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HomeMy WebLinkAbout065-171-0426 -171-" kir sther Benjamin �0y�Q//Ha ,270 Grandview Dr . , 1 t40 - N 2 yen Sub, Magalia ontr:Tri-V Development, Magalia �ermit 1J6 57 78P,E(util MH) LEC. J AS eUPPOR ST UCTURE REQ. /1JPj e COMPACTION THT REQ. NA 65-171-21 Con-tr : Beich MH, 'Chico: P rmit #6866-78MHI / Issued /.-2; /� Q r 065=171-042 06-1822 BENJAMIN TRUST, t~ .6466 GRANDVIEW AVE, MAGALIA+' Cont: GREENE ROOFING ` MH PERM FND(EX) rxf �g� z. RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 2006-0039518 Recorded I REC FEE 10.00 Official Records I County of 1 COWUM COPY 1.00 butte I LAOsiLE J. GRUBBS I County Clerk-Recorderl I I DD 010:26M 02 -Aug -2006 I Page 1 of 2 IIII III III I Ilii i II 11111 II III III III 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. BENJAMIN TRUST REAL PROPERTY OWNER/LESSOR PO BOX 784 MAILING ADDRESS MAGALIA BUTTE CA 95954 CITY COUNTY - STATE ZIP 6466 GRANDVIEW AVE. INSTALLATION MAILING ADDRESS, IF DIFFERENT MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME') 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 06-1822 530 538-7541 BUIL IT 0. TELEPHONE NU ER 6 • 1 O SIGNATU F LOCAL AGENCY OFFICIAL DATE NO DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. UNKNOWN 1979 BUDDY MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMFJNUMBER 04750378AM/BM 52'X 24' 127497/8 SERIAL NUMBERS) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 065-171-042 HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept. e a , Order Number: 0003-2448735 Page Number5 LEGAL DESCRIPTION Real property in the unincorporated area of the County of Butte, State of California, described as follows: THE NORTH HALF OF LOT 401, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "FIR HAVEN SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, MAY 19, 1955, IN BOOK 21 OF MAPS, AT PAGES 31, 32, 33, 34 AND 35, REVISED RECORD OF SURVEY RECORDED MARCH 12, 1962 IN BOOK 27, OFFICIAL RECORDS, PAGE(S) 8, 9 AND 10. EXCEPTING THEREFROM ALL THE VALUABLE MINERALS BENEATH THE SURFACE OF THE SAID LANDS, WITH THE RIGHT TO MINE AND EXTRACT SAID MINERALS, IT BEING AGREED AND UNDERSTOOD THAT IN ALL MINING OPERATIONS THE SURFACE OF SAID LANDS WILL BE PROTECTED AGAINST DAMAGED, AND THAT ALL MINING SHALL BE CARRIED ON FROM TUNNELS, SHAFTS OR DRIFTS HAVING THEIR ORIFICES OUTSIDE OF THE SURFACE AREA OF THE ABOVE DESCRIBED REALTY, ALL AS EXCEPTED AND RESERVED IN THE DEED FROM MAGALIA MINING COMPANY, A CORPORATION, TO E. D. STORTS, ET UX, RECORDED SEPTEMBER 4, 1947, IN BOOK 423 OF BUTTE COUNTY OFFICIAL RECORDS, AT PAGE 385. APN: 065-171-042-000 Mid Valley Title & Escrow Company Z A IM 'ON VIIVDVW 90 U LM 9002 '9Z'inr RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DMSION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 2 -Aug -2006 2006-0039518 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. BENJAMIN TRUST REAL PROPERTY OWNERAMSOR PO BOX 784 MAILING ADDRESS MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP 6466 GRANDVIEW AVE. INSTALLATION MAILING ADDRESS, IF DIFFERENT MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") 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 06-1822 530 538-7541 BUIL T 0. TELEPHONE ER 6 (� SIGNA F LOCAL AGENCY OFFICIAL DATE NO DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO UNKNOWN 1979 BUDDY MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMEINUMBER 04750378AMMM 52'X 24' 127497/8 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIAILABEL NUMBER(S) REAL PROPERTY LEGAL. DESCRIPTION SEE ATTACHED ASSESSORS PARCEL NUMBER 065-171-042 HCD FORM 433(A) REV. 8/91 Order Number. 0403-2448735 Page Number: 5 LEGAL DESCRIPTION Real property in the unincorporated area of the County of Butte, State of California, described as follows: THE NORTH HALF OF LOT 401, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "FIR HAVEN SUBDIVISION', WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, MAY 19, 1955, IN BOOK 21 OF MAPS, AT PAGES 31, 32, 33, 34 AND 35, REVISED RECORD OF SURVEY RECORDED MARCH 12, 1962 IN BOOK 27, OFFICIAL RECORDS, PAGE(S) 8, 9 AND 10. EXCEPTING THEREFROM ALL THE VALUABLE MINERALS BENEATH THE SURFACE OF THE SAID LANDS, WITH THE RIGHT TO MINE AND EXTRACT SAID MINERALS, IT BEING AGREED AND UNDERSTOOD THAT IN ALL MINING OPERATIONS THE SURFACE OF SAID LANDS WILL BE PROTECTED AGAINST DAMAGED, AND THAT ALL MINING SHALL BE CARRIED ON FROM TUNNELS, SHAFTS OR DRIFTS HAVING THEIR ORIFICES OUTSIDE OF THE SURFACE AREA OF THE ABOVE DESCRIBED REALTY, ALL AS EXCEPTED AND RESERVED IN THE DEED FROM MAGALIA MINING COMPANY, A CORPORATION, TO E. D. STORTS, ET UX, RECORDED SEPTEMBER 4, 1947, IN BOOK 423 OF BUTTE COUNTY