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061-350-059
_ _ 1 061-2 50-059 06-0415 RICF?ARDSON, REX I / ISSAQUAH RD, BERRY CREEK T: OWNER MIH ON TIE DOWNS SITE PLAN REVIEW APPLICATION Date: S d — y� AP# � f Permit Number (if applicable) Bin Number APPLICANT INFORMATION Parcel Size: 5 ACJ S Owners Name: Owners Address: r7U 3q -� Telephone No.: 5 3 Li 1 nt 0 Email: Situs Address: S S tZ 4tLi p . Proposed Use: Residential ❑ New Single Family Residents ^' ❑ Single Family Add ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwe'., ❑ Temporary Mobile Hor. int M .mie) ❑ ' Temporary Travel Trai. ❑ Multi -family Non-residential ❑ New Commercial ' ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel Other 11 Septic ❑ Well ❑ Agricultural Exempt Building ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A ❑ Other: ' Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval W Sit e Plan Stamped Approved By M L� c' G&via, Date I d ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: Snow Load Area: 02 S`�� - 3030" ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ® SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attaa hed) • Flood Zone: p • Flood Panel No.: ((� Q0-1CG XpaS C Index Date: (0 ' 8 ' 9 U ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) ❑ Oroville Enterprise Zone Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ----------------------------------------------------------------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front �U c Side 30, Side Street Rear �t 3 of Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Applicable Development Fees: Standard Fees ' Amount ❑ Fire ' ❑ School* ❑ Parks/Recreation ❑ Roads " ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area = Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) Formula * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By_ ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑'No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel. Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements 07� Subdivision Map/Parcel Map: Map Date of Recording: b, 13q Lot: I ❑ Use Permit/Minor Use Permit Permit Number: Book: i Q 77 Date of Approval: Page: -4`21 Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. ❑■ Page 4of5 r ❑ Summary of Specific Requirements: ' This information provided in this summary is based on the application information and on the best available data at the time of review. C:Uanys\Building Permit Site Plan Reviewl.doc ' REPORT OF LAND DIVISION RT Oje IGATION r -- Location: L`= C, t,,, - No. Parcels: Min. Parcel Size: Sewage Disposal: Public 1:7 Which system Individidual Q Soil type Slopes `�� Distance to public s— e e Owner:/ AP No: Max. Parcel Size: C�4� i Water Supply: Public C7 Which system Individual Distance to nearest public system Experience with wells in area:, Good L ss Questionable E' No experience [7 Soil tests needed to process; type tests: perc Q and/or soil depth Q Q Assumed Q Assumed Cj Based on slopes Cf Provided Perc tests Q Provided and soil depths Assumed P C/ Provided Useable areas required are: Parcels meeting min. requirements: Parcel N®s. Parcels not meeting gain. requirements: Parcel Nos. RECOMMENDED CONDITIONS: C] 1) Provide area for wells and 100' leachfield free area around said area. 2) Provide 100' leachfield free area around existing wells within (:7 and/or 100' of r erty boundaries. / — 3) Shoes: O'__ -leach. rp, a ,�, .:a" a Q BUTTE COM -TTY TIMAr,TH MEP- ART19M DIVISIOT.T OF ENWI.ROT11"17INTAL ?UvALTH Inspecti—Rn-nugr_ t Re: A iJ �'— B — `7--- ,`-7- S70 = 76g _ u� L7 within . 004 M Del Siemsen, TENTATIVE PARCEL MAP, AP 61-35-22 ptn., 4 parcels on the south side of Enumclaw Rd., approx. 1200 ft. west of its intersection with Bald Rock Road. Bald Rock area. Engineer: Ron Graves and Associates Public Works conditions: Provide two-way traversable access RS -B -LD -I to each parcel from EJ a county maintained road or state highway. 2 Access to be reserved in deeds as per county ordinance and offered l for' dedication on ,the final map. 3 7 Show 50 ft. building setback line measured from centerline of access easement., d K 4 Provide road maintenance agreement.//j�tr� A'C �l• a- S�s, Show all easements of record on the final map. O> �. 