HomeMy WebLinkAbout064-170-003\
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GILBERT GRAVES
14551
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GILBERT GRAVES
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t RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
COPY of Document Recorded
25 -Aug -2003 2003-0057336
Has not been compared with
original
BUTTE COUNTY RECORDER
SPACE ABOVE THIS LINE FOR RECORDER USE ONLY
NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH,
INSTALLATION ON A FOUNDATION SYSTEM
Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code
Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit
described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document
shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to
its contents to all persons thereafter dealing with the real property.
HARRY KARL KUYATH AND LOUANNA KUYATH
REAL PROPERTY OWNER/LESSOR
14551 CARNEGIE ROAD
MAILING ADDRESS
95965
MAGALIA�. BUTTE
CA 95954
CITY COUNTY
STATE ZIP
SAME '
Zgalft
INSTALLATION MAILING ADDRESS, IF DIFFERENT
SIMATURE OF LOCAL AGENCY OFFICIAL,
SAME
NONE
CITY COUNTY
STATE ZIP
. SAME
NONE
UNIT OWNER (if also property owner, write "SAME")
DEALER LICENSE NO.
SAME
MAILING ADDRESS
SAME
CITY COUNTY
STATE ZIP
UNIT DESCRIPTION
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
OROVILLE BUTTE CA
95965
CITY COUNTY STATE
ZIP
03-2315 530
538-7541
BUILD PERMIT NO., TELEPHONE NUMBER
Zgalft
$ A 1
SIMATURE OF LOCAL AGENCY OFFICIAL,
DATE
NONE
DEALER NAME (if not a dealer sale, write 'NONE')
NONE
DEALER LICENSE NO.
SKYLINE HOMES CORP 1981 CUSTOM VILLA / G00503B
MANUFACTURERS NAME DATE OF MANUFACTURE MODEL NAME NUNIBER
04700121AIB R 64'x24' 220292/1
SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER AP # 064-170-003
SEE ATTACHED
HCD FORM 433(A) REV. 8/91
WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept.
All that certain real property situate _n the State of California, County
of Butte, described as follows:
PARCEL I! Lot 11, as shown on that certain map entitled, "Paradise Pines
Lrni_t No. 1411, which map was recorded Jn the office of the recorder of the
Coui:ty of Butte, State of California, on July 15, 1971, in Book 3B of
A!?ps, at L ages 37, 38, 39, 40 and 41.
p
Excepting therefrom all minerals, oil, =gas, a.:phaltum and other
hvdrocarbon substances, with provision that any and all mining operations
shall be done from orifices outside the surface area of the land
ciE:suriued herein, and that no damage shall be done to surface of said
land.
ARCEL II:
non-exclusive easenent over lots A and B (the common area) of said
Par.aai-se Pines Unit. i.4', and the lots designated for common and.recreation
are as described in the Declaration of Panexation for units 1V, VI,
XIII AND. XIV.
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GNOLTDATION SYSTEM
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CERTIFICATEn4OFa0_ CCUPANCY5.1
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BUILDING PERMIT NUMBER: 03-2315
Address or location of unit: 14551 CARNEGIE ROAD, MAGALIA CA 95954
Legal Description of Real Property: AP # 064-170-003
SEE ATTACHED
(x) Mobilehome/Manufactured Home
() Commercial Coach
Has been affixed to the real property above by installation on a foundation system
pursuant to Health and Safety Code Section 18551.
Owner's name: HARRY KARL KUTATH AND LOUANNA KUYATH
Owner's address: 14551 CARNEGIE ROAD, MAGALIA CA 95954
INSIGNIA OR HUD NUMBER: 220292/1
SERIAL NUMBER OR V.I.N.: 04700121A/BR
MANUFACTURER'S NAME: SKYLINE HOMES CORP YEAR: 1981
OFFICIAL APPROVING INSTALLATION:
DATE: 9 1-03
PHONE: (530) 538-7541
H.C.D. 513C
STATE OF CALIFORNIA • BUStNBa9, IP M6PORTATION AND HOUSING AOCNCV
.�.._.._ --- ...... _ .....
GUY DAVIS, Gevmw
DEPARTMENT OF MOUSING AND COMMUNITY DEVELOPMENTsuvc q,
DIVlafon of Codes and Swndards
3 Q�
Title Search
Date printed : ' 07/07/2003
Decal. #: LAA4381 Use Code: SFD
Manufactures: 90002 SKYLINE HOLIES CORP Original Price Code: AKY
Tradenarne: CUS'T'OM v1 ,LA Rating Year:
Model: G00503B Tax Type: GPT
Manufactured Date: 07/08/1981 Last 1LT Amount:
Registration Exp: Date ILT Fee Paid: ,
First Sold On: 08/26/1981 ILT Exemption: NONE
Serial Number HUD Libel/ Insignia ' Length Width
04700121AR 220292 64' 12'
04700121BR 220291 64' 12'
Registered Owner:
HARRY K KUYATH
LOUANNA KUYATH (Joint Tenants with Right of Survivorsbip)
14551 CARNEGIE
MAGALIA, CA 95954
Last Title Date, 04/24/1992
Last Reg Card: ' 04/24/1992
a Sate/Trander tato: Price $34,500.00 Transferred on 03/06/1992
Situs Address:
14551 CARNEGIE
MADALIA, CA 95954' '
Situs County: BUTTE
Title Searches:
BIDWELL TITLE
7126A SKYWAY
P O BOX 490
PARADISE, CA 95967
Title Pile No: 209784 -MC
«*+ END 01° TITLE SEARCH«+°
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R^COR- • REOUESTED BY:
Harry marl Kuyath
Louanna Kuyath
1.4551 Carnegie Road
Magalia, CA 95954
WHEN RECORDED, K&IL' ' TO:
S,V4E AS ABOVE
*Sd.11, TAX STAT. rS To:
SAME AS ABOVE ^
APN 0- 170-003-0
94-.50222
94-050222: Rec Fee 9.00
I Check 9.00
Recorded I'
Official Records I
i County of I
i Butte I
i Candace J. Grubbs 1
Recorder I
8:02am 12 -Dec -94 I PUBL HP 2
I .v.•ua .-.t. n rf r�frT.. L+f1rs ,T1L. F.ATTaF1I �+ 4TL•4 '
NOTICE• "THIS' CONVEYANCE IS TO A REVOCABLE TRUST OR TRUSTEE NOT
YtJiES NT TO P�SP.LE- AND IS EXEMPT FROM TAX AND THE UNDERSIGNED ARE THE
DECLARANTS.'"
,
G R A N 'i DF E D
GRANTORS, Harry Karl Kuyath AND Louanna Kuyath, HUSBAND AND WIFE, GRANTS
TO GRANTEES, Harry Karl Kuyath AND Louanna Kuyath, AS TRUSTEES OF THE
KARL AND LOUANNA'KUYATH FAMILY TRUST, DATED ,
All that certain real property situate ,_n the State of California, County
of Butte, described as follows:
PARCEL_I- tot11, as shown on that certain map entitled, "Paradise Pines
Unit No. 14", which map was recorded in the office of the recorder of the
County of Butte, � State of California, on July 15, 1971, in nook 38 of
Maps, at pages 3'1, 38, 39, 40 and 41.
Excepting therefrom. all minerals, oil, gas, a:_phaltum and other
hv� rocarbon substances, with provision that any and all mining operations
stall be done from orifices outside the surface area of the land
herein, and that no aamage shall he done to surface of said
land.
2Ct7L IT:
A non-exclusiVe easenent over lots A and B (the common area) of said
^ar.ai°i-se Pines Unit;.4, and the lots designated for common and recreation
ureas, as -described in the Declaration of P.nnexa-ion for units 1V, VI,
,'111, X, „I', XII, XIII AND XIV.
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Page 1 of 2•
. t
E
04-50222
.ITNESS OUR HAND THIS DAY OF 19�.
! �
Harry .arl Y.uyath Ir3Ganna Kuyath�-'.
STATE OF CALIFORNIA ) CAPACITY CLAIMED BY SIGNER
) SS. i i_i INDIVIDUAL
COUNTY OF Butte ) _
CORPORATE
On this <- day, of _(7LC.r pt .4,;:F el , , OFFICER(S)
in the year of 1994, before me,
C:-. ,� �T� =' , Notary Public,
personally appeared Harry Karl Kuyath
and`Louanna Kuyath ----
' personally Y.noV.n to me OR
i;',,i Proved to me on the basis
of satisfactory evidence to be the
persons whose names are subscribed to
the within instrument and
acknowledged to me that they executed
the same in their authorized
capacities, -and that .'.)y- their
signFtures on the instrument the
persons, or the entity upon behalf of
which the persons acted, executed the
instrument.