OFFICIAL RECORDS, AT PAGE 385. APN: 065-171-042-000 Mid Valley Title & Escrow Company Z 'd I V C 8 ' 0 N W11WrWW 01 iu.)i(I-0 nnn7 n,7.lnf% o FOUNDATION SYSTEM CERTIFICATE OF OCCUPANCY BUILDING PERMITS NUMBER: 06-1822 Address or location of unit: 6466 GRANDVIEW AVE., CA MAGALIA 95954 Legal Description of Real Property: 065-171-042 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: BENJAMIN TRUST Owner's address: PO BOX 784 MAGALIA CA 95954 INSIGNIA OR HUD NUMBER: 127497/8 SERIAL NUMBER OR V.I.N.: 04750378AMIBM MANUFACTURER'S NAME: UNKNOWN YEAR: 1979 OFFICIAL APPROVING INSTALLATION: DATE: < 1) 6(/" PHONE: (530) 538-7541 H.C.D. 513C DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT- - wvkwn of C"" ow atsnmra d►' We Search Date Printed : 07/1712006 Delo Decal #: ABF9763 Use Code: SFD Manufacturer: Original Price Code: AEA Tom: BUDDY Rating Yew. 1979 Model: Tax Tom: ILT Manufactured Date: 0aroa1979 Last ILT Amount. $16.00 Registration Exp: 01312007 Date ILT Fee Paid: 03/17/2006 First Sold On: 01/11/1979 ELT Exemption: NONE Serial Number HUD Label / Insigni Length width 04750378AM 127497 52' 12' 04750378BM 127498 52' 12' Registered Owner: ESTHER ROBERTA BENJAMIN PO BX 784 MAGALIA, CA 95954 Lad Tide Date: 07/18/1995 Last Reg Card: 03/212006 Sale/Transfer Info: Unknown Situs Address: Inactive Decal/DMV: Open Escrow: 6466 GRANDVIEW AVE MAGALIA, CA 95454 Situs County: BUTTE DMV SL3658 MID VALLEY TITLE PO BX 1068 2295 FEATHER RIVER III. OROVILLE, CA 95%5 Escrow Fite No: 2448735 Pending Buyer: CRABTREE Dealer Name: None Reparted Escrow Opened On: 07117/2006 Expires on: 1 ]/142006 *** END OF TITLE SEARCH *** 9 A £££8'ON VIIVDVW 8o NV99:6 90OZ '9Z,Inr 065-171-042 06-1822 ,BENJAMIN TRUST,- lz-:"r -"t' Wz NOTES +6466 GRANDVIEW AVE, MAGALIA ._Cont: GREENE ROOFING_,, f'MI PF,RM F7,1MfRX1 u � Ri-- 4N TI - ASL' APN: 0(a5— 1-71 - o I rZ� Permit No. Owner. (,(.S"r ISE"Tf}YN JAZ Site Address: ( l (0 b C R,9N,0 V/EW f{ (/E , EIW(,gCliQ Contractor. Type ofPermlt: 6;xIS7-/Wa s�T� A -7" 7 C4� Q,- 7cO CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: SIGNATURE: +=OK n — u • nor MANUFACTURED HOMES MISCELLANEOUS - DATE PERMANENT FOUNDATION Lj SOFT -SET --DATE DECKS -COVERS -CARPORTS -GARAGE S 1 ZoningSetbacks-Easements 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 2 Figs; SailsSz-0pthSpacing-DnnctrsSteel 3 Sewer; Loctn-Test; Fall/C/O-Concrete 3 Decks, GirderslJoists-0cking-Brcing 4 Wtr; Loctn-Test-Easeinent Needed -Regulator Stairs-Guard/Handrails 5 Elec Loctn-DIrncs-Grnd "Am -Concrete 6 Yard Gas; Loctn-Test Wrap Nat or LP[—] 4 Wood Awn; Posts-Beams4Utrs-CnnctrsShthg, Frmg-Brcng Inch Sz Ft Lngth 5 Alum Awn; Columns-CnncinsSplice-Decal-Enclsrs 7 Blckng; SzSpacing-Marriage Line 6 Carports; Wndws-Doors 8 Gas; MH Test-Demand-Valve-Cnnctr 7 Electric 9 Elec MH Cntnty Test-Crossovers-Breakers-Clmcs 8 Frmg; Sills AnchrsStuds4fts Trusses 10 Drain; MH Test -Fall -Flex Cnnctr 9 Siding; Nailing -Veneer -Stucco -Lath 11 Wtr & Sewer Connected -C/O to Grade 10 Roof; Shthg-Roofing 12 Gas and Electricity Tagged 13 Tie Downs 0 Foundation ❑ 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers # DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 lec Pool Lting; 15 volts-GFI 6 Elec.Enclsrs; Conduit Entries—Terminals—listed . 7'Elec Banding; Metal w/5'-CrcItng Egp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxers-Enclsrs�nlboardsansultn to Main Conduit - 9 Health Dept AppivI 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide — 4p d� o'$ op • #` 3 xcu ' €+tis y Pool Drawing '4 0 = Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE IPLUMBING 1 ZoningSetbacks-Easements-FloodSlope 2 Fig Main; Soils-Elec Gmd Fig Dp.p 3 Fig Garage; Soils-Steel-Elec Gmd Ftg Dpth 4 Ftg Parches/Decks; Soils -Steel Fig Dpth 5 Stemwalls Main; Steel-Blockouts Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frpic FtgSteel 9 DWV; Fall -Fitting -Test -2 -way C/O -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgWService Test 12. Elec Undrgmd 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Acc & VnUtn 16 Insulation dA* d DATE jFrRAMING 17 Silts Proper Materiats & Anchrs 18 Walls Studs -Nailing Spacing & Braces -PlatesSound 19 Bearing Walls ovet Girders ,& fir Nailing 20 Draft Stop In Wails (rat proof) - 21 Fire Stops; Furred CeilingsStairs-Chasers-Tubs 22 Headers &- Bea risSi &'Bearidg' 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brae TrussShthg 25 Frpic Ties or Type A Flue=Frpic Throat Clrnc 26 Attic Acc; Sz & Rmz Pitctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting boors -Sill Ht & Dimensions 28 Garage Fire Prtctri Framing -RC Channel 29 Prprty Line Firewall & Opngs' 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run4 anding-Fire Prtctn 32 Plywd an Roof Ovrhng Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath Weep Screed-Fndtn Vnts-Undrfir Acc 35 Glazing Area -Glass PrtctnSkyLts-Plastic . 