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Home My WebLink About061-590-001-~. \ \ ' � . 1 � / � . ^ ' � � ) | ' / F�lfred Buchanan WIS Ponderosa Way, app.760'SE of Buck- board Way, Bl6omer Mtn. SUPPORT STRUCTURE REQ.__&19 COMPACTION TEST REQ Permit #4386 78MHI 61-59-01 1756-91E MULLIN, Steve f021 Encina Grand,�-�d,_Berry Creek Perm it#1754-911,111I J-,�� 6 59-01 l�� 9-0l ' 2832-91B _ . - MUDLLIN, Steve � 102I Encina. Graode� Rd,'Berry Creek ' |e�k/ ( '' mb\' ~.~ ~~ - -- - 06 ' N O CSI � - � �: � I, rP U- • 91-2145A Return to DPW AGRICULTURAL STATEMENT OF ACLNOWLEDGEMENT` FOR REKDEFTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. -r---- _ _ The property described herein is adjacent 91-021431 1 Rec Fee 5::00 to land or included within an area zoned i Cash 5..00.' for agricultural purposes, and residents Recorded of this property may be subject to incon-I veniences or discomfort arising from the Official Records 1 t y use of agricultural chemicals, including, County of Butte I but not limited to herbicides, pesticides, Candace J. Grubbs I' and fertilizers; .and from the pursuit ± Recorder of agricultural operations including, but not limited to cultivation, plowing, 12:39pm- 31 -May -91- 1 XX 1 spraying, pruning, and harvesting which T occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real :property. situate in the County of Butte, State of California, described as follows: • Lot -1, as shown on that certain Map entitled, "FEATHER RIDGE ESTATES SUBDIVISION UNIT NO. 1", which Map was filed in the office of the Recorder of the County of Butte, State of California, January 15, 1970 in Book 35 of Maps, at page 62, 63, and 64. Date: May 31, 1991 PROPERTY OWNI ERS : LISA MULLIN STEVEN M. MULLIN State of Calif. ) On this the 31 day of May , 19__31, before me, the SS. undersigned Notary Public, personally appeared County of Butte ) ®®®®®ommoem�mmovommmmmmmm� Personally known to me. 0 Proved to me on ® LBAABARA-EdGAR m of satisfactory B NOTARY PUBLIC -CALIFORNIA oto be the person(s) whose name(s) are Butte County ®subscribed to the within instrument and acknowledged that My Commission Expires march 27,1995 nexecuted the same for the purposes therein contained. IN WITNESS ommesa oa■®iiem®®-amONOMM541WHEREOF, I hereunto set my hand and official seal. the basis evidence. Present A.P. No. 061-590-001 Notary Xblic EN® OF DOCUMENT jP 4z t g- 001. 9 . i I RECO—1 bC4EO�' BY : 9 I " 2. 10'3 l I . Order No. aiT-f Esc; -ow N,,Coffjriclr Title & Escrow Co. 1 Loan No. ., ' 91-081037 1 Rec Fee 5.00 DOC 18.70 WHEN RECORDED MAIL TO: Recorded I Check 23.70 1 1.Official Records MR. AND MRS. MULLIN County of P.O. BOX 712 Butte I BERRY CREEK, CA 95916' Candace J. Grubbs I Recorder B:OOam 30 -May -91 1 VS 1 MAIL TAX STATEMENTS TO: DOCUMENTARY TRANSFER TAX t..2:1-10 ............................. -SAME AS ABOVE— X.. Computed on the consideration or value of property conveyed; OR - ...... Computed on the consideration or value less liens or encumbrances remaining at time of sale. COMMONWEALTH TITLE COMPANY Signature, of Qeclarent or Agent del mining tax — F Irm Name ap# nhi-ro-n-nni -n . � _ _1/)_ . GRANT DEED FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, ROBERT J. TIPTON AND MARGARET_1.A.1`T'1PT.0N hereby GRANT(S) to STEVEN M. MULLIN AND LISA MULLIN, HUSBAND AND WIFE, AS JOINT TENANTS the real property in the City of UNINCORPORATED AREA County of BUTTE State of California, described as LOT 1, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "FEATHER RIDGE ESTATES SUBDIVISION UNIT NO. 1", WHICH MAP WAS FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,.STATE OF CALIFORNIA, JANUARY 15, 1970 IN BOOK 35 OF MAPS, AT PAGE 62, 63 AND 64. Dated MAY 23, 1991 STATE OF CALIFORNIA )ea COUNTY OF BUTTE I On MAY -24, 1991 before me, the undersigned, a Notary Public in and for said State, per- sonally appeared ROBERT J. TIPTON AND MARGARET A. TIPTON 9 ®�®�®®tao®a®tsassr®e�.�to®oto®® personally known to me (or proved to me on the basis of satisfactory ® STEVE SEXTON o evidence) to be the person(s) whose name(s) Is/are subscribed to the ® o�� NOTARY PUBLIC -CALIFORNIA within Instrument and acknowledged to me that he/she/they executed Butte County O 0 My Commission Expires Sept -.10, 1993 9 the same. In WITNESS my hand and official seal �^ (Thea area for official notarial Seel) Signature Form 3195 STEVE SEXTON MAIL TAX STATEMENTS AS DIRECTED ABOVE END OF DOCUMENT BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA' PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: 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 FX1U No F-1 (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away.from septic tank and leach FV I fields and clear of all setbacks and easements? Yes No (If no, clarify 5. What. is. the. mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? ------------- Amps 7. What is the mobilehome site circuit breaker rating?-----fD d Amps 8. Is there.'any other electric load to be served by the mobilehome site service? -------------------------------- Yes No 1�.j (If yes, identify the load and size:J%/t s (Load) 3 d (Amps) 9. What is the mobilehome site gas pipe size? -------------- �"�� (in.) 10. What is the `type of gas service Natural LPG 11. What is the gas pipe length from meter or tank to the :mobilehome?--------------------------------------------- * 12. What is the mobilehome gas demand? ---------------------- �� 006 (BTU) *(This information not required if pipe length less than 6 ft. on natural gas or less than.50 ft. on LPG.) .BPS -i759-91 MW Tk N i w MOBILEHOME SUPPORT DATA If other than single.wide, Niobilehome`Mfr. V/% furnish Setup Model No. Year Width_ (ft.) Box Length �(ft.) Tagalong or Expando Size ft. k ft. 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). FOOTINGS (check one)© 1. Wood -pressure treated or foundation grade. 2. Other (specify) SUPPORTS (check one) 1. Concrete block.2. Other (specify) X Pier Footing Sizes. and Locations SINGLE -WIDE MULTI -WIDE Main Beams Line 2 s _ _ _ _ _ _ _ _ _ _ Line 1 � 14— Line —Line 2 Main Beams — — — — � in Line 1 —Line Tag or Triple t inn 4 .. Line 1 Line 1 Piers: Line 1 Openings• Size -Min. ---------- ,k „ Size-Min.------------------ Spacing-MAX - ---------------- Spacing -Max- --------- ,- Each Side of Openings '.From Ends -Max- ------- With Width Over --------- Line 2 Piers: Line 3 Piers: (Under Bearing Wall Only) Size-Min-------------� �k3 Size -Min------------------- RX „ Spacing -Max .-- --- _5-77(_57, Spacing -M ----------------- 'From Ends -Max ------- ��`(� From Ends -Max. - ------------ , Line 3 Roof loads: Size -Min .------------ Location (From Front) Size -Min ------------- 'k Spacing -Max.--------- From Ends -Max .------- „ Line 5 Piers: (Under Bearing Walls Only) Size -Min. ------------------ ,k Spacing -Max---------------- From Ends -Max .------------- Line 5 Roof loads: Size -Min .------------ x „ „x „ ,k ., ,k ,. ,� „ .,x „ nx ., „x „ Location (From Front), - I Al fro the and a setback },..t r the road of J�� e clear Of /�' i 'Inall be t ` / LI�i cen*-cline �. �t ment eXCeP �.