WITNESS ny hard and official -- al.
SIGNATliRE OF NOTAR-Y"
_ TITLES _
PARTNER(S)
_ L `4ITED
_i GENERAL
ATTORNEY-IN-FACT
X� TRUSTEES
GUARDIAN/CONSERVATOR
OTHER:
SIGNER IS REPRESENTING:
.NAME OF PERSON(S) OR
ENTITY(IES)
Page 2 o -f 2
eon C)F DorUMF-NT
eNg'D dV Frv�..v.a.�sdi
N
All that certain real property situate _n the State oz ua.L.LLVL17ia, ..--.-j
of Butte, described as.follows:
i
PARCEL I: Lot 11, as -shown on that certain reap entitled, "Paradise Pines
Unit No. 1411, which map was recorded in the office of the recorder of the
i County of Butte, State of California, on July 15, 1971, in nook: 38 Of
i A_•�ps, at pages 37, 38, 39, 40 and 41.
Excepting therefrom -all minerals, oil, gas, a::phaltum and other
hydrocarbon substanczs, with provision that any and all raining operations
shall be done from orifices outside the surface area of the land
dez7c riled herein, and, that no damage shall be dome to surface of sai(1'
land.
^nitC.r, I7
i� non-exclusive easement over lots A and S (the common area) of said
. -ar_-Oise Pines'Uni', 14, and the lots designated for common and recreation
ureas, as described in the Declaration of banexation for units 1V, VI,
X, y,i, XII, VIII ANC XIV.
I
Page 1 of 2
V NOTES
R
i
PERMIT
RESIDENTIAL
064-170-003 03-2315
KUYATH, MR. & MRS.
14551•CARNVGIE,-MAGALIA - --
Cont: SIERRA MHS
EX MH PERM FND EX SITE
THE HCD FORM 433A FOR THIS MH CANNOT BE,
fl RECORDED UNTIL ONE OF THE FOLLOWING HAS
-BIyEN TURNED IN TO THE BUILDING DIVISION:
(1) LICENSE PLO- E(S) OR DECAL (THE
--- INSPECTOR MUST RETREIVE).
(2) STATEMENT OF FACTS (ONLY ON
-- �; NEW MH'S).
DISPECTOR TO VERIFY SERIAL & LABEL #'S.
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
r
JOB FINALED (Date) ;v Irl
X<4� r,,44�
Signature
CHECKED
BY
�lJ=OK
0 = Not OK
. = otReadyable
Card B-1 Date . Card B-1
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1.
1.
Zoning Requirements -Setbacks -Easements
0
2.
Soils; Special MH Support Sketch
4.
3.
Sewer; Location -Test -Fall -C/O -Concrete
Drain; MH Test -Fall -Flex Connector
4.
Water; Location -Test -Easement Needed (Sketch)
7.
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
Gas and Electricity Tagged
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat. or/ /" L "ft./ P LPG
7. Well Clearance & Disconnect
8. Utilitv Clearance
Date
Card B-1 Date . Card B-1
Date
Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK :except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line -
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
Tie Downs -Type -Installation Cert:
10.
Exits; Insp.-Sketch
11. Cert. of Occupancy
7.
Date
Card B-1 Date
Card B-1
Date
Card B-1 Date
Card B-1
Date
PERMANENT END SYSTEM.(ONLY)
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
1. Zoning Requirements -Setbacks -Easements
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
2. Footings; Size -Spacing -Marriage Line.
3.
3. Blocking
4.
4. Gas; MH Test -Demand -Valve
5:
5. Electricity; MH Test
6.
6. Water; MH Test
7.
7. Water and Sewer Connected
8.
8. Gas and Electricity Tagged
9.
9. Exits t • ,
10.
10. License Decals --
11.
11. Verify #'s with Office '
12.
Enclosure; Fencing -Alarms
Date
Card B-1 Date
Card B-1
Date
Card B-1 Date
Card B-1
Card B-1 Date Card B-1
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing ,
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5:
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Panelboards-Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single &. Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftp. -Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
Date
15.
Access & Ventilation
47. Hangers -Post Caps -Anchors -Connectors
16.
Insulation
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
Date
Card B-1 Date Card B-1
Date
52. Garage Fire Protection Framing -RC Channel
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
17.
Water Htr.; Vent -Access -Combustion Air Baffle
18.
Water Pipe; Test & Anchor -Nail Protection
57. Siding -Nailing Veneer
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
20.
Shower Pan; Test, First Floor -Tub Access
60. Shear Walls; Nailing -Bolts
21.
Test Tub & Shower, Second Floor -Tub Access
22.
Gas Pipe; Sixe & Anchors
63. Infiltration -Walls -Windows
23.
Fire Sprinkler; Test
Date
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
65. Smoke Detector
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
67. Bedroom Exiting
24.
Fixture & Transformer Clearance -Ins. Protection
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
70. Stairs & Rails
26.
Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
74. Elec. Outlets & Receptacles at Kit. Counter
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral 0 Yes 0 No
32.
Service -Riser Conductors & Ground Main Disconnect
80. Insulation -Foam -Looked in Attic
33.
Equip. Clearances Panels-Motors-Mech. Equip.
34.
Clothes Closet Light -Shower Light -Spa Light
Clearance Looked under Floor 0 Yes
35. Smoke Detector
83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No
84. Stucco Brown -Finish
Date
85. A.C. Unit Disconnect, Electrical -Plumbing
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36.
A.C. Ducts Insulation & Support
90. Glass Protection
37.
Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
94. Energy Compliance Certificate -Other Certificates
40.
Attic Access & Platform if Furnace in Attic
Date
96. Fire Sprinkler
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
Comments at Final:
41.
Sills Proper Materials & Anchors
42.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
43.
Bearing Walls over Girders & Floor Nailing
44.
Draft Stop in Walls (rat proof)
45.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46.
Headers & Beams -Size & Bearing
Date
FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng.
49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -'Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s'
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door; Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
_
83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE --DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
c7.County'Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 /� PERMIT No°'
(Rev.12/96g' r APPLICATION AND PERMIT ,.
(J3'.il�
ASSESSOR PARCEL NUMBER
064-170-003
ZONING
-1'
BUILDING PERMIT
OWNER
KlIVA774 AR
TELEPHONE
I- sn
Sp, FT, OCC. BUILDING VALUATION
11440 A %�!1
.OWNERS MAID ADDRESS v
14551 CARNEG A , 1 95Q5_4
-- , . " .
CONTRACTOR'S NAME
SIERRA M14 SERVICE
TELEPHONE
5-34-0 599
CONTRACTORS MAILING DRIVE, I �' Q
C7 CIRCLE 1 lei �}V EMMM 1
_Z - �
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee r,/.n $ 7 7
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan CheckingFee $ �Z
BUILDING ADDRESS
Energy Plan Checking Fee $
_y _ _ �'_� - !
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee '20'.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome 'IqK Other
SPECIFY
Each Trap 1 7.00
Solar or heat pump water heater 23.00
Water piping 15.00 1 S
Each gas water heater or vent 15.00. — d
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other
Describe Work: EX MH ON PERM M
Gas piping system 1 - 5 outlets 15.00 � tlfl
Building sewer 15.00
Mobile Home ISI GI W1 @20.00
PERMIT FEE $ �o inn
ELECTRICAL PERMIT Fling Fee 20.00
OV OR LE
Main Service . OR LESS 23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class I'll Lic. No. 10c 1 S� C
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
O I have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier ��C,...2'a -• .t...-� �'
Policy Number L 1;1
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X Date 9/1/4 3 _
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or constructionI
of structures over 3 stories in height.
Main Service 200A TO +000A 46.00NEW
CONST. DWELLING OCCUR SO
OR ADDNS. ( & ACC. BLDS. 3.5tx,
NON.REOSID. MULTI -OUTLET BRANCH UITS @7,50
POWER APPARATUS
& SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FDTTURES ZO @'
BAIL @ .SO
Ex. Occup. DFuc�e ES,6.)
RE 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 363.25
HAZ.
D. FEES IMP
FLOOD
CDF PARCEL PD HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By 10 & iliv Date U
,
PERMIT EXPIRES ON j (� �4MV
Date/
I
ReceiptNo. S (i �, T r
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
" COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 Oounty Center Drive • Oroville, California 95965 • Telephone (530) 538-7541
(Rev. 12/961 ' APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
064-170-003
ZONING
R-1
BUinINGPERMIT
OWNER
L
TELEPHONE
SO. Fr, OCC. BUILDING VALUATION
. OWNER'S MAILI ADDRESS
14551 CARNEGIE 'RD- MAGAT-TA, CA 95954
1440 77y760-
CONTRACTOR'S NAME
STERRA MR ;FRVTC.P.
