HomeMy WebLinkAbout064-280-00264-28-2 ti
Vern EitTak //-/&,-77
+45rVrevard Cel;�Ekixil.
.,-lot 88_, PP#k5, Magalia
Permit #4787- ,MH
ELEC.
C,AS
PPORT STRUCTURE REQ.
COMPACTDN TEST REQ._
64-28-2
I
�contr:
Beich Mobile Home Serv.,Para.
Permit #5637-77MIc,
Issued /dJ�7 /7.7
6? Ofv�-ZQo-mZ 04-3216
WYLLIE, J90HN
6255 BREVARD CIRCLE, MAGALIA-
Cont: GREENE ROOFING . ;•
NEW SINGLE FAMILY +!'
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NOTES
RESIDENTIAL
PERMIT NO.
19061N
6255 BIq_-'V;A.R_D C1RCLE, MA( AIJA
Cont: G'f< E I --,, i -,E R 0 Of -'1, NT G
NUAV SING L,] --'F AIVII LY
� IR
"c of (,-,
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
rcA Cly
rr
01-T c re_s+o V�
k
JOB FINALED (Date)
Signature10-he ( kA lrlK__
x.c,'
YNq1TF,ATT0N CERTIFICATE
Job Nuniber:::::':S450'.:-:::
............... ...............
..............................
Job Address (street, city, state)
Contractor/Owner Name
..................
County Subdivision Name Lot Number
DESCWTION OF INSTALLATION
I. ROOF
Material:
........... o ............
.................
Thickness (inches): ...................... ....... .
Brand Name:::::::::,
Thermal Resistanceue
3. EXTERIOR WALL
Frame......... .... ....................
A. Cavity Insulation
Material:
Thickness (inches)::::
B. Exterior Foam Sheathing
Material:
Thickness
........................................................
4. RAISED FLOOR
.............. ......... "'; ......
Thickness (inches):
5. SLAB F1,00R/PERW
... ....... JER ........
... ........
ri
Thickness............. d ....... ; ......
Cinches):
........................................................
Perimeter Insulation Depth Inches:
...........
6. FOUNDATION WALL
Thickness' Cuchis):
............................................
Brand
Thermal Resistance
(R -Value)::':::::'::':::::::::...... . .......................
Brand
Thermal Resistance
.................................
Brand Name:::::::::::::':::::::
Thermal Resistance (R -Value):;::' . ........... I ......
Brand Name:
...................... I .............
Thermal Resistance
Brand
:::: .................. .... ....
Thermal Resistance (R-Value):'::'*::�'::"'::'�;:;��:;�:;*':;"::"::"::"::"��":."::":::::::::::�:::�::::::::
. ....................... ........... I ...............
General Contractor (Co. Name) or Owner
Item Number's Signature and Date Installing Subcontractor (Co. Name) or
General Contractor (Co. Name) or Owner
J=OK
0 = Not OK
Not
. = NotReadyable
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Soils; Special MH Support Sketch
3.
Sewer; Location -Test -Fall -C/O -Concrete
4. Water; Location -Test -Easement Needed (Sketch)
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
Carports; Windows -Doors
6.• Gas; Location -Test -Wrap;-/ /" L'ft..
/ P Nat. or / /" L "ft./ P LPG
7.
7.
Well Clearance & Disconnect
8.
8.
Utility Clearance
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
Date
Ext.; Steps -Doors -Landings
Card B-1 Date . Card B-1
Date
Braced Wall Panels
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Date
1.
Zoning Requirements -Setbacks -Easements
Date
2.
Footings; Size -Spacing -Marriage Line
Date
3.
Gas; MH Test -Demand -Valve -Connector
1.
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
2.
5.
Drain; MH Test -Fall -Flex Connector
3.
6.
Water; MH Test -Regulator -Connector
4.
7.
Water and Sewer Connected -C/O to Grade -HD Approval,
5.
8.
Gas and Electricity Tagged
6.
9.
Tie Downs -Type -Installation Cert.
7.
10.
Exits; Insp.-Sketch
8.
11.
Cert. of Occupancy
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
Date
Light Niche
Card B-1 Date Card B-1
Date
Enclosure; Fencing -Alarms
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Date
1.
Zoning Requirements -Setbacks -Easements
Date
2.
Footings; Size -Spacing -Marriage Line
3.
Blocking
4.
Gas; MH Test -Demand -Valve
5.
Electricity; MH Test
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals
11.
Verify #'s with Office
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3.
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4.
Wood Awn.; Posts- Beams- Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
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- Enc losures- Panel boards- 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
r
q `.
J=OK
0 = NotOK
= Not Applicable
Applicable
+ = Not Ready
RESIDENTIAL
Date UNDE LOO (Plans) OK except #'s
Card B-1 Date Card B-1
i etbacks- Easements- Flood -Slope
leo�Ftg.,
Main; Soils-Elec. Gr /-jZ/" tg. Depth
3.,oPtg.,
Garage; Soils-Steel-Elec. Gr . / I2 /" Ftg. Depth
4.
FA, Porches & Decks; Soils -Steel-/ /" Ftg. Depth
tr. . Water Pipe; Test & Anchor -Nail Protection
walls, Main; Steel-Blockouts-Wrapped
\6
to ails, Garage; Steel- Blockouts-Wra ed
6a
old D9w s and Spe ial Anchors
7.
SI eel.Wrapped
Ze Gas Pipe; Sixe & Anchors
s& ace Ftg.-Steel
23. Fire Sprinkler; Test 5`3(-5- U_
D. . • all -Fitting -Test -2 Way C/0 -Sewer Test
7�.
Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
Card B-1 Date Card B-1
Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
(Single &
Date ELECTRICAL (Permit) OK except #'s
24. Fi re & Transformer Clearance -Ins. Protection
-� lec. Receptacles Spacing -Lights & Switches at Doors
Size Boxes & No. of Conductors Stapled
Romex Installed Close to Edge of Studs & C.J.
- equip. Ground made up w/Mech Fasteners -Bond Gas & Water
pliance Circuits in Kitchen & Conductor Size GFI
QSubfeed Wire Size/ /ga C or AI-A.C. Wire Size/ /ga Cu or Al
Range Circle/ /ga Cu or Al -Oven Circ. / /ga Cu or At
Insulated Neutral ❑ Yes ❑ No
2. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
Clothes Closet Light -Shower Light -Spa Light
Smoke Detector
Date 'S -b �j Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except #'s
C. Ducts Insulation & Support
37,, Vent Fan, Exhaust above insulation
Condensate Drain & Overflow, Size & Grade
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
06. Attic Access & Platform if Furnace in Attic
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FR&MING (Permit) OK except #'s
Sills Proper Materials & Anchors
49JWalls Studs-NailingSpacinq & Braces -Plates -Sound
Bearind_Wgyover Girders Floor Nailing
Dra op in Walls (rat proof)
Qf re Stops, Furred Ceilings -Stairs -Chasers -Tubs
Headers & Beams -Size & Bearing
48' Clin oist-Rftr. Ties-Purlin-Roll Brac. Trus hting.-Rtng.
7 - 4 fireplace Ties or Type A trepl Throat Clearance
&0-A% Access; Size & Romex Protection -Draft Stop -Ins. Baffles
drm. Windows or Exiting Doors -Sill Ht. & Dimensions
e .
Ora raa Fire rotection,Framina-RC Channel
W. Ext. Doors -One 3' -Check Garaqe 3rd Story, 2 Exits
�K. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
5V' wood orAoof Overhana-Attic Vents -Rafter Outriaaers
Veneer
,figs StuccdMesh- Drip Screed -Fd. Vents-Underflr. Access
ng Area -Glass Protectio_ n -Skylights -Plastic
ear Walls; Nailing-BoDs"'
62. Insulation -Walls -Ceilings V,0 v
63. I nfi Itration-Wal Is,Nindows
Date 5 -5 -Q Card B-1 VO(U ,Date Card B-1
Date Carder -1 Ej( Date Card B-1
Date FIN Plans) OK except #'s
C64OXxt. Steps -Door & Sidelight Protection -Landings
oke Detector
Date Z
Card B-1 Date Card B-1
Date
G Card B-1 Date Card B-1
Date
PLUMBING (P mit)4.)K except #'s
'69.
. Water Htr.; Vent -Access -Combustion Air Baffle
70.
tr. . Water Pipe; Test & Anchor -Nail Protection
. D.W.V.; Test Fittings & Anchor -Nail Protection
72.
20. Shower Pan; Test, First Floor -Tub Access
3
21. Test Tub & Shower, Second Floor -Tu Access
74.
Ze Gas Pipe; Sixe & Anchors
75. Galoge Fire Door; Swing -Landing -Closure
23. Fire Sprinkler; Test 5`3(-5- U_
.C. Duct in Garage -Damper
tr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
7�.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
24. Fi re & Transformer Clearance -Ins. Protection
-� lec. Receptacles Spacing -Lights & Switches at Doors
Size Boxes & No. of Conductors Stapled
Romex Installed Close to Edge of Studs & C.J.