� ` Str, :tares or egoP rhan9•k = {# ; OM e06, �- --- - \ --1 _ .a 41 ,,7 r s12, � - `-.ter:- ,x•'- - :_ _'': .. - . _ 35-&3 I /fi �i. j �F �. a F .. ' �, � ,. i � �y' _ . COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive-,Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND -PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT _- permit Fee OWNER V /V o` �/ Ataggdl v^ TELEPHONE .Jr O� SO. FT. OCC. BUILDING VALUATION . OWNER'Sl{Q LING ADDRESS � n 2 -C (I _ CONTRACTOR'S NAME .J`j- 1 TELEPHONE coF CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER �.) UNKNOWN Total Valuation $ Filing Fee - $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS /�z i C V &NA Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeZ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home Is G W 0.00 ea • TYPE OF WORK New ❑ Addition ❑ Remodel[] Utilities ❑ Instaliation;,?� Other ❑ Describe work' Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 00V DR Oii 10.00 Main service 81100 AMP OR LESS L Main service EA. ADO -L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions -Code and my license is in full force and effect. License No. Classification. ❑ I, as the owner, or my employees with wages as their sole compen- sation,FIXED will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.. yxdsgft OR ADONS. ACC. SLOGS. I NEW CONSTR. MULTI -OUTLET 2,50 ea ESIO BRANCH CIRC ITS `"`- /POWER APPARATUS e (SINGLE OUTLET CIR. z0 0 AL130 Ex. Occup OUTLETS OR FIXTURES ewL030e Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor --- WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. MECHANICAL PERMIT FiIirig Fee 10.00 Heating ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑, I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Cooling Hood Ventilation permit Fee Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County oT Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnity and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which. may in any way accrue against said County in consequence of the granting of this permit. Mobile Home Installation Fee Energy Inspection Fee occ CONST TYPE TOTAL FEE S HAZ. I CUA I PARK I SCHL I FLO coF PAR I PO 11 HD. i ISSUE This permit is hereby issued unser the applicable provi- X Date sions of the Butte County Code and/or resolutions to do Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ I work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct. DIRECTOR OF PUBLIC WORKS ion of structures over 3 stories in height. Receipt No. _70 '0 By WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date_ Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. ,,-1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 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 City 0 Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: �- Property Owner Social Security Number Date - l NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. TO Buildinq Department FROM: Environmental Health SUBJECT: Sanitation Clearance 621 -57'-q L 04 Owner Location} AP# Plan Approved for: Sewaqe Disposal Water Supply Hold final for: Water Supply Final clearance O.K. for: �o Clearance for bedroom mobile home. Other Water Supply San arian a Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGE= FOR RESIDENTIAL'DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. LwO��F� 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 incon- veniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which 451 �1_ 21 "BUTTE COUNTY RECORDER occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property: situate in the County of Butte, State of California, described as follows: Lot 1, as shown on that certain Map entitled, "FEATHER RIDGE ESTATES . SUBDIVISION UNIT NO. 1", which Map was filed in the office of the Recorder of the County of Butte, State of California, January 15, 1970 in Book 35 of Maps, at page 62, 63, and 64. Date: May 31, 1991 PROPERTY OWNERS: LISA MULLIN STEVEN M. MULLIN State of Calif. ) On this the 31� day of May 19__g_L, before me, the ) SS. undersigned Notary.Public, personally appeared County of Butte ) Stpyan M_ Mullin C. T.i'ca Mullin Igo amsammaiiemmmommmmmemmmmIgo Personally known to me. U Proved to me on the basis u BARBARA EDGAR of satisfactory evidence. NOTARY PUBLIC CALIFORNIA Oto be the person(s) whose name(s) are U Butte County :subscribed to the within instrument and acknowledged My Commission Expires March 27,1995':executed the same for the purposes therein contained. MOMMEeeMamommons.0sommanow WHEREOF, I hereunto set my hand and official seal. Present A.P. No. 061-590-001 Notary Oblic that IN WITNESS' COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your,earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) _ 2. I (have/have not) J 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 City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner Social Securit Date NOTE: This Owner -Builder Verification is sent to you,as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. 0 (ft.)(in.) Center support locations* (ft.)(in.) , v (ft.)(in.) (ft.)I (in.) ( in. )�(�n..) Center support footing sizes (in.) qn.) (in.) t (in.) (in.) (in.)I (in.) Single *If center piers are other than drawn above, draw in locations, spacing, and dimensions. l 0 Footings (check one) 1. Wood either ;pressure treated c foundation grade. 2. Other (specify) Supports (check one) ® 1: Concrete block. 2: Other (specify) 4 ----Tagalong or Expando, show support details. -- Typical Support Footing Size -- Max. Pier Spacing (ft.)(in.) ' 31 z',' 1 -- Max. Overhang (ft.)(in.) BUTTE COUNTY 3UILDING DEPARTMW APPROVED MOBILEHOME SUPPORT DATA If.other than Mobilehome Mfr. S 0+) furnish .Setup single wide, Model No. Year Width_(ft.) Box Length U (ft.) Tagalong or Expando Size �— ft. x�- ft. (SHOW 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). All center -.supports measured from front of mobilehome unless otherwise specified. 0 (ft.)(in.) Center support locations* (ft.)(in.) , v (ft.)(in.) (ft.)I (in.) ( in. )�(�n..) Center support footing sizes (in.) qn.) (in.) t (in.) (in.) (in.)I (in.) Single *If center piers are other than drawn above, draw in locations, spacing, and dimensions. l 0 Footings (check one) 1. Wood either ;pressure treated c foundation grade. 2. Other (specify) Supports (check one) ® 1: Concrete block. 2: Other (specify) 4 ----Tagalong or Expando, show support details. -- Typical Support Footing Size -- Max. Pier Spacing (ft.)(in.) ' 31 z',' 1 -- Max. Overhang (ft.)(in.) BUTTE COUNTY 3UILDING DEPARTMW APPROVED BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County_Center Drive, Oroville;, CA�. I PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET ' u 1. Owner's name: 2. Installer's name: (( 3. Is the site currently under permit? Yes / / No (If yes, furnish permit 'number ) OR Is the site an existing.site? Yes / / No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear..of all setbacks and easements? Yes % No (If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- Amps 6. What is the mobilehome site service rating? ------- - �, ps 7. What is the mobilehome site circuit breaker rating. ---;--- -Amps 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- Yes / / No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ----------------- ----- (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG 11. What'is the gas pipe length from meter or tank t the mobilehome..) L� Aq 12. What is the mobilehome gas demand? -- --- --------- - - - 1.