO -� , 0 "00 mwasr"� ® - ----- — — mmMR,- APPRO -� ri" a -- 4"x V 2 X 12 STAIR STRIfJGER. 48'0.0. MAX. T PIERS -TOP VIEW t H AUDI?AIL NOT SHOW fJ FOR CLARITY. 3/g l F30I T � s 2;;x4. --r MOBILE HDME �f --- MAX MTL. FRMU CLIF (EA. DE) U y - 9 MIN. 4"x 4' F0ST CUP - 20x I20 - #2I)Fc0 171 71 �l TREATED OR � � 2 X 12 STAIR STRIfJGER. 48'0.0. MAX. T PIERS -TOP VIEW t H AUDI?AIL NOT SHOW fJ FOR CLARITY. 3/g l F30I T � s 2;;x4. MOBILE HDME �f MAX MTL. FRMU CLIF (EA. DE) U y 9 MIN. 4"x 4' F0ST - 20x I20 X #2I)Fc0 2'x4" PRESSURE' 3/0" TREATED OR 60LTS : REDWOOD PLATE - .�. ►4��M�N. 6 - I � - 90 DIACONAL �G TYPICAL RESI DEiVTM STEPS ANo/a0�Ck COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville• California 95965 j Telephone: S�R_75G1 • - TMs. set of plans w d spec-"ffcations MUST be. kept on the Job at all t:m. s emd it is unlawful to ma,ku a V ^,binges or = lteri,tions on name without written pamiia; .:an groat; the Department of PubHo. Works, GovxAy of DjUa. ou 4 rr� �o high with I ? t I i Tobi r ?! -10 be 36 int• t intermedi,6te rails to be not I s I i over'4 irt. c]Aart.- ^ ; ! j C: 1 mAV!1' •i r a -� 'i a kits I t