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HomeMy WebLinkAbout065-180-021AP 65-18-21 4 Glen R. Staub tau 210 Grand View_ , Lot-. 415, No.. 2, Fir Haven Sub Magalia " Permit 41 76 P, E (u 6� 1. /MH) r GAS t71 SUPPO T S RUC . ' COMPACTION TEST I. 77!- "coiitr:, Oakmont Mobile Home Center, Chico 4 Permit #76-77MHI Issued t,• Z —117 —7 IWO). 65-18-21 contr: Gary Mullanix, Paadise Permit #3586 79B,E(new-pridet. -- • garage) l i[Q l /V��/ • �� 65 18=21Y',`,•.31'17-89B,E;M� 15� STAUB,., Glen„ "-6608 Grandview,';' a a ia, { 1 {'(new cabana/MH)o - 19 A) -;..�..�-. •:�,f: Yii'e•-�.S,i-•".:,'.,'wy,:wi+r.,. .res 1.•�,:�'. __ 77 IN O . i t I { - 1 Y i Temp. Power Pole Called PG&E Temp/Elect Serv. Galled PG&E Telp. Gas Serv. Called PG&E OB a INALED (Date) _ �✓�" " r (Signatur94 . 11 'i PEF�IAIT NO. 3586-79B,E PERMIT EXPIRES OWNER Glen Staub Gary Mullanix, Paradise "CONTR. IrLOCATION (A. P. 65-18-21 `. 210 Grand View Dr., lot 415, Fir Haven Sub, Magalia Tj s: E , Temp. Power Pole Called PG&E Temp/Elect Serv. Galled PG&E Telp. Gas Serv. Called PG&E OB a INALED (Date) _ �✓�" " r (Signatur94 . 11 Interior Lath I Ventilation Penmane t Door Closer I Final Final Q /I'> MOBILEHOME UTILITIES Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping . MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity `Water PipingTT Drainage �/ Gas Piping /✓� 1. W s9/fd (, E GO rx ,mid %f �/`� � f T -1�we — DATE REMARKS OR CORRECTIONS 9-o2 3,7 !' 6�, tel/ w ��ctc �' .?� eZ-A /�-��1iGX 7£l a��� c��4�;�� �� /aa 4:2,� co41CZ< 4/04)AAl R�Tj U" I� (NOTE: An entry must be made on this form each time you visit the job site.! COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION R€MORD B I DING BUILDING (Cont'd) PLUMBIN Setback Firewall Soil Piping Forms Parapets 1st Floor Main"Bidg.-N, Restroom Finish 2nd Floor Footings Windows f - 3rd Floor StemwalI Siding .00—Z — 7 '29D To out Slab Roof Sheathing Water Piping Piers Roofing -J?, 7, ? Sewer Garage Fdn. Vents Fixtures Footings Stemwal I — / Garage Vents Insulation Water Htr. Heaters Slab Carport Footings 7Q ® Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping& Test Temp. Gas Slab Final Sanitation Patio I FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h 00,:173—,79' el;4 ,:17 — Reinf. Reinf. Steel Final Fixtures Bond Beam FIRE PRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heatina Service Brown Cooling Temp. Pole Finish Ducts ce0 Underground —�� .,7%A Interior Lath I Ventilation Penmane t Door Closer I Final Final Q /I'> MOBILEHOME UTILITIES Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping . MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity `Water PipingTT Drainage �/ Gas Piping /✓� 1. W s9/fd (, E GO rx ,mid %f �/`� � f T -1�we — DATE REMARKS OR CORRECTIONS 9-o2 3,7 !' 6�, tel/ w ��ctc �' .?� eZ-A /�-��1iGX 7£l a��� c��4�;�� �� /aa 4:2,� co41CZ< 4/04)AAl R�Tj U" I� (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 — Oroville, California 95965 Tel ephcines 5304541 APPLICATION AND PERMIT 3� A6 79, authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Y 01L Signaturvrp ermit a or Agent Receipt No. /LT -V7 i" 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 paid. DIRECTOR OE -PUBLIC WORKS BYDate Bu ding permit expires Date W �O BUILDING OwnerSQ. FT. OCC. BUILDING VALVA ION Mailing Address Telephone No. Contractor Mailing Address �® Fireplace Total Valuation ' Telephone No. —7 Permit Fee Building AddressPlan Checking Fee &/or Penalty Permit Fee al% O PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 C Repair drainage or vent piping 1.50 A. P. No. �8—�� Pk Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Vs n ion Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans ParcelEach Declaration Parcel M 60' R/W Im vements additional outlet .30 Building sewer 5.00 W4. Plans RecdA ro Parcel yal Plans Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ $ ELECTRICAL NO -1 @ FEE PERMIT FILING FEE $3.00 3.00 Main service 100 AMP 00V OORSLESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 100 AMP&o0v OR LESS 25.00 ' Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELLING OC 4 OR ACDNS. ACC. BLDGS. 