- �� (BTU) (This information not required if pipe length less than- ft. off natural gas or less than 50 ft. on LPG.) �!._ � E X11' .' �) �J �;+ K .. , • S � i( $e..in. _. _ ._--_-_ .r:--^. ,irn�r t,„4}�t, __ __ _._ R,.l,s ...&NCYE: �� r^ �c,•«,+.s� .c._l�r;:,Jl. e5 cnd �'�- �• • y. -„pr'. y.�I..n�� lr 1 ie ^P. �' Pct ,l Ilse in the " " Codes Plum'. ; �n & j Machanica, and the National Electrical Code.! ` This set of plans and specifications MUST be cept o -,I the job at all times and it is unljwful tc -nakc any-c'.,.wq„s or alterations on same without wri;r-n ^ !rmisson from tiie Da pariment of Public i Works, Cuuniy of Butt®. / i 9 o 410 The f; . 55-etboc4 shall! bo 3 ft. from the J t ti4e pre�.L; `, .':vc; an;:. 5� f.. froF�� the centerlir;e c:.;.0 :uI” , Nom.+a;.,"n j al;-irxi- .. r MU!". cr a c ►t. e::r a c. c. �, :.,� bui bili eu: srr cill eusern eras. f s Srptic system and location cfif�d- i= ' to be as per s EuttY County Health Dept. Re- quirements. 0.76-#c All utility connections sha!I be located within 4 ft. outs; de srear third sc. i ;n cf, the mobile home on the left (road) side of the mobile :Nl S � , :Nl I 0 a Ll fn 77 _3 RESIDENTIAL I ��- A 61-59-01 1754-91MHI MULLIN, Steve J�iljEnjiyj)Grande Rd, Berry Creek ns a ti OFFICE COPY Address GAS Meter By ELECTRIC Meter By JOB FINALED (Date) Signature Date Date 1.7 V=OK O=Not OKNot = Not Readyable MOBILE HOMES a Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Rgquiremenls-Setbacks-Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / P L" ft. / /"Nat. or/ /"L''ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBIL OME INSTALLATION (Plans) OK except #'s jAellogjAg- Req u ire ments-Setbacks Easements o gs; Size -Spacing -Marriage Line as; MH Test-Demand-Valve—Connector riCR�I HGH f� st-Crossovers-Breakers-Clearances W—Drain; MH Test -Fall -Flex Connector r; MH Test -Regulator -Connector r and Sewer Connected -C/0 to Grade -HD Approval Gas and Electricity Tagged Exits; Insp.-Sketch Cert. of Occupancy Date Card B-1 Date Card B-1 Date f� Card B-1 Date Card B-1 EN MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. _ Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O= Not OJ4011 = Not Applicable ' = Nit Ready RESIDENTIAL (; Date UNDERFLOOR (Plans) OK except it's 1. Zoning -Setbacks -Easements -Flood -Slope ' 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except a's tE. Water Htr.: Vent -Access -Combustion Air -Baffle 17. Water Pipe: Test & Anchor -Nail Protection ------------------ -- 9--------- -------------------- - --- 18. D.W.V.:-Test-Fittin s & Anchor -Nail Protection ----------------- - ------------------- ----19.-Shower Pan: Test. First Floor -Tub Access --- - ----------------- 20. -Test -Tub & Shower. Second Floor -Tub Access -- - - - - ------------------ 21. Gas Pipe: Size & Anchors ----------------------------------------------------------------------------- Date Card B-1 Date Card B-1 ------------------------------------ ------------------------------------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ti's 22. Fixture & Transformer Clearance -Ins. Protection ------------------ ------------------ ------------------------------------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors ----- ----------------------------------------------------------- 24. Size Boxes & No. of Conductors -Stapled ---------------------------------------------------------------------------------- 25. Romex Installed Close to Edge of Studs & C.J. --------------------------------- - ------------------------------------ - 26. Equip Ground made up w!Mech. Fastners-Bond Gas & Water ------------------------------------------------------------------ -------------- ----- 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI ------------------------------------------------- ---------------- 28. Subfeed Wire Sizer ga. Cu or AI-A.C. Wire Size ga. Cu or At ------------------------------------------------------------------------------- -- 29.`Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No ----------------- - ----------------------- - - --- -- - 30. Service -Riser Conductors & Ground -Main Disconnect ---------- - - --------------- - 31. Equip Clearances Panels-Motors-Mech. Equip. --------------- --- - ----- ---------------------------------------- 32. Clothes Closet Light -Shower Light -Spa Light ------------- 33. ------- 33. Smoke Detector -- --------------------------------- --------------- ----------------------------------- Date Card -B-1 Card -------------------------- ---. _ _------ Date ------------------B-1 ---- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) Ok except P's 34. A.C. Ducts Insulation & Support --------------------. ---------------------------------------- 35. Vent Fan: Exhaust above insulation --------------- -------------------------------------------------------- 36. Condensate Drain & Overflow. Size & Grade --------------------------------------------------------- 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet ------------ ------------------------------------------------ 38. Attic Access & Platform if Furnance in Attic ------------------------------------------------------------------------------ - Date Card B-1 Date Card B-1 ------------------------- -- -- ----- - --------- ------------ Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sits. Proper Material & Anchors ----------- -- - - ----------------------------------------------------- 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound ----------------------------------------------------------- -- - - - 41. Bearing Walls over Girders & Floor Nailing - --------------------------------------------- --- 42. Draft Stop in Walls (rat proof) _---- ----------------------------------------------------------------- 43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub ------------- ----------------- --------------------------- ---------------------- 44. Headers & Beam -Size & Bearing 1 llingle & `Duplex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing ------------------------------ 51. Property Line Firewall & Openings 52. Ext. Doors -One 3 -Check Garage -3rd Story, 2 Exits ------------------------ ------------------ 53. Stairs: Width -Headroom -Rise -Run -Landing -Fire Protection 54plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. -Sid i ng- Nailing Veneer 56. Stucco Mesh-DripScreed-Fd. Vents-Underflr. Access ----------------------------- 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls: Nailing -Bolts ---------- - - 59. Insulation -Walls -Ceilings 60. Infiltration-Walls-Windows -------------------- -------------------------------------- - Date Card B-1 Date Card B-1 ---------- Date ---------Date Card B-1 Date Card,B-1 Date FINAL (Plans) OK except ti's 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector--------------------- _ 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection 64. Bedroom Exiting -------- - 65. G F.t & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel: Breaker Sizes & Labels -------- ------------------- 67. Stairs & Rails 68. Fireplace or Stove: Clearances -Hearth 69. Elec. Outlets at Wood Panel: Int. & Ext. -------------------------------- 70. Kit.Fixt & Appliance: Grnd -Air Gap -Cooking Clearance --------------------------- -- 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door: Swing -Landing -Closer ------------ --------------- 73. ----------- 73. A.C. Duct in Garage -Damper ------- ----- - - 74. Wtr. Htr: Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection -------------------------------------------- 75. Plb.. Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection ------------------------------------------------- 7 . Insulation -Foam -Looked in Attic ❑ Yes ------------ - ----------------------------------- 78. Guard Rails & Deck -Const ruct ion -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes ...... -------------------------------- --------- 80. ---------------------------------------80. Following instld.: Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No ---------------------------------- 81. ---------_----- ----81. Stucco. Brown -Finish 82. A.C. Unit Disconnect Electrical, Plumbing --- --------------------------------- ---- -- 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings --------- --------------------- ---- 84. Water Well: Disconnect, Electrical, Plumbing - - -- ---- - - - - -------------------- -- --- 85. Exterior Elec. Trim: G.F.I. Receptacle-Underg round -- -- -- - - - ----------------------------- -- - 86. Ventilation Throughout House .. - - - - - - - - -- - - - -------------------------------- - 87. Glass Protection --------------------------- 88 - - ------------------ ----------------------- 88. Corrections from Previous Inspections ----- ------- -------------------------- ---------------------- 89. Gas Test -Meters Tagged: Gas -Electric - - - - - - - - - - --------------------- 90. ---------- 90. Water & Sewer Connected -C/O to Grade -HD Approval ------ - - - - - - - --- . ----------------- ---------- 91. Energy Compliance Certificate -Other Certificates ------- ---- - ------------------------------------ ------ - -- --- Date Card B-1 Date Card B-1 -------_......- -------------------- ----------------- Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: Date / Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE t OWNER — PERMIT NO. ` A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. a - f �! d!- M) 9 at'.Y If-- jrea" ive�'e A Date / Inspector COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 Cobnty Center Drive - Oroville, Califqrnla 95965 - Telephone: 916/538-7541 / APPLICATION AND PERMIT L ASSESSOR PARCEL NUMBER 61-59-01 ZONING. U BUILDING PERMIT owN R STEVE MULLIN .. is -� TELEPHONE 589-0819 SQ. FT. OCC. BUILDING VALUATION OWNER'SMAILING ADDRESS BERRY CREEK 95916 SBOX712 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONYWTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 9c; nn PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP. Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehomen Other • SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallationU Other ❑ Describe work: MBI 2BR - l=XISi1N6 SITE Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service OOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. -r--� I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.m) OR AODNS. ACC, BLDGS. Yz2sgft NEW CONSTR U TI.OUTLET NO N.RESID BRANCH CIRC ITS .2,50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 20050Q eAL03o FIXED APLNS Ex. Occup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �yirin 9 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. r, I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor ( I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against sai ty in consequence of the gpppting of this permit. _ 2/ _ X Q � �1 �` Date / &' Signature of Applicant — Owner ❑ Contractor ❑ IAgent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ 45.00 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 70.00 rlAz. _ CUA -1 _ PARK _ scHX ✓ FLo _ coF PAR PD I �. Iss; This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated ab ve for which fees have been paid. IR, OR F PUBLIC WORKS BY �^ �D{!/a9,tee PERMIT EXPIRES Date Receipt NO. 93920=70-00 WHITE-O.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR. GOLDENROD -APPLICANT r .-zrq.,.iV',�:,^r�r't+..• �r cti.. -.�- r .'`Ktil. _\.� ., _•t"^"._"'i�r'^`Tcf��• ,.r Rs:'Y'��'�-�"'._'�'� r. T Fsrs�' :>,.'1:�?ir^:'?�rfii'z-�. _r. ., a " BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number 6/"5-7ri—dr Building Department No. School District Q1� `t1�6 f1 City � County Jurisdiction Property Owner Project Location/Address Subdivision /oz l c��Ji9- 62 N . Lot Number Residential Development: m . 2 a l � I Sq. Footage # of Living MHI Addition (Group R) Units Commercial/Industrial: Sq. Footage New Addition (Including Exterior , Roofed Areas) Building D_.partment Representative J Date ¢/ c• (Floor Plans reviewed by School District Personnel) ;District Id No. 910234 . C)A" School District), certifies 'that Mx,;AM (Applicant Name) .(Phone Number) (Street,Address) iQcity) ( State) (Zip -Code) has complied with the requirements of Resolution No. �© J 20 by he payment of $ .�.... representing square feet. 001 District Rep ffen-t ati vtll.._ Date PAID BY CHECK NO. BANK NO l 1 ' PAID BY CASH t -Q1 WaR 6 MA white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) rd fJ ^f+<:f `..yirrr�-�--..-.•�.s.. i. ,.;rar:a zr4 N_,' .� �,�;��ti.��4��,�a,•�+_�+raM,.,,-i.•t.�r�. _..-r... n--rr+i"t�,,,,�XynY"i'a''��r'"1',.}�r''ir,J' b COUNTY OF BUTTE - DEPAR-MMEN;TAF`PUBLIC WORKS - BUILDING DIVISION 4 7 COUNTY CENTER DRIVE - OROV LLE'CAL'i'FORNIA 95965 —TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No.. OWNER A. No. � r Proposed Building Use m/c/ — 7- Building Inspector v Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................... 2. Plot plans in duplicate/triplicate, signed by preparer of .plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans .;. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design n Com liance and supporting Compliance pporting documentation ....:.... `7. Statement of Intent for Non -Heated and AC Buildings ................ 8. Engineered truss details and layout in duplicate (required prior.to plan check) �. Mobilehome installation data including manufacturer's installation S/' tea instructions .......................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fee paid.. . . (— �� ch oI District fees paid .............. 14. Sanitation approval from U6� Health Department , 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20, _Pre=Inspection for,. required ... Pre-Inspec. requ)stto Building Inspecdr (Date) 21. Contractors license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. —i' 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... X24. Recorded copy of Agricultural Acknowledgment Statement .........��—�I� 04D 25. Letter of signature authorization ................................... 26. 27. !2%ephone ssue the permit, process as follows: Mail to owner. Mail to contractor. 561 0&band hold for pickup at office. Deliver w/inspector. Other Applicant Date / Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent _Health Dept. Fire Dept. Other Date By The following data must be submitted pe L 1 ",new item not checked above). 1. Index permit for above items No. 2. Additional items required: -.t.:,. Contractor, designer, owner, was advised of above required data by_phone---nail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —ma il—counter by date Plans checked by Date (Pt Plans approved by ft) Date ,+Cfl Sets of plans on hold in File cabinet AP folder Copy—DPW �r / COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541-76,��.� / APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 61-59-01 ZONING U BUILDING PERMIT OWNER STEVE MULLIN TELEPHONE 589-0819 SQ. FT. OCC, BUILDING VALUATION OWNER'S MAILING ADDRESS PO BOX 712 BERRY CREEK 95916 CONTRACTOR'SNAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1021 ENCINA GRANDE RD BERRY CREEK Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 .Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomen Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New Add ition❑ Remodel❑ Utilities MX Installation❑ Other ❑ Describe work: REPLACE POWER POLE Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification, I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP..� OR ADDNS. `ACC. BLDGS. yz(Csgft NEW CONSTR ULTI.OUTLET NON.RESID BRANCH CIRCUITS .2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. / Ex. Occup( OUTLETS OR FIXTURES 20®a06 eALO 30 FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 MIN 2.50 2.50 Permit Fee $ 25.00 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. • I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. III I also agree to save, indemnify and keep harmless the County of Butte againstHALcuA• alt liabilities, judgments, costs, and expenses which may in any way accrue against said C-otinty in consequencFofgranting of this permit. -%t P��-'-� `f��c� Date 7 ` / �� oma/ Signature of Applicant — OwnertR Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ — 25.00 PARK SCHL FLD CDF PAR PD i HD. ISSU This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work Ind' ated above for which s have been paid. DIR OF P WORKS B Date PEWIT EXPIRES Date 93922 25.OQ Receipt No. — — WHITE-O.P.W., YELLOW-ASSE390R. PINK -INSPECTOR. GOLDENROD -APPLICANT ��._',,��r,,,��,�R+�y�•�,i�s�+,aan-�.,-vw.--r—„�s,�,f+..-;�'r"tiv''�"`. i �' ��'.',�,�""„'.'"W ”""'" ,�' `"'"�r,•l`°gni-.t"�`�.t'iA.:.ilrr?.n3..y.�r:....� ..�Y: / COUNTY OF BUTTE - DEPARTMENI OF'wPUBLIC WORKS - BUILDING DIVISION a. 7 COUNTY CENTER DRIVE -, OROVILLEkCALIFORNIA 95965- TELEPHONE: 916/538-7541 t PERMIT APPLICATION DATA SHEET Permit No. OWNER — �L.�(/ velr� ^� n A. P. No C� Proposed Builcirig Use /Vl �L d Por -wee- 6&t.iil'ding Inspector Date At time of permit application, I was advised the following data must be submitted priorto permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. ......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans . . 5. Hazardous Material Form ......................................... . 6. Energy Design Compliance and supporting documentation .......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 4 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... t 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorizatio ......... 26. FSCrDW �o E VAI +.. . 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at- office. Deliver w/inspector. Other Appl icant Date Copy of Haz-Mat form sent .—Health Dept. Fire Dept. Air Pollution Date Copy of plans sent _Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. s2. Additional items required: i Contractor, designer, owner, was advised of above required data by_phone_—mail counter by ..date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, iCalifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER C) f ZONING r 1 V BUILDING PERMIT OWNER/ � ONEo Sp �()8( SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS IYp�JS) 6V � //2- �� - CONTRACTORo5 NAME `�^ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS `` A.t7 r �� n U rL Permit fee $ ' PLUMBING PERMIT Filing Fee 10.00 r, C n iSe1` Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping • 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehomejzl� Other SPECIFY Gas piping system 1 - 5 outlets. 5.00 Building sewer 5.00 Mobile Home S I G W 10.00 ea TYPE OF WORK New[:] Addition[] Remodel[] Utilitie,�Erinstallation❑ Other ❑ Describe work: 43pel tc—e 22LOet 'Pc>Ie. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 10.00 100 AMP OR LESS Main service EA. ADO'L 100 AMP 2.50 $ 0 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ESID I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions -Code and my license is in full force and effect. License License No. Classification. ❑ I, as the owner, or my employees with wages as their sole compen- sation,XED will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. I DWELLING OCCUP.U) , OR AOONS. ACC. BLOCS. / h¢sgft NEW CONSTR.ULTI.OUTLET 2.SOea BRANCH CIRC ITS (POWER APPARATUS a SINGLE OUTLET CIR. Ex. OCcup(OUTL£TS OR FIXTURES .0 eALO 30t Temporary service 10.00 Mobile Home Facilities 15.00 Misc. 1Yirin 15.00 g S-0 1 1v Permit Fee gig5ie> $ •°J WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor � _.. ___.__ _ .. _ _ __2 S - � J . MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner C1 Contractor ❑ Agent ❑ I An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in h fight. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONSTTYPE TOTAL FEE g HAZ CUA I PARK scrlL I fLD coF PAR PD I Ho. ISSUE This permit is hereby issued unser the applicaole provi- sions or the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. 2 Z_/ 2S6% WHITE-O.P.W.. YELLOW-A—E»OR, PINK-,NePECTOR. GOLD ENROO-APPLICANT ;4 1.. - e ,-\ ,`� y, .. --e' �•�� i.. �p ' �. (L' PERMIT NO, 4385=18�,,E PERMIT EXPIRES— OWNER Alfred Buchanan CONTR. owner 'LOCATION (A.P. 62-41-1— W/S Ponderosa Way, app.700'SE of Buckboard Way Bloomer Mtn; ,--TempjjPowiLr�Pole Called PG&E ,i6i;v,Eleq. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date) (S* nature) COUNTY OF BUTTE _ DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback " F ewall Sit Piping orIFootin Par ets t Floor n Bldg. Rest om Finish 2n Floor s Windo 3rd loor emwall - Sidin To out I Roof ShAdhino Water PAng Pie Roofing Sewer Garage Fdn. Vents Fixtures Footin StemwaI l Garage Vents Insulation Water Htr. Heaters Slab Carport Footin s 'Prov. for physic ly handica ed Conformance of ex. structure Appliances Gas Piping & Tes Temp. as Slab Final A Sanitation PatioIR LACE Final Footin s Footin ELECTR AL Masonry Walls Throat Rou h Reinf. Stee Final Fixtures Bond Bea FIRE SPRINKL RS Motors Framing Test Water H . Stucco Final Sub a Is Mesh MECHANICAL Grd. ault Prot. Scralch Heati Ser ce B n P -11-g femp. Pole en nor Lain V ntilation oor, Closer I Final MOBILEHOMEUTILITIE------------------- Elec. Service Water Piping (�� rig SewerMUMMM/ }� 1 E OME INSTALLATION - - - - - - - - - - - - - Support Water Piping �j. Drainage DATE REMARKS OR CORRECTIONS 'Final Elec. Pedestal Gas Piping _ 2 Elec. Continuity Gas Piping�� (NOTE: An entry must be made on this form each time you visit the job site.) • . � • � 4 w4 . �� • �f � • i �� ♦• '� J 1 A r 1 .. 'A1 � � _ �. i ` � J ' 1 >> - � i • a _ �' J " ' .. ,. � - - f: :.A� �, 5 - . , _ 7+ ' _ � / �,,, • e - ._ _ � f , � � ,. y,., I . + � .I 1 i� � 4 4 � � _ • . � ,� .. i xX'.Q.1 - � y,. � j .. � i i ....Ti. � - � j'. l r . ^�.i 4�� • #- - � . , � �. y }, 1• , � L' � 'Y S •M !�' •� ,• � �- - � � �..g — .'1 •l fes` '' • f A _ �' . •� ... .. _.. i TO Buildinq.,.Desartment FROM: Environmental Health SUBJECT: Sanitation Clearance -'� Owner Location AP# Plan ADDroved for: Sewage Disposal _ Water Supply Hold final for: Water Supply Final clearance O.R. for: Water Supply c earc year s mo .e ome . Other �Ccj(- NOTE' jql. �- Date Sanitarian COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA •95965 Phone: 916-538-7541 '. OWNER -BUILDER VERIFICATION Attention Property Owner: _ An 'owner -builder" building permit has been applied for in your name and bearing your signature. 