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HomeMy WebLinkAbout063-300-052_ 3 3052 TOMMY W. HE RICK t.as j 4082`, �1 x� ar'.� '�'r `,} Permi 81 _ `.'' i1 �MHP)�r;,' . . p.. • ELEC.. .y • UPPORT_ STRUCTURE._RFQ._.,=u.`_'�__..______.:,, _,*�., COMPACTION TEST REQ. 63=3 2 4 s % 1085-91'E',p �* HERRICK; my' .Y 4082 Via -Mar i Ln;� Chico (new 61ec*pole r mh)'�ylj;f/ s�' ELEC" ' SOD her Vis- • -- S., GA©m COMPACTION TEST REQ.t SUPPORT STRUCT,RE .:-r { r r z Permit#1702-91 ` F r• , �% (nh,k nstall ion) r y. { ... .•� .� .fit .. h i a t J ` P Y. 0lm eo#pj*, of XUtbe OROVILLE, CALIFORNIA -��j % GENERAL aCLAIM CLAIMANT ' : 1 M M \I ' " , ' ` _ t _ ADDRESS: P.O. Box. 5222 CITY & STATE: - 95927 DATE OF CLAIM: SUBMIT CLAIM TO DEPAR MEN; RECEIVING GOODS IMPORTANT: SEE INSTRUCTIONS ON REVERSE SIDE OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) I AMOUNT Refund due to expiration of permits. Permit #3865-88 MHU & #386 8 AP#63-30-52, Receipt #27043, dated 12/1/88. MHI, j I ' I Total Permit Fees Paid For BP#3865-88-------------------- $82.50 Retain Plan Checking Fee------------------------- $15.00 Retain Plumbing Permit Filing Fee---------------- 10.00 Retain Electrical Permit Filing Fee-------------- 10.00 Total Permit Fees Retained------------------------------- 35.00 TOTAL REFUND DUE ----------------------------------------- $47.50 Total Permit Fees Paid For BP#3866-88-------------------- $70.00 Retain Building Permit Fi3ing Fee ---- Total Permit Fees Retained------------------------------- 10.00 ------------------------------ i I � TOTAL REFUND DUE FOR BOTH PERMITS TOTAL $107 jO I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. 1 ' + C Dated this a de of 19,1, et �(.� Calif. ,,, �:�1` �' ...... .. ..................... Y .......... K v-A-�- I Signature o 1 invent 1, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above he een performed or de- livered and that there is a Budget Appropriation ❑ or Specific Board Approvel ED(Check on the sott+e. .......... ...... ....... ............ Dated this 8th ................... day of ,.Januarx 19 92 at Oroville caul. ..........f/.././..j..�..................... .............. D partment Head or Authorized Dep Dept. Exp. t �+ Code .....440.-.0.02 ................... Code ......4.2.1.0.50()......................PAYABLE FROM ......\eQ ..... !~XII1�............................................. FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. wn name: two years? ❑ YES ❑ NO signature alone? ❑ YES ❑ NO is required: the enclosed return envelope by Date 1 sur answers: period beginning (13) wing all income received for period beginning ti. C) b jj� H C-0 yr COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS P�EF)MIT NO. n, 7 County Center Drive - Qroville, California 95965 - Telephone: 916/538-7541. ��% L, `�V APPLICATION AND PERMIT 00 J D ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWN 'S MAILIN7 AA "R L / �� ( e jLo 1 J CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ "_00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ Od PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 IC Solar or heat pump water heater 20.00 LOT N SUBDIVISION NAME PA CEL QTAAP 81-5 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 JJG4 W 0.00 ea a0.00 TYPE OF WORK New ❑ Addition ❑ Remodel❑ Utilities InstallationOther ❑ Describe work: Permit Fee $ .O Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 500V OR LESS 100 AMP OR LESS 10.00 h , CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, DIV. 3 of the BUSIneS$ and Professions Code and my license is in full force and effect. License No. Classification 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 Main service EA. ADD'L 100 AMP 2.50 '� V NEW CONST. DWELLING OCCUP.51 OR ADDNS. ACC. BLDGS. , /2dsgft NEW NON.RESID RA C CIRC I S CONSTR. I.OUTLET 2,50 ea B POWER APPARATUS 6I SINGLE OUTLET CIR. Ex. OCCU OUTLETS OR FIXTURES p 20050*eAL0 So FIXED AP Ex. Occup. OUTLETS P(RESID.)REA.Y 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 ,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 f Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling 9 Hood 3.00 Ventilation Permit Fee s Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue aga'nst said Count in consequence of the granting of this permit. %� Date Signature of Aqpkcont — Owner 9 Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0” deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ ISO OCCUP. CONST.TYPE SCHOOL I Flo„P.l P, ,:;I P ND IS9UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. V WHITE-D.P.W.. YELLOW-A3e9350R. PINK -INSPECTOR. GOLDENROD -APPLICANT �eo"J,r QjTx',,...Ri_-t, .-F.,. y,ly'.3:. Mr•`L y„i-� r�..�4�K1{�t N►^,Nw- , k,; %;r-Y2r+ MfX S 3.'�'�' `��•'��� �r i� �" ti'.t Tj.�'�;r,��., j� �' a COUNTY OF BUTTE'- DEPAI`iTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENT-Ot'DRIVE - OROVi E, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 ,,,PERMIT APPLICATION DATA SHEET ' ( 1 Permit No. OWNER _rQnnmt3 W, l4 e r r� G A. P., No. 63-30-5 Proposed Building Use Iq 14 Building Inspector `s Date At time of permit application, I was advised the following data must be submitted prior to permit processing and:/or issuance: DATE RECEIVED APPROVED 1. All items,have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate./triplicate, signed by preparer of plans. . 3. Complete plans in duplicate. /triplicate, signed by preparer.of plans. 4. Complete engineered plans and calcs, with wet signature on plans. _ 5. Plans with Energy Design Compliance Statement. 6. CtA - L - y School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ , , , , , , , 9. Letter of signature authori,ffion. • 10. Sanitation approval from Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. ./ r` 'l 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 (Date) 7. Pre -Inspection for . Required. Building Inspect r Recorded copy of Agricultural Acknowledgment Statement. 