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Home My WebLink About061-450-013o is al la emi.Nl10�31 �7J W/S pri.rd.,6/=.of Ord'Quincy Hwy, 209'N.of Cemetery, Berry Creek Pexin it X23 6-77P,E(us 1. ,MH) .4ja ELEC .® P GAS SUPP T ST UCTURE REQ, COMPACTION TEST REQ.y Louis Wallay,e W/S pri.rd.,6/lO mi.N.of Oro Quincy Hwy, 200'N.of Cemetery, -Berry Creek Permit #2357-77MHI. r Issued 0 0 r N 4 LO *All PERMIT NO. 2356-77P2E _ PERMIT EXPIRES i OWNER Louis Wallace CONTR. nwnPr LOCATION (A.P. 62-12-32 v W/S pri.rd., 6/10 mi.N.of Oro Quincy Hwy, 200'N.o. Cemetery, Berry Creek -5 Temp. Power Pole Called PG&E • Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E J0B ,�qqS/ / —�) FINALED V (Signature) s LRi'- � '� �`•��.�" � 1�� tib, �• �; i � 49 - �- Z = f r` � � x 1] •-�" •-� 4 � - '�: �r.,i�� r q-��. � •'y d yj`��'s .�+5�"��r�io` 'a* Y - ^4 ^ `' • rX �- `�` •- —' _. , P W ' %F :M1. � ""6�+ � •�y, ''�i .. �,�R"'y,7Cl � � �'N' yy� S -. ` !` ! z'A� t _ :-R._.,i�.�"' ��..� ."'..".� ''>a .►. '�. 'ti's - +� - Y 6•G$�eYy �'VSrd �:" _..Y--�..,• z i - -.. Ol -� �N9 ,�r�,�_�.;17.•a�t _ 1 rte`^ r� s' r•et_�� r � / •/ 3a� O W it �zz-' -,i: s. � .. ' - �� } is � ! � --- i - t. •- !� " A � : - -. x • '�1 a a � � :s .t � yr { 1 Vjf 1�1 Z Ste. P � € �•` cb :,� TY y- e - `�` � � g, cA.: o ,�-c,i�' t c � �1 "� A - i Ia�7.�� --• ��f •-3s.. _- �� '//�� b meg. sn�..; N � F _ _ �." ``•1 _ _ _ Ac„ •.� _ . ' �, G if 6,, � c , b G � .�/1/ ''•RSD -•i' k •°.` n ' � �,J��"� /� � � y �. ".'. - " _ •gyp � "s'� Qom+}(�'.,� ". �' Y r _ /J• rl `�- .' - _ qwJ� _ \ �� '_ - - �� , ,• �''� f ]� ` �a . ,ick r '�°4'�'�..__ \. _ _ � s' ..y _ fie\ �- = Gtr ��, �' - � � � ° . � � ,• " o � _ - .. � _ v '• � L� \ /- ail COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY this mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit numg*er- 7� for the following location: w�s N 0i= OW-6 QU//t/C,>/ Owner 00/5 (-IV1,4 4 C F—' / Owner's Address337 4-7-6,5'% PS<Pe 11,44E TO CA Mobilehome Mfg. AMOK 41 IF- Model Year Insignia No. NO -V/E7 Serial No.1/ 40yx:S1l S It is hereby certified for occupancy at the above described location and may be occupied. Directorof Pub°licb� � Date ��/!��,� By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED MQBT!XH0;11G DVS7'ALLA`i1 ON INSPECTION CHECK LIST 1. Is the. mobilehome located wi.i: required separation from lot lines and buildings and generally conform to plot plan? YCS / No 2, Does; the im-)bilehome have required clearances above ground? (.Sec. 5085) Yes `-- No 3. Are foot:in,s and supports properly sized, spaced, and braced as per pproved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level.? (Sec. 5088) Yes No 5. If more than a single unit,�are crossover connections properly installed? (Sec: 5088) S. Water. A. Is flexible connector of adequate size and properly installed (1/2" ID min,)? (Sec. 5566) Yes �Nc B. Test - Does -water piping withstand working pressure or 50 lbs, air test? Yes /--No ¢. Backflow - If coach is not State o iEalifornia approved, does station have backflow device 1 and pressure -relief valve? Yes No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes<:—go B. Does it have minimum 'L;" per foot slope and is it properly supported? Yes✓Ko C. Are any leaks detected in drainage system after running 3-Qal-ins of water through each fixture including washing machine standpipe? Yes No .% D. If coacki"i.s not State of 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 mobile me gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes_vNo_ Open all appliance connector valves. Shut off appliance burner and pilot valves. i,� 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. Connect: gas meter to mobilehome with connector, turn, on gas, test connections with sclapy water. C. Are all appliance vents properly 'installed? Yes �No S 1C 9. Ele.ctrT6a]l �1. Is selvice large enoitglk to provide adequatO amperage to mobilehome (must equal rating of me>bi.lehone caitic a ::;inir:um of 