1 Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit wi[2. issued until this verification is received. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) I (have/have not) zz a 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 City Phone Contractors License No. 4. J plan to provide portions of this work, but I have hired -the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted,(hired) the following persons to provide the work indicated: Name Address Phone. Type of Work Signed: r Property Owner Social Security Number Date / z NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. t:. "�Jh� K ..s. _ ..,.4 .._ 3 r . ,_. �. T� 4 .' .. ... . .. ... .?a .. ,. L 1. .i.- a•` ' a dd • � is . 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NOT SHOW N FOK CLARITY. 3/SI BOLT 1 Ya" TSG PLYW00D C L EXT. � w v� MOBILE HOME'. OR DELh (Y' d \ I - i MAX \ o I � Mn.FRMW — F4F CLIP (EA. DE qL 9'MIN. `� 4'x (o ' .4"x4" POST •1 � , Y.' ,: � � 2"X.12° . x ARPRAIL '# ZDF' 3/a'' oo z 2'x4" PRESSURE' TrRFATCD e"MT IN._ 60LT3 _RFD WOOD PLATE b MAX. DECKIIJ.G GIRDER ... EN I /� •ter .�/. •. `�`4 _ 1 DEPART CAST 4"X4." POST =190 • W PRE .. Qc PIER -ADFOUATE._' DIAD ONA L BRACING. . g°Mhl�".. S AivO/o L' i TYPICAL RSI DANT/ T aD D -- ------ - — --- - --- -- ' I •` �OUN�Y OF BUTTE - DEPARTMENT OF PUBLIC WCJRK. " r in lD n. 7 County Center Drive — Oroville, California 95965 '1�:•'; 14 x 14 MIN. Fool NC Telephone: — +. MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with required separation from lot lines and buildings and generally conform to plot plan? Yes k/ No / 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes LI/No- 3. 1/ No 3. Are footings and supports properly sized, spaced, and braced as p r approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level? (Sec. 5088) YesNo 5.' If more thgnja3ngle unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No B. Test - Does water piping withstand working pressure 6r 50 lbs. air test? Yes L.-No— C. Backflow - If colclnot State of California approved, does station have backflow device and pressure -rel tive? Yes— No 7. Wastes and Drains i A.' Is connection made with Schedule 40 DWV and -have flex connectors at each end? Yes Y"No B. Does it have minimum 4" per foot.slope and is it properly supported? Yes vNo— C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes ',No ' D.r If coach o ate 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 mobilehome gas line inlet without reductions other than,the mobilehome connector. Yes t,"'N"o B. ,Test OK as per following procedure.? Yes_i�No 1. Open.all appliance connector vfLlves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10";14" water column or test with slope gauge (minimum. 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to'mobilehome.with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes—No k` • ,- .� � S.. f ry..+ .. , Yom,; 4 • •,i tom. • �8-C 0 C'�' .: 9. Electrical 4 A. Ise service large enough to provide adequate. amperage to mobilehome (must equal 'rating of mobilehome with a minimum_of 1<0 amp)._and�;o:ther :facilities on lot, i.e., water-pumps," garage, cabana, etc.? Yes I-No t B. Is there proper clearances around panels? Yes C/ No C. Is power supply cord or feeder assembly properly fused? Yes No_ D Is continuity test satisfactory as per,,the following procedure? Yes/N90 - 1. De-energize electrical wiring, system-of the mobilehome at,the pedestal ��. 2. Make sure that the power supply cord or feede.r.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 r` apply the other le`ad.to,.each mobilehome supply conductor,,, including neutral. 5. All non -current,` carrying metal parts of the mobilehome, (aluminum siding,,-.gas line,' water line), includ ng7fixtures,and appliances, shall be tested for. continuity from such equipment and the grounding conductor. , 6. Upon completion of-the above4procedure, the power supply cord or feeder assembly -conductors shall be connected to the site service equipment. A further continuity test shall then be made'between the grounding electrode and the chassis of the - mobilehome. Upon' satisfactory'rcoinpletion.of the electrical tests, the lot or site service equipment may be approved for energizing. s 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 SANb'POIAI 6 X977 { Length Width ? VehicleSerial No. e. �- /A 64&&'701-S 3 State Identification No. eA.e Additional Information or Comments: - F . J F COUNTY � _ . . O, BUTTE — DEPAR,TMENT OF PUBLIC WORKS 7 County Center Drive — ' Orovi Ile, California 95965 r Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspe on purposes. X Date Signature of Permitee orr�Agent Receipt No. / 7V d % 3- 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. 1/ (0kREC/)rQFC OF PUBLIC WORKS B ate Building permit expires Date �'" Z� d46 BUILDING Owner e d 3u C, �p u SQ. FT. OCC. BUILDING VALUATION Mailing Address ?,q� Telepho`e�o;Q Contractor j�./ Mailing Address Fireplace Total Valuation I Telephone No. Permit Fee Building Address K/Plan O �✓��OS.A !.�%A Checking Fee&/or Penalty Permit Fee )f. `700 G%C PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 SeRUaLLon tFire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking I Plans Parcel Declaration I Parcel Map 1 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 Bldg. Pla s Rec'd Parcel royal Pla pproval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ $ �✓S i pi t�� is�T/p Y✓ e�nt► `. ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Sin le Family Duplex Mobil Home Others 9 Y ❑ P ❑ ❑ Main service EA. ADD'L 100 AMP 2.50 • Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST.( OR A.D.S. ACCLBLOGSCCUP. 71) 20 sq ft 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: NEW RES,., MULTI-OUTL T 2.50ea NON -RESIT BRANCH CIRCUITS) NEW CONSTR. IPOWER APPARATUS B NON -R ESID. SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTIIRES 3 L� Ex. QCCU FIXED APLNS. OR P•(OUTLETSP(RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License.No. Classification Misc. Wiring 6.25 Ff am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I 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 W9men's Compensation Insurance. 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 1 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 , 9 $ D • c+c TOTAL PERMIT FEE $ O authorize representatives of the County of Butte to enter upon the above-mentioned property for inspe on purposes. X Date Signature of Permitee orr�Agent Receipt No. / 7V d % 3- 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. 1/ (0kREC/)rQFC OF PUBLIC WORKS B ate Building permit expires Date �'" Z� d46 COUNTY OF BUTTE - DEPARTME-NT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT aurrlor v representatives of ine county or tsutte to enter upon the above-mentioned operty for insp ction purposes. Xr- �` Date % . ignature of Permitee or Agent Receipt No. /IO V46 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 f h'ch fees ha_v been paid. I CT PUBL WORKS i By ate - Building Building permit expires Date BUILDING Owner A I✓tiC, H A Al q N SQ. FT. OCC. BUILDING VALUATION Mailing Address S'� u 1)1 LL A AC.s.r. r Telephone o. 3 —90 Contractor 00 Mailing Address N r Fireplace Total Valuation Telephone No. Permit Fee Building Address �� W �/�eroSA l�.l Plan Checking Fee&/or Penalty Permit Fee r -o X'2410 O F 14C, k- ,fav A rd PLUMBING No.1 @ FEE q� !