- equip. Ground made up w/Mech Fasteners -Bond Gas & Water
pliance Circuits in Kitchen & Conductor Size GFI
QSubfeed Wire Size/ /ga C or AI-A.C. Wire Size/ /ga Cu or Al
Range Circle/ /ga Cu or Al -Oven Circ. / /ga Cu or At
Insulated Neutral ❑ Yes ❑ No
2. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
Clothes Closet Light -Shower Light -Spa Light
Smoke Detector
Date 'S -b �j Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except #'s
C. Ducts Insulation & Support
37,, Vent Fan, Exhaust above insulation
Condensate Drain & Overflow, Size & Grade
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
06. Attic Access & Platform if Furnace in Attic
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FR&MING (Permit) OK except #'s
Sills Proper Materials & Anchors
49JWalls Studs-NailingSpacinq & Braces -Plates -Sound
Bearind_Wgyover Girders Floor Nailing
Dra op in Walls (rat proof)
Qf re Stops, Furred Ceilings -Stairs -Chasers -Tubs
Headers & Beams -Size & Bearing
48' Clin oist-Rftr. Ties-Purlin-Roll Brac. Trus hting.-Rtng.
7 - 4 fireplace Ties or Type A trepl Throat Clearance
&0-A% Access; Size & Romex Protection -Draft Stop -Ins. Baffles
drm. Windows or Exiting Doors -Sill Ht. & Dimensions
e .
Ora raa Fire rotection,Framina-RC Channel
W. Ext. Doors -One 3' -Check Garaqe 3rd Story, 2 Exits
�K. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
5V' wood orAoof Overhana-Attic Vents -Rafter Outriaaers
Veneer
,figs StuccdMesh- Drip Screed -Fd. Vents-Underflr. Access
ng Area -Glass Protectio_ n -Skylights -Plastic
ear Walls; Nailing-BoDs"'
62. Insulation -Walls -Ceilings V,0 v
63. I nfi Itration-Wal Is,Nindows
Date 5 -5 -Q Card B-1 VO(U ,Date Card B-1
Date Carder -1 Ej( Date Card B-1
Date FIN Plans) OK except #'s
C64OXxt. Steps -Door & Sidelight Protection -Landings
oke Detector
urnace Vents -clearance -Comb, Air -Connector -
Garage; Above Floor-Ducts-Mech. Protection
,' droom Exiting
G.F.I. & Bath Fixtures & Tub Access -Spa
'69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70.
tairs & Rails
Fireplace or Stove, Clearance -Hearth
72.
Elec. Outlets at Wood Panel, Int. & Ext.
3
it. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74.
Elec. Outlets & Receptacles at Kit. Counter
75. Galoge Fire Door; Swing -Landing -Closure
7
.C. Duct in Garage -Damper
tr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
7�.
Plb.; Elec. & Mech. Equip. Listed for Location
9
lec. Receptacles in Garage (F.F.I.)-Romex Protection
ulation-Foam-Looked in Attic
VG
Rails & Deck Construction -Post Caps
2
,.2ard
dn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor O Yes
_
83.
Following Instld./Drive 0 Yes 0 NoMalks 0 Yes 0 No/Planters 0 Yes 0 No
84.
cco Brown -Finish
Unit Disconnect, Electrical -Plumbing
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87.
Water Well, Disconnect, Electrical, Plumbing
88.
Oxterior Elec. Trim, G.F.I. Receptacle -Underground
. Xntilation Throughout House
.lass Protection
Corrections from Previous Inspections
92.
Gas Test -Meters Tagged, Gas -Electric
93.
yfatpr & Sewer Connected -C/O to Grade -HD Approval
ergy Compliance Certificate -Other Certificates
96.
Address Posted
Fire Sprinkler
Date
Card B-1 Date Card B-1
Date t
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
205—���0674
Recorded
Official Records
I REC FEE 7,00
I CONFORM 1,00
County Of
I
BUTTE
I
CANDACE J. GRUBBS
I
Recorder
I
ROSEMARY DICKSON
I
Assistant
I Mark
12:25PM 04 -Jan -2005
I Page 1 of 1
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to 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 purposes,
.and residents of this property may be subject to inconveniences or discomfort 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, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
mixeLT ! L[3r%13, AS SHOWN 00 'rt4A - G ti iii N MAP Evrall i'). " 1�%AUsF_ /�>i)OFS 0)ij 0, N-
W ki &, i
WkiG+ rnA-P WAS QrCblt,%ED I N 1)4 F-- DrFitF6, DF -rlIE fe&'D/2DF,k OF TV CWS/ OF /3v1TF �
gjw-r DF CAUFDf?N111; Do J'vG�f )s", /q7/, 10 doaK 29 of /fv5i /;1 !)4w i2 33/wb 94,
CJI rer10N 'fNDIZr=FRD& A LL AI V 2/A LS . D!L , L;AS, P6oi-IHGTOW A t*.) pmF-/Z H bzlo 1360
5VA6TA,VCP-S, K1M4 PUVIS1UU-Fnfi4TAIi/y JWb ALL 1144 %/AIG BPF -9A bL6 5104Ct- 65
FtZbM 02oflLi✓5 DiT-4106 rNE s^vk,4iGr"_' AjZF-A DF TN87 LALD D<5C,21AFi) k4F- F-10, N,vD TNA -r
V6 hAp111jA E 5A16L 2E j\ 6.vF -rib -r s t Go�F_ -)r SA;JD LAND •
i rtc�LTi= A rv00rkLL051 vE EASF_0hFL; Dv6/Z LeIS A, BAND CPIc- e0 ►1Mou AkPA Gr- .Birth
i'�4/ZAh6E IN/UEC ONr MD.) S !OD Ldl?T Aa)AvAMh rOt Cm&)ioN M)b
fthotgAn6N nrer,-taS, it I 2S BQ IN 7W- bffi iAt lA7l&v OF i7/tAVkfktPbU A),( vyr6 [V)
V f I Vro, de'%X), II,Jr tlA.0b )ad.
Date�
/ /ia!z- PROPERTY OWNERS:
�AN IFLt�F k. Vint iE
-26HA) c-
State of California )
Countyof f3vttE- )
On / - D V — OS- before me,
h /C -1-/A oTh v //G
personally appeared n , o ., personally
known to me (or proved to me on the basis of s tisfactory evidence) to be the p sons) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
• tg
WCHELLE REI ,%i
Signature i ->riL Seal: _ Commission 8 1429067
Notary Public - California
Butte County
6, 2007
My Comm. Expires Jul
A.P. # d%`t " z 86 -aa z
Al
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.netldds
PERMIT NO.
BP043216
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am licensed under Issued Date: 01/10/2005 APN: 064-280-002-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect. Site Address:
License Class: License Number: 6255 BREVARD CIR MAG
Date: Contractor. Map Index:
OWNER -BUILDER DECLARATION Description: NSF (1474) GAR (571)COV(540)
I hereby affirm under penalty of perjury that 1 am exempt from the
Contractors' Stale License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a Owner: WYLLIE, JOHN C. & DANIELLE K.
permit to construct, alter, improve, demolish; or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a 2015 MERRILL ROAD
signed statement that he or she is licensed pursuant to the provisions of PARADISE, CA
the Contractor's State License Law (Chapter 9 commencing with Section 95969
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any 530-877-2039
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions Applicant: JOHN WYLLIE
Code: The Contractors' Stale License Law does not apply to an
owner of property who builds or Improves thereon, and who does
such work himself or herself or through his or her own employees, 2015 MERRIL ROAD
provided that such improvements are not intended or offered for PARADISE, CA 95969
sale. If however, the building or Improvements are sold within one
year of completion, the owner -builder will have the burden of (530 ) 877-2039
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does Contractor:
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
` '1 am Exempt under Article 3 of t e B iness and Professions Code
Date:
_aLi101bwner: J
WORKERS' CO tNSATION DE RATION License #:
1 hereby affirm under penalty f perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
•Labor Code, for the performance of the work for which this permit Architect:
is issued. Engineer:
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit Is issued. My workers' compensation
insurance carrier and policy number are:
Carrier.
Total Square Ft: 2585 S.F.
Policy #: Valuation: $118,154.00
Census Code:
I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California.
and agree that if I should become subject to the workers' �)• \
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant: )�/�
WARNING: Failure to secur workers' compensation coverage Is 1 � �
unlawful nd shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor//0/0
code, interest, and attorney's fees. `� (J /7
CONSTRUCTION LENDING AGENCY This permit is her.09 issu d undo e a i6able provisions of the Butte County Cods endlor
I hereby affirm that there is a construction lending agency for the Resolutions to work'lndicate above"rwhi fees have been paid. performance of the work for which this permit Is issued (Sec 3097 Civ.) ��� Dale: O D
Name: By'
PERMIT EXPIRES ON:
Address: Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that'I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes.
Print Name:Vt�l,G/FE Signature:
Date:
`QlOwner 0 Contractor ❑ Agent for Owner ❑ Agent for Contractor
I mLT!
il(ELM
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
COPY of Document Recorded
04 -Jan -2005. 2005-0000674
Has not been compared with
original
BUTTE COUNTY RECORDER
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to 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 purposes,
and residents of this property may be subject to inconveniences or discomfort 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, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
Ltsr%i5l AS GNvW,v 00 MAID civrf- iri). " Pf4i�AotSF_ JUiT' NO, 15 "i
WIa:ft,i MItP WAS t (U 'f11F_ DrTdF6 DF THE &--CORDFi� OF TIM CWArl OF &'VE. j
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Date_ Z/t9/1� PROPERTY ONERS:
,—, ,
State of California
County of f3v-e c_
lANiwtt, k. Wyt t /E
On / - O y - a S before me,
personally appeared ,AA.,l 10 ,, personally
known to me (or proved to me on the basis of s tisfactory evidence) to be the p sons) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
MICHEIJ.E REI
Signature i�� Seal:_Commission # 1429067
4PINly
Notary Pubtic - CaUtomlaButte County
A.P.# Comm. Expires Jul 6, 2007
��� ' � �Q - b0 Z..