36 Shear Walls; Nailing -Bolts 37 Brace IntlExt Wall pnls 38 insultn-Walls-Ceilings 39 Infiltration -Walls -W ndws i DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Gmdng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ❑CU or ❑AL AC Wire Sz ya ❑ CU or ❑ AL 48 Range Circ ya ❑ CU or ❑ AL Oven Circ Qa ❑ CU or ❑ AL Insulated Neutral ❑Yes 0 N 49 Service -Riser Cndctrs & Gmd Main Dscnnct 50 Eqp Clrncs pnis-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 53 Wtr Htr; Vent Acc-Dmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr. Nail Prtctn 56 Shwr Pan; Test, First fir -Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas.Piping DATE IMECHANICAL 61 AC Ducts Insuitn & Support " 62 Vent Fan, Exhaust abv Insulin 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pitirin if Furnace in attic c� 0,y' oa Sys a,a FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Meth Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Cimc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Gmd-Air-Gap-Cooking Clmc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garaire boor; Swing -Landing -Closure 79 AC Ductl.rdirage-Damper. _ 80 Wtr Htr, Vnts-Cim -Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG AppinceUndr House 3' drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Cirnc Drnge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, E1ec-Plmb 89 Vnts abv Roof, PImb-Appinc-Frpic-Cimc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgmd 92 Vntitn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler A.. ��4�y� � C�. �':_� .. 4 �y S(f� ..j �!. ..t` i ...� �{� . ���:�- . •, � -r � . _ ':��; ' v f,, ,'y'..r,,,�y� ,r ., ,� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 A. PERMIT NO. BP061822 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS 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 Issued Date: 07/28/2006 APN: 065-171-042-000 the Business and Professions Code, and my license is in full force and effect. License Class : - L i se Nu er: �/ O Site Address: 6466 GRANDVIEW AVE MAG Date: ` ` ,6 Contractor: Map Index: Description: mh perm fnd ex site OWNER -BUILDER D CLARATION I hereby affirm under penalty of perj. ry that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: TRUST BENJAMIN to its issuance, also requires the applicant for such permit to file a P.O. BOX 784 signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section MAGALIA CA 7000) of Division*3 of the Business and Professions Code) or that he or 95954 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: DOREMUS, GERALD GLEN owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, P O BOX 4121 provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one CHICO, CA 95927-4121 year of completion, the owner -builder will have the burden of 530-895-1774 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 not apply to an owner of property who builds or improves thereon, Contractor: DOREMUS, GERALD GLEN and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). P O BOX 4121 ❑ 1 am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95927-4121 530-895-1774 Date: Owner: r License #: 445103 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: 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: Square Ft: 0 S. F. •Total Policy ##: Valuation: $0.00 Q -1 -certify that in the performance of the work for which this permit is Census Code: 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. — G� Date: Applicant: WARNING: Fri ure t secure workers' compensa coverage is unlawful, and hall su ect an employer to criminal penalties and one hundred tho�rand ollars (5100,000), in addition to the cost of compensation damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. �fO CONSTRUCTION LENDING AGENCY This pe�miYis hey.by issued under t, applicable provisions of the Butte County Code and/or Resolu ons to work indlca4d ab ve for which fees have been paid. