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063-240-046
0 63-24- 3798-90P,E J \, ' THOMSEN, Lori �12604 Doe Mill Forest Ranch (utilities/MH) 46' 4 ELK oZ O_C100 - In (o GAS f. 3144 t COMPACTION• TEST ,'RE ' SUPPORT STRUCT,'REQ 3=24-46 Permit2023-91 .� (mh install ��a � �® C9 P't r Is) STDG ' ENiIAl. -24-46 3798-90P,F;_, 7 Z . THOMSEN, Loris / 12604 Doe Mill Rd, Forest Ranch s; (utilities/MH).,., a CN 141), 91 R 1B A .P cc, e, �abd� �� 3 s. n Paas +D� (J e-ae-k en7 per— Q�_p/1m. OFFICE COPY � r 1 nn 44 Address `r_\/I/�,An�D{^, ' ! .-v GAS B 7`% Meter y Date�-11 ELECTRIC Meter By U Date rz� t r ii, try C/ r JOB FINALED (Date) Signature `� J=OK O = Not OK !� =Not Readyable MO LE HOMES �11� Date MOBIL ME IES "Plans OK except #'s A oni equire ments-Setbacks- Ease me 2L.4o114'; Special MH Support Sketch 5. EI tricity; Loca4of�,-ear ces-Grfrd-gMmp-Concrete LoO 4o •7—J L, as; Location -T - p: W / /"L"ft. J d/ /,Aat. or/j.'2"L"ft./&'LPG WW"Lltilitv Clearance Date Lj Card B-1 ; Date Card B-1 Date / Cofd B-1 Date CardB-1 Date MOBJ11E HOME INSTALLATION (Plans) OK except #'s MISCELLANEOUS f-' �y c `r, Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1 P 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements ain• est -F, ( -Flex nector 2. Soils; Compaction -Structure Stability W er; MH Test -Regulator -Connector 3. Pool Structure; Steel -Connections -Thickness ater and Sewer Connected -C/O to Grade -HD Approval Dead Men -Lining as and Electricity Tagged 4. Elec.; Receptacles and Lighting, Distances-GFI 9. , Insp.-Sketch 5. Elec.; Pool Lighting; 15 volts-GFI : Cert. of Occupancy 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater '8. Elec.; Grounding; Equip. w/5' Circulating E uiP•-Pool L ht 9. Date '7, aj / Card B-1 g . � Date Card B-1 Boxes-Enclosures- Pane lboards-Ins. to Main in Conduit Date � '`%i Card B-1 V Date Card B-1 { 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Rte- tel, ala ' Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ti V d.; OK - O =Not OK z - = Not Applicable =Not Ready RESIDENTIAL (Single > 1 f & Duplex) _ Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continuedr 1. Zoning -Setbacks -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Fig., Main; Soils-Elec. Grnd.-/ /" Fig. Depth 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 3. Fig., Garage; Soils-Steel-Elec. Grnd.-/ /':Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth ; 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 49. Bdrm: Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped , 50. Garage Fire Protection Framing 6a. Hold Downs and Special Anchors 51. Property Line Firewall & Openings 7. Slab; Steel -Wrapped 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 8. Piers -Fireplace Ftg.-Steel 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. Gas Pipe; Size -Anchors 55. Siding -Nailing Veneer 11. Water Pipe; Test -Anchor -Regulator -Service Test ' _ _ 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric; Underground 57. Glazing Area -Glass Protection -Skylights -Plastic. 13. Pienums & Ducts; Clearance -Material -Support -Ins. 58. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 59. Insulation -Walls -Ceilings 15. Insulation 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Date Card B-1 Date Card B-1 16. Water Htr.; Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test &Anchor -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa Date Card B-1 Date Card B-1 66. Elec. Trim & Subpanel; Breaker Sizes & Labels Date Card B-1 Date Card B-1 67. Stairs & Rails Date ELECTRICAL (Permit) OK except #'s 68. Fireplace or Stove; Clearances -Hearth 22. Fixture & Transformer Clearance -Ins. Protection 69. Elec. Outlets at Wood Panel; Int. & Ext. 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 24. Size Boxes & No. of Conductors -Stapled 71. Elec. Outlets & Receptacles at Kit. Counter 25. Romex Installed Close to Edge of Studs & C.J. 72. Garage Fire Door; Swing -Landing -Closer 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 73. A.C. Duct in Garage -Damper 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 75. Plb., Elec. & Mech. Equip. Listed for Location 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 30. Service -Riser Conductors & Ground -Main Disconnect 78. Guard Rails & Deck Construction -Post Caps 31. Equip. Clearances Panels-Motors-Mech. Equip. 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No Date Card B-1 Date Card B-1 81. Stucco; Brown -Finish Date Card B-1 Date Card B-1 82. A.C. Unit; Disconnect, Electrical, Plumbing Date MECHANICAL (Permit) OK except #'s 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 34. A.C. Ducts Insulation &Support 84. Water Well; Disconnect, Electrical, Plumbing 35. Vent Fan; Exhaust above insulation 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 36. Condensate Drain & Overflow; Size & Grade 86. Ventilation Throughout House 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Glass Protection 38. Attic Access & Platform if Furnance in Attic 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card B-1 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Cqrd B-1 Date FRAMING (Plans) OK except #'s Date Card B-1 Date Card B-1 39. Sils, Proper Material & Anchors Date Card B-1 Date Card B-1 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Date Card B-1 Date Card B-1 41. Bearing Walls over Girders & Floor Nailing Comments at Final: 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing each time you visit job site) (NOTE: An entry must be made -` ` " 'COUNTY OF BUTTE, DEPARTMENT-W—PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 ' ar 7 County CentdDhve, Oroville — Phone: 538-7541 - 747 Elliott Road, •ParadIse — Phone: 872-6307 CORRECTION NOTICE PERMIT NC. OWER • r A routine inspection indicates that the following violations of County Ordinance exist attthe above address and should be corrected. Please notify this office when corrrection=ef.work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. a f0 AJ 4 1-11 13 AA v 1 ',v rc f l� ova v T +r12" u 0.nnf-.4a h0/L9,F 5u 02 a 4rf yr /2�� s COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS `? 