TELEPHONE
S34-0599
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
270.25 7"N
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checkin Fee $
BUILDING ADDRESS Q4_R_NR_Q9 RD. j, NX 144GALIA
Energy Plan Checking Fee $
PERMIT FEE
LOT NO.
SUBDNISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome NX Other
SPECIFY
Each Trap 1
7.00
Solar or heat pump water heater 1
23.00
Water piping
15.00 1 9-00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other
Describe Work: EX MH ON PERM FMD
Gas piping stem 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI GI W1
@20.00
PERMIT FEE $
ELECTRICAL PERMITFling
Fee 20.00
Main Service eoov OR LER ss
200A OLESS
23.00
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class C7 Lic. No. `t/% a 3�6
OWNER -BUILDER DECLARATION
from the Contractors License
I hereby affirm under penalty of perjury that I am exemptA
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier S�
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certifythat in the performance of the work for which this permit is issued, I shall
p p
not employ any person in any manner so as to become subject to workers'
' compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
X _ Date _g `� Q 3
Signature of Applican - ❑Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A 46.00NEW
CONST. DWELLING Occup. SO
OR ADONS. ( 8 ACC. BMS. 3.5QFT.
=NONR�lpT MULTI -OUTLET 97,50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FO(TURES SAL @';50
Ex. Occup. oFIXEDs E,s ) 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ -363.25
HAZ D FEES IMP
I FLOOD 4F PARCEL
_
PD
HD
6SU
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
,\
By Dat
PERMIT EXPIRES O p I
provisions
to do work
paid.
/ 0
ete
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESS R PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE -DEPARTMENT OF DEV. L(*MENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA� 959 h 1530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
70
Proposed
,(1�
OWNER: � � n ASSESSOR PARCEL NUMBER 70
Proposed Building Use: �'X MH Q�a(m rid Counter Technician: � Date:
Items required in order to apply for a per it. All boxes MUST be checked OR marked NA in order to apply.
V1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Energy compliance design and supporting documentation in duplicate.
❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate,. (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be
stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and
returned to the plan review line-up when required items are received. '
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate...
❑ 9. Site plan and business license approval from the City of Biggs.......
❑ 10. Letter of intent for non-residential buildings ...............................
❑ 11. Detached Accessory Building Form filled out by the owner.........
❑ 12. Hazardous Material Form ......................................................
❑ 13. Fire Sprinklers.....................................................................
❑ 14. Agricultural Buffer clr and site plan apr from the Ag Commissioner
❑ 15. Other
Date Received By
........................
\..
Sent by
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 16. Fees as shown on the attached Schedule of Fees Due Sheet .......................................
❑ 17. Statement of Intent for Non -heated and A/C Buildings .............................................
❑ 18. Sanitation and site plan approval from the Environmental Health Department in
❑ 19. City of Chico Plumbing permit........................................................................
❑ 20. California Department of Forestry plan approval ❑ paid. Sent by: ......................
❑ 21.• Planning approval for (A) Use: (B)Parking: (C) Parcel Check:
❑ 22. Contact Land Development about ❑ Improvements, ❑ Drainage ...............................
❑ 23. NPDES Form...........................................................:.................................
❑ Encroachment Permit for driveway from the Public Works Dept .................................
5. Pre -Inspection for /e( i M f"f U required ................
26. Contractor's license information. umber, Name -Style, Classification) ......................
❑ 27. Worker's Compensation Carrier and Policy Number .............................................
❑ 28. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) .....................
❑ 29. Letter of Signature authorization....................................................................
El 30. Recorded copy of Agricultural Acknowledgment Statement ....................................
❑ 31. Manufactured home utility clearance...............................................................
❑ 32. EA ting violations nd/or exp' ed permits .....................................................
❑ 33.Grant Deed;&M.H. Titltatement of Facts, ❑ Letter from Legal Owner, heck to H.C.D. $ ✓ v Gv
❑ 34. Other:
When issued Telephone and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant: Date: S/`// 3
1. Index permit application for the above items numbered: Plan Check Letter
2. Additional items required
Contractor, *designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, owner, was advised of the ve data bye,❑ phone, Elmail, ❑ coun er, by Date:
Plans reviewed by: Date: ✓ Plans approved by: Date:
Structural reviewed by: -Date: Q_4 Structural approved by: Dat
Note transfer by: Date:
Yellow: Building Division
August 15, 2003
Mr. and Mrs. Kuyath
-14551 Carnegie
Magalia, CA 95966
0
Department of Development Services
Building Division
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 (530) 538-2140 FAX
Assessor Parcel Number: 064-170-003
Building Permit Number: 03-2315
Thank you for submitting the plans for your building project. The plans have been reviewed, and
the plan examiner's comments are listed below. Please respond in writing to each item by
completing and returning the enclosed PLAN REVIEW RESPONSE FORM. Your complete
and clear response will expedite the re -check and approval of this project.
NON=STRUCTURAL COMMENTS:
None
ST UCTURAL COMMENTS:
Provide engineered plans, details and supporting calculations indicating how the mobile
home is supported and anchored to the garage below. To qualify as a permanent foundation
system, verification must be provided that the garage and attachment of the mobile to the
`garage is adequate to resist wind and seismic forces.
If you wish to discuss any of these requirements, please call (530) 538-7541 between the hours
of 1:00 p.m. and 4:00 p.m., Monday through Friday. To discuss non-structural items, ask for
Martha. Philo will answer your structural questions.
Please refer to your Data Sheet for remaining non -plan check items. (You received this form
when you applied for your permit.) The counter staff will answer any questions concerning the
Data Sheet.
Martha Christy Philo Hunt, P.E.
Plans Examiner Plan Check Engineer
1 of 1
Kuyath Family Trust Residence 08U170-0-3]
Kenneth D. Reed, P.E.
Registered Civil Engineer
8976 Simmons Rd
Redding, CA 96001
Voice/Fax 530-243-3296
Foundation System
for
Kuyath family Trust Manufactured Home
at
14551 Carnegie Road
Magalia, CA 95954
Foundation meets the requirements set forth Permanent Foundation Guides for Manufactured Housing dated
September, 1996 in paragraph 3-4b, as well as to the standards of other HUD Handbooks such as 4145.1 Revision 2,
and 4150.1 Revision 1
Using 1997 UBC, Seismic Zone 3, 80 mph wind, Exposure B
Foundation System -is classified as C2 -- allowed in all seismic zones
Coach is Multi -Section
Coach Length L = 60 ft
Coach Width W = 24 ft
Roof Pitch = 3:12
Coach Weight Wt = 39120 lb
SITE CONDITIONS
Site does not require a survey .
Building site is not in a flood -prone area
The unit is not to be on an elevated foundation
Per Appendix H, Frost Penetration Depth is 0"
Footing plan shows footing at or below Frost Penetration Depth
Footing base shall be place below topsoil layer, on undisturbed soil
Groundwater Drainage Plan is not required
Organic Soil is not present
Expansive Soil is not present
Site has minimal slope
Subsidence is not present
Area is not a known termite infestation area
BUTTS A�q UNTY
BUILDING ENE T M E N T
A P V 'D
Applicant has complied with local ordinances & CABO R-308 for construction procedures
D:\Data files\HUD_4930\2003WuyaN
i
Kuyath Famfl-y7r—usTFTiesidence 08/UT77070
Surface Drainage Plan data is provided ori attached Plot Plan
Grading Plan is riot required
There are no fill specifications
Finish grade elevation is unknown `
FOUNDATION DESIGN
Distributed Weight Wd : = Lt Wd = 652 plf
Design Snow Load SL = 20 psf
Basic Windspeed = 80 mph
Site is Inland
Seismic Zone is-3 -- Type C2 Foundation System is acceptable
Floor Live Load LLf:=40•psf
Seismic Load, UBC - Z = 0.3 , C = 2.75 , R,: = 6
Z.C. 1.0
V:= - V=0.137 W
R,
Wind Load - 80 mph, Method 1, 0-15' Exposure "C ✓
Ce = 0.62
Cq for Windward Wall Cel : = 0.8
Cq for Windward Roof C,2:'= -0.7
Cq for Leeward Roof C,3: =-0.7
Cq for Leeward Wall . C,4: =-0.5
qs : = 16.4-psf
1:=1.0
C1 Ce-Cel-l.gs CI=8.1psf
C2 Ce- CeTI.gS C2 = -7.1 psf
C3: = Ce'CeTI.gs C3 = -7.1 psf
C4: = Ce- Ce4-1'gs: C4 = -5.1 psf
DAData files1HUD_4930\2003\Kuyath\
Kuyath Family Trus est ence 08 0 20
SIN e
me o_C2
windward
Y
CI h
hl2
..t
2'
T
r_
A is
d
..