22 sq ft . &0 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 0=% ( 1 ttALU �\flt.f� tfr — �c.tt 1J L NEW CONST_ BRANCH CIRCUITS T NON.RESID. � BRANCH CIRCUITS 2.50ea NEWCONST_ POWER APPARATUS & NON -RESID. SINGLE OUTLET CIR. Ex. OCCUP(OUTLETS OR FIXTURES) B L@; FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. _�f�� ��� Classification �D Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ a $'7/3:7 WORKMEN'S COMPENSATION INSURANCE I 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. 'have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑1 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 $ $ 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 Land Development Fee Is TOTAL PERMIT FEE $ 6 �e authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Y 01L Signaturvrp ermit a or Agent Receipt No. /LT -V7 i" 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 paid. DIRECTOR OE -PUBLIC WORKS BYDate Bu ding permit expires Date W �O N � i�aQR•p./ '•�� y� G11t 1 PERMIT NO. 6641-76 P,E.''—'""' G PERMIT EXPIRES OWNER Glen R. Staub CONTR. owner LOCATION (A.P. 65-18721 ) .210 Grand View, No. 2.of Lot 415, Fir -Haven Sub. ,, Magalia Temp. Power Pole Called PG&E Temp. Elec. Serv. 7 Called PG&E Temp. Gas Serv. Galled PG&E- *0 !- JO B FINALED / _ 7 7 (Date) 686e (Signature) COUNTY OF BUTTE — DEPARTMENT OF,rPUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback r'2 -77 Firewall Soil Piping F rms Pais ets list Floor ain Bldg. Restro Finish 2nd Floor Footings Windows 3rd Floor temwaII SidingTo out ab Roof Sheathin Water Piping% Pie s Roofing Sewer Gara a Fdn. Vents Fixtures Footin s Garage Vents Water Htr. Stemwal Insulation Heaters Slab handl fo ehysic:x*. lly Appliances -7 - Carport Co rmancdde of Gas Pi In &Test —/ �.-7 Footings s ucture Temp. Gas Z -7 7 g5LiOL- Slab Final Sanitation Patio FIREPLACE Final 2 Ap,�' Footin s oting ELECTRICAL Masonry Walls Thr o t Rough Reinf. Steel Final N11., Fixtures Bond Beam FIRE SPRINKLE Motors — Framing Test X Water Htr. Stucco Final Subpanels Mesh MfCIUNICAL Grd. Fault Prot. Scratc Heating Service JU- 7 a!$e 41fintelor Cooling Temp. Pole h Ducts Underground 'e-ld -+'7t o Lath Ventlidtion Permanent /. �2 c �'7 7 46�P Dor Closer Fidl Final 2 7 DATE REMARKS OR CORRECTIONS /IX a 40 (NOTE: An entry must be made on this form each time you.visit the job'site.) L COUNTY OF BUTTE DEPARZMENT 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 1-641/' 74 for the following location: Owner /1'G f' Av X-' R Owner's Address -2-),0 o'rJ Ui"au.! Mobilehome Mfg. Model Year 76• Insignia No. Z -/9f;- Serial No. ,�J-=299 �21c1 It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date /-21/- 7-7 By THIS CERTIFICATE IS VOID WHEN MOBILEHOME.IS RELOCATED l ii0}3l.i,l?IiOLtG INSTALLATION n,SPECT.ION CHECK LIST 1. Is the mobilehome located wiiai required separation from lot lines and. buildings and generall.y conform to plot plan? Yes F: No^ "i 2, Doe:; the mobilehome have required clearances above ground? (Sec. 5085) Yes !/No 3. Are footin,s and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes/ No 4. Is the mobilehome level.? (Sec. 5088) Yes 1,"'No 5. If more than a single unit, are crossover connections properly installed? (Sec. 5088) Yes v TV0 5, Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes_ go B. Test - Does water piping withstand working pressure or 50 lbs, air test? Yes -1, -"No C. Backflow - If coachsj'noV State of California approved, does station have backflow device and pressure -relief coach's Yes No 7. Wastes and Drains A. Is connection made with. Schedule 40 DWV and have flex connectors at each end? Yes k ---No B. Does it have minimum per foot slope