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065-190-009
65-19-9-- I * ` Jame Cooper ' 55 e1 -Rdi.; .Magalia cont • P adise'Plumbing, Paradise Permit 26 76P,E til. MH) ELEC. _.GAS� 'w,s rZi r r SUPPORT S UCT EQ . �_ COMPACTION ST• REQ . , . 55-19-9 ma contr: Johns.,Mo Mai}a- ville Permit#3198-76MHI - Is6ued �Qtd=_., 65-19-9 • Qorothy Cox 1' G 55 Holly Rd., Magalia 1 Permit #2870-79B(2 decks/MH) �_Dorothy' 65-19-9 Buckle 55 Holly Rd., Magalia contr: Acro -Lune, Oroville Permit #5159-80B(new cover over exis. deck/MH) ' WhITAVI'd 65-19-09 ALL MOON =6453 -Ho ood -Rd, Magalia- - Contr: Pete Fox Bldr Permit#1449-86 E(new garage/workshop 65- -09)' Contr peter Fox- Bldr- Permit��1978-86B(wo tove/ir oP 65-19-09 Con ; . Peter 'Fox it#2134-86P(gAs piping/garage) 065-190-009 05-2049 MOON, ALLEN 6453 HOLLYWOOD RD, MA p,Tf D Cont: GREENE &- SON ROO REROOF 15 SQ:; rz s f N RESIDENTIAL PERMIT NO., 065-190-009 MOON, ALLEN 6453 HOLLYWOOD RD, MAGALIA Cont: GREENE & SON ROOFING - REROOF 15 SQ - t SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY s USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) %) p Signature �' v BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO52049 LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penally of perjury that Iam licensed. under Issued Date: 08/02/2005 APN: 065-190-009-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code', and mylicense Is in full force and effect•�'1,n' License Class : C -t License Number. _C lyS rf Site Address: 6453 HOLLYWOOD RD MAG Map Index: Date: -0 Contractor: Q Description: REROOF 15 SQ GARAGE ONLY OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Owner: MOON ALLEN J & SIBYL V CP Business and Professions Code: Any'city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior PO BOX 1455 to its issuance, also requires the applicant for such permit to file a MAGALIA, CA signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 95954 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 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 Applicant: MOON ALLEN J & SIBYL V CP intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not ,Intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 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 Contractor: GREENE & SON ROOFING and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed PO BOX 2467 pursuant to the Contractors' State License Law.). PARADISE, CA 95967-2467 ❑ I am Exempt under Article 3 of the Business and Professions Code 530-873-3940 Date: Owner: License #: 275057 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Architect: Labor Code, for the performance of the work for which this permit Engineer: is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: -nmre Total Square Ft: 0 S. F. Valuation: $0.00 Policy #: 3 g Census Code: ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to C become subject to the workers' compensation laws of California, J [ l and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall / l l forthwith comply -with those provisions. U I Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby'issued under the applicable Provisions of the Butte County Code and/or hereby affirm that there Is a construction lending agency for the, (o do.work inMtedbov for hich fees have been paiI R�-SAOut,_ performance of the work for which this permit is issued (Sec 3097 Civ.) �- LJ Date: Name: B PERMIT EXPIRES ON: Address: Dat ❑ 1 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 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I:hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. �� ef//P Signature: Print Name: / �' , Date: ❑ Owner l -contractor 0 Agent for Owner 0 Agent for Contractor J=OK 0 = Not OK - = Not ApplReady . =Not Ready oY® MOBILE ®BILE H ® E S Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / - P' L "ft1 P LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except fi's 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test-Regulator-ConnectoP 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify Ws with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except ff's 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Cana B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except ff's 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Bec.; Receptacles and Lighting, Distance -GR 5. Elec.; Pool Ughting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = NotAppricable = Not Ready RESIDENTIAL, (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /' Fig. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 s Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) .OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes O No Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdnn. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-UnderfIr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bogs 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive O Yes O NQMalks O Yes O No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44, Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdnn. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-UnderfIr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bogs 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive O Yes O NQMalks O Yes O No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: -(530.) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) k,OFFICE #: (530) 538-7541 PERMIT NO. BPO52049 LICENSED CONTRACTORS DECLARATION I hereby affirm' under penalty of, peddry -that* I- am licensed,. under Issued Date: 08/02/2005 APN: 065-190-009-000 provisions of Chapter 9 (commenting with Section 7000) of D ivision.3 of "full the Business and Professions Code: and niy)ic6ni'e-is' in forc.e and, . effect.Site License Class: S7 Address: 6453 HOLLYWOOD RD MAG Map Index: Date: :Contractor:V. : Description: REROOF 15 SQ GARAGE ONLY OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State' Lidense Law for -the following, reason (Sec. 7031.5' Owner: MOON ALLEN J & SIBYL V CP Business and Professions Code: Any1citV or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior PO BOX 1455 to its issuance, also requires the applicant for such permit to file a MAGALIA, CA signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 95954 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Secti6n 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 0 1, as owner of the property, or my employees with wages as their, sole compensation, will do the work,, and the structure is not Applicant: MOON ALLEN J & SIBYL V CP intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License* Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or'through his or her own employees, provided that such improvements are,.not,,intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner-builder.'Wfl have* theburden of* proving that he or she did not build :or improve for the purposd of sale.). 0 1, as owner of the property, JM exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business Contractor: GREENE & SON ROOFING and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed PO BOX 2467 pursuant to the Contractors' State License Law.). PARADISE, CA 95967-2467 0 1 am Exempt under Article 3 of the Business and Professions Code 530-873-3940 Date: Owner: License #: 275057 — WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: El I have and will maintain a certificate of consent to self -insure for workers' compensation,. as provided for by Section 3700 of the Architect: Labor Code, for the performance of the work for which this permit Engineer: is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: n'." — - I' ; I . Carrier: A sm Total Square Ft: 0 S. F. Valuation: $0.00 Policy #:_ 1753 L9 I Census Code: 0 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: —7 - Applicant: _ WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the Resoluti dmsCto do.work in ich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) JJ Name: 13�. I JQ— I /Date: PERMIT EXPIRES ON: a, Address: Dat I I 0 1 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. El Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. 0 Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. r A/ Signature: Print Name: Date: 0 owner ji contractor 0 Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY` APP CANT SIGNATURE X For office use only: OWNER Last Name e,. E First Narti� Address 5 3 City r Sta Zip Phone _ Fax E-mail 073! APP CANT SIGNATURE X For office use only: ARCHITECT/ENGINEER CONTRACTOR Name (�_ ,J� dq Address r City a . i91,7 Phone St Fax Phon 073! State License Number Fax ,�_ E-mail Lic. # , CI ,! -3,9 APP CANT SIGNATURE X For office use only: ARCHITECT/ENGINEER Name �►U Address SRA City Zip State Zip Phone E-mail Fax E mail Planner State License Number APP CANT SIGNATURE X For office use only: APPLICANT NAME Name Address �►U City SRA State Zip Phone Type Const. Fax E-mail Page APP CANT SIGNATURE X For office use only: Zoning Property dre s5 �) � Flood Zone Cross St 4f SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # LOCATION %'� API �S V Property dre s5 �) � City � r J 1L Cross St 4f WORKER' SATION Policy Number 7 Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of WG�� aQ d Sq. Footage ? C7 ❑ 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 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 SRA Receipt #: Sheriff Date: Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05 P 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 inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May -require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 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\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 1449-868; P" PERMIT NO. PERMIT EXPIRES - 1 OWNER ALLEN MOON kzl CONTR. Peter Fox Bldr. ASSESSOR PARCEL 65-19-09 LOCATION 6453 Hollywood Rd, Magplia' , rlle� c4l 6v�� aj Alf icE copra. -A io G Temp, P 96A 7i "!� ELECT Ca,liA;j6j--, H/C ate.- Temp. Z�r 'D 5 ' 3 Called PG&E— Temp. Gas Service Called PG&E JOB FINALED (Date) /O /��D' ! COUNTY OF BUTTE 'j DEPARTMENT OF PUBLIC WORKS r 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 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 co ection of work is completed. If you have any question pertaining to this matter need additional explanation, please contact this office immediately.. v ��,v�/I.�G.cJt.t-���A �lif/acs/1�� 4 /�i/lt .v�7O�iltu.�•tis T, Inspector C' - Z�— 4 Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE ►j 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. ti Sf�l�L1� f Inspector lG% <%� d� �L Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 53413541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE OWNER , 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 correc�edadditional work is completed. If you have any question pertaining to this matter, or explanation, please contact this office immediately. 