0= atan� y I 0= 14 deg h= 8 ft y= 3 ft 1:= 2
L \ 2 / J case )
Seismic Load ps : = Wt• V , Ps = 53791b
Wind Load pw : _ ( C1•h - C4 -h+ C2•sin( 0) •I1 - C3•sin( 0) •11) •L PW = 6345 lb
Support Pier Spacing s = 6.5 ft o.c.
W,
-- s
Moment Arm d. = s + 2 d = 9.2 ft
2 '
I1 = 12.4 ft
OTMCL: = Cl -h- 2 - C4 -h- 2 - C3 sin( 0) y. h + 2 I - C3 cos(0) W �d + 4 j ... L
+C2sin( 0) yI h+ ) CT cOS( 0) W d+41
OTMCL = 17 X015 lb ft
Dead Load Moment RM: = Wt.W RM = 469,440 lb ft Z
2
and
C4
hl2
Wind Controls
WNW flles\HUD_493012003\Kuy h7
Kuyath Family Trust Residence 08/01/20031
OTMCL —3 • RM
Holdown Force HD: _ HD = —14697 Ib No Vertical Anchorage is Needed
d
Transverse Sliding.
Longitudinal Sliding
Bearing Load
max Ps , Pu,)
ST:= N- -
Ps
SL:- N
ST = 2115 Ib < allowable
SL = 1793 lb < allowable
Pbrg : =Wt + (W + 2•ft)•L•( SL + LLf) Pbrg = 1327201b
Number of retrofit piers, N = 3
Number of remaining intermediate piers, Ni = 32 y
Bearing Pressure gbrg : = Pbrg gbrg 15g� p psf < allowable
N•6.67-sf + Ni-2-sf
This Manufactured Home is supported at one end by an engineered 24'x 24' garage below. This garage
and its attachment to the manufactured home was done in accordance with the 1 79� 6 UBC. This
foundation system analysis is for the portion of the Manufactured Home that is not supported by the
garage below.
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Building Permit Number: 6 3-231 �
Owner Name: )" Wem
Residential Construction Requirements
IMPORTANT
This set of plans and specifications MUST be kept on the job site at all times and it is
unlawful to make any changes or alterations on same without written permission from the
Building Division, County of Butte.
All materials and workmanship shall be in accordance with recognized good practices
and of a quality prescribed for the specific use in the 2001 California Building Code
(2001 U.B.C), 2000 California Plumbing Code ( 2000 U.P.C.), 2000 California
Mechanical Code (2000 U.M.C.) and the.1999 California Electrical Code (1999 N.E.C.)
COMPLY WITH ITEMS CHECKED BELOW
Your parcel lies within a designated 100 -year flood plain. Finish floor, electrical,
H.V.A.C. equipment and services shall be a minimum of one foot above the elevation
shown on the attached Flood Elevation Certificate. A Post Flood Elevation Certificate
will also be required
Note: We will normally accept the following as compliance with the flood elevation
requirements:
1. Building is anchored to concrete stemwall system with conventional anchor bolts.
2. Building plate on top'of stemwall to be one foot or more above the 100 -year flood
elevation. (Plate height less than 24" above grade, or engineered design required).
3. Electrical, heating, ventilation, plumbing and air conditioning equipment and
facilities located above the plate.
4. At least 2 openings in exterior walls, located on opposite or adjacent walls with a total
net area of not less than 1 square inch for every square foot of enclosed area.
5. The bottom of the openings shall be no higher than 1 foot above grade.
6. The openings may be screened or covered with other devices that will permit
automatic entry and exit of floodwater.
Page 2of 2
Building Permit Number:
Owner Name:
Parcel lies within the State Responsibility Area (SRA). Comply with attached
requirements.
Fire sprinklers are required in this structure.
The following parcel map requirements shall be met:
All,structures and equipment including overhangs shall be clear of all easements.
A setback ofXD1*4ne from the side and -6 feet from the rear property lines and 20
feet (25 feet if Federal Aid Route) from the edge of the right of way shall be clear of
structures and equipment except for a 2 foot overhang.
'lotExpansive soil may be encountered on this site. This condition may require the
foundation to be designed by a California registered engineer or licensed architect.
AAP M .s l<v�'RTt-r
I4ss 1 Co)R ►E(;.ir
06`x— 110- 003
813 - 506
13,e
NOTE:
See the attached
Re
Ai Conatr&on
Reg irementa
2
Pages
21�+
Ott K
cvMot31�>r ��:;. �od1�F
ovti� I Noa�E
GARP.c-s. I
I
t
v8 C o 1) D
i o2'
10
p � 2 31snm c-
UTT2 (NOUN 6 Y
110ILDING Dl=PARTTMF
� P P R 0 V F
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroyille, CA
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's name: « 6 AEI_ e��o�UL S
2. Installer's name: /-cc-ifA�0 ,,T 5;��,E�,� /K 14 Se2y;c�
3. Is the.—site—currently under permit? Yes 7_77-1___
`jam No
(If yes, furnish permit number to OR
Is the site an existing site? Yes /`' / No
(If yes., furnish two (2) plot plans,)
4. Will the mobilehome be located at least 5 ft. away from septic tank and leaoh fields and
clear.of all setbacks and easements? Yes /1//
No
( If no, clarify
5.
What
is the mobilehome electrical rating? -----------------------
Zp
o
Amps"
6'.
What
is the mobilehome site service rating? ---------------------
d
-� o
_ APs
7..
What
is the mobilehome site circuit breaker rating? -------- 2 o O
Amps
p
S.
iIs there any other electric load to be served by the
mobilehome
site
service?---
--------------------------------------------------
Yes
No
(If yes, identify the load and size:
(Load)
(APs)
9.
What
is the mobilehome site gas pipe size? ----------------------
�—
(in.)
10.
What
is the type of gas service? -----------------------------
Natural LPG
/ /
11.
What
is the gas pipe length from meter or'tank to
the mobilehome?
12,
What
is the mobilehome gas demand? ----------------o_---_-----_--
(B )
(This information not required if pipe length
less than 6 ft. on natural gas
or less than 50 ft, on LPG.)
r3I)TT= COUN s
gUILDING ®EPAPTM .'t.
'
� P R ON F'
MOBILEHOME SUPPORT DATA
If.other''than single wide,
Mobilehome Mfr.s,� CLIA✓ .s a -3 1
} furnish Setup Model No. Year
Width(ft.) Box Length loo (£t.) Tagalong or Ex Ando Size _- ft. xr
ft.
(SHOW SUPPORT DETAILS BELOW)
On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
All center supports measured from front of
mobilehome unless otherwise specified.
Footings (check one)
Single [:] 1. Wood either
AApressure treated o;
,( foundation grade.
(ft.)(in;) (in.) (in.) 2. Other: (specify) .
:enter support Center support
locations* footing sizes Supports (check one)
GI
(in.)
1: Concrete block.
L.� . X i .2: Other. (specify)
(ft.)(in.(in.) (in.-)
iVo
<—Tagalong or Expando,'.
show support details.
(ft.)(in.) (in.) (in.)
SO
Typical Support
Footing Size
(in.) (in.) -- Max. Pier Spacing
(ft.)(in.) 80TTE C®UN f
�JILDiNG DEPART["
L x J -- Max. Overhang V
(in.)
6 (ft.)(in.)
-7
J T TE ��� , ` ; ► :�
*
BUILDING DEPARTMENT
ADROVED
If center piers are other than drawn above /Z.
P ,
9raw in . -locations. snacine_ and d;mPnsiona_
VECTOR DYNAMICS
FOUNDATION SYSTEM
WIND ZONE 1 & 2
INSTALLATION INSTRUCTIONS
For the State of California
INDEX
SECTION
INTRODUCTION
PIER HEIGHTS
GENERAL INSTALLATION
SETUP INSTRUCTIONS
METAL PIER & V -DRIVE
PARTS LIST
CONCRETE INSTALLATION
SCHEMATICS
PAGE
NUMBER
3
4
5&5a
6
7, 7A, 713 & 7C
8&9
WIND ZONE I - SINGLE SECTION
10
- SINGLE V -DRIVE
11
- METAL.PIER _ __ _ _
12
LDOUBLE SECTION. _
-133
- TRIPLE SECTION
14
WIND ZONE II - SINGLE SECTION
15
- DOUBLE SECTION
16
- TRIPLE SECTION
17
SOIL CLASSIFICATION
COMPONENT PARTS AVAILABLE UPON REQUEST
Foundation System
BUTTE GGUN 1"t
UILDING DEPARTME.