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) By: Date: K Name: PERMIT EXPIRES ON: Address: ate ❑ 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 t 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 sust c any o 'al form or document of Butte County. I hereby authorize represent iveseof,Butte County to enter upon the above mentioned property for inspectio purp es. Print ' ��GLY c Signature: Name: Date: ❑ Owner Contractor ❑gent fo Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 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 OFAPPL_ICATION Website: www.buttecounty.net/dds y "PLEASE PRINT CLEARLY" APPLICANT INFORMATION OWNER INFORMATION Last Name /!J first Name -s v Address G �� City State State Zip Phone Fax Fax E-mail . State License Number APPLICANT INFORMATION CONTRACTOR Name Name — G6 Zip Address L (2 0 y State City Phone State Fax Zip Phone State License Number Fax Planner E-mail Date Approved: 5-lo3 Clas I APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Type Const. Fax E-mail Map Book State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail \ rAPPLICANT SIGNATURE For offi96 use only: Zonin Flood Zone SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT QNO. I3Y � D BIN # PROJECT LOCATION APIt�1 % .-0 y Z_ Property Address ` / - City ross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractorsi a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Sco a of Work: Sq FT- Living Garage Open Cov ❑ 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. Received by: Amount: Bldg Receipt #: Sheriff SMIP Date: Other Total REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ '4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (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. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. O 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 Zvi 64" Grandview Drive, P.O. sox 784 -Nagalla, CA 95954 SAM 118 A90VZ 50-16016 1 90-02&026- : it.a Fat . 5.00 1 Check 0.00 Recorded 1 official-Reoords 1 County of t Butts 1 Candace J. Grubbs 1 Recorder, 1 10a37a■ 21 -Jun -0 1 GF 3 Trust TramslerDead urszass -MM aosVs» 19 so A TM MW WUNN== TO A SMA =0 sa 1 N2 M ss ago SM H I ass =as asmmasaslra im at s� ova mass or Tans smssmssuers.— AMW 063-171-042-000 ! e� a widow, do hereby grant to WF � R. sower n=X TiUbl, whose, ZZustee is, at the time of recording, �•� sit, whose successors and aMQintaos ars also named in that Instrument known as the !R�lIlI>.AXVMWW or To V aGn Mf 'at said trust agreement, further id wtified as EMEMM es", attached hereto and made a part hereof, all that real property sib in the unincorporated ares of the Donety of Butte, state of California, described as follows: seeZ9 +�" fZ1l�af. attached hereto and made a port hereof. 1990. Da • State of California ) sq. County of Butte ) on this�� day of , in the year of 1990. before ms, the undessiggeed, a Notary Public, appeared �R. MMUMMUMip personally known to me -(or proved to me on the basis of satisfactory evidence), to be the person whose name is subscribed to this Instrument and acknowledged that ehe executed it. M1?1ESS my hand and official seal. SONsrau MARY PUBLIC, State of Ca11fornia• - em"s s. Ntse."W Z 'd ££E8'0N VIIVSVN 80 Nd£6:6 9002 '9Z'Inr Xi2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering Xi2 Concrete System Engineer Approval State .Approval MANUFACTURED HOMEIMOBILE HOME FOUNDATI& SYSTEM IMALTH AND SAFETY CODE, SECTION 18551 APPROVED XUBRWT TO CORRECTIONS NOTED APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS AND REGULATIONS State a Califomia Dwaaftwe ([Bowing aad C y (W j9S AND STANDARDS _ JDATZ AlW& 2-1 c •i z Wheaton Drive • Atlanta GA, 30336 Xi2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering REQUIREMENTS • These plans and specifications meet the requirements of Title 25 Section 1336.3 Sub Section A and 97 UBC Seismic Requirements, CBC 2001 addition. • Maximum vertical projection at sidewall is 9'. Higher walls may be used when the design loads are adjusted accordingly and approved by HUD. • Main rail spacing must be 75.5" - 99.5" * Except single sections 95" minimum • Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, and rim plates. The longitudinal component of the Xi2 system replaces end frame ties. Check manufacturers set-up requirements. • Maximum pier height is 48" pier. *Except for single sections 36". • Steel piers must be fastened to the I-beam with clamps provided with steel pier. • Systems must be placed as evenly as possible, no more than 10' from end of home. • Designed for 7:12 roof slope. *Except single sections, (20° - 4.37 in. 12" pitch). Additional Requirements for Concrete Systems • Poured concrete must be 2,500 PSI minimum at 28 days. • Square concrete pads minimum is 18" wide by 12" deep. Round concrete pads minimum is 18" wide by 14" deep. Strip footings minimum is 18" wide by 14' long by 6" deep. * Xi2 components exceed HUD code 3280.306g "Anchoring equipment exposed to weathering shall ha�a� resistance to weather deterioration at least equivalent to that provided by a coating of zinc on steel of not less than 0.30 ounces per square foot of surface coating...." Page 2 of 8 0 TIE DOWN ENGINEERING -, 5901 Drive o 1. 2. 3. 4. 5. 6. 7. 8. 9. 