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE 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 correc n of work is completed. If you have any question pertaining to this matter, need additional explanation, please contact this office immediately. izL'a� I �J Date tU 1 `—(1 Inspector 1W'w�� i Date tU 1 `—(1 Inspector 1W'w�� MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 , PERMIT N0. Address or location of mobilehome �^ `✓ Owner's name Owner's address Insignia or hud number�� Manufacturer's name Serial number of V.I.N.: :;' Year of manufacture (Official Approving Installation) (Date) 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. 5136 White - Owner, Yellow - Installer, Pink - D.P.W. Return to, DPW .i y AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT9 09 38 4 FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code OFFICIAL NOTARY SEAL reyuires.,u-th:is acknowledgement be recorded to me. C Proved to me on the Imsis of satisfactory ev:IcLc>nc:c . prior—to'-issuance of a building permit. KATHRYN A. LEE Notary Public -- C2lifarNa to be the personO whose name( )- 'I.'he property described herein is adjacent BUTTE COUNTY to Land or included within an area zoned ; 90-0493134 I Rec _ Fee 11.00.. for agri( a I.t..ur,91 purposes, and residents I Cash 11.00 'i of this prolu,rty mray he subject to ;incon- � Recorded I t; veiii-ences or d i.scomfort arising f rom the Official Records 1 t use of agr:ic:ult..ural chemicals, :including, County of but not l.im:iLed to herbicides, pesticides, Butte I and ferL.J lizers; and from the pursuit Candace J. Grubbs I ' c.>F: agI.-J.cu.l t.ural operations including, . Recorder I - but not. l.im:i.ted to cultivation, plowing, L9.35am 15 -Nov -90 ,I X 4 spraying, pruning, and harvesting which � occasionally generate dust, smoke, noise, and odor. Butte County, has esLabl.i.shed agri.c:.u.l- Lur.al zones which have as a priority use for productive agricultural purposes, aiid r.es.i.denl s within said zones and on adjacent property should be prepared .to accept such :inconvenvi.erice or discomfort from normal, necessary farm operations. All that r.ea'I property situate in the County oil Butte, State of California, ilc:,cri..bed as follows: Date: NJe-VA PROPERTY OWNERS: State of IF ) On this the aJ"1--� day of 1ioL)&-m,3,=+- 19 g0 , before me, SS. the undersigned Notary Public, personally appeared County of gu"-c ) o 12-(s A- ti t-)* 4-o M s F -b\) �* rc OFFICIAL NOTARY SEAL Personally known to me. C Proved to me on the Imsis of satisfactory ev:IcLc>nc:c . KATHRYN A. LEE Notary Public -- C2lifarNa to be the personO whose name( )- BUTTE COUNTY subscribed to the within instrument and acknowledged that Sf� ^ My Comm. Exp. OCT 21,9994 executed the same :for the purposes therein contained. '1N WfTNI?SS WHEREOF, I hereunto set my hand and official seal. PresenL A. P. No. !:" 3 —a4-46 12�011, 0 , 6;e No ary Publ-ic 9 31 Order No. 2-151286 SCHSDULE C The land referred to herein is described as follows: >i V A,3.1 that certain real property situate'in the County Of'Butte, State of California, described as follows: PARCEL I: Being a portion of the Southeast quarter of Section 17, Township 23 North, Range 3 East,.M.D.B. & M., more particularly described as follows: Parcel 2 as shown on that certain Parcel Map filed in the office of the Recorder of the County of Butte, State of California, on September 18, 1980, in Book 79 of Maps, at pages 3 and 4. RESERVING THEREFROM a nonexclusive easement.for ingress and egress and Public utilities as shown on the map referred to herein. ALSO RESERVING THEREFROM a non-exclusive easement for water -line', for ingress and egress and for maintenance purposes.over a strip of .land 20.00 feet in width, lying'10.00"feet on each side of the following described centerline: Running parallel to and 40.00 feet Easterly of the centerline of the road and utility easement of Lots 1, 2 and 3 as shown on Book 79 of Parcel Maps at pages 3 and 4. The strip of land in this easement lies between the East boundary of the aforementioned road easement and that line described as the building setback line of Lots -1,.2, and on the aforementioned Map. This easement benefits Lots 2, 3 and 4. AP No. 063-240-046 PARCEL II: A nonexclusive easement.over the following described property: Being portion of Sections 17 and 20 in Township 23 North, Range 3 East, M:D.B.'& M., and more particularly described as follows: A strip of land 60.00 feet in width, lying 30.00 feet on each side of the following described centerline: Commencing at the center of said Section 17, Township 23 North, Range 3 East, M.D.B. & M., as shown on that certain Parcel Map for Anthony Santos, on sheet 2 of 3 sheets, and recorded in the office of the Butte County Recorder in Book 63 of Maps, at pages 54, 55 and 56; thence from said point, along the East, West centerline of said Section 17, South 890 27' 12" East, 531.22 feet to the centerline of Doe Mill Road and the True Point of Beginning for the centerline herein described, said True Point of Beginning being an intersection with a 200.00 foot radius curve, concave to the East, the tangent of which, at this point, bears South 110 18' 58" East; thence from said True Point of�Beginning and along the centerline of (Continued) R 90-493$4 �O_�� Order No. 2-151286 3 said Doe Mill Road and the arc of said curve, through a central angle of 40 05' 01", an arc distance of 14.25 feet; thence South 15° 23' 59" East.