7 -2.5 -- Inspector [c'w�'v� "Cti� Date �� __ COUNTY OF BUTTE r DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 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 T v COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE AWN ;kl9lo/ V 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 correcti of work is completed. If you have any question pertaining to this matter,_ need additional explanation, please contact this office immediately. Z F OWN II l k. OJ Z'."ci Ve v Inspector_ _ Il1 _ DateI,���_�__ C 7 J 7- a d J = OK - Vo, - (Vo�1JK Kot Applicable i = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR K excep s Date F ING Continued oning requirements -S cks-Easements 4T perty Line Firewall & Openings E xt. Doors -One 3' -Check Garage -3rd story, 2 exits tg., Garage; /" Ftg. Depth ction d F�c�-o - -- -• c 'Ic ctPel i Pt 9 h 5 P wood on Roof Overhang -Attic Vents -Rafter Outriggers 5 Siding -Nailing -Veneer �✓em , Garage; el-Blo is ra reed-Fdn. Vents-Underflr. Access i o� W.V.: Fal gs way C -Sewer Tes S4g_ ^'az' ea ^�-ss Protection -Skylights -Plastic iling-Bolts t e, Teel - ,hr�eherse I ervi lAw"Electric; Underground ,t/ O L 47 S n r - 's. 1 s- les Card -BI Date 7W Card -BI Date Card -BI Date? %8 Card -BI Date Card -BI Date Card -BI Date Card -BI Date ,� Card -BI Date Date FINA tans) OK except #'s Card -BI Dat f2 -a ee Card -BI Date Date PLUMBING (Permit) OK except #'s Z�elExt. Steps-Dmr &g ci�Pr..�� - -- - --_ys _ (� Air-Connector- I - tion -/�er Pipe; & Apcher5-Nail c ion _7 1YTp. D W.V.; Test-Fttngs & Anchors -Nail Protection .Shower Pan; Test, First Floor-Ttft.,, eess d ath Fixtures &Tub-Aeeese- 1 s/ Elec. & Subpart*f Bre r Sizes _ ails ire lace or Stove; Clearances -Hearth lec. Outlets at Wood Panel; Int. & Ext. Card -BI �Y Date �� Card -BI Date _ n .- it ap- arance Card -BI bate Card -BI Date nter Date ELEC ICAL Permit OK except #'s - - ser [- r - - :j _ re &Transformer Clearance -Ins. Protection EI -Receptacles Spacing -Lights &Switches at Doors 2n._ - Si oxes & No. of Conductors -Stapled _ Installed Close to Edge of Studs & C.J. r. Htr.;.�s-Cly e-Gemb:-Arir-C&wieot5r-P`-T - I ection 7 I Elec. & Mech. Equip. Listed for Loc n 6• 7 Iec. RecgPteErs in Garage; omg�cetee 73 Qand R 'Ic r no..� r•..,.- post Caps _ - Equip. Ground ma w/Mech. Fasteners and fse ter - 25-2 opli nee "- - e ubfeed Wire Size /p=/ ga. 6rrer AI- e s --o n.417�j G6antT-Main nett At 1-' Door -Drainage & -Earth Clearance Yes LPI instld.: Drive es E) No; Walks s ❑ No; Planters ❑Yes Cd4le— ___ 2@r-ffq-uip. Clearances; Panels-Motors-Mech. Equip. 7 - h 7 et Card B -I Card B-1 ly 3 _ -Shower Light - -- .- Dat Card -BI Date �� I % � — . Date Card -BI Date 7e—Vents Above Roof; Fi -Clear 9•-AP9- state-ie9j3ngs. 7 ing xterior�l rim; G-c-�-Reeerytecle-Und use Date _ Card -BI Card-BI MECHANICAL (Pern•it) OK except #'s - _ pport -- t above Insulation - ---86, _Fi & Overflow; Size & Grade---- rade___3 _- en Access -Comb. Air -Return Air Vent_ -_175V_ outlet 3 35--1ttie-AQGesr_& Platform if Furnace in Attic /�� Dat is e7 �5Z_ Card -BI Date y� Date 0 Card -BI Date - ' ns -Meters Tagged; Gas -Electric ater & Sewer Con nected-C o Grade -HD Approval a -Other Certificates Card -BI Dat i Card -BI Date Card -B Date Card BI Date Card -BI Dat Card -BI Date Date FRA NG(Plans) OK except #'s Comments at Final: _ ,/7Draft 3 lls_Proper Material &Anchors _ _ 31- Studs -Nailing, Spacing & Bracing -Plates -Sound g Walls over Girders & Floor Nailing Stop in Walls (rat proof) - e_Stops: Furred Ceilings -Stairs -Chases -Tub 7i15:�Ks1/ _ 2 C.�bv _ � -174"=�r r7 4 Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors �Joist-Rftr. Ties-Purlin-Roof Brac. T thng.-Rfng. place Ties or Type A Flue -Fir ace Throat . AInc Access; Size ex ection- raft Slop -Ins. Baffles ows or Exiting Doors -Sill Hgt. & Dimensions _ollarage Fire Protection Framing_ - (NOTE: Anentrymust be made each time youvisit jobsite) ,/,= OK - O = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch _ 2. Footings; Size—Depth—Spacing—Connectors 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—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except k's 1. Zoning Requirements—Setbacks—Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except H's 1, Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 4. Electricity; MH Test—Crossovers—Breakers—Clearances 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4, Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/O to Grade—HD Approval 7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged B. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch ` 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT ASS?SOR PA L N RZONI G BUILDING PERMIT. OWN TE P ONE SO. FT. OCC. BUILDING VALUATION -OW 'S CONT A OR'S ITAMy,, TELEPHONE ' CO TR CTOR'S MAI NG ADORESS n ` e v e, ,1KAY Fireplace CONS UCTION LENDER 4N U KNOWN Total Valuation is Filing Fee $ 10,00 L L N ER'S AILING ADDRESS Permit Fee $119 ARC 1 ECT'OR ENGINEER LICENSE NO. Plan Checking -Fee $ , Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 91 PLUMBING PE MIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump ater heater 20.00 LOT NO. SUBDIVISION NAME AR EL 'P Water piping 5.00 f Each pas water heater or vent 5.00 USE OF STRU ZURE }� SF ❑ Duplex ❑ Mobilehome❑ Othe SPECIE Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main servica 24OO VOR o tk SE Main servic t L 0 A 0.00 0 �,5 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUSIneSS and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. I DWELLINc el OR ADDNS.' % ACC. BLD I �z2sgft Q NEW CONSTFL U TI -O E NON.RESID BRANCH CIRC ITS 2,50 ea /POWER APPARATUS e (SINGLE OUTLET CIR. / Ex. OCCUp\OUTLETS OR FIXTURES 20@50Q 9ALO30 FIXED APLINIS Ex. Occup. OUTLETS IPRESIO IKEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3,00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Cou in consequence of the granting of this permit. %� Datesi�^�� Signature of Ap is t — Owner$4 Contractor ❑ Agent ❑ An OSHA permit Is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in heigh . Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occuP.CONST.TYPEJ PAEL I FLOOD RC PoJ �/ ND ISS E This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC R OF PUBLIC BY PERPA' EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date r.. PL -1- Receipt No. ` WNITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT t, S { COUNTY OF BUTTE - DEPARTMENT' OF*PIDBLIC WORKS - BUILDING�DIV[SION � r 7 COUNTY CENTER DRIVE - OROVI'LLE,+CALIFORN_JA 95965 - TELEPHONE: 916/534 541 / PERMIT APPLICATION DATA SHEET �% Xt90 Permit No.LOWNER % J / Ie I ;A. P. No. _6 J _19 - Ile Proposed Building Use & ✓' Permit Fee Based Upon: Complete Contract Price DPW Valuation Other Expla' 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. . . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD ''Fees Paid'' Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of . . . . . . . . �rofsignature authorizatiA.. . . . . . Sanitation approval from ✓ d.l. Health Dept. . . X- 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . Pre-Inspec. request to (Date) . 17. Pre -Inspection for Required. Building Inspector 18. Recorded I Acknowledgment Statement . 19. Other DRMAV kfikto *r8onstruction approval requfrea prior to occupancy In you issue thee it, roe ss as follows: Mail owner. Mail to contractor. � Telephone and hold for pickup at C—)VO office. Deliver w/inspector. Other 6V^ Applicant ag, A�Date 5 —_-5O Copy of plans sent Health Dept., Fire Dept., _041,6/r Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date Plans approved by Date -7-- Vo Other: ,� Copy–DPW To: From: `eIivironment;-.il. flenit.h Subject: Sanitation Clearal-co Al, � A (,Amer Locat,Xbrf Plan Approved for: wi.1ter Fmn-t)ly Hold fiiial for: Final clearance O.''. Clearance for loearoowi mobile homC. v.;_IILcr supply COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. A SESSOR PARCEL NUMBER --f — ZON NG BUILDING PERMIT OWN16- A T PHOr•�,�� SQ. FT. OCC. BUILDING VALUATION OWN 'S MAI LI ADDRESS cc_ D �V ( / ` C N R CTO/R-'S N E Y TELEPHONE ' CON R CT R'S MA I ADDRESS )qdQ Fireplace CONSTRUCTION LENDER UNKNO Total Valuation Is s Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS G s3 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each gas water heater or ve _.00 r+� USE OF STRUCTURE SF L,B Duplex❑ MobilehomQ%e❑ Other ✓' C� SPE FY Gas Gas piping system 1 - 5 outVA 5.00 `` Building sewer 5 .00 Mobile Home S I G W 0.00 ea TYPE OF WORK New ❑ Addition❑ Remodelg Utilities ❑ Installation❑ Other 1 ( Describe work: ! 111 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW of perjury I declare under penalty p I y (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the BUSIneSS and Professions Code and my licerise is in full force and effect. License No. Classification El 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ontract- ors.(Sec. 7044) ors. ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& ( , OR ADDNS. C ACC. BLDGS. 2/20sgft NEW CONSTIRMULTI-OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup( 20050e p OUTLETS OR FIXTURES BAL@30 Ex. Occup. OUTLETS ((RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County consequence of the granting of this permit. 1� gC X Date �-Q n — owner❑ Contractor ❑ Agent❑ Signature of Appl6i..rr-Ystories An OSHA permituired for excavations over 5'0" deep and demolition or construct. ion of structures in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occuP. CONST*TYPEJ I FLOOD PARCEL P11 I NO I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR T F PU B PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. I ORKS m1 Date Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTVFNT OF PUBLIC WORKS 7 County Center Drive-Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PESIMIT ASSES R PARCEL NUMBER ZONING IN BUILDING PERMIT OWNER TELEPHONE— ,SO, FT. OCC. BUILDING VAL ATION OWNER' MAILIN�q ADDRESS le 6�qx CON ACT R'S NAM c G TELEPHONE CONTR CTOR'S MAI I G AJDDRESS Fireplace "All p00,OO CONSTRUCTION rENDER ANKNOWN Total Valuation 1$,Z 00 0 . Ci 0 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT R ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS _ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUC;..Ur�RE SF ❑ Duplex❑ Mobilehome❑ Other(O SPE cI y Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00 ea TYPE OF WORK New ❑ Addition Remodel ❑ Utiliti_e/s ❑ I ta11 tion Other K Describe work: l _06k Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 ' 00V OR Main service 600 AMP LESSORLESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BuslneSS and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& , ) hQsgft ACC, SLOGS. 