and is it properly supported? Yes Z�,No C. Are any leaks detected in drainage system after running 3- allons of water through each fixture including washing machine standpipe? Yes_ Nod/ D. If coachState of California approved, does station have required trap and vent? Yes Ne 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft, long? Note: All piping is to be'at least as large as the mobil gas line inlet without reductions other than the mobilehome' connector. Yes f� 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. C. Are all appliance vents properly installed? Yes il-�No 9. Electrical A. Is service Large eno iglu. to provide adequate amperage to)`mobileliome. (must equal rating of mobi.lehorie faith a :::in.ia:um of 100 amp) anal other faciliti.e:; on lot, i.e., water pumps, llaraoe, cabana, etc.? Yes 0_ B Is them proper clearances around panels? Yes A--, No C. Is power supply cord or feeder assembly properly fused? Yest N0 D. Is continuity testt satisfactory as per the following procedure? Yeses/No_ 1. De -energize electrical wiring, system of the mobilehome at the pedestal. 2. Make sure that T.lie 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. 11 4. Connect one lead of a test instrument to the mobilehome grounding conductor and , _ , apply' the oLlhe % 1c:au u each Tl1Ul)1.LCLlU17lt siupp,iy Cun,uuCtor, ilicluding neuLral. 5. All lion -current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), inr_lnding fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completicn of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity te:_;i_ shall then be made between the grounding electrode and the chassis of the rlobilehome.. Upon sat-i_sfactory completion of the ol.ectrical tests, the lot or site service equipment- may be approved for energizing. I:> job card signed by L'ealth Department for water and sanitation? 1.1. If evc_rything okay, sign off card and t.u;;; services. MOBILEi]ORE DATA Manufacturer and/or Namest:yle 144,V Length l��idth Vehicle Serial No A- •2 91 66 State Identif. icat ..on N -o. ..d(:itional Informa[Jon or Comur.ents: An r COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Oroville, California 95965 r7l r/ Telephone: 534-4541 / APPLICATION AND PERMIT All X X �� r� r/�''✓� L U��c.�s�;�-c�i( Date Z Signature offPerrlmitee or Agent Receipt No. - Z White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant ine tsutte county coae anaior resolutions to do work indicated above for which fees have been paid. DIRECTOR F UBLIC WORKS By Date ?� 7� ilding permit expires Date �/ BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor��� ` �� Total Valuation �// Mailing Address i1/ls Ci £ Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 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 Fpwsl WXe SeRi4aiiefa 1 Fire Dept. Fire Zone 1 Use Permit Building sewer 5.00 EQA Parkin PlansBldg. Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 PI nA s Recd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE PERMIT FILING FEE J$3.00 Main service 8000 AMP OV OR RSLESS 5.00 Main service EA. AOD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service R 600V 1100EAMP OR LESS 25.00 Main service/ EA. ADD'L too AMP 1,00 NEW CONST.OR ADONS. ( ACCLBLDGS.CCUP. &� 20sgft NEW CONSTR ULTI.OUTLET NON•RESID. ( BMRANCH CIRCUITS) 2.50ea NEWCONSTR. /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 style of:Occu Ex. Occup(OUTLETS OR FIXTURES) 1AL@@1 04 FIXED APP LNS. OR Ex. p.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 5/ 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 Workmen's Compensation. ©tel 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 authorize representatives of the County of Butte to enter upon the Ahnva-mantinncri nrnrt.. f- ;� ..t;.... .. / Io , DC TOTAL PERMIT FEE $ OC This permit is hereby issued under the applicable provisions of X X �� r� r/�''✓� L U��c.