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063-040-038
63-04-38 Ear: Osborne 0704-38 W/S Dbbe Mill Rd, app. 900' S of Schott Ra Permit#55-83A( 'cul'tural bldg Inters'Norest Ranch I peerrm^t for storage/feed) t Permit # 13:29-82P,E(uti1,MH Electric-(o-101,$2., . 20d/� ___10�A _. Gas% ' 10 -82 '24 _ 3/.r�,� L.n� -Support structure'*re Compaction test re ---------------- �I �63-0��3'�8 Permit # f6I -82MHI I s sued 063-040-038 OS-1109_ l . BOHN, MARK & LIZ ` 13061 DOE MILL RD, FOREST RANCH Cont: OWNER: NEW SINGLE FAMILY, •063-040=038 05-1110 BOHN, MARK & LIZ 13061 DOE MILL RD, FOREST RANCH Cont: STANSELL, LINDSEY I ' r - N rAd c� M O ct J 3 RESIDENTIAL P®¢gamES ri r PERMIT NO. OG3-040-033 __ �' ---, BONN. MARK & LIZ - -'US-1109 ' 13061 DOE MILL RD, FO}U3ST RANCH j Cont: OWNER �1CH NEW SINGLE FAMILY y 10, 441 a Ns p �a 7® 'S 2 4-<> Sc.4.o tf z . � nl k 1 II SPECIAL CONDITIONS CHECKED BY FLOOD CERTIFICATE REQ. _ FIRE SPRINKLERS REQ. — SPECIAL INSPECTION ITEMS —VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER OFFICE COPY Address GAS Rs Meter By— Date I Z- ELECTRIC Meter By Date •� j { JOB FINALED (Date �4 im - - y Signature J=OK 0 = Not OK o = NotReadyabte MOBILE NOES 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;-/ /" L'ft. / P Nat. or/ /" L "ftJ P. LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 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. r 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date . Card 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 Line 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. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 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 f - 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 RESIDENTIAL (Single & Duplex) . = Not Ready Date UNDERPL 01513 (Plans) OK except #'s e! Ftg., Main; Soils-Elec. Grnd.-/(Y/" Ftg. Depth 3. Ftg„-Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth tg,,.Porches & Decks; Soils -Steel -//r Ftg. Depth .5,-Srtemwalls, Main; Steel-Blockouts cooed Downs and Special Anchors CW' 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 W;,,-AQB-1 Date Card B - Date 67',Card B-1 r Date Card B - Date PLUMBING (Permit) OK except #'s 1� . Vater Htr.; Vent -Access -Combustion Air Baffle 1,e ter Pipe; Test & Anchor -Nail Protection D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor --Tub Access 21. TW Tub & Shower Second Floor -Tub Access Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test 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 fec.Receptacles Spacing -Lights & Switches at Doors 219o.' Size Boxes & No. of Conductors Stapled 2Y" Romex Installed Close to Edge of Studs & C.J. quip. Ground made up w/Mech Fasteners -Bond Gas & Water . 2 Appliance Circuits in Kitchen & Conductor Size GFI �bfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI V/Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect . Equip. Clearances Panels-Motors-Mech. Equip. 3�1 C es Closet Light -Shower Light -Spa Light eola-grSmoke Detector Date Card B-1 Date 'Card B-1 Date Card B-1 Date Card B-1 Date MEC NICAL (Permit) OK except #'s . Ducts Insulation & Support 3 . Vent Fan, Exhaust above insulation 33 -"condensate Drain & Overflow, Size & Grade . F ce-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 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 4 Proper Materials & Anchors Vjalls Studs -Nailing Spacing & Braces -Plates -Sound Bearing Walls over Girders & Floor Nailing graft Stop in Walls (rat proof) 4KF e Stops, Furred Ceilings -Stairs -Chasers -Tubs 4 Headers & Beams -Size & Bearing Date FR4MING (Continued) V. ytangers-Post Caps -Anchors -Connectors 48� C'ng. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. F eplace Ties or Type A Flue -Fireplace Throat Clearance c Access; Size & Romex Protection -Draft Stop -Ins. Baffles SJ/Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings L4ej"xt. Doors -One 3' -Check Garage 3rd Story, 2 Exits 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 ing Area -Glass Protection -Skylights -Plastic ( Shear Walls: Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiftration-Walls-Windows Date [2-_ - Card B-1 Date Card B-1 Date 2 -$ss Card B;J, Date Card B-1 Date FIN tans) OK- x ept #'s Steps -Door & Sidelight Protection -Landings �pnioke Detector _ 66. Furnace Vents -clearance -Comb, Air -Connector- arage; Above Floor-Ducts-Mech. Protection . mom Exiting G.F.I. & Bath Fixtures & Tub Access -Spa fJL,-c. Trim & Subpanel, Breaker Sizes & Labels 7e Oairs,& Rails 7 . F place or Stove, Clearance -Hearth 72o0o' W Outlets at Wood Panel, Int. & Ext. 7 ixt. & Appliance; Ground -Air -Gap -Cooking Clearance 7 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.El.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. F n. VBents & Crawl Hole Door Drainage & Wood -Earth learance Looked under Floor 0 Yes 83. Followinq InstldJDrive i!Ves D No/Walks O Yes O No/Planters D Yes 0 No 84. ST Amit Disconnect, Electrical -Plumbing move Roof, Plbg-Appliance-Fireplace-Ciearance to Openings 8T. Water Well, Disconnect, Electrical, Plumbing Ax or Elec. Trim, G.F.I. fjeceptacle-Underground Ventil tion Throughout House 9�zGJ3se-Protection 91� Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. ll1etr? Sewer Connected -C/O to Grade -HD Approval 940" En rgy Compliance Certificate -Other Certificates 96" -Address Posted 96. Fire Sprinkler Datet+s j .D&. j 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: 9, cf,Z>6 ^� - w Mark L. Bohn 13061 Doe Mill Rd. ' Forest Ranch CA, 95942 Home Ph, (530) 894-5604 Work Ph. (530) 345-6676 Cell (530) 828-6475 s Thursday, Larch 22, 2006 To: County of Butte -Department of Developmental services Building Division 7 County Center. Dr.' Oroviile CA,'95965 Re: , Letter of Intent ' The Bohn Residence 13061 Doe Mill Rd. Forest Ranch CA, 95942 APN: 063-040-038 . Fermis Number. 