HomeMy WebLinkAbout065-300-044i
_..- 65-30-44'
Robert L. Forrest
'1005 Northwood, 16t 268, Fir Haven Sub,
Magalia
contr: Par-A-Dise Const., agalia
Permit #6890-78 rutil. ,MH)6,a�
ELEC. . P
GAS
SUPP T eSTREQ•
COMPACTION TEST REQ. _
.p; TW
,,� 65-30-44
/c'on*r -r-- Wisp Const. , Magalia
Permit X6891-78P,ESuti1`:,MH),V,
ELEC . c�
44 107 Al2 10
GAS a �
SUPPO STRUCTURE REQ • –Lr V—
COMPACTION TEST REQ.
65-30-44
Cont r: Cal Gas, Paradise
Permit #670-7 P(inst. gas lime
for MH) ,? it
Ir 7 65-30-44
Contr: Cal Gas, _P,ar_adise
PErmit#1102-79P(gas piping) MH
65-30-44
CY I-+
Permit #113 -79MHI
Issued 9-7 .
5-30-44
contr: Hiltorjs MH •Serv. , 'MWlia
Permit #1612-79MHI 'J
Issued
65-30-44 y
Permit #1426-79'-Lr(rei�stall awning/MH)
65-30 44
Permit #3475-79B new awning/MH)
rcol~, krk
irk(.
S. ,n
7
i
Temp. Power Pole
Called PG&E
i
Temp.jElec. Serv.
Called PG&E
a Temp. Gas Serv.
Called PG&E
OB
ar.5
FINA.LED
` (Date
(Signa re AK
t
c�
,`FRMIT NO.
PERMIT EXPIRES
OWNER Robert L. Forrest
Par-A-Dise_Const.,
Magalia
+�
�ONTR.
LOCATION (A.P. 65-30-44
A
41"
1005 Northwood, lot 268,
Fir Haven Sub,
41,
I
Magalia
4
I
i
f�
S. ,n
7
i
Temp. Power Pole
Called PG&E
i
Temp.jElec. Serv.
Called PG&E
a Temp. Gas Serv.
Called PG&E
OB
ar.5
FINA.LED
` (Date
(Signa re AK
t
,�. _., i
,- .. ,, _ .
i - o '�
' `,
_ f
i �
1 �
_ � - � l
�� � -•
r,
COUNTY OF BUTTE —, DEPARTMENT OF PUBLIC WORKS '
BUILDING INSPECTION RECORD
II
BUILDING ' BUILDING (Cont'd)
w•l..�L
BI
)ti
Sla
Piers
trage
Foot!
Stem
Slab
rrport
Footi
Slab
Patio.
Footing:
isonry Wall
PLUMBING
ewall SdJI Piping
Pa ets 1 t Floor'
Rest om Finish 2n Floor
Windo
3rd Noor
Siding
To out
Roof Shea)iIlng
Water Pipixg
Roofing
Sewer
Fdn. Vents
Fixtures
Garage Vents
Water Htr.
Insulatiorl
Heaters
Prov. for ph
handicaed sicall
Conformance" of ex.
structure
Appliances
Gas Piping & Test
Temp. as
Final
Sanitation
56 EP CE
Final
Footing
ECTRI L
Fixtures
owccv i % i rinai o ♦ , sunnaneir. X
Mesh MECHANICAL Grd. Fabit Prot.
Scr ch HeatliA ServI96
B n coolAg TAO. Pole
nish D is nder round
Iriferlor Lath ntilation ZPermanent
oor Closer Inal inal
MOBILEHOME UTILITIES Elec. Service Elec. Pedestal %— f!— % GG ��
Water Piping -- Sewer r. S Gas Piping
M213ILEWOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity 7
Water Piping '� 7 Drainage Gas PipingZ
DAT REMARKS OR CORRECTIONS
�l
jam`` 7-
f 3, X941.
c-�i12—
(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 41
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—,//—r/-2 - 7�or the following location: t'7 C- 4Zs—'/�1.�
Mobilehome Mf �- 19II-XModel A�.-;hear� 7�
Insignia No. Serial No.
f
It is hereby certified for occupancy at the above described location and
may be occupied.
/% Director,of Public Works
Date �! / .� /7 � I, >tTi � i %-�_�,,.
f
THIS CERTIFICATE IS VOID WHEN,MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W. --
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1. Is�the mobilehome located wi/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) YesV.
No
3. Are footings and supports properly sized, spaced, and braced a0er approved plans? (Note
possible variation at -spring shackles.) (Sec. 5082 & 5083) Yes, No
4. Is thea �obilehome level? (Sec. 5088) Ye.sf/No
5. If a than a single unit, -are crossover connections properly installed? (Sec. 5088)
Yes No
6. Water
A. Is fle ble connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
Yes VNo�
B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes No
C. Backflow - If coach is not State of Califo` ,a owed, does station have backflow device
and pressure -relief valve? Yes_ No
—
7.
