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HomeMy WebLinkAbout065-340-056L' _ Edward --F: Brokelsby 32 H61mwood Dr., Magalia Permit #l8 4-76P,E(utAl. ,MH) ' 11lIb' ELEC.. S GAS Q. SUPPOR S RUCTURE REQ.* 00 COMPACTION TEST REQ. /00 65-34-56 contr:Gene Schmitt Mobile Home Serv., Chico a X * I A Permit #5732-76MHI Issued 65 -34 -56 - Ed Brockelsky : 'A'P'Ot4L + 32 Holmwood, Maga,4a Permit #l924-77B(deck/MH) t i�N io/Wb';65-34-56 contr: Panorama I,1obile Home Serv,Chic, Permit #1822-77B(new zwning/MH) lr#IKA.f &MOP%65-14-56 Permit #2200-77B(`"w deck/MH) =� 65-34-56 - - contrX D & E Const., Paradise Permit #3184-79B(new covered deck/MH) f %,®,141j;y 65-34-56 Permit#3334-84B,E(new garage) .065-340-056•. PERMIT#95=2299 _BROCKELSBY, Edward 14798 Holmwood -Dr.., Magalia Cont;.Morehouse'A/C Service Gas Piping/MH q :1 B07-0616 065-340-056 RESIDENTIAL SFD-Mobile Home RET EX MH PERM FND RETRO -FIT 14798 HOLMWOOD DRF1UA(-yjZ1O` BROCKELSBY, VIRGINIA V & EDWAR t _ Edward --F: Brokelsby 32 H61mwood Dr., Magalia Permit #l8 4-76P,E(utAl. ,MH) ' 11lIb' ELEC.. S GAS Q. SUPPOR S RUCTURE REQ.* 00 COMPACTION TEST REQ. /00 65-34-56 contr:Gene Schmitt Mobile Home Serv., Chico a X * I A Permit #5732-76MHI Issued 65 -34 -56 - Ed Brockelsky : 'A'P'Ot4L + 32 Holmwood, Maga,4a Permit #l924-77B(deck/MH) t i�N io/Wb';65-34-56 contr: Panorama I,1obile Home Serv,Chic, Permit #1822-77B(new zwning/MH) lr#IKA.f &MOP%65-14-56 Permit #2200-77B(`"w deck/MH) =� 65-34-56 - - contrX D & E Const., Paradise Permit #3184-79B(new covered deck/MH) f %,®,141j;y 65-34-56 Permit#3334-84B,E(new garage) .065-340-056•. PERMIT#95=2299 _BROCKELSBY, Edward 14798 Holmwood -Dr.., Magalia Cont;.Morehouse'A/C Service Gas Piping/MH q :1 B07-0616 065-340-056 RESIDENTIAL SFD-Mobile Home RET EX MH PERM FND RETRO -FIT 14798 HOLMWOOD DRF1UA(-yjZ1O` BROCKELSBY, VIRGINIA V & EDWAR N! ("moi LOM � , BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 3 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-0616 Issued: 03/27/2007 Address: 14798 HOLMWOOD DR Area: MAGALIA Owner: BROCKELSBY, VIRGINIAPN: 065-340-056 Applicant: SIERRA MOBILE SERVIMap Page: Permit Type: SFD-Mobile Home RET Description: EX MH PERM FND RETRO -FIT Flood Zone: None SRA Area: Yes SETBACKS Front Setback: Side Setback: Rear Setback: Other Setback: Minimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 "Z .T-. , Z,o Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing • 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 Ins ection Type I IVR I INSP DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: C A d—:7 Finils- Public Works Fina 538-7681 Fire Department/CDF 538-7111 Env. Health Final 538-7281 Sewer District Final "PROJECT FINAL 801 %Z , T z, o -rFUJCCL ru,a, s a ♦,crw,caLc ui vccupaucy ror tncswrnua, vmy/ PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy i BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 14798 HOLMWOOD DR Owner: Permit No: B07-0616 APN: 065-340-056 BROCKELSBY, VIRGINIA V & Permit type: RESIDENTIAL 15050 PINON RD Issued Date: 03/27/2007 By GLB Subtype: SFD-Mobile Home RET MAGALIA, CA 95954 Expiration Date: 03/26/2008 Description: EX MH PERM FND RETRO -FIT Occupancy: Zoning: RMH Contractor Applicant: Square Footage: SIERRA MOBILE SERVICE & SUPPLY SIERRA MOBILE SERVICE & Building Garage Remdl/Addn 466 CIRCLE DRIVE 466 CIRCLE DRIVE OROVILLE, CA 95966 OROVILLE, CA 95966 (530)534-0599 (530)534-0599 Other Porch/Patio Total FEE INFORMATION DBF MH Plan Check $219.96 DBMSC Mobile Home $329.94 LICENSED CONTRACTOR'S DECLARATION_ Contractor (Name) State Contractors License No. / Class / Expires SIERRA MOBILE SERVICE & S 470386 / C47 B / 03/31/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effit. X A__41 03/27/2007 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 211A E AV ND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Cartier: State Fund Policy Number:046-0004257 Fop. Date:01/01/2008 (This section need not be completed if the permit is for one hundred dollars ($100) or less. ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /7 X 03/27/2007 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. .90 Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 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]; Please check one of the following: ❑I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are notintended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this 1 03/27/2007 Owner's Signature Date I CONSTRUCTION LENDING AGENCY I I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorizedteon the prop rt ers behalf. /..� 03/27/2007 Owner - ontractor OR; Agent for Owner ElAgent for Contractor FILE COPY o4 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES PERMIT BUILDING PERMIT APPLICATION NO.A,ND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#g �� ROVILLE. (30) 538-7636 • CHICO: (530) 891-2834 BP I OFFICE #: (530) 538-7541 A FEE WILL BE REQ UIRED AT TIME OF APPLIC4 TION BIN # **PLEASE PRINT CLEARLY** Last Name &DCKE OWNER/, y,jY First Address J 7 7 b' Ciiy Al 14 6.,q4 A Stale <!y Phone Fax E-mail Name EAq w ,q R 1_,� zip ys 9S -y Name CONTRACTOR Address City State �a Zip YSf E E' Phone Shy OSy 9 Fax E-mail Lic. # y763Y, Class ARCHITECT/EGR Name NINEE Address City State Zp Phone Fax E-mailState License Number APPLICANT NAME Name _ /.ze ;• Address city , State �i ZIP Phonet: Fax S`3 q oS-6 6 E-mail APPLICANT SIGNATURE X For office use only: - d Zoning Flood Zone SRA Yes • No Occ. Type Const. Subdivision Name MapBook Page Lot # runner Dale Approved: 0 V E R FOR Sl1BMITTAI RF'fll IIA�nn�nirc Rec ived by: Receipt #: Date: �1 Amount RA 19 Other DECK � I Dt..) A D o e r- F 0 L 13- UTTE COUNTY BUILDING DIVISION -L Xi2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering 1p-)7 BUTTE COUNTY BUILDING DIVIS1`0f J APPROVED t � � 3/Zc Xi2 Concrete System Engineer Approval State Approval bIANUFACTURED HOME/MOBILE HOME FOUNDATION SYSTEM SEALTH AND SAFETY CODE, SECTION 18551 APPROVED WSJ= TO CORRECTIONS NOTED APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS ANIS REOULATIONS Stato Of Cabronie DWwtwW dROWkS and C M— ty DamlapOwd OF CO"9ES AND STANDARDS rn Page 1 of 8 C LO 0 � o 0 Xi2 Foundation System Installation Instructions for California for Ground & Concrete Systems MUD Wind Zone I, 15 PSF Wind Load Seismic 4 By Tie Down Engineering REQUIREMENTS • These plans and specifications meet the requirements of Title 25 Section 1336.3 Sub Section A and 97 UBC Seismic Requirements, CBC 2001 addition. • Maximum vertical projection at sidewall is 9'. Higher walls may be used when the design loads are adjusted accordingly and approved by HUD. • Main rail spacing must be 75.5" - 99.5" * Except single sections 95" minimum • Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, and rim plates. The longitudinal component of the Xi2 system replaces end frame ties. Check manufacturers' set-up requirements. • Maximum pier height is 48" pier. *Except for single sections 36". • Steel piers must be fastened to the I-beam with clamps provided with steel pier. • Systems must be placed as evenly as possible, no more than 10' from end of home. • Designed for 7:12 roof slope. *Except single sections, (20° - 4.37 in. 12" pitch). Additional Requirements for Concrete Systems • Poured concrete must be 2,500 PSI minimum at 28 days. • Square concrete pads minimum is 18" wide by 12" deep. Round concrete pads minimum is 18" wide by 14" deep. Strip footings