-, 431.73 feet; thence along the arc of a 100.00 foot radius curve, concave to the Northwest, through a central angle of 43° 49' 59", an arc distance of 76.50 feet; thence South 280 26' 00" West, 149.55 feet; thence along the arc of a 100.00 foot radius curve, concave to the Southeast, through a central angle of 290 32' 10", an arc distance of 51.55 feet; thence South 1° 06' 10" East, 702.62 feet; thence along the arc of a 100.00 foot radius curve, concave to the Northwest, through a central angle of 680 48' 52", an arc distance of 120.10 feet; thence South 67, 42' 42" West, 54.06 feet; thence along the arc of a 100.00 foot radius curve, concave to the Southeast, through a central angle of 280 03' 30", an arc distance of 48.97 feet; thence South 390 39' 13" West, 89.80 feet; thence along the arc of a 150.00 foot radius curve, concave to the Northwest,.through a central angle of 20° 14' 28", an arc distance of 52.99 feet; thence South 590 53' 41" West, 204.93 feet; thence along the arc of a 150.00 foot radius curve, concave to the Southeast, through a central angle of 200 39' 51", an arc distance of 54.10 feet; thence South 390 13' 50" West, 322.90 feet; thence along the arc of a 150.00 foot radius curve, concave to the Southeast, through a central angle of 220 40' 46", an arc distance of -59.37 feet; thence South 16° 51' 20" .West, 407.10 feet; thence along the arc of a 150.00 foot radius curve, concave t6,7 the Northwest, through a central angle of 170 00' 04", an arc distance of 44.51 feet; thence South 340 26' 02" West, 103.83 feet to a point on the South line of said Section 17, which point bears South 89° 28' 04" West, 19.02 feet from the South quarter corner of said Section 17; thence continuing along the centerline of Doe Mill Road, South 340 26' 02" West, 132.78 feet; thence along the arc of a 150.00 foot radius curve, concave to the Southeast, through a central angle of 9° 31' 39", an arc distance of 24.94 feet; thence South 240 54' 23" West, 364.32 feet; thence along the arc of a 200.00 foot radius curve, concave to the Southeast, through a central angle of 120 15' 42", an arc distance of 42.80 feet; thence South 120 38' 41" West, 231.47 feet; thence along the arc of a 200.00 foot radius curve, concave to the Southeast, through a central angle of 180 05' 56", an arc distance of 63.18 feet; thence South 50 27' 15" East, 141.08 feet; thence along the arc of a 200.00 foot radius curve, concave to the Northwest, through a central angle of 25° 42' 55", an arc distance of 89.76 feet; thence South 200 15' 41" West, 288.54 feet; thence along the arc of a 200.00 foot radius curve, concave to the Southeast, through a central angle of 20° 46' 37", an arc distance of 72.52 feet; thence South 00 30' 56" East, 473.66 feet; thence along the arc of a 200.00 foot radius curve, concave to the Northeast, through a central angle of 210 06' 27", an arc distance of 73.68 feet; thence South 210 37' 23" East, 541.35 feet; thence along the.arc of a 199.95 foot radius curve, concave to the Northeast, through a central angle of 27° 34' 59", an arc distance of 96.26 feet; thence along the arc of a 305.70 foot radius curve, concave to the Southwest, through a central angle of 180 14' 31", an arc distance of 97.33 feet; thence South 30° 57' 50" East, 305.83 feet; thence along the arc of a 100.00 foot radius curve, (Continued) Order No. 2-151286 concaue•to the Southwest, through a central angle of 3° 16' 18", an arc.riistance of 5;71 feet to a point on,..the East and West centerline of&1Section 20, said point bears North 86° 54' 58" West, 23.03 feet from the center of Section 20,'Township 23 North, Range 3.East, M.D.B. & M. o .PARCEL III: A right of way for�road•and utility purposes over a strip of land 60 feet in width, the centerline of which is described as follows: Commencing at the center of said Section 17; thence North 89018123" East, along the East and West centerline of said Section 17, a distance of 510 feet to a point in the centerline of Doe Mill Road and the point of beginning for said centerline; thence North 26°11'10" East, along the centerline of said Doe Mill Road, 730.54 feet to the end of the County maintained road and the end of said centerline. PARCEL IV: A non-exclusive'easement for ingress and egress and for public utilities as shown on that certain Parcel Map filed in the office of... the Recorder of the County of Butte, State of California, on September 18, 1980, in Book 79 of Maps, at pages 3 and 4. PARCEL V: A non-exclusive easement for water line, for ingress and egress and for maintenance purposes over a strip of land 20.00 feet in width, lying 10.00 feet on each side of the following described centerline:'t . Running parallel to and 40.00 feet Easterly of the centerline of the road and utility easement of.Lots 1,.2 and.3 as shown on Book 79 of Parcel Maps at pages 3 and 4. The strip of land in this easement lies between the East boundary of the aforementioned road easement and that line described as the building setback line of Lots 1, 2, and on the aforementioned Map. This easement benefits Lots 2, 3 and 4. . END OF DOCUMENT END OF DOCU oe a U) ` wy O G C" co U IL _-1. Oa 5 G (D 0 d w .a n t COUNTY OF BUTTE -.DJA TMENT OF PUBLIC WORKS 7 County Center Drive - Or6ville,'California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT O. 7 37 ASSESSOR PARCEL NUMBER - 63-24-46 ZONING TM -10 BUILDING P R OWNER TELEPHONE Loris Thomsen 895-3288 OWNER'S MAILING ADDRESS P.O. Box 756, Forest Ranch 95942 SQ. FT. OCC. BUIL NG VALUATION CONTRACTOR'S NAME TELEPHONE Owner CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN LENDER'S MAILING ADDRESS Total Valuation Is Filing Fee Permit Fee $ ....