6 Provide street name signs per requirements of the Department of c, Public Works prior to recordation of the final map. 1 T ee- A✓d -Ali 1,0^5 v4A .4DC 11 /4#7t 41,00 -odds �i( p�_ , 7 Pay off any assessments. Provide cul-de-sac at the end of the street. 9 Pay any delinquent taxes or current taxes as required. cr /IZI- 12 - /9 -9Z 10 Meet the requirements of the Division of Forestsry re: Timber Harvest Report. rT` r1 N3•- /YEZ � 1_ Planning Dept.. condition: 1 All parcels are to comply with the A-5 zoning. Health Dept. cnditions: 4.2` Show a 50 ft. leachf field setback from the drainage way on parcel 1. Indicate on the map that areas with slopes in excess of 30 percent are unsuitable for sewage disposal. The following mitigation measures are required: Note on map: All cuts to be 2 ft. or less. 15 Note on map: No earthwork during the rainy season. 16 Note on map: All wells, pools or water storage shall be fitted with CDF-approved drafting connections if required by CDF. SIEMSEN, TPM 17 All development,and buildings on lots 2, 3 and 4 are to be located within 350 ft. of the southerly line of lot 1 with the remainder,of lot's 2, 3 and 4 to be designated as a no development area. 18 Note on map: Recommend all buildings and mobile homes be constructed with fire resistant roofing and siding. 19 Note on map: Recommend fencing to be limited to a minimum of 18" above ground, and maximum of 48" ablve ground. 20' Evidence of water shall be submitted prior to recordation of final map. ,,' WW7eA-,',FO Z1AAVZ1,1TAae46 )-`e7l? All eei7:5' 7?7 .,VF -4) 4) 46) 10 d-176A7eR 7AW',A4A-1 jelle7d' -1.4-OP6 AA112 Ilf 4'4-W,4t7M- A�' e AF'OF7 e?1! z4rle2vl AV .6,4177x1ma". zoelvIxIc-o- IP41,, v.y ,4ee kVe'4eZ41 .1 /V?701-57 X1,47ZA? o0f- A-17'AF1.7 iVl;rll e?jVel.7 IM AAWAlor-i C40A141kPe-7-10A149 IA- RY rl.7A- Ree'40"M,FAW .44 L 44,e -Ve114191A1rv-5' AA.10 AfORIZ46' IMAIM4' AV 06-� 4*VAOW7R'41Cr,6rO W17W oc-IRO A?-e-'AV1-f;r.4A17 117-047,47AA 0 AA/l) X-11.71AA9. ;W - AY.,c ZIAV7410 70-A ,44 1411AW" e7lo=- /.*A' 1"4OVeORMIA11.) alc 400Y "* 4.0060y4r q4 495�4- yet qo. 106o 000l�zl tip game Q3 Ao . a doo tN. 7 -- Its a SLS a doo 4W MIIE4 A?EA N 4 EATERMAW JW 41ppE AN4 /S ey QgZ ACC CUTS TO AE ? FEET O? Ze4V . 447 EA?Ti/",W I)l//7/.t/Ca RR/.VY JBASO.✓ 4.e,e WECCf/ AWM4' OA' AVATEQ 97T7/1 Ke f fU ?F F/77" /V/T.V C/)F - A/1/RO✓E'4 "AFT/NG VA14,ECT/ON5 /F RSQU/QE.0 RY G!4 ?ECO.NMENO ACC .9U/Cq/.t t3S 0410 AWAJ&E HOMES •O RE C'ON.'TQli1C'TBO sv?N F// REiISTAN7 'JOOF/NG4 ANI) S/O/.<,f.7. OE�77MMEN/J FB.Ve/.tom 7" 9e C/.0/TEI) TO A a4i V/ML/M CSF B' A9O�E GQOUNq 4AoO A MAY/Mc . M Oi 4B'A.40✓e G.POY/N/J. El \ S / !h �� / 6O•a/�u. AT T.VY• T/�`_ • . moi ,or?E+s �� � / AC.PES / 0 / /�i8%9133 T7l6 GO'!l/RV ANq /!!/.E, A•B iAOWV �/ERfO)V .•A U7 TTCs� Y oactxeo: vtw .vsox or%v xn !/TC~7y State of California BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS REGISTRATION AND TITLING PROGRAM PO Box 2111 Sacramento CA 95812-2111 1 800 952-8356 httpJ/www.hcd.ca.gov/codes/rLhtm NOTICE OF SALE OR TRANSFER In order to process your Notice of Transfer, please complete the following sections: la n s ee zul SECTION- I: Please enter the Unit description information pertaining to your Mobilehome. Remember to include your - Decal/License plate number(s), Serial(s) number, and Trade name of Unit. SECTION II: Complete all information requested for the sale of the Mobilehome, include purchase.price and date of sale. SECTION III: Please provide new owner information, including full name and address. SECTION IV: Please date; enter City and Sate. Remember to include your signature and printed name. TJ -PON COMPLETION, PLE&SE RE-fL'INZN iv i -ABOVE I.1j 1:� E►JJDICJf':SJ. SECTION I. .DESCRIPTION OF UNIT Decal Number(s) Serial Number(s) Trade Name CA Fi. I X6426o 0 0 3 -. SECTION 11. SALE OR TRANSFER INFnRMATInN For the sum of $ y the receipt of which is hereby acknowledged, 1/we did sell, transfer and deliver to the purchaser/owner named below, on i2/� �D�� . _ , my/our right title and interest in the unit described above. Date of Transfer SECTION Ill. NAME OF PURCHASER/NEW OWNER: . Name: Address: City: State: Zip Code: Vwe certify under penalty of perjury under the laws of the State of California that: 1) I/We are the lawful owner(s) of the unit, and 2) I/We have the right to sell it, and 3) I/We guarantee and will defend the title to the unit against the claims and demands of any and all persons arising prior to this date, and 4) the unit is free of all