minimum is 18" wide by 14' long by 6" deep. ®� �, * Xi2 components exceed HUD code 3280.306g "Anchoring equipment exposed to weatheringsha11 hav��a�� `7 resistance to weather deterioration at least equivalent to that provided by a coating of zinc on steel of not less than 0.30 ounces per square foot of surface coating...." Page 2 of 8 0 Li o ' O 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Installation of Xi2 Ground Systems Identify the number of systems to be used on the home using the chart provided. Identify the location where the systems will be installed. Clear all organic matter and debris from the pad site. Place U -bolts through holes in pan provided. Place pad centered under beam with the lateral strut bracket towards the inside of the home. Press or drive pan into ground until level and flush with prepared surface. Build pier according to State, Local or Home Manufacturers guidelines. (Figure 1) Attach the end of the smaller tube to the inside of pan using U -bolt & nuts provided Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 2) Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together. (Figure 1) rnd °f Name Install frame bracket clamps to I-beam on in side of block/pier. Do not tighten nuts at this time. Attach longitudinal strut to U -bolt in pan using nuts provided. Insert strut in the frame bracket clamp, attach with nut and bolt. Do not tighten at this time. Pull the frame bracket clamp with the fastened strut outward to remove any slack. Tighten all nuts and bolts on the struts and beam clamps. aim> 677'7 '�; 11Y--2.. r�E 'DO ENGINEERING XiP_ Ground Parts Detail Xi2 Ground Lateral System Part Number 59306 Includes: 5' Strut, pad & hardware kit (#59329-1 includes all nuts and bolts). Longitudinal Hardware Kit Part Number 59331 Includes: 2 I-beam brackets & 2 U -bolts with all nuts and bolts. Lateral and Longitudinal Combination Part Number 59333 Includes: 5' Strut, Pad, Longitudinal Strut (#59329), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Struts for Longitudinal Systems Part Strut Pier Height No. Length Up To: 59330-44 44" 4 Blocks or 32" 59330-65 65" 6 Blocks or 48" Ground Longitudinal Hardware Kit Xi2 Ground Longitudinal Strut & Hardware Kit Ground Longitudinal Strut Xi2 Stabilization Pier Placement for Ground or Concrete Single Section Home 0 -80' (76' Box) 4 Xi2 Systems L. Xi2 Pier Placement Double Section Home 0 -62' 3 Xi2 Systems' 63' - 80' 4 Xi2 Systems •2 Xi2 systems can be placed at either end of the home. Triple Section Home 0 -62' 4 Xi2 Systems 63' - 80' 5 Xi2 Systems &.1S., 1 2 Page 4 of 8 1. 2. 3. 4. 5. 6. 7. 8. 9. 10 11 Installation of Xi2 Concrete Systems Identify the number of systems to be used on the home using the chart provided. Identify the location where the systems will be installed. Build pier according to State, Local or Home Manufacturers guidelines. Drill two 3/8"x 3" deep holes in the concrete using holes in galvanized bracket as a guide. Attach bracket to concrete pad using 3/8"x3-1/2" wedge anchors provided. Place. nut & washer on anchor, leave enough room for 1 to 2 threads showing on top of bolt. Using a hammer, tap the wedge bolts into hole through bracket, leaving nut & washer flush with bracket. Using a 9/16" socket wrench, tighten wedge/anchor bolt, securing bracket to the concrete. Attach the end of the smaller tube to the bracket mounted on the pad, using the grade 5,1/2" x 2-1/2" bolt/nut provided. