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HomeMy WebLinkAbout058-370-010-Y 58-37-10 Loren J. McNeil W/S Windermere West, @ corner of Came r( Lot 54, Camelot Springs Valley Ranch Permit #,188-76P,E(util.,MH) ELEC . �S�Ai :5 -13 GAS S -4V 124 G -N/ :r f- SUPPO T 9TRUCTUgE REQ. zAM COMPACTION TEST REQ./vo �ONTR: Gerald ermit #2109-76MHI Issued I 058-37-0-010 95-1173 B JOHNSTON, Melody 3805 Wiridemere Lane, Oroville (repair deck)MH „` „-,/& //0I9I j 1 � W2 OD M Y 058-37-0-010 95-1173 B. JOHNSTON, Melody 3805 Windemere Lane, Oroville (repair deck)MH 4 � f � i ! 4 � f � i .. _ r+rr[..d�., "'ur y... ���Z'1�'�iR�f �T,'"/4�"`5:;..:{1M'•�.�4':t�°RI.Z^'4'4AG+v ,•yv,+�t.��.: COUNTY OF BUTTE - DEPARTMENT OF DkVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California -95965 - Telephone (916) 538-7541. PERMIT NO. APPLICATION AND PERMIT erg-' //!7.31 °, ASSESSOR PARCEL NUMBER....� „r ©//yV ZONING ! 1 BUILDINGPERMIT OWNER r Q•0HAX10A) T NE —. SQ. OCC. BUILDING VALUATION OWNERS MAID DRESS .� /� ��+ Lff G � CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Fling Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE Nd. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS ��jh� ,)Ogg JIM OW PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar Or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF El Duplex ❑ Mobilehome 04her SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodellj0 Ubllibes ❑ Installation ❑ Other ❑ Describe Work: � �� 4>A) e 4) J<K Mobile Home I S I G W 1 920.00 PERMITFEE g Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service a V oR LESS z00 OR LESS ) 23.00 Main Service 200A To 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.Ex. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: I, as owner of the property, or my employees with wages astheir sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. OR ADONS. .& .ACC. BLDS. ) SO. 3.5¢ Fr. NEW CONST.MULTI.OUTLET NON-RESID. BRANCH CIRCUITS ) @7.50 G POWER APPARATUS ) 8 SINGLE OUTLET CIR. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL 0 .50 EX. Occup. FIXED APPLNS. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE s Contractor WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50° Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with t ose provisions. _ --.. X, Date Signature of App Ica t -0 Owner ❑ Contractor ❑ Agent An OSHA permit is require for excavations over 50" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee Is occ CONST. TYPE TOTAL FEE $ HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL PD I Ho I ISSU This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have B PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Dat ( ate) Receipt No. I R66Q WHITE -D. D.S.P B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, ,California 95965 - Telephone (916) 538-7541 PERMIT N APPLICATION AND PERMIT �' �� 3 ASSESSOR PfRCEL NUMBEAO ZONING BUILDING PERMIT OWNER rn 8-L ® ,6 `VVVI T ONE SQ. OCC. BUILDING VALUAT19 It OWNER'S MAID DRESS �� C ��4 CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNXNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAIUNG ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS��-•• ,, W uziSle/ ORS LN 04D PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF 0 Duplex ❑ Mobilehome V101ther SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel0 Utilities ❑ Installation ❑ Other ❑ Describe Work: �. / -PA i P— Mobile Home I S I G W I @20.00 PERMITFEE g Contractor , ELECTRICAL PERMIT Filinq Fee 20:00 Main Service800v OR LESS ( 200A OR LESS 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 0( I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ADONS. ( a ACC. ) SO. 3.S¢ FT. NEW CONST. MULTI-OUTLEUTLE T NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS (a SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES) 20 @ 1.00 BAL 0 .50 Ex. Occup. (oFIXEEDTs RES D.OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with t e pro I ions. XIQ - _ Date_ wf\ Signature of App Ica Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height.C4041�at­ Mobile Home Installation Fee Is Energy Inspection Fee Is OCC CONST. TYPE TOTAL FEE $ HAZ. 1 D. FEES I IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated above for which fees have been k4m/ PERMITEXPIRESON /� •— provisions to do work paid. Dat �y -- / �� ate) Receipt No. I co WHITE-D.D.S. B. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 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 pro erty improvement :YES NO[ ]. 