616� asp. $sUjli 4U4.4-1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION ' I
Website: www.buttecounty.net/dds j 600 -�'`�
"PLEASE PRINT CLEARLY* * foo • a q
ARCHITECT/ENGINEER
OWNER
Last NameFirst
LL1¢
W
Na e
Addr ss
2_01s-
D/S-City
City
12kmas
Zig„S�
77
Stat1
Zip 5
Phone _ ZG
State License Number
Fax 7 .
E-mail
eW
ARCHITECT/ENGINEER
CONTRACTOR
Name
W
Address
City/ --to
City
Zig„S�
77
State
Zip
Phone
State License Number
Fax -
E -mail
Planner
Lic. #
Class
ARCHITECT/ENGINEER
Name
Address
Address
t/off. Sic
State
City/ --to
'4. 1
Zig„S�
77
Phone
Fax
E-mail
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT®SII G�NATURE
`9
X
Fo ffice use only:
Zoning
PropertyAddress
ZS 5'
Flood Zone
I x
SRA
res
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
BPo4-3:DL1 i°
BIN
A43
LOCATION
AP#
PropertyAddress
ZS 5'
City
Cross Street
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
ds r— 14Z!! ^-rr 6r Ara- 71
co v Dom. X40
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
required.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Page 1 of 2
Received by: 4<:fj.-j Amount: 1175= '+2-13ldg
2e4.GI6SRA
Receipt #: 4-13 I E; 5 Sheriff
SMIP
Other
Date: i j , ¢. C,4-
1 '}SA• 40 Total
REV 7-27-04
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
ermit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to
mobile or modular homes.)
❑ 5. Statement of Intent for Non-heated and A/C for Non-Residential Buildings.
❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down
or fnd plans, all in duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet-signed by the engineer.
❑ 8. Flood Elevation Certificate, wet-stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
❑ 13. Sanitation and site plan approval from the Environmental Health Department.
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3. California Department of Forestry plan approval (if required).
❑ 4. NPDES Form.
❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy),
❑ 6. Contractor's license information. (Number, Name Style, Classification).
❑ 7. Worker's Compensation Carrier and Policy Number.
❑ 8. Owner-Builder Verification (if required).
❑ 9. Letter of Signature authorization (if required).
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's).
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530)538.7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04
1-y�-s..--,-...--•r-�e�.....a.^+�.+�+�w+.a+�"."":+.%`�'-`�s""�a'� 4t-:N"��^i.-t����ar
COUNTY OF OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING. DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: W./ i ► E ASSESSOR PARCEL NUMBER e::4-, 4- • 26,n e5p
1 Co v p EGIL C s4o�
Proposed Building Use: i -I S F / f 4.74-1 AMI -4e 1671 Counter Technician: Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
1. Site plan or ets, signed by the preparer of the plans.
_5 2. Complete an 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered pia , 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Letter from Engineer or Architect for truss design review.
6. Energy compliance design and supporting documentation in duplicate.
O 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate
❑ 11. Site plan and business license approval from the City of Biggs
❑ 12. Letter of intent for non-residential buildings
❑ 13. Detached Accessory Building Form filled out by the owner
❑ 14. Hazardous Material Form
15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.
'❑ 16. Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 17. Fire Sprinklers............................................................................................
❑
18.
Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
I,,
❑
❑
19.
20.
Soils Report and/or Engineered Foundation required ...........................................
Erosion Control Plan Required
........
1
21.
.....................................................................
Fees as shown on the attached Schedule of Fees Due Sheet ..............................
❑
22.
23.
24.
City of Chico Plumbing permit........................................................................
California Department of Forestry plan approval p paid. Sent by: F a t `� ***it
Planning approval (A) Use: QL(B)Parking: (C) Parcel Check: 1;Ll
1 • o4
0� 25. Contact Land Development about _ Improvements, _ Drainage .........................
rte' 26. NPDES Form.............................................................................................
❑ 27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28: Pre -Inspection for required.......
❑ 29 Contractor's license information. (Number, Name Style, Classification) ...................
o / 30. Worker's Compensation Carrier and Policy Number ..........................................
31. Owner -Builder Verification Given to owner, _Mailed to owner) .....................
❑ 32. Letter of Signature authorization .................................. ....:.................
............
33. Recorded copy of Agricultural Acknowledgment Statement'.*.
tatement.................................
❑ 34. Manufactured home utility clearance...............................................................
❑ '35. Existing violations and/or expired permits.........................................................
❑ 36. Deed Restriction.........................................................................................
❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
38. Other: -ate 'Przew,_,�v oc h) r= v
02 s �.1R
39. Other: I r D 10
When issued Telephone tg -7 7 and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant: /-,7)- j ,1 A /' _ / / Date: _ VIC-/ Z&J12 J �/
1. Indexpermit/ap • lica ioriffor the above item numbered: Plan Check Letter
2. Additional item requ' d
Contractor, designer ner, as advised of the above data by phone, ❑ mail, ❑ counter, by
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by
Plans reviewed by: Date: Plans approved by:
Structural reviewed by: Date: Structural approved by:
Note transfer by: Date:
Yellow: Building Division
Date:
Date:
Date:
Date:
)?et>
3
f
'�
,a
P0
p: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
E.H. USE ONLY
4 'Piet Plan Attached
+ ~ if Floor Wen Attached
Sant to B.D.
3-0 C
t
Owner Location l / AP#
Plan Approved for: Sewage Disposal iC / /Water Supply: Public Private Well
Clearance for k dwelling. Other ,6&Zuz�
old final fdr:
Final clearance O.K. for:
NOTE:
Envir m alth Specialist Date
8/96
t
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVI i E, CA 95965 TELEPHONE (530)538-7541
4 -' SCHEDULE OF RECEIPT OF FEES
OWNER V� fG-t , l t A.P. #
PROPROSED BUILDING USE I S DATE I ' �-
"� 1. BUILDING PERMIT FEES
--- Balance Due .....................
--- Additional Fees Due...........
4-3
e
--- Revised P1an.Checking Fee.... $
2. SCHOOL DISTRICT FEES fl t S 6
(paid at School District Office) (form available after Plan Check)
A'' 3. SHERIFF FEES (paid at Building Division)
Residential............ X $360.00 =$
Units
Commercial (sq. ftg.)..... X $0.03 = $
4. URBAN AREA FEES
Residential (per unit).....
Sq.Ftg. .
X
# Units Amt.
RECEIPT # DATE REC.
(paid at Building Division)
Commercial (Sq. Ftg.).... X = $
Sq. Ftg. Amt.
5. RECREATION DISTRICT FEES
(paid at Recreation District Office) (form available after Plan Check)
6. THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at Building Division)
AA 7. SRA FIRE INSPECTION AND PLAN CHECK FEE
.$"A6 aid at Building Division)
-2-e>4 0
8. WATER TENDER FEES BATTALION #
$200.00 (paid. at Building Division)
9. NORTH CHICO SPECIFIC PLAN (paid at Building Division)
Residential Zone X = $
Zone # Units Amt.
Commercial (sq. ftg.) ......... X = $
Sq. Ftg. Amt.
10. OTHER �+-� t • ��
/ G/C 57- ptxi(�>
4-�3 iss � �•�-•��
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees
may be changed during the pl . A� checking process.
APPLICANT - ,
DATE Q
i
Pursuant to Govemyhepf Code Section 66020.,ffou are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You
have 90 days from date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a
protest are specifilKin Government Code Section 66020(a).
Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003)
BUTTE COUNTY DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE
CERTIFICATION OF EXISTING SQUARE FOOTAGE
School District A�-�r> a s A,P #' 4n4=, 4- . n go . �o
Owner's Name 'may E
Property Location/Address e-255 _B 12.r ro'. -a_0 Ci rZ
Square Footage �� �' Residential — Commercial
Demo permit issued (Date issued ) — obile home replaced
E� Verified by Building Department Records
0 Verified by Assessor Department Records
Bu i m Department Representa6e
11.4-o4 -
Date
,- _ ;�� _ .. r. -._.- ,.,.r,�,�,•-r.a� '_ � hya,,,,{.Y ��;, }'rya�.•"r'r y};,.-,,�ij Y.t.. v .. _ :..:.
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(one form per Building)
School District Building Department No.
A.P. Number Jurisdiction: city =f!�County
Property
Property
6,0-5'a/ -
Subdivision
Lot No.
..............................................................
......................................
Residential Development
Sq. Footage
No of Living
Mobile Home
Addition/
*Supplemental to
Units
Installation
Conversion
Permit #
................................................................................................
*(No foundation inspection)
. ...
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
New Addition
Representative
No.
'Ac /-6-
(Street Address)
(City)
School District certifies that
has complied with the requirements of Resolution No.
repr enting square ee.
Representative
Paid by Check # Remarks:
(State)
Sq. Footage
(including Exterior
Roofed Areas)
Date
IIA4ficant)
to.1— ion
7-9,0 5
(Phone Number)
by payment of $
FULL 2926
MMGATION
Date
Notlics: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, in compliance with
Govomna Code Section 6602%a), within 90 days from the date fees are paid. Failure to submit a timely wftm protest will'prohlblit
you from chol"Ing the Impostillon of the ton In any court action.