P P R 0 V
Release Date 8/13/2001
Engineer Approval
x: N.
n
201
18551
Lo
SUBJECT TO CORRECTIONS NOTED
APPROVAL DOES NOTAUTHORIZE OR APPROVE ANY
OMISSIONS OR DEVIATION FROM REQUIREMENTS OF
APPLICABLE STATE LAWS AND REGULATIONS
State of Cw0mia
Department of Housing and Community Development
DMS C AND STANDARDS
Ey Date -/O -O /
(sign ure)
SPA NO. 99 IF
9-/D -off
For Further Information
TIE DOWN ENGINEERING
5901 Wheaton Drive
Atlanta, GA 30336
404-344-0000
FAX 404-349-0401
www.tiedown.com
Tie Down Engineering, Inc.
VECTOR DYNAMICS INSTALLATION INSTRUCTIONS
Introduction
These instructions describe the proper use of the Vector Dynamics Foundation System in Wind Zones 1 & 2. Additional
installation instruction is available in VHS video, from manufactured housing distributors or from Tie Down Engineering, tilled, Vector Dynamics Installation
Video.
The Vector Dynamics foundation system supports the home by anchoring the two longitudinal main rails. The system is approved in Wind Zone I & II &
III areas of the Manufactured Home Construction and Safety Standards and Wind Standards; Final Rule 24CFR part 3280 for both single and multi sec-
tion homes. Instructions for Class 5, Sub Soil Conditions, (Wind Zone I & II), are available through local distributors of Vector Dynamics or directly from
Tie Down Engineering.
General
The Vector Dynamics Foundation System provides the support to resist lateral and over -turning movement of the home as required by the Federal
Manufactured Home Construction and Safety Standards in Wind Zones I & II when the system is used as described in these instructions. See manufac-
tures Home Installation Manual for other Qier & anchoring requirements. The following characteristics apply to both single and multi section homes:.
• Main rail minimum spacing of 86 inches or greater.
• Nominal 8 foot or less top plate height at side walls.
• Main rail depth of 12 inches or less.
• Maximum roof slope of 20 degrees (4.4 in. in 12 in.)
• Maximum pier height under main rail of 56 inches (see page 3).
WIND ZONE 1
• Maximum single section home width is 16 feet including eaves; maximum eave width of 12 inches on each longitudinal side of home.
• Maximum double section home width is 36 feet including eaves; maximum eave width of 12 inches on each longitudinal side of home.
• Maximum triple section home width is 48 feet including eaves; maximum eave width of 12.inches on each longitudinal side of home.
WIND ZONE II
• Maximum single section home width is 15 ft. including eaves, maximum eave width is 6" per side.
• Maximum single section home width of 16 fL including eaves must use two additional vertical ties/
anchors/stabilizer plates (one per side) as listed in the charts on page 15.
• Maximum double section home width including eaves 32 ft., maximum 12" eaves per side
• Maximum triple section home width including eaves 48 ft., maximum 12" eaves per side
The Vector Dynamics Foundation Systems may be used as a part of the vertical or gravity support system considering that each set of Vector Dynamic
pad (s) has two (2) or three (3) square feet bearing area. Piers not used as part of the Vector system shall be located and constructed in accordance with
the home installation instructions and/or state standards.
To inquire about the use of the Vector Dynamics Foundation Systems with homes of four or more sections or on homes requiring pier heights greater than
56 inches which are not included in these instructions, contact Tie Down Engineering, Inc. at 800-241-1806.
The Vector Dynamics Foundation Systems may be used on homes which require pier heights not to exceed 56 inches under one or both main rail(s). See
page 3. Note that a ground anchor is used at each Vector system location in Wind Zones II & III. The use of interlocked double stacks of concrete blocks
may be required by the home manufacturer or the state. Check with the most recent regulations in California.
The Vector Dynamics Foundation System has not been designed for use on exposure "D" homes. Exposure "D" homes are homes located within 1500
feet of the coastline.
Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations include shear walls, mar-
riage line ridge beam support posts, end frame ties and rim plates. The term end frame ties refers to the longitudinal ties that are attached to a home to
resist wind load on the end walls. If longitudinal ties are required by the home installation instructions or other state standards, these longitudinal ties must
be installed and connected to anchors that are independent of other ties and anchors. See separate instructions for the use of Vector Dynamics with Tie
Down's Longitudinal Stabilization Device. The term rim plates refers to the factory brackets fastened onto the perimeter joist or specified as a location for
vertical ties.
Page 2 California 8/2001
56 i
ma
Figure 1
Maximum Pier Height (Wind Zones 1 & II only)
The Vector Dynamics Foundation System may be used on homes which require pier heights not to exceed 56 inches
under one or both main rail(s). Note that a ground anchor must be used at each side of a Vector system location
in Wind Zone II, and where the pier heights exceed 24 inches on a single section home in Wind Zone I. Piers
must be constructed in accordance with the manufacturer's installation instructions and/or state requirements.
The use of interlocked double stacks of concrete blocks may be required by the home manufacturer or state. Check
with the most recent regulations in your state.
56 i
mai
rnyu►e c
Unequal Pier Heights ( Wind Zones I & II only)
3 in.
iax.
Vector Dynamics may be used on homes with unequal pier heights of 56" or less under one or both main rails.
The difference between the taller pier and the shorter pier cannot exceed 26". Note that a ground anchor must be
used at each side of a Vector system installation in Wind Zone I and where either of the pier heights in that location
exceeds 24 inches on, a single section home in Wind Zone I. Only concrete blocks and pressure treated lumber
compression members are permitted on unequal pier heights.using the Vector system. Piers must be constructed
in accordance with themanufacturer's installation instructions and/or state requirements. The use of interlocked
double stacks of concrete blocks may be required by the home manufacturer or state. Check with the most recent
regulations in your state.
c
Page 3 California 2001
GENERAL INSTALLATION INSTRUCTIONS
SITE PREPARATION
It is necessary that the home site be properly graded and sloped to prevent water and moisture from standing or
flowing beneath the home. See manufacturer's home installation manual and state requirements for grading
and other site preparation.
FOOTINGS AND FROST LINES
The Vector Dynamics Foundation System can be placed directly on top of the ground after clearing all loose
vegetation. In areas where frost line/poured footers are required, the Vector system for concrete is used. See
pages 8 & 9.
FOUNDATION/FOOTING SPECIFICATIONS FOR VECTOR PADS
Vector Pads must be used in place of conventional foundation pads for each Vector foundation system. Each
(set of) Vector Pad(s) provides two or three square feet of pier bearing support. Vector Systems should be
spaced as evenly as possible along the length of the home, with one Vector system within two feet of each end
of the home. For pier locations in between the Vector Systems, use the foundation pads normally recommended
by the home manufacturer and/or state requirements. Pier heights in excess of 24 inches or when unequal must
follow instructions printed on page 3 of these instructions. Nominal 3-1/2 inch or 4 inch Schedule 40 PVC pipe
or TDE steel compression strut (#59043) may be used only when the pier heights are similar on fairly level
ground. Steel strut and PVC are not permitted when metal pier foundations are used. The adjustable galva-
nized steel compression strut, #59043, is attached to each inside pad with a 1/2" X 2-1/2" grade 5 carriage bolt
and can only be used with the swivel connector on strap. The grade 5 bolt attaches the swivel connector and
the steel strut to the pad. When the swivel connector is used with a wooden or pipe compressive member, the
vector diagonal connector should be part #59279 not #59276. After tightening the end grade 5 bolts, adjust-
ment bolt is installed through the two square steel compression struts to lock them in place. Foundation pad size
and pier spacing must be consistent with home manufacturers' instructions and/or state requirements.
LUMBER/MOISTURE - TERMITE SHIELD
To cut lumber (2 - 2x4's or 1 - 4x4 per Vector system) for the center compression section, when using con-
crete blocks for piers, measure center to center frame (I-beam) distance and subtract 16". When using METAL
PIER STANDS, measure center to center frame distance and add 16". 3-1/2" or 4" nominal schedule 40 PVC
pipe meeting ASTM D1784 or Tie Down's steel compression strut (#59043) may be substituted for lumber
as the center compression strut under certain conditions described above. Pipe adapter bracket, part #59281
must be used with PVC pipe simultaneously with the Inside Tie Brackets, -part number 59276. The pipe adapter
bracket is used on top of the pipe and under the Inside Tie Bracket. In certain regions the optional Moisture
Termite Shield may be required between the lumber and ground.