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 1 next page) Install a minimum of four'(#12 x 1" tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together Install frame bracket clamps on I-beam on the inside of block/pier. Insert strut in frame bracket clamp and attach with nut & bolt. Attach opposite en�te brack t. Pull the frame bracket clamp with fastened strut outward to remove any slac . /� Tighten all nuts and bolts on system.:;= -1 z Page 5 of 8 riE DOWN ENGINEERING -' 0 0 0 0 O r y Install frame bracket clamps on I-beam on the inside of block/pier. Insert strut in frame bracket clamp and attach with nut & bolt. Attach opposite en�te brack t. Pull the frame bracket clamp with fastened strut outward to remove any slac . /� Tighten all nuts and bolts on system.:;= -1 z Page 5 of 8 riE DOWN ENGINEERING -' 0 0 0 0 O Xi2 Lateral Concrete Systems Part #59307 Includes: 5' Strut, Bracket, & Hardware Kit #59315-1 with all nuts and bolt. Longitudinal Struts for "Concrete Systems" Part No. Length Pier Height #59013 44" up to 4 Blocks #59015 65" up to 6 Blocks Longitudinal Hardware Kit Part#59263 (Includes 2 sets per kit: I-beam bracket, nuts, bolts and washers) Lateral and Longitudinal Combination Part#59332 Includes: 5' Strut, Longitudinal Strut (#59364), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Figure 1 Li Nut & Washer iM Beam Clamp Bracket Lateral r Longitudinal # <�� j 1 -Beam 1 � � Xi2 Installation Placement Knee Longitudinal Strut Concrete Longitudinal Hardware Kit of Nome En Page 6 of 8 CTIE DOWN ENGINEERING • 5901 Wheaton Drive • Atlanta GA, 30336: FIE www.tiedown.com • (404) 344.0000 • FAX (404) 349-0401 ;' DOWN' _._........ _.......... ' ENGINEERING Longitudinal Strut Concrete Longitudinal Hardware Kit of Nome En Page 6 of 8 CTIE DOWN ENGINEERING • 5901 Wheaton Drive • Atlanta GA, 30336: FIE www.tiedown.com • (404) 344.0000 • FAX (404) 349-0401 ;' DOWN' _._........ _.......... ' ENGINEERING Offset Placement Diagrams represent examples of double and triple section offsets. Total size is determined by the length of unit plus offset. Xi2 Stabilization Pier Placement for Ground or Concrete a i 9 t s Single Section Home 0 -80' (76' Box) 4 Xi2 Systems Xi2 Pier Placement Double Section Home 0 -62' 3 Xi2 Systems* 63' - 80' 4 Xi2 Systems `2 Xi2 systems can be placed at either end of the home. Triple Section Home 0 -62' 4 Xi2 Systems 63' - 80' 5 Xi2 Systems ag TIE DOWN' ENGINEERING Hardware Breakdown #59329-1 Hardware for 59306 Lateral System 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread Beam Clamp Base 1-3/4 zinc 4 10556 Tek Screw #12 x 1 " 1 10631Z J Bolt 1/2 x 5-1/2 grade 5 zinc 2 10640 Push Nut 1/2 1 12107 Flat Washer 1x2" SS 1 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10519 Hex Nut 1/2" w/ Serr flange #59331 Longitudinal Hardware for 59306 2. 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-12 x 1-1/4 Carriage Bolt 1/2-12 x 1-1/4 4 10801 Full Thread 10 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10801 Carriage Bolt 1/2-12 x 2-1/2 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread Grade 5 2 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread 2 10519 Hex Nut 1/2" w/Serr Flange 1-3/4 zinc 4 10640 Push Nut 1/2 4 10519 Hex Nut 1/2" w/ Serr flange # 59329 Hardware for 59333 Lateral and Longitudinal combination 1 59329-1 Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-12 x 1-1/4 4 10801 full thread 5 10646Y Hex Nut 1/2-13 Grade 5 zinc 1 10801 Carriage Bolt 1/2-12 x 2-1/2 2 10801 Grade 5 zinc 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread 6 10646Y 1-3/4 zinc 2 10640 Push Nut 1/2 2 10519 Hex Nut 1/2" w/Serr Flange #59315-1 Hardware for Lateral System 1 10631Z J Bolt 1/2 x 5-1/2 Grade 5 zinc 1 12107 Flat Washer 1/2" SS 4 10556 Tek Screw #12 x 1 " 2 10646Y Hex Nut 1/2x-13 Grade 5 zinc 1 10826 Carriage Bolt 1/2-12 x 3 4 10801 Grade 5 zinc #59027 Hardware Kit for 59307 Lateral System 2 59264 3 Way Concrete Bracket 4 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Hardware