100 amp) and other facilities on lot, i.e., water pumps, g..crao,e, cabana, c,Fc.? Yes No B. Is thea proper. clearances Around panels? Yes_ No____ / C. Is power supply cord or feeder assembly properly fused? Yes Z-"- D. �continuity test satisfactory as per the following procedure? Yes_ No De -energize electrical wiring systeri of the mobilehome at the pedestal. Ftt9P 2. Make sure that the power supply cord or feeder assembly conductors, including neutral FJ conductor, hZWEe been disconnected, 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one I _gid of a test instrument to the mobilehome grounding conductor and apply the otccc'r lc:au to each moui.�Cu.vu�e supp�y cur►uucto'i, illi IiiCiLng t�euiral. 5. All nor. -current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), inclitding 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 toss_ shall then be made between the grounding electrode and the chassis of the Mobilehome. UDOn satisfactory completion of the electrical tests, the lot or site service equipment- may be approved for energizing. Is job card si-ned by health Department for water and sanitation? 1.1.. If everything okay, sign off card and t.a.- services. MOBILI;:I ME DATA Manufacturer and/or Namestyle�- Length 1,/15' Width l6' Vehicle Serial No. State Identification No. r.ddutional Infoimat-lon or Comments: Seloack For Malk Bldg. Fo tin s Stem all Slab Piers Garage Footings Stemwa I I Slab Carport Footings Slab Patio Footins MasonryWalls Reinf. Steel COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS t-, I BUILDING INSPECTION RECORD BUILDING i-Kewaii I S611 Piping PaNpets I 1 t Floor Rest om Finish I 2n Floor Windo Sidin Roof She In Roofing Fdn. Vents Garage Vents Insulation Prov. for ph sical handicaonedy Conformance of ex. Foot F SPR L PLUMBING 3rd Noor To out Water PipAig Sewer Fixtures Water Htr. Heaters Appliances Gas Piping & Test Temp. Gas Sanitation Final Fixtures Grd. F It Pro Servs ulywil moo ng IT mp. Pole F nish D is I idnderground Inferior Lath rFina tllation Permanent oor Closer l Final MOBILEHOME UTILITIES ----------•------- Elec. Service aOC2 =3j) T-c3jJJk4 Elec. Pedestal Water Piping Sewer �� _ Gas Piping E ME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Pipings �4) '� ^ Drainage Gas Piping DATE L % / REMARKS OR CORRECTIONS iAY94,L . &(Or--- /!ri .w i4 M/ pG P, WA/ -:)cl I ECTRICILL (NOTE: An entry must be made on this form each time you visit the job site.) BUTTE„ — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT Owner Mailing Address 671el e • Telephone No. Contractor W Mai I i ng Address Telephone No. Building Address ( //Z /�%41r a. U!2 0 ®u 1,-7 c, l tAu- 00 iG�20�lL- A. P. No.<,V� Zoning & Planning F W.C. 3aniterftn FireDept. Fire Zone Use Permit EQA Parking Parcel Parcel Ma 60' R/W Imp rovements Plans Declaration p p Bld PI Parcel pproval Planspproval NEW ❑ ADDITION ❑ UTILITIES . OTHER ❑ Single Family ❑ Duplex ❑ Mobil Home Others ❑ 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: License No, I am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT FILING FEE I am aware of the provisions of Section3700 of the California Labor Heating 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. Classification _ BUILDING I " SQ. FT.7 OCC. I BUILDING VALUATION Fireplace Total Valuation —It Permit Fee _ Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sarinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD•L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADO'L 100 AMP NEW CONST. ! OR ADONS. 1 DWELLING OCCUP. & ACC. BLDGS. NEWCONSTR. mom .RESID_ / MULTI -OUTLET (BRANCH CIRCUITS $3.