8 19. Driveway Permit. �t��-E � �n �ru�r 60:2a 20. Plot plan approval from city of V ''' 21. Engineered trusses in duplicate (required prior to plan check). 22, CUA FEES RECEIPT N When ou issue the permit, process as follows: Mail to owner, Mail to contractor. i Telephone X3=3) and hold for pickup at�cl(efice, Deliver w/inspector. nthpr J , Copy of pl"ans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to per Se: (Circle new item not c;hecked above). 1. Index permit for above litems No. -'" : + 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 —mal l—counter by date Plans checked Copy—DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder Date TO 3uildino Department FROM: Environmental Health SUBJECT: Sanitation clearance _ ✓►.�v.. L 2s2cclL VIA; yll&y a �.N. 3-30 — (-L- --I L .. �Q I Owner Location p0:an -Approved for: S.ewage Disposal :✓ Water Supply Hold final for: Final clearance O.K. for: clearance for .,�.e bedroom mobile home. Other' Water Supply Water Supply ®._ Sanitarian Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit: No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (.yes or no) QA 2. I (have/have not) _ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate,,supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner �4' - Social Security Numb - 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- t. mitted to issue the permit. 173 - • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.-)` 7 County Center Drive - proville, Califqrnia 95965 - Telephone: 916/538-7541. .. V APPLICA4TION AND PERMIT ASSESSOR PARCEL NUMBER �c ,3 - 0- ZONING BUILDING PERMIT OWNER la) E"Ierr'G TELEPHONE - D SO. FT. OCC.1 BUILDING VALUATION /IOWZzNER'S MAILING +APDRESS ALI CONTRACTOR'S NAME LEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ - LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ f70 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ y� PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 G� 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 U E OF STRUCTURE SF❑ Duplex❑ Mobilehome < Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W O.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation)& Other ❑ Describe work: o< n, - Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AOOV MP ORLESS10.00 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. (cense No. Classification 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 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.al) ,/:2Sgft OR ADDNS. ACC. BLDGS. / NEW CONSTR U I.OUTLET RA C CIRCU ITS 2.50 ea NoN.RESID BRANCH POWER APPARATUS IN (SINGLE OUTLET CIR. I P 20050 01 Ex. OCcU OUTLETS OR FIXTURES BAL030 Ex. Occup. OUTLETS ((RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 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 Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue ag inst said Count in c asequence of the granting of this permit. X I Date Signature pp cant — 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 $ 0 Energy Inspection Fee $ TOTAL PERMIT FEE $ `7e , 00 OCCUP. CONST.TYPE SCHOOL FLOOD PARCEL I PD I ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. WHITE-D.P.W.. YELLOW-ASSE5e0R. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 Tommy W. Herrick 13524 Autumn Lane Chico, CA 9592.6 With reference to the above subject: / / Attached is: OTHER DATE April 18, 1991 RE' building permit application for elAeari service 63-30-52 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 We need the following information: Permit application signed and completed where 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. Sanitation approval from Butte County Health Department at: 196 Memorial Way, Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. / X`✓ OTHER You made application on 4/15 MI. for. an elprtric pole fnr a mnhilP hnmp. Tn researching our records I found that you made annlicatinn for utility and _ installation permits for a mobile home in 1988, but these permits were nP\/Pr issued. These applications are now ex ip'rede however, it is nossible for you to apply for a partial refund on these permits and than reapply, lie cannot issue the electric permit without having complete applications and inspections for the mobile home. Should you have any questions concerning the above, please contact Anne of this office. Yours very truly, William Cheff Director of Public t4orks J.F. Glander JFG/aj Chief Building Inspector File No. i t- - A F Y _fFor Action 1, 2,ept. (For Information Rd. & Br, Mtce. Shop & Yards Bldg. Insp. Admin. Land Dev, Drng. /S.I. Sub. & Pcl. Maps Permits Addr. j Sr September 22, 1988 Thomas•Herrick, Etala RE': Building Permit 13524 Autumn Lane A;P; #63-30-52 Chico, CA 95926 Dear Me s Herrick: 'With reference to the above subjecto' we have been advisedby one. of* our building inspectors that you have not obtained the required permits and inspections from this office for the work you are doing'as.follows: Installed a 10'x55' mobilehoiae on- your property, at the end of Maria Lane in the Forest Ranch area;, Since 'permits and inspections arerequired by both State and' Gouniy'-laws please contact this office within ten days of the date of this letter,'submit two complete sets of plans, apply for the required permits, and pay the appropriate fees. All work must stop until -you obtain- these permits and are authorized by our field inspector" to proceed; This field 'authorization cannot be made until the existing work is•inspected and approved. Your cooperation in resolving this violation'in' g timely manner would be' appreciated. Should you have any questions'. concerning this letter, please contact Bob