�s�;�-c�i( Date Z Signature offPerrlmitee or Agent Receipt No. - Z White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant ine tsutte county coae anaior resolutions to do work indicated above for which fees have been paid. DIRECTOR F UBLIC WORKS By Date ?� 7� ilding permit expires Date �/ 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: OA�n���ii/i ��Dv ALF f/o.s7� CcyTG� 3. Is the site currently under permit?. Yes / /7/ No (If yes, furnish permit number /�� /'G /-� L ) 0' Is the site an existing site? -Yes / / No ,. (Ifyes, 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 No / (If no, clarify' ) 5. What is the mobilehome electrical rating? -=--------------------- /00 .-Amps 6. What is the mobilehome site service rating? --------------------- Amps 7. What is the mobilehome site -circuit breaker rating? / CJ Amps 8. Is there any other electric load to be served by the mobilehome ------------------------------------------------ site service? --- Yes / / No (If yes, identify the load and•,size: (Load)', (Amps) 9. What is'the mobilehome site gas pipe size? ---------------------- 10. What is the type of gas service? ----=------------------------ Natural / / LPG 11. What is the gas pipe length,from•meter or tank to the mobilehome? (ft.) 12.. What is.the mobilehome gas demand? ----=------------------------- i (BTU) (This -information not required if pipe length less than 6 ft. on natural gas or less than.50,ft, on...LPG.) MOBILEHOME SUPPORT DATA -// f , A . - Mobilehome Mfr. Setup Model No. /S Year Width 2 4/ (ft.) Length </D (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 .file with.the County of Butte). (in.) (in.) *If center piers -are other than drawn above, draw in locations, spacing, and dimensions. x ��� Typical Support Footing Size in. in.) Max. Pier Spacing �f"t.) (i.n. ) BUTTE COUNTY BUILDING DEPARTMENT APrKOVED - Sin le. - Footings -(check. -one) 1. Wood. either 77K1. .(in.)(in.) /� lCe "'up pressure treated or Center A d fdn. grade. Supp Footing Sizes inn. . .) in.) Loc tions (in.) 2. Concrete pad. x3�' _ / / 3. Other,: specify in, in.jtlin. Supports (check one) /� '.Concrete block � 2. Concrete piers l r t Un. (in.)(in.) 3. Steel piers 4. Other, specify (in.) (in.) *If center piers -are other than drawn above, draw in locations, spacing, and dimensions. x ��� Typical Support Footing Size in. in.) Max. Pier Spacing �f"t.) (i.n. ) BUTTE COUNTY BUILDING DEPARTMENT APrKOVED Y ((:Ln. .(in.)(in.) �tj inn. . .) in.) - (in.) (in.) *If center piers -are other than drawn above, draw in locations, spacing, and dimensions. x ��� Typical Support Footing Size in. in.) Max. Pier Spacing �f"t.) (i.n. ) BUTTE COUNTY BUILDING DEPARTMENT APrKOVED COUNTY OF BUTTE — DEi AR HENT OF PUBLIC WORKS 7 County Center Diive OroviIIe, California 95965 / 1-76 Telephone: 534-4541C�/, APPLICATION AND PERMIT /jlJ 1 auinonze representatives of the county of butte to enter upon the above-mentioned property for inspection purposes. r- X Date4 Sig ature of Perrnitee or Agent Receipt No. 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 paid. DIRECTOR 0 UBLIC WORKS By Date�Z-- uilding permit expires Date '77 BUILDING Owner a S -r-4 SQ. FT. OCC. BUILDING VALUATION Mailing Address 0,R 0 x3 , A4 to g Telephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address C>2/0 C"—,q ud view PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 ,00 tit 09 Each Trap 1.50 09 Repair drainage or vent piping 1.50 Water piping 400 le). 00 W ✓a X 5u b �, 0 7— »$ninq Verificafion On Each gas water heater or vent 1.50 A. P. No. .S — r- 1e 7�;•/� anning Gas piping system 1 - 5 outlets � Q , O d Each additional outlet .30 F s Sa i on Fire Dept. FireZ se Permit Building sewer a O EQA Parking Parcel Plans Declaration sl p 60' R/W Improvements Lawn sprinkler system 2.00 Bldg. Plans Rec'd �arcel Approval Plans Approval Permit Fee $ 33. Qa $ ©C, NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 p Main service 600V OR LESS 5.