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 50ea Ex. Occup OUTLETS OR FIXTURES. ggL@lm1' FIXED APPLNS. OR EX. OCCU P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 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 propertyfor inspection purposes. X Z I//-kfld-16� Date ✓ — ��' ' 7 Signature of Permitee or Agent Receipt Nol (91J AO - White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Cooling Ventilation Hood Permit Fee FEE FEE @ FEE $3.00 2.00 OA TOTAL PERMIT FEE $ 3a I" 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 bee aid. DIRECTOR P BLIC WORKS By Date —�— % uilding permit expires Date G—� a OWNER IiV 6`l 1, L /� (� 6y- Zoning SZoning Use Propos Permit fee based upon: 1. 2. _ 3. PERMIT APPLICATIONWORK SHEET Complete conttact price. Partial contract price (explain). DPW Valuation (show): Permit No. A. P. No. Cp2-1Z-3Z. Approved Not approved At time of permit application, the applicant was advised the following data or information must be submitted prior to permit processing and/or issuance: Date Received 1. All items have been submitted. ------------------------------ 2. Plot plans in duplicate/triplicate.----------- ,--------� C 3. Complete plans in duplicate%�'�. -� �_____ 4. Complete engineered plans and calcs. ------------------------ 5. Fees of $ ------------------------ 6. Letter of signature authorization. -------------------------- 7. Sanitation,approval.---------------------------------------- 8. Planning approval for -_ 9. Workmen's Compensation Insurance Certificate. --------------- 10. Contractors license information. ---=------------------------ 11. Parcel declaration, recorded copy. -------------------------- 12. Access declaration. -=--------------------------------------- 13. Aunt Minnie information. ____________________________________ 14. Deed of access, recorded copy. ------------------------------ 15. Deed of parcel creation, recorded copy. --------------------- 16. Parcel map, recording data. _________________________________ 17. Pre -inspection request for 18. Improvements - plans required & DPW approval: --------------- 19. Other n By Date / [7) Bldg. Inspector During plan checking process, the or information must be submitted issuance: 1. Index permit for items above and in addition the following: following data r�or to permit 2. Applicant advised by Telephone Mail Other 3. Plans checked by Date 4. Plans approved by Date 9mss/ When prm't is issued, process as follows: 1. Mail to owner. 2. Mail to contractor. 3. Deliver with inspection. 4. Telephone and hold for pickup. 5. Other Before permit issuance, all of the following items must be signed or.marked NA: 1. Zoning use 2. Legal parcel 3. Envir. Health Plans Sent A. Sanitation B. Restaurant C. Other 4. Public Works Plans Sent A. Street Imp. B. Drainage C. Permits & Fees D. Other 5. Planning A. Use Permit B. Variance C. Other 6. Other Agencies Plans Sent A. Fire Dept. B. Other BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville., CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: VV l %le G e ; �- 0 u / 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 t --ie 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 ) I 5. What is the mobilehome electrical rating? ----------------------- Amps 6. What =s the mobilehome site service rating? --------------------- �� Amps _ p 7. What is the mobilehome site circuit breaker rating? --------- /��;5 Am s 8. Is there any other electric load to be served by the mobilehome site service? ----------------------------------------------- / / No / / ---- Yes (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- /VD 've (in.) 10. What is the type of gas service? --------------------- N dlve Natural / / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand? ------------------------------ (This information not required if pipe length less than 6 ft. on natural gas or less than -50 ft.: on LPG.) $ ' ` A , ` r (BTU) MOBILEHOME SUPPORT DATA Mobilehome Mfr. A A -)-I Setup Model No. O - Year 159,!�l Width /D (ft.) Length 4s (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).. F -i :)din. ) I enter Suppo t ooting Siz (in.) X..._ in.)