K subsequent to the School District Represudadve signing this - Butte County Schools Impact Fee Certification Form, the School. District Is
Will bythe appil, " Local Planning Agency that this project Is being reviewed under the California EnvIronmerital Q"Ity Act (CECkA),
this project maybe subject to additional school fess to fully mttlgalte.ft Impact on the school distillcrs schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls ( 1 0f03)dmm
%
f60 Tr
6 I �, A A A
A
A
• \ A A
\� c0 U t4l
A�eLIC W0��5
Department
J. Michael Crump, Director
Public Works
LAND DEVELOPMENT DIVISION
Storm Water Management Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase II
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (SWPPP) Acknowledgement LLESS THAN 1 ACRE1
Project Description: m S F
Project Location and/or Parcel Number: ULA q— 2 �-G -- 0C) -.7
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTIIRB
1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit
from the State of California Regional Water Quality Control Board. Phased projects that contain
multiple site build -outs of less than one acre but when combined with subsequent phases total more
than one acre of disturbed soil will require a Construction Storm Water Permit from the State of
California Regional Water Quality Control Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
Signed:
Title:
Date:/DLJ 4
Less than I Acre NPDES & SWPPP Compliance Certification
Butte County Storm Water Management Program
Revised 5/24/04
D.B.- I
Attention Property Owner:
An "owner -builder" building permit has b_ een 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.
f1. I personally plan to provide the major l�bor and materials for construction of the
proposed prop improvement : YES[ 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: CONTRACTOR'S LICE;\1S;v N0.
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: CTTY:
PHONE: CONTRACTOR'S LICENSE NO.
5^ I will provide some.of the work but I have contracted (hired) the following persons to
provide the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
!PROPERTY
DATE:
NOTE: This owner -Builder Verification is required by Section 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before
we are permitted to issue the' permit.
May 1995 - 2.26
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
property improvements specified
For your protection, you should be aware that as "owner -builder" you are the responsible party of record
on such a permit Building permits are not required to be signed by property owners unless they are personally
performing their own work If your work is being performed by someone other than yourself, you may protect
yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all permits
for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials and other costs) is $300 or more for -the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially
serious with respect to worker's compensation insurance.
0 For more specific information about your obligations under Federal Law, contract the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your
obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are -not licensed contractors are allowed to
perform their work personally or through their own employees, without a licensed contractor or subcontractor, only
under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder"
building permit, erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing their own
work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned
C. Vie* C.B.O.
, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
May 1995 2.27
J" ,a
WILLDAN
J — Serving Public Agencies
December 30, 2004
Scott Rutherford
Butte County Building Department
7 County Center Drive
Oroville, CA 95965
(530) 538-7169
(530) 538-2140 FAX
SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL
Willdan Project No: 14353-1235
Jurisdiction Job No: 04-3216
Assessor's Parcel No: 064-280-002
Description: New Single Family Dwelling
Dear Mr. Rutherford:
117 C Street
Marysville, California 95901
530/749.2373 fax 530/749.2199
www.willdan.com
Willdan has completed a plan review of submitted plans and documents for the above referenced project
and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and
documents provided for this review that have been found in compliance with the applicable codes are:
* Plans: Two (2) copies sheets T1 through D2 dated 09-16-04, by David G. Anderson Architects.
* Structural Calculations: Two (2) copies dated 09-04, by David G. Anderson Architects.
* Energy Calculations: Two (2) copies dated 09-16-04, by Serena E. Brown.
* Truss Calculations: Two (2) copies dated 05-16-03, by Larry Messamer.
The plans have been stamped with the Willdan approval stamp and dated the date of this letter.
On the pages to follow is the identification of the codes and standards applicable to the project, a code,
analysis, conditions -of -approval and identification of any deferred submittals.
' W I LLDAN Ma s Street
_ Marysville, California 95901
Serving Public Agencies 530/749.2373 fax 530/749.2199
www.wilidan.com
APPLICABLE CODES
Unless noted otherwise, all comments are based on requirements of the 2001 California Building
Standards Code found in the California Code of Regulations, Title 24:
• Part 2, known as the California Building Code and abbreviated herein as "CBC"
• Part 3, known as the California Electrical Code and abbreviated herein as "CEC"
• Part 4, known as the California Mechanical Code and abbreviated herein as "CMC"
• Part 5, known as the California Plumbing Code and abbreviated herein as "CPC"
• Part 6, known as the California Energy Code, and Energy Commission Standards, and
abbreviated herein as "CECS"
CODE ANALYSIS
Type of
Type of
`
1" Floor
2 nd Floor
Occupancy
Construction
Sprinklers
Stories
S Ft
Total Sq Ft
S Ft
R-3
V -N
No
1
1474
1474
U-1 . _
V -N
No
.1
571
571
Covered
V -N
No
11
540
540
Porch
CONDITIONS OF APPROVAL
1. Approval is contingent upon the review, requirements and approval of other departments
and/or agencies that have jurisdiction over this project.
2. Revisions and/or notes as red -lined on the plans.
DEFERRED SUBMITTALS
Our plan review reveals no deferred submittals noted at this time.
SPECIAL INSPECTION NEEDS
Our plan review reveals no special inspection needs pursuant to CBC 1701:
A
er Gordon Wright, P.E.
Plans Examiner Plan Check Engineer
Cc: Alice Mefford, E-mail: amefford@buttecounty.net
John Wyllie, 2015 Merrill Road, Paradise, CA 95969, FAX: (530) 877-2039 Email: jwyllie@aol.com
.Page 2 of 2 Courl.ly of'Buttc Pe.rltli.t Number 64-321.6
Willdan Pr(liect Number 11353-.1235
PA. Ic
RECORDING REQUESTED BY
Mid Valley Title & Escrow Company
AND WHEN RECORDED MAIL TO:
John.C. Wyllie and Danielle K. Wyllie
2015 Merrill Road
Paradise, CA 95969
A.P.N.: 064-280-002
2Q)104—goGD53CEO CEO 7
Recorded
Official Records
Count yy a-
BUT1E
CANDACE J. GRUBBS
Recorder
ROSEMARY DICKSON
Assistant
09:00AM 02 -Sep -2004
REC FEE 13.00
TAX 63.80
Mark
Page 1 of 3
Space Above This Line for Recorder's Use Only
GRANT DEED
The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $63.80; CITY TRANSFER TAX $0.00;
SURVEY MONUMENT FEE $
r X 1 computed on the consideration or full value of property conveyed, OR
File No.: 0402-1572077 (AMM)
computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale,
X unincorporated area; [ ] City of, and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Kenneth Griffith and Yvonne
Griffith, husband and wife as joint tenants who acquired title as Kenneth and Yvonne Griffith,
Husband and wife as joint tenants
hereby GRANTS to John C. Wyllie and Danielle K. Wyllie, husband and wife as community property
the following described property in the Unincorporated area of , County of Butte, State of California:
PARCEL I: .
LOT 88, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "PARADISE PINES UNIT NO. 15",
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,
STATE OF CALIFORNIA, ON JULY 15, 1971, IN BOOK 38 OF MAPS, AT PAGES 42,43 AND 44.
EXCEPTING THEREFROM ALL MINERALS, OIL, GAS, ASPHALTUM AND OTHER HYDROCARBON
SUBSTANCES, WITH PROVISION THAT ANY AND ALL MINING OPERATIONS SHALL BE DONE
FROM ORIFICES OUTSIDE THE SURFACE AREA OF THE LAND DESCRIBED HEREIN, AND THAT
NO DAMAGE SHALL BE DONE TO SURFACE OF SAID LAND.
PARCEL II:
A NON-EXCLUSIVE EASEMENT OVER LOTS A, B AND C (THE COMMON AREA) OF SAID
PARADISE PINES UNIT NO. 15, AND THE LOTS DESIGNATED FOR COMMON AND
RECREATION AREAS, AS DESCRIBED IN THE DECLARATION OF ANNEXATION FOR UNITS IV,
VI, VIII, X, XI, XII, XIII AND XIV.
Dated: 08/26/2004
Mail Tax Statements To: SAME AS ABOVE
ALL-PURPOSE ACKNOWLEDGMENT
State of California
%-Q)"L4_y_R�SS.
County of On lij�^ (yj,before me,ilrba-u.'p, (V�__
(DATE)
personally appeared t ( nc-�,,
❑ personally known to me - OR -
PATRICIA M. CANADA
DA
Comm. # 1455035
UI NOTARY PUBLIC: CALIFORNIA UI
Sociamento County
PdY Comm. Expires Dec. B, 2001 L
'proved to me on the basis of satisfactory
evidence to be the person(s) whose name(s)
is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed
the same in his/her/their authorized
capacity(ies), and that 'by his/her/their
signatures(s) on the instrument the person(s),
or the entity upon behalf of which the
person(s) acted, executed the instrument.
WITNESS my hand and official seal.
P�,, 4a,
NOTARY'S SIGNATURE
OPTIONAL INFORMATION
The information below is not required by law. However, it could prevent fraudulent attachment of this acknowl-
edgment to an unauthorized document.
