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062-700-019
kNDtRSEN, Stanley t n'/s. Bald--Rock•Rd.*-across from Pine Tree Lane, Bald Rock Permit 2782 73P,E (utllit e-for`mobi]e`home TANLEY ANDERSE from . P' ne i Tree Lane Permit 4040-73B dick -fo MH Permit #5214-7„6B(deck/MH-useb°°IN,,� up0 to #4040-73 & add'1 fees) 1"14rF) r Layton Ford - SIS Bald Rock Rd., @ inters.of Pine Tree Lane, Berry Creek Permit#60599/�-8_0�B,E(.ne,�a� pr. d t garage)AlA i -7Oo-o 19 6 _5 LAYTON FORD �n 15 Pinetree Lane, Berry Creek ' a Permit#3633-87MlIII(e• ing site) Issued / //.. &- 7 7-88E(split ele for MH) BLACKWELL, MARY 15 PINE TREE LN, BERRY Cont: GREENE-' ROOFING EX MH PERM FND \.Permit #6133-80P,E(relocate existin ut4lities/MH) W 0(i3-700-019 04-2673 Z�DA 24A BLACK WELL, MARY GAS .1 17/ 4-21 314 15 PINE TREE :.N, BERRY CREEK SUHURT STR` TURE HQ • /jicp "'ON'I : OWNERCOMPACTION TE REQ1-`I'GRADE ELECT �\ Q • � s7 062-700-019 05-1721 LAYTON E. FORD 7` POLMAN, TED S a R.d—t inter of 15 PINETREE, BE Pine Tree L Berry Creek Cont: OWNER Permit##r5 41-80N ( -1-_ - __t_ ) DECK COVERY-d -6 Permit#588-81B(open deck/MH) Per mit#1418-81B (add' 1 area • /garage) Permit #404-84P,E(util, MH)' travel Qtrra. ELEC GAS SUPPORT STRUCTURE REQ COMPACTION TEST REQ 2r 0 k cjol rir NOTES 6( RESIDENTIAL PERMIT NO. 062-700-019 OS -1721 POLMAN, TED ] 5 PINETREE, BERRY CREEK Cont: OWNER DECK COVER SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 6-3 JOB.FINALED (Date)—� `- Signature J=OK 0= Not OK - = Not Applicable MOBILE HOMES . =Not Readyeady 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-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ P' L'ft. / P Nat or/ /" L "ftl P 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. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert of Occupancy Date Cana B-1 Date Cana B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Une 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. Ucense Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 PA Date DECK , COVE CARPORTS, GARAGES (Plans) OK except #'s 1. Zo uirements-Setbacks-Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Dem, Girders and/or Joists -Decking -Bracing -Stairs -Rails ood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Elec rmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Suing; Nailing -Veneer -Stucco -Mesh oof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Dateq -OS 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 Ughting, Distance -GA 5. Elec.; Pool Ughting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries-Terminals-Usted 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 Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Nat OK = Not Applicable = Nat Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth S. 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 -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 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 #'s Date 17. Water Htr.; Vent -Access -Combustion Air Baffle Date 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test 69. Elec. Trim & Subpanel, Breaker Sizes & Labels Date Card B-1 Date Card B-1 Date Card B-1 Date Card -B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral D Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 84. Stucco Brown -Finish Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors Date 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Date 43. Bearing Walls over Girders & Floor Nailing Date 44. Draft Stop in Walls (rat proof) Comments at Final: 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrrm. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 53. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (EEI.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler 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: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:'(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO51721 LICENSED CONTRACTORS DECLARATION. Issued Date: 07/29/2005 APN: 062-700-019-000 1 hereby affirm under penalty of perjury that F am. licensed under provisions of Chapter 9 (commencing with Section 7.000) of Division 3 of the Business and Professions Code, and my license is in full force and Site Address: 15 PINE TREE LN BCK effect. License Class'. License Number: Map Index: Dale: Contractor: Description: deck covers (480) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Owner: POLMAN, TED AND RUTH Business and Professions Code: Any'city or county which requires a 15 PINE TREE LN permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a BERRY CREEK -CA... signed statement that he or she is licensed pursuant to the provisions of 95916 the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the.alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the. applicant to a civil penalty of not more than five hundred dollars ($500).): yy I, as owner of the property, or my employees with wages as their ' \ sole compensation, will do the work, and the structure is not Applicant: POLMAN, TED AND RUTH intended or offered for sale (Sec. 7044, Business and Professions 15 PINE TREE LN Code: The Contractors' State License Law does not apply to an BERRY CREEK CA owner of property who builds or improves thereon, and who does such work himself or herself or through his or her'own employees, 95916 provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business Contractor: and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ' ❑ I am Exempt under Article 3 of the Business and Professions Code Date: `U 5 owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perl'ury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for Architect: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Engineer: is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Total Square Ft: 480 S.F. Carrier Valuation: $7,680.00 Policy #: Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' _ 9- 43 1� compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: L/ ` `il Applicant: yr WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and oneXY ([ l L ? T1 > hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutio s e d work indicat abo forhich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) B y Date y Name: - i a PERMIT EXPIRES ON: Address: Date Q. I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substan e -of any official for or document of Butte County. I hereby authorize representative of/Bnutte County to enter upon the above mentioned property for inspection p po Print Name:: Signature: L� 7— f Date: Owner ❑ Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES ; ,` • _ BUILDING PERMIT 24 HOUR, INSPECTION M"(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 PERMIT NO. BPO51721 LICENSED CONTRACTORS DECLARATION ' Issued Date: 07/29/2005 APN: 062-700-019-000llcensed I hereby affirm under of pery"ury that I4am..,under .penalty provisions of Chapter 9 (commencing with Section 7.000) of Division 3 of the Business and Professions Code, and my license is in full force and Site Address: 15 PINE TREE LN BCK effect. License Class `. License Number: Map Index: Date% Contractor: -;,,,_.•_ ., Description: deck covers (480)" -• OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Owner: POLMAN, TED AND RUTH Business and Professions Code: Anycity or county which requires a 15 PINE TREE LN permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 'BERRY CREEK,,•CA.,,, signed statement that he or she is licensed pursuant to the provisions of 95916 the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the,alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the. to a civil penalty of not more than five hundred dollars ($500).): Sapplicant �I I, as owner of the property, or my employees with wages as their ' \ sole compensation, will do the work, and the structure is not Applicant: POLMAN, TED AND RUTH intended or offered for sale (Sec. 7044, Business and Professions 15 PINE TREE LN Code: The Contractors' State License L•aw.does not apply to an BERRY CREEK, CA owner of property who builds or improves, thereon, and who does such work himself or herself or through his or hey own employees, 95916 provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business Contractor: and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am under Article 3 of the Business and Professions Code _Exempt �/ Date: 7-0 5 Owner.( License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for. Architect: workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Engineer: is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Total Square Ft: 480 S.F. Carrier: Valuation: $7,680.00 Policy M Census Code: AI certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' _ f l /i/ compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. -A? Date: rrrVl///J/ Applicant: WARNING: Failure to secure workers' compensation coverage is p% ?� unlawful, and shall subject an employer to criminal penalties and one l'/`�f(' J hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutio s ftwork indicat abo for hich fees have been paid. o a performance of the work for which this permit is issued (Sec 3097 Civ.) �Cf Name: 3v. D�ate 71 / Address: PERMIT EXPIRES ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge itis unlawful to alter the substan any official form or document of Butte County. I hereby authorize represe/ntttative ofButte County to enter upon the above mentioned property for inspection p o Print Name`: / \� + U l4161 Vk Signature: 6;2/_ Date: / Owner 0 Contractor ❑ Agent for Owner O Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR MSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER Last Name 10 Ql k4o First Name T�rce Address 5 - Pr ti City 6et-P C'r•rK State �� Zip 9- 16 Phone S�� _ °/9 7 Fax E-mail 7Crh!' i ��f�lJ 3d�(1 Cort APPLICQ NT SIGNATURE X For office use only: CONTRACTOR Name Flood Zone Address SRA City I No State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICQ NT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name Flood Zone Address SRA City I No State Zip Phone Map Book Fax 'E-mail Planner State License Number APPLICQ NT SIGNATURE X For office use only: APPLICANT NAME Name Flood Zone Address SRA City I No State Zip Phone Map Book Fax E-mail Planner APPLICQ NT SIGNATURE X For office use only: Zoning Property Address Flood Zone . SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # LOCATION AP# �Gz_7o0 o� Property Address Cit Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footage El Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Receiv byn _ l //J Receipt #: `2r,� Date: C6_ Amount: Bldg Other Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION' 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: C: ASSESSOR PARCEL NUMBER Proposed Building Use: Permit Technician: 6& Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. \TqI f/1 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. N 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential` buildi6gs ❑ 12. Hazardous Material Form 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other ©G? - 700-0/ 9' \ Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) NJ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable . ° ❑ 16. Fire Sprinklers............................................................................................ P 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... Erosion Control Plan Required........................................................................ 0. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 2T. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. \ O 23. California Department of Forestry plan approval ❑ paid. Sent by: f� 24. Planning approval for (A) Use:(B)Parking: (C) Parcel Check: ...J .... ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... / AJ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.......................................................'........... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits.......................................................... ❑ 34. Deed Restriction.............................................................. .............................. ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone d �� 9 9 ;9 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant:Date: G 3y d 5 1. Index permit application for the above items numbered: Plan Check L It 2. conal items r Aked Contractor, design r, own , was advised of the above data by phone, ❑ mail, ❑ counter, by Date: Contractor, designer, er, was advised of the above data by phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER O6 Z— PROPROSED BUILDING USE L�/� eU &;X- S a<l.UILDING PERMIT FEES , Balance Due ..................... $ 232 --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ 3q. r tg. 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per. dwelling) Zoning A.P. # DATE RECEIPT # DATE RIC, 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) C� 8. SMIP rl 9. OTHER 10. OTHER 11. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed dtDtra& the Klan chetg process. APPLICANT DATE 6 `3 c' -o Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) ;,,,¢v ad: �e..,;r .r�?�'C _. •�.. •• ., iw:n.�r}y,, `'ri..`•_� , [ � .: •.—r; p:: `�J " � .'6' o - �r,,K"fj j��,����,s�..ta, l` .�^�.�,.'�j,. • ��..-' 4' aA'.,i `: '.'Ly '17::. •1� !}i" ..t,�; yT1 •�tf7ai. .. IK."5"�:rwo.. :v3v8iiN' c7"i'..=.2•-.�[3... "iiy'��4iC.p1 .C'�". .-. Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: 'YES [ /-J— NO [ ]. 2. I HAVE [ PI -14 -AVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY 0 DATE: ( —30-6 S - NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd ] ] /42004 Butte County Department of Development Services ADMINISTRATION `BUILDING * GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile ME sur •v_M, ZAR19 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, Califomia 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. miclIael C. Vieirl C.B.O. Majager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. Butte County Department of'Developinent SerwCes 0 '1".. a 7 County Center Drive o oroville, CA 95965 o (530) 538-7601 Telephone (530) 538-7785 Facsimile OU14 BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: I need to submit applications for septic and/or well to Butte County Environmental Health immediately. e I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained. I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not .limited to, verification the parcel was legally created, adherence.to.all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). . Please print: I` Da /' `7Z-1--) X62- 701 r V//% Applicant Name: APN: Building site address: Permit No rro5S/72/ I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: _�' SIGNATURE OF APPLICANT 6 -Yo - o ;— DATE Copy to Applicant/EH/File KFonns/BidgPennitMthoutCiearances 020705 E.H. USE ONLY Fiat Plan Attechad Row Plan Attached Sant to 8.0. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposes Water Supply: Public Private Well_ Clearance for dwelling. Other f x A -4- Hold final for: Final clearance O.K. for: NOTE: Environmen 8/96 ealth Specialist Date a#t �. � P � Y. . �}n -F t w ,t� y ,}a} "'}�.'CH i J 5trl i. �,} >• t�t�k t S� p }c'� 4 ^H l {�4'ar �c Y}4` 9i } � rp.:< t�i''svrsyt ':i ,:�bs�,�F y �S 4y .x t.: t w.. r 1 s i�i.h.. Mt �t e �} ,� r,.Pt ..W<tit ,t - � a rG rT✓e ) a Pt p 4�t ,q.:, i x � ytdf+1 c t +y> }�. i f,� t� _ 1 �� �7 1d heir l � 3' t t MiF-;> 11r r .. , t ) C � 5 � t u �•"' r! i �� .e : r. x , �FOUNDATI t {ix t t Jl 1 �, h v rtn { :>+i 'F ry �i t r1 1 ! 1i � Vtt�. a� c><�Yz Sx �!' I �Y ns � ii! •. ! } ° r< +}�, s 1 C i `� �"� CERTtIFtICA�TE LOF ;OCCUPANCY . 3 ' °t i t Ei� IN, BUILDING PERMIT NUMBER: 04-2429 Address or location of unit: 15 PINE TREE LN. BERRY CREEK, CA. d Legal Description of Real Property: AP#: 062-700-019 r SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: MARY E. BLACKWELL Owner's address: 15 PINE TREE LN. BERRY CREEK, CA. INSIGNIA OR HUD NUMBER: CAL187515/6 SERIAL NUMBER OR V.I.N.: S1163A/B MANUFACTURER'S NAME: SILVERCREST YEAR: 1980 OFFICIAL APPROVING INSTALLATION Wjej� V DATE: PHONE: (530) 538-7541 H.C.D. 513C 06/1&'04 09: 34 MID IJP.L.LEY TITLE ORGY I LLE -) 5305340709 —'A. ienm!�A _ BUSINESS. TRANSPORTATION AND HOUSING AGENCY ARNOLD [1C�AR17AENT OF HOUSING AND ComM1JNITY DEVELOPMENT 6tvis-o4 o1 C*= and StAfOw'dS Title Search Date Printed, 08/09/2004 Decal W. LAY9731 Manufacturer: S11.VERC3tEST Tradenune: SILv ERCREST Model: LFT Manufactured Date: 00601]980 Registration Exp: Date MT Fee Paid: First Sold On: 00x00/1981 Serial Number HTJD Label / Insignia S 1163A CAL187515 S1163B CAL187516 Record Conditions: PPF Exempt Use Code: SFD Original Price Code: AF] Rating Year: 1981 Tax Type: LFT Last ILT Amount: Date MT Fee Paid: jLT Exemption: NONE Length Width (p (� 12, Registered Ownelr. MARY E BLACKWELL 15 PINE TREE LN 13ERRY CREEK, CA 95916 Laet Title Date. 01!13!1999 Last Reg Card: 01/13/1999 Sale/Trawder Info: Price $25,051.00 Transferred on 02/20/1998 Situs Address: 15 PIDTE TM LN OROVILLE, CA 95965 Situs County: BUTTE Legal Owner: LAYTONE FORD GEORGIA R FORD (Joint Tenants with Right of Survivorship) 51 HORSESHOE TRAIL BERRY CREEK, CA 95916 Lien Perfected On: 02x25/1998 16:13:57 Inactive Decal/DMV: DM,V 660QYH Open Escrow: MID VALLEY TITLB p0 BX 1068 2295 FEATHER RIVER RL OROVILLE, CA 95965 !Escrow File No: 1555614AM Pending Buyer: POLMA*1 Dealer Name: None Reported Escrow Opened On: 08x09/2004 Expires on: 12/07/2004 *d* END OF TITLE SEARCH *** 140.135 P02 STATE OF CALIFORNIA W'. BUSINESS, BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT a a DIVSION OF CODES AND STANDARDS REGISTRATION AND TTTLING PROGRAM STATEMENT OF FACTS This unit is a: �Mobilehome 0 Commercial Coach 0 Floating.Home 0 Truck Camper Decal (License) No.