ALL WOOD MUST BE PRESSURE TREATED, GROUND CONTACT RATED.
Tip: Pre-cut your lumber and mark as to brand or model of homes you will be installing. If frame widths
are the same, the pre-cut boards will also be the same length in each Vector set-up.
STRAP TENSION
All strapping must be tight upon assembly of the Vector system. Tests have been conducted with "hand tight-
ened " strap in the Vector system to remove the need for specific tension specifications. Hand tight is defined
as removing all slack with minimum of movement available when pressing on the strap. While subsequent tight-
ening of the straps is not required, straps should be checked after any strong wind conditions, just as conven-
tional anchor tie down straps should also be checked, to insure the maximum performance of the foundation
system. A minimum of two factory 1/4" spot welds must be used when straps are connected to the swivel con-
nectors with welds.
c ,
Page 4 California 8/2001
Set -Up Instructions for the
Vector Dynamics Foundation System
#59007 (Kit #59007 is interchangeable with Kit #59018)
1. SET VECTOR FOUNDATION PADS snort uou snort
Clear all loose vegetation from the immediate U -bon U -bon
area where your Vector foundation pads will
rest. Press or hammer pads into the ground.
Tip: Place a 3/8" nut on each U -bolt to keep it
in place while you position the Vector pads.
2. SET BLOCKS (OR PIERS) ON
VECTOR FOUNDATION PADS
Center the foundation blocks over
the Vector pads. Place the pre-cut
4x4, 2x4's (side by side), Schedule
40 PVC (w/PVC adapter plate, part
#59281) or 1 adjustable TDE steel
compression member, (part
#59043) tightly between the blocks,
with ends resting on the Vector
pads, and centered on each
U -bolt.
3'. OUTSIDE TENSION BRACKETS
Attach an Outside Tension Bracket
to the U -bolts on the outside of the
foundation blocks and Vector pads.
Place one of the short 6"- 2x4's
between the bracket and Vector
pad. Adjust the short 2x4 so that it
pushes against the foundation
blocks, removing any space
between the piers and center
compression section. Tighten the
3/8" bolts.
2 square foot
i pad placement
i or (1) 3 square
i foot pad
i
4. INSIDE BRACKETS AND
i
STRAPS
Attach the Inside Tie Brackets to the
U -bolts over the pre-cut boards or
PVC. Attach a strap with hook to
each inside tie bracket. Tighten
bracket. When using looped strap and
a crimp seal, in place of the hook,
place a 3" long section of strap,
folded in half and inserted between
the strap and inside tie bracket. Place
other end of strap over the opposite (-
beam and continue down to outside
of the foundation blocks. Attach the
strap to the Outside Tension brackets
using the slotted bolt and nut
provided. Wind strap a minimum of
five times around the bolt. Continue
tightening the slotted bolt until all
slack has been removed and the
strap is tight.
5. SET ANCHORS
Refer to sectiori home drawings for anchor installation information. Stabilizer plates are required for
diagonal ties only. Preload anchor against stabilizer plate. Make certain all slack is removed and strap is
tight. For single section homes in rocky soil conditions in Wind Zone 1 only (Soil Classifications 24 3
only), use minimum of 3 each V Drive anchors per side. See drawing on page 6 for placement. �, t
Page 5 California 8/2001
Set -Up Instructions for -
Vector System #59018
(Kit #59018 is interchangeable with Kit #59007)
A
o �0.
gig O
Long U -Bolts
1. Set Vector Pads
Clear all vegetation where pads will rest. Place
a long U -bolt in pad "as shown. Press or ham-
mer pad into the -ground.
2: Set Block or piers on pads.
Center foundation blocks or piers on pads.
Place pre-cut center compression member
between blocks, resting on pads, centers
between U -bolts as shown.
3. Outside Tension Bracket
Attach outside tension bracket as shown to out-
side of pads. . .
4. Inside brackets & straps
Attach the inside tie brackets to the U -bolts over
the compression member. Attach a strap
w/hook or swivel strap w/nut/washer & bolt
(washers are required). Place other end of the
strap over opposite I-beam & down to outside
tension bracket. Cut strap 12 - 15 inches past
bracket. Attach strap & slotted bolt in bracket.
I Tighten strap until tight with 4-5 wraps around
bolt. Repeat with opposite strap.
Page 5a
c
California I/2001
N
CA)
WIND ZONE I _ - - " - Ome \yes.
Vector Dynamics Systems Required "" \e se�te o"svm a19u`de� -
for Double Section Homes _ - - ' of a -� e�aa pa�me?1 S a\\at\o(N ---
9\e
- -
1 \
VI
(Materials Requiredl - - - EXamPsho�ts 9e"stoe to "o
pads
t
— — — " — �� \ ♦ \ r. x;;35 . r'',�' — .•7etr�. — — \ \ 1
Maximum allowable working drag load
for the Vector System with the steel
compression strut Is 3,150 pounds per
the K2 Engineering test report.
0
0
N2 sq. ft. pad/
I .�•.p � 'a21�
♦ ?a fs_ .- _ - - " " NOTE: Vector Systems should be spaced as evenly as
s :3- is practicable along the length of the home. Wer spacing
must be consistent with hone man llattrers' Installation
instructions andfot state requlie nertts.
Soil Classifications: 2, 3, 4A, & 413
Soil Bearing Capacity: 1,000 PSF minimum
Anchors Required: None (marriage wall anchors may be required by home manufacturer)
Home Length
Vector Systems
Required
0 to 48'
2
48' to 71'
3
72' to 89'
4
Each Vector Foundation System requires
• One Vector Kit, 2 slotted bolts
• 2 ea. 1-1/4 in. ties, length will vary with pier height
(4725 Ib. min. break),
• 1 ea. 4 x 4 pressure treated wood
compression member
• or 2 ea. 2 x 4 pressure treated wood
compression member
• or 1 ea. 3-1/2" or 4" nominal SCH 40 PVC
pipe compression member
• or 1 TDE adjustable steel strut
DOWN
VECTOR DYNAMICS INSTALLATION DESIGN INSTRUCTIONS
This Vector Dynamics Foundation system instruction is applicable only on homes set on soils classified
as Class 4A 413, 3 and 2 as described in the table below. For separate instructions for sub -soil, Class
5 conditions (above 50 in. lbs.), contact Tie Down Engineering.
SOIL CLASSIFICATIONS
Soil Class
Types of Soils
Blow Count (ASTM
Soil Test Probe (1)
D1586)
Torque Value (2)
1
Sound hard rock......
NA
NA
Very dense and/or
40 -up
More than 550 in. lbs.
cemented sands, coarse
2 •
gravel and cobbles,
preloaded silts, clays,
and corals
Medium -dense coarse
24-39
350-549 in. lbs.
3
sands, sandy gravels, very
stiff silts and clays
4A
Loose to medium dense
14-23
275-349 in. lbs
sands, firm to stiff clays
4B
and silts, alluvian fill
175-275 in. lbs
Peat, organic silts,
0-14
175 in. lbs .
5
inundated silts, loose fine
and lower
sand, alluvium, loess,
varied clays, fill, fly ash.
(1) The purpose of the. soil test probe is to gage the strength of the soil below the surface
and near the anchor's helical plate. The strength of the soil is estimated in terms of its'
resistance to penetration (flow) under load by means of the torque probe and is measured in
inch lbs. The test probe has a helix on it. The overall length of the helical section is 10.75 in.;
the major diameter is 1.25 in.; the minor diameter is 0.81 in.; the pitch is 1.75 in. The shaft
must be of suitable length for anchor depth.
(2) A measure synonymous with moment of a force when distributed around the shaft of the test
probe.
Information about geographical areas of termite infestations which might require the optional termite
and moisture shield when a wood compression member is used may be obtained from the local
.building official or, may be found in the 1995 edition of the One and Two Family Dwelling Code.
Page 18 California N001
RE INSPECTION: REPORT
LOCATION:
„<-
PRE-INSPETION
DATE:_ g ��
�r
A -P. # � � 'I 2;2 —69!�
ZONING:
DATE TO INSPECTOR:
3 "ERN11T HISTORY:( ) NONE (GylFOLLOWS:
�-U
BUQ.DING INSPECTOR'S REPORT
Building Description:
Commercial/Usage:
ResidentiaU# of Units:
Currently Occupied
Abandoned/Vacant
Electric:
Yes No Electric currently on Off
Condition of Electric
Gas: /
Natural Propane l!� None4 Currently On Off
Obvious Problems: A n
Sanitation:+
Plumbing Working S
Well Working Potable Water
Obvious
Comments:
A V
CTION RECOMMENDED: ISSUE:
HOLD FOR
Inspector. Date v ? a 03
Sketch buildings on reverse and indicate location on property.