10 Installation of W Ground Systems Identify the number of systems to be used on the home using the chart provided. Identify the location where the systems will be installed. Clear all organic matter and debris from the pad site. Place U -bolts through holes in pan provided. Place pad centered under beam with the lateral strut bracket towards the inside of the home. Press or drive pan into ground until level and flush with prepared surface. Build pier according to State, Local or Home Manufacturers guidelines.(Figure 1) Attach the end of the smaller tube to the inside of pan using U -bolt & nuts provided Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 2) Install a minimum of four (#12 x 1 "_ tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together. (Figure 1) 1-3/4" Tube Lateral Struts �° ° ° 1-1/2" Tube 4-#12x1" Tek Screws Figure 1 lcn� °f No�je U -Bolt & mounting Bracket v' J -Bolt Nut & Washer Strut (flag end) 1 -Beam Figure 2 Install frame bracket clamps to I-beam on in side of block/pier. Do not tighten nuts at this time. Attach longitudinal strut to U -bolt in pan using nuts provided. Insert strut in the frame bracket clamp, attach with nut and bolt. Do not tighten at this time. Pull the frame bracket clamp with the fastened strut outward to remove any slack. Tighten all nuts and bolts on the struts and beam clamps. ®> tlrlF OWN,` ENGINEERING ` 0 LD 0 0 Xi2 Ground Parts Detail Xi2 Ground Lateral System Part Number 59306 Includes: 5' Strut, pad & hardware kit (#59329-1 includes all nuts and bolts). Longitudinal Hardware Kit Part Number 59331 Includes: 2 I-beam brackets & 2 U -bolts with all nuts and bolts. Lateral and Longitudinal Combination Part Number 59333 Includes: 5' Strut, Pad, Longitudinal Strut (#59329), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Struts for Longitudinal Systems Part Strut Pier Height No. Length Up To: 59330-44 44" 4 Blocks or 32" 59330-65 65" 6 Blocks or 48" Ground Longitudinal Hardware Kit Xi2 Ground Longitudinal Strut & Hardware Kit Ground Longitudinal Strut Xi2 Stabilization Pier Placement for Ground or Concrete Xi2 Pier Placement Double Section Home 0 -62' 3 Xi2 Systems* 63'- 80' 4 Xi2 Systems *2 Xi2 systems can be placed at either end of the home. Triple Section Home 0 -62' 4 Xi2 Systems 63'- 80' 5 Xi2 Systems M31> Page 4 of 8 m 0 0 0 0 1. 2. 3. 4. 5 7 Installation of Xi2 Concrete Systems identity ine numoer or systems to De used on the nome using the chart provided. Identify the location where the systems will be installed. Build pier according to State, Local or Home Manufacturers guidelines. Drill two 3/8"x 3" deep holes in the concrete using holes in galvanized bracket as a guide. Attach bracket to concrete pad using 3/8"x3-1/2" wedge anchors provided. Place nut & washer on anchor, leave enough room for 1 to 2 threads showing on top of bolt. Using a hammer, tap the wedge bolts into hole through bracket, leaving nut & washer flush with bracket. Using a 9/16" socket wrench, tighten wedge/anchor bolt, securing bracket to the concrete. Attach the end of the smaller tube to the bracket mounted on the pad, using the grade 5,1/2" x 2-1/2" bolt/nut provided. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 1 next page) Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together 8. Install frame bracket clamps on I-beam on the inside of block/pier. 9. Insert strut in frame bracket clamp and attach with nut & bolt. Attach opposite end to concrete bracket. 10. Pull the frame bracket clamp with fastened strut outward to remove ar lack. 11. Tighten all nuts and bolts on system. M C p1> 16,5 Page 5 of 8 TIE • • i Ti 3 O www.tiedown.com• '344-0000 FAX /349-0401 Q f O Xi2 Lateral Concrete Systems Part#59307 Includes: 5' Strut, Bracket, & Hardware Kit #59315-1 with all nuts and bolt. Longitudinal Struts for "Concrete Systems" Part No. Length Pier Height #59013 44" up to 4 Blocks #59015 65" up to 6 Blocks Longitudinal Hardware Kit Part #59263 (Includes 2 sets per kit: I-beam bracket, nuts, bolts and washers) Lateral and Longitudinal Combination Part#59332 Includes: 5' Strut, Longitudinal Strut (#59364), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Nut & Washer Figure 1 Beam Clamp Bracket J -Bolt Lone Xi2 Installation Placement Beam Xi2 Concrete System Longitudinal Strut Concrete Longitudinal Hardware Kit d of N°'t1e Fn r Page 6 of 8 m 0 Li 0 1 I o 0 Offset Placement Diagrams represent examples of double and triple section offsets. Total size is determined by the length of unit plus offset. Xi2 Stabilization Pier Placement for Ground or Concrete Single Section Home 0 -80' (76' Box) 4 Xi2 Systems &-- Xi2 Pier Placement Double Section Home 0 -62' 3 Xi2 Systems* 63' - 80' 4 Xi2 Systems *2 Xi2 systems can be placed at either end of the home. Triple