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Single FamilyQ❑ ❑ Mobil Home ®. Others ❑ Main service OVER 00 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 \ q,dDuplex go S FT., MINi�1'JM . OR ADDNSCONST.NEW ( ACCLBLDGS.LING CCUP. &) 22sgft CONSTR. NEW CONST(MULTI-OUTLET ITS) NON -R ESI D. BRANCH CIRCU JrEt NEW CONSTPOWER APPARATUS &) NON.RESI R D. (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 style of: Ex. Occup(OUTLETS OR FIXTURES)@ BAL C' 1 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 igI am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I 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. �/j 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 bui l4ing construction, and hereby 4A u a iJede 4.0 P A4 e ,✓'T F.& o TOTAL PERMIT FEE $ 9,3 sz auinonze representatives of the county of butte to enter upon the above-mentioned property for inspection purposes. r- X Date4 Sig ature of Perrnitee or Agent Receipt No. 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 paid. DIRECTOR 0 UBLIC WORKS By Date�Z-- uilding permit expires Date '77 a COUNTY OF BUTTE Department of Public Works 7 County Center Drive Oroville ----- 534-4541 ELECpTR�ICAL INFORMATION FOR DE -RATING MOBILEHOMES Owner Location Mobilehome Installation Permit No. 1. FILL IN INFORMATION FOR ITEMS 1 THRU 10 . Width 2- -//� x Box Length 36" Watts x3= 1)59 2- 2. 2 Kitchen Appliance Circuits ................. = 3,000 3. 1 Laundry Circuit ........ _ .1,500 4. Ovens ...... .. ..... = G a5 5. Cook Stove Top ..... 6. Hot Water Heater ...... = 6 A S 7. Dishwasher'& Disposal ......................... d 8 Clothes Dryer __& 35b , 79 r9¢ Y.W t r sit � .......... 9. Other (specify, i.e., motors, exhaust fans, etc.). Sub -total - Watts ..... First 10,000 watts @ 100% ..... = 10,000 Remaining c5 watts @ 40% ....................... _ x- 10. Air Conditioner watts .@l 07. _ /✓DN ) 1�0� 04UfO Largest Demand Central Heat System _ f4 Q_a watts @ 6 '/o.. _ 4-1,-5-4 jr"� pp TOTAL DEMAND WATTS REQUIRED ............. v>. "Demand Watts Required" 230 ..... ....... ............ _ � AMPS De -rate Mobilehome to ............. .... .. AMPS -aff 401WS p ceJt2PVS G � � ✓� (1 5 a 3117-8, ,E,M C -STA_ 6,, Glen-' 6608 Grandview;` Magalia pEF (new cabana/MH) PER. OWNER- CONTR. ASSESSOR PARCEL " LOCA"N 4 tiC „I • � ,tom', � . .J� `tilt+�✓��•� . (:' .. •1 ti � rs 'r Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) Signature R OK 0 = Not OK = Not App ' = Not Readyable MOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. -Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete• 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Beam s-Rftrs.-Con nec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-drnd.-/ / Amp -Concrete" 6. Gas; Location -Test -Wrap: / /" L" ft. / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance r 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh • l Card -B1 Date Card -B1 Date a 10. Roof; Shthg-Roofing Card -81 Date Card -B1 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -B1 Date Card -B1 Date ' 2. Footings; Size -Spacing -Marriage Line Card -B1 Date Card -B1 Date 3. Gas; MH Test -Demand -Valve -Connector It . f • .�; 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged ; 9. Exits; Insp.-Sketch _ _ 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy _ 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit Card -B1, Date Card -B1 Date Card -B1 Date Card -B1 Date 9. Health Department Approval - 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date i s = UK o = Not OX - =Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready Date- UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) oning-Setbacks;-Easements-Flood-Slope 45. Hangers -Post Caps -Anchors -Connectors Ftg., Main; Soils-Steel-Elec. Grnd.-//L/" Ftg. Depth -46-Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. F 9, Garage; Soils -Steel-/ P' Ftg. Depth 4,7.