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? Yes No
C. Are any leaks detected in drainage system after running /allons of water through each
fixture including washing ma bine standpipe?..Yes No
D. If coach is not State C - fornia approved; does station have required trap and vent?
Yes No
8. Gas Piping and Gas Vents
A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum,
mobilehome connector of more than 6 ft, long? Note: All piping is to be at least as
large as the mobil ome gas line inlet without reductions other than the mobilehome
connector. Yes_ No_ ZNo-
1.
B.. Test OK as per following procedure? Yes 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? Ye" No
9. Electrical '
A. Is service large enough to provide adequate amperage -to mobilehome (must equal, ra4ng of
mobilehome with a minimum�o/ 100 amp) and other facilities,on lot, i.e., water pumps,
garage, cabana, etc.? Yed/ No
V
B. Is there proper clearances around panels? Yes No
C. Is power supply cord or feeder assembly properly fused? Ye�No
D. Is continuity test satisfactory as per the following procedure? Yes Y No
1. De -energize electrical wiring system of the mobilehome at the pedestal.
2. Make sure that the power supply cord or feeder assembly conductors, including neutral
conductor, have been disconnected.
3. Switch all breakers and switches in the mobilehome to the "on" position.
4. Connect one lead of a test instrument to the mobilehome grounding conductor and
apply the other lead to each mobilehome supply conductor, including neutral.
5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line,
water line), including fixtures and appliances, shall be tested for continuity from
such equipment and the grounding conductor.
6. Upon completion of the above procedure, the power supply cord or feeder assembly
conductors shall be connected to the site service equipment. A further continuity
test shall then be made between the grounding electrode and the chassis of the
mobilehome. Upon satisfactory completion of the electrical tests, the lot or site
service equipment may be approved for energizing.
10. Is job card signed by Health -Department for water and sanitation?
11. If everything okay, sign off card and tag services.
MOBILEHOME DATA `
Manufacturer and/or Namestyle
Lengt X4. Width_
Vehicle Serial No. IJY /T
State Identification No. 1569323 /
Additional Information or Comments:
COUNTY OF,'�tJ,TTE — DEPARTMENT OF PUBLIC WORK
7 County Center Drive - Oroville, California 95965 �/� `�]
Tel phone: $34-4541 161,_
/J
APPLICATION AND PERMIT l
OU111U11GU 1VP1V0UIItatIVCJ UI t1IV %,Uunty UI DULLU tU CIRCI upon LFIU
above-mentioned property for inspection purposes.
X �' Date YA 6
Sig ture of Permitee or Agent
Receipt No. 19 � +_ 0' <
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 which fees have been paid.
0 OF PUB C WORKS
3 a�A�y
B Date
- 3_�_ X0
Building permit expires Date ,
BUILDING
Owner W14116t
SO. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor 9 i,ii-174ts,SiF i U i Ccs
Mailing Address A 0 CFireplace
%
Total Valuation
elep one No.
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee
„ r �z/Z; /Y ��8 ��
PLUMBING No. @ FEE
�'
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. Not. _3 t;3 7 `�'
In� &Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fba
.
-eartlTIri-on
FireDept.
FireZone
Use Permit
Gas piping system 1 -5 outlets 1.50
EDA
Parking
Plans
ParcelEach
I Declaration
I Parcel Map
60' R/W
I Improvements
additional outlet .30
Building sewer 5.00
Bldi.flans Recd
Parcel 4 roval
Plan pprovol
Lawn sprinkler system 2.00
NEW ❑ ADDITION UTILITIES❑ OTHER AA
Permit Fee $
$
I
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Single Family ❑ Duplex ❑ Mobil Home Others ❑
600V OR LESS
Main service 100 AMP OR LESS 5.00
Main service EA. ADD'L 100 AMP 2.50
'
Main service OVER 600V 25.00
100 AMP OR LESS
Main service/ EA. ADD'L 100 AMP 1.00
NEW CONST. C
OR ADDNS. ACC LBLDGSCcup. S� 2¢sgft
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
Sttyll 0 : t �/ C'
/7/ Yid �I �.S' SOP• /e_ //Cl '�! Q- S"o- -i a
NEW CONSTR .OUTL T
NON-RESID, (MULTI BRANCH CIRCUITS 2.50ea
NEW CONSTR. (POWER APPARATUS.6,
NON-RESID. SINGLE OUTLET CIR,
Ex. OCCUD(OUTLETS OR FIXTI1PES1 5 L�
Ex. Occup. (OUTLETS FIXED P(RESID•IREA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification Ill
Misc. Wiring 6.25
❑ I 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.