liens and encumbrances I/We certify under penalty of perjury. under- the laws of the State of California that the foregoing is true and correct. Executed On 7 h? at fSrrr�r Date / City at Signature of Sellers: 'W MAT17M HCD 476.8 (06JOO) a 2006-0018354 Recorded I REC FEE 10.00 AND WHEN RECORDED MAIL TO: Official Records I BUTTE COUNTY BUILDING DIVISION County of I COPIES 2.50Butte I CONrORNS COPY 1.00 7 COUNTY CENTER DRIVE cam J. GWBBS I OROVILLE, CA 95965L'ounty Clerk -fiecorderl I DD 89:00 12 -Apr -2@M I Page I of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to 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 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 purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: arm �- l�5 slTvc�n ori �'llcc�" c �-� I'v,arc r l P / Date --A/-- l( '�i� PROPERTY OWNERS: State of Califo County of . On before me, personally appeared personally known to me (or proved to me on th asis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowit4ged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signs re's) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signatu A.P. # 4 r • �, Y • ' STATE OF CALIFORNIA } ss: COUNTY OF On t 0 before me, Notary Public, personally appeared rC\ (or proved to me on the basis of FOR NOTARY SEAL OR STAMP remonally known to nic satisfactory evidence) to be the person(sl whose name(6) is/4/e subscribed to the within instrument and acknowledged to me that he/sKe tht/y executed the same in his/haf/thod authorized capacity(i�s), and that by his/hvi'/th/ir signature(,a'j our. the instrument the person(, or the entity upon behalf of which the person(sl"acted, executed the instrument. SHAWN I. NEISON Comm. # 1363163 'n L NOTARY PUBtIC•CAIIFORNIA N WITNESS my hand and official seal. MvCommYExRiesuJune30,2006 Signature. Shawn I. Nelson, Notary Public Notaryak 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. BP060415 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: 04/12/2006 APN: 061-350-059-000 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: 62 ISSAQUAH RD BCK License Class : License Number: Map Index: Date: Contractor: Description: NEW MH NEW SITE TIE DOWN SYSTEM OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the (792) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: RICHARDSON, REX 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 1098 WOODCREEK OAKS the Contractor's State License Law (Chapter 9 commencing with Section ROSEVILE, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95747 she is exempt therefrom and the basis for the alleged exemption. Any - violation of Section 7031.5 by any applicant for a permit subjects the 916-521-5895 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 Code: The Contractors' State License Law does not apply to an Applicant: RICHARDSON, REX owner of property who builds or improves thereon, and who does 1098 WOODCREEK OAKS such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for ROSEVILE, CA sale. If however, the building or improvements are sold within one 95747 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 916-521-5895 sale.). ❑ I, 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 not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the inessVfessiVns C de LL i Date y Owne WORKERSOM SATI N DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ 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. Architect: ❑ 1 have and will maintain workers' compensation insurance, as Engineer: g 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. Policy #: Valuation: $0.00 I certify that in the performance of the work for which this permit is Census Code: 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 with those provisions. l Date: Applicant: WARNING: ailure to secure workers' compensation coverage is unlawful, and shall 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 I , , / 11 code, interest, and attorney's fees. l�l.-.l\ �� 1 CONSTRUCTION LENDING AGENCY This pe y issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Re of i d ork indic ted above for which fees have been paid. / , 0 D performance of the work for which this permit is issued (Sec 3097 Civ.) 4', 1 Name: By: Date: I PERMIT EXPIR N: Address: (Date) ❑. 