(s) /,#r 973/ Trade Name I/We, the undersigned, hereby state: 1), e. -a- �4r773 Serial No -(s) S//G36 51(43--'5 I/We further agree to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above-described anit in California, or from issuance of a California certificate of title covering the same. I/We certify under penalty of perjury that the foregoing is true and correct. Executed on--7-(Date) n at C�� (Date) (City) Signature(s) Address Y6 C Printed name(s) c'�o City's a' . , State HCD 476.6 (REV 9/91) C�--- (Statc) 1.0:06 111 D VALLEY T I TLE CPOU I LLE -; 5305340709 . . . . . . . . . . . . . . . . . . . . . . NO. 035 002 n A 11. STATE OF QUAVIV" COLWff CP GUM 2 -LI -98 C. ENCIA"O, Nar F.Muc E. -FWD AND CD4 Iroop to," it, OMW to Im OR WW on*ll . -1-1 VIA jOe&Q"pvwtjj) uteas nvrot4o) WanomAmcrbad tour go - am comm in ftWWvWj coo -Olt- -A-WMI, 0,4 aw as V~.&6 90 PDVWW V ft rr P4068 tv OW paqumA 40 98-0053551 raip 0.00 Wd vauw TV& a caww c&WWr Rea Oidw ft& I ode ;pd. so I ZJVF Lban M& allialiql R&COrda I Ct#&Ck A4, 80 vmew AGOOMM MIL TO: 490VOCY of WAY F- sLczrlwrrLL J1022ab JZ -Feb -90 i PURL MA 2 MNL TAX STATEMaM TCL 00CUMEWARY TFJMFER TAX A XIM O.'PAW 4m OW awamam a too d Poo* laftwIlt M SAME AS ASOVE CM PAW on OW cavagoverm cr '4AM bom ft* W A low of mb6 ads— swoon at cad&" 0, Ae- W-*Av an • Fes. Iftwo GRANT CES Alt WL- 90-00-U64M F Mj% VAU&V L.9 =49 DE PAT M MOW d W". #4 h& M rdwb**& tAYM &qMDuW GEORM P. FWD. NMAMW Od Wft ftWAN,GWWq MAW L W.ACXWEU. AN tMUARMW SX)MM Wimm"Ou"D AMA STB SM ATTACMW L&VAL O=Fd"OV n A 11. STATE OF QUAVIV" COLWff CP GUM 2 -LI -98 C. ENCIA"O, Nar F.Muc E. -FWD AND CD4 Iroop to," it, OMW to Im OR WW on*ll . -1-1 VIA jOe&Q"pvwtjj) uteas nvrot4o) WanomAmcrbad tour go - am comm in ftWWvWj coo -Olt- -A-WMI, 0,4 aw as V~.&6 90 PDVWW V ft 1 ry DE/ 10104 10:16 MID UALLEY TITLE ORGUILLE 5=•05-34a?09 NO. 035 Dai ' 1 98--05355 r4i E i ORAER fes. BU-3i395A-9 - >s�BCSY&�'Oq 1 7HE: tAX0 REPMM0 To Ig 2=9 .REPORT YS SITUATED IN'STATB OF ' =ALIFOF ia, COMM OF II DTft, JWD ZS DBSMUSEB AS FOLLOWS: PARC;9L . 3, AS =OWN ON THAT CUPAIN PARCEL i3AI►, RECO9DE9 IIsi oFPtcB OF TM PECORO i OP'TRE .COMV OF BUTTE, STAin OF CA=VoL ZA, dOd S�PR'E ER 681, X978, XU BOOK 68 OF RAPS, AT P1MSi 33. { i t MXD VALLEY Z'ITLH & ESCROW CoMpA�� 2295 FEATHER RXVLPR BLVD, St' XTEE A OROVILLE, CA 95965 TELEPHONE NUAMER 530-533-6680 September 17, 2004 To Whom It May Concern Re, 1981, Decal LAY9731, Silvercrest, Serial #51163AE Upon successful closing of escrow number 1555614, we will obtain a release from the Ford's on the above described mobile home. Sincerely Angela Mastelotto Manager z0. 6 99t, *ON --imn -411 1 1 1»7Nn rtri.i C( - -OT ATTACHED ARE THE DECALS FOR AP# C)(Z -700 -D PI 'J ' NOTES , I f i' y i RESIDENTIAL -062`-700-019 --_ PERMIT NO. _ .__. 04-2429 BLACKWELL, MARY 15 PINE TREE LN, BERRY CREEK I I Cont: H 75ervli e I 1 EX MH PERM FND I I: THE HCD FORM 433A FOR THIS MH CANNOT BE RECORDED UNTIL ONE OF THE FOLLOWING HAS BEEN TURNED IN TO THE BUILDING DIVISION: (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). ' (2) STATEMENT OF FACTS (ONLY ON NEW MH'S). INSPECTOR TO VERIFY SERIAL & LABEL #'S. SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER s t JOB FINALED (Date) Q/ a Signature t � J=OK 0 = NUOK' . = NotReadyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s MOBILE 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-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ P' L 'ft. / P Nat. or/ P' L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 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. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Blocking as; MH Test -Demand -Valve 5. Electricity; MH Test ater; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged B_ffx_15�_ icqaWDecals . erify #'s with Office Date c, Card B-1 412Date Card B-1 Date Card B-1 Date Card B-1 CAL I d7S76 � S pl..sYsa�__ - 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, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels 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, Distance-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 Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'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 -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) Date Hangers -Post Caps -Anchors -Connectors Card B-1 Date Card B-1 Date Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 50. 17. Water Htr.; Vent -Access -Combustion Air Baffle 51. 18. Water Pipe; Test & Anchor -Nail Protection 52. 19. D.W.V.; Test Fittings & Anchor -Nail Protection 53. 20. Shower Pan; Test, First Floor -Tub Access 54. 21. Test Tub & Shower, Second Floor -Tub Access 55. 22. Gas Pipe; Sixe & Anchors 56. 23. Fire Sprinkler; Test 57. Siding -Nailing Veneer Date Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access Card B-1 Date Card B-1 Date Glazing Area -Glass Protection -Skylights -Plastic Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. Date 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Date 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 64. 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 65. 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No 66. 32. Service -Riser Conductors & Ground Main Disconnect 67. 33. Equip. Clearances Panels-Motors-Mech. Equip. 68. 34. Clothes Closet Light -Shower Light -Spa Light 69. 35. Smoke Detector 70. Stairs & Rails Date Fireplace or Stove, Clearance -Hearth Card B-1 Date Card B-1 Date Elec. Outlets at Wood Panel, Int. & Ext. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date 79. Card B-1 Date Card B-1 Date 80. Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Guard Rails & Deck Construction -Post Caps 41. Sills Proper Materials & Anchors Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Clearance Looked under Floor 0 Yes 43. Bearing Walls over Girders & Floor Nailing Following Instld./Drive 0 Yes 0 No/Walks 0 Yes O No/Planters O Yes O No 44. Draft Stop in Walls (rat proof) Stucco Brown -Finish 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs A.C. Unit Disconnect, Electrical -Plumbing 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes _ 83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes O No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler 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: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042429 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: APN: 062-700-019-000 the Business and Professions Code, and my license is in full force and effect. a s : �� License ClLicense Nu ber: l D Site Address: 15 PINE TREE LN BCK Map Index: Date: Contractor. Description: EX MH PERM FND OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: BLACKWELL MARY E permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 15 PINE TREE LN signed statement that he or she is licensed pursuant to the provisions of BERRY CREEK, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95916 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: SIERRA MOBILE SERVICE Code: The Contractors' State License Law does not apply to an BILL REID owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 466 CIRCLE DRIVE provided that such improvements are not intended or offered for OROVILLE, CA 95966 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-534-0599 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: SIERRA MOBILE SERVICE not apply to an owner of property who builds or improves thereon, REID and who contracts for such projects with a contractor(s) licensed BILL pursuant to the Contractors' State License Law.). 466 CIRCLE DRIVE O 1 am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 530-534-0599 Date: Owner: License #: 470386 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: O 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: 15, Carier: � �" Total Square Ft: 0 S. F. Valuation: $0.00 Z S Policy #: Census Code: ❑ 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the icable provisions of the Butte County COdA anrVor I hereby affirm that there is a construction lending agency for the Resolutions to cj work indicatedtabo a for which fees have been paid. / performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By: Date: .- PERMIT EXPIRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of anyofficialform or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes �E /0 "V Print Name: Signature: Date: 0 Owner ❑ Contractor 0 Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION CONTRACTOR OWNER Name Address466 Circle Dr. AddressL s- � 411-e City Phone 534-0599 Statee Zip 7 Sw'c Phone U Fax E-mail Planner CONTRACTOR Name Sierra Mobile Service Address466 Circle Dr. City O r o v i l l e State C A Zip 95966 Phone 534-0599 Fax 534-0709 E-mail Lic. # 470386 Class B APPLICANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name Flood Zone Address `�� C !R �Z t' D K City olze, 111 14- L State Zip Phone 57 y 0S9 g Fax E-mail Planner State License Number APPLICANT SIGNATURE X For office use only: APPLICANT NAME Name Flood Zone Address `�� C !R �Z t' D K City olze, 111 14- L State CA Zip g6-966 Phone 57 y 0S9 g Fax may_ 7-0 q E-mail Planner APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP o4z4•y7 LOCATION AN m ro Z 76 0 o Property Address Cross Street WORKER'S COMPENSATION Policy Number 4257 Carrier State Comp I n s If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Foundation under existing M/H Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 1 of 2 Received by: lcfi-1 Amount: ` 9 d Bldg SRA Receipt #: 7 3 Sheriff SMIP Date: Other S 17' �� 5 q-9 90 Total REV 4-30-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: � � VV ii ASSESSOR PARCEL NUMBER '� 7eDe:) 1--7 Proposed Building Use: X M N �E? r-- I Ftii Counter Technician: Date: hems required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. AL( 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. . ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. �ry� ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings? 7 ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan,ioJie dow K or fnd plans, II in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers......................................:..................................................... ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit................................................................:....... ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: .......... ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form....................:........................................ ..... ........... ........... ..... 27. Encroachment Permit for driveway from the Public Works Dept ........................... 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization........................................................... .......... ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction ........................................... ........................ ❑ 37.4Gran D d, d1 &I.H. Ti a/Statement of Facts etter from Legal Owner, ❑ Check to H.C.D. $ 38. Other ❑ 39. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: j6,io Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ' phone, ❑ mail, ❑ counter, by Date: Contractor, designer, ownoNva advised of the ov d a by ❑ phone, ❑ mail, 01counteDate: Plans reviewed by: l L Date: �L.�' 04 Plans approved by: r y E; Date : • D Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 -- CORRECTION NOTICE OWNER / ',PERMIT NO A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice 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. Date Inspector -- REV 1042 ,i* PRE -INSPECTION REPORT OWNER: zE� czc.._ DATE: 8• I 04 LOCATION: S �► N E ! 2�ee eQ,e 4feEiee_ A.P. # 700 • a r9 CONTRACTOR: ZONING: REASON FOR PRE -INSPECTION M 84 ,�G M o. DATE TO INSPECTOR: is/1.8 PERMTr HISTORY ( ) NONE (-)-SEE ATTACHED BUILDING INSPECTOR'S REPORT Building Description: Cominercial/Usage: _ Residential # of.Units: Currently Occupied ( ) Yes ( ) No 4 Abandoned/Vacant: Electric: Gas: Electric Currently ( ) On ( ) Off Condition of Electric Currently ( ) On ( ) Off Condition Sanitation: Plumbing Worldng ( ) Yes ( ) No Obvious Sewage Problems ( ) Yes ( ) No Mobile home # of Units: ACTION RECOMMENDED: ISSUE ( ) Yes (•-YNO, Hold for permits or verify:SIC-4, C+�, Inspector• /r�— / g Date: 9//)�? ANDPRSJN, Stanley E n/a.Bdid Rock Rd. across from Pine . Tree Laney. Bald Rock VA -1 N , 0 " I W Permit`-2782-73P,E AN n :ANDERSEN, Tree jR Bald Lanes P r ( Permit` 3 (Utllitl'e" for mobile home 3 - t TANLE ANDERSE N a rom - P Tree re'etRLane Permit 4040-73B cLe ck f 6 Permit #52l4-76B(deck/MH*-used4,,,L update #4040-73 & a7dd'l fees)4-st'L �UV 62 Layton Ford, SIS Bald Rock Rd., @ inters.of Pine Tree Lane, Berry Creek Permit#6b0595-80-B,1E.,(.n det. e garag `Permit #6133-80P,E(relocate existing , U / MH) E LEC. -5-g/ Z�9,0 4 :004 GAS SUHUKT 6TRUCTUE—HQ COMPACTION TNT REQ, LAYTON E. FORD �f �' S - Ta 7 -VT -d V'----fd--R-o-Ck a in of Pine Tree La'e, , Berry Creek Permit, 54'1-80MBI �Lrs�-Arnlg-s-i-te) 7%4 Pe.rmit#588-81B(open deck/MH) P 't*1418-81B(add'l area/garage)_ -6Q-4U& -UAs- Permit #404-84P,E(util, MH) travel tra. 0'o-'700-(DP7 LAYTON FORD 15 Pinetree Lane, BeLLyqreek Permit#3633-87MHI(ep- 11,11111, 111 *ing site) Issued 11 Im J'K )rerl A6LJ 7 mit 7-88E(split ele for MH) Lj Building Permit Number: Owner Name: Residential Construction Requirements IMPORTANT This set of plans and specifications MUST be kept on the job site at all times and it is unlawful to make any changes or alterations on same without written permission from the Building Division, County of Butte. All materials and workmanship shall be in accordance with recognized good practices and of a quality prescribed for the specific use in the 2001 California Building Code (2001 U.B.C), 2000 California Plumbing Code ( 2000 U.P.C.), 2000 California Mechanical Code (2000 U.M.C.) and the 1999 California Electrical Code (1999 N.E.C.) COMPLY WITH ITEMS CHECKED BELOW Your parcel lies within a designated 1.00 -year flood plain. Finish floor, electrical, H.V.A.C. equipment and services shall be a minimum of one foot above the elevation shown on the attached Flood Elevation Certificate. A Post Flood Elevation Certificate will also be required Note: We will normally accept the following as compliance with the flood elevation requirements: 1. Building is anchored to concrete stemwall system with conventional anchor bolts. 2. Building plate on top of stemwall to be one foot or more above the 100 -year flood elevation. (Plate height less than 24" above grade, or engineered design required). 3. Electrical, heating, ventilation, plumbing and air conditioning equipment and facilities located above the plate. 4. At least 2 openings in exterior walls, located on opposite or adjacent walls with a total net area of not less than 1 square inch for every square foot of enclosed area. 5. The bottom of the openings shall be no higher than 1 foot above grade. 6. The openings may be screened or covered with other devices that will permit automatic entry and exit of floodwater. Page 2of 2 Building Permit Number: d) V- Z Z{Z Owner Name: 0 .; Parcel lies within the State Responsibility Area (SRA). Comply with attached requirements. kiiEiM Fire sprinklers are required in this structure. F€ ;; The following parcel map requirements shall be met: All structures �d eq ipment including overhangs shall be clear of all easements. A setback ofW eet from the side andee from the rear property lines and 20 feet (25 feet if Federal Aid Route) from the edge of the right of way shall be clear of structures and equipment except for a 2 foot overhang. r ; Expansive soil may be encountered on this site. This condition may require the. foundation to be designed by a California registered engineer or licensed architect. ` MOBILEHOME SUPPORT DATA R� If other than single wide, Mobilehome Mfr. Me,*ry //-/vNl div c_ furnish Setup Modal No4Iyr60 Year `1F1'G _ T - Width 2_(ft.) Box Length G O (ft.) Tagalong or Expando Size Mb.-?'-e—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. Single (ft.)(in;) (in.) (in.) iter support Center support Locations* footing sizes (in.) 13 y7j . 'Zyx3 o -(ft.)(in.) (in.) (in.) (fit.) (in.) (in.) (in.) E center piers are other than drawn above, Footings (check one) Ek_f�- Wood either pressure treated or foundation grade. El 2. Other; (specify) Su 'ort (check one) 1. Concrete block: .2. Other.. (specify) E—Tagalong or Expando,' show support -details. -- Typical Support (in ./l (in.) Footing Size ' p -- Max. Pier Spacing (ft.)(in.) 9,/ 1 -- Max. Overhang (ft.)(in.) Barre couNrr BUILDING DEPARTMENT APPROVED 2 2 24!X3c� 2 6 ?„ (ft.)(in.) (in.) (in.) (fit.) (in.) (in.) (in.) E center piers are other than drawn above, Footings (check one) Ek_f�- Wood either pressure treated or foundation grade. El 2. Other; (specify) Su 'ort (check one) 1. Concrete block: .2. Other.. (specify) E—Tagalong or Expando,' show support -details. -- Typical Support (in ./l (in.) Footing Size ' p -- Max. Pier Spacing (ft.)(in.) 9,/ 1 -- Max. Overhang (ft.)(in.) Barre couNrr BUILDING DEPARTMENT APPROVED 2 2 36 Xaa (ft.)