05-1109 To Whom It May Concern:. As, specked on the site plan of the approved drawings, a mobile home that is the original primary residence will be replaced by a new single family dwelling under. permit No. 05-1109, located at the above listed project address. We are currently residing in the mobile home and are ready for final inspection on the replacement home. As the owner of the property mentioned above, it is my intent to either remove the existing mobile home or convert this structure into storage following final inspection and when certification of occupancy has been granted. The task of removing or converting the mobile home'or will be completed prior to the date of expiration of my permit (08/02/2006), as I will need some additional time to complete this task given our current situation. I have discussed the situation in detail with the"building inspector and have prepared this letter at their request. if you have any further questions or comments please contact me at my office, Sincerely, Mark L. Bohn - Owner (530)345-6676 Signed ' ,Y Date N Q. BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH SEPTIC SYSTEM INSPECTION CERTIFICATE• , �� � ��' o 411 MAIN STREET - R O, BOX 5384 CHICO, CALIFORNIA 95927 7 COUNTY CENTER DRIVE TEL; (916) 891-2727 OROVILLE, CALIFORNIA 95965 FAX; (916) 895-6512 TEL: (916) 538-7281 The Sewage Disposal System was inspected at FAX: (916) 538-2140 FOR G'E'C /4 L SEPTIC TANK Size LEAcH .HING FIELD — Gallons. Length Materia! /feet Width No. of lines inches Rock Under Pipe The above dimensions meet the minimum requirements of Butte County Code, Chat orches Additional leaching area will be required if experience shows it to be necessary,per 19 Remarks Mar 23 06 12:54p Lavinia Divine 530-898-0586 p.2 To: Mark L. Bohn 13061 Doe Mill Rd. Forest Ranch CFS, 959442 Home Ph. (530) 894-5604 Work Ph. (530) 345-6676 Cell (530) 829--6475 Thursday, March 23, 2006 County of Butte -Department of Developmental services Building Division 7 County Center Dr. Oroville CA, 95965 Re: - Letter of Intent The Bohn Residence 13051 Doe Mill Rd. Forest Ranch CA, 95942 APN. 063-040-038 Permit Number. 05-1'09 To Whom It May Concern: As, specked on the site plan of the approved drawings, a mobile home that is the original primary residence will be replaced by a new single family dwelling under permit No. 05-1109, located at the above listed project address. We are currently residing in the mobile home and are ready for final inspection on the replacement home. As the owner of the property mentioned above, it is my intent to either remove the existing mobile home or convert this structure into storage following final inspection and when certification of occupancy has been granted. The task of removing or converting the mobile home or will be completed prior to the date of expiration of my permit (0810212006), as I will need some additional time to complete this task given our current situation. I have discussed the situation in detail with the building inspector and have prepared this letter at their request. If you have any further questions or comments please contact me at my office, Sincerely, Mark L. Bohn - Owner (530)345-6676 Signed Date a PLAN REVISION Owner's Name: nhn AP#: no) - Opt% "' V 2 r/ BP#: n5- I Q C Received By: T� ct, barn Date:J�= �?-n Time: 5AM j� 31 S —G�� Contact Person & Phone Number: apQ �) Y) '' wopk PURPOSE OF RE—SUBMITTAL OR REVISION ❑ Permit Application Data Sheet Item ❑ *Engineering _10/*Plan Revision ❑ *Requested by Building Inspector's Correction Notice — Inspector's Name: ❑ Requested by Plan's Examiner — Plan Examiner's Name: ❑ Other: . *If revising a plan which has already been issued, submit two (2) drawings reflecting the revision for plan review along with your approved plans. If engineering is involved in this revision, the engineer must put his requirements on these drawings and wet stamp and sign two sets of engineered drawings. Revised drawings must clearly show changes proposed and locations involved. s WHEN APPROVED, PROCESS AS FOLLOWS: ❑ Mail to Owner/Contractor at this address: ❑ Call and hold for pick-up. o Deliver with next inspection. Minimum revised plan check fee to be collected at time of submission of revision, plans examiner will determine if additional plan checking fees are needed: Minimum $54.99 Receipt #: �3�7 ❑' Fee not required for revisions requested by plans examiner prior to issuance of permit. ❑ Additional Fee Amount: Receipt #: Revised 2/04 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. BP051109 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 08/02/2005 APN: 063-040-038-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Site Address: 13061 DOE MILL RD FRN License Class : License Number: Map Index: Date: Contractor: Description: NSF (2166) COV (290) OWNER -BUILDER DECLARATION 1 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: Anrcity or county which requires a Owner: BOHN, MARK & LIZ permit to construct, alter, improve, demolish, or repair any structure, prior 13061 DOE MILL RD to its issuance, also requires the applicant for such permit to file a FOREST RANCH, CA signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 95942 7000) of Division 3 of the Business and Professions Code) or that he or (530)894-5604 (530)898-0586 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).): 4/ 