-}9.99�. $ ARCHITECT OR ENGINEER LICENSE NO. ARCHITECT OR ENGINEER'S MAILING ADDRESS Pian Checking Fee Energy Plan Checking Fee Penalty $ $ $ BUILDING ADDRESS . Permit fee $ 15.00 PLUMBING PERMIT Filing Fee 10.00 4 Doe Mill Rd., Forest Ranch 95942 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. v� 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 Mob le Home S W X 10.00ea 30.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Z] Installation❑ Other ❑ Describe work: 60 X 12 _ Permit Fee $40.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 1 10.00 10,00 Main service EA. ADD'L 100 AMP 1 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions Of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License. No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.DWELLING OCCUP.& OR ACDNS. ( ACC. BLDGS. I �22sgft NEW CONSTR MULTI -OUTLET NON•R ESID BRANCH CRC" RC ITS 2,50 ea (POWER APPARATUS &\ (POWER OUTLET CIR. Ex. Occup( OR FIXTURES 20050C BAL93o FIXED APLNS, Ex. QCCup. OUTLETS P(RESID,)REA.) 1 2.00 Temporary service 1 10.00 Mobile Home Facilities 1 15.00 15.00 Misc. byirin 9 15.00 Permit Fee $37.50 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 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 X ai 1 a1 yin on equence of the granting of thi�e �// Date Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5't)" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ :)Cc CONST TYPE TOTAL AL FEE .50 FtgZ CLIA PARK FL PAR ' PD H ISS This permit is nereby issued under sions or the Butte County Code and/or work indicated abov for which fees DIRE C RPUBLIC By 'PERMIT EXPIRES ate it lul-ol the applicable provi- resolutions to do have been paid. WORKS �1 D to Receipt No. 84004 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTkNT OF PUBLIC WORKS 7 County Center Drive - Orovile, California 959§5 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARC NUMBER � v Z TN GnJ ^ BUILDING PERMIT OWNER •/ TELEPHONE SO. FT. OCC. BUILDING VALUATION OW R' LING ADDRESS ^ �,f,1// CONTRACT1PSS_�1-A_ME TELEPHONE CONNTRACCT0OR''SyMAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ r Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRE505 14 Z lI � CLQ ` L /�G� Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Z� Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 55,00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehom� Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S V [10-00ea. TYPE OF WORK New ❑ Addition ❑ Remodel❑ Utilitiert2�,, Installation❑ Other ❑ Describe work: yy Permit Fee $ Contractor Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS IOO.AMP OR LESS 10.00 D Main service EA. ADD'L 100 AMP 2;50 � CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification F -1I, 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.tk OR ADDNS. ( ACC. BLOGS. , /Zdsq ft NEW CONSTR.MULTI-OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea (POWER APPARATUS 6) l SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES e0050 eALG 30 FIXED EX. Occup. OUTLETS IPRESID IREA.) 2.00 Temporary service 10.00 Mobile Home. Facilities 15.00 , O Misc. byirin g 15.00 Permit Fee $ , WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 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 suchprovisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee] 10.00 Heating Cooling g Hood 3,00 �- ntilation [PermitFee $ ntractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ ,sZ% HAZ I CUA I PARK I SCHL I FLD 1 PAR I PD HDI ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WNITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE -.Department of Public Works T_County Center Drive, Oroville, CA 95965 OWNER -BUILDER VERIFICATION Attention -Property Owner: .. I Phone: 916-538-7541 f 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 beissued until this verification is received. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not.) Q,ItiQ signed an application for a building,permit for the proposed work. 3. I have contracted with the following person (firm)' to provide the proposed construction: Name Address City Phone Contractors License No. 4. `I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Addres7si,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 A igned : � , Property Ouwneryy Social Sec aU"ti�i� �e Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. M __j _anis s*t -0 plans and 's specifications MUSI .Opt on 's and IT 15 U le 10 T m - a Tv -nake any chbnqes ow dA, ra.-Hors on some withow — W0406 _00urft 01, &ftO, A cPtharlr nJ'f*ft: 'fr6R the -- -.7 "Property -fines --and a -setb6clk' for a 2 ft. eave overhanq. + 1>1 1 rmff wfil BUTTE -C NOTE:—All Materials & Workmanship S# all Be in with -Recognized.. o-d-..-Pra, ice G_Q ct a -an -d of a quality prescribed for the Specified use in the Uni for-m--Bui-lding; -Plumbing & Mechanical-C-edes- and the National Electrical Code. Comment �:-.-rv.':..y R�%..i:.;.r=�►'.�?'�,,;,;,,�"�c�'71�%i:+f:.f'.vo6""`...^(*yiV.7�2�'^��i%"'�.f�'�i�''"7'`^.;��.y;=.