(in.) (in.) (in.) (fit.) (in.) (in.) (in.) E center piers are other than drawn above, Footings (check one) Ek_f�- Wood either pressure treated or foundation grade. El 2. Other; (specify) Su 'ort (check one) 1. Concrete block: .2. Other.. (specify) E—Tagalong or Expando,' show support -details. -- Typical Support (in ./l (in.) Footing Size ' p -- Max. Pier Spacing (ft.)(in.) 9,/ 1 -- Max. Overhang (ft.)(in.) Barre couNrr BUILDING DEPARTMENT APPROVED 2 2 1. 2. BUTTE COUNTY. DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET Owner's name: Installer's name: C o 0Me 3. Is the site currently under permit? Yes /.L,/i 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? ----------------------- % O C> Amps 6. What is the mobilehome site service rating? --------------------- -�� ZOO Amps 7. What is the mobilehome site circuit breaker rating? ------------- SOU Amps 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- (If yes, identify the load and size: (Load 9. What is the mobilehome site gas pipe size? --------------- -- 10. What is the type of gas service? ------------------ -- -- Na 11. What is the gas pipe length from meter or tank to the mobilehome. 12. What is the mobilehome gas demand? ------------------------------ Yes _Z No TUTU 20 (Amps) 3�31�� tural / / LPG pC�, 00 a (BTU) (This information not required if pipe length less than 6 ft. on natural gas or les's than 50 ft. on LPG.) Vector Dynamics Foundation System INSTALLATION INSTRUCTIONS for the State of California Version 9/212003 INDEX PAGE SECTION NUMBER INTRODUCTION 2 GENERAL INSTALLATION 3 PARTS LIST 4 & 5 LONGITUDINAL DEVICES 6 PIER HEIGHTS- 7- SET-UP INSTRUCTIONS S ET -UP 8 FOOTER SIZES WIND ZONE I WIND ZONE it - SINGLE (_ -..DOUBLE - TRIPLE - HIGH PIER - SINGLE - DOUBLE - TRIPLE V -DRIVE & PIER SYSTEMS SOIL CLASSIFICATION CONCRETE INSTALLATION 9 11 12 13 14 15 16 17- 18 & 19 COMPONENT PARTS AVAILABLE UPON REQUEST RELEASE DATE .9/2/03 9/2/03 9/2/03 9/2/03 9/2/03 9/2/03 9/2/03 9/2/03 9/2/03 . 9/2/03 9/2/03 9/2/03 9/2/03 9/2/03 9/2/03 9/2/03 Approval MANUFACTURED HOME/MOBME HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE,.SECTION 18551 APPROVED SUBJECT TO CORRECTIONS NOTED OVAL DOES NOT AUTHORIZE OR APPROVE ANY MISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS AND REGULATIONS State of California tf'H:ZS d Community DwMopmssd N AND STANDARDS i y/�%.7'D.T-Y? RUILLDINGDEPAFi E"P-- o.� co �i 0 N O O O Tie Down Engineering, Inc. VECTOR DYNAMICS INSTALLATION DESIGN INSTRUCTIONS Introduction These instructions describe the proper use of the lateral and longitudinal foundation system. You may also refer to the home manufacturer's installation manuals that include the Vector Dynamics system as an alternate foun- dation system. General The Vector Dynamics Foundation System provides the support to resist lateral, longitudinal and over -turning movement of the home as required by the Federal Manufactured Home Construction and Safety Standards in a specified wind zone when the system is used as described in these instructions. Please verify state or local wind load requirements prior to installation of the home. The Vector Dynamics Foundation System resists lateral & longitudinal wind & seismc loads by anchoring the two longitudinal main rails. The system is approved to be used on single or multi section homes: Nominally 12 feet to 16' feet wide- (single section) with main rail spacing of 95 inches or greater on center; multi section main rail spacing of 75 inches or greater on center. Nominal 8 foot or less top plate height at sidewalls-with main rail depth of 12" or less. Maximum roof slope of 20 degrees (4.4" in 12" slope). Maximum eave width (roof overhang of sidewal1) of 12" for Zone. I, 8" fo Zone II Maximum pier height under main rails -see page 7. The Vector Dynamics Foundation Systems may be used as a part of the vertical or gravity support system con- sidering that each Vector Dynamics pad has two (2) or (3) square feets bearing area. To inquire about the use of the Vector Dynamics Foundation Systems with homes of four or more sections, other widths, or on homes requiring pier heights which are not included in these instructions, contact Tie Down Engineering, Inc. at 1-800-241-1806. The Vector Dynamics Foundation System has not been designed for use on exposure "D" homes within 1500 feet of the coastline. Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, end frame ties and rim plates. Page 2 California ` 9/24 GENERAL INSTALLATION INSTRUCTIONS SITE PREPARATION It is necessary that the home site be properly graded and sloped to prevent water and moisture from standing or flowing beneath the home. FOOTINGS AND FROST LINES The Vector Dynamics Foundation System was designed to be placed directly on top of the ground (or poured concrete) after clearing all loose vegetation. In areas with frost heave, use Vector for Poured Concrete (see pages 20 & 21) to comply with local requirements for footer depth. FOUNDATION/FOOTING SPECIFICATIONS FOR VECTOR PADS Vector Pads are used in place of conventional foundation pads'. One Vector pad provides two or three square feet of bearing support. Vector Systems should be spaced as symmetrically as possible along the length of the home. For pier locations in between the Vector Systems, use the normal foundation pads. LUMBER/MOISTURE -TERMITE SHIELD To cut PVC or lumber (2 - 2x4's,1 - 4x4 or 1 adjustable steel commpression member per Vector system) for the center compression section,when using concrete blocks for piers, measure center to center frame (I-beam) dis- tance and subtract 16". When using METAL PIER STANDS, measure center to center frame distance and add 16". ALL WOOD MUST BE PRESSURE TREATED, GROUND CONTACT RATED . Tip: Pre-cut your lumber and mark as to brand or model of homes you will be installing. If frame widths are the same, the pre-cut boards will also be the same length in each Vector set-up. STRAP INSTALLATION All frame ties and diagonal straps must go from the anchor. to the top'of the I -Beam. See illustration below. 1. Attach frame hook to top inboard location of "I" beam. (Frame hook must be attached to frame at points closest to floor support.) 2. Keeping in line with the hook, wrap galvanized strap completely around "I" beam. 3. Pull strap past anchor head approximately ten inches before cutting to allow enough strap to give a minimum of five turns around the slotted anchor bolt. 4. Thread loose end through slotted bolt so that the strap is flush with the other side of the bolt. 5. Tighten slotted tensioning bolt a minimum of five full turns. Page 3 California 4�/2/03. Longitudinal Stabilizer Devices -The use of LSD systems on a. single or multi section home replaces longitudinal anchors, stabilizer plates and straps. ' The Longitudinal Stabilization Device (LSD) is vseci with the Vector Dynamics System to resist loads in the longitudinal direction (short dimension) of home. The number of LSD required is. shown on pages 10-13. LSD 1. Longltudlnal Foundation Pad 2. Beam Clamp (2 per system) 3. Longltudlnal Strut (2 Per System) 4. Tie Bracket (2 per system) Combine Vector Dynamics & LSD Note: Two struts = 1 L.S.D. Can be used on one Pad or e opposite ends of the home. Exa m pl e5 of Possible Placement: (Contact TIE DOWN for placment in other Wind Zones) Wind Zone I Single Section I I .I I I I I I I I I I I I I I I I I I I I I I Wind Zone I Double Section 18 Ft. Max. 32 Ft. Max. Forgreater widths use triple Section design. Page 6 Wind Zone I Triple Section I ; I I I Wind Zone I Tag Section 48 Ft. Max. California 9/2/03 50 i6 max. Maximum Pier Height Vector Dynamics Foundation Systems may be used on single section homes in Wind Zone I which require pier heights (from surface of Vector pads to top of concrete or metal pier) not to exceed 50 inches under one or both. main rail(s). Note that a ground anchor must be used at each Vector system location where the pier height exceeds 24 inches for single section homes. On multi -section homes in Wind Zone I, an anchor must be used at each Vector System location with pier heights above 46" with the following exception: double section homes that are 24' wide, in Wind Zoned., have a maximum pier height without anchors of 38", See page 12 for double section home high pier set instructions. 50 it max. Unequal Pier Heights 4aximum Homes with unequal pier heights are limited to 50" maximum pier height. The difference between the taller pier and the shorter pier cannot exceed 26". i, Page 7 California` 9/2/03 Set -Up Instructions for Vector System #59018 Long U -Bolts 1. Set Vector. Pads Clear all vegatation where pads will rest. Place - a long U -bolt in pad as shown. Press. or ham- mer pad into the ground. . 2. Set Block or piers on pads. Center foundation blocks or piers on pads. Place pre-cut center compression member between blocks, resting on pads, centers between U -bolts as shown. 3. Outside Tension Bracket Attach outside tension bracket as shown to out- side of pads. Page 8 YI slfi'-;j: 4. Inside brackets & straps Attach the inside tie brackets to the U -bolts over the compresion member. Attach a strap w/hook or swivel strap w/nut & bolt. Place other end of the strap over opposite I-beam & down to out- side'tension bracket. Cut strap 12 - 15 inches past bracket. Attach strap & slotted bolt in bracket. Tighten strap until tight with 4-5 wraps around bolt. Repeat with opposite strap. < =HIC FY Califor 9/2/03 tea, e y i 1. Set Vector. Pads Clear all vegatation where pads will rest. Place - a long U -bolt in pad as shown. Press. or ham- mer pad into the ground. . 2. Set Block or piers on pads. Center foundation blocks or piers on pads. Place pre-cut center compression member between blocks, resting on pads, centers between U -bolts as shown. 3. Outside Tension Bracket Attach outside tension bracket as shown to out- side of pads. Page 8 YI slfi'-;j: 4. Inside brackets & straps Attach the inside tie brackets to the U -bolts over the compresion member. Attach a strap w/hook or swivel strap w/nut & bolt. Place other end of the strap over opposite I-beam & down to out- side'tension bracket. Cut strap 12 - 15 inches past bracket. Attach strap & slotted bolt in bracket. Tighten strap until tight with 4-5 wraps around bolt. Repeat with opposite strap. < =HIC FY Califor 9/2/03 L W co \, N A WIND ZONE I, SEISMIC ZONE 4 Vector Systems' Required Anchors Required Per Side L.S.D. 0 to 40' Vector Dynamics Systems Required for 0 2 41' to 66' 3 0 Double Section Homes 67' to 84' ♦ _ (Materials Required)- I hOme 1 S _ -, - ♦' \'. Sec�;CP ble --- 2, dou_ ;♦♦♦ _ - 1 \ ♦ 1 L — ' '-,n �L'-�J. ST''`Y 'R ,��' .�:Ya� I — '. — I _ \ _-. zei... `t4i �'� .- a ''�.. ... �rs•:'dil•�".:�A� �. ... N maX - �p�T�•. NOTE: Vector Systems should be spaced as symmetrically as possible along the length of home. Pier spacing must be consistent with manufacturers' instructions and/or state requ No anchors required. For pier heights up to 46" for WIND ZONE I 28'-36' wide, 38" for 24' wide. See Pg 12 for high pier instructions. 2 sq. ft. pad Soil Bearing Capacity Anchors Reauired': 1,000 PSF minimum None ("Marriage wall anchors may be required by home manufacturer) Home Length Vector Systems' Required Anchors Required Per Side L.S.D. 0 to 40' 2 0 2 41' to 66' 3 0 3 67' to 84' 4 0 4 85' to 90' S 0 4 Each Vector System.requires one of the following: 1-4x4 or 2-2x4's pressure treated wood compression member, Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) Note: L.S.D.- Longitudinal Stabilization Device See Page 6. VECTOR DYNAMICS INSTALLATION DESIGN INSTRUCTIONS ' Vector Dynamic Foundation Systems may be used only on homes set on soils classified as Class 2, 3, 4A and 4B as described in the table below: SOIL CLASSIFICATIONS Soil Class Types of Soils Blow Count (ASTM Soil Test Probe (1) D2586) Torque Value (2) 1 Sound hard rock...... NA NA Very dense and/or 40 -up More than 550 lbs - in, cemented sands, coarse 2 gravel and cobbles, preloaded silts, clays, and corals Medium -dense coarse 24-39 350-549 lbs - in. 3 sands, sandy gravels, very stiff silts and clays 4A Loose to medium dense 14-23 275-349 lbs - in. sands, firm to stiff clays 4B and silts., alluvian fill 175-275 lbs - in Peat, organic silts, 0-44 175 lbs - in. 5 inundated silts, loose fine and lower sand, alluvium, loess, varied clays, fill, fly ash. (1) The purpose of the soil test probe is to gauge the strength of the soil below the surface and near the anchor's helical plate. The strength of the soil is estimated in terms of its resistance to penetration (flow) under load by means of the torque probe and is measured in Ib -in. The test probe has a helix on it. The overall length of the helical Section is 10.75 in.; the major diameter is 1.25 in.; the minor diameter is 0.81 in.; the pitch is 1.75 in. The shaft must be of suitable length for anchor depth. (2) A measure synonymous with moment of a force when distributed around the shaft of the test probe. Vector Foundation Pads Equivalent to Footer Pads* Footer Size: Footer Size: 16x16 = 256 sq. in. _ ' Y = 20x20 = 400 sq. in.or 1 6x1 8 = 288 sq. in. or 17x25=425 sq. in. - - - - EQUALS EQUALS 2 -Vector Pads # 59275 1 -Vector Pad # 59271 - - - 288 sq. in. or 432 sq: in. 1 Vector Pad # 59130 Vector Pad(s) exceed the surface area required when used as the equivalent liste bove. 'Foundations in soil.with a bearing capacity of less than 1,000 PSF must be designed by a Registered Professional En in tar with site condilons Page 17 California 9/2/03 MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. Mel ry 11loN)•-,P,_ Zi c_ furnish Setup Modal No,2yr60 Year `1 Fla W.idth�(ft.) Box Length G 0 (ft.) Tagalong or Expando Size MbdV-e—ft. x ft. • (SHOW SUPPORT DETAILS-$ELOW) 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. Footings (check one) Single �� Wood either AA pressure treated or foundation grade. 0 ' (ft.)(in:) (in.) (in.) 2. Other.(specify) iter support Center support Locations* footing sizesSu ort (check one) (in.) 1: Concrete block.' -2. Other. ( specify) .(f t.)(in.) (in.) (in.) 4—Tagalong or Expando,' ZS_X 3c7 show support details. 6, (ft.)(in.) (in.) (in.) Typical Support (in. (in.) Footing Size L/L/ (ft.)(in.) (in.) (in.) O �� -- Max. Pier Spacing (ft.)(in.) Max. Overhang E center piers are other than drawn above, BUTTE COUNTY ` BUILDING DEPARTMENT APPROVE® 2 BUTTE COUNTY. DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: A Y AN 2. Installer's name: (�-" Z AAA bl 3. Is the site currently under permit? Yes /.L.Y No (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No /t�f (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? -------- ------ 6. What is the mobilehome site service rating? --------------------- 7.. What is the mobilehome site circuit breaker rating? ------------- 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- (If yes, identify the load and size: (Load 9. What is the mobilehome site gas pipe size? --------------- .7__ ----------- --------- -- Na 10. What is the type of gas service. -- ------ 11. What is the gas pipe length from meter or tank to the mobilehome. 12. What is the mobilehome gas demand? ------------------------------ / O C6 Amps 0 ® 200 Amps /Oa Amps Yes � No /� 20 (Amps) tural / / LPG (ft.) 4000 (BTU) g .J (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft, on LPG.) DROP BOX COVER SHEET. -.,.,4 t �. All -of the following information must be completed. Writing must be legible. - Date: Assessor's Parcel Number: i Owner and/or Applicant: Permit/Application Number: E -Mail Address: Contact .Phone Number: Directed to (Staff Person): ►►�5/y:��� -leo /0y - 0.0; ��-s 6 6. yo C���f S 32 • (90� �`�``y`` a�� da- :)<, RECORDING REQUESTED BY: 20 04 — 0059 1 8 4 Recorded i REC FEE 10.00 Official yyRecords I CONFORM 1.00 CoBU7 E f I CANDACE J. GRUBBS I AND WHEN RECORDED MAIL TO: Recorder I ROSEMARY DICKSON I Assistant I Lisa 12:30PM 24 -Sep -2004 I Page 1 of 2 BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, "2-(i INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. MARY E. BLACKWELL REAL PROPERTY OWNER/LESSOR 15 PINE TREE LN. MAILING ADDRESS BERRY CREEK BUTTE CA. 95916 CITY COUNTY STATE ZIP SAME INSTALLATION MAILING ADDRESS, IF DIFFERENT SAME CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") _ SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE UNKNOWN MAILING ADDRESS DATE OF MANUFACTURE OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 04-2429 530 538-7541 BUILDIN E IT N0. TELEPHONE NUM ER 0/ S TUM OF LOCA AGENCY DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE N0, SILVERCREST 1980 UNKNOWN MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER S 1163A/B 60'X 24' CAL187515/6 SERIAL NUMBER(S) LENGTH T WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 062-700-019 HCD FORM 433(A) REV. 8/91 WHITE - County Recorder CANARY - HCD PINK - Applicant GOLDENROD - Building Dept. ',3&/10./04 10:06 MID VALLEY TITLE ORGYILLE 5305340?09 NO. 035 Dd3 .98-05355 o�at.