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
e
$
TOTAL PERMIT FEE
$ .SIJ
OU111U11GU 1VP1V0UIItatIVCJ UI t1IV %,Uunty UI DULLU tU CIRCI upon LFIU
above-mentioned property for inspection purposes.
X �' Date YA 6
Sig ture of Permitee or Agent
Receipt No. 19 � +_ 0' <
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 which fees have been paid.
0 OF PUB C WORKS
3 a�A�y
B Date
- 3_�_ X0
Building permit expires Date ,
4
y
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
0
duulUncr ICPICSen IdtIVUb UI the IJUUn Iy UI MULLU IU enlef upon the
above -menti d property for nspeotion purposes. C'
X Date b
Ignature o Per.
or Agent
Receipt No. /R �c r
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 r which fees have been paid.
71
i3IRECROA OF PUBLIC WORKS
Building permit expires Date
�P1171A
BUILDING
Owner6160—V71 A/ 2
rb ,@
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor Pw ��- 4r_ o"J'r- dz,1%7
Mailing Address A0 77d
Fireplace
Total Valuation
Tele hone No.
Permit Fee
Building Address QQ, A-49Permit o v'7W &3C� D
Planng Fee&/or Penalty
t Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00 ®C�
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No. 3b•— 31-V
• ' Zoning & P n ng
Water piping 4.60
Each gas water heater or vent 1.50
F 84T
n t on
Fire Dept.
FireZone
Useermit
Gas piping system 1 •- 5 outlets 1.50
EQA
Parking
Plans
P rcelEach
Declaration
I Parcel Map
60' R/W
I Improveme s
additional outlet .30
Building sewer .&80' p, ofd
Bldg. ens Recd
Parce A royal
Plan pproval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES JK OTHER ❑
Permit Fee $
;$
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00 <c*
r
Main service 600V OR LESS
100 AMP OR LESS 5.00 • b�
Single Family ❑ Duplex ❑ Mobil Home ® Others ❑
Main service EA. ADD'L 100 AMP 2.50 U
Main service OVER 25.00
100 AMPP OR LESS O
.
Main service/ EA. ADD'L 100 AMP 1.00
NEW CONST.DWELING
OR ADDNS. ( ACCLBLDGSCC UP. 'Y) 20 sq ft
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
Styl of:
N-ftf-A A16e CCPnS+Y• C O
NEW CONSTR MULTI -OUTLET
NON.RESID ( BRANCH CIRCUITS) 12.50ea.
NEW CONSTR. (POWER APPARATUS.8
NON.RESID. SINGLE OUTLET CIR.
EX. OCcuo(OUTLETS OR FIXTIIRES BAL 250 1@
Ex. Occup. (FIXED OUT ETS P(RESID )LNS REA) 2•��
Temporary service 10.00
Mobile Home Facilities 15.00 Jd-,00
License No. Classification RMisc.
3Q34 I
Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
r -1I 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;
$ s" r
TOTAL PERMIT FEE
$
duulUncr ICPICSen IdtIVUb UI the IJUUn Iy UI MULLU IU enlef upon the
above -menti d property for nspeotion purposes. C'
X Date b
Ignature o Per.
or Agent
Receipt No. /R �c r
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 r which fees have been paid.
71
i3IRECROA OF PUBLIC WORKS
Building permit expires Date
�P1171A
rh_ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
- 7 County Center Drive - Oroville, California 95965
Tel ephone:'534-4541
APPLICATION AND PERMIT
Ins e Ins
BUILDING
Owner �j �'�
SO. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
/p)
Contractor e9AL 0 A G(f, G• tJCA.�l.
//
Mailing � 6 Address jSd'V
Fireplace
Total Valuation
(�Q-h=ne
ele3t�
`� Y�
Permit Fee
Building Address
Plan Checking Fee&/or Penalty,
Permit Fee
A /
5 / Y 0 V42T
PLUMBING No.1 @ I FEE
PERMIT FILING FEE $3.00
Each TraD 1.50
ten, ji•! 1J;__i'1 A07-.2 i7 u`4
Repair drainage or vent piping 1.50
A. P. No. �j :3(�"C�� ` ng-&/
n
ig-&/Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fee/sl
Wle.1 ftr-rarhnr
Fire Dept.
FireZone Use Permit
Gas piping system 1 - 5 outlets J.69' p
EOA
Parking I
Plans I
ParcelEach
Declaration
I Parcel Map
60' R/W
Improvements
additional outlet .30
Building sewer 5.00
Parcel AEeroval
I Plans Approval
Lawn sprinkler system 2.00
NEW 'ADDITION ❑ UTILITIES ❑ OTHER
..