2. I HAVE(] HAVE NOT[ ] signed an application for a building permit for the proposed work. 3. I have contracted with the followiniz person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S 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: CONTRACTOR'S 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 PROPERTY OWNER: 12 i - - SOCIAL SECURITY i; R , DATE .",'� � NN 4 I 07 _.. . NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER Dear Property Owner: i An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sinc�rel , Michael C. Vieira, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER 1 • --PI?RMIT NO. 1880-76P,E PERMIT EXPIRES OWNER Loren J. McNeil, CONTR. owner LOCATION (A.P. 58-37-10 W/S .Windermere West, @ corner of Camelot, lot 54 Camelot Springs Valley Ranch d s ' r. . v i s S \\ Temp. Power Pole Called PG&E Temp. EIec. Serv.A"--' 6 Called PG&E �- Temp. Gas Ser". Called PG&E ° `OB FINALEDZ lyse —�— (Date) (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING I BUILDING (Cont'd) I PLUMBING Setback Firewall Soil Piping_ Forms Parapets list Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwalI Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handicaped Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR.CORRECTIONS pod- (NOTE: An entry must be made on this form each time you visit the job site.) MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with required separation from lot lines and buildings and generally conform to,plot plan? Yes-.,,�No 2. Does the mobilehome have required clearances above ground? (Sec.5085) YesK No 3. Are footings and supports properly sized, spaced, and braced as , p eapproved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level? (Sec. 5088) Yes)( No 5. If more /khan a single unit, are crossover connections properly installed? (Sec. 5088) Yes 114 � . 6. water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Ye sA No B. Test - Does water piping withstand' working pressure or 50 lbs�irtest? ,Ys No _� C. Backflow - If coach is not S at�f California approved, does station have backflow device and pressure -relief valve? Y 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 No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes No D. If coach is not St ,e f California approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an 'approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the moehome gas line inlet without reductions other than the mobilehome connector. Yes 1No B. Test OK as per following procedure? Yes No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes 14 No 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of mobilehome with a minimum of 100 amp), and other facilities on lot, s.e.,* water pumps, garage, cabana, etc.? Yes/L No B. Is there proper clearances around panels? Yes No C. Is power supply cord or feeder assembly properly fused? Yes No D. Is continuity test satisfactory as per the following procedure? Yes_ No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected, 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test.instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral, 5. All non-current., carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure,, the power supply cord or feeder.assembly conductors. shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA —� Manufacturer and/or Namestyle LengthWidth1 -2 Vehicle Serial No. State Identification No. Additional.Informati.on or Comments: 4 COUNTY OF BUTTE — DEtPARTMt_VT OF PUBLIC WORKS _ 7 County Center Drive — Uroville, California 95965 Tel ephofte: 534-4541 APPLICATION AND PERMITZ_�� �/09 authorize representatives of the County of butte to enter upon the above -menti d property for inspection purposes. X '� Date ignature of Permite 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. DIRECTOR OG-PbBLIC WORKS Ilding permit expires Date '"l BUILDING Owner d /j C �' SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor �f/j2s Q Total Valuation Mailing Address r, Qr r/y� �7 • Permit Fee Plan Checking Fee&/or Penalty Telephone No. —/p Permit Fee $ is Building Address S w� �D� Ft PLUMBING No: @ 'FEE PERMIT FILING FEE $3.00 /N E—L Each Trap 1.50 CAMELOT IT � V till Repair drainage or vent piping 1.50 Water piping 1.50 . P_1Q\{ It LU Each gas water heater or vent 1.50 A. P. No.,J_ `] ` • Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet 30 Fbo<l VW- mva tatirnr Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im prove ents Lawn sprinkler system 2.00 aid ec Parcel provol Plan pproval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER R ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 M34. 1 �` , . t U �;T—LLA O ®.. Main service 100 AMP LOR ESS 5.00 pE, Main service EA. ADO'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ER Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW LING O OR ADDNST ( ACCLBLDGS.CCUP. 6) 20sq ft NEW CONSTMULTI-OUTLET NON•R ESI D. (P- BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS & "' NON-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: QJ/9J-�Ri�� � �/ � Ex. Occup(OUTLETS OR FIXTURES)�� BAL@1 Ex. Occup. FIXED APPLNS. OR P•(OUT LETS (RE SIDEA) 2•00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. - ?,Q 3 Y!!F Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for orkmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit 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 I & 15S A C LAM L9 i\J '30 00 TOTAL PERMIT FEE $ DC authorize representatives of the County of butte to enter upon the above -menti d property for inspection purposes. X '� Date ignature of Permite 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. DIRECTOR OG-PbBLIC WORKS Ilding permit expires Date '"l MOBILEHOME.SUPPCRT DATA �5" Mobil ehome Mfr. LmaS s h 6y �ui'�4�.t'yyl Setup Model No. �,6a� �/%� Year % J� Width a '(ft.) Length(ft.) -Expando Size ft.x 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) . Sin le —� Footings- (check.one; i , V. N; 11. Wood :either . pressure treated or Center Center Support :. fdn.