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HomeMy WebLinkAbout058-500-034Frank Moore � s .E/S Nelson Bar Rd. 4_mi.N- 6f Lunt Permit,#33425-76P E(ut GAS SUPPORT STRUCTURE TBQ�—V UIPACTION T REQ. kl Permit #3326-76MHI 7-.20-76 Issued 058-500-03406-1287�; MC MORROW, NANCY 9W,' 11489 STAGE COACH LN, C' 09NCOW. -i "' - c OWNER ont, TEMP POWER FOR WELL 9 -11 gra � gra o BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP061287 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 05/31/2006 APN: 058-500-034-000 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. Site Address: 11489 STAGE COACH LN CON License Class : License Number: Map Index: Date: Contractor: Description: temp power for well & future lot development OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: MC MORROW NANCY A permit to construct, alter, improve, demolish, or repair any structure, prior 7107 OAKDALE AVE to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of WINNETKA CA the Contractor's State License Law (Chapter 9 commencing with Section 91306 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any (818) 519-2117- FAX (818) 347-6539 violation of Section 7031.5 by any applicant for a permit subjects the march unter@sbcglobal. net applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 (Sec. 7044, Business and Professions Applicant: MC MORROW NANCY A Code: The Contractors' State License Law does not apply to an 7107 OAKDALE AVE owner of property who builds or improves thereon, and who does WINNETKA CA such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 91306 sale. If however, the building or improvements are sold within one (818 ) 519-2117 FAX (818 ) 347-6539 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of marchunter@sbcglobal.net sale.). 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt nder Article 3 of the usines anZPr ssio s Code Date: owner: ' License #: -5/3 RKERS' COMPEN ATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of Consent to self -insure for workers' compensation, as provided for by Section 3700 of the Architect: Labor Code, for the performance of the work for which this permit is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: Policy #: 15 //l 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 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 wi those provisions. Date: Y� Applicant: WARNING: Filure to secure workers' compensation coverage is unlawful, and s all subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This pe7it is h reby issued under th licable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resol tions t o work indicated a ve f r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: Date:- Sa Address: PERMIT EXPIRES ON: Date O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any fficial for�l or docent of Butte County. I hereby 71 authorize representatives of Butte County to enter u on the above mentioned property for inspection purposes. Print Name: n4 -TZ Signature: Date: ❑ Owner ❑ Contractor 4 Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 31 06 09:27a 1". May 31, 2006 Marc Hunter To: Tammie Powell Butte County Permit Technician From: Nancy A. Hunter 8183476539 I hereby authorize my husband, Marc S. Hunter, to represent me in all aspects. Also, attached is a copy of our marriage certificate so that my name can be changed on your records from Nancy A. McMorrow to Nancy A. Hunter. Thank you. Nancy A. Hunter 31 06 09:27a Marc Hunter 8183476539 p.2 I - -NC,t I rvii,, r;,14- -� > State of Nevak .Uarriage'Certiirate' 11 No. D820130 -wify C', 16'It th'. (fitf m! dw N 2t lit A44— MARC STANLEY LINTER of WrN.NETKA CALIFOR-NIA arrcl NANCY ANN MCMORROW WINNETKA (L'ALIFORNIA with dicil- III Imi'dCollsolt, ill rfic-Praqji: um &AAAA J�k f i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name Name Address d Q� GE 4L City � ° AJ _0_r`<4 State QI Zip %30( Phone 19' 5)1 Z11 -% �5 I Fa" �� 3 q 7 �S 31 E-mail g A 0 Al —Ime_ C to�A�•/�f- APPLICANT INFORMATION CONTRACTOR Name tk Address Zip / O� City Fax PIZ 3q7 � s3 State Zip Phone Planner Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name CityState / Address Zip / O� City Fax PIZ 3q7 � s3 State Zip Phone Planner Fax E-mail State License Number APPLICANT INFORMATION Name � Address CityState / /j. /f Zip / O� Phone b� F5 z 1( 7 b Fax PIZ 3q7 � s3 E-mail /7 56G i For office se only: Zoning ro _ Flood Zone SRA I r SNo Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BP