Permit Fee $
$ 3
ELECTRICAL No. @ FEE
{`
PERMIT FILING FEE $3.00
Main service 100 AMP OROR LESS5.00
Single Family ❑ Duplex Mobil Home Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service/ EA. ADD'L 100 AMP 1.00
OR ADDNS. ACCNEW CONST. LBLDGS.LING Ccup- 9� 22sgft
C
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
st le f:
Y � t,
221 1od,,J pa YD.oIt /--A
NEW CONSTRESID, MULTI -OUTLET 1
NON.RESID BRANCH CIRCUITS/ 12.50ea
NEW CONSTR. (POWER APPARATUS a
NON.RESID. SINGLE OUTLET CIR.
EX. OCcuD(OUTLETS OR FIXTIIRES gAL�
x. CCU EOFIXED APPLNS. OR
p• OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
�
License No. FS Classification -cam
Misc. Wiring 6.25
❑ I 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 re uires eve em I er to be ' r d a a'
MECHANICAL No.i @ FEEPERMIT
FILING FEE $3.00
Heating
q ry p oy u g Ia I I y
for Workmen's Compensation.
S;JeI have placed on file with the County of Butte a certificate of
J� 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.
I certify that I have read this application and state that the above
information is correct. 1 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.
ie DateVRIJ
i ure �of Permitee or Agent
Receipt No./ d X 3f 0
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
Coo I i
Ventilation
Hood 1 1 2.00
Permit Fee $ $
Land Development Fee $
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:
DI CTOR OF PUBLIC WORKS
BY � Gt/� Date ,
g permit expires Date
License No. 354166
i'. 0. Box 668
t -Ac gollio, CA 95954
(916) 873-0851.
COUNTY -OF BUTTE
Department of Public Works
7 County Center Drive
..Oroville ----- 534-4541
ELECTRICAL INFORMATION FOR DE -RATING MOBILEHOMES
Owner_
Location
Mobilehome Installation Permit No. _/� a - 7 q
1.
. FILL IN INFORMATION FOR ITEMS 1 THRU 10
Width a x Box Length,
SZ
Watts
x3=
2. 2 Kitchen Appliance Circuits ................. = 3,000
3. 1 Laundry Circuit ............................ 1,500
4. Ovens ................... = 7S0 U
5. Cook Stove Top =
6. Hot Water Heater .......�'��!............... _
7. Dishwasher & Disposal ........................ _ .3795
8. Clothes Dryer ................................
9. Other (specify, i.e., motors, exhaust fans, v
etc_1
9,0 U
Sub -total - Watts ..... 4 SF
First 10,000 watts @ 100% ................................ = 10,000
l
/
Remaining e �(8y watts @ 40% ....................... = 7 7J
10. Air Conditioner . S j Z 9 watts @100%.. _ ) _
Largest Demand
Central Heat System A6 -d> watts @ 65%.. _ )
i
TOTAL -DEMAND WATTS REQUIRED .............
"Demand Watts Required" , 230 ............ _ 3, AMPS
De -rate Mobilehome to ........ E.� .......... D c3 AMPS
AUNTY
BUILDING DEPARTMENT
APPROVED
a
IV -
PEW+T NO. 6891-78P,E S
PERMIT EXPIRES l�/����
OWNER Robert L. Forrest
eONTR. Bob Powers/Par-A-Dise Const., 19aga.
65-30-44
LOCATION (A.P. )
1005 Northwood, lot 268, FH Sub, Magalia
I .
. a.
�r A'
i
f�
4 �
Temp. Power Pole Called PG&E
Te p. Elec. Serv. - "21 -
Called
Called PG&E
i emp. Gas Serv. "
Called PG&E
�F .{
JOB
FINALED
(Date)
,
s
(Signal
1
i
i'
• `
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
y BUILDING INSPECTION ReCORD
'
BUILDING
BUILDING (Cont'd)
PLUMBING
SItback
lkewaII
SNI Piping
Fors
Pa ets
1 t Floor
Ma Bldg.
Rest om Finish
2n Floor
Fo tins
Windo
3rd Noor
Stem all
Siding
To out
Slab
Roof Shea)hina
Water PI 1
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwal I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
r
Prov. for physical
n ed lk
Conformance
C } mance of ex.
structure
Appliances
Gas Piping & Test
Tem . Gas
r Slab
Final
Sanitation
Patio
F E ACE
Final
Footings
Footing
LECTRI L
Masonry Walls
Throat
Rou h
Relnf. Steel
Final
Fixtures
Bond Bea
IRE SPRINKLE
Motors
Framing
Test
Water Htr
Stucco
Final
Sub ane
Mesh
MECHANICAL
Gird. F It Prot.