-124replace Ties or Type A Flue -Fireplace Throat Clearance Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth ¢8,-40ic-AFcess; Size & Romex Protection -Draft Stop -Ins. Baffles 1�-Stemwalls, Main; Steel- Bloc kouts-Wrapped 49-.8d=. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel- Blockouts-Wrapped 59:-Gafage Fire Protection Framing 7. Slab; Steel -Wrapped .51 -Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 5,4,,Ptywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test iding-Nailing Veneer 12. Electric; Underground 5 Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance- Material -Sup prt-Ins. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 58. Shear Walls; Nailing -Bolts 15. Insulation 59. Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card-BlAf, U, Date ( d -B1 Date Card -B1 Date Card -131 Date Date PLUMBING (Permit) OK except #'s 1 Water Ht. Vent-Access-Combusson Air -Baffle 17. r Pipe; Test & An s -Nail Protection 18. D.W.V.; t -F s & Anchors -Nail Protection 19. Shower irst Floor -Tub Access 20. Te_ub & Shower, 2n Floor -Tub Access 21 as Pipe; Size & Anchors Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23 lec. Receptacle pacing Lights & Switches at Doors Size Boxes & No. of Conductors -Stapled . Romex Installed Close to Edge of Studs & C.J. 6. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water. 2Z_2Apptkance Circuts in Kitchen & Conductor Size/G.F.I. 28.-SubleU& Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 29 -Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30_.Sa vice -Riser Conductors & Ground -Main Disconnect 31:-Egffip. Clearances Panels-Motors-Mech. Equip. 32 [os Closet Light -Shower Light -Spa Light 3. Smoke Detector Card -131 r,G Date�a-)Co-x$11 Card -B1 Date Card -B1 Date Card -B1 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35"Vsqt Fan; Exhaust abo u ation 36. Conden D & Overflow; Size & Grade 37. Furnac ent;- omb. Air -Return Air Vent -115 outlet 38. Access & Platform if Furnace in Attic Card -131 Date Card -B1 Date Card -B1 Date Card -81 Date Date FRAMING (Plans) OK except #'s 3@-SiJts, Proper Material & Anchors 40"Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) 4 Fire Stops; Furred Ceilings -Stairs -Chases -Tub 4¢!Header & Beam -Size & Bearing Card-B1i COUNTY OF BUTTE DEPARTMENT OF,PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 f. 7 County Center Drive, Oroville-- Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER ii PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work Is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector Da COUNTY OF BUTTE r .... DEPARTMENT OF PUBLIC WORKS • 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or additional explanation, please contact this office immediately. �- 1>> Pi I Wla r n it (L2 2' tj()sr. �Qo�1t'�>Nf -46Q,k:ICAf\,A 6r ' InNt,(t/1 1=LoofZ M q aG u (A, _ O! V'40. .I O -to _k 9 Inspector �. �.�o- ,� Date_ N(;.._Y--• C I,. it 'b.'. J L I� (; A 1' JieU IJ L(t,;A'L'i) f. A. P. flu. � f11.:;i(;R1L''17.UN (tl.'"i ZUSIIlJ1'T�.UN t•fntertal_>C�� buui;is it wnii.iBC) I XTI ll1OR WALL tlaterial._ Fi.}xe.rgAtzts s s firnnd_Nnme_CertainTeed' 1'I►ickttess(inchee)� (l U, 'lherntal Re©lotnnce(tt Value) / 9 cI 11..tNl', Dntt or 13intticet Type Fiberwass Ltrntid Nnme CertaitiTeed Thiclo.tess(ittches) ".Thermim1 ltesietntti (lt V t ,---- A• . ce a u e ) Loose F.t.il TypeuP'ibcrgJ.ass 1lrntul `Name Certain'1'eed tltttinni►n l'Iticknes@(Tttches)-Tfuutl)eC'"of Iktf;d Wt. per bng 25 The Aren covered—(ft. ;'111crmnl •Renietattce(tt Value)_ Fl -POR, I;t,I;VA'VED �. Mnt.cran (_ l .i.bc,rqp:L`tss Afraid Nnme CerL.a:ii0.'eed h tclr,::;-.9 (ittche s )� GCS /5��• .;c , _ — _------- -- { thermal ttenintance(R Vnlue) rLOOR, Hateri.a l .A '1111 elmeng flrnnd Flaute .t. •-•_-- ' '1'henuctl Reslntnncct(It Val.ur) � '•'•f' FUUWI)A'f-1i1N WALL firrtrtd Nrintr. ' 1'hetmni R^sintrtttr.e(ti Vnl.tte) .1 t;t,�-�1,,,, :'. i.:ai i.itc ttiic►vt j Y 1.n.nt I7 t i.