2 New CONSTFL ULTII-OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea RUS e POWER APPAAT (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20090C DAL@3o FIXED Ex. Occup. OUTLETS P(RESID )LNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury. (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department 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 7� to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. %� Date -7 ` �� �y.� Signature of Appli ant OWner;] Contractor ❑ Agent ❑ An OSHA permit is quired for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ Z,7 ,5'0 occu P. CONST.TYPIJ FLOoo PARCEL I PD I ND I ISSUE This permit is hereby issued under sions of the But County Code and/or work indicated above for which IR TO OF PUBLIC B PERMIT E D e_ the applicable provi- resolutions to do fees have been paid. WORKS Z� ✓� Dat L Receipt No.�6�n Z 12Y WHITE-D.P.W.• YELLOW-ASSESSO . PINK -INSPECTOR. GOLDENROD -APPLICANT uta►il. ,MH `2638-=76P,E PERMIT NO. PERMI-5rER4§FS OWNER 06" Cooper CONTR.. Paradise RINUM Plumbing, Para. LOCATION (A.P. 65-19-9 55 Holly Rd., NIS Holly Rd., 700' E. of Skyway, Maga Iia XA •' .. Y Temp. Power Pole 01 Called PG& /ALED rv._`/�� 2c� E � 6+-1 f.S•ti-r v. _ E —,�)"rfature) Y 9. Electrical A. Is service large enough to provide adequate amperage to-•mobi-lehome (must equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? .Yes" -V No B. Is there proper clearances around panels? Yes)C— No C. Is power supply cord or. feeder assembly properly- fused? Yes No D. Is continuity test satisfactory as per the following procedure? Yes No 1. De -energize electrical wiring system of the mobilehome at the pe estal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. > 4.. Connect one lead of a test. instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current., carrying metal parts of the mobilehome (aluminum siding, gas line, water line),• including fixtures and appliances', shall be tested for continuity from. such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder.assembly conductors. shall be connected to the site service equipment. A'further continuity test `shall then be made between the, grounding electrode and the chassis of; the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site 'service equipment may be approved for energizing. 10. Is job card'signed by Health Department for water and sanitation? P1 11. If everything okay, sign off card and tag services. MOB ILEHOME DATA C , 'Manufacturer and/or Names(tyle /,19V1 Length Width Vehicle Serial No. State Identification No. S Additonal.Informati.on or Comments: 11 MOBIL EHOME INSTALLATION INSPECTION CHECK LIST 1: Is the mobilehome locattd't i h required separation from lot lines and buildings and generally conform to plot plan? Yes No 2. Does the mobilehome have required clearances above ground? (Sec. 5085) Yes-XNo Are footings 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 No .5. Ifo than a single unit, are crossover connections properly installed? (Sec. 5088) YesNo 6.(er l A. Is fl xible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes X No B: Test - Does water piping withstand working pressure or.50 lbs. air test? Yes�No C. Backflow- IZah isnot State of California approved, does station have backflow device and pressure -f valve? Yes No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No B. Does it have minimum k" per foot slope and is it ;properly supported? Ye s4 No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture in washing machine standpipe? Yes No* D. Ifoa is not State of .California approved, does station have required trap and vent? Yes o 8. La Piping and Gas Vents 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 mo,i}ehome gas line inlet without reductions other than the mobilehome connector. Yes��P� No \ B. Test OK as per following procedure? YesX, 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 No COUNTY ;OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING Setback — a Forms Main Bldg. Footings Stemwal l Slab Piers BUILDING (Cront'd) Firewall Restroom Finish Windows Siding Roof Sheathing Roofing Fdn. Vents Garage Vents Soil Piping 1st Floor 2nd Floor 3rd Floor Topout Water PI ina< Sewer 6 Fixtures Water Htr. • e: PLUMBING G Stemwal I Insulation Heaters Mesh Slab Carport Footings Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping& Temp. Gas Test Slab Final Sanitation Temp. Pole Patio FIREPLACE Final — S Footings Footing Door Closer ELECTRICAL Masonry Walls Throat Rou h s� Reinf. Steel Final Fixtures FI Stucco Final Subpanels Mesh MECHAI ICAL Grd. Fault Prot. Scratch Heating Service Brown • Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final 15? Z� — DATE REMARKS OR CORRECTIONS Cute �� J � 6� e " 9 — `76 /� ® �-�-/Oct -+� _ �S` r k • (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, 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: f Owner - Owner's Address Mobilehome Mfg. 1.-<- _... r Model "" Year Insignia No. � '`.' �` �'�r : � _ w, -. •.