(in.) S ingle , *If center piers are other than drawn above, draw in locations, spacing, and dimensions. �. Footings (check one) 1. Wood either pressure treated or �i fdn. grade. - Typical Support Footing Size MSpacingr Overhang BUM Couwy BUILDING DEPARTMENT APPROVED 2. Concrete pad. 3. Other, specify Supports (check one) 1. Concrete block 2. Concrete piers 3. Steel piers 4. Other, specify PERMIT APPLICATION WORK SHEET Permit No. OWNER d: O A. P. No . 6 - 172 - . Zoning Use Proposed Approved Not approved Permit fee based upon: 1. Complete contract price. 2. Partial contract price (explain). 3. DPW Valuation (show): At time of permit application, the applicant was advised the following data or information must be submitted prior to permit processing and/or issuance: Date Received 1. All items have been submitted. ------------------------------ 2. Plot plans in duplicate/triplicate. ------------------------- 3. Complete plans in duplicate/triplicate. --------------------- 4. Complete engineered plans and cales. ------------------------ 5. Fees of $ ------------------------ 6. Letter of signature authorization. -------------------------- 7. Sanitation approval. ---------------------------------------- 8. Planning approval for -- 9. Workmen's Compensation Insurance Certificate. -------------- 10. Contractors license information. ---------------------------- 11. Parcel declaration, recorded copy. --------------------------- --------------------------------------- 12. Access declaration. - 13. Aunt Minnie information. ----; -------------------------------- 14. Deed of access, recorded copy. ------------------------------ 15. Deed of parcel creation, recorded copy. --------------------- 16. Parcel map, recording data. --------------------------------- 17. Pre -inspection request for Improveme is - plans required &DPW aper. al.,,, - l-------------- 19. Other l Cr�.c��P/s By. `�. /V %G/ Date Bldg. Inspector During plan checking process, the following data or'information must be submitted prior to permit issuance: 1. Index permit for items above and in addition the following: 2. Applicant advised by Telephone Mail Other 3. P1ans,checked by Date 4. Plans approved by Date When permit is issued, process as follows: 1. Mail to owner. 2. Mail to contractor. 3. Deliver with inspection. 4. Telephone and hold for pickup. 5. Other Before permit issuance, all of the following items must be signed or marked NA: 1. Zoning use 2. Legal parcel 3. Envir. Health Plans Sent A. Sanitation B. Restaurant C. Other 4. Public Works Plans Sent A. Street Imp. B. Drainage C. Permits & Fees D. Other 5. Planning A. Use Permit B. Variance C. Other 6. Other Agencies Plans Sent A. Fire Dept. B. Other NOTE:—AII Materials & Workmanshi Accordance with Recognized Good I of a quality prescribed for the Specifi Uniform Building, Plumbing & Mechanic the National Electrical Code. / fel Od Shall Be in ectices and use in the Codes and Septic system and location �.'� to be as per Butte County Health Dept, Re. quirements. U& UI All utility connections shat? 6L- located elocated within 4 ft::.outside the i ear third section of the mobile h me on the left (road) side of the mo ile home. 2 lot tag feauoV4l 0mp'" the M' /chis set of plans �d specificallons .MUST be dept on the in !. at all times and it is unix wf,�! .tn Make any chgnges or c7ltcrFatie>ns nn some wi;liout vrRfen permission from the Drtm Norks, County of Butte. epaent of Public Q � WWI la1 The Bldg. Setback shall be X ft. from the side property line and 5Q ff: from th%i 9 P P Y centerline of the.perrnitting a.moxi- mum of a 2 ft. eave overhang but entirely out of all easements. BUTTE COUNTY BUILDING DEPARTMENT � APPROVED /� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 �Z — 7 7 APPLICATION AND PERMIT autnor(ze representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. j X \�` is %�lL�t Date 1�r= /6 Signature of Permitee or Agent Receipt No. / 4z. )-:I - 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 Date_ N • 4n-7 tlding permit expires Date -7 BUILDING Owner X If & L1 rWALIL_, ACe- SQ. FT. OCC. BUILDING VALUATION Pt Mailing Address J3 ,4 