�)tt waft' i.ns L'rt i 1ec1 1. n` Litt, above bn 1.ltl ing y r in cottformartce with I:lte Stole (if Cnl.i,Eorr-in iuergy IierjuiCemectL96 Ilawle i tt., 1.1t�tt 1 aL.i.ort �° 379407,.„„ t = of A k y FIRM MAtir/mvil.-It t SlA'CI:.coil 'jpC'1OIt19 T 11,,.IIU, RMI At'i't—iCATOR bAITH 1 ltr..r.eby cet(:ify Lite nbwe i.nnulit tjot, atuL'nil reryttl.recl itetnn an nithwn on,the E. lluilclittR �)ra,�trCntnttt: nl1Pr�vCsl ptm)l att..i nUnclnnettte lin uivll,"beell ittntalled n9`:,. reF re -t Ir I y the State of 6111f.urttin I:uertty'.Recluirentettte.`3 j :r- All ertttia,mettL, clev.lcr.g rtncl »trtteri-ais n' 'quality prenc:ribed or art! ,gay alrltrvvcll I)y tite Stnl:e of CstIIfornin. t V] M-1 NAI -In, OWNER '-`-------- __._ r a S 1A,CL CUN1'ItAC'1'Uli IS LiCI:N3f' t1U; a U! (t l:. t'!1'.ItAL !'Ills cEWl 1. IF 1.CA'l'E f1I1S'.I' Ilf: UIJ FILE 141'.l'll '1.111,5 13U11aTNG I)I"spl'AR'1MI:fVi''1'li1(iIt 7o C1tUlL t 11131 IiCT-1.0IJ APPROVAL AND A Cory SUAL L' BE. cuSTED' WiTn1N 'ruL'')1UILUING . '~ J:utuary 191I4;. COUNTY OF BUTTE - DIPAR`�TMENT OF PUBLIC WORKS \ 7 County Center Drive - Oroville, Cglifornia-95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ERMITNO.� �l ASSE =E CUMBER ^ p(+//` ZONING BUILDING PERMIT01 OWNER ub e5 MAI TY�H E SO. FT. OCC. BUILDING VAL AT.I N �T O LI G ADDRESS Y CONTR TOR'NAME ^ 1 TELEPHONE CON AC OR'S MAILING C.AAC,ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Q LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ �_ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ -, S3 Energy Plan Checking Fee $ S7 o ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee -73--1$ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water he 20.00 LOT NO. SUBDIVISION NAME c PARCEL MAP Waterpiping5.00 Each qas water h90er or vent 5,00 USE OF STRUCTURE S0� R Duplex Mobilehome❑ Other SPECIFY Gas piping sy em 1 - 5 outlets 5.00 Building er 5.00 Mobil ome S I G I W 10-00ea. TYPE OF WORK New ❑ AdditionRemodel ❑ Utilities ❑ Installation❑ Other, Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service SS 100 AMP O 1 OR R LESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the BuslnesS and Professions Code and my license is in full force and effect. License No. Classification �7 ITXj I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L 100 AMP 2.50 NEW CONST. / DWE I UP.&\ OR ADDNS. ACC 1 . / 2yZQsq ft 0� NEW CONSTR U LOUT LET NO N.RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS e\ SINGLE OUTLET CIR. / Ex. OCcup(OUTLETS OR FIXTURES 20080¢ ISAL030 FIXED APPLNS• OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. j I shall not employ any person in any manner so as to become subject Y� to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating to O Cooling g Hood 3,00 Ventilation. permit Fee $ 16 i4� Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabiliti s, judgments, costs, and expenses which may in any way accrue agains I Count in co uen of the granting of this per it. X Date Signature of Applicant — Owner Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3rystories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOT$ AL AL FEE HA2 ,� CUA PARK FL PAR H Issu This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which fees IRE TO F PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Qi Date V ' �� Receipt No �S WNIT!-D.P.W., YELLOW -ASSESSOR, PINK•IN9PECTOR, GOLDENROD -APPLICANT PRIVATE INDUSTRY COU CN I �C7 S`U Lo a _ P ProS��c��� r C 0 Ql 0((led L n-q=r.1�'�r.'""�?'6'?=qL`^'""'•.4"'F'f^r+:, i�t*N�'`l+R�(` ; .i-`J►SIa; ,r� 4tS+,:, COUNTY OF BUTTE - DEPARTME`Nf4 PUBLIC WORKS - BUILDING DIVISION lieilk OWNER Proposed Building Use y.. 7 COUNTY CENTER DRIVE - OROVILLE,1CAL'Ii?0ANIA 95965 - TELEPHONE: 916/538-7541 a PERMIT APPLICATION DATA SHEET w ; �A u Permit N.o A. P. Nob;7— ./, Building Inspector Date -At time of permit application, I was advised the.following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items' have been submitted. ........ ............................ . 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans :. 4. Complete engineered plans and calcs, with wet signature on plans . . 5. Hazardous Material Form ........................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation - instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ................................:...... :12. Park fees paid .................................................... 01 13. chool D trict fees paid ............. . 14. Sanitation approval from ` Health Department 15. City of Chico plumbing permit ..................................... 1& Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use:. (B). Parking: ...... 18. Improvements may be required` Contact Land Development Section DPW 19. Driveway permit (construction approval required .prior to occupancy) 20. Pre -Inspection for - required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans. Compensation Insurance .................. 23. Owner -Builder Verification (Given to ownerMail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledg ent Statement ......... 25. Letter of .signature authorization ................................... 26. 27. When you issue the permit', process as follows: Mail to owner. Mail to contractor. J. Telephone Oyoz end hold for pickup at office. Deliver w/inspector. Other Applicant Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: \L v7 I Contractor, designer, owner, was advised of above required data by—phone---mai [—counter by ..date Contractor, designer, owner, was advised of above required data by—phone—mall Plans checked by Copy—DPW Date Plans approved by Sets of plans on hold in— File cabinet AP folder\ nter by date/,_ —Date" TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location App Plan Approved for: Sewage Disposal Water Supply Hold final for: Water Supply Final.clearance O.R. for: Water Supply Clearance for bedroom mobile home. Other NOTE I* `Q IYA w. o a v S i aria Date COUNTY OF BUTTE - De artment of Public Works 7 County Center Diive,'Oroville, CA 95965 !!Phone: 916-538-7541 .• 1 OWNER -BUILDER VERIFICATION Attention Property Owner: I An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor ano materials for construction of the proposed property improvement (yes or no) '2 2. I (have/have not) R V'e signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to.prov.ide the proposed construction: Name Address City Phone Contractors License No. �lan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name ` Address City Phone Contractors License No. 5 I will provide some of the work but I have contracted (hired) the following. - persons to provide the work indicated: Name Address . Phone Type of Work Signed: ' Property Owner Social Security Number Date t t i NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831' and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. G Signed: ' Property Owner Social Security Number Date t t i NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831' and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. I t47u t-r.TE F1<'f/ l Fes. Avo �- .'MMLOt 4C b(�i+fl AUG I Z l . _..�____--=�=``�-------__._--- 9,a�t:Y Jt��t'�{� 'g�.rY�ti fr ��.$''�",�� g�►;rw+�36 4x� @ i /;ti/'CfL aVA4S 0f1CY kmT-Ts lZD,4V ton W�. rip. G' r t --l:rr- 1`J. V\-. let 1 `rR 2� C7h1 � 'F bJ�S3 r LA-�` �le -1 . Ir. UV i — 20 5 Jvl�v J V c�. �i �FLE Cr/ ,511" - //;?,Y, Z D 40-11, turCiY�� �.._...__ vn�fNatianal GIQa 4- -? L4 _� _ g- 4 -� ^ 4 -7 do SL"T 1 `APIC + ` M1C7'�7�f�1J 0LC!e- 4AA 3 N setback of 5 tt. tra ' the Aetback I prcp:rw lines ani a i ij r. ri.� ;; t`? rota of 5(j�t. &"ar of► centmm,n-e shad ' enfi eXc P� j utr. 4)(87� sfiruct or equip^ l� t aV e Ove dor a � i �, kit 2 r Ogy . � .-yam jr• C � _.Ltr,r� - } I t