�r�,,.H _ COUNTY OF BUTTE - DEPARTAIleflT ZP1 1PUBLIC WORKS)- BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 T PERMIT A+PPLICIATION DATA SHEET �A _Permit No. Proposed Building Use Building i Inspector At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... , . Plot plans in duplicate/triplicate, signed by preparer of plans;f,....... //- t �. U3. Complete plans in duplicate/triplicate, signed by preparer of'plans .. 4. Complete engineered plans and calcs, with wet signature on'plans .. 5. Hazardous Material Form .......................... ! ......... 6. Energy Design Compliance and supporting documentation ... i.li.. 7. Statement of Intent for Non -Heated and AC Buildings ........ .... . 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions........................................................ 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13- School District fees paid .............. Ti- Sanitation approval from -g: A! C-42 Health Department 1 City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... Improvements may be required. Contact Land Development Section DPW 9. Driveway permit (construction approval required prior to occupancy)—//��T`�6 0. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. ReOwner-Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Z24 corded copy of Agricultural Acknowledgment Statement ......... //-- /97- 9'6 C _ �5. Letter of signature authorization 6, coP _ �� i S -`Po 27. =Telephone u issue the permit, process as follows: Mail to owner. Mail to contractor. and hold for pickup at office. Deliver w/inspector. r, Other A p p I i c a n Date 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. 2. Additional items required: A Ir vv -,Contractor, designer, owner, was advised of a9ve required data by? phone -2 --mai I _coun*r!by .date Contractor, designer, owner, was advised of above required data _phone_mail_coun er by date P hecked by Date P ns approved by Date )t '?I;/) Sets of plans on hold in . File cabinet AP folder Copy—DPW �`J// Y /,� T J/SfL� s •. rr TO Buildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance _ _Tk 3 - L y y 6 Owner Location AP# Plan Approved for: Sewage Disposal '� Slater •Supply, Hold final for: Slater Supply 7inal clearance O.R. for: Water Supply Clearance .fors Z-- bedroom mobile home. Other NOTE 5o • , . -'-_L�'.�1�.—' _ ... � Sanitarian Date ter. . TO: Building Department FROM: Encroachment Permit Section RE: Driveway Clearance d sikhature owner location AP # has been issued for the above property. CID date AII Materials & Workmanship Shall Be in 1-- ZUTE-_Accordance with Recognized Good Practices and of a quality prescribed for the Specified use in the Uniform Building, Plumbing & Mechanical Codes and 4,, — S — the National. Electrical Code. v a , This set of plans and specifications MUST be ' kept on the job at all times and_it.is unlawful to ; make any changes or alterations_on_sarrie without- _—._ written permission from the Department of Public Works, County of butte. i . , • � pule �$ - y A setback of ft. Brom the property -lines and a setback.'. of 50 It-. from the road centerline sliall be clear of �� #°f6.7 °f6 .7_? q1 structures or equipment except BUTTE COUNTY fora 2 ft. eave overhand. BUILDING -DE'PART'MENT a�11 � AR R.-0V,E -21- - / +' -BUTTE `COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 1-' PHONE: 538-7541 MOBILEHOME'•INSTALLATION SHEET 1. Owner -sName': 2. Installer's Name:l� 3. is the site currently under permit? Yes. No (If yes, furnish permit number 9 ) OR Is the site an 'existing site? Yes No (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 �1A i No (If no, clarify 5. What is the,mobilehome electrical ratin ? -----� -� - Y g .. Amps b. What,is the mobilehome site -service rating. --- ' '; Amps 7. 'What isthe mobilehome site circuit breaker rating? ----- ��� Amps`. .8. Is there any other electric load to be served by the mobilehome site service?--------------------------=------ Yes No. (If yes, identify. -the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe -size? ---=------- '(in. type ? -------------- 10. What „is the t e of gas service. ---- Natural ', LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- 1`<,� (ft.) ,r 12. What -is the mobilehome gas demand? ------------------- -- 1 (BTU) . *(This information not required, if pipe length less, than 6 ft. on 1 " natural gas or less than 50 ft. on..LPG. ) z . 'BUTTE COUNTY ®' - MOBILEMG M SUPPORT DATA S QJ�� - S 2 h -'"if-other than single wide,. '4obilehome Mfr.��G'' 1u�a furnish Setup Model No. Year 1 Width �t _(ft') Box Length _(ft.) Tagalong or E:cpando Size ! n ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's';installation manual and structural setup.sheets•(if no,t on file with the County of Butte)'. FOOTINGS (check one) 7 1.' Wood -pressure treated or foundation grade.) I2. Other (specify) SUPPORTS (check one)'K 1. Concrete block.a 2. Other -(specify) Pier'Footing-Sizes,and Locations, SINGLE -NIDE MULTI -WIDE n ..� Line 1 Line 7 _ :.ine 'L Main Beams 'ne 2 — _ —. — _ —. _ — — _ — _ — tine 2. G y— Line '.ine2 Zr GfX��i[iC'1 d o�---�---------- ' vv Main Beams Line LL r� '.ire t Lin . �%/ r✓� //� , / —Tag or Triple - — �_inp 4 Line ' Line 1 Piers - Line 1 Openings: Size -. Size -Min. in1- ------------ x -----,� Spacing -Max- --------- „ Each Side of Openings From Ends -Max. ------- _ " With Width Over- -------- Line 9 Piers: Size-Min.------------ Spacing-Max - -----------Spacing-Max---------- Froo Ends -Max -------- Line------- Line 3 Roof mads: Size -Min ------------- Location (From Front) Line 3 Piers: (Under Bearing Wali only) Size -Min - ------------------ Spacing -Max---------------- From Enda-Max.