Reith or Jim Glander of this office. /,,ti� jai J Yours very truly, PQ2A1,v William Cheff , Director of Public Works WtZ4G-71 Robert Reith RR:ahb Supervising Building Inspector cc6. Building Inspector - Chico Assessor ^-.,i 19 of 4% September 22, 1988 Thomas•Herrick, Etala RE': Building Permit 13524 Autumn Lane A;P; #63-30-52 Chico, CA 95926 Dear Me s Herrick: 'With reference to the above subjecto' we have been advisedby one. of* our building inspectors that you have not obtained the required permits and inspections from this office for the work you are doing'as.follows: Installed a 10'x55' mobilehoiae on- your property, at the end of Maria Lane in the Forest Ranch area;, Since 'permits and inspections arerequired by both State and' Gouniy'-laws please contact this office within ten days of the date of this letter,'submit two complete sets of plans, apply for the required permits, and pay the appropriate fees. All work must stop until -you obtain- these permits and are authorized by our field inspector" to proceed; This field 'authorization cannot be made until the existing work is•inspected and approved. Your cooperation in resolving this violation'in' g timely manner would be' appreciated. Should you have any questions'. concerning this letter, please contact Bob Reith or Jim Glander of this office. /,,ti� jai J Yours very truly, PQ2A1,v William Cheff , Director of Public Works WtZ4G-71 Robert Reith RR:ahb Supervising Building Inspector cc6. Building Inspector - Chico Assessor ^-.,i 19 of 4% Cp�mplaint-Date ❑ Ottir-Date ` BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION REPORT Owner: Addres Tenant: ZON'IN'G A.P. # G 7—�� Date of Inspection Inspector v Building Location: A 4� -;9-A16 /a. )X Type of Inspection requested: 1. Housing ".2. 2. Financing / / 3. Change of Occupancy to J 4. Work W/O Permit / / 5. Other (specify) Present use of building: ✓ -�.` w Pt V --e_ A. Sanitation (Housing) 1. Water closet: 2. Lavatory: 3.. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating facilities: ' 7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11: ,Connection to sewage disposal: 12. Connection to water supply:,' 13. Rubbish and garbage facilities: ,147. Stairs :(Rise, Run,: Headroom, 1HR, Tolerance, Handrails) ` 15. Comments: B. Structural 1. Piers' and footings: 2. Floor. construction: 3. Wall construction: 4: Ceiling and roof construction: 5.• Fireplaces::. 6. Comments: t C. Electrical 1. Service and ground: -'2. Receptacles: 3. Fusing: 4. Comments: N I E. F. Plumbing 1. Fixtures connected and vented: 2. Gas water heater: 3. Gas heating vents: 4. Comments: Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Energy:: 7. Comments: Commercial Buildings 1. Roof covering: 2. Distance'to property lines: 3. Physically handicapped: _ 4. Restroom floors and walls: 5. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give complete description)_ y^-iD M,n 61 LIZ �&4" t s` �.1LT� 2. What action taken (give complete description): 3. What action recommended: A. Information only - file. lFeA.B. Hold for ten days, then write letter. %% C. Write letter. / / D. Other: Nf © wA4A2 S 190tZT -5 Sat S 8o(3 sjjae 5 E3g3-3o' t vLSTt00 0wApA2 —100q "?Q¢ k �P �3-JD -�5- Z - Eatte ®unt LAND OF NATURAL W E A L T H AND BEAUTY PLANNING DEPARTMENT 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (916) 538-7601 November 21, 1988 Mr. Tommy W. Herrick Mr. Robert Seals 13524 Autumn Lane Chico, CA 95926 Re: Butte County Building and Zoning AP#063-30-0-052 violations on 47.16 acres'on Autumn Lane, Chico Dear Mr. Herrick and Mr. Seals: This is a warning letter to notify you that you are in violation of the Butte County Code, as follows, at the above -referenced location: Operating a recreational business in a "U" (unclassified) zone without the required conditional Use Permit. Site development and installation of a mobile home without permits. You are directed to: Cease and desist the recreational business and its advertising until you have obtained a Use Permit from the Planning Department; and to obtain site development and installation permits from the Building and Health Departments for.the mobile. You have 10 days to voluntarily comply with these directives. You should be aware that Butte County has entered into a code enforcement program that seeks voluntary compliance with the Butte County Code but provides an effective means of enforcement if com- pliance is not obtained. If voluntary compliance is not obtained, enforcement will be pursued through the issuance of citations, fines, and recording Notices of Violation. q i -Continued Should you have any questions regarding this matter, please contact this office at the address or telephone number listed above. Sincerely, .A. Kircher Director of Planning BAK : f b cc: Code Enforcement JBT -- Building Dept. Health Dept. V Approved as to Form Butte County Counsel ss: Neil H. McCabe 10/19/88 PRE -INSPECTION �/ A) / . ' OWNER : C DATE �+ ` LOCATION:fe _el 7i (L!,4 /m,4 fflA.P. l0 3 — 3o -D� CONTRACTOR_ ZONING . PRE -INSPECTION FOR: /(f �i (,(� � � �,1 � n „ I , DATE TO INSPECTOR PERMIT HISTORY: NONE FTJ AS FOLLOWS: TYPE OF OCCUPANCY �Q FIELD /- INFORMATION. -BUILDING USAGE: a �Q, HEATED-COOLEDMOCCUPIED TRX OTHER COMMENTSA HAS ELECTRIC :IAS GAS [ HAS SANITATION- FAc'I ITIES `PERSON CONTACTS ACTIO COVDED: ISSUE [� HOLD FOR 2 9y -7s1 _, I r OTHER: BY � DATE l,I.,g,�� ; zc PT`' 2E 1-n PT 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 youi signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit: No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no).0 2. I (have/have not) signed an app ' ation for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No, 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work.but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property Owner QfL h Social Sec uri y N mbe - 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. �* i00 \ COMPLAINANT ADDRESS: PHONE NUMBER: OTHER COMMENTS: 11 13 � 0 8 � PW 1FOR .DATE—"5I TIME P. M .4 t- ) OF qo-� ..PHONE- AREA CODE NUMBER.' EXTENSION 2 a��x,s^3"I. �TELEPHONEO� ���s r�LEASEC��ALL� �CAMETOSEEYOU' �' �- �WILLCAl1AGAIN', � :ac " �EIETURNEOrYOURCALL n ? ` gSPE avviENTi6N r„<w ,.t H �* .