Scra h
Heatinif
Servile
B n
CooIJ9g
T mp. Pole
F ish
Du s
nder round r
In rior Lath
V ntilation
Permanent
40. or Closer
anal
inal
MOBILEHOME UTILITIES ----
Elec. Service
C EleoVi0estal ._ IVC7
Water Pipi
Sewer
Gas Piping
E ME INSTALLATIO Support/
Elec. Continui Ul F4
Water Piping
,�(
Drainage 13 it b
Gas Piping fd,
DATE REMARKS OR CORRECTIONS !/
�—
/ /3
(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 �� `s1' for the following location:
Owner 1r r n e,.4–
Owner's
,y
Owner's Address U
Mobilehome Mfg. '%!'1/A+^ %7//"'?'� Model' —Year "
Insignia No. ,[%�1• 7%�„ w��% Serial No.- S`�U 2_
It is hereby certified for occupancy at the above described location and
may be occupied.
Director of Public Works
11
Date By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W. ...���
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1._ Is tine mobilehome located w_i�h required separation from lot lines and buildings and generally
confprm to plot plan? Yes\(,No
2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes No
3. Are footings and supports properly sized, spaced, and braced a`s /per approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes�(.r No
4.-, Is the mobilehome level? (Sec. -5088) Yea`s No
5. If. more than a single t, are crossover connections properly installed? (Sec. 5088)
Yes No
6. Water +
C9Is flexible connector of adequate size. -and properly installed (1/2" ID min.)?'(Sec. 5566)
v Yes No
B. Test - Does water piping withstand working pressure or SO lbs. air test? Yes No
C. Backflow - If coach is not State of California approved, does station have backflow device
and pressure -relief valve? Yes_ No
7. Wastes and Drains
A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No
B Does it have minimum k" per foot slope and is it properly supported? Yes_ No
C. Are any leaks detected in drainage system after running. -gallons of water through each
fixture including washing machine standpipe?..Yes No
D. If coach is not State of California approved, does station have required trap and vent?
Yes- No
8. 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 mobilehome gas line inlet without reductions other than the mobilehome
�-� connector. Yes No
B.).Test OK as per following procedure? Yes_ No
1. Open all appliance connector valves.
2. Shut off appliance burner and pilot valves.
3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum
6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without
drop.
4. Connect gas meter to mobilehome with connector, turn on gas, test connections with
soapy water.
C. Are all appliance vents properly installed? Ye S4 No
� e
9. Electrical
A. Is service large.enough to provide adequate amperage -to mobilehome (must equal rating of
mobilehome with a -minimum f 100 amp) and other.facil ties on lot, i.e.., water pumps,
garage, cabana, etc.? Yes No `^
B. Is there proper clearances around panels? Yes No
C. Is power supply cord or feeder assembly properly fused? Ye No
D. Is continuity test satisfactory as per the following procedure? YeNo
1. De -energize electrical wiring system of the mobilehome at the p destal.
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 the electrical tests, the lot or site
service equipment may be approved for energizing.
10. Is job card signed by Health Department for water and sanitation?
11. If everything okay, sign off card and tag services.
MOBILEHOME DATA
Manufacturer and/or Namestyle (�
Length Width
Vehicle Serial No.
State Identification No.
Additional Information or Comments:
41 ' a
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive -, .Oreville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-menlioned property for inspection purposes.
Date
Signature of Permitee''or Agent
Receipt No. / J_ Z Y6 2--
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.
RECTOR OF PUBLIC WORKS
BY Date a -%-7
Building permit expires Date -— 7-- 9_0
BUILDING
Owner 41
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.
Contractor
Mailing Address,Q •
Fireplace
Total Valuation
'63- �y
Telephone No -
Permit Fee
Building AddressPlan
✓Od O13Thf 1U1�
Checking Fee&/or Penalty
Permit Fee
am/
PLUMBING No.1 @ I FEE
PERMIT FILING FEE J$3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No. ,-- Sf
T %
2�Oning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
F&_s
8amtat n
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 439
EQA
Parking
Plans
I Parcel
Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer 5.00
Bldg. Pfarr9 ec'dParcel
A roval I
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $ % , tZ
$ j3 d.
*U.sTetAAZ, 6r ��w� / o�P j,/�!
ELECTRICAL No. @ FEE
r-
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5•��
Single Family ❑ Duplex ❑ Mobil Home 10 Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADD•L 100 AMP 1.00
NEW CONSDWELING OOR ADDNST ( ACCLBLDGS.CCUP. 7i) 22 sq ft
/
CONTRACTORS LICENSE LAW
1 am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
styl f: r-
1� �QJq 23 �J li `�'
NEW RESID,CO N MBRANCULTI.OUTL T
NON -REBID BRANCH CIRCUITS) 12.50ea
NEW CONSTR. (POWER APPARATUS 6
NON.RESID. SINGLE OUTLET CIR.