CAPACITY CLAIMED BY SIGNER (PRINCIPAL)
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE(S)
❑ PARTNER(S)
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
DATE OF DOCUMENT
OTHER
d
RIGHT THUMBPRINT
OF E
SIGNER
0
a
t°
APA 5/99 VALLEY -SIERRA, 800-362-3369
A.P.N.: 064-280-002 Grant Deed - continued File No.:0402-1572077
(AMM)
Date: 08/26/2004
Kenneth GriffithYvo Gritfi
i
STATE OF CALIFORNIA }
) ss.
COUNTY OFSILQJ(,�1�04,*-16 - }
On
before me,
personally appeared
Kenneth Griffith and Yvonne Griffith ,
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies) and that his/her/their signature(s) on the instrument the person(s) or the
entity upon behalf of which the persons) acted, executed the instrument.
WITNESS my hand and official seal. This area for off1ciai
notarial seal
Sig tur_eg�
P
My Commission Expires: Z)R-C_ S f a.00r1
Notary Name: )A _rQ,IC, IFS �A N �>A Notary Phone: 5
Notary Registration Number:_ ASS a) County. of Principal Place of Business: CSA ry\_ `-STD
PATRICIA M. CANADA
e�A Comm. # 1455035 rn
NOTARY PUBLIC -CALIFORNIA N
�' • Sacramento Counly
a" MOY Com1m�Explres De 07
Page 2 of 2
SITE PLAN REVIEW APPLICATION
-bate:
Permit Number (if applicable) U y� 3a �(o
Owners Name:
Owners•Address: off/
AP# U /o `f - 28o -60.2
Parcel Size:
Telephone No.: % 7—.,U3
Q
Situs Address: /jt,Q v�,t w e. t- C_c
Proposed Use:
Residential
lb New Single Family Residential
❑ Single Family Addition ❑ Single Family Remodel
Mobile Home
Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
❑ Septic
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation (if necessary):
❑ Commercial Remodel
❑ Industrial Remodel
❑ Well
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
9M
Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
Site Plan Stamped Approved
By a4 Date /a 0
Page 1 of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
® Snow Load Area: • 000 fo .Z Sb 4 � , w
❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
❑ Watershed Protection Overlay Zone (See attached standards and requirements)
Expansive Soils (Test for expansive soils and 'if verified proper foundation design required
SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (Seeattached)
• Flood Zone:
• Flood Panel No.: 41666F 7cpWOC, Index Date:
❑ Sacramento River, Reclamation District (Approval must be obtained from the Calif mia Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See. attached handout)
Use Requires:
❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit
❑ Minor Variance ❑ Variance
❑ Detached Building Use Form ❑ Encroachment -Permit —�
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning: P, — t
6P-
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
20 ,
Side
S ►
Side Street
0
Rear
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Applicable Development Fees:
Standard Fees
❑ Fire '
`❑ School*
❑ Parks/Recreation
❑ Roads
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Impact
❑ Other '
Amount Formula
--------------------------------------------------------------------------------------------------------------------
Subdivision Map Special Fees
❑
Water Tender
❑
Road Improvement'
❑
North Oroville Area
❑
Other (per map)
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit.
Parcel Created By
❑ Deeds:
Date of Creation: Legal Access Provided: ❑ No ❑ Yes
Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:[] No ❑ Yes
Comments:
❑ Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑. Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
Page 3 of 5
i, Subdivision Ma /Parcel MaR: Ala-o-cl
P p
Map Date of Recording: / 5- 7
Lot:
❑ Use Permit/Minor Use Permit
Permit Number:
Book: 3 d Page: L(. -
Date of Approval:
Parcel Map/Subdivision Map[Use Permit Conditions
❑ Comply with the following Conditions of Approval:
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel.
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan
must be prepared by a registered civil engineer or other qualified professional and be
submitted to and approved by the Department of Public Works.
❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate
Battalion Water Tender Fund may be required.
❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development. , Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
❑ Property owners responsible for roa
EJ
10
Page 4 of 5
u
u
Summary of Specific Requirements:
This information provided in this summary is based on the application information and on the best available data at the time
of review.
CALarrysU3uilding Permit Site Plan Reviewl.doc
Page 5 of 5
OWNER'S CERTIF'I'CATE
LARWIN DEVELOPMENTS INC.. A CORPORATION .4S OWNER OF THE LAND INCLUDED
WITHIN'P ARADISE PINES UNIT NO. IS AS SHOWN WITHIN THE COLORED BORDER
LINE ON THE ANNEXED MAP, AND ALLIANCE ESCROW COftP., A CALIFORNIA
CORPORATION. TITLE INSURANCE AND TRUST COMPANY, A CALIFORNIA
CORPORATION ANO OROVILLE TITLE COMPANY. A CALIFORNIA CORPORATION AS
TRUSTEES UNDER RECORD DEEDS OF 'TRUST, 00 HEREBY CERTIFY THATWE ARE
TME ONLY PERSONS WHOSE CONSENT IS NECESSARYTO PASS C_EAR II TLE
TO SAID LAND AND WE CONSENT TO THE PREPARATION AND RECORDATION OF
SAID MAP AS SHOWN WITHIN THC COLORED BORDER LINES. THOSE PORTIONS OF
PONDEROSA WAY, RUTGER COURT, HOBART COURT, CHESTNUT GIRLIE, DOBBS COURT, OLIVET
OR VE HOOD COURT, CLUSTER COURT,CRESTON ROAD, STETSON GOURT,COAIPTON DRIVE,
BREVARD CIRCLE. JOPLIN COURT, AND ODESSA COURT, AS SHOWN WITHIN THE
COLORED BORDER LINES ON SAID !AAP ARE HEREBY OFFERED FOR DEDICATION
FOR PUBLIC USE FOR COUNTY ROAD PURPOSES. WE ALSO OFFER FOR DEDICATION
AND DO HEREBY DEDICATE. FOR SPECIFIC PURPOSES. THE FOLLOWING:
(A) RIGHTS OF WAY AND EASEMENTS FOR WATER, GAS, SEWER, AND DRAINAGE
PIPES. TOGETHER W'IT'H ANY AND ALL APPURTENANCES APPERTAINING THERETO.
ON, OVER, AND UNDER THOSE STRIPS OF LAND DESIGNATED PUBLIC UTILITY
EASEMENT CONTIGUOUS TO THE REAR AND/OR SIDELINES OF LOT'S AND OF THE
WIDTHS SHOWN HEREON,
(8) EASEMENTS FOR LIGHT AND AIR OVER THOSE STRIPS OF LAND LYING
BETWEEN THE FRONT AND/OR SIDELINES OF ;.OTS AND TME LINES SHOWN HEREON
AND DESIGNATED SET BACK LINE, SAID STRIPS TO BE KEPT OPEN AND FREE
OF BUILDINGS.
IC) R;GHTS OF WAY AND EASEMENTS FOR DRAINAGE PIPES TOGETHER WITH ANY
AND ALL APPURTENANCES APPERTAINING THERETO ON, OVER, AND UNDER THOSE
STRIPS OF LAND DESIGNATED DRAINAGE EASEMENT IN THE LOCATIONS AND OF
T.HE WIDTHS SHOSVH HEREON.
(,O) EASEMENTS FOR ANCHORS. GUYS, OVERHEAD AND UNDER GROUND WIRES AND
CONDUITS FOR ELECTRIC AND TELEPHONE. WATER. SEWER AND GAS SERVICE
TOGETHER WITH ANY AND ALL APPURTE.4 4N CES THERETO ON, OVER ANO UNDER
STRIPS OF LAND 10 FEET IN WIDTH WITHIN THE LOTS AND CONTIGUOUS TO
ANY STREET OR OTHER PUBLIC W Y TOGETHER WITH THE RIGHT TO TRIM OR
REMOVE ONLY THE NECESSARY TREES, TREE LIMBS OR BRUSH.
IFI CSESENTS FOR POLES. ANCHOR AND GUYS ON. OVER AND ACROSS THOSE
STRIPS OF LAND LYING WITHIN 2 FEET ON BOTH SIDES OF ALL SIDE LOT
LINES AND EXTENDING 35 FEET BACK FROM THE FRONT PROPERTY LINES.
(f) A RIGHT OF WAY AND EASEMENT TO THE COUNTY OF BUTTE FOR CON-
STRUCTING, RECONSTRUCTING AND MAINTAINING NECESSARY DRAINAGE
F 4C IL I T I F.S AND APPURTENANCES THERETO. ON. OVER ANP. UNDER ALL OF LOTS A,B
AND C SHOWN HEREON.
IG) EASEMENTS FOR PUBLIC UTILITIES AND SEWERS ON, OVER, UNDER, AND
ACROSS A FIVE (5.00) STRIP OF LAND ALONG EACH SIDE OF ALL SIDE LOT
LINES.
.LARWIA DEVELOPMENTS, INC., A CAL IFORNI4 CORPORATION, AS OWNER
EXECUT V VICE -P ESIDEN ASSISTANT SECRETARY
STATE OF CALIFORNIA 1 SS
COUNTY 0 ��2f4�)
ON THIS /''%QDAY OF K�). 1970. BEFORE ME, THC UNDERSIGNED A
NOTARYPUBLIC IN AND FOR THE COUNTY OFt_a"y� 'PERSONALLY APPEARED
JERRY BERGER AND MICHAEL D. C.ATCHCART KNOVIN' TO ME TO BE THE
EXECUTIVE VICE PRESIDENT AND ASSISTANT SECRETARY, RESPECTIVELY OF
LARWIN DEVELOPMENTS. INC.. A CORPORATION, WHICH EXECUTED TS.E FORE-
GOING CERTIFICATE ON BEHALF OF THE CORPORATION THEREIN NAMED, AND
ACKNOWLEDGED TO ME THAT SUCH CORPORATION EXECUTED THE SAME.
