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062-440-002
� � ~ .. . . � GASCo ACTION.TEST RESUPPORT STRUCT,RE9215 Pine Ridcontr:- crestmhi ° - / . m RESIDENTIAL 62-44-02 92-1918 P,e GOMES, Michael & Judy 15 Pine Ridge Ln, Berry Creek contr: M & S Pump & Elec mh utilities OFFICE Copy i Address GAS Meter By i ELECTRIC Oat �. a Meter By --- --- - - Da, JOB FINALED (Date) Signature J=OK O = Not OK Not = Not Ready MOBILE MOBILE HOMES Date MO E HOME UTILITIES Plans OK except #'s . Zoning Requirements -Setbacks -Easements ils; Special MH Support Sketch Sewer; Location -Test -Fall -C/O Concrete 4. ater; Location -Test -Easement Needed (Sketch) Electricity; Location-Clearences-Grn mp-Concrete I 6. Gas; Location-Test-Wra /"L"ft. / /"Nat. orfj,f/"L"iL LPG A-rwell Clearance & Disconnect Utility Clearance Date 1� 2 -Card B-1 ZA Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s t%1.,,Z4ning Requirements -Setbacks Easements i Footings; Size -Spacing -Marriage Line 3. Gas; MH Test-Demand-Valve—Connector Electricity; MH Test -Crossovers -Breakers -Clearances (ice"5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. titer and Sewer Connected -C/O to Grade -HD Approval y s and Electricity Tagged Exits; Insp.-Sketch 10. Cert. of Occupancy Date , r B- � Date Card B-1 Date g Card B-1 Date Card B-1 56 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plan's)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 .. J=OK O = Not OR -aN'otyRESIDENTIAL (;able Ready eadr ' =Not Ready Date UNDERFLOOR (Plans) OK except h'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-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 h'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 h's 22. Fixture & Transformer Clearance -Ins. Protection - ------------- ----------------------- 23. Elec, Recept-acles 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 SizerGFI -------------------- - ----------------------------------------------------- ----- 28. Subfeed Wire Size 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 -------------------------------------------------------------- Equip Clearances Panels-Motors-Mech. Equip. --------- Clea-ra- nces 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 h'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 ------------Date Card -B-1 Date Card -B-1- Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except h's 39. Sils. Proper Material & Anchors - - ----- ------------------------------------- -------------- 40. ------ ----40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound ----------------------------------------------------- ---------- 41. -------- 41. Bearing Walls over Girders & Floor Nailing ---- -- -- -- - - - -- - --- ----------------------------------------- -------------------- 42. Draft Stoi-Wall-s-n (rat p-roo-f) ---- -- p------------------ ------------- ----------------------------- 43. -Fire-Stops: Furred Ceilings -Stairs -Chases -Tub --------------------------------------------------------------- 44. Headers & Beam -Size & Bearing 14 - single & Duplex) Date • FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng -Rfng. 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- Land in 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 h's 61. Ext. Steps -Door & Sidelight Protection -Landings 62 Smoke Detector 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meeh. Protection - --------------- 64. Bedroom Exiting 65.--G.-F.I. & 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 ------------------------------------- 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 Construction -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. 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. Gas Test -Meters Tagged; Gas -Electric -- -- - -- - ..-..------------------------------- 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates ------------------------------------ D ------- -- --ate-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: C A. COUNTY -OF BUTTE A 1 ' DEPARTMENT OF PUBLIC WORKS 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE © 'ff S �( 01V N E R PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. n h ^; 3�TManspect'or Date REV 11/81 MOBILEHOME INSTALLATION ACCEPTANCE.. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: j(916) 5.38-7541 PERMIT NO.I Address or location of mobi lehome ks— Owner's name M 1 G , 14c— /— Owner's Owner's address �7 / Insignia or hud number Manufacturer's name �Al e / / Serial number o� V.I.N. �^ 6 - 0' ? 2/1— —/Year of manufacture ficial Approtiin'g'I�rstollatio IF.THE MO ILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. OWNERS aYl S PERMIT MH UT IL. CLEARANCE DATE INSPECTOR > ELECTRIC GAS Support Struc. Compaction 'zest Req. Service Other Pipe YESI NO -YES1 NO Size Load Type Size Len th ' Li i I W COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS L-- 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT (;PERMIT NO. ASSESSOR PARCEL NUMBER - 062-440-002 ZONING U _ BUILDING PERMIT OWNER So— MICHAL & JUDY GOMES (209) TELEPHONE 772-2636 SQ. FT. OCC. BUILDING VALUATI. OWNER'S MAILING ADDRESS P.O. BOX 268 BURSON 95225 CONTRACTOR'S NAME SKYCREST ENTERPRISES TELEPHONE 42-2694 CONTRACTOR'S MAILING ADDRESS 13468 ffiiY 99 CHICO 95926 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 20.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING AD ss PINE RIDGE RD BERRY CREEK 95916 Permit fee $ 35.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. 2 SUBDIVISION NAME PINE CREST ESTATES PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomeg Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S FGTW @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remode -❑ Utilities ❑ Installation M Other ❑ Describe work: 9 R RM W ktyL:F_ / _ L Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR LESS 200A OR LESS 18.50 Main service 20CATO1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions odoe nd my license is in full force/hand effect. r� i / License No. ` Classification Fl 1, 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) ElI, as the owner, am exclusively contracting with licensed cont ors. ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.&) OR ADDNS. ACC. SLOGS. / 3.64sq.ft. NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 5.00 POWER APPARATUS (SINGLE OUTLET CIR.e ) Ex. Occup( OUTLETS OR FIXTURES 20 AL _ 76 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 9 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. ❑ 1 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 FiIingFee 15.00 Heating Cooling g Hood 6.50 Ventilation penult 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agr o sav , i, emnify and keep harmless the County of Butte against ai 1 I I I eS, Juen , COSt S, and expenses Which may In any way accrue a n aid Count n ns ce of the granting of this permit. X Date si nature of A lice - owner 9 PP ❑ 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 S 70.00 Ener Inspection Fee $ Energy P OCC CONST TYPE TOTAL FEE $ 105.00 HAZ D FEES IMP FLOOD — COF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butte Count ode and/or resolutions to do hich fees have been paid. work indicat ab��o I UBLIC WORKS By Date P M EXPIRES Date 8'- S` -�— Receipt No. 122364 WHITE-O.P.W., YELLOW-A58C940R, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF4P UB LIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE dLIFORNIA 95965- TELEPHONE (916) 538-7541 e PERMIT APPLICATION DATA SHEET OWNER `'(l( I C H �i ELr .� U D� Co ONA F_S A/. P. No. 0 G z - 0/0 - Z Proposed Building Use `� Building Inspector 16/� Date 71c� 3 time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ......................................... 2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... ngineered truss details and layout in duplicate (required prior to plan check). . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 14 -- Fees f$....................................RI&69?� 11. Impacttfees as shown on attached schedule . ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............. 15. City of Chico plumbing permit. ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). ..PGi.. . re-lnspeon requeis 20. Pre -inspection for required. . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner ) ............ 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. py of recorded deed of parcel creation and 60 right of way to a public road. .... . Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ................................. / ..... 