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 an ' i or document of Bu I h by authorize represenn es of Butte upo a above mentioned property for inspection purpos �,/Onter Print Name: /l l x �4a I - -XI Signature Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2534 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY"' APPLICANT INFORMATION OWN R INFORMATION Last NameQ Address Address First Name X Address State . State City t / Fax State c Zi t�L Phonevq Lic. # Class Fax E-mail LENDING AGENCY Name APPLICANT INFORMATION CONTRACTOR Name City Address Address City City State . State Zip Phone Fax Fax E-mail State License Number Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State . Zip Phone WORKER'S COMPENSATION Fax Email Carrier State License Number APPLICANT INFORMATION Name -- / �7�( Address City State Zip Phone Fax E-mail U PERMIT NO. 6(p p �. BIN It For offiee use nly: PROJECT LOCATION Flood Zone ert ress X 14 CA 3� � Cross 9tr ( A Type Const. Subdivision Name Map WORKER'S COMPENSATION Policy Number Lot # Carrier Date Approved: 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 For offiee use nly: Zoning Flood Zone X. SRA No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: Description or Scope of W rR: `5 Sq FT- Living Garage pen 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 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: r t v� Bldg SRA Receipt #: %C Date: Sheriff SMIP a EA, N Y Plot Plan Attached Floor Plan Attactied Sent to BD/DS TO:. Building Division — Development Services FROM:. Environmental Health SUBJECT: Sanitation Clearance We le -Af F b6 � If " &2� Z:5 5,::�L2 clo r,5 Owner Location U AP# Plan Approved for: Sewage Disposal:_ Water Supply: Public Private Well Clearance for dwelling. Other Hold final for:- - - Final clearance O.K. for: NOTE: Environmental Health Specialist Building Clearance 9/2005 Date COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET GWNER: T C r�` ASSESSOR PARCEL NUMBER Proposed Building Use: UQ /,l NA'[ k*,A )t iJ Permit Technician: Date: �4 U hems required in order to apply for a permit. All boxes MUST be checked OR marked NA in order apply. CC, 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings 8. Manufactured homes: (Ayinstafl tAeri-marrual; mrlcrdirig'nranfage-Nne-Wo,T Floor Plan,) Tie down or fnd plans, all in duplicate. ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other ARe ainin ms needed to issue the permit. (May require additional plan review upon receipt of the following items.) 14. anitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑ 8. Erosion Control Plan Required........................................................................ t ®/ 49 Fees as shown on the attached Schedule of Fees Due Sheet......... I .................... ❑ 20. City of Chico Plumbing permit........................................................................ D 21. C Site plan and business license approval from the City of Biggs. California Department of Forestry plan approval ❑ paid. Sent 043 Planning approval for (A) Use: �(B) Parking: ) Pare :............ l0�4/'4aZ #4 407- ,g ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ .29. Worker's Compensation Carrier and Policy Number .................................. .."'. �I3 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ Letter of Signature authorization.................................................................... Recorded copy of Agricultural Acknowledgment Statement ................................. 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone 1 �l ' and hold for pickup. I have been inform diM -e _a3ove 'te nd quirem t for obt 'rting a building permit. -�2^--�16 Applicant: _ _ Date: 1. Index permi p Ii6a ion or the Mems numbered: I Q 41 Plan Check Letter 2. Additional it his re 4 41 Contractor, designer, as advised of the above data by phon ❑ mail, ❑ counter, by9M Date: 0 Contractor, designer, o err as advised of the above data by one, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by:_.' Date: Plans approved by: Date: Structural reviewed by: Dat /;/&Z</Structural approved by' Date' Note transfer by: Date: Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecountV.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner RICHARDSON, REX APN No: 61-350-059 Application Date 2/22/2006 Permit No: BP 060415 Permit Type: NEW MH NEW SITE TIE DOWNS 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $549.90 Plan Check portion of Permit Fee $219.96 $329.94 Balance of Building Permit Fee 2 FEMAYes Flood Elevation Review $109.98 0 3 SRA* X Yes Fire Plan Check - Non -Refundable $95.00 $95.00 $204.98 (State Responsibility Area) Building Inspection $109.98 $109.98 1 NON-REFUNDABLE portion of fees due at application $314.96 FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $424.9: FEES 16ELOW1 DUE PRIOR TO ISSIIANCF OF PFRMIT V1 Arl 41 5 SMIP* - Strong Motion Instrumentation Program (Enter amount from permit system) 6 Additional Plan Check Fees (NON-REFUNDABLE) 7 Other*: 7a Other*: 8 IIMPACT FEES - RESIDENTIAL* I lPerllwelfinn I IPPrnwP.11inn I I Par nwallinr 9 10 10a 11 11a 12 SCHOOL DISTRICT FEES* 12a RECREATION DISTRICT FEES* RECEIPT E Tech/Asst $329.94 -11,-)— $5.15 r,RECEIPT $3,217.43 �7 zclj&3 Ut RECEIPT DATE Tech/Asst At the time of permit application, I was advised the aboye ere wired to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. 11 Applicafit: Date: �2_7�� —i�� Pursuant to Govern nt de S ction 6 0, are h reby notifie -ose t s y an " " may have been impo ed on your project. You have 90 days from the date of a al of the porject or from the impostion of the above referenced items during which you may protest. The requirements for a protest are specified in Gove ent Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 121205 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 material for construction of this proposed property improvement: YES [Yq NO [ ]. 2. I HAVE HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: 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 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.. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION * BUILDING * GIS * PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your naive listing yourself as the builder of the 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact 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 contractor is to secure an "owner -builder" 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 contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. r - ��.,.::;::;• Of public WorksDepartment. o C o u n t y a i• i % /1 2 LAND DEVELOPMENT DIVISION ;; '•' _ , ,� ). Michael Crump, Director Storm Water JAanagement Pro;rzrn �.• ~� � @ 7 County Center Drive Oroville, CA 95965 (530) 538-7266 p�Uc WOF�S (FAX) 538-7171 hase It National Pollutant Discharge Elimination System (NPDES) Prevention Construction Storm Water Permit and Storni Water pollution Pr Plan (SWPPP) Acknowledgement (LESS THAN 1 �C Project Description: andlor Parcel Number: Project Location ., By signing below, I, the project Own By agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L therefore, do not need to apply for a ConsP S°whatr an t fion ri the State of California Regional Water Quality Control Board. projects multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre .Of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I mitting false andlor inaccurate information or failure to apply for a Construction am aware that sub Storm Water Permit from the State of California Regional Water Quality Control Board for a project• that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed:. Title. Date: Butte CountyDepartment of'Development S'ervlces 0 011 Tho 7 County Center Drive. •' \�. o-: C Oroville, CA 95965 C`_ (530) 538-7601 Telephone ° ^.� ° (530) 538-7785 Facsimile cOUN�y BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I iequest and authorize the Building Division to process this building pen -nit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: 9 I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained a I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition, of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: Building site address: APN: G Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building pe it application and my signature below: SI TU OF XMLICANT DATE BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District IL—, C(b Building Department No. A.P. Number �� V �" \ Jurisdiction: �^ City I lCounty Property Owner 0 Property Location/Address Subdivision Lot o's - C4-1-5 ............................ Residential Development 0 Q Q Sq. Footage No of Living Mobile Home Addition/ "Supplemental to (Group. R) Units Installation Conversion Permit # ,................... •(No foundation inspection) :.................................. Commercial/Industrial d 'e Building Department 0 •.New Addition Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use_Facility document), i Sq. Footage 1j (Including Exterior Roofed Areas) Date District Identification No. 7 " %F - 0 U11 i p School District certifies that (Applicant) (Street Address) V v (Phone Number) r r C rte. C (City) (State) (Zip Code) has complied with the requirements of Resolution No. representing 1 1.�— square feet. Paid by Check # &15S� Remarks: 10 1 V . 1 by payment of $ / r 0 L JFB 2926 $ ULL MITIGATION $ Date .f A Not/ce: You may protest the Imposition of the fees Identified above by submitting a written protest.to the District, In compliance with Govemment Code Section 66020(a), within 90 days from the date fees aro paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the fees In any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School Dh*lct Is LnoUfled by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQA), project may be subject to additional school hes to fully mitigate Its Impact on the school district's schools. te (school district), Yellow (building department), Pink (applicant) feefwm.xis (3l05W m BUTT COUNTY DEVELOPMENT FEE CERTIFICATION FORM FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Q( -Q (' - U S Building Pen -nit Number Property Owner (s) Project Location /Address `,�qzu 1 Subdivision Name Assessable Sq. Ftge 19 Type of Residential Development (check one) New Development Single Family -Detached Single Family -Attached Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling -ice--- Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) verified by Building Department Comments: Building Department ep esentative Date ❑ ZD A [DhPRPD ❑ DRPD certifies that: 5C Applicant Name , Phone Number Mailing Address City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of. Dwelling Units @ $ per unit for a total of $ Square Feet @ $ per sq foot for a total of $ Remarks: _ t Paid by Check No: Paid by Cash: dO Receipt No: h(M3 District COPY of Document Recorded 12 -Apr -2006 2006-0018354 AND WHEN RECORDED MAIL TO: Has not been compared with original BUTTE COUNTY BUILDING DIVISION BUTTE COUNTY RECORDER ' COUNTY CENTER DRIVE OROVILLE, CA 95965 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to 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 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 purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: lA•5 Shady ®0 ��c� C-er �G, ,'v, POLY -c 1 1� f � a P �ec�r� I � ��� LTi + cue n�' �"�� rz°Cr��-�e o� .�►-� Civ v� �v��. Vc,4 K 1® 7 Date/� ���r� PROPERTY OWNERS: State of Califor ) County of ) On before me, personally appeared personally known to me (or proved to me on th asis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknow ed to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signs re(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature STATE OF CALIFORNIA } ss: COUNTY OF `w On V LPbefore me, Notary Public, personally appeared - _ \C—e�l \Lr6)LWU (or proved to me on the basis of FOR NOTARY SEAL OR STAMP satisfactory evidence) to be the person(sl whose name(l) is/fie subscribed to the within instrument and acknowledged to me that he/SI%/thi/y,, executed the same -in his/haf/thWr authorized capacity(iWs), and that by his/hor/th it signature(j on the instrument the person(, or the entity upon behalf of which the person(�cted, executed the instrument.,;„, . SHAWN I. NELSON c Comm. 91363163 NOTABYPUBLIC-CALIFORNIA Yuba County WITNESS my hand and official seal. r MY Comm. Exyires June 30, 2006 Signature Shawn 6. Nelson, Notary Public • Notaryak a Notaryak STATE OF CALIFORNIA - DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT CERTIFICATE OF TITLE Manufactured Home Decal No: LBB2064 r Manufacturer ID/Name Trade Name SANDPOINT Model JJ DOM 00/00/1977 DFS 10/29/1976 RY Exp. Date Serial Number Labellinsignia Number Weight Length Width SPC SCC Exempt Use Type 0332 CAFL1X640670332. 