Section Home 0 -62' 4.Xi2 Systems 63' - 80' 5 Xi2 Systems IF A Hardware Breakdown #59329-1 Hardware for 59306 Lateral System 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread Beam Clamp Base 1-3/4 zinc 4 10556 Tek Screw #12 x 1" 1 10631Z J Bolt 1/2 x 5-1/2 grade 5 zinc 2 10640 Push Nut 1/2 1 12107 Flat Washer 1x2" SS 1 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10519 Hex Nut 1/2" w/ Serr flange #59331 Longitudinal Hardware for 59306 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-12 x 1-1/4 Carriage Bolt 1/2-12 x 1-1/4 4 10801 Full Thread 10 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10801 Carriage Bolt 1/2-12 x 2-1/2 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread Grade 5 2 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread 2 10519 Hex Nut 1/2" w/Serr Flange 1-3/4 zinc 4 10640 Push Nut 1/2 4 10519 Hex Nut 1/2" w/ Serr flange # 59329 Hardware for 59333 Lateral and Longitudinal combination 1 59329-1 Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-12 x 1-1/4 4 10801 full thread 5 10646Y Hex Nut 1/2-13 Grade 5 zinc 1 10801 Carriage Bolt 1/2-12 x 2-1/2 2 10801 Grade 5 zinc 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread 6 10646Y 1-3/4 zinc 2 10640 Push Nut 1/2 2 10519 Hex Nut 1/2" w/Serr Flange #59315-1 Hardware for Lateral System 1 10631Z J Bolt 1/2 x 5-1/2 Grade 5 zinc 1 12107 Flat Washer 1/2" SS 4 10556 Tek Screw #12 x 1 " 2 10646Y Hex Nut 1/2x-13 Grade 5 zinc 1 10826 Carriage Bolt 1/2-12 x 3 4 10801 Grade 5 zinc #59027 Hardware Kit for 59307 Lateral System 2 59264 3 Way Concrete Bracket 4 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Hardware Kit #59263 Longitudinal Hardware for 59307 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-13 x 1-1/4 1 59315-1 Full Thread zinc 12 10646Y Hex Nut 1/2-13 Grade 5 zinc 4 10801 Carriage Bolt 1/2-13 x 2-1/2 4 10926 Grade 5 zinc #59364 Hardware for 59332 Lateral and Longitudinal combination 1 59264 3 Way Concrete Bracket 2 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Lateral Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-13 x 1-1/4 Full Thread zinc 2 10801 Carriage Bolt 1/2-13 x 2-1/2 Grade 5 zinc 6 10646Y Hex Nut 1/2-13 Grade 5 zinc ®1��� � Pa oLl -p ; I F,1� Page 8 of 8 T/E DOWN - ENGINEERING m 0 0 s 0 - PERMIT NO. _. 69257-78P,E PERMIT EXPIRES OWNER Esther Benjamin Tri-V EMN Const., Magalia CONTR. 65-171-21 LOCATION (A.P. ) 70 Grandview Dr., lot 401 N2, Fir Haven Sub, Magalia s` i. 1 ' a i; Temp. Power Pole /jCalled PG&E Temp. Elea Serv. tl Called PG&E �i U yTemp.Gas Serv. Called PG&E \JOB INALED (Date) (Signature) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE 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 White - Owner, Yellow - Installer, Pink - D.P.W. • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD may. BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Sod Piping Forms Para ets 1st Floor Ma( Bldg.>� Restroom Finish 2ndiFloor Footings Windows 3rd Faloor Ste wall Sldin To out \ . Slab Roof She*kthing Water PI in Piers Roofing Sewer 'N' Garage Fdn. Vents Fixtures Footings Stemwall Garage Vents Insulation Water Htr. 0 Heaters Slab Carport Footings Prov. for ph sica ly handicapred �•. Conformance of ex. X structure Appliances Gas Piping &Test Temp. as / Slab Final Sanitation Patio / FIR LACE Final Footings Footing EVECTRICAL Masonry Wall Throat Rough Reinf. StAl Final Fixtures Bond Beim FIRE SPRINKL&M Motors anal MECHANICAL bcyaxcn Heating Servlc¢� wn Ventilation T p. Pole Inlsh .. der round terI, Lath ,Permanent oor Closer anal MOBILEHOME UTILITIES_-f�00W4- Elec. Service 7 P Elec. Pedestal 4? --7— Water Piping Sewer 7— 7 rap Gas Piping E ME INSTA LATI - - - - - - - - - - - - - - Support Elec. Continuity /-97 Water Piping Drainage Gas Piping 12. -1 3-7'r DATE REMARKS OR CORRECTIONS \V fc /%�0 d.�� �✓r a �o 7-v i2.sT py w C � - g- 7 %i�� Lr �, d, ss - Gpf%t , T/O�"G�� Aol� (NOTE: An entry must be made on this form each time you visit the job site.) G MOBILEHOME INSTALLATION INSPECTION CHECK LIST' &1�i�'—As the mobilehome located with required separation from lot lines and buildings and generally conform to plot plan? Yes /y, No is'2�G Does the mobilehome have required clearances above ground? (Sec.5085) Yes No (3P Are footings and supports properly sized, spaced, and braced as per approved plans? '(Note possible variation at spring shackles.) (Sec. 5082,& 5083) Yes No vv. Is the mobilehome level? (Sec. 5088) Yes No '(5�C�If more than a single unit, are crossover connections properly installed? (Sec. 5088) Yes—".No_ A. Is flexible connector of adequate size and properly installed (1/2" ID mein.)