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. .... ....... 31. Existing violations/expired permits . ............................./ ....... . 32. Plan check list . ........................................... ......... 33. 34. When you issue thep rmit, proc ss as follows: Mail to ow er. Mail to o tractor. Telephone Z-26 and hold for pickup at G office Deliver with inspector. Other _ Parcel Creation Acreage Applicant Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Copy of plans sent Health Dept. Fire Dept. Other D The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Date �/� 3/�Z By 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 _ mail Counter by _ Date Plans checked by iiw Date 17%f19,Z Plans -approved by IqW Date 8/q/92 Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works 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 66z- b — 062 ZONING - BUILDING PERMIT OWNER f TELEPHONE ZO 1 Z- SO. FT. OCC. BUILDING VALUATION WNER M ILING ADDRESS z A.9sZZS CON ACTOR'S N F_ 'n(j,.�-�L � A, _. �.. rz (w -,o TELEPHONE 342 z6 CONTRA TOR'S MAILING ADORES q ((�� 1-36,6 tk (� 1 �G Gam- / S/� Fireplace CONSTRUCTION L NDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 LEND 'S AILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Q Energy Plan Checking Fee $ ARCH C OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS jtiP_ Permit fee $ 3 ov( PLUMBING PERMIT Filing Fee 15.00 �j e1Z k- a— - ` % Each Trap 5.00 IF Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP C I` Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex[] MobilehomqW Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW I @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstallationA Other ❑ Describe work: 60P2 _ Permit Fee $ Contractor ELECTRICAL PERMITFiling 4 Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200A TO 1000A) 37.50 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. 223 <4 Classification C_+ _ ❑ 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 OCCUPM OR ADD NS. ACC. BLDGS. I 3.64sq.ft. NEW CONSTR ULTI.OUTLET NO N.RE SID BRANCH CIRCUITS @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 EX. Occup. OUTLETS (PRESID )FIXED APLNS.REA.1 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. byirin g -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. NrNr 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 FiIingFee 15.00 Heating Cooling g Hood 6.50 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 abov mentionedpropertyfor inspection purposes. 1 also agree to save, in em If and keepharmless the Count of Butte against all liabilit" udgme s, osts, and expenses which may in any way accrueHAz agai a ounty i c sequ sof the granting of this permit. a X Date —7' Z -J'� / -2, Signature PP ❑ Contractor Agent An OSHA ion of structures toverr39storiesoin height. excavations over 5'0" deep and demolition or construct- Mobile Home Installation Fee S y, (7!-2 Ener Inspection Fee $ 9Y P DCC CONST TYPE TOTAL FEES L I I DFEES IMP I FLDDD CDF PARCEL I PD HD IssuE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. ZZ 3r WHITE•D.P.W.. YELLOW -ASST SSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLt, CALIFORNIA 95965 - TELEPHONE (916)5387541 OWNER 4410-14AE[. -1� jv0'4 60/MES A. P. NO. O6 00 -z- PROPOSED PROPOSED BUILDING USE A DATE % ai 3 %Z REC . - # DATE REC 1 School Distric Fees 01W (paid at District Office) 2. Sheriff Fees (paid at Building Department) Residential .......... _g 36-0 =$ -3 41a unit amt. Commercial(per sq.ft.) X =$ _�,Q�/ 1 3. Urban Area Fees sq.ft. amt. (paid at Building Department Residential (per unit) % _$ # units amt. Commerical(per sq.ft.) X =$ sq.ft. amt. j�i 4. Recreation District Fees (paid at District Office) /1� 5. Drainage District Fees (Contact Land Development) 6. Other 7. Other At time of permit ppli ati n, I was advised the above fees are required to be paid prior to issuance of t�per1m .I APPLICANT DATE 3 7i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 • Telephone: 916.