�vD. ffi0-36a9so-3 . TItE .Li1di0 BtEMMD IV 3M =8 .REitORT IS SITGATED IN 1'm.91oATg Op CAS.IFOR7tlIA, OODNTY O? , 31P19 ES DESCRIBED AS POLWWs PJIRC Y.. 1, tA9 SROws ON THAT cmer x PARceL �. Reco 1DE9 , IR Tu - i OFTICE OF TM RSL'oRM OF 'J n .c6vxTv OF BUTTS, STATS OP CA=Y RtU, a" Ii:. BOOK 68 OF MAN, AT .pB.GJ3(8j 33. t t • 1 f _ 1 J • t RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE -COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 24 -Sep -2004 2004-0059184 Has not been compared with original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. MARY E. BLACKWELL REAL PROPERTY OWNER/LESSOR 15 PINE TREE LN. MAILING ADDRESS BERRY CREEK BUTTE CA. 95916 CITY COUNTY STATE ZIP SAME INSTALLATION MAILING ADDRESS, IF DIFFERENT SAME CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") ^ SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE UNKNOWN MAILING ADDRESS DATE OF MANUFACTURE t OROVILLE BUTTE CA- 95965 CITY COUNTY STATE ZIP 04-2429 530 538-7541 BUILDIN E IT N0. TELEPHONE NUM ER 6/& -M-4 SW,bMTUK OF LOCAL AGENCY QQ ak( DATE NONE rw DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. SILVERCREST 1980 UNKNOWN MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER S1163A/B 60'X 24' CAL187515/6 SERIAL NUMBERS) LENGTH X WIDTH INSIGNLA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 062-700-019 HCD FORM 433(A) REV. 8/91 WHITE - County Recorder CANARY - HCD PINK - Applicant GOLDENROD - Building Dept. te/1k 10:06 MID VALLEY TITLE ORGUILLE + 5305:W10r•09 1,10.035 Dai 98-05355 ORDER.1Eio. SO-2i�95®'�9 - ' At,SCAYB�$'CJ�i • 'nO: l"C' IV IH WXS .P-EftltT IS SYTUTED IN '1'IStB 91°AT8 OF CAt.YFOR4II&, COUNTY OF 18L12°% p, MM IS SIFSCRISED AS POLLOWS., PAR;9L. 1, A9 GROW as TMT C&RTAXH PARCEL iSAP, REOORlDB67 IN OPPICB OP TRSRgCOPOER Of"M .C6VXTY OF BUTTE, STATE OP CAtYp*RxIa SEBTS . eg, 1978, i>sl SOOH 68 OF !PAPS, AT .Pi"(Sjj 23. i i a � STATE OF CALIFORNIA - BUSINESS, TRANSPORTATION AND HOUSING AGENCY ARNOLD SCHWARZENEGGER, Governor DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT OVStNGgL ,,,Division of Codes and Standards Registration and Titling Program 3 0 EllII w 2986 Bechelli lane, Suite 201 Redding, CA 96002 RECEIVED 3Gy£ ''630) 224-4815 MID VALLEY TITLE DeJ° November 4, 2004 NOV 5 2004 MID VALLEY TITLE AND ESCROW CO PO BOX 1068 OROVILLE, CA 95965 ATTN: ANGELA MASTELOTTO Decal or ID Number: LAY9731 DTN Number: 370000 Amount Paid: $0.00 Escrow Number: 1555614A IMMEDIATE REPLY REQUESTED If the Building Department still has the original Title and Registration Card, they also need to be surrendered to this department. What we still require is a copy of the recorded HCD 433A. 11 Registration and Titling Program Initials: DS w (Rev.iiio 0 .- e '.- � r t � + ; � 3 T �� 4'✓yy "! t�H': 1r; k � �� '� �z t' IS s. r o� *' :;, _ � y, �' n t� °s 7 .w .r. � � rid � C r�;dt1 # r'•� rA '.r K r'r j s FOUNDATIONl SYSTElVi:' 1 rF' J a t rr CERTIFICA;T`E'OF OCCUPANCY F.. �'AT.-.. n .� _ i• -r 1't Y BUILDING PERMIT NUMBER: 04-2429 Address or location of unit: 15 PINE TREE LN. BERRY CREEK, CA. Legal Description of Real Property: AP#: 062-700-019 SEE ATTACHED OCT s 5 2004 (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: MARY E. BLACKWELL Owner's address: 15 PINE TREE LN. BERRY CREEK, CA. INSIGNIA OR HUD NUMBER: CAL187515/6 SERIAL NUMBER OR V.I.N.: S1163A/B MANUFACTURER'S NAME: SILVERCREST YEAR: 1980 OFFICIAL APPROVING INSTALLATION DATE: qp3 llo /Y PHONE: (530) 538-7541 H.C.D. 513C Angela Mastelotto Manager n M ST cn�� NQ 1F9N. 2295 Feather River Blvd., Suite A Oroville, CA 95965 Direct: (530)'532-6080 0 'rel: (530) 533-6680 Mid ValleyTitle and Fax: (530) 533-3018 — Email: amastelotto@firstam.com Escrow Company Web Site: http//www.firstam.com 2004 D ESCRIPTION All that certain real property situate in the County of Butte, State of California, described as follows: Lots 532 and 548, as shown on that certain map entitled, "FIR HAVEN SUBDIVISION", which map was filed in the office of the Recorder of the County of Butte, State of California, May 10, 1955 .in Book 21 of Maps, at pages 31, 32, 33, 34 and 35. EXCEPTING and RESERVING. THEREFROM all of the valuable minerals beneath the surface of said land with the right to mine and extract said minerals, it being agreed and understood that in all mining operations the surface of said land will be protected against damage and that. all mining shall be carried on from tunnels, shafts or drifts having their orifices outside of the surface area of the above described realty, all as excepted and reserved in that cer- tain Deed.from the Magalia Mining Company, a corporation, to E.D. Storts, et ux, recorded September 4, 1947 in Book 423 of Butte County Official Records, at page 385. lb 5 - 2004 D ESCRIPTION All that certain real property situate in the County of Butte, State of California, described as follows: Lots 532 and 548, as shown on that certain map entitled, "FIR HAVEN SUBDIVISION", which map was filed in the office of the Recorder of the County of Butte, State of California, May 10, 1955 .in Book 21 of Maps, at pages 31, 32, 33, 34 and 35. EXCEPTING and RESERVING. THEREFROM all of the valuable minerals beneath the surface of said land with the right to mine and extract said minerals, it being agreed and understood that in all mining operations the surface of said land will be protected against damage and that. all mining shall be carried on from tunnels, shafts or drifts having their orifices outside of the surface area of the above described realty, all as excepted and reserved in that cer- tain Deed.from the Magalia Mining Company, a corporation, to E.D. Storts, et ux, recorded September 4, 1947 in Book 423 of Butte County Official Records, at page 385. lb OCT - 5 2004 ATTACHED ARE THE DECALS FOR AN 6)MZ-7aO-011 STATE OF CALIFORNIA BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT a a 5 -* i Z DIVISION OF CODES AND STANDARDS �y��.;s • cxn D:�' REGISTRATION AND TITLING PROGRAM STATEMENT OF FACTS OCT s 5 2004 This unit is a: E�Mobilehome . ❑ Commercial Coach ❑ Floating.Home ❑ Truck Camper Decal (License) No.(s) Trade Name Serial No.(s) 73 I/We, the undersigned, hereby state: 1),� *-- j4r7�3� I/We further agree to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit, for any loss they may suffer resulting from registration of the above-described anit in California, or from issuance of a California certificate of title covering the same. I/We certify under penalty of perjury'that the foregoing is true and correct. G Executed on � /7 e at dill``- 1 (Date) (City). (Statc) . Signature(s) Printed name(s) Ego Address Y6 City State HCD 476.6 (REV 9/91) MID VALLEY TITLE & ZSCRow CoNpANy 2295 FEATHER RIVER BLVD, SUXTE A OROVILLEo CA 95965 TELEPHONE NUAWER 530-533-6680 September 17, 2044 OCT s 5 2004 To Whom It May Concern Re: 1981, Decal LAY9731, Silvercrest,, Serial #S1163AB Upon successful closing of escrow number 1555614, we will obtain a release from the Ford's on the above described mobile home. Sincerely Angela Hastelotto Manager Z06 99r•0N VALLEVFo T/TCE 5 2004 b 14 604OVESO29 E 311100,140 31111 A31- UO Q I W S2 :9L t70/8T/60 w 06110.104 10:06 MID VALLEY TITLE ORGVILLE j 5305340?09 N0.035 D03 r 98-05355 OCT s 5 2004 ORDER.YJD. Td0-363950-� DLDCSY1?SII"®11 TM: t"o RLFEM*D To X1 ZUS .JMMRT YS SITGATE® =N. M STATS Op CAUrOMIA, CWM OP Wl'ft, Wig %S VESCRIBSD f►S P�DLBAVTs: PA Y.. 1, AS '=OWN ON IMT STAIN -PARCEL. Ko, MCO .jWrV It7 Tn ONM ''� FYCS OF * �D� TRS OP .edunif Of ]auTTE, STATE OF CdlIt.YFORN=A, ��, 1978, XX BOOR 68 OF Xk", AT.PAG$`8i 32. 0 i 08/10"04 MID VALLEY TITLE OPOVILLE 5305340709 1-40.035 002 .......... wo vau4v Tme & amw cm"r 09w m EMMW M& la385*M-3 UaD 006 vmeN A90UPDO ML T* KAAY F- MACKWaL Ls YOM UM LRM OCT - 5 2004 98-0053551I ir,.. r.,p I o6c fi"orded I Z.VF OfIlcieJ Records I Check CGVA*y at I Butte 0 Con(face, J. Grubbip Secorder JJ*21&b 12 -Feb -90 A PURL RX 2 MAL TAX MATMOCS TO, DDOA*NYARY TRANSFER TAX IX41A OwoAsd m to MMMLIM 0 tMA J PW*Pf awAV04 On smse AS ABOVE *"PAW an to WMWAMM 4w A0 am fto v anowww" swiman of Dadbvvt of Awe smaw4v am Fd* wkw GRANT REED AP WW M400 -US -M FM tAYM F- OWD wW GE(WJA K FORD. husbMW 074 WW ftwdw Gwffgo 10 MARY L SUCKWUL. AN UNUMRMU 9OMM- uNW=P0MTW AMEA sumd Chi SU ATTACHED kZMAL UMPIPTION STATE OF QqA*R" coum" OF SUM C'_ 2-11-98 bakwo R% -pain C. -tvma FAUC pow" 4"ned J&r" E. !M _AND CMRGEA ft. FM pmwttk owmi w f" (,w vzww to ON oft,ft baft do 19%faivy wAo~ b em wa pww,(vj w4am mmsts) Was PA%Obmd to 0* *Mia L,04w,,Wt Ard "*rff..Qdpw to fm aw wwovor gle"W ft eft"a in hwh~ VAW*w upsc"w, 4"d to by GA 0* vowwr.ws Um wbova a- ft Mat 0 06/ 18/"04 05:34 M I D UP,I_LEY TITLE OROI.' I LLE 4 5305340709 • $TATE 4f t;Al IFORNIA- BUSINESS. TRANSPORTATION AND HOUSING AGENCY ARNOLD • � ARTMEfd7 OF 110USINO AND COMMUNITY DEVELOPMENT GlvisioA 0� Cotloa and Sgndards Decal ##: LAY9731 Manufacturer: SILVERCREST Tradenarne: S1LVIERCREST Model: LFT Manufactured Date: OO/GO/1980 Registration Exp: Date MT Fee Paid: First Sold On: 00/00/1981 Serial Number S 1163A S1163B Record Conditions: Registered OwtteT: 140.135 D02 o SNCy O� Title Search/ Date Printed, 08/09/2004 Use Code: SFD Original Price Code: AF) Rating Year: 1981 Tax Type: LFT Last ILT Amount: Date MT Fee Paid: ILT Exemption: NOf E HUD Label / Insignia CAL187515 CAL187516 PPF Exempt Length Width (p d 12' MARY E BLACKWELL OCT m 5' 2004 15 PINE TRFE LN BERRY CREEK, CA 95916 bast Title Datc: 01/1.3/1999 Last Reg Card: " . 01/13/1999. Sale/Transfer Info: Price $25,051.00 Transferred on 02/20/1998 Situs Address:. 15 PINE TREE LN OROVILLE, CA 95965 Situs County: BLrrM T.egal Owner: LAY TONE FORD GEORGIA R FORD (Joint Tenants with Right of Survivorship) 51 HORSESHOE T1LAIL BERRY CREEK, CA 95916 Lien Perfected On: 02/25/1998 16:13:57 Inactive Decal/DNIV: D'MV 660QYH Open Escrow: MID VALLEY TITLB PO BX 1068 2295 FEATHER RIW:R BL OROVILLE, CA 95965 Fscrow File No: 1555k14AM Pending Buyer: POLMI_AN Dealer Name: None Reported Escrow Opened On: 08/09/2004 Expires on: 12107/2004 ** END OF TITLE SEARCH *** COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET www.buffecount-y.net/dds OWNER: ASSESSOR PARCEL NUMBER Proposed Building Use: Permit Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ` 1. Site planr 4 sets, signed by the preparer of the plans. �j 2. Complete pans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. must be stamoed and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings. ❑ 12. Hazardous Material Form. ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable O 16. Fire Sprinklers ❑ 17. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office ❑ 18. Soils Report and/or Engineered Foundation required. ❑ 19. Erosion Control Plan Required. ❑ 20. Fees as shown on the attached Schedule of Fees Due Sheet. ❑ .. 21. City of Chico Plumbing permit. ❑ 22. Site plan and business license approval from the City of Biggs. ❑ 23. California Department of Forestry plan approval ❑ paid. ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _Drainage. ❑ 26. NPDES Form ❑ 27. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 28. Contractor's license information. (Number, Name Style, Classification). ❑ 29. Worker's Compensation Carrier and Policy Number. ❑ 30. Owner -Builder Verification ( _ Given to owner, _ Mailed to owner). ❑ 31. Letter of Signature authorization. ❑ 32. Recorded copy of Agricultural Acknowledgment Statement. ❑ 33. Existing violations and/or expired permits. ❑ 34. Deed Restriction. ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ❑ 36. Other: ❑ 37. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. All of these Applicant: Date: EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees, and other department costs are not refundable. Original -Applicant a i COUNTY OF BUTTE -DEPARTMENT -OF DEVELOPMENT SERVICES -BUILDING DIVISIOAt' 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET ,1 OWNER: ASSESSOR PARCEL NUMBER Proposed Building Use: Permit Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plan 3 0 4 sets, signed by the preparer of the plans. 2. Complete -plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential` buildirigs. ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 15. Sahitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ 19. Erosion Control Plan Required........................................................................ ❑ 20. Fees as shown on the attached Schedule of Fees Due Sheet .................... ❑ .. 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 26. NPDES Form.....................................................................:....................... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits....................:.................................... ❑ 34. Deed Restriction..........................................................::..........................1111 ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... C 36. Other: ❑ 37. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division j )PEMIT NO. 404-84P,E(NH) PER IT EXPIRES IT OWNE LAYTON FORD CON R. owner ASSESSOR PARCEL 62-50-145 LOCATION S/S Bald Rock Rd @ Pine Tree, BC Temp. Power Pole_ Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Servici Called PG&E JOB FINALED (Date) Signature = OK = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except H's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size-Depth-Spacing-Conneclors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4, Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing_ 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete _ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance _ 7. Elec. e Card -BI Date . Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except k's 1. Zoning Requirements -Setbacks -Easements Card -BI Date _ Date Card -BI Date _ POOLS (Plans) OK except #'s 1, Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure: Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding: Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date V = OK 0 = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK except#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic _ 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples . Card -BI Date Card -BI Date Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except #'s 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Card -BI Date Card -BI Date _ Date Card -BI Date PLUMBING (Permit) OK except #'s 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 16. D.W.V.: Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting _ 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19._ Gas Pipe; Size & Anchors 62. 63. Stairs & Rails Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except #'s 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper --- 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. r tet. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. Installed 23. Romex Close to Edge of Studs & C.J. -_ - 24. 25. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen & Conductor Size 72. Insulation -Foam -Looked in Attic ❑Yes 73. Guard Rails & Deck Construction -Post Caps _26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes __ 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ]Yes ❑No 75. Following instld.: Drive EJYes ❑ No; Walks [IYes ElNo; Planters El Yes 0 N - 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish -_ 29. Equip. Clearances; Panels-Motors-Mech. Equip_ 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _- 30. Clothes Closet Light -Shower Light - 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. ---------------------- Card B -I ------ -----.- Date Card -BI Date 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Perrr,it) OK except #'s 83. 84. 85. _ Corrections from Previous Inspections Gas Test -Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval - -__31._ 32.Vent A.C_.-Ducts: Insulation & Support _ Fan_Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates _ 33. Condensate Drain _& Overilow; Size & Grade 34.--F urnace-Vent; -Access-Comb.-A i r -Ret urn Air Vent -115V outlet Card -BI- Card -BI 35. -- -- Attic Access & Platform if Furnace in Attic --- ------ -- --- -----------.---- Date Card -BI Date_- Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except #'s Comments at Final: _ 36. 37. 38. 39. 40. Sills; Proper Material & Anchors Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailin_g__ _ Draft Stop in Walls (rat proof) _Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties -Purl in -Roof Brac.-Truss-Shthnp.-Rif ng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Slop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hg_t. & Dimensions Garage Fire Protection Framing (NOTE: An entry must be made each time you visit job site) .'LAND OF NATU.R.AL WEALTH AND BEAUTY DEPAFiTMEN'r OF PUBLIC WORKS 7 COUNTY CENTER DRIVE, OROVILLE, CALIFORNIA 95965 Telephone:(916) 534-4541 WiLLIAM.(B li) CHEFF Director February 7, 1985 W'allaston & Bullington RE: Building Permit P;o.. 3037-83, Star Rt,, Box 37A, Expired 9/14/84 Berry Creek, CA 95916. (A...P: No.. Dear Mr. Wallaston & Ms. Bullington: With reference to the above subject, our records indicate that your Building Permit expired on the above date. Building permits are valid' -for one year and should construction be.started but not completed by_the expiration date of the permit, the permit shall be renewed for 1/2the original Building' Permit Fee (plus a $10.00." * Filing. Fee").. The renewal permit will. extend the Building Permit for an additinal year from the.original.expiration date. Should you not rcnew your permit in a timely manner, it cannot be renewed and all work must cease untila new building permit is issued. If your construction is completed or should you have any question concerning this matter,.please contact the Oroy.ille office. For your convenience, we are enclosing a renewal application form and an owner - builder form to be completed and signed by you where indicated and returned to this office together with the fee shown. Pleasereturn all copies of the application form. Thank you .for your prompt attention concerning this matter. Yours very truly, William Cheff Director of Public Works I F G1' �ander JFC:ajChief Building Inspector Attachments : Permit Application . Owner -Builder Information Owner -Builder Veriii.c'ati_on cc: Building inspector - Orovil-le Chico - 196 Memor.i.a1 Way/899.