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: BORN, MARK &LIZ intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an 13061 DOE MILL RD owner of property who builds or improves thereon, and who does FOREST RANCH, CA such work himself or herself or through his or her own employees, 95942 provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one (530)894-5604 (530)898-0586 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.). ❑ lam Exempt under Article 3 of the Business and ,rofessions Code Date: 6 Own r 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 workers' compensation, as provided for by Section 3700 of the Architect: CRETE, TIMOTHY J. Labor Code, for the performance of the work for which this permit Engineer: is issued. ❑ 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: Total Square Ft: 2456 S.F. Carrier: Valuation: $145,430.00 Policy#: Census Code: ❑ 1 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' 0 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: q34q I I 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_o_f 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 Resolutions to do work indicated a ove f r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) q _n , OS By: Date:[[)) Name: Q 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 any official form or document of Butte County. I hereby .authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: Gv✓ L �� I �n Signature: Date: Vwner 0 Contractor ❑ Agent for Owner 0 Agent for Contractor BT kz J1OUNTY 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 OFAPPLICA TION �� " Website: www.buttecounty.net/dds L) 1 V� **PLEASE PRINT CLEARLY** v OWNER Last Name D4yN First Na 7A �d Address QL6 I Dae P ; (` z a City fQ Ye F',k yic(,i State Ch Zip 9 5 q7 Phone 5 30 $9 y 56 Fax 0 s �� E-mail ARCHITECT/ENGINEER CONTRACTOR Name City D Address Zip 5 �jy City Fax... 8�8, 6�g State Zip Phone Subdivision Name Fax E-mail Page Lic. # Class ARCHITECT/ENGINEER Name m ell -ell ><L Address City D tater Zip 5 �jy Phone S30 y� 67� Fax... 8�8, 6�g E-mail C✓� Le //�'S y T Q' State License Number - Z to ,, APPLICANT NAME Name Gc-v 50 A Address PO � 63 City T ✓ C5 State I ZipyZ Phone L% IV -7S_ Fax E-mail 6 c -e, APPLICANT SIGNATURE X For office use only: NO Zoning tfjA lv 1 Flood Zone , SRA I v No Occ. Type Const. Subdivision Name Policy Number Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO AP#� 1� _ 65.• 11(A BP Ci y BIN # K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Paget of 2 Description or Scope of Work: CZ -I( a b Sq. Footag a/ 6 C ❑ 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. Receipt #: I jk3 Date: e-pa 0 S Amount: I ✓' Bldg r ' ► SRA Sheriff SMIP Other Total REV 2-24-05 LOCATION AP#� 1� _ oY�- 05 Property Address 1-3 0.61 Poe m , Ci y 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 K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Paget of 2 Description or Scope of Work: CZ -I( a b Sq. Footag a/ 6 C ❑ 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. Receipt #: I jk3 Date: e-pa 0 S Amount: I ✓' Bldg r ' ► SRA Sheriff SMIP Other Total 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 AIC 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\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 t Butte County Department of Development Services wTtF YVONNE CHRISTOPHER, DIRECTOR 1 0 I o0 7 County Center Drive o - o G Oroville, CA 95965 c�UN'�y O (530) 538.7601 Telephone_ (530) 538-7785 Facsimile TO: WILLDAN ; ' FROM: Scott Rutherford (530) 538-7160 srutherforcIEDbuttecountv.net LO^ SUBJECT: Plans Transmittal For Review Per Contract O 1114 DATE: 5/3/2005 Applicant: Bohn, Mark & Liz Permit No: 05-1109 Project Type: NSF/Cov 'APN: 063-040-038 100% 70% Plan Check Fees $ 1,193.83 $ 835.68 $ 1,193.83 $ 835.68 WILLDAN Fee $ 835.68 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other 6�-1/ol 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: ASSESSOR PARCEL NUMB R Proposed Building Use: s ` Permit Technician: Date: D S On Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in orde to apply. 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. 41, 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. j 6. Energy compliance design and supporting documentation in duplicate. 0 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 buildings ❑ 12. Hazardous Material Form 13. Acknowle ement o#�buildin permit app Si ation w�ut requirtid clearances. 14. Other y ` z �" �- T 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 ❑ 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 ............................................ ❑ 1 Erosion Control Plan Required........................................................................ l 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 Citof Biggs .............................. 23. California Department of Forestr an approval E paid. Sent by: &_ 4. Planning approval for (A) Use:(B)Parking: (C) Parcel Check:....i✓...f ❑ Contact Land Development about _ Improvements, _ Drainage ........................ tj26. 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 ( �it'Given to owner, _Mailed to owner) ..................... W,1�041ecorded etter of Signature authorlzatlon............................................................ 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 0�� i'� and hold for pickup. I have been informed of the above items a d- equirements for obtaining a building permit. �L �- . 2 L10O 0 z 8 S� 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: D F Yellow: Building Division E.H. U5E_0MY 'Piot Plan Attechad Float Plan Attachad�— ti .. Sent to S.D. ! TO. LnDgDepartment FROM: Environmental Health SUBJECT: Sanitation Clearance IRA&o /�/l.