------------- _ Line 4 Piers: q q Size -Min ------------- Spacing-Max.---------f-- From -From Ends -Max., -----� Line 5 Roof Loads: Size -Min .------------ Location (From Front) Line 5 ?iers: (Under Bearing stalls Only Size -Min.----- ------------- Spacing -Max---------------- c Frcm Ends-Max-------------- x--.x —.i ..x .x BUTTE COUNT WILDING DEPARTMENT A PrN l 'TO Buildi'nv Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner. Location AP# .Plan Approved for: Sewage"Disposal Water Supply Hold final.for: Water Supply Final clearance O.K. for: Water Supply Clearance for bedroom mobile home. Other NOTE x Sanitarian Date ELECTRIC. GAS Support Struc. Compadtion Test eq. service >ize Other Load Type Pipe Size Len th YES NO YES 'NO zoa . 100 L • rte. • rte. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Californba 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT A? PERMIT NO. ASSESSOR PARCEL NUMBER 10 -- a-� — � �O , ZONING BUILDING PERMIT OWNER I��Rt s �"hc�ls e TELEPHONE V SO. FT. OCC. BUILDING VALUATION O WNE S j.AA IONG AD—J_, p� Col%CY)q y` CONTRAIICI\TOR'S NAM E�kCJ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ /O, ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee ; p O Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ r PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10-00 ea' TYPE OF WORK New ❑ Addition ❑ Remodel [JUti Iities ❑ Installation Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 OR L Main service 100 VAMP ORSLESS 10.00 Main service EA. AOD'L too AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. [� I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.8d OR ADDN5. ( ACC. SLOGS. , �z¢Sgft NEW CONSTR ULTI.OUTLET NON.R ESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20@5 0 FIXED APPLNS. Ex. OCCUp. OUTLETS IIRESID,IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ Ishall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling 9 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 sa County in c sequence of the granting of this permit. X i�7,Gr� ��� �a Cf r �� Date Signature of Applicant — Own er�ontractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE—i TOTAL FEE $ r HAL CUA PARK sCHI ftp CDF PAR Pp i HO • Issue This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date Receipt No. -3! COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive,,0roville,.CA 9596.5 PHONE: 916-538-7541 • DATE 8-15-91 LORIS THOMSEN, F RE: B P A #2368-91 P.O. BOX '756 A.P. # FOREST RNCH CA 95942,63-24=46 With reference to the above subject: Attached is: j Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet. Engr. Calcs Typical Plan Sheet ' Owner-Builder.Verification Form List.of Codes Enforced OTHER /_x1 We need the following information: Permit application signed and completed.whei•e indicated,with all copies returned. Fees of.$ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. ., Complete plans in including plot plans. Plot 'plans in Structural details in ` Complete plans and,calcs in by'registered engineer or architect. • Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of .plans in accordance with the changes marked in red. X Sanitation approval from Butte County Health Department at: �/ 4169 HUMBOLT RD CHICO , county enter n rove e Skyway & Elliott Rd:, Paradise Planning approval from Butte County Planning Department, 7 County'Ce`nter Drive, Oroville, for Completed Owner -Builder Verification form.` Recorded copy of deed showing Recorded 'copy of agricultural acknowledgement statement. /X / OTHER PLANS SUBMITTED FOR PORCH COVER'ARF INADEQUATE- PLEASE REDRAW ANT) RESUBMIT (SEE ATTACHED PLAN GUIDELINE) Should you have any questions concerninj the above, please contact DAVE WASNEY of this office. BETWEEN 3.& 5.P.M. Yours very truly, rA JFG/aj William Cheff� Director of Public Works J.F.- Glander Chief Building -Inspector VAR/ES 36" MIN. � Q__)� E x � m 2q t� 6' 3 33 klX • 7Q Q � r r . r o � w O D - m -- � � 3 r X � Q__)� E x � m 2q t� 6' MAX, 33 r r . w A o D - - -- � r X 3 a� iJ�m Z (� •� ' I 1 771 V o e W r9 ��' m z C t� .. r% MAX, o 3 00 o • _ J/ NAIJDRAiI HEIGHT , I —Zi MAX. 2" MIN, S TAI R .-- . . rn 36 W I DT14 6' -u �' -bs O 7Q off' . t2 DO r. w - - o X II o 3 00 o • _ J/ NAIJDRAiI HEIGHT , I —Zi MAX. 2" MIN, S TAI R .-- . . rn 36 W I DT14 6' -u �' -bs O 7Q off' . t2 DO r. COUNTY OF BUTTE - DfEPA'RTMENT-OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 6 '11; ',�. APPLICATION AND -PERMIT ASSESSOR PARCEL NUMBER -63-24-46 ZONANG —I M 110 BUILDING PERMIT OWNER TELEPHONE S0. FT. OCC. BUILDING VALUATION Loris Thomsen OWNER'S MAILING A.D DR ESS 455-00 P.O. Box 756, Forest Ranch 95942 CONTRACTOR'S NAME TELEPHONE Owner CONTRACTOR'S MAILING ADDRESS ` Fir la CONSTRUCTION LENDER UNKNOWN Tot I aluation $ 55.00 LENDER'S MAILING ADDRESS i g Fee $ 10.00 ermit Fee $ 10,00 ARCHITECT OR ENGINEER LICENSE NO. Ian Checking Fee $ 15.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking ee $ Penalty $ BUILDING ADDRESS Permit fee $35.00 PLUMBI PERMIT Filing Fee 10.00 12604 Doe Mill Rd. Forest RAnch i Each Trap 2.00 Solar or hea!hump water heater 20.00 LOT NO. SUBDIVISION NAME ARCEL MAP Water pipi 5.00 Each qas ater heater or vent 5.00 USE OF STRUCTURE as pipg system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehome® Other Build sewer 5.00 SPECIFY Mob' a Home- G W TYPE OF WORK "00 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation® Othe ❑ P rinit Fee $ Describe work: Porch ontractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 sin Service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW N W CONST. DWELLING OCCUP.