</� lc7L00 �^ tr �1owvJi-i1i�✓ PERMIT FILING FEE $3.00 b Each TraD 1.50 ;Aft Y@ti$cafi n _O,ly Repair drainage or vent piping 1.50 A. P. No. t �._ Zg Water piping V/,06.d5(? Each gas water heater or vent 1.50 io FireDept. FireZone Use Permit Gas piping system 1 -5 outlets 1� EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvem Each additional outlet .30 Building sewer -0;;w /40 •OU Bldg. P ans Recd P a r c e rovaI Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES EL OTHER ❑ permit Fee $ .3 06 i 73764 ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 '3r00 Main service 6000 OR LESS 100 AMP OR LESS 5•00 Single Family ❑ Duplex ❑ Mobil Home 0 Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADO'L 100 AMP 1.00 NEW CONST OR ADDNS. ( ACCLBLDGSCCUP. S) 2�sgft 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: NEW CONSTR -OUTLET (MULTI NON -REBID BRANCH CIRCUITS 2.50ea NEW CON STP. (POWER APPARATUS 8 NON.RESID. SINGLE OUTLET CIR. EX. OCcuD(OUTLETS OR FIXTIIRES BAL010Q FIXED APPLNS. 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 $ 51 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. 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 $ $ 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 Land Development Fee $ a.S OI TOTAL PERMIT FEE $ -7-7 aurrlor v representatives of ine county or tsutte to enter upon the above-mentioned operty for insp ction purposes. Xr- �` Date % . ignature of Permitee or Agent Receipt No. /IO V46 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 f h'ch fees ha_v been paid. I CT PUBL WORKS i By ate - Building Building permit expires Date MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT NO. ,Z 7SC1, Address or location of mobi lehome / b Z / ,riT c ",-em 6 �P Le'l)3.0 - I� Owner's name `S,l Owner's address S,z /,-I E' r Insignia or hud number a, Manufacturer's name Serial number of V.I.N. `r/ _� °a 2a �1 Year of manufacture, al/Approving Installation IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL" NOT BE USED WHEN THE MOBILEHOME IS INSTALLED bN A FOUNDATION SYSTEM. i _RESIDENTIAL 61-59-01 2832-91B _ .r' MULLIN, Steve 1021 Encina Grande Rd, Berry Creek (deck/mh) 4 V. i+ F f JOB FINALED (Date) Signature V OK O=Not OK =Not Applicable Not Ready RESIDENTIAL (Single & Duplex) = Date UNDERFLOOR (Plans) OK except N's Date r FRAMING (Continued) 1. Zoning -Setbacks -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Fig., Main; Soils -Flet. Grnd:-/ /" Ftg. Depth 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 47. Fireplace Ties or Type A Flue -fireplace Throat clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except a's 16. Water Htr.: Vent -Access -Combustion Air -Baffle ----------- ------- ---------------------- 17. Water Pipe: Test & Anchor -Nail Protection -------- ----------------------------------------- 18. D.W.V.: Test -Fittings & Anchor -Nail Protection ------------ -- - ----------------- 19. Shower Pan: Test. First Floor -Tub Access ---------------- ------------------------- 20. Test Tub & Shower. Second Floor -Tub Access --------------------------- ------------------ 21. Gas Pipe: Size & Anchors Date- - Card B_1 --- Date - Card B-1 ------------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ti's 22. Fixture & Transformer Clearance - Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors --------- -------------------------------------------------------------- 24. Size Boxes & No. of Conductors -Stapled --------------------------------------------------------------- 25. Romex Installed Close to Edge of Studs & C.J. - -------------------------------- --------------- 26. Equip Ground made up wlMech. Fastners-Bond Gas & Water --- ---- ------------------------------------------------------------- 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI -----------------------------------'------------------------- 28. Subfeed Wire Size r r ga. Cu or AI-A.C. Wire Size ! / ga. Cu or AI ----------------------------------------------------- 29. ------------ ----------------29. Range Circ ! ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes 13 No ------------------------------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect -- - - ----- -- - ------------------------------ 31. Equip Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light ---------- - ----------------------------------------- ------ ------------------ 33. Smoke Detector ------------------------------------------------------------------------ -------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 --------------- --------------------------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except ir's 34. A.C. Ducts Insulation & Support ----- ------------------------ -------------------------------- 35. Vent Fan; Exhaust above insulation ----------- ----- - ---------------------------------------------- 36. ------------------------------ 36. Condensate Drain & Overflow: Size & Grade ----------------------------------------- _...-...__. 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet ----------- ----------------------------------------------------------------- 38. Attic -Access-&- Platform if Furnance in Attic ------------------------------------------ ------------------------------------- Date Card B-1 Date Card -B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except n's 39. Sils. Proper Material & Anchors . .------ ----- ------------------------------------------------------------ --------- 40. Walls Studs -Nailing. Spacing -&-Bracing-Plates-Sound ---------------------------------------- --- 41. Bearing Walls ove-r-Girders--& -Floor -Nailing ----------------- ---------------------------- 42. Draft Stop in Walls (rat proof) ---------------------- ---------------- ----------------------- 43. Fire Stops: Furred Ceilings -Stairs -Chases -Tub ------------- ------------ - ---------------------------------------------- 44. Headers & Beam -Size & Bearing 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51 Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs: Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows ---------------------------- ------ Date Card B-1 Date Card B-1 ----------------------------- --- Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except N's 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector --------------- ------------------ 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor-Ducts-Mech. Protection ------------------------------------- 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa ----- ------------------ 66. Elec_ Trim & Subpanel; Breaker Sizes & Labels ---------------- 6T Stairs -&-Rails--- 68. Rails68. Fireplace or Stove: Clearances -Hearth ----------- ---------------------- 69. Elec. Outlets at Wood Panel: Int. & Ext. 70. Kit.Fixt & Appliance; Grnd.-Air Gap -Cooking Clearance ------------- 7l..-Elec.-Outlets & -Receptacles at Kit.