Ex. Occur){OUTLETS OR FIXTURES 1 5 L ,
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
11
Mobile Home Facilities 15.00
License No. -S I I q- 1Classification �
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of Cal ifomia.
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.
f�Cl have placed on file with the County of Butte a certificate of
,yam 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.1 @ FEEPERMIT
FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
$
TOTAL PERMIT FEE
$ oD
authorize representatives of the County of Butte to enter upon the
above-menlioned property for inspection purposes.
Date
Signature of Permitee''or Agent
Receipt No. / J_ Z Y6 2--
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.
RECTOR OF PUBLIC WORKS
BY Date a -%-7
Building permit expires Date -— 7-- 9_0
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965
v !^ Telephone: 534-4541
APPLICATION AND PERMIT A�
.. ..� n.ua % VV 11%y UI UU L— N OI Il0l UPUII UIr.
above -me ) ed propert f ection purposes.
Date �' � " -7 8
Signatures/ of Permitee 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 r which fees have been paid.
IRE IC WORKS
B /6Date /
Building permit expires Date %W/
5
02
BUILDING
71,
Owner A T , Forrest
�.OJer i O-_1 e5$
SQ. FT. OCC. BUILDING VALUAT N
Mailing Address J:
Telephone No.
Contractor Dob Povjers Par-.ti-Dise Coils t. Co.
Mailing Address /o Bob Powers P.O. BO1> 776
Fireplace
Total Valuation
Ma�alia, Ca. 9595 ?
Telep o
5 ( - j0
Permit Fee
Building Address Fir i�a��eri L01= 2f�o
Plan Checking Fee &/or Penalty
Permit Fee
PLUMBING
No.
@
FEE
PERMIT FILING FEE
X
$3.00
Each Trap " 1.50
Repair drainage or vent piping 1.50
A. P. No. 65-30-4,�
'--Zoning &Planning
Water piping
-i.90
/p, &a
Each gas water heater or vent 1.50
es
VI�GI ation
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking Parcel
Plans Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
Building sewer X 5.00
/®r®®
Bldg. P s Recd
Parcel A vol I
Plansva
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ® OTHER ❑
permit Fee $
,C9p
�3&C
ELECTRICAL
No.1
@ I
FEE
PERMIT FILING FEE
X
$3.00
3r®6
Main service 800V OR LESS
100 AMP OR LESS X 5.00
aV
Single Family ❑ Duplex ❑ Mobil Home ® Others ❑
Main service EA. ADD'L 100 AMP 11 2.50
2,576
Main service OVER 600V
100 AMP OR LESS
25.00
Main service EA. ADD'L 100 AMP 1.00
NEW OR ADONST % ACCLBL ILDGS.NG CCUP. !i� 20sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
f:
st le ox.
y ..,
Par-A-Dise LOris'tryt ctiori CO.
NEW , MULTI BRANC-OUH CTL
NON-RREBIESIDDT
UITS/
12.50ea
NEW CONSTR. (POWER APPARATUS 8
NON-RESID. SINGLE Of CIR.
Ex. Occup{OUTLETS OR FIXTIIRES O L25
E OCCU FIXED APPLNS. OR
p•(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities X 15.00
i 00
License No. 3234'10B Classification
Mise. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
45-13-4
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.
❑X 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.l 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
z5 -,,X)
$ as:
TOTAL PERMIT FEE
$ %.3
.. ..� n.ua % VV 11%y UI UU L— N OI Il0l UPUII UIr.
above -me ) ed propert f ection purposes.
Date �' � " -7 8
Signatures/ of Permitee 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 r which fees have been paid.
IRE IC WORKS
B /6Date /
Building permit expires Date %W/
5
02
COUNTY OF BUTTE — bEPAF�TMENT OF PUBLIC WORKS
s 7 Cpunty Center Drive - Oroville, California 95965
TelephGne: 534-4541 1XV
APPLICATION AND PERMIT M
abolve -ment' edZe eproperty for inspecun n purposes.iy of Butte to enter upon the
X ate
4/74V
Signature of ermitee or ant
Receipt No.�W-g 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 fQr which fees have been paid.
�!1 DIRIECT01390F PUBLIC WORKS
B 144 4 4NJ I Date ..
Building permit expires Date 7 �"
BUILDING
Owner C�
SO. FT. OCC. BUILDING VALUATION
Mailing Address �d
Telephone No.