`538.7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 062-440-002 ZONING U BUILDING PERMIT / OWNER MICHAEL & JUDY GOMES 209 TELEPHONE 772-2636 SO. FT. OCC.1 BUILDING VALUATI OWNER'S MAILING ADDRESS 13665 KEYSTONE WAY BURSON 95225 CONTRACTOR'S NAME M & S PUMP & ELECTRIC CO 26480 TELEPHONE 589-1468 CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 15.00 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 ZY PINE RIDGE LAE BERRY CREEK 959 Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20-001 20.00 LOT NO. 2 SUBDIVISION NAME PINE CREST ESTATES PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomel] Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home @ 15.00 TYPE OF WORK New ❑ Addition jJ Remodel ❑ Uti lities M Installation C Other ❑ Describe work: MH U 2 BDRI`1 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200ATO1000A) _ 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 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.8.\ OR ACDNS. ACC. BLDGS. 3.64sq.ft. NEW CONSTFL MULTI -OUTLET NON.RESID, BRANCH CIRC ITS @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES20 6d @ 7— RAL P 4614 FIXED APLNS. Ex. Occup. OUTLETS PIRESID IREAJ I 3.00 Temporary service 1 15.00 Home Facilities Mobileo- 15.00 Misc. H g 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 FiIingFee 15.00 Heating Cooling g Hood 6.50 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 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 Iia 'lilies, judgments, c ts, and expenses which may in any way accrue agai t aid Co my in co uence of the granting of this permit. Date g a re of Appl' ant — Owner Contractor ❑ Agent ❑ An $HA permit i5 required for excavations over 5'0" deep and demolition or construct- ion of structures over ren stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TA TOL FEE $ 128.50 HAz 0FEES IMP FLOOD CDF PAR PD D S This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees T R 9F PUBLIC By XPIRES Date provi- applicable protvi- resolutions to do have been paid. WORKS Receipt No.PERMI WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT TO: Building Department FROM: Encroachment Permit' Sect.ion. RE: 'Diiveway Clearance owner _ location AP # Driveway permit lql Q �2eP��� has been issued for the above property. n b date sign re .V.r.. :..' a' ,. S +"+"i ,. 9 ., �,�.. �'� .t ¢+w '; tti5r _ 1:."•;."y , ''YAP041 COUNTY OF BUTTE' PARTMENT OF PUBLIC WO1�. BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 .TELEPHONE (916) 536.754:1_c� 4. PERMIT APPLjGTON DATA SHEET OWNER rG/t� mud �JoN►>!S A. P. No. 6v2'11L1Q --Oct Z -- Proposed Building Use(% Building Inspector Date C - "- 7 Z At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED . BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ .......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood �b�•California Engineer. . . 14. Sanitation and plot plan approval�i�Y/ff Health Department . ............j�: j!2_-eL SS- 15. City of Chico plumbing permit . .......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 9. Driveway permit (construction approval required prior to occupancy). .. ... ... . 20. Pre -inspection for to Building Inspector ) required. . to Building Inspector (Date 21. Contractor's license information. (No., Name Style, Classification) . ............. . Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _) . .......... f 24. Recorded copy of Agricultural Acknowledgement Statement .................. f? 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... ^� 27. Letter of' intent on building use . ......................................... 28. Mobilehome utility clearance . ........................................: . 29. Documentation of legal access . ....................................:... 4 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33� 34. Whe ou issue the permit, process as fo�foricku _ Mail to contractor. Telephone and!Idt -- e. Deliver with inspector. Other / Parcel Creation �- Z + Acreage-'Applica Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air ollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted pr' r* trmit issuance: (Circle new item not checked above). 