�. Serial No. � -;•: ,l: -• . -h k 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 Y --� COUNTY OF BUTTE — Dt.PAR-rMENT OF PUBLIC WORKS 7 County Center Dkive —� OroviIIe, California 95965 Telephone: 534`4541 A1 � APPLICATION AND PERMIT 9 Mildinqper=texpires Dateu—� eceipt No. White-D.P.W. — Yellow -Assessor — Pi k -Inspector — Goldenrod -Applicant Date t6' �7 BUILDIN Owner i SQ. FT. OCC. BUILDING. VALUATION Mailin ddress Telephone No. Fireplace 09 Contractor Total Valuation Mai I i ng Algress jr �� Permit Fee Plan Checking Fee &/or Penalty T lh e e — late -toe ZZ 0,4 —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 ' t—_ / A. P. No. l� — Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F nitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA P�lannssDDeclaratlon Parcel Map 60' R/W i Improvements Lawn sprinkler system 2.00 Bldg. Plal4e�fTec'd Parcel Ap royal Pla proal Permit Fee NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER [ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 // —7/ zozz P"-�CF 6P- /b Main service 100 AMP ORSLESS 5.00 Main service EA. ADD'L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD'L too AMP 1.00 NEW CONST.DWELLING OCCUP. & OR ADDNS. ( ACC. BLDGS. ) 20sgft NEW CONSTR. MULTI -OUTLET NON-RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS & NON -RES,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: y . r yT Fs!.✓S /Yl dAi ��SS ��PPL iY/rA yc!/f ,4 Ex. Occup(OUTLETS OR FIXTURES) BA@@t FIXED APP LNS. OR Ex. Occup. (FIXED (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. °n� �/ / _5�C) Classification a "�% Misc. Wiring 6.25 ❑ I am exempt from the Contractors License taws 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. ❑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 above-mentioned property for inspection purposes. Date4 ign ture of rmitee or A ent TOTAL PERMIT FEE $ 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 PUBLIC WORKS 9 Mildinqper=texpires Dateu—� eceipt No. White-D.P.W. — Yellow -Assessor — Pi k -Inspector — Goldenrod -Applicant Date t6' �7 ra COUNTY OF BUTTE —� DEPARTMENT OF PUBLIC WORKS 7 County Center Dfi*ve —1' OroviIle, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT IGi auL11011 Ge IepfebefltdtlVeb Of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Permitee or AdWnt i i Receipt No. /+G a' V 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 p 'd.. DIRECTOR OF U LIC WORKS BY Date_6 -7—%�,_ i ding permit expires Date _ — 3 — 77 BUILDIN Ownerc�� E� 1W IfMai SO. FT. OCC. BUILDING VALUATION I i ng Address ele o hone No Contractor RA RA V&I FLo AA B l A4 Fireplace Total Valuation Mailing AddressS T �� Permit Fee Plan Checking Fee &/or Penalty c RA P -A Q I ♦� QSJ� T le h ne o. Permit Fee $ Building Address ®L� PLUMBING—No. @ FEE PERMIT FILING FEE $3.00 pp "6 cc- 00" F Each Trap 1.50 SRepair drainage or vent piping 1.50 Water piping •q-gfl (� r00 /� 1 k (4Au Pt Each gas water heater or vent 1.50 A. P. No. j t onin Gas piping system 1 - 5 outlets .-4 A( Q,�Q Each additional outlet .30 F Sa t on FireDept. FireZone Use Permit Building sewer o 0(-) EQA Parking Plans arcel parcel Ma Declaration P 60' R/W Im prove s "Lawn sprinkler system 2.00 3 Ions Recd k0 ��OO' arcel Approval Plan Approval Permit Fee /yam $ eco ©fv NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 :3,00 Main service 100 AMP ORV OR LESS5.00' Main service EA. ADD'L 100 AMP 2,50 Single Family ❑ Duplex ❑ Mobil Home �. Others ❑ Main service OVER 600V S00 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1,00 (90 f ' �� l..AW NEW CONST. DWELLING OCCUP. & OR ADDNS. ACC, BLDGS. ) 2¢syft _ NEW CONSTR. MULTI.OUTLET NON•RESID. (BRANCH CIRCUITS) '2.50ea NEW CONSTR. (POWER APPARATUS & NON•RESI 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: L Ex. Occup(OUTLETS OR FIXTURES)@251 104 FIXED APPLNS. OR Ex. Occup. (OUTLETS (RESID,) EA) 200 Temporary service 10.00 Mobile Home Facilities 15.00 J �� C -3-t License No.Classification / Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ -0 $ Z �� 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. EI/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. 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 MECHANICAL No.1 @ I FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ L TOTAL PERMIT FEE ff auL11011 Ge IepfebefltdtlVeb Of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Permitee or AdWnt i i Receipt No. /+G a' V 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 p 'd.. DIRECTOR OF U LIC WORKS BY Date_6 -7—%�,_ i ding permit expires Date _ — 3 — 77 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: o Oa„/ -s Ada 6�� 46- 40 4 SlZe c r 3. Is the site currently under permit? Yes T_7 No (If yes, furnish permit number ) 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 clean of all, setbacks and easements? Yes: /�/' No :;a (If no, clarify r 5.` What•is the mobilehome electrical rating? ------=--------==----- /p r2 Amps 6. What is the mobilehome site, service rating?; -------- -------------- �� Amps s 7. What is the mobilehome-site rcircuit'.breaker rating? •------------- Amps,- 8. Is there any other electric load to be serried by the mobilehome site service? ----------------------------------=--------------- Yes /. / No (If yes, identify the load and size: (Load) (A� s) i 9. What is the mobilehome site gas pipe size? ------------------ .