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address
d
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trao 1.50
Repair drainage or vent piping 1.50
A. P. No.
Zo ing & Planning
Water piping 1.50
Each gas water heater or vent 1.50
l
gig,,ta�
Fire Dept. FireZone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EOA
Parking
Plans
I Parcel
Declaration
Parcel Map
60' R/W
I Improvements
Each additional outlet .30
Building sewer 5.00
BI
Parc pproval
Plan pproval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00
600V OR LE
Main service SS
10o AMP LESS 5.00
Single Family EJ Duplex Mobil Home Others
❑ �
Main service EA. ADD100 AMP 2,50
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW OR ADDNST ( ACCLBL GSLING CCUP. 4) .20 sq ft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
st Ie of:
y
TLET
NEW CONSTR BRANCHMIILTI-OCIRCUITS.)
NON.RESI D, � BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS 8
NON-RESID. SINGLE OUTLET CIR.
Ex. Occur)(OUTLETS OR FIXT11RES) g L9;
Ex. Occu FIXED APPLNS. OR
p• OUTLETS (RESID.) EA))2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
=1 am from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
ermit is issued I shall not employ any person in any manner
so a 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
$ 0 v
TOTAL PERMIT FEE
$ C�1�
abolve -ment' edZe eproperty for inspecun n purposes.iy of Butte to enter upon the
X ate
4/74V
Signature of ermitee or ant
Receipt No.�W-g 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 fQr which fees have been paid.
�!1 DIRIECT01390F PUBLIC WORKS
B 144 4 4NJ I Date ..
Building permit expires Date 7 �"
1426-79B '
t:PERMIT NO. '
PERMIT EXPIRES
OWNER Robert Forrest
CONTR. owner
LOCATION (A.P. x1m 65-30-44
1005 Northwood Dr., lot 268,Fir Haven Sub, Maga.-
Temp.
aga.Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
�FINA
ailed PG&E
I
t! JOB
L s�
Setback
Forms
Main Bldg.
Footings
Stemwal I
Slab
Piers
Garage
Footings
Stemwal I
Slab
Carport
Footings
Slab
Patio
Footings
Masonry Walls
Reinf. Steel
Mesh
Scratch
Brown
Finish
Interior Lath
Door Closer
MOBILEHON
Water Piping
MOBS
Water Piping
s
DATE
- x
COUNTY OF BUTTE — DEPARTMENT OF.PUBLIC WORKS
BUILDING INSPECTION`kC&D ,
BUILDING' I t UILDING (Cont'd) 1 PLUMBING ,
Firewall
Parapets
Restroom Finish
Windows
Sidin
Roof Shea in
Roofing
Fdn. Ven
Garage V nts
Insulatlo
Prov. fo physically
hand ica Ded
Confornjange of ex.
LACE
Final
F E SPRINT
Test
Final
MECHAN
Heating
Cooling
Ducts
Ventilation
Final
----- Elec. Service
Sewer
=ION- Support
Drainage
REMARKS OR CORRECTI
0
Soil Piping
1st Floor
.2nd Floor
3rd Floor
Topout
Water Pipin<
Sewer
Fixtures
Water Htr.
Heaters
Appliances
Gas Piping
Temp. Gas
Sanitation
Final
Rough
Fixtures
suo anels
Gird. Fault P o
Service
Temp. P e
Under ro nd
Perman t
Final
Elec. Ped stal
Gas Pipin
Elec. Co knuity
Gas Pipi g
N
(NOTE: An entry must be made on this form each time you visit the job site.)
ELECTRICAL
J
• ,` COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS
FCountly.Center Dri.'ve-�Oroville, California 95965
.� _ • Telcphone:=534-4541 "
` APPLICATION AND PERMIT
autnonze representatives of the County of Butte to enter upon the
above-mentioned property f spection purposes.
"4 Dat /
Signa/_e of Pe .tee or Agent (�
Receipt No.. / 6 ,97 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
abo rior which fees have been paid.
VD
ll I IR OR OF UBLIC WORKS
ir �y�
Dat 3!'-!yp
Building p
BUILDING
Owner
SO. FT. OCC. BUILDING VALUATION
Mailing Address 3—
Tay 71 No.
/
Contractor W-0,
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address�OS�-
it-.
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No. @ FEE
IL ��
PERMIT FILING FEE $3.00
Each Trao 1,50
Repair drainage or vent piping 1.50
P. No. �^ G—
Z
_Water
IP C11
n.n &anning
piping 1.50
Each gas water heater or vent 1.50
Fe
Fe
W.
A
Sa I
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking Parcel
Plans Declaration
Parcel Map
60' R/W
Improvements
Each additional outlet .30
wilding sewer 5.00
Lawn sprinkler system 2.00
Bldg. PINS Recd
Parcel A royal
Fa
Plans Appr
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
$
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service 600V OR LESS
100 AMP OR LESS 5•��
Single Family Duplex ❑ Mobil Home Others ❑
Main service EA. ADD'L 100 AMP 2.50
LItMain
u,
service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
NEW CONST.( OR ADDNS. ACCLLING BLOGS.CCUP, Y) •24,Sgft
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
le of:
NEW RESIDCONSBRANCH CIRCUITS)
NON-RESID, � BRANCH CIRCUITS 2.50ea
NEW CONST R. POWER APPARATUS a
NON-RESID, SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTIIRES) 6 Lg;
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
--al'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.