? (Sec. 5566) Yes -/—N0 B. Test - Does water piping withstand working pressure or 50 lbs. air test? Ye§Z— No C. Backflow - eif is not State of California approved, does station have backflow device and pres V valve? Yes_ No C71"astes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes -VII. No B. Does it have minimum 'k" per foot slope and is it properly supported? Yes %Z No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe?,Yes No_ D. If coa of State of California approved; does station have required trap and vent? Yes 8�. Gas Piping and Gas Vents A. Connector - Is mobilehome connected.to the gas supply w�ping ed 3/4" minimum mobilehome connector not more than -;6 ft. long? Note: to be at least as large as the mobT ehome gas line inlet without reductio the mobilehome connector. Yes No B. Test OK as per followin rocedure? Yes_ N 1. Open all appliance conn for valves. 2. Shut off appliance burner and of valves. i 3. Air test with manometer t59, -f6-,-1411 wat r� column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) c rated in tenth pound -increments. Test for 10 min. without drop. 4. Connect gas eter to mobilehome with connector, turn on gas, test connections with soapy w r. C.. Are all appliance vents.properly installed? Yes No V '`electrical v A.,jIs 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.? Yeses No B. �Is there proper clearances around panels? Yeses No C. OIs power supply cord or feeder assembly properly fused? Yes No D. Is continuity test satisfactory as per the following procedure? Yes No 1.1 -'De -energize electrical wiring system of the mobilehome at the pedestal. 2.61'Make sure that the power supply cord or feeder assembly conductors, including -neutral conductor, have been disconnected. 3.V Switch all breakers and switches in the mobilehome to the "on" position. 4.t/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.L% 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 the electrical 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. T� State Identification No. co. /97-Vf7 60"_l 27 tf Additional Information or Comments: COUNTY OF BUTTEt — DEPARTMENT OF PUBLIC WORKS t 7 County Center Drive Orovi lie, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT An s z7p Land ,cr, c.avna a�u v c o v� ll l- Vvullly vl pull- lv -Ill-1 UFUII 1110 above-mentioned property for inspection purposes. X Sigrie►d'rKof Permitee or Agent 3ceipt No. ✓ v ite-D.P.W. — 1`d�jAJ*sor —/. ink-Insp .Date 0 T�enrod- App lican t eve opment ee $ � � TOTAL PERMIT FEE This permit is hereby issued under the applicable provi f.5'0 the Butte County Code and/or resolutions to do work in above for which fees have bee5,pNd. DIRECTOR LIR POBLIC WORKS BY 7 –7 ding permit expires Date a 7 - 7 BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor — Mailing Address �,rJ� Fireplace. Total Valuation • Telephone No. Permit Fee Building Address y/ MjPermit Plan Checking Fee&/or Penalty Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 O A/— /Repair drainage or vent piping 1.50 A. P. No _ K7Z174 Zoning & Pla Ing Water piping 1.50 167� 00 Each gas water heater or vent 1.50 F it n Fire Dept. Fire Zone I Use Pe it Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Ma 60' R/W Imp vements Each additional outlet .30 Building sewer Bid ans Recd Parcel ,oval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ Permit Fee $ • "r,71c ELECTRICAL No.1 @ I FEE PERMIT FILING FEE J$3.00 1,00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service 600v OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD -L 100 AMP 2.50 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST % ACCLBLDGS.LING CCUP. 4\ 20sgft 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 style of: —� % C '/ "' �/ tO NEW CONSTRES'D. MULTI-OUTL T 1 NON-RESID, BRANCH CIRCUITS/ 2.50ea NEW CONSTR. POWER APPARATUS 6 NON-RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTIlRES B L@; EX. OCCU FIXED APPLNS. OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 a License No. =�D�i, (�� Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 3-5 $ L 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 iNo. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee 1 certify that i have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Lad Development F ,cr, c.avna a�u v c o v� ll l- Vvullly vl pull- lv -Ill-1 UFUII 1110 above-mentioned property for inspection purposes. X Sigrie►d'rKof Permitee or Agent 3ceipt No. ✓ v ite-D.P.W. — 1`d�jAJ*sor —/. ink-Insp .Date 0 T�enrod- App lican t eve opment ee $ � � TOTAL PERMIT FEE This permit is hereby issued under the applicable provi f.5'0 the Butte County Code and/or resolutions to do work in above for which fees have bee5,pNd. DIRECTOR LIR POBLIC WORKS BY 7 –7 ding permit expires Date a 7 - 7 C06i TY OF BUTTE DEPARTMENT OF PUBLIC WORKS ,t 7 County Center Drive , Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT�- aULIIUIILe IUPIWbVIILQLIVCJ UI llle %IUUnly UI DULLe LU enter upon the above-mentioned property for ins ection purposes. t X Date Signature of Permitee or Receipt No. / 14(r& White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit i"s�liere6y'is'sued und`eFtlie appl`,i�able provisions of the Butte County,Code and/or resolutions: to do work indicated above for whi'dh)fees,have been, paid.