QNzoc lit. E O 9Vs- o, Telephone NO. Fireplace Contractor WLc/epl-` Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Tlephone No. e Permit Fee $ Building Address S , pa / o A" i . PLUMBING No. @ FEE PERMIT FILING FEE $3.00 - / (� v U / r7 r C J(illt V ADO , Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 4-51:r- -3'[TEach Eachgas water heater or vent 1.50 A. P. No. f/H-C y oZ _32, Zonirj Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s W. Fire Dept. Fire Zone Use Permit Building sewer / T EQA Parking Plans Parcel DeclaratJZ-}i—on a P 60' R/W Improvements provements Lawn sprinkler system 2.00 Bldg&,Q ,Q Rec'd 1 arcel pproval Plans praval Permit Fee NEW ❑ ADDITION ❑ UTILITIES OTHER E]ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 5.00 �- 100 AMP OR LESS Main service EA. ADD•L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobi1.Home Others ❑ Main service OVER 00 AMP oR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 NEW OR ADDNST ( ACCLBLDGLING OCCVP. &) 22sgft 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)50 @25q� 13AL@104 Ex. Occu FIXED APPLNS. OR P• OUTLETS (R SI'EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 /S ^ License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ a 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 V e LE• TOTAL PERMIT FEE $ autnor(ze representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. j X \�` is %�lL�t Date 1�r= /6 Signature of Permitee or Agent Receipt No. / 4z. )-:I - 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 Date_ N • 4n-7 tlding permit expires Date -7 gd ' U l tycp a3.adctn� 3 t � } r 1 y 1 r �7 e �n0 ' ny adv/ J/ ver �m CY "I dV z }uaaa — L -7T' S a-1va � capivra --am 1i PERMIT APPLICATION 14ORK SHEET / Permit No. OWNER A.P. No .- Zoning Use Proposed Approved Not approved Permit fee based upon: 1. Complete contract•price. 2. Partial contract price (explain). 3. DPW Valuation (show): At time of permit application, the applicant was advised the following data or information must be .submitted prior to permit processing and/or issuance: Date Received 1. All items have been submitted. ------------------------------ 2. Plot plans in duplicate/triplicate. ------------------------- 3. Complete plans in duplicate/triplicate. --------------------- 4. Complete engineered plans and calcs.________________________ 5. Fees of $ ------------------------ 6. Letter of signature author za$'�n.------------------------ 7. Sanitation. approval. - ��--�____________________ 8. Planning approval for -- 9. Workmen's Compensation Insurance Certificate. -- 10. Contractors license information. ____________________________ 11. Parcel declaration, recorded copy. -------------------------- 12. Access declaration. - ---------------------------------------- 13. Aunt Minnie information. ____________________________________ 14. Deed of access, recorded copy. ------------------------------ 15. Deed of parcel creation, recorded copy. _____________________ 16. Parcel map, recording data. _________________________________ 17. Pre -inspection request for 18. Improvements -.plans required & DPW approval= --------------- 19. Other By (lam Date S / (o 7 Bldg. Inspector During plan checking process, the or information must be submitted issuance: 1. Index permit for items above and in addition the following: following data prior to permit 2. Applicant advised by Telephone Mail Other 3. Plans checked,by Date 4. Plans approved by 11.11A Date When permit is issued, process as follows: 1. Mail to owner. 2. Mail to contractor. 3. Deliver with inspection. 4. Telephone and hold for pickup. 5. Other Before permit issuance, all of the following items must be signed or marked NA: 1. Zoning use 2. Legal parcel 3. Envir. Health Plans Sent A. Sanitation B. Restaurant ' C. Other 4. Public Works Plans Sent A. Street Imp. B. Drainage C. Permits & Fees D. Other 5. Planning A. -Use Permit B. Variance C. Other 6. Other Agencies Plans Sent A. Fire Dept. B. Other