NOTARY PUBLIC J
MY COMMISSION EXPIRES '+/4
ALLiI/(q/DICE '/C(/p'OIY�SORP pfl AT J,00 A CALIFOR\I A -S ORP R%1{0+�)�,(7 AS TRUSTEE
COUNTSTATE OF C IF •�d �/�-_.2 IAO. /I SS
COUNTY OF �-�'-'9'` /) I
ON THIS /3 26AY OFw ,i 70, BEFORE ME, THE UNDERSIGNED. A NOTARY
P LIC IN NO FOR THE COUNTY OF PERSON LLY APPEARED
�Z��� AND
XNOWN TO ME TO 9E NEo-.-G_2�v-�=�,ANO�--
RESPECTIVELY, OF ALLIANCE ESCROW CORPORATION. A CALIFORNIA CORP RATION.
WHICH EXECUTED THE FOREGOING CERTIFICATE. AND KNO'NN TO ME TO BE THE
PERSONS WHO EXECUTED THE FOREGOING CERTIFICATE ON BEHALF OF THE CDR
-
PORATIOM THEREIN NAMED. AND ACKNOWLEDGED TO ME THAT SUCH CORPORATION
EXECUTED THE SAME. �7
NOTARY PUBLIC(
JMY COMMISSION EXPIRES Cv/ciJ eZ//
TI LE INS A: - AND TRUST COMPANY, A CALIFORNIA CORP RATION, AS TRUSTEES
/izs. i£i P/CS �i� S6GB
STATE OF CALIFORNIA 1
COUNTY OF -1 R.P.ff£f2F1 SS
ON THIS 17 DAY OF He 1970, BEFORE M"c. THE UNDERSIGNED, A NOTARY
PUBLIC IN AND FOR THE COUNTY OF S ea PERSONALLY APPEARED
fv.. AND •rc••
KNOWNTO ME TO BE THF ANDr!✓
RESPECTIVELY, OF TITLE INSURANCE AND TRUST COMPANY, A CALIFORNIA COR-
PORATION WHICH EXECUTCD THE FOREGOING CERTIFICATE. AND KNOWN TO ME TO
BE THE PERSONS WHO EXECUTED THE FOREGOING CERTIFICATE ON BEHALF OF TNF
CORPORATION THERE'- NAME O. AND ACKNOWLEDGED TO ME T T SUCH CORPORATI
EXECUTED THE SAME.
� �"G.'OKGIAnC yPA TSN III
C u. .`uTy •••� T
M1, I.Ov>)' 9 NOTARA�£OXJ
.x.,i��....n.nv..nr�n:..,a•a,.'wv MY COMMISSION C IRES
OROVILLE TITLEE, COMPANY. A CALIFORNIA CORPORATION, AS TRUSTEE
ASSISTA.' VICE PRESIDENT ASSIST NT $FGRE TpRW
STATE OF CALIFORNIA I
COUNTYOF r— 1 SS
ON THIS[ -DAY OF ilCMC4R✓ 1971, BEFORE ME. THE UNOE RSIGNED. A NOTARY
PUBLIC IN AND FOR THE COUNTY OF S_ PERSONALLY APPEARED
,?4y .VARri, ,AND �!'AFSARET B /D
KNOWN TO ME TO BE THE V iREf/OL T AND wftrs�./•/T S .es>ARI'
RESPECTIVELY. OF OROVILLE TITLE COMPANY, A CALIFORNIA CORPORATION WHICH
EXECUTED THE FOREGOING CERTIFICATE, AND KNOWN TO ME TO BE THE PERSONS
WHO EXECUTED THE FOREGOING CERTIFICATE ON BEHALF OF THE CORPORATION
THEREIN NWED,AAD ACKNOWLEDGED TO ME THAT SUCH CORPORATION EXECUTED
THE SAME.(
IlItLUI
1 •:
NOTARY PUBLI:JA f�4�'_��'
.� ... MY COMMISSION EXPIRCS_61,2-x12�,?
SURYID'OR'S CERTIFICATE
1. DONALD D. MCCOHMICK. DO HEREBY CERTIFY THAT I AM A REGISTERED CIVIL
ENGINEER OF THE STATE OF CALIFONNI A. T`I AT THE ANN_"X EO NAP OF PARADISE
PINES UNIT NO. IS CORRECTLY REPRESENTS A SURVEY MADE UNDER MY DIRECTION
IN OCTOBER. 1970 THAT IT IS TRUC AND COMPLETE AS SHOWN THAT' THE MON-
UMENT'SSHOYfN THEREON ARE SET IN THEIR CORRECT POSITION AND ARE SUF'FI-
CIEN'T T'0 F. NA BLE THE SURVEY TO HE RETRACED.
ald—
DONALD Oti MCCOFWJCK, R.C.E. 9033
AUDITOR'S CERTIFICATE
I, H.SEELY. JR., AUDITOR OF THF. COUNTY OF BUTTE, STATE OF CALIFORNIA D(
HEREBY CERTIFY THAT THERE ARE NO LIENS AGAINST PARADISE PINE$ UNIT 10. 15'
AS HEREON SET FORTH, OR UNPAID STATE. COUN TY, MUNI CIPAL OR LOCAL TAXES OR
SPECIAL ASSESSMENTS COLLECTED AS TAXES E%CC PT TA%ES OR SPECIAL ASSESSMENT;
NOT YET PAYABLE. TAXES OR SPECIAL ASSESSMENTS VOTICH ARE A LIEN BUT NOT
YET PAYABLE. I ESTIMATE TO BE I- THE yAIOUNT Ad / O ✓O.J=� G ✓C.J�
F.H.
EisC���<((
F.H. SEELY, JR., COUN' AU01 TO
PUBLIC WORK'S CERTIFICATE
I, CLAY CASTLEBERRY. DIRECTOR OF PUBLIC WORKS OF THE COUNTY OF BUTTE,
STATE OF CALIFORNIA DO HEREBY CE FY THAT I HAVE EXAMINED THE FINAL MAP
OF PARADISE PINES UNIT NO. IS THAT IT IS SUBSTANTIALLY THE SAME AS
APPEARED ON THE TENTATIVE MAP ON FILE AND ANY APPROVED ALTERNATIONS THER
OF, THAT ALL PROVISIONS OF THE SUBDIVISION MAP ACT OF THE STATE OF CALI-
FORNIA, AND LOCAL ORDINANCES APPLICABLE AT THE TIME OF APPROVAL OF SAID
TENTATIVE MAP HAVE BEEN COMPLIED WITH, AND I AM SATISFIED THAT SAID MAP
IS TECHNICALLY CORRECT.
CLAY
A I B� ll.0 E. '/4220
DIRECTOR OF PUBLIC WORKS. COUNTY
OF BUTTE
COUNTY CLERK'S CERTIFICATE
I. CLARK A, NELSON. COUNTY CLERK OF THE COUNTY OF a TT STATE OF CALI-
FORNIA. DO HEREBY CERTIFY THAT ON THEI '% DAY OF_T.7 .1971 THE
BUTTE COUNTY BOARD OF SUPERVISORS OFFICIALLY APPROVED T E SUBDIVISION
MAP OF PARADISE PINES UNIT NO. IS THE RECEIPT OF SATISFACTORY SECURITY
IN THE AUDITORS ESTIMATED AMOUNT OF�- V p •TO INSURE PAYMENT OF TAXES
WHICH ARE A LIEN BUT NOT YET PAYABLE WAS ACKNOWLEDGED. THOSE PORTIONS OF
PONDEROSA WAY, RUTGERS COURT, COMPTON DRIVE, HOBART COURT, CHESTNUT CIRCLE, OLI VET
DRIVE, 00085 COURT, HOOD. COURT,CLUSTER COURT,CRESTON ROAD, STETSON COURT,BREVARO
CIRCLE, JOPLIN COURT. AND ODESSA COURT AS SH01T'N WITHIN THE COLORED BOP.DEfl
LINES ON SAID MAP AND OFFERED FOR DEDICATION FOR PUBLIC USE WERE ACCEPTED
ON BEHALF OF THE PUBLIC FOR COUNTY ROAD PURPOSES.
Ua_rJ FL p� s b.a•
CLARK A. NELSON. CCUN TY CL ERK�j�?h
3Y DEPUTY
RECORDER'S CERTIFICATE
RECORDED IN THE OFFICE OF THE RECORDER OF BUTTE COUNTY. STATE OF CALI-
FORNIA, QT THE REOVEST OF OR." LIF T TLE COMPANY AT�MINUT PAST/%
O'CLOCK ¢M. ON IH,r.1i DAY OF
19 ]I IN 800K OF MAPS
AT PAGLS�3yyY RECORDING NU ER /,/pj0
LO ISE KL'J EN DE R, DUTTF. COUNTY
BY DEPUTY
SUBDIVISION NO. 34
PARADISE PINES UNIT N0. 15
PTN. SEC. 26 T, 23 N, R3 E., M. D. M.
BUTTE COUNTY, CALIFORNIA
NOVEMBER 1970
MURRAY B McCORM!CK INC.