-2751 Paradise 747 Elliott Rd/872.-2951., Ext. 57 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. w if ASSES OR PARCEL NUMBER ZON NG- ..�r BUILDING PERMIT OW TELEPHONE SQ. FT. OCC, BUILDING VALUATIO OWN R'S NrItN ADD SS A (`/TELEPHONE CONTRACTOR'S NAME CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDR SS Permit fee $ �. BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome Other SPECIFY -1 Building sewer 5.00 Mobile Home Jel G 10.00 e .PLO.OQ TYPE OF WORK New Addition Remodel Utilities Installation❑ Other Describe work: Tt`�✓°� �11�'r Permit Fee $ 110 00 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 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. t 2/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the BusinessX and Professions Code and m license is in full force and effect. y License No. 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) ❑ 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 CONSTR. U TC1 OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea NEW CONSTR POWER APPARATUS &) NON-RESID, (SINGLE OUTLET CIR, / 20@50C Ex. Occup(o OR FIXTURES oALeao IED A Ex. Occup. OUTLETS PLNS (RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 �� Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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. ISI 1 shall not employ any person in any manner so as to become subject J� 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. 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 aid ty in c ns e ce of the g Ing of this permit. X Date ` Signature Applicant — Owner, Contractor ❑ Agent An OSHA permit is required for exc.Rtions over 5'0" deep and demolition or construct- ion of structures over ren stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ , d OCCUP, GROUP I TYPE OF CONST. I PARCE PD HD Issu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PE #T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 0?—/ 24/ r ?v_ Receipt No. _ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT LAND > U � lAywo Ford Stu Rts Box U"? DOTTY 0160 6 QA 9$016 Deal Mr. ftr4t �iufie Count, OF NATURAL WEALTH AND BEAUTY DEPARTMENT OF PUBLIC WORKS. CLAY CASTLEBERRY, Director 7 COUNTY CENTER DRIVE, OROVILLE, CALIFORNIA 95965 Telephone: (916) 534-4541 WILLIAM (Bill) CHEFF Deputy Director Jouetrr ry 91; 1984 RE Building Permit A. P. # 62-$001,45 With reference to the above subject, we have been advised by one of our building .inspectors that you have not obtained the required permits and inspections from this office for the work you are doing as follows: lustalUA s slCer4 most a the yow voportg locat 4d. Ott Uld Rock Rondo . 4evvy 4*40k a Since permits and inspections are required by both State and County laws, please contact this office within ten.(10) days of the.date.of this letter, submit two (2) complete sets of plans, apply for the required permits,*and pay the appropriate fees All work must stop until yo obtain.these permits and are authorized by our field inspector to proceed. This field authorization,cannot .be made until the existing work is inspected and approved. Your cooperation.in resolving this matter would certainly be appreciated. Should you have any questions concerning this matter, please contact this office. JFG:aj cc:uilding Inspector - 09a=1110 Amst.'t�iifl� Yours very truly, Clay Castleberry Director of Public Works Original dpip-d bt, J, F, Glandor- J.F. Glander Chief Building Inspector File No, E' U BUTTE COUNTY (For Action 1, Public Works Dept. 2, 3) i (For Information ✓) Director Dep. Dir. Sec. Rd. & Br. Mtce. Shop & Yards Bldgs. & Grnds. Bldg, Insp, Admin. I Design Engr. Bridge Engr. i Constr. Engr. ' it Surveys Mapping Transp. �I Land`Dev. <� Drng. S.I. Sub. & PcI. Mops Permits Addr. BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS r SPECIAL INSPECTION REPORT Owner: %b/U A—A A.P. # Address: w5 //84? Date of Inspection Tenant: Inspector , Building Location: s S /4Z7 0,—.00 �. 23 ® MTV25, chow DF P/tOZ- 7;v -c&' la,l itl aA4y aA-, Type of Inspection requested: 1. Housing / / 2. Financing Change of Occupancy to rip; 4. Other (specify) Present use of building: A. Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating facilities: 7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection to sewage disposal: 12. Connection to water supply: !. 13. Rubbish and garbage facilities: 14. Comments: B. Structural 1. Piers and footings: Ul0 j /) Ve- 4GIAW K 2. Floor construction: 3. Wall construction: d d ±Ln14 4 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments: C. Electrical 1. Service and 2. Receptacles: 3. Fusing: — 4. Comments: ground: D. Plumbing 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. CoRiments : E. Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: S. Underfloor and attic ventilation: 6. Comments: F. Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: _ 4. Restroom floors and walls: S. Exits: 6. Improvements: 7. Zoning: 8. Comments: . I I G. Field Problems or Violations 1. Problem or violation (give compl to description): �?� _ rti � Ow _FRS w4� ��a (IA14. P1. cDd-7 Nom. 2. What action taken (give complete description): _ 3. What action recommended: 7-7 9. Information only file. B. Hold for ten days,'then write letter. C. Write letter. / / D. Other: qD Wma!t; 1 1aCL)E-0 This set .of :plans and sp;?cifications MUST be 9cept on the job .at,a' h times. and it is unlawful to '' ' n� . T� =AII Materials & lNorkmanship Shall Be in . . make'any changes or alterations on same.w.ith=', .Accordance with cc ;i;Cry p ares a^� /' out written permission from the bepartmii at- of a .quality prescrif od� for.the SoEcifriad use:in tl,� P:6blic W6 ks,, County of.Butte. =' Uniform .Building, Plurrmbing & Mechanical Codes r and -the National. Electrical Code: i' f Ack of 5 ft from the is ro ert lines and a's P yetback- _ / Of :50ft. from the road _.. centerline shsll.be c1ea.0 of structures or equipment except } ; I 1 for'a.2`ft, eav overhang. ' y 011, I : i �F i LI4OLrD r . A perbrill be required for the.y . .. mitinstallati on of the mobilehom' A setback of 5 ft. from the' , -property lines and a setbal. of 50ft. from the road .��{� Utal�tnections shall be withiet: centerline shall be.clearof ` _ ,r. of:the'rhobilehome, either structures or equipment except erectly: behind.nr within fhe: rear � . for a.2 ft, esve overhang: ;hal; •of.the roadside (ieft) of the =8 s �I�TTE `COUNTY 2 ILDING :DEPARI'MEN . This set of plans orad specrf cai r e MUST 6e on Ae job at ale #times and dt is:a to - -. p Sh 41 ein _ '� ; maEP any omn9es or off erof6REan: a�,rte'it Practices': ano . ` '�`rrriffen permi&sion from Ow d3ep nes$ a�f PublEc . fed - -use in -th :. ��': l orks;�Q9nfy .of Ruffe. ` .. t; PERMIT NO. 5214-769 PERMIT EXPIRES�� OWNER Stanley Andersen CONTR. owner LOCATION (A.P. 62=50-123 NIS Bald Rock Rd.',across from Pine Tree Lane, Bald. Rock 9' li Y, .II A.� C 1 e Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E t JOB / G FINALED o (Dat (Signature) It COUNTY OF BUTTE — DEPARTMENT'0F PUBLIC WORKS BUiLDING-INSPECTION RECORD - BUILDING I BUILDING (Cont'd) I PLUMBING SetbackForms Main Main Bldg. Footings StemwaI I Slab Piers S: Garage Footings Stemwa l l `!e! Slab Slab Patio Footings_ isonry Walls Reinf. Steel Firewall Soil Piping Parapets 1st Floor Restroom Finish 2nd Floor Windows 3rd Floor Siding ' To out Roof Sheathing Water Piping Roofing Sewer Fdn. Vents Fixtures Garage Vents Water Htr. Insulation Heaters Prov. for physically handica ed Conformance of ex. . structure Appliances Gas Piping & T Temp. Gas Final —� �` Sanitation FIREPLACE Final Footing Throat i Rough FinalFixtures FIRE SPR LERS Motors Test Water Htr. Stucco Final Subpanels Mesh C MECHA AL Grd. Fault Pro . Scratch Heating Service Brown Cooling Tem ole Finish Ducts Und round Interior Lath Ventilation Permanent Door Closer Final Final DATE 7 7 ►Pfi4t-, REMARKS OR CORRECTIONS Atom-c*9 C> e><. cr/ occ AI O FZ/��4E� (NOTE: An entry must be made on this form each time you visit the job site.) ELECTRICAL j'�fliocE ff PEACE kmw DnH V/ 5A saiv-�� f3 12770 SARATOGA AVENUE April 24, 1977 SARATOGA, CALIFORNIA 95070 STANLEY B. ANDERSEN, Pastor Phones: Church 253-7167 Residence 253-2887 County of Butte, Dept. of Public Works 7 County Center CKve Oroville, Ca. 95965 Gentlemen: I am sorry it has taken so long to complete corrections to complete.the permit for construction of the deck on our property on Bald Rock Road in Berry Creek, I -have been ill_for some time, and since the trailer has not been in use, we hope the length of time is immaterial. Mr. Kelley left.us.the enclosed instruction when he inspected the site last fall; I hope he'll find it acceptable now that work has been com- pleted accoming to his instructions, Sincerely yours, Rev. St ley B. Andersen l �1 N r i • V. COUNTY OF BUTTE DEPARTMENT OF PUBLIC.WORKS �\ 695 Oleander Avenue, Chicb Phone 343-4211, Ext.'70 7 Courlty Cent8r Drive, Oroville — Phone 534-4541 °�- 1'eyway and Elliott Road, Paradise — Phone 877-3435 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS 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. Inspector Date V Inspector Date J COUNTY OF BUTTE RE-'ARtMENT OF PUBLIC WORKS Ir a 7 County Center Drive — oroville, California 95965 Telephone: 534-4541 _ S01 / C/—/ APPLICATION AND PERMIT /Oft) auulUrlcC reNle5enlauve5 of the Vounry of tsurre to enter upon ine above-mentioned property for inspection purposes. Date Signature of Perrr/itee or Agent Receipt No.7i Z ?'J White-D.P.W. _ } layNs Pink-InspectC .®�1icant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OKIP-01BLIC WORKS ding permit expires Date /�— 7 BUILDING Owner §T���� ��� -�— SQ. FT. OCC. BUILDING ALUATION Mailing Address ;j 15'z 04A, 157,4,se aA o N C 12 Telephone No. Fireplace Contractor Total Valuation /;P ( . O Mailing Address d'~ Permit Fee Checking Fee &/or Penalty Telephone No.Plan Telephone No. Permit Fee $ ; 00(9 is vi Building Address /VS�`.!' �,�, � PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 �l sv C SdIi✓m//{ice �� ��., Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. �� ` ��_/� Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fjs I 4e Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Recd A/ Pm_cel.Approval Approval Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHERJS ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 dp.!E C/<Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 00 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 NEW CONS:F ODWELING R ADDNS. ( ACCLBLDGS.CCUP. &) 21tsq ft NEW CONSTRMULTI.OUTLET NON.RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS &) NON.RESI D. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) BAL@1 FIXED ALNS. Ex. Occup. (OUTLETS P(RESIo )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 INI am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 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 TOTAL PERMIT FEE $ auulUrlcC reNle5enlauve5 of the Vounry of tsurre to enter upon ine above-mentioned property for inspection purposes. Date Signature of Perrr/itee or Agent Receipt No.7i Z ?'J White-D.P.W. _ } layNs Pink-InspectC .®�1icant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OKIP-01BLIC WORKS ding permit expires Date /�— 7 L K ! � ( ;tri �..-�.c.:_..• �T�✓" �.�d-�+''_.'-:�. �=•�..-�-L' ��._ r'c�,:C:. =� - �� � A Wor"wMvrsh;p S'lac�ii r; ��. a.^t�.�t�� ,�•�-•" 1�cea�rc�ic��ro r•i�h R�c��r�irea ond Prdc+ice� Oft +n ,� C ur.> _ t; �r`1aw . 1 �. Of O C?L1 INN r^Eccf il-ind fnr ,'he r x �o t�� .� '",, ;"nrs ��. r ... °� SI itsISriocifi�� use k G �''��� c w��,s or rlrrr--. '� �w :��lewAil +� ��� / °: iform �Rui mcf, PSUr�' Y'l—n � M�chap,,' �! Cady.. ���r�� - 'f#err r,, cion i orn a inns � r �� ����e ti if h ut S %Ef ��� r�'--�/-�� Zo �1rat�ofaol_ ir!ec�°ricoi Code._ } j I, �X-A-cz, K t s f U_ COUNTY �- 6 7 � _ ' =�'I/'C J 1 �a — ., � ,�-- - ../ w z • -. .e. 1; -��_ e .._ �, �� .. � �� a r� � �b -��_ e .._ �, �� .. � �� a r� � �b a r� � �b �'�:v' U��. Z`�v. - ��; f! _,^-• t,..-. � .� ,. � . �. � .r—a'"`�✓ti.�_�.�2r -f ti� � .:-`•-`'�'at„f' ..�.. ,h �. , 'ti 1. Layton Ford ,, $ Permit #2707-88E COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 �^ ! APPLICATION AND PERMIT ,1// ASSESSOR PA CEL'NLOiABER ZON NG BUILDING PERMIT OWNER TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER's MAILING ADDRESS - r CONTRACTOR'S NAME �+ !"! J/' f J^ 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 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 r� f ti ( A./ Each Trap 2.00 -7 r f (r -t ` 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©'''rOther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 Be TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 2- Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 _ Main service DODv OR LESS 100 AMP OR LESS 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/POWER and Professions Code and my license is in full force and effect. License No. Classification J Il\/Ji 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) ❑ 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.al '/zQsgft OR ADDNS. ACC. BLDGS. \ NEW CONSTR U '.OUTLET 2,50 ea NON.RESID BRANCH CIRCUITS) APPARATUS eI (SINGLE OUTLET CIR. 000t Ex. Occup OUTLETS OR FIXTURES eAla30 FIXED APPLNS, OR EX. OCCUp. OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 0 Misc. Wiring 15.00 Permit Fee $ C * U 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 wiih 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 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 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,sa d unty In co se uence o he granting of this permit. X _4 L22 - 777 Date-� �• SOYO Signature of Applicant — Owner LJ 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 $ TOTAL PERMIT FEE $ occu P. CONST.TYPc I SCHOOL FLOOD PARCEL PD I ND I ISSUE 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. DIRECTOR F PUBLIC'WORKS B / 1 �� /�J� .Dat9 PERMIT EXPIRES Date - Receipt No. J WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 'I TY OF BUTTE EPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-275T _Z.C,ounty Center Drive, OroviIle— Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE ER 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. Inspector G,�v/ Date �� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKSPERMIT NO. 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 ; `7©- 7 APPLICATION AND PERMIT [ // 00 ASSESSOR PARCEL NUMBER D — .S ZON G - Z BUILDING PERMIT OWNER _0, iayt-y FO r-61 TELEPHONE SQ. FT. OCC. BUILDING VALUATION �JLING OWNER / /IIN C- A �RE55 �,v p ee CONTRACTOR'S NAME �v� / e -T TELEPHONE 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 - Permit fee $ PLUMBING PERMIT Filing Fee 10.00 S I Each Trap 2.00 e _ e 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 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 [J Addition❑ Remodel❑ Utilities �Installation❑ Other[] Describe work: o Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 .1,44 t u L'XS >Ria S�.-vi a bvX Main service 1000 AMP OROR SLESS Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the BUslnesS and Professions Code and my license is in full force and effect. License No. Classification I. as the owner, or my employees with WflgeS 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.eI) '/z¢sgft OR AODNS. 1 ACC. BLDGS. NEW CONSTR_ MULTI -OUT LET U TI.OUTLET 2.50 ea NON-RESID .BRA CH CIRC ITS POWER APPARATUS eI SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES SALOt ALvo 3 FIXED EX. Occup. OUTLETS TS (RES(RESID..0)R EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 rT Permit Fee $ Q�t7 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 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 agains sa' unty in cos uence o e granting of this permit. 1 Signora a of Applicant — Owne Contractor ❑ at Agent ❑ An OS 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 $ TOTAL PERMIT FEE $ g5 &--c> Oc CUP. CONST.TYPZJ SCHOOL FLOOD PARCEL PD ND 59UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which IREC PU B PERMIT EXPIRES Date the applicable provi- resolutions to do ee have been paid. I ORKS t Receipt No. d WHITE-D.P.W.. TELLOW-ASBE35011. P I NK -IN SPECTOR, GOLDENROD -APPLICANT � . °��.������^�����/�^.^'~ -` , ^ A��imoof p�nni�app|ica�ion. | wooadvioed�hefo||mwingdm�axnuo� beaubmi��nd prior�opermi� proneooing ono/ uonce� o�Ts�s��mso uPP�o�so _�^�_ 1, AU iU*mo�havebeenoubmi�Uod. . , , , . . . . , . , _---_ �, P|c� p|ana in dup|ico�e/hip|k��e, oigned by preparer nf p|omn. , ---_-' 3. Cmnp|e�e p|ana in dup|ica�e/�rip|ioaUa. signed by pnapmrer of p|ano. --___ 4. �omp|e�e engineered p|ano and oa|us, wi�h we� oigna�ure on p|mno. ---__ 5. P|ana vvi�h Ene»gy Oeoign �omp|iance S�a�omenL . . .