- !I )� D E 7 �OFtPUBLIG WORKS By Date / 1kAr Building permit expires Date _ ��✓���7 BUILDING Owner6gAl I k*n SO. FT. OCC. BUILDING VALUATION / Mailing Address • 1 Tel one No. • Contractor ' i Mailing AddressdSor A01AV4 .. Fireplace Total Valuation I p T ho11= t^/ Permit Fee Building Address Plan Checking Fee&/or Penalty Permit.Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 I* Repair drainage or vent piping 1.50 A. P. No. -- �% �— J O� vYdn;nonning Water piping 1.50 Each gas water heater or vent 1.50 F &anitatl0l) Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. ons Recd Parcel 4pproval Pla Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONS. OR ADONST // 1 ACC. BLDGS.DWELLING CCUP. Y) 22sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9. Div. 3, of the State of California Business & Professions Code un er the name St Ie y , &IN ^ ham! 4l T NEW RESID. BRANCH CIRCUITS NON.CONST l BRANCH CIRCUITS) 2.50ea NEW CONST R. POWER APPARATUS 6 NON -RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTIIRES 5 L� EX. OCCU FIXED APPLNS. OR p•(OUTLETS (RESID•) EAJ 2.00 Temporary service 10.00 4,de /C U II�� A License Noll G1 Classification t.- Mobile Home Facilities 15.00 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 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. @ FEEPERMIT 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 OrdinancesTOTAL�ERNFITEE:� and State Laws relating to building construction, and hereby Land DeveoprniMIFee1WO'f3 .i .1`t°,Vv�t IL l Lan ., $ F tzt $ d aULIIUIILe IUPIWbVIILQLIVCJ UI llle %IUUnly UI DULLe LU enter upon the above-mentioned property for ins ection purposes. t X Date Signature of Permitee or Receipt No. / 14(r& White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit i"s�liere6y'is'sued und`eFtlie appl`,i�able provisions of the Butte County,Code and/or resolutions: to do work indicated above for whi'dh)fees,have been, paid.- !I )� D E 7 �OFtPUBLIG WORKS By Date / 1kAr Building permit expires Date _ ��✓���7 bi G7®G PNG6f6 WORKS �fl r NOV 2 2 19X ACS IU 71819110111112111213141516 1 11 "'1 . MOBILEHOME SUPPORT DATA rte' If other than single wide, �? Mobilehome Mfr. 2"s w� �® furnish Setup Model No. ���- �Year d Width,q (ft.) Box Length -LL --(ft.)- - Tagalong or Expando Size t. 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 mobi-lehome unless otherwise specified. F 91 .0K LO (ft.)('in. '(in.) (in.) Center support Center support locations* footing sizes (in.) (ft.)(in.) (in.) (in.) (ft.)(in.) D (ft.)(in.) (ft.Vin.) (tin.) in. .1 A *If center piers are other than drawn above, draw in -locations, spacing, and dimensions. Footings (check one) _ F4 -k " Wood either pressure treated or -� foundation grade. 2. Other (specify) Supports (check one) FL-LA-r-C-on-crete block. 2. Other (specify) I' Tagalong or Expando, show support details. X.F471 Typical Support in.) (in.) Footing Size .4 t I -- Max. Pier Spacing (ft.)(in.) -- Max. Overhang (ft.)(in.) BUTTE COUNTY BUILDING DEPARTMEN' APPROVED 0 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: 16 A `G ��� •�/� �i /�!i'� �, 3. Is the site currently under permit? /Yes / L� No _1 (If yes, furnish permit number -7-7 900 -7900, ) 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 ( If no, clarify ) ) ( gQ©y Amps .5. What is the mobilehome electrical rating? ----------------------- ®y Amps 6. What is the mobilehome site service rating? --------------------- 7. What is the mobilehome site circuit breaker rating? ------------- fps.- 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes / / No (If yes, identify the load and size: (Load) j'tl (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- -,0- (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? /L,0 ��(ft.) 12. What is the mobilehome gas demand? -- ------------------- �� -�°�� (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) r !t �r 1 7-1 l 3 ' FS i r + 2 0"s T Allr r ;u 7 �zz )OUTrE COUNT Sul L®ANG DIVISION' APPROVE; b�ee4,1 4 ve.. __ -k 01 a 4 9 f x f 9 r� a :i Qa�4 2 Y di i} '1 �f {1yF i% 4� N -- Z— Jr; F. Al 0 V�4 z` ..BUT'T`E COUNTY BUILDING 61VISIO ,'. rf APPRO® 4 -. �. -__ -__ _- _ __. __. _ _ �� � _ _____ _ _. "-___ . _ ..._-__- _ 1. _ _ _