�rs� � cw: r �;i1^�t':��s,�`�✓QC 4'�'u .,.. �:� �, �''�. t>� ;Y£ MESSAGE • IVA SIGNED UTHO IN UzJL TOPS FORM 3002S'` f S:U O N 6,51DNTIAL 4�L s' 1085-91P,E(MH) I nj5i DG 1-70 L I cN �) TOMMY HERRICK 4082 Via Maria Lane JOB FINALE Signature Lm P"VVr-- C I� CE CO p wJl Address `l o EA GAS Meter By ELECTRIC Meter By 1 Date 1 -2 -47 -!? J=OK S O=Not OKNot �- =NotReadyable MOBILE HOMES Date MOBILE E UTILITIES Plans OK except #'s 1. Z g Requirements -Setbacks -Easements Soils ecial MH Support Sketch 3e<_wqA Location -Test -Fall -C/ Concrete 4woKater; Location -Test - Ease ment Needed (Sketch) 5. Electricity; Loca ' -Clea ren -Gr /6VAmp-Concrete 6. "L"ft. / /"Nat or/ I"' "ft i --"LPG 7. Well Clearance & Disconnect tility Clearance Date Card B-1 Date Card B-1 Date Card B- Date Card B-1 Date MOBI OME INSTALLATION (Plans) OK except #'s onin equirements-S acks Easements otings; Size -Sp g-Mefr+aVe-ti++e 3. - — r lect ' ity; MH est-Cro er rea -Clear s 5 rain; M est -Fall -FI onnector � v-1VfFl Test -Regulator -Connector ater and Sewer Co ected-C/ o Grade -HD Approval 8. gas.aaf}.Electr' y Tagged its; Insp.-Sketch Cert. of Occupancy Date/Z,-11-11 Card B-1 V 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; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea ms- Rftrs.-Con nectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 f V OK O = Not OK =Not Applicable Not Ready RESIDENTIAL (Single Duplex) = Date UNDERFLOOR(Plans) OK except ft's 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except 4's 16. Water Htr.: Vent -Access -Combustion Air -Baffle ---------- ------ --------------- ------------- ----- 17. Water Pipe: Test & Anchor -Nail Protection 18. D.W.V.;-Test-Fittin s & Anchor -Nail Protection --------------------- - ------------------- 19. Shower Pan; Test. First Floor -Tub Access ------- --------------------------------------- 20. Test Tub & Shower. Second Floor -Tub Access 21. Gas Pipe; Size & Anchors --------- ------ ----------------------------------------------------- Date Card B-1 - --Date - Card B-1 ------------------------------ - ----------- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except 4's 22. Fixture & Transformer Clearance -Ins. Protection --------- -------------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors --------------------------------------------------------------- 24. Size Boxes & No. of Conductors -Stapled ------------------------------------------------------------ 25. Romex Installed Close to Edge of Studs & C.J. ------- -------------------------------------------- ---------------- 26. Equip. Ground made up w!Mech. Fastners-Bond Gas & Water ---- ----------------------------------------- - -------------------------- 27. 2 Appliance Circuts in Kitchen & Conductor SizerGFI --------- ---------------------------------------------------------------- 28. Subfeed Wire Size r / ga. Cu or AI-A.C. Wire Size ! ! ga. Cu or AI -------------- --------------------------------------------- 29. Range Circ r / ga. Cu or AI -Oven Circ. ! / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect --------- ---- --- ----------------------- ----------------------------- 31. Equip. Clearances Panels-Motors-Mech. Equip. ---------------------------------------------------------------------------------- ------------ ---------------- 32. Clothes Light -Shower Light -Spa Light --- - - --- - - -- -- -- -------Closet- -- -- - --- ---- ----------------- --------------------------- 33. Smoke Detector ----------------------- --------------------------------------------------------- ate Card B-1 Date Card B-1 ----------- --- - ---------------------------------------------------- ate Card B-1 Date Card B-1 [ate MECHANICAL (Permit) OK except n's 34. A.C. Ducts Insulation & Support ------------------------------------------------------- 35. Vent Fan Exhaust above insulation ------ --------------------------------------------------- 36. Condensate Drain & Overflow: Size & Grade --- --------------------------------- --..-....- 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet - ---------- 38. Attic Access & Platform if Furnance in Attic --- _ - ---- - - -- -------------------- --- I Card Date Card B-1 --------------------_B-l____----------------------------------------- ---------- te Card B-1 Date Card B-1 to FRAMING (Plans) OK except k's 39. Sils. Proper Material & Anchors -- -------------- -------------------- ------ -- ----- - - - - 40. Walls Studs- Nailing. Spacing & Bracing -Plates -Sound ----- --- -- -- - - -- - - ----- - - - --- 41. Bearing Walls over Girders & Floor Nailing - - - - - -------------------------------------------------- - 42. Draft Stop in Walls (rat proof) 43. Fire Stops. Furred Ceilings-Stairs_Chases_Tub--------------- 44. Headers & Beam -Size & Bearing Date FRAMING (Continued) _ 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54plywood on Roof Overhang -Attic Vents -Rafter Outriggers _ 55. Siding -Nailing Veneer --------- 56.- Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access ----- - ------- _--- 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows ------------------------------ Date Card B-1___ Date Card B-1 -- ------------------------ Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except N's 61. Ext. Steps -Door & Sidelight Protection -Landings ----------------- ___________ 62. Smoke Detector 63. Furnace: Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection ------------------ 64. Bedroom Exiting _______ _ 65. G F.I_& Bath Fixtures & Tub•Access-Spa 66. Elec. Trim & Subpanel: Breaker Sizes & Labels ------------------------ 67. Stairs & Rails ------------------------------------ 68. Fireplace or Stove: Clearances -Hearth -------------- 69. ------------ 69. Elec. Outlets at Wood Panel: Int. & Ext. 70. Kit.Fixt. & Appliance, Grnd.-Air Gap -Cooking Gap-CookingClearance 71.--Elec. -Outlets & Receptacles at Kit. Counter -------------------------- ---- 72. Garage Fire Door: Swing -Landing -Closer ------------------------------------ - 73. A.C. Duct in Garage -Damper 74. Wtr. Htr Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection -------- ---------------------- 75. Plb.. Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection ------- -------------------------------- 7;. Insulation -Foam -Looked in Attic ❑ Yes -------- - - - - - - 78. Guard Rails & Deck -Const ruction- Post Caps 79. Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes - - - - - - -------------------------------- ---------- 80. Followinginstld.: Drive ❑ Yes ❑ No: Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ N_o 81. Stucco: Brown -Finish ------------------------- A.-C.- -------------------A.C. Unit: Disconnect. Electrical, Plumbing 83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to Openings -------------------------------------------- -- ---- 84. Water Well: Disconnect, Electrical, Plumbing -------------- ------------------------ -- -- 85. Exterior Elec. Trim: G.F.I. Receptacle -Underground -------------- -- ----------------------- 86. Ventilation Throughout House .. ... - ... ---------------------------------- 87. Glass Protection - - ------------- --- --------------------- 8d. Corrections from Previous Inspections ------ --- ------- ------------------------------------- i59. Gas Test -Meters Tagged: Gas -Electric ------ ------------------------------------------- 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy -Compliance -Certificate. -Other Certificates -- ------------------------------------- --- -- Date Card B-1 Date Card B-1 ---------------------- ---------------- ----------------- Date Card B-1 Date Card B-1 ------- ---------- ---------------------- Date Card B-1 Date Card B-1 Comments at Final: MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 +� I PERMIT N0. Address or location of mobilehome `� r !? .7'7 l.&- i Owner's name ~ ` %1 r4 Owner's address L� Insignia or hud number i r' ,Manufacturer's name t Serial number of V.I.N. (0 r Year of manufacture f (Official Approving Installation) (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ,ACCEPTW4CE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 1 513B White - Owner, Yellow - Installer, Pink - D.P.W. L . COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovllle, Callfornla 95965 - Telephone: 916/538.7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 63-30-52 ZONING U BUILDING PERMIT OWNER Tomm W. Herrick - TELEPHONE 521-2205 SO. FT. OCC, BUILDING VALUATION 2.50 OWNER'S MAI ING ADDRESS PO Box 5222 Chico 959,27 Zh¢SQft CONTRACTOR'S NAME Owner TELEPHONE POWER APPARATUS e 1 SINGLE OUTLET CIR. CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ ';0.00 LENDER'S MAILING ADDRESS Perm;! Fce $ ARCY.ITECT OR LV ;I;aEER LICENSE NO• Plan Checiking Fee $15-00 Energy Plan Checking Fee $ n ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 4089 Via Maria Lanp, Chiro 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 FGW 0.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti Iities ❑ Installation[N Other ❑ I Permit Fee $ Describe work: RE: B.P. #3866-88 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. )cense 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 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 �� f Consent to Self -Insure. Cld 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. 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 agai st said County in consequence of the granting of this permit. 1 r Date Q Signature of App ican — Owner ❑ Contractor ❑ Agent fJ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Receipt No. 88961 WHITE-D.P.W., YELLOW-ASSC350R, PINK -INSPECTOR. GOLDENROD -APPLICANT Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 60011 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCU"'6 OR ADDNS. ACC. BLDGS. Zh¢SQft NEW CONSTR. U TI.OUTLET NO N.R ESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e 1 SINGLE OUTLET CIR. Ex. Occup( OUTLETS OR FIXTURES 20®50C eALO 30 Ex. OCCUp. OUTTS ((RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Venti Iation Permit Fee $ Contractor Mobile Home Installation Fee $45.00 Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 70.00 HAZ. CLA PARK I Sy I FLp CDF I P=R I P j ,D • SU E .� 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. DIRECT OF PUBLIC WORKS BY Dateh— 3— 9 f PE T EXPIRES Date L-3^ 'Z- — e, v _ .. ... 1.. _.. - .,r.� •r. a ^-T1S� �ef:�•-1� w. r.,,, ,�; .err, t � Y �. � . COUNTY OF BUTTE - DEPARTMENT�OF PUBLIC WORKS - BUILDING DIVISION t 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 85965 T.5,.EPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET � V/00 Permit No. OWNER% IYI /Yl 2 r e_/4/?C/ \ A. P. r� 3 30 — Proposed Building Use 3 '" Bu "lding.Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED' 1. All items have been submitted. .� r 2. Plot plans in duplicate/triplicate, signed by preparer of plans ....... . 3. Complete plans in duplicate/triplicate, signed by prepa'rer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... ,. 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation. instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... ]2. Park fees paid ..............................................:. 