�/,� (in.) 10. What is the type of gas service? ------------------=---------- Natural / / jLPG A-7 7& .11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) - 12. What is the mobilehome gas demand? -------------- -------- 11 ------- / L (, v v v (BTU) (This information not required if pipe length -less than 6 ft. on`natural gas or less 'tHan('50) ftp To*K1'L'PG.)TP` 1711 - -1 A1 MOBILEHOME SUPPORT DATA Mobilehome Mfr. _� py i✓G��. Setup Model No. Year 7 Width (ft.) Length (ft.) : Expando- Size ft.x ft. (Draw support details below) On 11 mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on .file with the County of Butte). Sin le -� Footings-(check.one) *If center piers are other than drawn above,, draw in locations, spacing, and dimensions. /v/ i. Wood either pressure treated or fdn. grade. 2. Concrete pad. 3. Other,: specify Supports (check one) T -r -l-. Concrete block 2. Concrete piers / / 3. Steel piers -7-1 4. Other, specify Typical Support Footing 'Size Max. Pier Spacing Max. Overhang BUTTE COUNTY BUILDING DEPAPT! 17NT APPROVED 1/�/Iv Center Support Footing Sizes (in.) X iri.) din. (in:) (in.) -x3 in. in,, (in.) (in.) 4 (in.) (in.) ! - -- -.. in., *If center piers are other than drawn above,, draw in locations, spacing, and dimensions. /v/ i. Wood either pressure treated or fdn. grade. 2. Concrete pad. 3. Other,: specify Supports (check one) T -r -l-. Concrete block 2. Concrete piers / / 3. Steel piers -7-1 4. Other, specify Typical Support Footing 'Size Max. Pier Spacing Max. Overhang BUTTE COUNTY BUILDING DEPAPT! 17NT APPROVED 1/�/Iv PERMIT NO. 5159-80B PERMIT EXPIRES Midy OWNER Dorothy Buckle i CONTR. Acro-Lume, Oroville z .i ' ASSESSOR PARCEL 65-19-9 LOCATION 55 Holly Rd., Magalia Temp. Power Pole Called PG&E Temp. Elec. Service - Called PG&E Temp. Gas Service Cal led PG -&- Y JO/ALED(Date) Signature J OK O = Not OK – = Not Applicable ,MOBILEHOMES _ MISCELLANEOuS = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements–Setbacks–Easements 2. Soils; Special MH Support–Sketch 3., Sewer; Location–Test–Fall-C/0–Concrete ', AY Zoning Requirements–Setbacks–Easements Footings; Size–Depth–Spacing–Connectors ;Decks; Girders and/or Joists–Decking–Bracing–Stairs–Rails 4. Water; Location–Test–Easement Needed (Sketch) 4, Wood Awn.;–Beaw&P-Rttrs -Conner Shthg.–Rfg.–Bracing 5. Electricity; Location–Clearances–Grnd.–/ / Amp–Concrete 5. Alum. Awn.; Columns–Connections–Splice–Decal–Enclosures 6. Gas; Location–Test–Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows–Doors 7. Utility Clearance 7. Elec Card -BI Date Card - BI Date Card -BI ate elLt ZIR Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements–Setbacks–Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1. Setbacks–Easements 2. Footings; Size–Spacing–Marriage Line 2. Soils; Compaction–Structure Stability 3. Gas; MH Test–Demand–Valve–Connector 3. Pool Structure; Steel–Connections–Thickness–Dead Men–Lining 4. Electricity; MH Test–Crossovers–Breakers–Clearances 4, Elec.; Receptacles and Lighting; Distances–GFI 5. Drain; MH Test–Fall–Flex Connector 5. Elec.; Pool Lighting; 15 volts–GFI 6. Water; MH Test–Regulator–Connector 6. Elec.; Enclosures; Conduit Entries–Terminals–Listed 7. Water and Sewer Connected–C/O to Grade–HD Approval 7. Elec.; Bonding; Metal w/5'–Circulating Equipment–Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'–Circulating Equip.–Pool Lghtg. Boxes–Enclosures–Panel boards–Ins. to Main in Conduit 9. Exits; Insp.–Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test–Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers _ 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel -Bloc kouts-Wrapped-S lab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except k's Card -81 Date Card -BI Date Date PLUMBING (Permit) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector _ 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels _ 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth Card -BI Card -BI Date Card -BI Date Date Card -BI Date 64. 65. Elec. Outlets at Wood Panel; Int. & Ext. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except q's 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb: Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation- Foam- Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. Guard Rails Deck Construction -Post Caps _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral ❑Yes ED No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes 0 N 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. 80. Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B-1 Date Card -BI Date 81. Ventilation throughout House Card B-1 Date Card -BI Date 82. Glass Protection Date MECHANICAL (Perrr,it) OK except H's 83. Corrections from Previous Inspections 84. 85. Gas Test -Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval 31. A.C. Ducts; Insulation & Support ^ _ 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86, Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Card -BI Date Card -BI Date Date Card -BI Date -- Card -BI _ _Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except N's 36. _Sills; Proper Material & Anchors 37._ Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Copmenty at Final: _ 38. 39. Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. _Header & Beam -Size & Bearing Hangs -Post Caps -Anchors er-Connectors Cl ng. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfnq. Fireplace Ties or Type A Flue -Fireplace Throat Iru 45. Attic Access; Size & Rom_ex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: Anentrymust be made each time youvisit jobsite) y � COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS � �P� NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4 1 APPLICATION AND PERMIT ASSES OR_PARCEL NUMBER ZONING kri 0- UILDING PER 10 I OWNEI � EPHON 1 SO FT OCC. BUILDING VALUATION VA. OWNER'S MAILIN A ESS CO A TO NAME _ TELEPH N I CONTRACTOR'S MAILING D RESS ^ CONSTRUCTION LENIR UNKNOWN _ Fireplace Total Valuation $ U LENDER'S MAILING ADDRESS - �- Permit Fee $ ARCHITECT OR ENGINEER -�- LICENSE NO. Plan Checking Fee Penalty $ ARCHITECT OR ENGINEER_'S MAILING ADDRESS Permit fee $ V BUILDING ADORE PLUMBING PERMIT Filing Fee 3.00 Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex[] Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other [/ ` � Describe work: � 1 `+e ,,nn e` I -L5 V` ®V �+ ��,r(:n �1�C1 � Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business o C d my license is in full f ce an effect. and ProfessiFIXED License No. Classification'% ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEWcON5TNON.RESI D R BRANCH CI RC TITS 2.50 ea &\ NEw NON.RCONSTR (POWER APPARATUS , / ESID. SINGLE OUTLET CIR Ex. Occup(OUTLETS OR FIXTURES so@zsa BAL@1O¢ Ex. Occup.(OUTLETS P(RESID )RE A./ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6,25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 3.00 Heating Cooling Hood 2.00 Ventilation permit Fee '$ Contractor 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilit'es, judgments, costs, and expenses which may in any way accrue again t sa d County in nseAl uence of the granting of this permit. `10 _NC _S�'1� 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 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ OCCUP, GROUP I TYPE OF CONST, L/ PARCEL PD ND I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTO OF PUBLIC BY P T EXPIRES Date_. the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. Y3 (A;,3 Z WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT .; - PERMIT NO. 2870-79B- PERMIT EXPIRES'/�/ d .,OWNER Dorothy Cox owner CONTR.' hh� 11 qq LOCATIdVTA'P-9 ) 7 55 Holly Rd., KKMd Bagalia ,t I f� -1 J p . tt Py P j r { Temp. Power Pole r" Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. J.* Called PG&E 0 FINALED (Date (Signature Mesh COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS . BUILDING INSPECTION RECC-.RD Grd. Fault Prot. BUILD NG BUILD, G (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets list Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwaII Siding To out Slab ! Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for phcally handica edy Conformanc of x. structu Appliances Gas PI in & Test Temp. Gas Slab Final Sanitation Patio FIR LACE Final Footings Footing ELECT ICAL MasonryWall Throat % Rough Relnf. Steil Final Fixtures Bond Beam FIRES RINKLERS Motors Mesh M CHANICAL Grd. Fault Prot. Scratc Heating Service- Broww Cooling Temp: Pole FlnlA Ducts UAer round Interioll Lath Ventilation Permanent Door dloser Final Final MOBVLEHOME UTILITIES - - - - - - - - - - - - - - - - - Elec. Service Elec. Pedestal Wate Piping Sewer Gas Piping E OME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Wat f Piping Drainage Gas Piping P 9 DATE_ \� REMARKS OR CORRECTIONS= (NOTE: An entry must be made on this form each time you vislt the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telraphone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature'7 Per itee or Agent Receipt No. 2,3%-/ 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 JOF PUBLIC WORKS By Date L-1 Z,r 7/ wilding permit expires Date S' L4�d'a BUILDING Owner / SQ. FT. OCC. BUILDING VAL ON 4-46 Mai I i ng Address Telephone No. Contractor. Mailing Address Fireplace Total Valuation Telephone No. Permit Fee , 0-0 Building Address A4. Plan Checking Fee&/or Penalty Permit Fee 0S PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 / A. P. No. `p.� � 9 Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 Fp4s' jtion Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improv ents Each additional outlet .30 Building sewer 5.00 Ions Recd Parcel A oval ons Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00. 600V OR L Main service 100 AMP ORSLESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVER sOOV 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST. / OR ADDNS. ACCLBL GS LING COUP. 7i1 2¢Sgft .CON 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 le of: ON RESID, BRANCULTI.OUTL T NEW NON. -REBID ( H CIRCUITS 12.50ea SCONTRACTORS NEW CONST.. POWER APPARATUS B NON- RRESID. SINGLE OUTLET CIR. Ex. Occur){OUTLETS OR FIXTIIRES B L01 Ex. OCCU FIXED APP LNS, OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 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. 1 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 1 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 $ TOTAL PERMIT FEE $ 91 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature'7 Per itee or Agent Receipt No. 2,3%-/ 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 JOF PUBLIC WORKS By Date L-1 Z,r 7/ wilding permit expires Date S' L4�d'a ..n' -+.' _, .. „ , , . r ,. , .. ri».. .., ...r znetir :n�.. .. mw•,. r. aa-.vr_...a, ±I ,v,a•,e re : P h h1 .a.,, r;'I :w?„ h� N.� . r Y. by y a K,.,.. 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