1. Index permit for above items No. �- 2. Additional items required: 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 -mail Counter by Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works low'* Imai tow v FROM: SUBJECT: Buildina Department Environmental Health Sanitation Clearance _ MCAIA�Lk-0 Lac/ Owner Location `� AP# Plan Approved for: Sewaqe Disposal. Water Supply Hold final for: Water Supply ^inal clearance O.K. for: Water Supply Clearance for Z bedroom mobile home. Other NOTE *:* ED /- &2 Z - Sanitarian Date 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 OWNER TELEPHONE S0. FT. OCC. BUILDING VALUATION OWN �V MAILINGSS— I • I / / DKS'rOVe G �J VD� C/I gV Gam-- � c 2 % CON R'S DAME LEPHONE o - CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee C $ 15.00 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 Ile Permit fee PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LO�T7 NO. l/ SUBDIVISION NAME ,1' 1lA(e Sfi (i5 rAle5 PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeR Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home 615.0045. - 15.00 .TYPE TYPE OF WORK New _, Addition Remod�elJL Utilities- Installation[ Other ❑ Describe work:/" t/ 2— �� _ Permit Fee $ (� Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600VORLESS 200A OR LESS 18.50 Main service 200ATOI000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): -1 J 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 ;Jo. Classification _j 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) Ej 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 OCCUPM OR ADONS, l ACC. BLDGS. 3.6Qsq.ft. NEW CONSTR. 1ULTI-OUTLET NON-RESIC BR NCH CIRC ITS ^ 5,00 / POWER APPARATUS &) \SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES AO 760 FIXED EX. Occup. OUTLETS PLNS. OR IRESID ) EA. I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring '15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I dec;are under penalty of perjury (check one): F-1 The permit is for $100.00 (valuation) or less. Ej 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 1 15.00 Heating Cooling g LHood 6.50 Ventilation pertnit 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 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 Date Signature of Applicant — OwnerO ContractorEl Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Receipt No. 17V WNITE•D. P. W., TEL LOW•ASSCSSOR, PINk•IN SPECTOR. GOLD ENROO-♦PPLIEANT Mobile Home Installation Fee S Energy Inspection Fee $ OCC l CONST TYPE J" ':TOTAL FEE $ �8J HAz DFEES IMP FLOOD CDF PARCEL PD HD ISSUE I 1 This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. ♦�A DIRECTOR OF PUBLIC WORKS % \� Date PERMIT EXPIRES Date ~ Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section, 26-8.j of the Butte County Code requires this acknowledgement be recorded . prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to 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 occasionally generate dust, smoke, noise, and odor. tural zones which have as a priority use for productive within said zones and on adjacent property should be or discomfort from normal, necessary farm operations. JUN 19 1991 NOT COMPARED WITH ORIGINAL DOCUMENT 92-027285 Butte County has established agricul- agricultural purposes, and residents prepared to accept such inconvenience All that real property. situate in the County of Butte, State of California, described as follows: Date: �, PROPERTY OWNERS: State of SS. County of ) COUNTY OF BUYtl BUILDING DEPT J U N 19 1S�l OFFICP AL NOTARY SEAL LOU ANN ?MARIE RUPP w „ = Notary Public — Ca'itornla e BUTTE COUNTY My Comm. Expires JUL 27,1994 On this the ay of 19 -AL—, before me, the undersigned Notary Public, rsonally appeared Personally known to me. ❑ Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) 12X1 subscribed to the within instrument and acknowledged that executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. /06. 6D ` a l 354ct t / L This set of plans an a.. ) 7" / kept. on Lc`1e job at all t ' /c,_ make anp changes or written permission h? z 6n rks, County of Butt 3. A permit will be required foc installation of ih-s_'rtnobi#eb'omm. q-4 D90n: All Materials & Workmanshtp Shad�1 Be In AaQordauce wiithAeaogni2ed GQod Practices an.d 'Of a QUEWtY Prescribed for the Speoitod une M tie UIWOrtn Bu14ing, PiuY bIng & Reaban1W Qodee =d the Idadonal EieaUlcai Code. wif esMUST be ,sand 01- wRil, to rrations on same without the Depwbumt of POW 0 -Location of itructures. & equipment all tie as shoWA & dear of a easements. J Well DUTTE COU TY ? D� APPROVED-` BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name: rl+'l 14Db V� A 2. Installer's Name: G N-1 3. Is the site currently