� On - a3-642-(9-16 Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwelling. Other 3 a Z2 WZ4(.- � E AO N 8/96 Specialist Date COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNERlJ� PROPROSED BUILDING USE -V 1. BUILDING PERMIT FEES --- Balance Due .................... $ --- FEMA Flood elevation review A.P. # DATE Y �� RECEIPT 1 # �V - Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES Cz (paid at School District Office) (form available after Plan Check) SFfEk1FF FEES (paid at Building Division) Rest dent X $360.00 =$ Units Commercial (sq. )..... X $0.03 = $ Sq. Ftg. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) RESIDENTIAL DEVELOPMENT IMPACT FEE COUNTY WIDE (per dwelling) $ dam r 14 CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per. dwelling) Zoning 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00�(Spaid at Building Division) �Je! \ 8. SMIP 13� q �� 9. OTHER 10. 11. OTHER DATE REC. 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 during the plan checking process. APPLICANT =� �i/�� �J DATE d , 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) 4 pi-,�•rn E;�; T f f !ice: r 1 a \� c0i/j��`� A�tic WOV�S ®epartrnent C o u n t J. Michael Crump, Director Public f B u t Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase Il Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement BLESS THAN 1 ACRE] a Project Description: S v r Project Location andlor Parcel Number: (o) rW �O� 063—Uy0 `a38' By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from :the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more -than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project. that disturbs one acre or more of land may result in revocation of grading and/or other permits or other ` sanctions provided by law. Signed: Title: Date: `% Z fl A,700 00 Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 ` 'Ione Le, "� 4 s re GJ l ri r� a Timothy 3. Crete, Architect 2540 suite 12, Esplanade License No. C24094 Chico CA, 95973 ....experience you can build on.... Ph. (530) 345-6676 Fax. (530) 898-0586 Architecture & Planning www.cretedesign.com _ Wednesday, April 27, 2005 To: County of Butte Building Division 7 County Center Dr. Oroville CA, 95965 Re: Truss Documentation Design Review The Bohn Residence APN 063-040-038 Permit No. 04-3520 To Whom It May Concern: We have reviewed the truss documentation, for the project listed above. The trusses conform to applicable design criteria. -0�'G N31- q�`Q.� Sc �V rel 0 W I LLDAN Serving Public Agencies July 21, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com r BUTTE COUNTY PLAN REVIEW REPORT Status: Approved Jurisdiction Job No: 05-1109 Assessor's Parcel No: 063-040-038 Description: Bohn-NSF/Cov Willdan Project No: 14353-1601-M Dear Mr. Rutherford: . F Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions rioted on the 2"d page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: * Plans: Two (2) copies, sheets 1 through 16 dated 4/26/05 revised date 6/19/05 by Timothy Crete, Architect, Crete Design ; # Structural Calculations: Two (2) revised copies dated 7/6/05 by Timothy Crete, Architect, Crete Design �k Truss Calculations: Two (2) revised copies dated 7/7/05 by Jarrod P. Holliday, P.E. * Energy Calculations: Two (2) copies dated 1/24/05 revised date 7/5/05 by Marty Runnells, Energy Calculation Services # Miscellaneous: Two (2) copies AOR's revised -truss review letter dated 7/8/05 by Timothy Crete, Architect The plans have been stamped with the Willdan approval stamp and dated. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. WILLDAN Serving Public Agencies APPLICABLE CODES Unless noted otherwise, all comments are based on requirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Cod'and abbreviated herein as CBC. • Part 6, known as the California Energy Code, and Energy Commission Standards, and abbreviated herein as CECS. CODE ANALYSIS Specific Type of Type of Stories_ 1g` Floor Sq 2 "d Floor Sq Total Sq Ft Use Occupancy Construction Ft Ft Dwelling R-3 V -N 2 1830 336 2166 Covered R-3 V -N Porches 1 290 0 290 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and/or notes as red -lined on the plans. SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection pursuant to CBC 1701. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals. Sincerely, Richard Essenwanger Plans Examiner II Ricardo Guzman, S.E. Structural Engineer Cc: Alice Mefford amefford@buttecounty.net Timothy Crete, Architect, 2540 #12 Esplanade, Chico, CA 95942, E-mail tim@cretedesign.com Mark Bohn, P.O. Box 763, Forest Ranch, CA 95942, Email: mbohn@sunset.net, Fax: 530-898-0586 Page 2 of 2 :Butte County 05-1109 Willdan 14353-1601.PCH V BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) r .� School DistrictC�, I Gn Building Department No. v �' A.PyNumberOlUJ"V`TQ"'t��p Jurisdiction City V County n - Property Owner Property Location Subdivision Residential Development E7:1 Q No of Living Mobile Home Units Installation F ,...�.. -w ».� � ..�1!�-.' : ;F-. �v `�,'. -kyr . •�:�. , +{.� w1- Commercial/Industrial 0 New Addition Lot No. ........................................................................................ I Sq. Footage 1 (p (0 Addition/ "Supplemental to (Group Conversion Permit # •6f n (N, .. foundation inspection) (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) District Identification No. 0A 603 5 �(A( School District certifies that �l 3 (Street (City) has complied with the requirements cif Resolution No. representing ^square feet School District Representative Paid by Check # Remarks: Sq. Footage (Including Exterior Roofed Areas) 1-7/Aar Date (Zip Code) AQg 'Q T by payment of $ ll 3131. So{ ULL MITIGATION $ D Date Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the fees In any court action. N, subsequent to the School District Representative signing this Butte County Schools Impact Fee CwtMcation Form, the School District is notified by the applicable Local Planning Agency that this project Is being reviewed under the Catifornla Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate Its Impact on On school district's schools. White (school district), Yellow (building department), Pink (applicant) feefonn.xls (3/05W= BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 LICENSED CONTRACTORS DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Dale: Contractor: 'OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' Slate 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 signed statement that he or she Is licensed pursuant to the provisions of the Contractor's Stale 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 penally 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' Slate License Law does not apply to an 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 roving 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' Slate 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' Slate License Law.). ❑ I am Exempt under Article 3 of the Bu Iness an Pe glons Code Dale: �� Owner: A� WORKERS' COMPENSATION DECLARATION I hereby affirm under penally 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 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: Carrier: Policy if: IN, 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' compensation provisidns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: U� Applicant: WARNING: Fallure 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 I hereby affirm that there Is a construction tending agency for the performance of the work for which this permit Is Issued (Sec 3097 Civ.) Name: PERMIT NO. BP051110 Issued Date: 04/28/2005 APN: 063-040-038-000 Site Address: 13061 DOE MILL RD FRN Map Index: Description: UPGRADE EX PANEL TO 200A Owner: BOHN, MARK & LIZ 1061 DOE MILL RD FOREST RANCH, CA 95942 (530)894-5604 (530)898-0586 Applicant: BOHN, MARK & LIZ 1061 DOE MILL RD FOREST RANCH, CA 95942 (530)894-5604 (530)898-0586 Contractor: LINDSEY STANSELL PO BOX 187 FOREST RANCH, CA 95942 530-864-7594 License #: 284616 Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: This permit Is I Resolutions to PERMIT EXPIRES Issued under the applicable provisions of the Butte County Code k indicated above for �yhich fees have been paid. /">.- "- - ; & Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19627.5 of California Health & Safely 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 slate 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 Butte County to enter upon the above mentioned property for inspection purposes. Print Name: O Signature: Date: G� / lB'- Owner � C3 Contractor ❑ Agent for Owner ❑ Agent for Contractor a C Rid1dinn Permit 01-16-04 nn 1 f. 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 OFAPPLICATION Website: www.buffecounty.net/dds *PLEASE PRINT CLEARLY** OWNER Last Name 0 First Nae Address Io I Dof- w (` F - A City 1 o ye s � �tok State rh Zip 9 5 q Z Phone 5 30 $9C/ 56 Fax sJ'3o $ 5S D 5 E-mail 66h 5L405ej• ref CONTRACTOR Name Address Ci Stat Zip "q�)- Phone ,I . Fax E-mail Lic.#� ClassC ARCHITECT/ENGINEER �� ✓� �� Name rx Addres City I.\ o t 1 Zipq1/ Z Phone 6 7 Fax 910 E( 61 9^,6 E -m i ,Sta i nse Number APPLICANT NAM Name 414,YL— Uo 17 Address 63 Cityir State Zip�� Phone 6 Y 7 �— Fax O S '?L E-mail -A 11 -1 APPLICANT SIGNATURE X �". For office use only: Zoning jj1N lv 1 Flood Zone , SRA I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT 65 ,Ilia -j B �_._� B,-... OVER FOR SUBMITTAL REQUIREMENTS L K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 I-- QP,Crlp On or Srnno_nf.lArn.b• ell Sq. Footag iu-1 ❑ Structure K-6 tumour vermits ❑ 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. Receipt(#n� Date: O Amount: 't' bldg JM Sheriff SMIP __',her r � Total REV 2-24-05 01 LOCATION AP# a � - � ��� O5 Property Address 0.61 Poe 2;'� %/ Ci �Vr1 Cross Street WORKER'S COMPENSATION Policy Number N 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 -d Address OVER FOR SUBMITTAL REQUIREMENTS L K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 I-- QP,Crlp On or Srnno_nf.lArn.b• ell Sq. Footag iu-1 ❑ Structure K-6 tumour vermits ❑ 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. Receipt(#n� Date: O Amount: 't' bldg JM Sheriff SMIP __',her r � Total REV 2-24-05 01 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 J� �t' AGRICULTURAL B& LDING EXEMPTION PERMIT PERMIT NO. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR 7—� O. ZONING 7M /D OWNER PHONE NO. OWNER'S ADDRESS /__�; Oa, / �)OE 7—_0 - LOCATION OF BUILDING USE OF BUILDING SIZE OF STRUCTURE X 7A = 9-R0 SO. FT. TYPE OF CONSTRUCTION: WOOD FRAME -9—' STEEL CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COVERING FLOOR TYPE i'1. S�c��� ,QD.C,t`--00"-//V C' G)Do� ESTIMATED COST OF CONSTRUCTION $ 250. ©O AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows://�� FRONT ST. f d✓o M L� SIDES REAR - AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building., AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building. will be usec conforms with the AG Building definition. If any change in use or contact the Department of Public Works and will obtain any necessE comply with the requirements in effect at that time and before o c Date '� Signature of O Permit Fee - $25.00 The above described AG as stated above and the proposed use ccupancy of the building is made, I will per, its, inspections, and approvals to Building is exempt from a building permit. Receipt No. bG>%DS Director of Public Works 9�By Date$�zS White - DPW, Yellow - Assessor, Pink - B. I., Goldenrod - Applicant Y COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT AR'FgCICdITION DATA SHEET Permit No. OWNER Proposed Building Use. Permit Fee Based Upon Building Inspector Complete Contract Price Other (Explain) A. P. No. 1-2-3 DPW Valuation Date A— ZZ/ �zz At time of permit applicatiVn, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . 2. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate. /triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . , . 9. Letter of signature authorization. 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. I 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . .. . . . . 16. Mobilehome Installation Data. . . . . . . . •. . Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector 18. Other Date) When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at�) office. Deliver w/inspector. Other - Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: . (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail By Plans checked by Date Plans approved by Date Other: Copy—DPW Date Other COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROV.JL�-5;:6ALIF. - 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 Lor 30- J Z' for the following location: `tSrWF 4:)A A* 0 241 sr1v 1-11r' S> Owner �'C• �' %�j�SDiaO��U� / Owner's Address /'n Mobilchome Mfg. T //l ate , Model ---'" Year qq,7 Insignia No. ;qt% 0 Serial No. 1-79 It is hereby certified for occupancy at the above described location and may be occupied. Director of,,Public.N�oorrkks Date 7- l - R2-- By THIS CERTIFICATE IS VOID WHEN MOBJLEHOMEAS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. f PERMIT NO. 1329-82P,E PERMIT EXPIRES OWNER Earl Osborne CONTR. Owner ASSESSOR PARCEL 63-04-38 LOCATION WAS Doe Mill Rd, app 900' S. of Schott Rd intersection, Forest Ranch r P "l Temp. Power Pole Called PG&E Timtf. Elec. Service r Called PG&E - V// fit. Gas Service Co"ed4XG&F- JOB FINALED//at -on `Signature i 4 R h V = OK 0 Not OK = Not Applicable MOBIL.EHOMES = Not Ready MISCELLANEOLS- Date MOBILE -UTILITIES (Plans) O xcept #'s Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except a's If"lo!'"ng Requirements-Setb s-Eas is 1. Zoning Requirements -Setbacks -Easements _"i Is; Siert-Sketch _ 2. Footings; Size-Depih-Spacing-Connectors _ 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails T ate ; Lo a ' -T as eeded (Sketch) 4• Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing lec ricity; LcezooF=CI (nces- -/A)00 Amp -2!!M@ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures Location -T -W ./ 7-C-mr—t•Nat. or "L"ft. "LPG 6. Carports; Windows -Doors P tility Clearance 7. Elec. Card -BI Date Z. Card -BI 40 Date Card -BI Date Card -BI Date Card -BI Date (Q-$2. Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's oning Requirements -S s -E rtts Date POOLS (Plans) OK except N's 1. Setbacks -Easements ootings; Size- tng-Merrpe 2. Soils; Compaction -Structure Stability as; MH Test-Demeffdd-YALve-'Con ec 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining ectricity; MH Test -C -Bre lggwees 4. Elec.; Receptacles and Lighting; Distances-GFI T rai H le ygbtor 5. Elec.; Pool Lighting; 15 volts-GFI 02frater; Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed L-W11'.111and Sewer Connected -C/0 de -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater •�Jcl� ascend Electricity Tagged 8. Elec.; Grounding; Equip.w/5'-Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit xilnsp.-Sketch 1t. of Occupancy ! 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test ' 4 Card B -I Date /J - Y Card -BI Date Card -BI Date Card -BI Date Card B -I Date% o e Card -BI Date Card -BI Date Card -BI Date ' �T� ��L 14 ��111Qql AJ /z,e6 �/ iso - e K w. • � -..... � # 7y` i u /797 'N 7�1 licable ' Nol Ready RESIDENTIAL'(Single and Duplex) 1W Date UNDERFLOOR Plans OK except N's _Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage73rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width-Headroom-Rise-Ru6-Landing-Fire Protection 114. Ftg., Porches & Decks; Soils -Steel-./ /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer -$ 6. Stemwalls; Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn.. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel - 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 54. Glazing Area -Glass Protection -Skylights -Plastic 55. Shear Walls; Nailing -Bolts 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 Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except H's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except N's 57. Smoke Detector . 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meeh. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. 18. Shower Pan; Test, First Floor -Tub Access Test Tub & Shower, 2nd Floor -Tub Access 60. G.F.I. & Bath Fixtures & 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 N's 67. Garage Fire Door; Swing -Landing -Closer 68. 69. A.C. Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mecfi. Protection 20. Fixture & Transformer Clearance -Ins. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. &Mech. Equip. Listed for Location 23. 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 ❑Yes73. 25. 