13. ��(�S :� School District fees paid .............. — — 14. Sanitation approval from �" a / G C> Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) \t 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-I"Spec. 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. mi -to r 0yaAam ce 27. When you issue the permit, process as follows: Mail owner. Mail to contractor. Telephone and hold for p;i.ekup at office. Deliver w/inspector. Other ,Applicant Copy of Hdz-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,rsubmritted p ' r to ermit issuance: (Circle new item not checked above):' 1. Index permit for above ite `s No. U IS 2. AIdditional items required: 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 —mal l—counter by date Plans checked by Q, Date 6 I Plans approved by ?Ek) Date (ef 4191 Copy—DPW Sets of plans on hold in File cabinet AP folder COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ° PERMIT NO. ASSESSOR PARCEL NUMB 69 3 ' _ �- e _ ZONING BUILDING PERMIT OWNER 0 1M� - Z Z TELEPHONE $Q. FT. OCC. BUILDING VALUATION OW R'S MAI LINGIDI 1 (, �^ CONTi A�G� j3R S _NA / _ -TELEPHONE CONTRACTOR'S FWAILINGADDDD'RESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee _ $ ;0.00 LENDER'S MAILING ADDRESS Permit F`a $ ARCHITECT OR L.a ;INFER LICENSE NO. Plan Che ;<.ng Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING AD R Ss v� L ,vim Permit fee $ of 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 F 10-00 ea TYPE OF WORK New ❑ Addition ❑ Remod 1 ❑ Utilities Installation) Other ❑ Describe work: e 3 l0 6 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESs 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2,50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the BUslnesS and Professions Code and my license is in full force and effect. License No. Classification. El 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason GOCCUP ei1 oa ADDNST CONAC STS./ '/xQsgft New CONSTR. U TI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e SINGLE OUTLET CIR. I EX. OCcup(OUTLETS OR FIXTURES 0050t 2AL@ eLa30 FIXED APLNS. EX. OCCup. OUTLETS PR (RESID IEA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ 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. I Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating n g Cooling Hood 3.00 Ventilation Permit Fee . . _._ s _ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 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 agai t said County in consequence of the ranting of this permit. X �6mm�M . W Qilh� Date A2"1 Signature of Applicolr Owner F1 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 E HAz. CUA- PARK SCHL rLD PAR PD i Hp. IssuE This permit is hereby issued unoer the applicable provi- sions or the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt NO. WHITE-O.r.W., YELLOW-ASSEe90R, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Deoartment of Public Works . 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 " OWNER-3UII.DER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the ma' or labor and materials for construction of the proposed property improvement lY§ or no) �2. I Q(haa/have not) signed an app ication for a building permit foero osed work. P P .I have contracted with the following person (firm) to provide the proposed construction:". _ ........ -- Name' Address City Phone Contractors License No. 4. I plan to' provide' portions of this work, but I have hired *the following person to coordinate,. supervise, and. provide the major work: Name Address City Phone Contractors License No. 5: I will provide some of the work but I have contracted (hired) the following persons to -provide the work indicated: Name Address Phone Type of Work Signed: (� Property OwnerS Owner-Crm Social Securit Numb r - -- - - ---_ Date - - 5 - - - --- ----..__.-_--- . 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_ > toxUtility tonneions shall be witMn < 4 ft. of the m bilehome, either Al directly behin or within the rear / half ) of the `pnobilehome. J�. A §g bd& Of 5 ft. from the � pimporty lines and a setbe k gf g®'ft, from the road \ •' cowk cline shall be clear of structures or egrrfpmenf_ I NOTE: r3�ll terials & W rkmanship Shall Be in for a 2 ft, eave overhang., I � Accordc ncd viii, Recognizec Good Practices and of a qutlify Ves.,ribe_f for 4c Spe::ified use in the i Uniform 'uilclin. Plumbing &' Mechanical Codes and the Nation ecfrical Code. I I I his set of plans and sp tications MUST be - kept on the job at all times n1d it is unlawful to rlo a any changes or alterati ns on same without written permisson from the epartment of Public rks, County of Butte. I �I L1\ BUTT COUNTY rn 8i - 57 BUI�DIN DEPART MENS ` APPR ov ED -� 1-702- 9/ r" I . sW &/41 9,/ f 3U r�f BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA f PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: O 2. Installer's Name: O `M `ih j Vy C\ C R 1� I C k 3. Is the site currently under permit? Yes No (If yes, furnish permit number�_i _ /035 _�> ) 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 � No (If no, clarify 5. What is the mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? ------------- Amps 7. What is the mobilehome site circuit breaker rating? ----- _ ^ l© Amps 8. Is there any other electric load to be served by the mobilehome site service? -------------------------------- Yes a No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? -------------- 'v 8 (in.) F I 10. What is the type of gas service? ------------------- Natural LPG 11. What is the gas pipe length from meter or tank to the mobilehome?----------------------=---------------------- (ft.) �e 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 JV .. If other than single wide, 1 Mobilehome Mfr. G OIy M furnish Setup Model No. Year—�_ Width0 (ft.) Box Length5 0 (ft.) Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). FOOTINGS (check one) V1. Wood -pressure treated or foundation grade. 2. Other (specify) SUPPORTS (check one)Concrete block.02. Other (specify) ,Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE sem. Main Beams Li ne 2` — — — � Main Beams Line 1 Piers: Size -Min. ------------ "x , Spacing -Max. -•---'--- i Line 1 Piers: 'is Ize-MLn------------- S pac J.,g -Max - ------------Spaci.g-Max.---------From Ends -Max .------- Line 3 Roof Wads: Size -Min.------------ Tag or Triple Line 1 Openings: Size -Min. ------------------� "x Each Side of Openings With Width Over --------- " Line 3 Piers: (Under Bearing Wall Only) Size -Min ------------------- x •Spacing -Max________________ „ From Ends-Max-------------- "r. "x 11 "x "x LAA ation (From Front) _ 11_ 1 _ _ _Ili '_ I- L! n J. L_i.ne 4 PLers: Line S Piers: (Under Bearing Walls Only) Size• -Min------------- Size -Min .------------ — ---- , 'k 'x Spacing -Max.--------- ,_ „ Spacing -Max .--------------- From Ends -Max.------- From Ends -Max .------------- " (line 5 Koof !Dade: au f I C C( it IN 1 Size -Min.__.._-___-___ IPraLion (From Front) mmm my", wb� ROVED M1'�..v�a+•.—n•'yf. R;i,� [wS,tg r,YM„�''�,,• tr, ".. C�,+' TH BUTTE <COUNT.Y SCHOOLS` DEVELOPMENT Fff' CERTIFICATION FORM '(One Form;'per Building) A.P. Number � a. _ '' Build ikg Department No. School District �� City -County-PSL Jurisdiction Property Owner Project Location/Address Subdivision ;: Lot Number Residential Development: a Sq. Footage # of Living MHI Addition (Group R) Units 1 Commercial/Industrial: Sq. Footage New Addition (Including Exterior Roofed Areas) Building"DepartmIent Representative Date y f (.FTbor Plans reviewed,by School District Personnel)IL I `District Id No. ( , School ,'(Applicantf Name Street Address District certifies that (Phone Number) PL (City) (StatLO (Zip Code) t has complied with the+ requ,iyr.ement's of Resolution No. I �' by the payment,of $��;� �.''. representing square feet. A -MA -k (0 3 School Dis rict Representative ate PAID BY CHECK NO. REMARKS: 4 a U - BANK NO PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) AP #� -- C�- �Z-• OWNER i PERMIT Nei UTIL.CLEARANCE DATE INSPECTOR ELECTRIC GAS Support Struc.. Compaction Test -Req. Service Other Pipe YES NO YES NO ' Size Load Type Size Len th l leo � 3 ° .Q^,�' _ �' -8- `.�- .: •"' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. t 7 County Center Drive - OrRville, ddlifornia 95965 - Telephone: 916/538-7541 _ APPLICATION AND PERMIT ASS SSOR PARCEL NUMBER 63-300-052 ZONING U BUILDING PERMIT OWNER TELEPHONE 521-2205 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAIL NG ADDRESS Aiitilmn CONTRACT O R'S NAM E Ownpr TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace T$_ CONSTRUCTION LENDER UNKNOWN Total Valuation Filing Fee $ 11151W LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 408-2 Ili Marin T.Anp, Chirr) Each Trap 2.00 -2 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP PITI 8 — % Water piping - 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF [:1 Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W O.00ea X,00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities9l Installation[] Other ❑ Describe work:rro ^^' n , �Iv axcccrr�t t7��' �"�x >� Q t"t®=� Permit Fee $ 3© .06 Contractor ELECTRICAL PERMIT Filing Fee 10.00 V OR Main service 100 AMP ORSLESS 1 10.00 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification, YI, 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.S OR ADDNS. ACC. BLDGS. , /20sgit NEW CONSTR. U TI.OUTLET NO N.RESIO BRANCH CIRC ITS 2,50 ea POWER APPARATUS e SINGLE OUTLET CIR. ) Occup(OUTLETS OR FIXTURES Ex. Occu zo eAL130 FIXED PR EX. Occup. OUT LETS (RESID IEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 1 15.00 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. E] 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 aga' st said County in conseqnce of the anting o uf this p rmit. Date Signature of App l' — Owner Contractor ❑ Agent ❑ An OSHA permit I 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 $ H CUA- PARK SCHL FLD coF PAR PD I HD Issy�; V This permit is hereby issued unser sions of the Butte County.Code and/or work indicated above for which fees DIRECTOR/6Fj PUBLIC By � PER EXPIRES Date the applicable provi-Irfm resolutions to do have been paid. WORKS Date 7-22 Receipt NO. 88375 'Y t7 30, � WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, I.DENROD-APPLICANT i vn c t _-caT+rti7aw.a ,y,._ _.� - ..F - .-• • r-ti.+�. :�i�: �.'�- t "�•'tX,'R, �'�e•epi:+:wr.y`f+Yt1.•h�a3",'' .,°�'�'{,�'!.. . ; , c ¢ L""7 COUNTY OF BUTTE - DEPART-PeqTIOF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE�OROVILLE, CALIFORNIO,95966-- TELEPHONE: 916/538-7541 V/ ` PERMIT APPLICATION DATA SHEET ( r OWNER _/1/1 M Y _ ,/t�/c 4f Proposed Building Use Permit No. A. P No. Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to'permit processilIg and/or issuance:,) 'vDATE RECEIVED. APPROVED 1. All items have been submitted . ............ 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in dt�"plicate/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 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 . Fees of $ �r�`.0�........................................... -%/ 1 �j Chico Urban Area fees paid ....................................... 12. Park' fees paid % ......... 13. .. chool District fees paid .............. Sanitation approval from %% Health Department X5' City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of 1 (see City for other requirements) �' r 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway per;VAo c ion a roal e iprior to occupancy) —0� 21. Pre -Inspection for required •••Pre-Inspec. request to Building Inspector (Date) Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. 24. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization .............................. 27. When y-cau issue the permi process 06S follows: Mail o o ner. Mail to contractor. Z Telephone Z Oand hold for pickup atCoffice. Deliver w/inspector. Other ra. Applicant �'t .Date Copy of Hldz-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 r to rm• � su e: (Circle new item not checked above). 1. Index permit for above items No.04-)2 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone._rnaiI—counter by ..date Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by —Date -41q Plans approved by 6W Date % Sets of plans on hold in File cabinet AP folder Copy—DPW p Buildird Department FROM: Environmental-Haalth SUBJECT: Sanitation Clearance ;11A 4n 0xner Location AP# Plan Approved for: Sewace Disposal ✓ Water Supply '- Hold final for: Water Supply Final clearance O.X.- for: Clearance !or l bedroom mobile home. Other Water Supply Sanitarian Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMB Er 0�� 3 ZONING BUILDING PERMIT OWNER ` TELEPHONE 05' SO. FT. OCC.1 BUILDING VALUATION OWNER'9 MAILING ADO IESS z U CONTR O SNAM TELEPHONE CONTRA CTOR'SMAILI ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BU LDING ADDRESS Permlt fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping - 5,00 Each qas water heater or vent 5.00 US`E OF STRUCTURE SF ❑ Duplex[]Mobilehorufit Other "`SSS���� SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New❑ Addition❑ Remodel❑ Utilities,_ Installation[] Other[] Describe work:A)eU J E E C PO L0 �� _ —T—�� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eooV OR LESS 100 100 AMP OR LESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I am licensed under provisions of Chapt. 9, Div. 3 of the Bushes$ and Professions Code and my license is in full force and effect. License No. Classification. ❑as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure isnot 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 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.N OR ADDNS. ACC. BLOCS. , /zQsgft NEW CONSTR. U TI -OUTLET NON-RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS &) (PO OUTLET CIR. Ex. OCcU OUTLETS OR FIXTURES p 200500 eALO 30 FIXED APPLNS, Ex. Occup. OUTLETS RESID )RE A.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 ,Misc. Wiring 9 15.00 Q Permit Fee WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating 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. 1 agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner El 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 $ p Energy Inspection Fee $ occ CONST TYPE I TOTAL FEE $ H . CUA PARK SCHL FL coF PAF Po I HD. 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 PERMIT EXPIRES Date Receipt No. WNITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLD EMPOO-APPLICANT COUNTY OF BUTTE - Deoartment of Public Works . F 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will�be issued until this verification is received. /�. I personally plan to provide the- labor and materials for construction of / the roposed property improvementye or no) 2. I �hav/have not) signed an application for a building permit for the proposed work. 3. •I have contracted with the following person (firm) to provide the proposed construction: Name Address City 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 someof the work but I have contracted (hired) the following persons to provide the work indicated: T� Name Address Phone Type of Work Signed: Property Owner Social Security Number _.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. Return LO DPW - AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT s FOR RESIDENTIAL DEVELOPMENT Section 26-8:1: of the Butte County 'Code -. r.equi.res this. acknowledgement be recorded prior to :issuance of a building' permit. The property described herein is adjacent to land or included within an area zoned for agricultural pur.poses,- and residents of this property may be subject to incon- veniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides,' and fertilizers; and from the pursuit of� 'agricultural operations including, but not limited to cultivation, plowing, 8-40-425 spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor.Butte County has established a�ri.cul tural. zones which have as a priority use for productive agricultural. purposes, and resideill� within said zones and on adjacent property should -be prepared to accept such -i.nconvcuience or disconfor.m from normal, necessary farm operations.. All that real property situate in the County of Butte, State of California, described ;Iti follows. PARCEL 4, AS SHOWN ON THAT -CERTAIN_ PAR_CEL_,MAP,,ENTITLED,---"A .PORTION.- OF-- SECTIONS - 1� 'AND- 2, TOWNSHIP 22 NORTH, RANGE, 2 EAST, - M. D. B. & M. ", SAID PARCEL MAP WAS RECORDED IN THE OFFICE ,OF THE RECORDER --OF - THE --COUNTY, -OF--BUTTE; STATE -OF -CALIFORNIA, ON -JANUARY 26, 1981, IN BOOK 81 OF MAPS, AT PAGE(S) 57. 1 Date: �I PROPERTY OWNERS: �h. I 9k�m 1N� W tl 'E P-9 I- `"ommy W ii rrick 1 Slate of Ca ) SS County of Butte ) OFFICIAL SEAL ~ CAROL L. BIRD °o NOTARY PUBLIC — CALIFORNIA •. PRINCIPAL OFFICE IN BUTTE COUNTY My Commission Expires Oct. 30, 1992 On this the 29th day of November , 1.988 hefore Inc•, the undersigned Notary Public, personally appeared , mommy W Herrick Personally known to me., Proved to me on;; the ba..,,I'.-; of satisfactory•ev-Adence. to be the.person(s) whose name(s) subscribed to the within instrument and acknowledged that _ executed the same for the purposes therein contained. 1.N WT'.I'NRSS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. 063-30-0-n52 Notary PJAAC END OF DOCUMENT i .. �N, �u ��� J �p _._ ,b DENTE