�,, , ------ G, Sohoo| Die�ric� ''Feeo Paid'' S�amp on F|oor P|sh� ------ 7 S�oU*men� of |n�en� for Non-Heo�ed and A{� Bui|dingn. , , . . -_---- 8, Feea of � , . . . . , . , , ------ Q. Le�U*r of nigna�uno au�horiza�ion, . . , , . . , . , , ______1U, Sani��ionapprovo| �rom Hea|�hOe��, . , _____11, P|anningapprova| for��) Uoa�--_-__--(B) Porking�---__-___- . ______12. Codifioa�o of VVorkmen'a �ompenoo�ion |nou:anoo. , , , . . _____13. Con�rac�or'o Lioenae |nforma�ion (no,. namo a�y|a. c|oamif.) . ______14, {}wner-Bui|der Verifioa�ion (�iven �o mwno��l. K�ai| �o mwner�l) `� _____15, |mprovemon�umayborequined. , , , , ,^, , , , , , -----'16. K4obi|ohome |no�oUe�ion Do�a. , . . . . . , , . , , ~/ _____1�, Pre'|napacUonf Required. a"~" �«��'_* "*} --_---18' Reuonind oopy ofAgricu|�ura| Aoknmm|edgmen� Stu1emen�. ______10, Oriveway PenniL ' ______2O. P|c� p|onapprovo| f/omoi1yof �1. Engineenad buaoeo1ndup|ioa�e (nequired prior�op|ancheck]. ____ �� � ______2�. VVhen you ianue �he pormi�. pruoone oo �o|\uwa� ______�ai| �oowner. ______�oi| �onontrmo1or. _---_J'e|ophone ' and hold for pio�up a�______offioe._____Do|ivor w/�nopao�or, -___-_ C)�her v O - . ' oon�ump,. ueo/one� v�nv,. wasuuwaeuvxuunvemqu/mmuo�auv /|---roun*wuv oun�n,vm� uesione,. owne,. wnsauv/seuv,ouvv�mquimuuam uv_��nun�---�u|/__�vuun�e,uy P\onaohen�ed by Cm1e � - P|ono 'provedby So�ac�p|anaonhn|d in---_Fi|eoobine� _--__APhddn/ Copv-oPw 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/.�) signed an application for a building permit for the proposed wo k. 3. I have contracted with the following person (firm) t construction: / Name Address Phone Contrac rs Lice a No. 4. I plan to provide portions of this word to coordinate, supervise, and provide t Name Address Phone Cbntrac ors 5. I.will provide some of the work persons to provide the work ind Name Address . provide the proposed City yE. I have hired the following person major work: City ense No. dt I have cdntracted.(hired) the following ated: Phone Signed: 1-7 Property. Owner 1. Social Security Numver — Date aIc"c Type of Work 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. a PERMIT NUMBER - B 2782-73P,E P :t J E PERMIT EXPIRES O `,a —7 4— OWNER Stanley Andersen CONTR: • owner +, LOCATION (A.P. 62-50-123 n/s Bald RockR.d.• across from Pine Tree Lane, Bald Rock h 0. I k OVry 74 911,, COUNTY OF BUTTE Department of, Public Works BUILDING INSPECTION RECORD Zoning Setback Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing Plmg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ' ELECTRIC GAS BUILDING Temporary. Temporary Cert. of Occup. Final Final Final 1 DATE REMARKS OR CORRECTIONS k c COUNTY OF BUTTE —..DEPARTMENT OF PUBLIC WV r 7 County Center Drive - Orovi Ile, California 95965 / 4PC Telephone: 534-4541 k APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X/O-j, A0Z il gn44. Date7h/ Siature of Permit' e or Agent Receipt No.�- White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work/indicated above for which fees have been paid.. DIRECTOR OF PJ6JBLIC WORKS BY--.-----�i _ _ Date_ a'�Z —7L Building permit expires Date . BUILDING Owners r- SQ. FT, OCC. BUILDING VALUATION Mailing Address Telephonepo. Fireplace Contractor �cs/�� Total Valuation Mailing Address �� Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ $ Building Address �� CL- 4PERMIT PLUMBING No. @ FEE FILING FEE $2.00 00 /' Pf.. Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 ds -0 Each gas water heater or vent 1.50 A. P. 7 - O' %� � - g $ a Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W.C. Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Improvements Lawn sprinkler system 2.00 Bldg. Plans Recd Pa Plon�proval Permit Fee $P. $ SZ NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 01J Main service incl. 1 meter d!/ Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Laio Light fixtures ballal(@10 - Receps., switches & fix outlets 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. lisp. or D.W. 1.00 Air conditioner or heat pump Water pump t •/➢ Mobil Home Facilities 5.00 SC' Temp. Power Pole 5.00 License No. Classification Misc. wiring — I am exempt from the Contractors License Laws of the State of California. Permit Fee $ /' $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 1 I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ �4 iJ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X/O-j, A0Z il gn44. Date7h/ Siature of Permit' e or Agent Receipt No.�- White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work/indicated above for which fees have been paid.. DIRECTOR OF PJ6JBLIC WORKS BY--.-----�i _ _ Date_ a'�Z —7L Building permit expires Date . A` locate fil,t�, third d wi th , co„n^^� sect;r h`n on th ^.tip hO� left' (r `' ... 'r'all b e.e °adJ s -de l''`'bile he rear °ft ho he ,fob ee Sept;c system Butte tub -out to 9uirern nts. health De te-�s per . s ePt. Re - 3 The BI he shall be . operty I ine S ft. from, nterline and 50 aX,m�m o f aft ft road ft - from permitting eave overhan g• COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N "7 Counry Centgr Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT 001 ASSES OR P RCEL NU BER E ZONING - 0_ 14? S�gpi: BUILDING PER OT& ,MAJ C__. �^� ���- TELEPHONE SO. FT. OCC. BUILDING VALUATION 22O AtYiINGc%NR ESS CONTRACTOR'S NA paw TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LEN - UNKNOWN Total Valuation is Filing Fee $ 1.000— LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINE E LICENSE NO. Plan Checking Fee $ 0,019 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS - Permit fee $ BUILD NG ADDRESS Is _91pe e14LD TZF,iGIG . �1�, !� l�(/r 2$. PLUMBING PERMIT Filing Fee 10.00 OF P/A/E TX�� ���� Each Trap 2.00 Repair drainage or vent piping 5.00 e,0?_K, Water piping X00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 149, Oc, USE OF STRUCTURE SF ❑ Duplex[] Mobilehomel�-'Other SPECIFY Building sewer .00 Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities P Instal lation ❑ Other ❑ Describe work: M L-OCA'7E 0EXI.0Wei Permit Fee $ r.pp Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service GOOV OR LESS 100 AMP OR LESS 500 r�T . Vv Main service EA. ADD'L 100 AMP 2.50 NEW CONST. /DWELLING OCCUP.y) OR ADDNS. \ ACC. BLDGS. 20 sq CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BusinessD002DC and Professions Code and m license is in full force and effect. y 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 CONSTR. OUTLET 2.50 ea NON.RES'. BRA CH CIRC ITS NEW CONSTF;L / POWER APPARATUS IN NON-RESID. %SINGLE OUTLET CIR. / Ex. Occup OUTLETS OR FIXTURES BAL@1 IXED APPLNS, OR Ex. Occup.�OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 /S OO Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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. Heating Cooling Hood 3.00 Ventilation , Permit Fee S 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. 1 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 agai t sa' unty in ons uence oft ranting of this permit. K 1141A Qrme S( Signot a of Applicant — Owner Contractor ❑ Agent ❑ An OS permit is required for ex ovations over 5'0" deep and demolition or construct- ion of structures over 3 sto ies in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ i'2 -A5!2 OCCUP. GROUP I TYPE OF CONST, PARCE PD ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR OR OF PUBLIC By 2��IT EX Pf RES Date the applicable provi- resolutions to do fees have been paid. WORKS Date !2 11 FE' Receipt No. 7 &j WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT PERMIT NO. 3633-87MHI ex site PERMIT. EXPIRES iwu OWNER LAYTON E. FORD CONTR. Owner ASSESSOR PARCEL 6.2-50-145 LOCATION .15 Pine Tree Lane, Berry Creek Temp. Power Pole Called PG&E Temp. Mac: Service Called PG&E Temp. Gas Service Called PG&E Q� JOB FINALED (Date) " Signature = OK 0 Not OKNot E = Not Read�yable MOBILE HOMES • MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footirigs; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Beams-Rftrs.-Con nec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures [ 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -B1 Date Card -B1 Date 10. Roof; Shthg-Roofing Card -B1 Date Card -B1 Date 11: Ext.; Steps -Doors -Landings Date MOINLEHOME INSTALLATION Plans OK except #'s Z ping Require Kis -Setbacks -Easements Card -B1 Date Card -B1 Date F tings; Spacing -Mani ine Card -B1 Date Card -B1 Date G ; MH Test -Deman -VAt a Connector 1 ,ctricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s rain; MH Test -Fall -Flex Connector 1. Setbacks -Easements r; MH Test -Regulator -Connector ' 2. Soils; Compaction -Structure Stability and Sewer Connected -C/O to Grade -HD Approval , 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining as a -Electricity Tagged Insp.-Sketch a 4. Elec.; Receptacles and Lighting, Distances-GFI . Cert. of Occupancy 3 5. Elec.; Pool Lighting; 15 volts-GFI i 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 Card -B1 Date — and -B1 Date Card -B, Date/ _ _ (Zard-B1 Date 9. Health Department Approval i O O 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date = OK 0 = NotOK RESIDENTIAL, (Single and Duplex) - =Not Applicable = Not Ready, Date UNDERFLOOR (Plans) OK except #'s 1. Zoning requirements -Setbacks -Easements 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. De 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Del 5. Stemwalis, Main; Steel- Bloc kouts-Wrapped 6. Stemwalis, Garage; Steel-Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air 17. Water Pipe; Test & Anchors -Nail Protection 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pioe: Size & Anchors Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date ELECTRICAL (Permit) OK except #'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. Fasteners -Bond Gas & Water 27. 2 Appliance Circuits in Kitchen & Conductor Size 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI. 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 Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date MECHANICAL (Permit) OK except #'s 33. A.C. Ducts Insulation & Support 34. Vent Fan; Exhaust above insulation 35. Condensate Drain & Overflow; Size & Grade 36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 37. Attic Access & Platform if Furnace in Attic Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date FRAMING (Plans) OK except #'s 38. Sills, Proper Material & Anchors 39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 40. Bearing Walls over Girders & Floor Nailing 41. Draft Stop in Walls (rat proof) 42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 43. Header & Beam -Size & Bearing Date FRAMING (Continued) 44. Hangers -Post Caps -Anchors -Connectors 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 46. Fireplace Ties or Type A Flue -Fireplace Throat 47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 49. Garage Fire Protection Framing 50. Property Line Firewall & Openings 51. Ext. Doors -One T -Check Garage -3rd story, 2 exits 52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 54. Siding -Nailing Veneer 55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 56. Glazing Area -Glass Protection -Skylights -Plastic 57. Shear Walls; Nailing -Bolts 58. Insulation-Walls-Clg. 59. Infiltration-Walls-Wndws Card -B1 Date Card -Bi Date Card -B1 Date Card -61 Date Date FINAL (Plans) OK except #'s 60. Ext. Steps -Door & Sidelight Protection -Landings 61. Smoke Detector 62. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 63. Bedroom Exiting 64. G.F.I. & Bath Fixtures & Tub Access -Spa 65. Elec. Trim & Subpanel; Breaker Sizes -Labels 66. Stairs & Rails 67. Fireplace or Stove; Clearances -Hearth 68. Elec. Outlets at Wood Panel; Int. & Ext. 69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 70. Elec. Outlets & Receptacles at Kit. Counter 71. Garage Fire Door; Swing -Landing -Closer 72. A.C. Duct in Garage -Damper 73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 74. Plb., Elec. & Mech. Equip. Listed for Location 75. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 76. Insulation -Foam -Looked in Attic 0 Yes 77. Guard Rails & Deck Construction -Post Caps 78. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 79. Following instld.; Drive 0 Yes O No; Walks O Yes 0 No; Planters 0 Yes o No 80. Stucco; Brown -Finish 81. A.C. Unit; Disconnect, Electrical, Plumbing 82. Vents Above Roof; Plbg.-Appliance-Firepl -Clearance to 83. Water Well; Disconnect, Electrical, Plumbing 84. Exterior Elec. Trim; G.F.I. Receptacle -Underground 85. Ventilation throughout House 86. Glass Protection 87. Corrections from Previous Inpections 88. Gas Test -Meters Tagged; Gas -Electric 89. Water & Sewer Connected -C/O to Grade -HD Approval 90. Energy Compliance Certificate -Other Certificates Card -B1 Date Card -131 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -Bt Date Comments at Final: (NOTE: An entry must be made each time you visit job site) MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE A DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 PERMIT N0. 36 l 'Address or location of mobilehome y^ .�-��. H Owner's name f ��•� a' rn �i`J jj jOwner's address �� S _ ✓f+ `-x l,'/Lts /.yt_ JInsignia or hud number 'Manufacturer's name�!+� Serial number of V.I.N.✓�/ 7'. / Year of manufacture �f (Official Approving Installation) (Date) r 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 ON A FOUNDATION SYSTEM. r51313 White - Owner, Yellow - Installer, Pink - D.P.W COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle— Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE ratel 3 �oj3-,�- 1 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 of!jce immediately. Inspector / Datel /���'� Y7 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 G3- <� 7 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. Inspector �� Date Z �' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT 0. ASSESSOR PARCEL NUM R -�,� ZONI BUILDING PERMIT IV OWNERR_� �Q o o rc TELE} NE L/f SQA FT. OCC. BUILDING VALUATION OWNER'S M ING A DRESS CO A TO 'S N AME I •MAIL^ING TELEPHONE C TRACTOR'S ADDRESS Fireplace CO S RUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARJVJ4TECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty BUILDING ADDRESS Permit fee !$ $ s O 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 gas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0,00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation Other ❑ Describe work: ` Ri �141v Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eo0v OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 1 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 l��(I 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 OR ADDNS. ACC. BLDGS. CONST. DWELLING OCCUP.EI , �20sgft NEW CONSTR. TI.OUTLET RA C CIRCUITS) NON.RESID BRANCH 2,50 ea POWER APPARATUS e (SINGLE OUTLET CIR. ) EX. Occup(OUTLETS OR FIXTURES ALO 30 .220 0 00090 FIXED APPLES. OR EX. Occup. OUTLETS (RESID.) EA.1 2.00 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. U 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 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, Jjidgments, costs, and expens s, which may in any way accrue agai said C t rpn 2once of the piing of this permit. X Date Applicant — Owner Contractor ❑ Agent ❑ Signat#uc�tures An OSrmit is required for excavations over 5'0" deep and demolition or construct- ion of over stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TYPC SCHOOL PLO !�DrARCELJO PD u! This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PE IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date � If — /3 Receipt No. �1)Q �/ WHIT!-D.P.W.. YELLOW-A3eC330R. PINK -INSPECTOR. GOLDENROD -APPLICANT AN'•n,, --fl- OWNER COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION r 7 COUNTY CENTER DRIVE - OROVILLE.EA- IEO.I NIA 95965 - TELEPHONE: 916/538-7541 -PERMIT APPLICATION DATA7SHEET Proposed Building Use V Permit No. A. P. No. (orY -,)() Building Inspector 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 _�/�All items have been ubmitted. Plot plans in plica 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. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp on Floor Plan. Statement of I ent for Non -Heated and AC Buildings. . Fees of $ 1� . , 0� 9. Letter of signature authorization. 10. Sanitation approval from �!'�O Y/ �� Hea th Dept. 1.1.E Planningapproval for A _Used P 12. Certificate pof Workmen's �Com ens tion Insura 8e.`„ :�' ySP . v � Contractor's License Information (no., name style, classif.) :DS4. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 5. Improvements may be required. . . . . . . . . . . . y 6. Mobilehome Installation Data. . . . . . . . . . Z��q� Pre -Inspection for__.._-Pre-Inspec. request to ._ _ ._.._.__ _ Required. Building Inspector Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. — 20. Plot plan approval from city of 21. 22. en you issue the �pr it roc ss as follows: Mail to owner, Avlail to contractor. Telephone and holie ld for pickup office, Deliver w/inspector. Other _ t Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. e ,C 2. Additional items required: —_—_ r. Contractor, designer, owner, was advised of above required data by—phone _—nail_counter Contractor, designer, owner, was advised ci above required data by—phone —mail —counter Plans checked by Copy—DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder date— date ate—date ate t TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance LA 'If -7, Own r Lo ti n Plan Approved for: Sewage Disposal C� Water Supply Hold final for: Water Supply Final clearance O.K. for: Water Supply a AP# Clearance for bedroom mobile home. Other Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 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 ap lication for a building permit for the proposed wort. 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 1 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 Num r � Date / �f',Q�, 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. Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT RECORDED BUTTE COUNTY FOR RESIDENTIAL DEVELOPMENT OFFICIAL RECORDS BY ., . Section 26-8.1 of the Butte County Code requires this acknowledgement P/!,Rr(+SHOWN be recorded prior to issuance of a building permit. 87m-41108 1981 NOV -2 AN II: 52 The property described herein is adjacent to land, or included within an area zoned for agricultural purposes, and residents of this CANDACE J. GRUB property may be subject to inconveniences or discomfort arising from-pC pp FF r"'` the use of agricultural chemicals, including, but not limited to herb J JCfC and fertilizers; and from the pursuit of agricultural operations including, but not limits `• to cultivation, plowing, spraying,,pruning, and harvesting which occasionally generate dus;%J smoke, noise, and odor. Butte County has established agricultural 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 disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: i Parcel 1, as show on that certain Parcel W.p being o portion of tbo.Southaast •,. quarter of Section 33, Yowahip 21 Horth, Range S Ze aty Y..C.H:I& M-, filed in the office of the Recorder of the County of Butte,,Stste of Cilitorniai on September 28, 1978 in Book 68 of Parcel Maps, at gaga 33.. , Date: f r7 State of ) S S . County of ( PROP TY ERS On this the day of /P�'L 19V, before me, the undersigned Notar rubblic, personally appeared ®®°®m°®am eggs afaanwaa " / / Personally known to me. / / Proved to me on the basis ��� AkR.a,�r�: GAR ® of satisfactory evidence. NOTARY PUS' VA m to be the person(s) whose names) subscribed to "iaO-Mnl�istr 8 ��i ® the within instrument and acknowledged that �,yco,n,n;sslonEx� 6 executed the same for the purposes therein ° s'o®m® lea°®s®IN WITNESS WHEREOF, I hereunto set my hand ° huhaaoe+sh�®�a 0 Present A.P. No. contained. and official seal. Notary P ,ybrl is P(setback or 5 ti. from the property Nn --2 and a setback of 50ft. from the road centerline shall be clear of structures or equipment except fuer a ? ft. eavp overhang. ,40TE: 11 Mcfe"'.-fils a Vv 0' Fan M 4.ni7,ed r h 0 Accordance ifh 9i�'-Ir'oanized >b of a quality pr crlb-e7d)�nr the Uniform f 8UX -�g niform BuilWding, ImbirgA M $e National Electrical Code. --This�f ol�-n-,,cmd sp�CifZv-ronvi MUST �,�@ kept on the job ateaH-ind R 14 unNOLA 4, make any chcmiges or alteri-*, im an ocIM@ With@Mt written F.mission from the Depar nt of PU6116 Works, qounfy of Butte. - nt'lity connections shall be, 4 �. of the mo ilehome, eith dir-Ictly behin(4- f within th(,,, reit 4 1 climc rr 0, ,)ad Practices and ha acified use in the Alico, Cadw and Cli ---------------- rip U i4�y 'dpi -UILDD', J" 17 33 My BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: &a 2. Installer's Name: 'q 101 3. Is the site currently under permit? Yes F No (If yes, furnish permit c=umber ) OR Is the site an existing site? Yes © No D (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 (If no, clarify 5. What is the mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? ------- ----- Aff Amps 7. What is the mobilehome site circuit breaker rating? ----- �'� Amps 8. Is there any other electric load to be served by the -------------------------------- mobilehome site service? Yes F No Jelii (If yes, identify the load and size: (Load), (Amps) +r 9. What is the mobilehome site gas pipe size'? -------- N (in.) 10. What is the type of gas service? ---------------`--- Natural U LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- * 12. What is the mobilehome gas demand? ---------------------- *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG:) (ft. ) (BTU) . MOBILEHOME-SUPPORT DATA If other than single wide, Mobilehome Mfr. furnish Setup Model No. Year Width LQ (ft.) Box Length_ (ft.) Tagalong or Expando Size 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) X 1. SUPPORTS (check one) 1. Line 1 Piers: Wood -pressure treated or foundation grade. 2. Other (specify) Concrete block. 1:1 2. Other (specify) Pier'Footing Sizes and Locations SINCLE-WIDE MULTI -WIDE j,�ne 1 i Line 1 Line 2 Main Beams iinencl ------------- q l — — — — -- — — — — — — — — — Lam ---1 in 2 Main Beams 2 — — — — — — — —' — — Size -Min. ------------ Spacing -Max. --------- , Frani Ends -Max. ------- I.iiie "l Piers: size -Min. ------------ Spacing -Max•--------- v �� 11 From Ends -Max -------- Li �Rt ------- L.1ne 3 Woof Loads: Size -Min. ------------ Line Tag Tag or Triple —i •� Trop . I r Line 1 Line 1 Openings: Size -Min. ------------------ "x ' Each Side of Openings With Width Over--------- I= Line 3 Piers: (Under Bearing Wall Only) Size -Min .------------------ "x 'Spdcing-Max- --------------- From Ends -Max -------------- "x Location (From FronL) _ _ _ _ _ _ '_ I - Line 4 Piers: f Line S Piers: (Under Bearing Walls Only) Slut -MS n.------------ uX „ Size -Min .------------------ x Spac LAK-htax- --------- ,_ „ Spacing -Max ---------------- Front --------------prom Ends -Max.------- _ From Ends -MAID � �/�y�v u I_iiie_ 5 Egof (nada: Qt in nING DERkFITMENT Size-Min.------------ locaLion (From Front) P PERMIT N0. 588-81B 09 ...� .��� PERMIT EXPIRES OWNER LAYTON FORD CONTR. owner ASSESSOR PARCEL 62-50-145 LOCATION S/S Bald Rodk Rd at inter of Pine Tree Lane, Berry Creek Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E �I JOB FINALED (Date) 1; Signature r J = OK 0 = Not OK = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except k's Date DEC COVERS, CARPORTS, ETC. (Plans) OK except q's 1. Zoning Requirements—Setbacks—Easements . Zoning Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch o 'ngs; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete ecks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Fbs—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. IAAurrrAwn.; mns—Connectio s—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ P'Nat.or/ PV ft./ /"LPG 7. Utility Clearance 6 ( rpor s; nd ws—Doors E Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N'S 1. Zoning Requirements—Setbacks—Easements Date POOLS (Plans) OK except H's 1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Electricity; MH Test—Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/O to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 9. Exits; Insp.—Sketch 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK O = Not OK - = Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /'' Fig. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Fig., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers _ 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except #'s 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except #'s 14. Water Ht.; Vent -Access -Combustion Air 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except #'s 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 72. Insulation -Foam -Looked in Attic E) Yes 73. Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral ❑Yes ❑No 75. Following instid.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes El No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. 80. Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except #'s 31. A.C. Ducts; Insulation & Support 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates _ 33. Condensate Drain & Overflow; Size & Grade 1 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic - Card -BI Date Card -BI Date Card -BI _- Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING Plans OK except #'s 36. Sills; Proper Material & Anchors 37. Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. _Walls; Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. _Header & Beam -Size & Bearing _ Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng -Rfng. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT MIT N`. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4 1 d APPLICATION AND PERMIT Al I ASSESSOR PARCEL UMBER ,f �-- ZOWI G BUILDING PERMI ow R TELEPHONE SQ. FT. OCC. BUILDING VALUATION t7 &Pgn DS' AIL NG A DRESS ONTRA TOR' NA ELEPHONE 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 $ 0 DO t Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING A RESS PLUMBING PERMIT9 Filin Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME ARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome�Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe work: nQiv1 .o , Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR101 OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.B\ OR AODNS, ACC. BLDGS. / 20 sq ft 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 CONSTR I.OU LET 2.50 ea NON .RES ID BRANCH CIRC S NEW CONSTR. I POWER APPARATUS e) NON-RESID, I SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES a i'� FIXED APP LNS, OR Ex. Occup.(OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate I of Consent to Self -Insure. NI 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. Heating Cooling Hood 3.00 Ventilation permit Fee S 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 s 'd County in conse uence of the granting of this permit. X _ Date a3' / - 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 $ TOTAL PERMIT FEE $ �� occuP. GROUP ` / TYPE oP CONST. V PARCEL v*_ C"/ HD Issue This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREPUBLIC B PyIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. �7 g72 WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT t tAll—MbterWorkmanship ials $hall w cC� r,,Ge with Recognised .Good Practices aftd of a qualifv nrescr%ed for the Specified use in fhe,, Uniform Building,Plumbing & machanical Code to d the National electrical Code. Th:s- of plans and specifieaiiors MUST be . kept on, the job at all times and it is w crwfi l to mo'<A any chonges or oltero+ions on some w4hou written permission from the Department of Publ' Works, County of Butte. 1 V setback of 5 fpe' from the Utility connections shall be within property lines/nd a setback- +` 4 ft. of the mobileho4 either of 54ff. fror,Y�he road directly behind or w centerlines ithin�#he rear all be clear of half of the roadside (left) of the. structure str equipment except. mobilehome. for a 2 ftpeave overhang. e ! Aa Y ' � ^C) 1 { OCI i616 lb4i`iit 16 "iiiaai"•0•i40 •• 0••i�••••00000.W: l l_ LLI C .o E_• El. o LU ` 5< r z . D • i� aci Ll o be 36 in hig wit l � Topi ove iate iails to be not e 2 X /U ( 0 io I Fr II bri r/ cing i _ ��S � . � 4w '� ~�� �- .. � � •�. �� +�, _. i -, �, • . � _ 1 • ... � � �• ! - DS I • �® , � • •� _ ��..�_.• • _ 1 ' , � � 2 r °a g _ � _ �—_ . -` � � . � � :� � CQ � 1- r. - TM .� >, � � `- .. � ----- ,� 1 '� +. . . 4 .. .f • �` __ 1 �� J_ - .:�. -- .�. . � �� r M _ ��H I r� • ��— ` ` e �- .. � � •�. �� +�, _. i -, �, COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 r- Telephone: 534-4541 r `APPLICATION AND PERMIT nvut:I PL IV U. White-D.P.W. -Yellow-Asses P'In -Inspector — Goldenrod -Applicant audding permit expires Date .-.-._-_:.;_�..�..+... BUILDING A � Owner �� `eC SQ. FT. OCC. BUILDING VALUATION LvrG > Mailing Addres - . Z Q r/2Q 7 Tel h+neflo. ��( Fireplace IV Contractor vj tel/ Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee F $ od $ o� Building Address I Q�G s PLUMBING,#' No.1 @ FEE PERMIT FILING FEE $2.00 �d vh L Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 491.50 Each gas wap'pr heater or vent 1.50 A. P. No. Zoning & Planning Gas pipi system 1 - 5 outlets 1.50 Each a&ritional outlet .30 F � Sa ' ation Fire Dept. FiAon e Use Permit Build'i g sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P �0' R/W Improvements Pv L?,A sprinkler tem 2.00 . Plans Recd Parcel Approval � Plans Approval J Pe it i t ,...Y NEW FEADDITION ❑ UTILITIES ❑?� OTHER L T CA o.r MIT PA.AG f EE $3.00 Pain service i cl. 1 meter di ona .,eters, Vch 1 0 ) (m ret n 1 w =AfAag4.�J2f Single Family ❑ Duplex ❑ Mobil Home 40tthhers ❑ ng ook-top or Oven 1.00 Water-Spacee'H•eater n. 1-00-t Light fixtures bal io Receps., switches & fix outlets Z CONTRACTORS LICENSE 1206Hood, I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. di sp. or D.W. 1.00 'Air conditioner or heat pump Wa�'er pump Mobil}Home Facilities 5.00 Temp. 0110wer Pole 5.00 License No. Classification Misc. winng I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ A WORKMEN'S OMPENSATION INSURANCE 1 am aware of the prove ons of Section3700 of the California Labor Code which requiresOvery employer to be insured against liability for Workmen's Compensation. ❑I have placed`on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify t At in the performance of the work for which this permit is -sued I shall not employ any person in any manner so as to be • me subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood t4 , 2.00 Permit Fee $ $ I certify that I have read this application and state that the above inform ion is correct. I agree to comply to all County Ordinances and ate Laws relating to building construction, and hereby r authize representatives of the County of Butte to enter upon the abo ;mentioned property for ins ection purposes. X Date !� Signature�Plea or Agerit; /'7 —, / r t_ .. �.. pie �i' TOTAL PERMIT FEE $ d This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions "todo work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS i r _ �i� .rW -- . p Date �.. nvut:I PL IV U. White-D.P.W. -Yellow-Asses P'In -Inspector — Goldenrod -Applicant audding permit expires Date .-.-._-_:.;_�..�..+... 1 r1 J - r COUNTY OF BUTTE - DEPARTMENT OF PUB/1534 PERMIT O. ° 7 County Cater. D;,ive - Oroville, rCalifornaa 95965 - Telepho41 /� APPLICATION AND PERMIT � ASSE SOFT —XMBER I/� /- ccc.���' '�. f ZON G� BUILDING P R OW R TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S AI ING ADDRESS CONTRACTOR'SNAME TELEP ONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ , Dn- Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDI G ADDRrJE55 I J 1R PLUMBING PERMIT Filing Fee 3.00 aV\ ` h Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USEOFSUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK�„( New ❑ Addition Remodel –1Ut'lities rL�eO, lirs\tall tion Other ❑ Describe work: _ U-r1L / p �/T �,/��� — �/�+ Permit Fee $ Contractor ' ELECTRICAL PERMIT Filing Fee 3.00 Main service 10000 AMP 100AMP5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 20 sq it 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 CONSTR ULTI-OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS NEW CONSTF;L NON-RESID. ( SINGLE OUTLET CIR. POWER APPARATUS &1 Ex. Occup(OUTLETS OR FIXTURES B 10T FIXED APPLN5. OR Ex. Occup.(OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 3.00 WORKMEN'S COMPENSATION INSURANCE 1 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 �l 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. Heating Cooling Hood 2.00 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 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 expen es which may in any way accrue agains said ty in onse ce of the r nting of this permit. X Date ! Signature Applicant — Owner Contractor ❑ Agent ❑ An OSH ermit is required for excav tions over 5'0" deep and demolition or construct- ion of st ctures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ occUP. GROUP I TYPE -FF -7 I PARCEL I PD N ISSUE V/ This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which BLIC DIRE RV-4 PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS / �/ +- i /(/-c'-7-�ByDate Receipt No. –�`I' WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT i --COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 ` CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number 5 %r %`1'/'s � for the following location: 5lii /.S d,4Z��V ai t .;. ' fir• B' �C!-/t..L . /"tva^�y Owner Owner's Address I.Zzo 1,1,-'--.s-,st r,., st/ L • .�Gc+r-�-' - Mobilehome Mfg. �;�Ll:a��� iyzclModelYear Insignia No. Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works .�� Date ` / <� _3 % rc7 l' By � � v THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. �AA-t" 6-fV -kb • PERMIT NO. 6133-80B,E PERMIT EXPIRES OWNER Layton E. Ford CONTR. owner ASSESSOR PARCEL 62-50-145 LOCATION SW/S Bald Rock Rd,, @ inters. of Pine Tree Lane, Bdrry Cr. Temp. Power Pole Called PG&E Temp. Elec., Service Called PG&E Temp. Gas Service Called PG&E 1. JOB FINALED (Date) L Signature J = OK 0 = Not OK = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS r Date MOBILEHOME UTILITIES (Plans) OK except k's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's onin _Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—Easements _ oil Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors 91'9e_w • Location—Test—Fall-C/0—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails ater; Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5 lectricity; Loc 'o Clearances—Grnd.—/1-'%Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures ; Locatio Wrap:/ /"L"ft./ P'Nat. "ft. "LPG 6. Carports; Windows—Doors _ 7. Utility Clearance 7. Elec. i Card-B1,e6j_/Date1 —�r�� Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOB]HOME INSTALLATION (Plans) OK except N's Card -BI Date Date Card -BI Date POOLS (Plans) OK except k's Z_gaiog Requirements—Setbacks—Easements 1. Setbacks—Easements Foo ' s; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability G H Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining Elect 'city; MH Test—Crossovers—Breakers—Clearances r'• 4, Elec.; Receptacles and Lighting; Distances—GFI rain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI mnt , Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed ater and Sewer Connected—C/0 to Grade—HD Approval 7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater as and Electricity Tagged B. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9 Exits; Insp.—Sketch 0. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date 1 i Card -BI Date Card -BI Date Card -BI Date Card B -IW, Date .Z f Card -BI Date Card -BI Date Card -BI Date V = OK O = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) � , Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg: Depth 51. Plywood on Roof Overhang -Attic -Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 8. D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Date Card -BI Date ELECTRICAL Permit OK except q's 66. Elec. Outlets& Receptacles at Kit. Counter 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. 23. Size Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G'.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic E) Yes 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. Guard Rails & Deck Construction -Post Caps _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral ❑Yes ❑No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes 0 N 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B-1 Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except H's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _ 31. 32. 33. A.C. Ducts; Insulation & Support Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 85. Water & Sewer Connected -C/O to Grade -HD Approval 86, Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING Plans OK except q's Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub _ 41. 42. 43. 44. 45. Header & Beam -_Size_& Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties -Purl in -Roof Brac.-Truss-Shthnq.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles _ 46. 47, Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS 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. r,+ i,C_ Inspector �� ✓� Date 112 -:� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70 7 County Center Drive, Oroville — Phone 534-4541 Skyway and Elliott Road, Paradise — Phone 877-3435 CORRECTION NOTICE - BUILDING OR PROPERTY ADDRESS 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. r Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70 7 County Center Drive, Oroville — Phone 534-4541 Skyway and Elliott Road, Paradise — Phone 877-3435 CORRECTION NOTICE L 7 r�i 7 -r-Ab f tyk— -1WAos- I A n4- -BUILDING OR PROPERTY ADDRESS 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. Inspector• W— �%�' Date ' BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville., CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Instal-ler's name: 4' Z 0M e 3. Is the site currently under permit? YesLk_No (If yes, furnish permit number ) OR F 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 7. What is the mobilehome site circuit breaker rating? ------------- 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- (I£ yes, identify the load and size: s (Load 9. What is the mobilehome site'gas pipe size? ----------- 10. ------ . -- 10. What is the type of gas service? ------------------ -- -- Na 11. -What is the gas pipe length from meter or tank to the mobilehome. 12. What is the mobilehome gas demand? ------------------------------ 100 Amps Yes No 24 (Amps) 3111 (in.) Nat / / LPG C90 (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) t clear of.all setbacks and easements? Yes c,7 No (If no, clarify ) ( ) 5.. What is the mobilehome electrical rating? ----------------------- �O b Amps 6. What is the mobilehome site service rating? --------------------- -% 20 O Amps 7. What is the mobilehome site circuit breaker rating? ------------- 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- (I£ yes, identify the load and size: s (Load 9. What is the mobilehome site'gas pipe size? ----------- 10. ------ . -- 10. What is the type of gas service? ------------------ -- -- Na 11. -What is the gas pipe length from meter or tank to the mobilehome. 12. What is the mobilehome gas demand? ------------------------------ 100 Amps Yes No 24 (Amps) 3111 (in.) Nat / / LPG C90 (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) t *If center piers are other than drawn above, draw in -locations, spacing,. and dimensions. BUTTE COUNTY BUILDING DEPARTMENT APPROVED 2/ 2 MOBILEHOME SUPPORT DATA If' other than single wide,' Mobilehome Mfr. Merry 111yN) -e._ TN c_ furnish Setup Model No42:yy60 ?9-e A4-C/k Year e1 Flo Width— 2 Y _(ft:) Box Length'-&O' O ((ft.) Tagalong or Expando Size 1V610 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. Footings (check one) Single Lam' l• Wood either pressure treated or / 2 � foundation grade. (ft.)(in:) x. (in.) (in.) 2. Other: (specify) Center support locations* Center support footing sizesSu ort (check one) (in.) 1: Concrete block. 3 y �' y x 3 O -2i Other. (specify) (ft.)(in.) (in.) (in.) �r E---Tagalong or Expando,' 25-X So show support details. 1,261 (in.) (in.) yY"Xso x -- Typical Support (in. (in.) Footing Size /2X30, @ 6 "ASC _ (ft.)(in.) (in.) (in.) Max. Pier Spacing Max. Overhang (in.) (in.) (in.) *If center piers are other than drawn above, draw in -locations, spacing,. and dimensions. BUTTE COUNTY BUILDING DEPARTMENT APPROVED 2/ 2 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042673 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/10/2004 APN: 062-700-019-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 15 PINE TREE LN BCK Date: Contractor. Map Index: Description: UP GRADE ELECTRICAL DUE TO HAZARDS OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the PER INSP. Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: BLACKWELL MARY E signed statement that he or she is licensed pursuant to the provisions of 15 PINE TREE LN the Contractor's State License Law (Chapter 9 commencing with Section BERRY CREEK, CA 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 95916 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: BLACKWELL MARY E pp owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: License #: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Architect: ❑ I have and will maintain workers' compensation insurance, as Engineer; 9 required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy #: 1 certify that in the performance of the work for which this permit is Valuation: $0.00 Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the wplicable provisions of the Butte County Coda ?nNor I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions do work indicated ab e Or which fees have been paid. Name: By: /� Date: ZZ PERMIT EXPIRES ON: ./ CJ Address: Da te ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butttee• County to enter upon the above mentioned property for inspection purp s. Print Name: Y G `i>t G/( �ii%E/—� Signature: Date:��10 Owner 0 Contractor ❑ Agent for Owner 13 Agent for Contractor BUTTE COUNTY DEPARTMENT OF.DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 'OFFICE #: (530)'53$=7541: A FEE WLLL BE REO UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" APPLICANT NAME OWNER Last Name Jim -el {{n�� irst Name Address / S I r C h• Ci f State State Phone Ph�Fax Fax E-mail E-mail Lic. # APPLICANT NAME CONTRACTOR Name City Address Zap City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zap City Fax State Zip Phone Map Book Fax E-mail Planner State license Number APPLICANT NAME Name Address City State Zap Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. 0jq_ a(a'�3 BP BIN # LOCATION AP# - G l Property Address City rn� r e t'_ r Cross Street WORKER'S COMPENSATION Policy Number Carrier /f hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address I Description or Scope of Work: Sq.' Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will. be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. I I Received by -7F Amount m) C?• to Bldg I I c/ SRA Receipt #: �, �I D Sheriff � Of � I Q SMIP OVER FOR SUBMITTAL REQUIREMENTS 11 KAFORIAMBUILDING FORMS1BldgAPDISubRgmts.doc Page 1 of 2 Other Date: 14 / �j • '?K Total REV 7-27-04 SUBMITTAL & PERMIT REQUIREMENTS 10 The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND /N INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Ketunds can oniy be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\BIdgApp1SubRgmts.d6c Page 2 of 2 REV 7-27-04 O.B.-1 OWMR-]BUILDER VERIFICATION Attention Property Owner. An "owner build' 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 -anad 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: YESX NO ❑ 2. I HAVE HAVE NOT ❑ signed an application for a building permit for the proposed wo& 3. I have contracted with the following person (firm) in provide the proposed construction: NAA'M - ADDRESS: CITY.. PRONE: CONTRACTOR'S 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 NAAX: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. r yes e- e, wee_ �e 1� e e e• e• eos en e o &' work indicated -- NAME ADDRESS PROM, TYPE 1 • SIGNED: PROPERTYOWNER: SOCIAL SFkTRI'TYNT31!'BER: DATE: — /O O NOT' This Owner-B;dUer Verffmdon is required by Section 19831 and 19832 of the Calif brnia Heafth and ,safety. Code. This verification must be completed and returned to our off 'we before we are permitted to issue the vermit OWNER BUILDER INFORMATIrON Dear Prop6rty owner. An %� a g Pem has been submitted in yoga name Hsfmg YoumIf as the builder of property For yourpro eetion, You should be aware that as `0w=4m7dei" You are the rMpMSIm party ofrecord on such a Penal Building Pette are not requfied to Se signed by property owners unless are own work. If your work is being p by someone other than P�o�Y Perfomimg thea Iiabiihy if that person applies for the Y�sel you may P Yourself from possible CmftwProper penult in his or her name. licensees are required by law to be licensed and bonded by the State of California and to have a business apPIY• from the city or ' They are also required by law to put their license nnm er on all permits for which they Ifyoube aware of the fop Il to do your own work WA the mon of Various trades that You plan to �g mforaiation for your benefit and protection; Yon shouild + Myon employ or others M MWV any Pelsoas other than yolr immecrafe family, and the work imciuding mater als and other costs) is $"300 or more for the entire prof and such pennons are not licensed as contractors or subco1-actors, then yon may be an employer. ♦ If you are an employer, you mustre&terwig. the State and Fedaaal Goveaments as as I subf e# to several obligations inclndmg sib and federal _ �P oyer and yoga are worb�s compensation , ��Y ice costs, and taR ovilhhoIdm� �deaal social secvuty tom, + There may be f>aaacial ris.t you if you do not compeasaiioa cans, with to worhes �Y out these obligations, and these rift are Mpecially sextons �P� cempensalion insurance, ♦ Formore specific mfg u 6011your obligations under Federal Law ifyou wish, the U.S. Small Business - • the mal Revue Service (anti, State Law. the D � For more %)=Mr m£oxmation about your obligations under ePaziment ofBeaefii Payer and the Division of industrial Accidents. If the structare is int ded for sate, property owners who are not licensed contzactore are allowed to perform thea work odit cuL natty their own �Pm3` , whhout a licensed factor or subs, only under Iimited A frequent practice of mmlicensed p== pre g to be yrs is to secure as p� erroneously impiyh2g that the _owner buiu7d�' b PreP�Y ow= is providing his or her own labor andy. mIdmg mIdmg PestsLi are non about hcm be owners valets they are p d �Y o by g �e Contractors Stale cense Board in your community or at 1020 N Strom Sam GA. 95814. Please complete the "Owaar Builder Vedficalion" on the reverse side of flits fora so that we can confrm that you are aware of these martens, The bmlftg p� WM not be issued mo the Vedf� is ret®ed. �T T&it Orvaer-Sur7derlr ar oa is required by Secdan 'P830 ofBre Cafe M7d4 Hed& and SVr jV Code AMIT rrlv% =" PERMIT NO. 6059+-80B,E PERMIT EXPIRES OWNER Layton Ford CONTR. owner ASSESSOR PARCEL 62-50-145 LOCATION S/S Bald Rock Rd., @ inters.of Pine Tree Lane, Berry Creek Temp. Power Pole_ Called PG&E Temp. Elec. Service Called PG&E_ Temp. Gas Service _ Cal led PG& j JOB PINALE[ Signature J = OK 0 = Not OK - = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS s' Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch _ 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; LocatiorrTest-Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1, Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater B. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date V = OK 0 Not OK - Not Applicable RESIDENTIAL Sin le and Duplex) aiF = Not Ready � 9 p I Date UNDE OOR Plans OK except #'s Date FRAMING (Continued) oning requirements -Setbacks -Easements 48. Property Line Firewall & Openings =-2-ftg.,. Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits g., Garage; Soils -Steel- // " Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers r.--3temwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer emwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7 Pi=rs-Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test _4_-Gaws Pipe; Size -Anchors 55. Shear Walls; Nailing -Bolts IQ --Meter Pipe; Test -Anchors -Regulator -Service Test __JJ Electric; Underground _19,-411enums & Ducts; Clearance -Material -Support -Ins. -i�rs-Sills-Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI. Date Card -BI Date Card -BI 11.4 Card -BI Date D � `%" Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meeh. Protection Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's _ 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic EJ Yes Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen &Conductor Size _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral []Yes ❑No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78, Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except N's 83. 84. Corrections from Previous Inspections Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval _ 32. Vent Fan; Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates _ 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties- Purlin - Roof Brac.-Truss-Shlhng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles T _ 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) +' COUNTY OF BUTTE �y =r DEPARTMENT OF PUBLIC WORKS r t" ia6 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville— Phone: 534-954a1s Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS 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. i r t Inspector 4Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PIT NO.�, 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT I1 ASSESSOR PARCEL NUMaER II ��/--%///''--`� ZO ING BUILDING PE 0 EX banp E6SO. V TELEPHONE FT. OCC. BUILDING VALUATION r3Z en OWNER'S AI I G AD RESS CONTRACTOR'S NA E L PHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER At UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee . $ �Q ARCHITECT OR ENGINEER LICENSE No. _Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDINGADDR, " S S PLUMBING PERMIT Filing Fee 10.00 _ h Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCLL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRU.1 URE SF ❑ Duplex ❑ Mobilehome❑ OtheYrI 10 � a4 G SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Addition El Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work:, Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2:50 NEW CONST. DWELLIN •SI� OR ADDNS. ACC. BLDG 20 sq It 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 m license is in full force and effect. Y 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 CONSTR I-Ou LET 2,50 ea NO N.RESID BRANCH CIRCUITS) NEW CONSTR / POWER APPARATUS 8� NON-RESID. `SINGLE OUTLET CIR. W02S¢ Ex. Occup OUTLETS OR FIXTURES BAL@1 Ex. Occup, UTLETS P(RESID.IR EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): , ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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. IVI 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. 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. 1 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 agains said f! nse ce of the Ing of this permit. Q X Date `D Signature Applicant — Owner Contractor❑ Agent ❑ An OSHA ermit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP �_� TYPE of CONST. -j/ - PARCEL PD N ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which • DIRECT" OF PUBLIC BY PE#T XPtRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 6-✓ Receipt No. 47M WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT fAppy f,;�AcKw6:.L�- lS Piwr- `KEE. IANf 6EE , v C12c Er- CA `I591C oc-)�- 160 0I9 S cAkE = I : 10 G kS Q . I = 3'1t1-3 S blo ovC Yeo 1165 d7 ��133VD /.�y►�� ;ndt -33V-1 INIJ Sl -1-1jr�W� WWI 4 1 -4 0 IN to V,•LACK vr-LL lS T'KEE LANE f3ft,e% CREEK] CA `S91C ol°I S cAk I �� 0 c 0 ••�, c, 4oKc }` �a, ��• ,i Qom cl Voy 7- w T J QT_ ELECTRICAL, <_ ( NOT PLAN -CHECKED) SHALL COMPLY WITH CURRENT EDITION -OF NEC, UMC AND Un. 0 40 Irl r ai 4r cl Voy 7- w NOTE: See the aftached lz ��ntial Go. r on Pages 16 il - 2 VZ 9 mc-, BUTTE COUN'ry AUILDING DEPARTMIF_y= P-P R 0 V F T J ELECTRICAL, MECHANICAL, AND PLUM NG CONSTRUCTION ( NOT PLAN -CHECKED) SHALL COMPLY WITH CURRENT EDITION -OF NEC, UMC AND Un. NOTE: See the aftached lz ��ntial Go. r on Pages 16 il - 2 VZ 9 mc-, BUTTE COUN'ry AUILDING DEPARTMIF_y= P-P R 0 V F