2 Appliance Circuits in Kitchen &Conductor Size 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 EJ No 75. Following instld.: Drive El Yes E] No; Walks El 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. Corrections from Previous Inspections 84. 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 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. 38. 39. _Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing 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-Shthnq.-Ring. Fireplace Ties or Type A Flue -Fireplace Throat _ 45. Attic Access: Size & Rom_ex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgl. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) COUNTY OF BUTTE __ DEPARTMENT OF PUBLIC WORKS '1`96 f emorial Way, Chico — Phone: 891-2751 " 7 County Center Drive, Orovi Ile — 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. Inspecto//%jw r f r� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS + 1?>6=bit=fnorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and EIIioR Road, Paradise — Phone: 872-2961, Ext. 57 - CORRECTION NOTICE 1 / 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 �matt�er,,,r need additional explanation, please contact this office immediately.�ru 61 rl.F� i� ow £yf ;.cam �, e, r 7'f .4fi6� &v 7S r c t" /! Ser /..4/X -- C/) /'/DST ", � /OJ,/tel 4,,,, _i/ n/ Inspector Date ems— 1115 —,Fe/ COUNTY OF BUTTE r DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and EllioH Road, Paradise — Phone: 872-2961, Ext. 57 /� CORRECTION NOTICE 11>"em-- /mow /3z 5- s-.?- BUILDING -zBUILDING 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, pl as contact this office immediately. la Cis- / /1 rr sa/ ;P- zzl Dmf �� r e;,(,J d 9 /dfd/ /® /_ �/r-/c '0f dv &:-z ro„ r lz- ;;r' s/ b Gia of - ou J /J'( /c' co'/z f 6116 //� � U Inspector 1� Tom— Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center.Drive - Oroville, California 95965 - Telephone 916/53 541 % �Q "t APPLICATION AND PERMIT N u ' ASSCffR PARCEL NUMBER .�' :Opi'I G on I BUILDING PERM( OW -TELEPHONE rV e - SQ. FT. OCC. BUILDING VALUATION ER'S MAIG ADDRESS I- L( / / C N ACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER V UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 660 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS c Permit fee $ BUILDING DDRESS / 0 PLUMBING PERMIT Filing Fee 10.00 (` Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets . USEOFSRUCTURE EJ Duplex ❑ Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation P- Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service DOOV OR LESS 100 AMP OR LESS 5.00 r \-T/' Main service EA. ADD'L 100 AMP 2.50 OR ADDNSNEW T DWELLING ACC. BLDGS.CCUP Ol) 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 BuSlnesS 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 -OUTLET CIRCUITS)BRH 2.50 ea nNiEw CONST R /POWERCAPPARATUS NON -RES ID. (SINGLE OUTLET CIR. ) EX. OCCUROUTLETS OR FIXTURES_ BAL@ FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ 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 FiIingFee 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.. l also agree to save, indemnify and keep harmless the County of Butte against all liabil' ies, judgments, costs, and expenses which may in any way accrue againd County ' c nsequ ce otthe granting of this permit. ` / (i', %�1-1 Date Elf _ 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 ,ID7 OCCUP. GROUP I TYPE OF CONST. PARCEL PD I ND 19S This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC R F PUBLIC BY P T EXPIRES Date the applicable pro vi- . resolutions to do fees have been paid. WORKS Date Receipt No. IR C?7 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: f 0,,,a ,J'2ZL W��4� I— W,,4 /" Ze-, 3. Is the site currently under permit? Yes / / No / �lr (If yes, furnish permit number ) OR t Is the site an existing site? Yes / / No 7_17-K r (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 / 7K No (If no, clarify ) ( ) 5. What is the mobilehome electrical rating? ----------------------- Amps 6. What is the mobilehome site service rating? -------o Amps 7.. What is the mobilehome site circuit breaker -rating? ------------- Amps . r ` . 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- Yes L No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- in.) 10. What is the type of gas service? ----------------------------- Natural T-1 LPG 11. What is the gas pipe length from meter or tank to the mobilehome? ' (ft.). 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas . or less than 50 ft. on LPG.) MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. – urnish Setup Model No. Year %9 7� Width j (ft.) Box Length (ft.) Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. Single —F — x (ft.)(in:) (in.) (in.) Center support Center support locations* footing sizes (in.) I (ft.)(in.) (in.) (in.) Footings (check one) P11"i- Wood either pressure treated or foundation grade. 2. Other: (specify) Supports (check one) ff'1: Concrete block. -2: Other. (specify) *---Tagalong or Expando,' show support details. *If center piers are other than drawn above, draw in -locations, spacing, and dimensions. 13 -Zr. BUTTE COUN I 1 BUILDING DEPARTMEN' APPROVED (ft.)(in.) (in.) (in.) •�Y3a�� x -- Typical Support (in.) (in.) Footing Size (ft.)(in.) (in.) (in.) Max. Pier Spacing (ft.)(in.) Max. Overhang (ft.) (in.) (in.) (in.) (ft.)(in.) *If center piers are other than drawn above, draw in -locations, spacing, and dimensions. 