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drivea�- Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO.
(Rev.12/96). APPLICATION AND PERMIT 3��
ASSESSOR PARCEL NUMBER.. ZONING BUILDINGPERMIT
OWNER `TELEPHONE SQ. FT. OCC. BUILDING VALUATION
OWNERS MAID G D -
GO
CONTRACTOR' TELEPHONE
1 rr if
CONTRACTORS NG DRESS
f_ s
CONSTRUCTION LENDER
LENDERS MAILING ADDRESS Fireplace ,
Total Valuation $ C
ARCHrrECT OR ENGINEER LICENSE NO.
Filing Fee $ 20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee
Plan Checking Fee $
BUILDINGADDRESS J` Energy Plan Checking Fee $
i}� $
PERMIT FEE $
LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00
Each Trap 7.00
USEOFSTRUCTURE Solar or heat pump water heater 23.00
SF ❑ Duplex ❑ Mobilehome ❑ Other Water piping 15.00
SPM" Water
gas water heater or vent 15.00
TYPE OF WORK Gas piping system 1 - 5 outlets 15.00
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 0 Building sewer 15.00
Mobile Home7_6TW @20.00
Describe Work:
PERMIT FEE S °
ELECTRICAL PERMIT Filing Fee 20.00
Main Service z�Doo, o LESS 23.00
Main Service 200A TO TowA 46.00
NEW CONST. DWELLING OCCUP. SO.
_
OR ADONs. D'=ACC. eLos. 3.5Qff,
-MW CUM]. MULTI -OUTLET
i NON aESSID, @7.50
t a swop o P� 7 aR.
�� OtmEr OR FDmIRES L O I'so
Ex. Occup. B20 .00
Ex. Occup. oTrsn is�slD FRA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
11111111111111MMisc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
•��
tea...Hood 6.50
Ventilation
PERMIT FEL $
Mobile Home Installation Fee is
Energy Inspection Fee /L C $
i OCC CONST. TYPE TOTAL FEE $36 3�
1 HAL p, FEES IMP FLOOD I CDF I PARCEL I PD I HD ISSUE
I
This permit is hereby issued under the applicable, provisions
-of the Butte County Code and/or Resolutions -to do•work
Date indicated above for which fees have been paid.
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 60° deep and demolition or construction
of structures over 3 stories In height. By Date
ReceiptNo. PERMIT EXPIRES ON
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Dere
A Y
K R. Gig i,. -i
069- 110- ooz
11 1
PERMIT NO.
184878lPiE (util, MH
-_ �---
PERMIT EXPIRES
OWNER GILBERT GRAVES
CONTR. Wentland Const, Magalia
ASSESSOR PARCEL_ 64-17-3
114
LOCATION 14951 CArnPcfjP Rd. 1Qt- 11 DD 1
Maqalia
f
Temp. Power Pole
Called PG&E
Temp. Elec. Service
z
Called PG&E
Temp. Gas Service./
,r Cal led PG&E
JOB FINA ZED (Date)— /.I
Signature
OK
0 = Not OK.
- = Not Applicable MOBILEHOMES•.
* = Not Ready
MISCELLANEOUS "j
Date
MOWtEHOME UTILITIES (Plans) OK except N's
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except ft's
Zoning Requirements -Setbacks -Easements
1. Zoning Requirements -Setbacks -Easements
2. oils; Special MH Support -Sketch
_
2. Footings; Size -Depth -Spacing -Connectors
ewer; Location -Test -Fall -C/0 -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
.eater; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing
AK Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
, n -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
6. Carports; Windows -Doors
lity Clearance
7. Elec.
V -940-e4
----- -
it Ff
Card -B
ate Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOP&EHOME INSTALLATION (Plans) OK except N's
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except N's
ning Requirements -Setbacks -Easements
1, Setbacks -Easements
Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
�s; MH Test -Demand -Valve -Connector
Eylectricity; MH Test -Crossovers -Breakers -Clearances
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Elec.; Receptacles and Lighting; Distances-GFI
.rain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
Eater; MH Test -Regulator -Connector - '
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
Water and Sewer Connected -C/0 to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Elect tty Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
F�xits; Insp.-Sketch
{6lCert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date 1' Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
{{
.,
I
a
V = OK -
0 Not OK
= Not Read, Not Applicable
* RESIDENTIAL (Single and Duplex)
Date
UNDERFLOOR Plans OK exce tit's
_Date
FRAMING (Continued)
1. Zon i ng.requ i rements-Setbacks- Easements
48.' Property Line Firewall & Openings
2.
Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4.
Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
51.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
-
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
52.
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7.
Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
8.
D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
Electric; Underground
-
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except q's
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI
Date
_
Date Card -BI Date
PLUMBING (Permit) OK except N's
14. Water Ht.; Vent -Access -Combustion Air
57.
58.
Smoke Detector
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fitngs & Anchors -Nail Protection
59.
Bedroom Exiting
_ 17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except q's
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
20.
Fixture & Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
21. Elec. Receptacles Spacing -Lights & Switches at Doors
22.
Size Boxes & No. of Conductors -Stapled
70.
Plb., Elec. &Mech. Equip. Listed for Location
23.
Romex Installed Close to Edge of Studs & C.J.
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
Insulation -Foam -Looked in Attic C] Yes
25.
2 Appliance Circuits in Kitchen & Conductor Size
73.
Guard Rails & Deck Construction -Post Caps
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral "JYes ❑No
75.
Followinginstld.: Drive
❑Yes []No; Walks E) Yes ❑ No;
Planters❑Yes ❑ No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
77,
A.C. Unit; Disconnect-Clrnces=Brkr.-& Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -BI Date
81.
Ventilation throughout House
Card B -I
Date Card -BI Date
82.
Glass Protection
Date
MECHANICAL (Permit) OK except p's
31. A.C. Ducts; Insulation &Support
83.
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
85.
Water & Sewer Connected -C/O to Grade -HD Approval
32.
__Vent Fan; Exhaust above Insulation
86,
Energy Compliance Certificate -Other Certificates
_ ___33.
34.
Condensate Drain & Overflow; Size & Grade
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -BI
Card -BI
-_
Date _ _ Card -BI Date
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRAMING Plans OK except q's
36. _Sills; Proper Material & Anchors
Comments at Final:
_
_-
37.
38.
39.
40.
Walls; Studs -Nailing, Spacing & Bracing-Plates-Soun
Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof)
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
41.
42.
43.
44.
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -Connectors
Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
Fireplace Ties or Type A Flue -Fireplace Throat
45.
Attic Access; Size & Rom_ex Protection -Draft Stop -Ins. Baffles
_
46.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
_
Garage Fire Protection Framing
(NOTE: An entry must be made each time youvisit jobsite)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70
7 County Center Drive, Oroville — Phone 5.34-4541
Skyway and Elliott Road, Paradise ---Phc5ne 87? 5495
�p
�7;i-241,� ks�•
C�RRECTIOON W")TICE
BUILDIfVG OR PROPER?1' ADDRESS
I
I
A routine inspection indicates that the following violations of County Ordinand'e
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you�have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Date.
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENYR DRIVE-
OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the ,,Californiar Administrative Code, Title 25, Chapter. 5, under permit
number z��� ' J `fir %for the following location:
Owners
Owner's Address ..1ZI-e-A'
Mobilehome Mfg. %A Model Year
Insignia No. 19.4 2. 9 7 � er Serial No. +'
_"
It is hereby certified for occupancy at the above described location and
may be occupied.
Director of Public Works
Date l ` •= (�" / By? ,
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PER T 0.
7 County Center Drive Oroville, California 95965 - Telephone 916/534-454
•
APPLICATION AND PERMIT C2? 2V
ASSESSOR PA NUMBER
AlL /7,3
ZONING
UILDING PERMIT ,
OWNER1L C.�/V, �, ^�� J r
A///i[J/ 5
TELEPHONE
SQ. FT. OCC. BUILDING VAL ATION
OWNER'S MAILING ADDRESS
C 1JIGA TOR'�Sjy/NAME / /��, /,Q/,7D,1�
KR`r/G V����j
/(��iP
Aq,�VD/RE✓SS�
/
C/ 7 "✓D �/ /IC//���(�`
Fireplace
CONSTRUCTION LEN ER/'`/
UNKNOWN
Total Valuation $
Flling Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGIN ER
LICENSE No.Plan
Checking Fee
act
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDI�,G �.Bqa-EPSs �,
/ J J /
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT% 0,
SUB 10 AMS
r///f_/ F� /7/'
PARCEL MAP
Each pas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome[ge"*'Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Ins ulatio,n// Other ❑
Describe work:—),� ���— �C�/V% �d`Y p �/
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 800V OR LESS
100 AMP OR LESS
5.00
fi )(&0
6
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. / DWELLING OCCUP.D)
OR ADDNS. \ ACC. BLDGS. _
2¢ sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
ff—NON-RESID.