CIVIL ENGINEERS LAND SURVEYORS
1912 F ST, SACRAMENTO, CALIFORNIA
SHEET I OF 3 SHEETS
70
08
66
3.
13
97
I.
__
BASIS OF BEARINGS
THE CALIFORNIA CO RDIMATE SYSTEM ZONE 2
SAWMILL (X-2,124.2 90. Y -781.60.98I
TO TRIANGULATiON STATION BALD MOUNTAIN
(X-2.145,390.63. Y-832.948.12) BEARING
N 22' 23' 29� E AS SHO� DON THAT AMENDED
RECORD OF SURVEY Fi-4E IN 900K 33
PAGES 95,96.97,saagg BUTTE COVNTY
RECORDS. DISTANCES SHOWN HEREON ARE
GRID DISTANCES; MULTIPLY BY 1.0001138
TO OBTAIN GROUND DISTANCES.
LEGEND
ALL LOT CORNERS NOT INDICATED BY THE ABOVE
SYM30LS 0 BE MARKED BY 3/4* IRON PIN WITH
SUBDIVISION NO
Of
0 53.20,9 PARADISE.PINES 'UNIT NO. 15,
BUTTE COUNTY, CALIFORNIA
/c 95. Y04 SCALE, r- lod NOVEMBER, 1970
MURRAY a McCORMICK INC.
CIVIL ENGINEERS' LAND SURVEYORS
SHEET 3 OF 3 SHEETS
i
PE9MIT NO. 4787-77 P,E
PERMIT EXPIRES
'OWNER Vern Pitzak
CONTR. 1 owner
64-28-2
,LOCATION (A.P.
(02 Ss
—4%P-5' Brevard Circle, Lot 88, PP#15, Magalia
y
N
'
l 3
�I
I Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB fG G
7
„
FINALED L
(Date)
. t
(Signature) 1
9. Electrical
A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of
mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps,
garage,,cabana, etc.? Yes% No
B. Is there proper clearances around panels? Yes ' No
C. Is power supply cord ,or feeder assembly properly fused? Yes �To
D. Is continuity test satisfactory as per the following procedure? esNo
1. De -energize electrical wiring system of the mobilehome at the pedestal_
2. Make sure that the power supply cord or feeder assembly conductors, including neutral
conductor, have been disconnected.
3. Switch all breakers and switches in the mobilehome to the "on" position.
4. Connect one lead of a test instrument to the mobilehome grounding conductor and
apply the other lead to each mobilehome supply conductor, including neutral.
5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line,
water line), including fixtures and appliances, shall be tested for continuity from
such equipment and the grounding conductor.
6. Upon completion of the above procedure, the power supply cord or feeder assembly
conductors shall be connected to the .site service equipment. A further continuity
test shall then be made between the grounding electrode and the chassis of the
mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site _
service equipment may be approved for energizing.
10. Is job card signed by Health Department for water and sanitation?
11. If everything okay, sign off card and tag services.
MOBILEHOME DATA
Manufacturer and/or Namestyle
Length Width
Vehicle Serial No.
State Identification No. n l6/ ;R.2 62
Additional Information or Comments:
/ Yv�
... - ...,
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1. Is the mobilehome located withxeequired separation from lot lines and buildings and generally
conform to plot plan? Yes No
2. Does the mobilehome have,required clearances above ground? (Sec.5085) Yes"—_ No
3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes
4. Is the mobilehome level? (Sec. 5088) Yes Y No_
5. If more than a ,� ie unit, are crossover connections properly installed? (Sec. 5088)
Yes No_
6. Water
A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
Yes / No
B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes No
C. Backflow - If coach is not State of Calif 7�_ approved, does station have backflow device
and pressure -relief valve? Yes_ No
7. Wastes and Drains
A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes,1' No
B. Does it have minimum" per foot slope and is it properly supported? YesNo_
C. Are any leaks detected in drainage system after running 3 Ilons of water through each
fixture including washing machine standpipe? Yes_ No �
D. If coach is notate of California approved, does station have required trap and vent?
Yes No, A /
8. Gas Piping and Gas Vents
A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum
'v mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as
'V large as the mobilehome gas line inlet without reductions other than the mobilehome
connector. Yes_ No
B. Test OK as per following procedure? Yes_ No
1. Open all appliance connector valves.
2. Shut off appliance burner and pilot valves.
3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum
6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without
drop.
4. Connect gas meter to mobilehome with connector, turn on gas, test connections with
soapy water. /No.
C. Are all appliance vents properly installed? Yes
..'
1 4'
1 1 � �
t f r /
e I ♦ � i
t �
COUNTY OF BUTTE
Department' of Public Works
7 County Center Drive
.Oroville ----- 534-4541
ELECTRICAL INFORMATION FOR DE -RATING MOB ILEHOMES ` \
Owner y s1 a s?
Location
Mobilehome Installation Permit No.
FILL IN INFORMATION FOR ITEMS 1 THRU 10
,-/ Watts
d /L
1. Width �.Z x Box Length 60 F/ x 3 = '44yko'
2. 2 Kitchen Appliance Circuits ................. = 3,000
3. 1 Laundry Circuit ............................ 1,500
4. Ovens ........................................ _ .S'6 O P
5. Cook Stove Top ............................... = 9'2oy
6. Hot Water Heater .............................
7. Dishwasher & Disposal ........................ _ /S a D
8. Clothes Dryer .................. ............... = S-4;0,9
9. Other (specify, i.e., motors, exhaust.fans,
etc.)
Sub -total - Watts ..... 3, VV Y
First 10,000 watts @ 100% .......... = 10,000
Remaining alza /9 watts @ 40% .......................
10. Air Conditioner �5"�%/C� watts @100%.. =
Largest Demand
Central Heat System 45-00 a watts @ 65%.. =
TOTAL DEMAND WATTS REQUIRED ............. 119- 9: S/ I
"Demand Watts 'Required" ; 230 ...... ............ _ _12 3113 AMPS
De -rate Mobilehome to .............. ...TTE, ?�p1 ..... /ZSR S
•Cl ►V
j j.OING DEPARTMENT
AP OOVED
o �
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
At OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the California Administrative Code, Title 25, Chapter 5, under permit
number for the following location:
Owner
Owner's Address
Mobilehome Mfg. Model Year
Insignia No. Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Director of Public Works
Date By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS •
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
N
F ewall it Pipin Par ets st Floor
g. Restr om Finish d Floor
s Window 3 Floor
all SidingToo t
Slab Roof Sheaking Water i in
Piers Roofing Sewer
Garage Fdn. Vents Fixture
Footin s Garage Vents Water Ht .
Stemwal l Insulation Heaters
Slab Prov. for ph sicall Appliances
handica ed
Carport Conformance of ex. Gas Piping Test
Footings structure Temp. Gas
Slab FI'nal Sanitation
Patio FIREPL CE Final
Footings Footing EL CTRICAL
Masonry Walls Throat Rough
Reinf. Steel Final Fixtures
Bond Beam FIRE SPRINKLERS Motors
Framing Test Water Htr.
Stucco Final Subpanels
Mesh MECHANICAL Gird. Fault Prot.
Scratch Heating Service
_ Brown Cooling Temp. Pole
Finish Ducts Underground
Interior Lath Ventilation Permanent
Daor Closer Final Final
MOBILEHOME UTILITIES - - - - - - - -Elec. Service b Z. I 41 Elec. Pedestal I
Water Piping 10 ..Z Sewer Gas Piping
BI E ME INSTALLATI N - - - - - - - - - - - - Support , -7 e—p Elec. Continuity 3 1 _ •7 Z6�9
Water Piping (f (i0 Drainage Gas Piping
DATE REMARKS OR CORRECTIONS
0 2,7�
T
(NOTE: An entry must be made on this form each time you visit the job site.)
• COUNTY•'OF BUTTE — DEPARTMENT OF PUBLIC WORKS
• � 7 County Center Drive — Uroville, California 95965 C���
Telephone: 534-4541
APPLICATION AND PERMIT 1 1�1�
u onze representat)ves of the County of Butte to enter upon the
abovelmo4neroperty for inspection purposes.
i
X Date 6-7
Signature of Permitee gent
Receipt No. 170-713
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
7 above for which fees have been paid.
DIRECTOR PUBLIC WORKS
By Date_ /4z:). is7 —7 i
ding permit expires Date /a- vi - 7,f
BUILDING
Owner E Z
SO. FT. OCC. BUILDING VALUATION
Mailing Address jA 0 C/ 4E glo 4 R t+V I` S(4�
�� / /
Telephone No.
Fireplace
Contractor `C OS�f� ��
Total Valuation
/ ��
Mai I i ng Address /� ,.i may' e !f . G
Permit Fee
Plan Checking Fee &/or Penalty
S () � Aa "
Telephone No.
Permit Fee
Is—s
Building AddreAWS 41_�Ia
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
r
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F s
9etritetiofl'
Fire Dept.