� , /20sgft I declare under penalty of perjury (check one): o ADONS. ACC. BLDGS. 2 2.50 ea ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Bu Ines NON RESID BRANCH CIRCUITS POWER APPARATUS e CIR. and Professions Code and my license is in full force and ffect. SINGLE OUTLET License No. Classification. Ex. Oc0 u p OUTLETS OR FIxTURES 50C 200030 2AL@30 I, as the owner, or my employees with wages as their sol compen- FIXED APPLNS. OR Ex. OCC - OUTLETS (RESID.) EA. 2.00 sation, will do the work,and the structure is not intende or offered Temporary service 10.00 for sale. (Sec. 7044) Mobile Hom Facilities 15.00 ❑ i; as the owner, am exclusively contracting with licen ed contract- ors. (Sec. 7044) Misc. Wiring 9 15.00 ❑ I am exempt under Sec. , Business and Pr fessions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANC I declare under penalty of perjury (check one): MECHANICAL ERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insu ance or a Certificate of Consent to Self -Insure. Cooling g I shall not employ any person in any manner o as to become subject Hood 3.00 (`- to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, s ould you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the Countyot IDcC CONSTTYPE. Butte to enter upon the above-mentioned property for inspection purposes. TOTAL F E $35.00 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 RK SCHL F C P P ) HD ISSUE again"aid 11 County ig consequence of the granting of this permit. This permit is hereby issued unser the applicable provi- Date sions of the Butte County. Code and/or resolutions to do Signature of Applicant - Owner Contractor ❑ Age work indicated above for which fees have been paid. —An OSHA permit is required for excavations over 5'0" deep and demolition or construct- DIRECTOR OF PUBLIC WORKS 1 -structures over 3 stories in height. , 94398 By Date lliiijliiiI.\'-kOR, PIN.-I..P.CTOR, .OI .... 0. -APPLICANT PERMIT EXPIRES Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVIL LE,}YC,,4LI -ORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET i OWNER P%IZ I Sr�M S' " A. P. Proposed Building Use T �f� Building Inspector Date / I _ 47/ At time o permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1* All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3 cmplete plans in duplicate/triplicate, signed by preparer. of plans . . (41.—Zomplete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and At Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... -c13. School District fees paid .............. 14. Sanitation approval from (CA( 60 Health Department 2 o 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at /office. Deliver w/inspector. Other ApplicaDa�e7����� Copy of !-Idz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted pr� r to permit issuance: (Circle new item not checked above4" 1. Index permit for above items No. foo 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---nail—counter by ..date Contractor,, designer, owner, was advised of above required data by—phone —mai I—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW / COUNTY OF BUTTE - DEPARTMENT-�OF PUBLIC WORKS VVV 7 CSunty Center Drive - Orovjl'!,e.'Ca;l�.fo-rnia 95965 - Telephone: 916/538-7541 APPLICATION SND PERMIT PERMIT NO. ki ASSESSOR PARCEL NUMBER —24-046 'o . �- -•- ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION Ann Thomsen 895-3288 O NEiR S MAILING ADDRESS Chico 95927 CONTRACTOR'S NAM nwnpr TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ �,QQ LENDER'S MAILING ADDRESS Permit Fie $ ARCoR i;aet� "' `- - ucEr,sE No. Plan Che- King Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS _ Penalty $ BUILDING ADDRESS Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 12604 Doe Mill Rd Forest Rnnrh Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex[]Mobilehome® Other Building sewer 5.00 SPECIFY Mobile Home IS G W I 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[E Other ❑ Permit Fee $ Describe work: _ Contractor — ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD•L 100 AMP 2.50 CONTRACTORS LICENSE LAW NEW CONST. ( DWELLING OCCUP.BI� I/z�sgft I declare under penalty of perjury (check one): OR ADONIS. ACC. BLDGS. NEW CONSTR ULT' -OUTLET 2.SOea ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business NON-RESID BRANCH CIRC ITS POWER APPARATUS 6 C'R. and Professions Code and my license is in full force and effect. SINGLE OUTLET License No. Classification. Ex. Occup OUTLETS OR FIXTURES zAL spa eAL030 I, as the owner, or my employees with wages as their sole compen- ED APPLNS. Ex. Occup. OUTLETS RESID IREA.) 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) Mobile Home Facilities 15.00 ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) Misc. Wiring 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Cooling I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation 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 permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $45.00 is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the County of -:)cc CONST TYPE Butte to enter upon the above-mentioned property for inspection purposes. TOT FEE $ 70.00 I also agree to save, indemnify and keep harmless the County of Butte against HAz. cuA all liabilities, judgments, costs, and expenses which may- in any way accrue PAFI( SCHL FLD cDF PA P i.rl�'ss !i agains aid Count ' consequence of the granting of this permit. G% 6 `�� �� This permit is hereby issued unser the applicable provi- Date cions of the Butte County. Code and/or resolutions to do Signature of Applicant — Owner r Contractor ❑ Age work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct. DIRE C OR OF PUBLIC WORKS ion of structures over 3 stories in height. Receipt No. 93761 iBy Date -7-3? 