BIN # PROJECT LOCA TION AP# 0S? ^ 5�� 0'57 ' jf Property A dr s �yk� .5 keolx� LO - City C_4 ross Street o/j Sw I WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: i Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: Bldg � ) SRA Receipt # / Sheriff SMIP Date: Other 15_A/(z LJ Total REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS. , The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a: new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 Q) Q) CIO c 0 0 0 0 0 PERMIT NO. 3325-76P,E, PERMIT EXPIRES OWNER Frank Moore CONTR. - owner ,LOCATION (A.P. 58-19-164 ) Ej" Nel'6n Bar Rd,, 4 mi. No.of Lunt Rd.,'Orov:M4 ik4 Y 1;. ;3n �k , .fr h 1 C rA fi d Temp. Power Pol Called PG Temp. Ele AS Serv.-�% L0 7 Call PG&E Temp. as -Serv. ZS ailed PG&E ' J B INALED% 6 (Date) t COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMB114G Setback,%— Firewall Soil Pipin Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor' < Footings Windows 3rd Floor Stemwal l Sidina Topout Slab Piers Garage Footings Stemwa I I Foot! Slab Patio Foot! sonry 1h Reinf. Mesh Scratch Brown Finish Interior Latt Fdn. Vents Garage Vents Insulation Prov. for ph sicaliy handicapped. Conformance of ex. structure Final FIREPLACE FI HANICAL Water Piping, Sewer Fixtures Water Htr. Heaters Appliances Gas Piping& Test Temp. Gas Sanitation Final Motors Water.Htr. Subpanels Grd. Fault Pro Service ' Temp. Pole Underaround ELECTRICAL 7/, 7 Door Closer I Final Final ` j f"Zo/ j,,6 DATE REMARKS OR CORRECTIONS �� �fV��l,�v ✓1/1%20 '�'vL� . /o o A- & , ' < (NOTE: An entry must be made on this form each time you visit the job site.) V ' 1 9. Electrical A. Is service large enouglt to provide adequate .amperage. to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) and other faciLit.ies-on lot, i.e., water pumps,., garage, cabana, etc.?. Yes No B. Is there proper clearances around panels? Ye_ No C. Is power supply cord or feeder assembly properly fused? Ye No D. Is continuity test satisfactory as per. the following procedure? Yes N0 1. De -energize electrical wiring system of *the mobilehome at the pe es al. 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 liine),•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 ;ahall 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 Length / ,V - Widt6 Vehicle Serial No. -0"sa 71 State Identification No. Additional.Informati.on or Comments: MOBIL EHOME INSTALLATION INSPECTION CHECK LIST L Is the mobilehome located with required separation from lot lines and buildings and generally conform to.plot plan? Ye `s no 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yesy.No 3. Are footings and supports properly sized, spaced, and braced a er approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level? (Sec. 5088) Yes No 5. I.f more than a sin le unit, are'crossover connections properly installed? (Sec. 5088) Yes No 6. Water /U A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes/. No l/' B: Test - Does water piping withstand working pressure or.50 lbs, air test? Yesx_ No C. Backflow - If coach is not State of Cali o � approved, does station have backflow device and pressure -relief valve? Yes No 1. Wastes and Drains X A. Is connection made with Schedule 40 DWV and have flex connectors at each end? YesNo B. Does it have minimum k" per foot slope and is it properly supported? Yes_X No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture in washing machine standpipe? Yes NoAX D. If qoaph is no State of. California approved, does station have required trap and vent? yea 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 mobilehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes o 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 411 appliance vents properly installed? Yesi No. TO: Building Department' FROM: Environmental riealtn / RE: Sewabe and/or 'eater Clearance 0 NER LOCATION A .P## Has been approved for: SSWAGE DISPOSAL uAT�R SUPPLY 41 Sanitarian Date S95-775 k z:..c^sa .nr3<'c9 17�° ' ,f' r •1 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the CJ,i�cbrni Administrative Code, Title 25, C}�apter 5, under pe mit number 3G for the following location. e//s Nelson Bar Rdr. 1/4 mi. No. of Lunt Rd., Yankee Hill area Owner Frank Moore Owner's Address Rt. 1, Box 215, Oroville, CA. 95965 Map- Mobilehome Mfg. Crown Model Clialet o is Year 1961 Insignia No. 343607 Serial No. 2259 It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works i1 Date July 29, 1976 By = THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED r, COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive —y OeoviIle, California 95965 Teoephone: 534-4541 i APPLICATION AND PERMIT Pusiding Receipt No.White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant permit expiresDate BUILDING a Owner -- k/),/_ o/2ff— SO. FT. OCC. BUILDING VALUATION Mailing Address 13ax I Telephone No. Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address1 spAJ PLUMBING No. @ FEE PERMIT FILING FEE $3.00 {j kcl 1A N \,\ OF d Each Trap 1.50 j Repair drainage or vent piping 1.50 Water piping 1.50 a.Qtting Yerification Qnl' Each gas water heater or vent 1.50 �� ti / A. P. No.. C7 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. 6awi-Eeli�w Fire Dept. Fire Zone Use Permit Building sewer 5.00 ECA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Imp rovements p Lawn sprinkler system 2.00 Parcel[Approval Plans pproval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 S e Main service 600v OR LESS 5,00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600v 25.00 100 AMP OR LESS Single Family ❑ Duplex ❑ Mobil Home L[�--' Others ❑ Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST ( DACCL BLDGS,LING CCUP. &) 20 sq tt NEW CONSTR. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTFR. (POWER APPARATUS & NON.RESI D. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) 109 FIXED APP LNS, OR Ex. Occup. (OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 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 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 Permi Fe $ $ 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. X TOTAL PERMIT FEE $ 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 Pusiding Receipt No.White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant permit expiresDate BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,.CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: �/��� I7R p M to0- 2. Installer's name: 3. Is the site currently under permit? Yes / / No �l (If yes, furnish permit number ) OR Is the site an existing.site? Yes 7_1 No _IVI (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? ----------------------- Amps 6. k What is the mobilehome site service rating? ------=----------- Amps 7. -What is the mobilehome site circuit breaker rating? ------------- �_Sy� Amps 8. Is there any.other electric load to be served by the mobilehome site service? ------=--------------------------------------------- Yes / / No (If yes, identify the load and size: (Load) (Amps) 13i�f®11r 9. What is the mobilehome site gas pipe size? ------------- 10. What is the type of gas service? ---------------------------- Natural / / LPG h-4 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) .��k MOBILEHOME SUPPORT DATA j a. Mobilehome Mfr'. Setup Model No. Year / 16( Width (ft.) Length... A C� (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 �.(Footin&s--(check.one) o A. Wood . either pressure treated or Center CenterSupport Support .'-" -fdn:: grade.: Support Footing Sizes Locations (ir.) :: /�.2:: Concrete pad. - x 3. .Other, 'specify in. in. in. --- - - - - - - -I c Supports (check one) 1. Concrete block 41 2. Concrete piers /73. Steel piers :. ::....:.... 4 Other, specify i _ ,/ c� Typical Support 'ice ......... x3Z� Footing Size ' 1I1 a lIl. W *If center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COUNTY • BUILDING DEPARTMENT APPROVED J COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: '534-4541 APPLICATION AND PERMIT'° — ..� .. r.. v....n.u.., va.a , a,c V—, y UI ou�iv lU CIIICI UPVII ule above-mentioned property for inspection purposes. x 2 . L 4- L Date Signature of Permitee or Agent y^ 9/ Receipt No. / </o 1 C�� 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 OF PUBLIC WORKS By -�— Date _8n0"g permit expires Date _ �/���T, 7 BUILDING _. Owner K 0 — SQ. FT. OCC. BUILDING VALUATION Mailing Address © - Ih C Telephone No. Fireplace Contractor UJ iiJ z aTotal Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee Building Address �'- � PLUMBING No. @ I FEE PERMIT FILING FEE $3.00 CK) , iZptn-k 6 i= Each Trap 1.50 1—• L) N i � cyS " Repair drainage or vent piping 1.50 _ Zoning (61 Water piping Each gas water heater or vent 1.50 /Gas A. P. No. (� Zoni P a piping system 1 - 5 outletsFiE3 Q Cb Each additional outlet .30 Fees W.C. Fire Dept. Fire Zone Use Permit Building sewer .swop EQA I Parkn g eclara ion Parcel Map 60' R/W I Improveme is Lawn sprinkler system 2.00 Bldg. Plans Recd P a r ck ApprovalPlans proval Permit Fee ,$ -06 0r - NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE J$3.00 Main service 100 AMP ORV OR LESS5.00 Main service EA. ADD'L too AMP 2.50 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 NEW CONST. DWELLING CCUP. & OR ADDNS. ( ACC. BLDGS. ) 22syft NEW CONSTR. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS) 12.50ea 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. Occup(OUTLETS OR FIXTURES)BA@L @1 �' 09 Occup. FIXED Ex. OCCU FIXED APPLNS. OR (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ O p 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. 1:1 I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. MV 1 certify that in the performance of the work for which this VV permit is issued. I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No.1 @ FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE Is i� Oz — ..� .. r.. v....n.u.., va.a , a,c V—, y UI ou�iv lU CIIICI UPVII ule above-mentioned property for inspection purposes. x 2 . L 4- L Date Signature of Permitee or Agent y^ 9/ Receipt No. / </o 1 C�� 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 OF PUBLIC WORKS By -�— Date _8n0"g permit expires Date _ �/���T, 7 NOTE:—ABI Mclteriryls & Workmanship Shall Be _in ol Accordcnce with RPcnnn;� d Gnr d . practices and of a qurlit„ hrezr-4,1,rN4 ¢nr •the Stec;feel use, in the Uniform B��ildinq, �Ip,mf .; o & t,4achanica! Codes anc� the National Electrical Code. Ibis set of plans a s MU5`1 be kept on the job at all-times,and it is unlawful tc make any changes or alterations on same without 10 written permisson from the Department of Public Works, County of. Butte. All utility .connections shall be located Nvi,-hin 4 ;t. outside the rear third section of the mobile hom,- on the left (road) side of the mobile home. BUTTE COUNTY AYIV wrl 4L 17. t��-5 BUILDING DEPARTMENT The. Setback'shall,be 5 ft. from the side property line and 50 ft. from A P P R OU - ) the centerline of the road; oe^miftinq a maximum of a 2 ft. erwe, overhwnci. Sepi;; system and location to be as per r Butte County Health Dept. Re- N quirements. o0 9A permit will be required for the installation of the nnobilehom'e: DECLARATION REGARDING LOTS OR PARCELS I certify that as owner of the property acquired by deed in Volume' % 1 , Page Official Records of Butte County, (AP# 0_6"rr- _0 6) , I am requesting permission to build or install an additional living unit on this property. I will not divide the aforementioned property for sale, lease, rent, or financing unless all.applicable land division laws and map requirements are com- plied with. I am conversant with the present zoning regulations affecting the aforementioned property, and declare that I shall not violate same. I represent that the proposed use of the additional living unit is Aelaejg�. � and that further I shall not change this proposed use of the additional living unit unless and until I receive written approval therefor from the County of Butte. I fully understand that pursuant to Chapter 20 of the Butte County Code and §1153S et seq of the Business and Professions Code that if I, in the future, sell, lease or finance the area on or adjacent;t.O said improvement without fully complying with the applicable laws and ordinances, that I shall be guilty of a misdemeanor and therefore, subject to the aforesaid penalties and imprisonment pursuant to law.. Further, this statement shall be properly acknowledged and recorded at the request of the County of Butte. COUNiY-CALIF CSU!? 5i! ? b 9 29 �1119�6; LOUISE KLUENDFR COUNTY Fi CORDER, FEE Address a � � NOT COM?ABED WI -114359'7 Date S UP.IC I•IN 1 �L DOCUMENT- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - STATE OF CALIFORNIA ) ss COUNTY OFi�, ) On this day of 197 before me, a Notary'Public in and for the County of ' State of Ca Lia, residing therein, duly commis- sioned•and sworn, personally appeared known to me to be the person whose name_ subscribed to the within instrument and acknowledged to me that the_ executed the same. IN WITNESS WHEREOF I have hereunto set my hand and affixed my.official seal in the County of S ,,�4the day and year in this certificate first above written. u -. �• OFFICIAL SEAL WANDA E. FARRIS G NOTA^Y PUBLIC -CA: Notar Ub11C G..� PRI'4C:PAI OFFICE IN SAN (Ji EC>O,COi1NTY My Commission Expires July 18, 1977 S96-1275