E] I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
P 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
+2,0011
Hood
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
Land Development Fee
$
TOTAL PERMIT FEE
$ %
autnonze representatives of the County of Butte to enter upon the
above-mentioned property f spection purposes.
"4 Dat /
Signa/_e of Pe .tee or Agent (�
Receipt No.. / 6 ,97 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
abo rior which fees have been paid.
VD
ll I IR OR OF UBLIC WORKS
ir �y�
Dat 3!'-!yp
Building p
3475-79B t
` PERMIT NO.
Ak
s PERMIT EXPIRES
t Robert Fortest
OWNER
CONTR. owner
yLOCATION (A.P. 65-39-44
d 1005 Northwood Dr., Magalia (lot 268,FH Sub
t
I
t_
E`.
Temp. Power Pole
.t
Called PG&E
1
_
#
Temp. Elea Servs
3475-79B t
` PERMIT NO.
Ak
s PERMIT EXPIRES
t Robert Fortest
OWNER
CONTR. owner
yLOCATION (A.P. 65-39-44
d 1005 Northwood Dr., Magalia (lot 268,FH Sub
t
I
t_
E`.
Temp. Power Pole
Called PG&E
_
#
Temp. Elea Servs
fl
t`
Called PG E_
Temp. Gas erv. _
f
Calle tl PG&E-
G&E -
JF
JO
FI2ALED
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS -
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLo SING
Setback Firewall
Soil Piping
Forms Parapets 1st Floor
Main Bldg. Restroom Finish 2nd Floor
Footings Windows 3rd Floor
Stemwall Siding To out
Slab Roof Sheaths Water Piping
Piers Roofing Sewer
Garage Fdn. Vent Fixtures
Footings Garage V4nts Water Htr.
Stemwall Insulation Heaters
Slab Prov. forhysically Appliances
Carport handica ed
Conformance of a Gas Piping &Test
Footings structure Temp. Gas
Slab Final 9 Sanitation
Patio FIREPLACE Final
Footings Footing ELE TRICAL
Masonry Walls Throat Rough
Reinf. Steel Final Fixtures
Bond Beam FIRE SPRI KLERS Motors
Framing Test Water Htr.
Stucco Final Subpanels
Mesh . . MECOANICAL Grd. Fault Prot.
Scratch Heating Service
Brown Cooling Temp. Pole
Finish Ducts Underground
Interior Lath Ventilation Permanent
Door Closer V Final Final
MOBILEHOME UTILITIES ------------ -•--- Elec_ Service Elec. Pedestal
Water Piping Sewer Gas Piping
EHOME INSTALLATION - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE REMARKS OR CORRECTIONS
7?V?
D J
12 ti
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BOTTE —. DEPARTMENT OF PU'BLICsWORKS
7 County Center Drive . - .Ormville, California 95965
a Telephone: 534-4541
a APPLICATION AND PERMIT
2
BUILDING
Owner
SQ. FT. OCC. BUILDING VALU TION
Mailing AddressAA
:
Tel epho�N gn
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address_ n
i�
Plan Checking Fee&/or Penalty
Permit Fee
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
9�
A. P. No. 65-34
7t- j
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
es
W-:
S ept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improve ents
Each additional outlet .30
Building sewer 5.00
g. Plans Recd
Parcel A royal
Pla Approval
Lawn sprinkler system 2.00
NEW ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service MooV OR LESS
100 AMP OR LESS 5.00
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service EA. ADD'L 100 AMP 2.50
CIL.
OVER MOON
Main service 100 AMP OR LESS 25.00
Main service EA. ADD'L 100 AMP 1.00
NEW
OR ADDNST ( ADWECCLBLDGSCCUP. 'f') 20sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
of:
(MULTI
NEW CONSTR. -OUTLET
NDN.REsID BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS 8
NON.RESID. (SINGLE OUTLET CIR.
Ex. Occuo(OUTLETS OR FIXTIIPES) MOLD
104,
FIXED Astyle
Ex. Occup. ( OUT LETS P(RESID.)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
MI am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
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
Land Development Fee
$
TOTAL PERMIT FEE
$ �% O(
autnonze represenianves or the county o1 tsutie io enier upon the
above-mentioned property for inspe tion purposes.
X �_Vate
Signature ooff�PeCrmitee 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.
„DIREC,X-QR QFAJALIC WORKS
By /�s,�LrDate 6fo3ol
Building permit expires Date