91 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT MIT EXPIRES Date 7- ✓— ! '�-- COUNTY OF BUTTE - DEPAR')GI0lI9zkj *O y PUBLIC WORKS - BUILDING DIVISION rp 7 COUNTY CENTER DRIVE - OR�VIL, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET _ /► Permit No. t `�. / OWNER �Q,l��/If/l/ �Yyli v No. �'� 7 `T Proposed Building Use Building Inspector Date L� At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. —���En eered truss details and layout in duplicate (required prior to plan check) 9. obilehome installation data including manufacturer's installation Instructions........................................................ 10. Fees of $ ..................... 11. Chico Urban Area fees paid ........ ............................... --1_,.>2/ Park fees, ria i School District fees paid ............. . School District fees paid . 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. tter of sign ure Zhorizati 27. When you issue theermit, proces as follows: Mail o w er. Mail to contractor. �elephone and hold for pickup at office. Deliver w/inspector. Other Applica.Date Copy of !.az-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date— ate The The following data must be submitted pr 1. Index permit for above items No. 2. Additional items required: By— By o per "_XS new item not checked above). Contractor, designer, owner, was advised of above required data by_phone_—naiI—counter by ..date Contractor, designer, owner, was advised of above required data by_phone_mail_,,,rzcounter by date Plans checked Copy—DPW Date Plans Sets of plans on hold in File cabinet AP folder bye Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT A SSES$Q�(�RCE�NUI.,LB ,� �O '+� `I 1ICC��//, OO)`)`'' H1 ZONING BUILDING PERMIT OWNER �UfZls �>1n �Yhser� T LEPHONE q�-3 g$ S0. FT. OCC. BUILDING VALUATION OWNER? AI NG�/ADD 1 ©/ CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee - $ '0,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCY.ITECT OR LN ;WEEP• LICENSE NO. Plan Checking Fee $ � 1 6y Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESSwoe Y1�'l � o l� Permit fee $ pZs Q PLUMBING PERMIT Filing Fee 10.00 Forest �aLY1CI� Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW 1 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remod//el Utilities y❑,n I stal�ation� Other ❑ Describe work: �� MH 91 �'/// / \ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee .10.00 Main service ;poo AMP OR1 OR LESS10.00 Main service EA. ADD -L 100 AMP 2.50 CONTRACTORS LICENSE LAW of p I y (check one): I declare under penaltyperjury ❑ 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-'Misc. ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.N) OR ADONS. ACC. BLDGS. ,�:23gft NEW CONSTR. MULTI -OUTLET NON.R ESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES zoeeoe eAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.I EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. _ ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the.W. C. provisions of -the Labor�Cod-e; you must -forthwith comply -with such provisions or this permit shall be deemed revoked. . MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation _Penult -Fee-- -- -- --- - — -$ — --- — Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ 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 $Z9 0 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ oce HAL. I CUA- I PARK SCHL FLD CDF I PAR Pp I HD. 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 OF PUBLIC WORKS By Date PP=RUIT F:yPing:q nntc Receipt No. 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 willb 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) 0A),Q signed an application for a building permit for the proposed work. 3. 1 have contracted_ with the following person (firm) to provide the .proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the .major work Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work igned •. Prope Socia Date NOTE: This"Owner-Builder Verification is sent to you -as required by Sections 19831 and 19832 of'the,California Health and Safety Code. This verification must..be completed and returned to our office before we are per- mitted to issue the permit. _ . ,.� i j;:.l� -1{+1 .� S. 'i - !4: +.�' �.+iV'r...k a+� 7n�' .ti-"..s1N...iz�r�' "�'.s.:'���1r�,'•;`%L�..�V'ti., .- : n!"�t�. � � •// e�.4'j •ti'�� ..`a `;�. j,.'12". BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number 1p �-'�!�"lQ Building Department No. School Disjtrict 05 /D City D County Jurisdiction Property Owner Project Location/Address (C� ` 0 Subdivision Lot Number Residential Development: Sq. F*`� � •� ootage OC 1 # oiving MHI Addition (Group R)j o �.m�t s r Commercial/Industrial: Sq.NVFootage New Addition (Iryc-uding Exterior " Rooted Areas) Building Wepartmeht Representative I jDvate r (Floor Plans reviewed,by School District Personnel) District Id N'?` t r 10 n School District certifies that Applicant Name) Aqp' hone Number) _257G (Street Address) circ �h CGt� 95 9-ya (City) (State) (Zip Code) has complied with the requirements of Resolution No. by the p yment of $%%f�'f" representing square feet. M R41 qJ School District Representative Date PAID BY CHECK NO. REMARKS: LLWwI. BANK NO � L .0_46 ✓N PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) 9