`grade.:- Support Footing Sizes !! Locations Concrete pad (in.) i.. /�,�. : yxa � /./ 3. Other, specify 1. in—) _ _ 6 Supports (check one, 1. Concrete block /#--,p 36� (I I I I f 2. Concrete piers 3. Steel piers I 4. Other, specify T / 41. .... ...... Typical Support r/Tx3 O Footing Size /�f x �.n. in. (ff.� in. ----.(3n.)(1 .) F a �..... Max. Pier. . s- 6 Spacing - d77-1/ lri. ft in.) in. in.) (in.) (in.) i ! Max. i Overhang ^If center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COUNTY BUILDING DEPARTMENT APPROVED 0 BUTTE COUNTY DEPARMTNT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owners name: " n 2. Installer's name: 3. Is the site currently under permit? Yes No (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes % No / (If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- ( d O Amps 6. What is the mobilehome site service rating? ---------------------- f 2 � Amps 7. What is the mobilehome site circuit breaker. rating? -------------- 0 D Amps 8. Is there any other electric load to be se. ---,red by the mobilebome (This information not required if pipe length less than 6 ft, on natural gas or less than 50 ft. on LPG.) site service? ----------------------------------------------------- Yes / / No -C/ (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- 10. What is the type of gas service? ------------------------------- Natural / / LPG AK / 11. What is the gas pipe length frog± meter or, tank to the mobilehome? _ 3 D —(f t.) 12 What is the mobilehome-gas demand? -r ----------------------------- (BTU) (This information not required if pipe length less than 6 ft, on natural gas or less than 50 ft. on LPG.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive ,,_ roville, California 95965 Tel ephone:.534-4541 ra 76 APPLICATION AND PERMIT ,4 authorize re entatives of the County of Butte to enter upon the above -me on d property for inspection purposes. // X C I"�Date fq b Signature of Permitee or Agent Receipt No. / `/Is- ?P 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. DIRECTOR PUBLIC WORKS By Date 2 �' wilding permit expires Date BUILDIN OwnerSQ. RCAlejZ. FT. OCC. BUILDING VALUATION Mailing Address ©, 13o X 10 b 6 Telephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building�Ies Address �� ft��s (,t>itJ�e�-�L1gr� A% PLUMBING No. @ FEE PERMIT FILING FEE $3.00 CIO Or A.1 Q r o — e L. o% 4b7— S -q Each Trap 1.50 1,14 A!e Lo7� ri�/G U LQ AAJ� Repair drainage or vent piping 1.50 Nater piping J-=50 D .a Each gas water heater or vent 1.50 A. P. N .— 3 % %Zo Gas piping system 1 - 5 outlets /O. 00 Each additional outlet .30 F s a i 'o Fire Dept. Fire Zone Use Permit Building sewer EQA I Parking Plans Parcel 'Mar 1 ' 60' R/W Declaration , P Improve p ove ents Lawn sprinkler system 2.00 BI C4g. Plans Rec'd Parcel Approval Plans Approval Permit Fee $ �3.pQ --?--3T0 NEW ❑ ADDITI-ON ❑ UTILITIES ®. OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ,p Main service 100 AMP AMPOR5.00 Main service EA. ADD'L 100 AMP 2.50 :z . 5 Single Family ❑ Duplex ❑ Mobil Home ® Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service( EA. ADD'L too AMP 1.00 OR ADONS.NEW CONST. \ DWEACCLBLDGOCCUP. &) 20sgft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON•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. u'^ P. �' a Ex. Occup(OUTLETS OR FIXTURES) -L BAL�1 Occup. ( OUTLETS P(RESID )REA) 2.00 Temporary service 110.00 Mobile Home Facilities 5.00 I> License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ a(o JO WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit 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 TOTAL PERMIT FEE $ 5 q So authorize re entatives of the County of Butte to enter upon the above -me on d property for inspection purposes. // X C I"�Date fq b Signature of Permitee or Agent Receipt No. / `/Is- ?P 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. DIRECTOR PUBLIC WORKS By Date 2 �' wilding permit expires Date L - rT,BAIC IVELO -- ,his mcikeny l se o a',-- -,ha ste car . !+ r r; MS s-' bo--.— ! _ ns imdd wi ho` i �" I ! __ 1 _—�__-• i } { wr tte pei'rs� { i { • I fie tic sys m nd loc ��-- ---- - j J� do ofbud- , t f ft� f06M itt -t-i-- "9 rian-'-s' tu 1 U 0 Iqui ements -o -tb nth I' t�eoa 4TY--O-er-�-_ _--- �_---_ �;w i e � � a imti f QJ�� 21 ft. � ea � J11L_ � . _- I T" { ';, er ve he�g. ng t �i — -_j—i _�T ,I ; I1-40 11 171 6 1 I �si { thi d ect on a` or� e e r e o ,_4 ,r� 10, 6h cti of the, si M063 otlthe 1C i-5ei -home. mo iTe' -- - I- ` - - , i -- °-15 - -�-- �--; _ l ? - 7 _ 44 i tt r --- cur --- -�- - - --- -- - I _-ohm - - cc -E- rd -. '.-- !l_ nc _ $u ith ' rh..?iwi— R�l-�, d I" '�. ize -+Foy lie wwf.sh' $ a d ra_ tics and Sn c+fi .d use in .he - - BUILDR - - - IGDP -- -- -- - RT _ D - - --I i - i e a ion_ I E ect ica Code - .- �I. ch rric I - _ --- _