under permit? Yes No (If yes, furnish permit number ) OR Is the site an existing site? Yes NoLZU (If yes, furnish two 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 F7 (If no, clarify a 5. What is the mobilehome electrical rating? --------------- �I ( Amps 6. What is the mobilehome site service rating? ------------- 0-) Amps 7. What is the mobilehome site circuit breaker rating? ----- ' d� Amps 8. Is there any other electric load to be served by the mobilehome site service? -------------------------------- Yes No a (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? -------------- �� (in.) YP g ? ----- ------ 10. What is the type of as service --- ---- - Natural � LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- � �.2. What is the mobilehome gas demand? ---------------------- (BTU) (This information not required if pipe length le,s,U-It"grariia'6 10on natural gas or less than 50 ft. on LPG.) d��� ty.EpNSTME"' MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. furnish Setup Model No. Year Width2lg (ft. ) Box Length 60 (ft.) Tagalong or Expando Size XT ft, x 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)P�11. Wood -pressure treated or foundation grade.0 2. Other (specify) SUPPORTS (check one)1. Concrete block. 2. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Main Beams Line 2 Line 1 Piers: Size -Mir.. ------------ Spacing -Max. --------- „ From Ends -Max. ---- - Line 2 Piers: Size -Min.------------ I ax 30. Spacing -Max.--------- 4._-3. From Ends -Max .------- Line 3 Roof Loads: Size -Min. ------------ Location (From Front) Main Beams Tag or Triple Line 1 Openings: Size -Min. --------------- Each Side of Openings With Width Over --------- Line 3 Piers: (Under Bearing Wall Only) Size-Min------------------- Spacing-Max - ------------------Spacing-Max.--------------- From Ends -Max .------------- n i Z„x Z q,. t Z"x ZAP D Z'k Z+z4 x z 3 b "x 3d 130"x -3 6„ 1 2-4 N 2-„ N ( -0 Z-'-8 J 1n_111+4' A CL 4"127 -4 -e> - D '_ '- Size -Min ------------- Spacing-Max --------- Size-Min.------------ Spacing-Max.--------- ,- From Ends -Max .----- Line 5 Roof Loads: Size -Min. ------------ Location (From Front) I Line 5 Piers: (Under Bearing Size -Min. ---: --------------- Spacing-Max ------- ---------Spacing-Max.------ ------From Ends -Max.------------- '- " RIVIEVIED BY ENGINEERING DEPT. ISSMD SY FOLLOW UP SERVICES DEPT J U L 10 1992 UME)ERWRITERS LA90RATORIES, INC. CENTERLINE SUPPORT REOUIREMENTS THIS SHEET TO BE INSERTED WITH SUPPLEMENT 70 FIELO INSTALLATION MANUAL FOR Zl�>f ROOF SNOW LOAD FILE IIIII 9021 VOL 1 SEC, 4 ILA.. 61 PO. B-Z"K a_ SI.�NE SERIES DESGRIP710N ZAC>9 ROOF (,t2L ?�►S 15�-p! ?Pym ? o LIVE LOAD D•10.F•qZ CHECKED , SHT OF t .;�:irr' r.��ty�•��u:�.yr)�"�,-)E�;•:�.,.'b�,:.r,�vj:;;,;,��`.Y„'l.�c''.;, :�:qyf:rx'�r'�`tr.:r-y.+�iKi";•Y°'.=x.Y..7�.�ury-!.,. C BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Per Building) ~`-- School District 0PGO Building Department No. A.P. Number 66 Z -W6 D U Z Jurisdiction • I_._.._J City IX County Property Owner rc l+/4 E.L V D-1 (::2, 0 E, � Property Location/Address --_- .... Tl ) Fl 9 -1 C. 11- l� Subdivison — Lot No. Residential Development !/�'/ 0 Sq. Footage 1511 No. of Living MHI Addition (Group R) Units Commercial/Industrial Sq. Footage New Addition (Including Exterior Roofed 4reas) Building Department Represe tative Date (Floor Plans reviewed by School District Personnel) District Identification No. 7 30 54 0AA) "A _ School District certifies that pplic nt) (Street Address) (Phone Number) (City) (State) (Zip Code) G/y has complied with the requirements of Resolution No. _/Q15' -9v by payment of $ representing _�L _ — _ square feet. a School District Representative Date Paid by Check Number _—_ _ _ _ Remarks: Bank Number _ Paid by Cash -^--__ - If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeformmkl (4/92) REVIEYIED BY ENGINEERING DEPT. ISSUED $Y FOLLOW UP SERVICES DEPT. JUL 10 1992 UIVE)ERWRlTJ:.HS LABORATORIES, INC. CENTERLINE SUPPORT REQUIREMENTS THIS SHEET TO BE INSERTED WITH SUPPLEMENT TO FIELD INSTALLATION MANUAL FOR 2n ROOF SNOW LOAD FILE A1N 0021 C7 VOL I SEC. 4 ILL. T c a SMiNE a `Flhryti�A.�IrJicedQ>'c• SERIES DESGRIP71ON Nm %bJk ROOF�L. -r52-Pl! ?13CSr 'J50? o LIVE LOAD ej �- Dql BY � 'j -qZ CHECKED $aiT. OF