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code a my license is in full force and effect.
License No. Classification ,
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am'exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR-OUTLET
NON-RESID BRANCH CIRC ITS
2.50 ea
NEW CONSTR. (POWER APPARATUS 01
1SINGLE OUTLET CIR. /
Ex. Occup(OUTLETS OR FIXTURES a ®�
FIXED APPLNS. OR
EX. QCCUp.�OUT LETS (RESID.) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith Comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
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
against said County in consequence of the granting of this permit.
%� (/ Date 7 — —��
I
Signature of Applicant — Owner J Contractor ❑ Agent ❑
AnOSHA 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 $ p0
TOTAL PERMIT FEE $ 50-_00
0CCUP. GROUP
TYPE OF CONST.
PARCEL
PD
I HD
ssuE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIREC OF PUBLIC
By
PE T EXPIRES Date_
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
_
z- ���
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
BVTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
11. What is the gas pipe length from meter or tank to the mobilehome?
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 INSTALLATION
SHEET
1.
Owner's name: 6(cAAEK-r 6�ly-vim S
2.
Installer's name: R(C-flA#R-Q STrsvEeeN dK.
(4, SL-2vick
3.
Is the site currently under permit? Yes /
No
( If yes, furnish permit number
OR, ,`
Is the site an existing site? Yes / `; /
No / F-
(If yes, furnish two (2) plot.plans.)
4.
Will.the mobilehome be located at least 5 ft. away from septic tank
and leach
fields and
clear of all setbacks and easements? Yes /V/wa
No
( If no, clarify `
)
5.
What is the mobilehome electrical rating? -----------------------
-2o o
Amps'
6.
What is the mobilehome site service rating? ---------------------
0 o
Amps
P
7..
What is the mobilehome site circuit breaker rating?
-------------
2-00
Amps.'
8.
Is there any other electric load,to be served by the
mobilehome
siteservice? -------------------- ----------------------------
Yes
x
No
(If yes, identify the load and size:
(Load)
)
(fps)
r
9.
What is the mobilehome site gas pipe size? ----------------------—...
(in.)
10.
What is the type of gas service? -----------------------------
Natural/%
LPG
11. What is the gas pipe length from meter or tank to the mobilehome?
12. What is the mobilehome gas demand? ------------------------------ (BTU)
(This information not required if pipe length less than 6 ft. on natural gas `
or less than 50 ft. on LPG.)
MOBILEHOME SUPPORT DATA
If other 'than single wide, sC S
Mobilehome Mfr. Skn(!,/'/v furnish Setup Model No. Year'
Width �` (ft.) Box Length 6o (ft.) Tagalong or Expando Size ---ft. x�-- ft.
(SHOW SUPPORT DETAILS BELOW)
On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
All center supports measured from front of
mobilehome unless otherwise specified.
Footings (check one)
Single [—].l. Wood either
pressure treated or
foundation grade.
21
(ft.)(in;) (in.) (in.) 2. Other; (specify).-
Center support Center support
locations* footing sizes Supports (check one)
(in.) /
1: Concrete block.
E] .2: Other,. (specify)
(ft.)(in.(in.) (in.)
/r
Q� G
4--•--Tagalong or Expando,'
(� 4�j show support details.
(ft.)(in.) (in.) (in.) _
v -- Typical Support
Footing Size
V
V � .
(ft.)(in.) 1 (in.) (in.) -- Max. Pier Spacing
(ft.)(in.)
C� -- Max. Overhang
(ft.) in.) (in.) (in.) (ft.)(in.)
Z7 Ll-8/
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED �
*If center piers are other than drawn above,
/Z.
draw in -lncatinns. snacine. and dimensions.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PPRM IT,NO. %
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-45
APPLICATION,AND PERMIT
ASSES,VR PARCEL NUMBER
' !% — 3 •
O N
BUILDING PER
O CER
�`rL �� V 6S •
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
CONTRACTOR'S NAME,
LA0 In s
T LEPHON
��-� y()°
C NTRAG R'S MAILING DRESS
UDI G c2 A m c-- Ce
Fireplace
CONSTRUC TICY LENDER
UNKNOWN `
Total Valuation Is
Filing Fee
$ 10_00
LENDER'S MAILING ADDRESS
Permit•Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
,$
Penalty
$
ARCHITECT ORN INEER'S MAILING DRES
,57 ��/L �_
Permit fee
$ 1 —
BUILDING ADDRESS -
PLUMBING PERMIT
Filing Fee 10.00
P A ��,
(�T,
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
/0
LOT NO.
SUBDIVISION NAM
1 L_/Gas
PARCEL MAP
Each gas water heater or vent
5.00
piping system 1 - 5 outlets
USE OF STRUCTURE
SF ❑ Duplex ❑ Mobilehome`Z� Other
SPECIFY
Building sewer
�—
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities Installation❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service DOOv OR LESS
100 AMP OR LESS
5.00 5 -
Main service EA. ADD'L 100 AMP
2,50 0_
NEW CONST. OR ADDNS. (ACCLBLDGS.DWELING CCUP.y`
I 22 sq ft
CONTRACTORS LICENSE LAW
I declare rider 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.
I
License No. 3/G6Z69 Classification /3
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR I.OUT LET
NON-RESID BRA CH CIRCUITS2.50 ea
NEW CONSTR. (POWER APPARATUS &I
NON-RESID, SINGLE OUTLET CIR.
EX. Occup OUTLETS OR FIXTURES 21
BAL
(,FIXED APPLNS. OR
Ex. Occup. UTLETS (RESID,) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
�have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
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, cost n xpenses which may in any way accrue
against said County in co a the granting of this permit.
X Date �� 2J
Signature of Applicant — caner ❑ Contractor C_4--- Agent ❑
An OSHA permit is required For excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ 7 A r
OccUP, GROUP
TYPE OF CONST.
PARCE
L.PJ
ND,
Iss
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRE OF PUBLIC
BY
P�ITXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS,
Date
Receipt No. ����/
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
NOTE:—All Materials .Workmanship .ShaA Be in
Accordance' with Recodnized Good Practices arid `
of a quality prescribed or the 'Specified use in the
Uniform Building, Plumbing & Machanical Codes and A permit wiii"b re wired
the National Electrical Code. installation of the mobilehome
A setback of 5 ft. from the
property lines and a setback
of 50ft. from the road .
Utility connections shall be within --cwterme shall be clear of
4 ft. of the mobilehome, either, structures or equipment except
direct) behind or within theirear for a 2 ft. eave overhang.
half of the roadside (left) af�he ti �' ss
mobilehome. / _ `y 20144114oivs
S6745.4c r c iadr
P
500 SQ. FT. MINIMUM
FOR MOBILES
• / ;� �ANK��
oAi
/ NBS AR 60 17— 03
.. PLOT PL,4 N . BUTTE COUNTY
�� 40 BUILDING DEPARTMENT
This set of plans and specifications MUST be
kept on the job at all times and it is unlawful to APPROVED
make any changes or alterations on some without
written permission from the Department of Public '
Works, County of Butte.
'OERMIT N0. 1$49-$16,E
"• PERMIT EXPIRES/z✓
OWNER GILBERT .GRAVES
CONTR. Wentland Const Cn, Ma dal i a
- ASSESSOR PARCEL 64-17-3
LOCATION
,i
41
r ` { . • . it
. r
I s' Temp. Power Pole
*: Called PG&E
Temp. Elec. Service
Caller' PrA'=
• 4
-� Call
JOB FIN
Sign
' t
yCOUM OF BUTTE - Department of Public Works
_ 7 County Center Drive, Orovil,le, CA 95965
OWNER -BUILDER VERIFICATION
Attention Property Owner:
Phone: 916 -538 -7541 -
An 'owner -builder" building permit has;been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the Major labor and materials for construction of
the proposed property improvement (yes or no)
2. I (have/have not) signed an 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
Social Security Numbe
Date=9(�
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.
G
i N /
/-
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