60' 12' 34 SFD LPT Issued Total Fees Paid Jun 06, 2005 $51.00 Addressee HARRY M MOORE 9056 NEW CLASSIC CT ELK GROVE, CA 95758 Registered pOw�r(sR HARRY M MORE tea[ ANNA M MOORE� Joint Tena #s with Right of 9056 NEWCLASSIC CT ELK GROVE, CA 95758 . Situs Address 351 DANIELLE WY FOLSOM1 CA 95630-1175 1 UNI D rM IMPORTANT THE OWNER INFORMATION SHOWN ABOVE MAY NOT REFLECT ALL LIENS RECORDED WITH THE DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. THE CURRENT TITLE STATUS OF THE UNIT MAY BE CONFIRMED THROUGH THE DEPARTMENT. DTN: 3963106 e 06062005- 475 SECTION A:=SMOKEDETECTORCERTIFICATION... ` n�� The California Health and Safety Code requires that all used manufactured homes and used mobilehomes be equipped with a smoke detector which is in proper working order on the date of transfer. A declaration may be signed within 45 days prior to the date of sale stating that the smoke detector was operable on the date the declaration was signed. ' I/We further agree to indemnify and save harmless the Director of the State of California, Department of Housing and Community Development, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the unit in California, or from, issuance of a California Certificate of Title coveting the same. I/We certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on at ate City State Signature Printed Name sSECTIO 'S;= RELEASING SIGNATUR W �`•3 ".. ES,3�r'timF:' •�:�4`�'x,:,..?{ent"•r.��,....+i'.���..L'"..sa"C':��=��.,n.:Pi;'r�`5�.,. �,'�a 4,:,iv�?�'�+,q' Date of Release W 710 S Rteleasing lasin ignature of Registered Ow er Date of Release �� zO i Signature of Register Owner QN Release ❑ Retain * ❑ - Assign Interest 0 nor of Record (if any) sign and check appropriate box If Assign Interest is checked - Complete New Legal Owner Below) SECTION�C EWOWNER°INFORMATION �� Yii "",�},; r� -. r tt�v . .�.. air R �f ! ,t t ,? , xs �..3.NEWREGIDSTEREOWNER,_ Please "ieCarlysL�� _ _le _ 3a. 3c. New Registered Owners Name New Registered Owners Name 3b. 3d. New Registered Owners Name New Registered Owners Name If more than one New Owner going onto title, please check the appropriate Co-owner term box. ❑ Joint Tenants with Right of Survivorship ❑ Tenants In Common OR *❑ Trust/Trustee(s) (' If this box is checked -Complete HCD 476.6B) ❑ Tenants In Common AND ❑ Community Property ❑ Community Property with Right of Survivorship 4. Mailing Address of New Registered Owner City/State Zip Code 5. Actual Location Address of Unit • City/State Zip Code 6. Purchase Price or check box if Gift -LY Purchase Date or Transfer Date 7a. 7c. Signature of New Registered Owners Signature of New Registered Owners 7b. 7d. Signature of New Registered Owners Signature of New Registered Owners " 8a. 8b. New Legal Owners Name New Legal Owners Name If more than one New Lender going onto title, please check the appropriate Co-owner term box below. ❑ Joint Tenants with Right of Survivorship ❑ Tenants In Common OR *❑ Trust/Trustee(s) (- If this box is checked -Complete HCD 476.6B) ❑ Tenants In Common AND ❑ Community Property ❑ - Community Property with Right of Survivorship 9. Mailing Address of New Legal Owner _City/State a•a" .,, •..�.�_•._... :ax•,�+.r—•nx,..r-- Zip Code NEW'JUNIOR LIENHOLDER = Please Print or;Type.Clearly � 10a. l Ob. New Junior Lienholder Name New Junior Lienholder Name H. Mailing Address of New Junior Lienholder City/State Zip Code SECTION D'= REL'EASE;OF DEALERS?i~;e .,a.. z 12. Signature of Selling Dealer Print Dealers Name and Dealer Number Al- J - Yo J � AID cz c CZ. 4_\ 141 „ fL SITE PLAN ------------- :...........:...... :...... :_....:...... ...... ..... ...... ....... ............ :.................... :................... .. _. .. ... .. .. .. .: ti.>:: .. .. .. ._ ._ .. .. .. .. .. ... .. .. ... _. .. ... .. .. ............ .. .. .. .. .. .. .. .. .. _.. __ .. ... ._ .. ... _. .. ... .. ... .. .. ......................- ._ _.. _ .a+.- .. .. .. _. .. _.. _. ._ ... .. .. _.. ._ .. ... ._ .. ... ._ .. ... ............ __ _. .. ... ... .. .. .. .. .. .. .. .. .. ............... 9'6...... _.. .. : v. _. .. .. .. ....... ............ .. .. ............ .. ........._ .. .. .. .. .. .. ............ ................. :. 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Assessors Parcel Number: Baer Name Address / Phone No. Site Locatuon `? Contact: Names 1= � a L�j� m ®® Scale: lot= +. r. - V --v - Phone 11 e A=3 FOR OFFICE USE ONLY Zoning: General Plan Desig: ,4�2 Sime, Acres L— 4.