- Counter ----------------- ----- 72. Garage Fire Door: Swing -Landing -Closer -------------------------------------- - 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. . In Garage: Above Floor-Mech. Protection ------ --------------------------------- 75. Plb.. Elec. & Mech._Equip. Listed for Location ----------------------------------- 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection --------------- 77. Insulation -Foam -Looked in Attic ❑ Yes ---------------------- --------------- -- 78. Guard Rails & Deck -Construction -Post Caps 79. Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes_ 80. Following instld. Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No --------------------------- - ------------ - - ----- 81. Stucco: Brown -Finish 82. A.C. Unit: Disconnect. Electrical, Plumbing 83. Vents Above Roof: Plbg -Appliance-Fireplace.-Clearance to Openings 84. Water Well: Disconnect, Electrical, Plumbing -------------- .------------------------- - ----- 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House --- - --------------------------------------------- 87. Glass Protection ----------------------------------- 88. Corrections from Previous Inspections - - - ---------------------------- 89. - - ----------------------- 89. Gas Test -Meters Tagged Gas -Electric - - --- ---------------- --------------- 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates ------------------------------- Date ----------------------------- Date Card B-1 -Date -----...-------B-1---- - ---- -- ----------- CardCard------- Date Card B-1 Comments at Final: ------------------- Date Card B-1 Date Card B-1 Date Card B-1 J=OK O = Not OK Not-Applicable Not ReadyMOBILE-HOMES ' Date MOBILE HOME UTILITIES -(Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / P L" ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date _ Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 s MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 COUNTY OF BUTTE 4bE P ATMENT OF PUBLIC WORKS 7 County Center Drive - Orovlllet Calife�-;la 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PE NO. ASSESSOR PARCEL NUMBER 61 -99-ni ZONING I BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC, BUILDING VALUATION 128 0 896 OWNER'S MAILING ADDRESS P.O. BOX 712 BERRY CREEK CONTRACTOR'S NAME MMOR TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS • Permit Fee $ 16 ao ARCHITECT OR ENGINEER QNE LICENSE No. Plan Checking Fee $ 15 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit tee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping, 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other DECK SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 0.00ea TYPE OF WORK New q Addition EJRemodel ❑ Utilities El Installation[ Other E]Permit Describe work: Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification, i', as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ ossa the owner, am exclusively contracting with licensed contract- 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.( OCCUP. OR ADDNS. ( Nyd ACC. BLDGS. , /20sq ft NEW CONST R.MULTI-OUTLET NO N.RESID BRANCH CIRC ITS CIRCUITS) 2.50 ea (POWER APPARATUS &I SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20050t eAL03o FIXED APPLNS. OR \ EX. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed.revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Coolin g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against sa44Sounty in consequence of he granting of this permit. X O , �� Date /Z Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 41.00 HAL CUA- PARK SCHL FLD EDF This permit is hereby issued unser sions of the Butte County. Code and/or work indicated above r which fees IR 1490 FjPtF@LIC By l�// j�J - PE IT EXPIRES ate / PAR PD ) HD Iss the applicable provi- resolutions to do have been paid. WORKS '(r Date Receipt No. 97170 41.00 WHITE-D.P.W.. YELLOW -ASS E330R, PINK -INSPECTOR, GOLDENROD -APPLICANT '.`,`--•v,,=,;i�•'r,,"..-.rF;7+`xr�'%Va��`^'�'�f`�.i�,,�'';W''��ar"`°��,'�� COUNTY OF BUTTE - DEPARTMENT ,Qw P'UBLIC WORKS - BUILDING DIVISION ." .7 7 COUNTY CENTER DRIVE OROVILLE, CAL�FORNIA 95965 _ TELEPHONE: 916/538-7541 `.x PERMIT APPLICATION DATA SHEET ' Permit No. GG OWNER 5fC( A. P. No. 61- S-( - 0/ Proposed Building Use eC_ Building Inspector ai'`- • Date 4�'r12 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ..........:......................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School Dj§trict fees paid .............. 14. Sanitation approval from _ C)r?57V I ( C... Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of q (see City for other requirements) " 17. Planning approval for (A) Use: (B) Parking:: ...... 18. Improvements may be required. Contact Land Development Section DPW �44 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec.request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans CoM.pensation Insurance .......... �.... 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, rocess as follows: Mail to owner. Mail to contractor. _ Telephone ..�8��%c1 and hold for pickup at office. Del.iver w/inspector. Other A p p I i c a n t Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date opy of plans sent Health Dept. Fire Dept. Other Date By ) The following data must be submitted prior to permit issuance: (Circle new item not -checked above1. 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_mail,_couI ter by ..date Contractor, designer, owner, was advised of above required data by -phone -mall -co nter by . dates Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy -DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - OroVille, Crallfornia 95965 - Telephone: 916.538-7541 APPLICATIO&AND PERMIT PERMIT NO. ASSESSOR Pf RCE UMBER / - -07 ZONING BUILDING PERMIT OWNER Sf TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS ESS PCS b Der rr-:�ek_ CONTRACTOR'S NAME CW Ker TELEPHONE CONTRACTOR'S MAILING ADDRESS r Fireplace CONSTRUC�TTIONyLLENDER in, UNKNOWN Total Valuation .� •` Filing Fee 5 10.00 LENDER'S AILING ADDRESS Permit Fee $ ARCHITECT OR E GINEER LICENSE NO. Plan Checking Fee $ IS Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS _ 02 Encina 6min Permit fee $ CIO PLUMBING PERMIT Filing Fee 10.00 C� Eacn Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE,,, �` SFE] Duplex❑ Mobilehome❑ Other Ue-C- SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 61100 00V OR L=ss AMP OR LESS 10.00 Main service EA. ADO -1- 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑NON.RESID I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification, the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.6\ OR ADDNS. ACC. BLDGS. , NEW CONSTRESIC, RANCH TLET BRANCH CIRC ITS CIRCUITS) 12.50eaI POWER APPARATUS .&) SINGLE OUTLET CIR. ) Ex. OCCUV(OUTLETS OR FIXTURES 1209500 eAL_ 30: FIXED APLNS.17as Ex. OCcuo. OUTLETS (RESID )REA.) I 2.00 Temporary service 1 10.00 Mobile Home Facilities 1 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for 5100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g I Hood .•3.00 I Ventilation Permlt Fee $ Contractor r I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct. ion of structures over 3 stores Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE p� L TOTAL FEE S t ~A` I UA i PARK I scr,L I FLo i coF PAR Po tio.: ssu= I ! Th;s permit is hereby issued unaer sions sions or the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date (n�height. Receipt No. % D I -� WNiT[-O.P.W., YELLOW- StIE3]OP, PINK -INSPECTOR. GOLDENROD -APPLICANT