13 -Zr. BUTTE COUN I 1 BUILDING DEPARTMEN' APPROVED COUN`T`Y OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - T.elephone 916/534-45 ///13 x 'z— CA 9 APPLICATION AND PERMIT v A Sr%bb $ES�iPlaR `tMR �Jf� ZONING UILDING PERMI �`ar S r k T y ELEPHON 2 -lo- lv SQ. FT. OCC. BUILDING VALUATION `EOR'; M;WG ADDRESS R�IM C14 (/off w CONTRACTOR'S IN AME TELEPHONE • CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Q Total Valuation $ Filing Fee $ 44.-99— LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ L0 b'6 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS l PLUMBING PERMIT Filing Fee 10.00 SJutb RJ -I Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping �rb� LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex FJ Mobi lehome E?r Other SPECIFY Building sewer /6.00 Lawn sprinkler system 5.00 TYPE OF WORK, -,� , New ❑ Addition ❑ Remodel ❑ P Utilities Installation ❑ Other ❑ Describe work: Permit Fee $ LlI Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR101 OR LESS5.00 Main service EA. AOD'L 100 AMP 2'.50 NEW CONST. DWELLING OR ACDNS. � ACC. BLDGS.CCUP.pI) 20sgft 1l CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Businessso and Professions Code and my license is in full force and effect. License No. Classification [r I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NON.RESiD R. BRANCH CIRCTITS 12.50 ea NEW CONSTR. / POWER APPARATUS e1 NON.RESID. -SINGLE OUTLET CIR. / @ 25¢ Ex. Occup(OUTLETS OR FIXTURES BAL@1 IXED APPLNS. OR Ex. OCCup.�OUTLE TS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 21 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 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 ee to save, indemnify and keep harmless the County of Butte against all 'Ti -m ties, judgments, costs, and expenses which may in any way accrue ag t aid Cou in con en of the granting of this permit. Date 11141 E ignature of Applicant — Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures 3(sytorrii7es in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE OCCOP. GROUP TYPE OF CONST. PARCE PD ND ISSUE This permit is hereby issued,4nder sions of the B e County od and/or work indica d bove f ich DI ECHO F PUBLIC By PER T EXPIR the applicable provi- resolutions to do fees have been paid. WORKS �i Date a Z' over Receipt No. lD 6 7 % WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT INTER -DEPARTMENTAL MEMORANDUM TO: BUILDINGD IS ION O OVILLE w FROM: , ENVIR. HEALTH, CHICO DATE: d RELEASE ENV. HEALTH HOLY) ON BUILDING FINAL FOR: OWNER NAME: ��J�/ SEPTIC: AP#: O(0�- ��(� ( � ADDRESS/LOCATION: •13O(O/ L Comments: GL/memos/releasehold 342 _657 Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8.i of the Butte County Code requires this acknowledgement ,E L ��:T;_r•. be recorded prior to. issuance of a building permit. rD'DSr ,.. '! The property described herein is adjacent to land or included 1� 9.12 �' Q P P Y �, I � �•� within an area zoned for agricultural purposes, and residents of ELFARURM. tv this property may be subject to inconveniences or'discomfort arising CLERK -RE �`'KER from the use of agricultural chemicals, including, but not limited to herbiciN� ER pesticides, and fertilizers; and from the pursuit of agricultural operations includi.n E but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa- sionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. X11 that certain real proerty situate in the County of Butte, State )f California, described as follows: ChSouth 239 feet of the West half of the Northeast quarter of Section 3, Township 23 North, Range 3 East,M.D.B. & M. COGETHER WITH a non-exclusive easement to be used in common with others -or road purposes and public utility purposes over a strip of land 60 =eet in width, lying contiguous to and Northerly of the North line of the parcel of -land described hereinabove. k SO TOGETHER WITH a non-exclusive easement to be used in common with others Lcr road purposes and public utility purposes over the West 60 feet of the 3cuth half of the West half of the Northeast quarter of said Section 8. EXCEPTING THEREFROM that portion thereof lying within the bounds of the parcei of land first described hereinabove. Date • PA, PROP OW State of California ) On this the 26 day of May , 19 82 , ) SS. before me, the undersigned Notary Public, personally County of Santa Clara ) appeared known to me to be the person(s) whose name(s) subscribed to the within instrument and acknowledged OFFICIAL $EAL that executed the same for the purposes '-- therein contained. JULEE ANNE TONNA m y NOTARY PUBLIC - CALIFORNIA IN WITNESS WHEREOF, I hereunto set my hand and official SANTA CL COUNTY seal. W comm. expires AUG 2, 1985 Present A.P. NO. 3 O Notary Public This set of plans and specificatg kept on the job at all times and it is unlawful t - make any changes or alterations on me with- out written permission from the De artment o a' 05/- 38- Pu orks, County ofuButte.' rAA 0 E:—All Materials & Workmanship I all Be ccorOnce with Recognized Good Practices ar bf a, qullity prescribed for'the Specified use in tl• 1_1 rniform=Building,—Plumbing-& Mechani`a, od( Ip �; and the Niona Electrical Code. ,Der A41V �t� property lines and a setb of- Oft. from the road centerline shall be clear of structures or equipment except for a 2 ft-eave overhang, ' �. WA APP Utility connections shall be within' �" ' • ' 4 ft. of the mobileh'orne, either, directly behind or within the ream 0 half of the roadside (left) Rohe mobilehornoe 4 er-m►_ 4Lbe required 'tow ALL 1 Itt�p�on nf`thoYrnc dle lea BUTTE COON I-1' SUILDING DEPARTM.EN APPROVED May 26, 1982 To Whom It May Concern, (,.Earl Osborne authorize David Bibeau to sign for my bu.ild.ing permits. Signed, Ea 1 Osb ne Y 1 l May 26, 1982 To Whom It May Concern, (,.Earl Osborne authorize David Bibeau to sign for my bu.ild.ing permits. Signed, Ea 1 Osb ne