®tr PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: , MANUFACTURING PLANT SANDPOINTE l Sandpointe Mobile Homes, Inc. 1600 Clancy Street Visalia, California 93277 (209) 733-3820 COMPLIANCE CERTIFICATE OCTOBER 8,,1976 Date of Manufacture CA -FL -1-x-6-40-67-0332 1562K Manufacturer'sjSerial Number and Model Unit Designation RQDCO Design approval by (DA.P.IA.) If questions regarding the.'operation, maintenance, warranty or performance of this mobile home should arise.please contact the dealer from whom it was purchased, the manufacturing plant listed below or: a FLEETWOOD ENTERPRISES, INC.' �,. P. 0: BOX 7638 3125 MYERS STREET RIVERSIDE, CALIFORNIA 92503 Answers to most questions regarding operation, installation, maintenance,and design capabilities are found in the appropriate sections of the owners maintenance and information manual and installation Instructions furnished with each mobile home. This mobile home is designed to comply with the federal mobile home safety standard in force at the time of manufacture. The factory installed equipment includes: , as Equipment Manufacturer Model No. Equipment Manufacturer M'o`del No. For heating _ CO 1 eman 7656 Washer For aircooling – – – – –– ----- Clothes Dryer: Forcooking� IGaffers & Sattler R31DIO Dishwasher Reif rigerator..= Gene ra 1. Electric TB 14 Garbage Disposal f Wa4 heater State Stove C4 -30 -TMH Other STRUCTURAL DESIGN BASIS CERTIFICATE North Note: Hawaii, Canal Zone; Puerto Rico and Virgin Islands are South Zone 40PR — North DESIGN ROOF LOAD ZONE MAP X South 20 PSF X Middle 30 PSF -North "40 PSF 1 Other—PSF M�r irHawaii and Canal Zone = Zone Puerto Rica and Virgin Islands = ZoWIZOne I I Zone I None - DESIGN WINDZONE MAP, Standard Wind Zone I Hurricane Resistive Zone II ,15 PSF Horizontal 9 PSF Uplift 25 PSF Horizontal 15 PSF Uplift _PSF Horizontal ,_PSF Uplift HEATING AND COOLING DESIGN BASIS CERTIFICATE r The above heating a ui ment has the ca acct tom inta'i ann DESIGN WINTER CLIMATE ZONE This mobile home has been thermally insulated to g, ` !,conform with the requirements of the Federal Mobile ?' Home . Construction and .Safety Standards for all • 1 " s•, locations within climatic Zone I X Zone•1I ZonellI 1 a. INFORMATION PROVIDED BY THE MANUFACTURER NECES SARY TO CALCULATE SENSIBLE HEAT GAIN, Walls (without windows and doors).; ....... 'U" m0� 0.0611 Ceilings and roofs of light eolor.'.. Ceilings and roofs of dark color......... " ..U" =0.061 1 Floors ..........:... :" .........'U=0•_0736 Air ducts in floor .... ................:'U" =0.2500 Air ducts in ceiling ...... ...........: 'U = Air ducts installed outside the home ........ '.."U'• =0.2 00 Heat transfer area to outside. of home from air ducts located: n c Inside home ..: ..... "Sq.:Ft." d 54.0 ` Outside home .............. .... .. "Sq: Ft." _ DATA PLATE CODE 280.5 q P P YI P, av�r�ge 70° F temperature in this home at outdoottemperatures of To.; maximize. furnace operating economy, and to conserve energy, it -.is recommended that'this home be installed where the outdoor winter design temperature (97W is not higher thanl:F. The above information has been calculated assuming a maximum wind velocity of 15 MPH at standard atmospheric pressure. The air distribution system of this home is suitable for the in- stallation of central air conditioning. The supply air distribution system installed In'this home is sized for Mobile Home Central, Air Conditioning Systems of up -to 39.- 600—_B.T:U./Hr.'rated capacity which are certified in ac- cordance'with the appropriate Air Conditioning and `Refrigeration Institute Standards. When thb air circulators of such,air conditioners are rated at 0.3 inch water column static pressure o► gieater for the cooligg air delivered to the mobile home supply ami duct'system... . ,,Information necessary,.to calculate cooling loads at various locations and orientations is provided in the special comfort cooling Information provided with this mobile home. To determine the required capacity of equipment to cool a home efficiently and economically, a. cogling. load (heat gain) calculation is. required. The cooling load is dependent on the orientation, location and the structure of the home. Central air conditioners operate most efficiently and provide the'greatest comfort when their ca)facity closely approximates the calculated, cooling load. Each home's'air conditioner should be sized in accordance with Chapter 22 of the American Society of Heating, Refrigeration and Air Conditioning Engineers (ASHRAE) Handbooks of Fundamen- tals, once the location and orientation . are known. ALTERNATE 2 1 - 10