FireZone
Use Permit
Building sewer 5.00
EOA
Parking
Plans
Parcel
claration
Parcel Ma P
0' R/W
Improvements
P
Lawn sprinkler system 2.00
Bldg. Plone Recd
Parcel Appro
Plansroyal
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
I --7e — 7
600V OR LESS Main service 100 AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home ❑Others ❑
Main service 10 0 AMP OR LESS 25.00
Main service// EA. ADD'L 100 AMP 1.00
NEW CONS, OR ADONST + ACCLBLDGDWELING OCCUP. &) 20sgft
NEW CONSTR MULTI -OUTLET
NON.RESI D, BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS &
NON•RESID. (SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
StyleY"% �• / ��/J (�
�// . �[� (j%�/��i l�,� (r �/�%r� �,
Ex. Occup(OUTLETS OR FIXTURES) rBOA@L�
Og
EX. Occup. ( OUT ETS ((RESID )RE A) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. �Q �-/ G1 Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Wo�rkn's Compensation.
have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not em
P employ y person in any manner
so as to become subject to an bject to the Workmen's Compensation Laws of
California.
MECHANICAL No.1 @ FEEPERMIT
FILING FEE J$3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$ QG
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
a
and State Laws relating to building construction, and hereby
a th '
TOTAL PERMIT FEE
$ .?0
u onze representat)ves of the County of Butte to enter upon the
abovelmo4neroperty for inspection purposes.
i
X Date 6-7
Signature of Permitee gent
Receipt No. 170-713
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
7 above for which fees have been paid.
DIRECTOR PUBLIC WORKS
By Date_ /4z:). is7 —7 i
ding permit expires Date /a- vi - 7,f
11
MOBILEHOME SUPPORT DATA
Mobilehome Mfr. Si ��`N�Z Setup Model No. G Year' -77
Width (ft.) Length 6 ... (.ft.) . �Expando .Size _ft.x ft.
(Draw support details below)..
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural setup sheets. .(.if not on .f,il.e with .the County of Butte) .
*If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
Footings -(check one)
/ / 1. Wood. either
pressure treated or
fdn-. grade.
2.. Concrete pad.
3. Other,: specify
Supports (check one)
/ 1. Concrete block
2. Concrete piers
3. Steel piers
4. Other, specify
Typical Support
Footing Size
Max. Pier
Spacing
—f Maxer.
Ovhang
Tr
BUTTE COUNTY
BlJILDINr DEPARTMENT,
APPROVE®
t
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive,.Oroville, CA.
PHONE: 534-4541
MOBII,EHOME INSTALLATION SHEET
f
1. Owner's name: i R,j P
2. Installer's name: Q E+`cF� ! 10 ig �� �' -0 t;;y
3. Is the site currently under permit? Yes No
(If yes, furnish permit number l{ ) OR
Is the site an existing site? Yes / / No
(If yes, furnish two (2) plot plans.)
4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and
clear of all setbacks and easements? Yes 14=,L,'. No
(If no, clarify )
5. What is the mobilehome electrical rating? ----------------------- O� O C7 Amps
6. What is the mobilehome site service rating? --------------------- 52, o-0 Amps
7. What is the mobilehome site circuit breaker rating? ------------- Amps
8. Is there any other electric load to be served by the mobilehome
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft.. on LPG.)
site
service? ---------------------------------------------------
Yes / / No /�—
(If yes, identify the load..and size:
(Load) (Amps)
9.
What
is the mobilehome site gas pipe size? ----------------------
/V'0 (in.)
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? /V D 0J/�ts' (ft.)
12.
What
is the mobilehome gas demand? ------------------------------
0 q S (BTU)
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft.. on LPG.)
1
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
•7 CoSnty Center Drive — Oroville, California 95965
Telephone: 534-4541
y. APPLICATION AND PERMIT
authorize representatives of the county of Butte to enter upon the
above
° -mentioned property for inspection purposes.
Date
Signature ofrrPermitee or Agent
Receipt No. % b - c;, 9 a
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been aid.
DIRECTOR F UBLIC WORKS
By Date 7 -1-1-77
u
ilding permit expires Date lc-Z� " 77
BUILDING
Owner 7- /L.
SO. FT. OCC. BUILDING VALUATION
Mailing Address Or iq10LL`
It. 171yC
c7((�T� qg
e/ Ja—Oa 2
Fireplace
Contractor 0 U A( t: PL +
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
is
Building Address 1 , �j/L e U,4 C1 r,
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
P f 57 r
Each Trap 1.50 _
Repair drainage or vent piping 1.50
Water piping
Z0Ifn9 Verfficati p
Each gas water heater or vent 1.50
pO —a G
A. P. No. � �j
font/ II
Z 4,
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
FetaeiC.
i io
Fire Dept.
Fire Zone
Use Permit
Building sewer
EOA
Parking Parcel Parc I M
Plans Declarations�
60' R/W
Im ro ments
P
Lawn sprinkler system 2.00
BI (J�s�Rec'd
L Pcrcel Ap roval
PICKApproval
Permit Fee $ � '�
$ I-
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service io°°V OR L o AMP ORLESS5.00 %
Main service EA. ADD -L too AMP 2.50 S�
Single Family ❑ Duplex ❑ Mobil Home Others ❑
0 OEAMP OR LESS 25.00
'Main service 1
Main service EA. ADD'L too AMP 1.00
'
500 SQ. FT. MINIMUM
NEW CONST. ( DWELLING
LIN OCCUP. &)
WEACCLG2¢sgft
OR ADDNS.
NEWCONSTR. MULTI -OUTLET
NON -RESID. ( BRANCH CIRCUITS) 2.50ea
EOR MOBILB
NEW CONSTR. POWER APPARATUS &
NON-RESID. (SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions -Code under the name
st le of:
y
Ex. Occup(OUTLETs OR FIXTURES) BA@L@ta
Ex. Occu FIXED APPLNS. OR
P•(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25,
1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$ Sti
00
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen;s Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
4 EW92 VtS.), lct&_
�^
TOTAL PERMIT FEE
$ 3
authorize representatives of the county of Butte to enter upon the
above
° -mentioned property for inspection purposes.
Date
Signature ofrrPermitee or Agent
Receipt No. % b - c;, 9 a
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been aid.
DIRECTOR F UBLIC WORKS
By Date 7 -1-1-77
u
ilding permit expires Date lc-Z� " 77
Butte Co. Dept. of Public Works
7 Cou#ty Dr.
Orovill e t Calif.
Sirs;
a
# 12 Pueblo Dr,
Aan Rafael Calif.
Aug. 3, 19711
Rea Agency authorization for
construction permits.
LeVern A. Hadley, Registered Building designer is hereby authorized
to act as our agent in the signing of , mnd the obtaini.ng'cf the necessary
permits for the lot development and the installation of a mobile home
on our lot # 88 Paradise Pines unit 15 located on Brevard circle,
Magaxia, Cr.11f, \r1
Sincerely,
Mr & Mrs Vei-A Pitzak
C%�
11
COUNTY OF BUTTE
Department' of Public Works
7 County Center Drive
.0roville------534-4541
ELECTRICAL INFORMATION FOR DE -RATING MOBILEHOMES
Owner /"/r .
Location /V.S Q!V Y e
Mobilehome Installation Permit No. r=a 97--71-^
FILL IN INFORMATION FOR ITEMS 1 THRU 10
Watts
12—
a
1. Width ZA x Box Length 4 x 3
2. 2 Kitchen Appliance Circuits ................. = 3,000
3. 1 Laundry Circuit 1,500
4. Ovens ........................................
5. Cook Stove Top ............................... _ Lo&o
6. Hot Water Heater .............................
7. Dishwasher & Disposal ..... _ ,/1.S -V 6
8. Clothes Dryer ................................ _ �S� O,� J
9. Other (specify, i.e., motors, exhaust fans,
etc.)
Sub -total - Watts ..... 12Z2 Olid
First 10,000 watts @ 100% ................................ = 10,000
Remaining a,2,Q -elwatts @ 40% .......................
10. Air Conditioner �� watts @100%.. _ )
Largest Demand = ��
Central Heat System AS o d e watts @ 65%..
TOTAL DEMAND WATTS REQUIRED ............. 31f
"Demand Watts Required" - 230 ............. ............ _ 1,93./ 3 AMPS
De -rate Mobilehome to .................................... �
Lloyd Smith
Butte Co, Bldg, Dept.
7 County Center Dr.
Oroville, Calif.
Dear Friend,
1100 Goldcone Dr..
Magalia, Calif.
October 31, 1977
Re; Elect. Dec -rating Request
Mobile Home
I am enclosing herewith, the major electrical appliance wattages for
a mobile owned by.Mr. & Mrs Vernon Pitzak and located at 145 Brevard
Drive Paradise Pines,''lot 88- PP unit 15.
The mobile is a 12' X 601(net) plus.an 8' X 12' expando having a total
area of 816 sq. ft.
The owner would like the coach de -rated to
an amperage as close to the
actual dmand amperage as is practical.
1. total area 816 sq. ft.✓
2. Kitchen appliance circuits
3.Laundry.circuits
—4. -Range -cooking top- 4 burners
8200
watts
oven -bake & broil
5000
watts
j�. Water heater
4500
watts
16 Dishwasher & Disposal
1500
watts
` `7.Clothes Dryer
5900
watts
8. Ceneral Heat (Electric Furnace
15000
watts
9. Air Conditioner (future)
5940
watts
I would appreciate you( providing the necessary de -rating calculations
and requesting the area inspector to de -rate the coach in accordance with
your proceedure.
Lloyd, if you would send me some of your,de-rating forms,.I would be
glad�to make them out and sears copies to you for your approval.
Sincerely,
LeVern A. Hadley
Bldg. Designer #874
oi%
pi°g►814
LZ61 �v
X10 N
ii