Kit #59263 Longitudinal Hardware for 59307 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-13 x 1-1/4 1 59315-1 Full Thread zinc 12 10646Y Hex Nut 1/2-13 Grade 5 zinc 4 10801 Carriage Bolt 1/2-13 x 2-1/2 4 10926 Grade 5 zinc #59364 Hardware for 59332 Lateral and Longitudinal combination 1 59264 3 Way Concrete Bracket 2 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Lateral Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-13 x 1-1/4 Full Thread zinc 2 10801 Carriage Bolt 1/2-13 x 2-1/2 Grade 5 zinc 6 10646Y Hex Nut 1/2-13 Grade 5 zinc flUal'*> A-t�l. Page 8 of 8 T/E; DOWN ENGINEERING '% 0 LO s 0 03.22/,u; 1G 24 F, BIDWELL TITLE 2003 •- � �- ,�:IIli��lEl1�!!l�I�l�II�IEIEItIli�l Pecerding Requested by: ) Recorded 1 REC FEE 19.00 -- _.,ueuzieeit.lrikoan.��-_._- � � —.---()•f-#-iiia-I-Records 1•-----.....------ - ----- Atturaey at Law ) County OfBUTTE 6393 Skyway, Suittz, s I O�Recorder- Paradise, CA 9594.0 ) t When Recorded, Mai! ;c,, arm ) FMSE DICKSON Mrail Tax Statements te: sR I Travis Virginia & Edward Bro6kelsby ) 09t02AM 08 -Nov -2004 I Page I of 2 15050 Pinon Road tvfzgalia, CA. 959.54 ) -rhe underoigned Grantor(s) declare(s): A.P.N. 0155-340.056 Documeniary Transfer tax Is $ NONr-* O computed on full value of property, cr O Computed on full value less value of liens and enoumbranoes remaining at time of sale GRANT DEED FOR A'VAILUABLE. CONSIDERATION, redeipt of'Which'is hereby acknowledged. Edward F. Brockelsby, who acquired title as his sole and separate by Affidavit - Death of Joint Tenant filed as Instrument No. 2002.-0060764 on november 12, 2002, Office cf the Recorder of Butte County, State of California hereby GRANT(S) to rL Virginia V. lar ckelsby and Edward F. Brockol5by, TrustCCs of THE VIRGINIA V. AND EDWARD F. BROCKELSI3Y 2004 1 f-RUSTXfor the bcnefit of Virginia V_ Bro.-ke)sby and Edward F. Brocicr,Isby, and their issue under instrument dated Noverr]b.:r 2, 2004, community prop`riy. The real p:,; -perry in the County of Burm, State of California, described as: SEE ATTACHED EXHIBYr "A" FOR LEGAL DESCRIPTION This convoja:-]ce is to a revocable trust created by the &-rentor and does not eonstitute a change of ownership and is not 5abject to reassessment pursuant to Revenue and Taxation Code § 62. * This conveyance is to a trust (THE VIRGINIA V. AND EDWARD F. BROCKELSBY 2004 TRUST, Virginia V. Srockelsbyanvi Edward F. Brockelsby, Trustees and Grantors) which is not pursuant to a sale and is exetnpt from documentary _ransfer ,rIx. Sca:e ofCalifzt 'a ) Gated: County ofd>rT } Signature of Grantor(s) before nie, Notary Public, personalty appeared Edward P. Brockelsby, personally EDWARD F79ROCKELSSY known to me ( :-overt tt me on the basis of satisfactory evidence) to be the person subscribed to die within instrument and acknowledged to me that he executed the same in his -authorized capacity, and that by his signature on the instmment the person, or the entity upon behalf of whizh the person acted, executed the instrument. LI,IP'M ANDIS p- EDWARDS Comm. #1202604WITNESS my han and official seal. OTAHI >;UBltc cat IFo]3N14 pBUTr!_ OOUNTY zVTTyCaam:s T Drpkos fib. FQ 2oC5 % f IMAI TAX STATJ3NIENTS TO: Per Above Page 1 of 2 V')• u I J.v: W4 1-_i A 1311AELL TITLE Legal Deseriptson 00011 Lot 124, ay sl,owl, oil that certailx snap entitled, "SIERRA DEI, ORA ESTATES UNIT NO, 211, which re-jap was recorded ir. the office of de. Recorder of the County of Butte, State of California, ork October 19, 1955 in Boole 34 of Mam, at pages 27, 28 and 29, EXCEPTING A..•-iD IRESERVING THEREFROM, all of the valuable ndr_erals beneath t:,Ie surface of the said land, with the 69-11t to rn;i ,e, ,tpd extract said minerals, it being agreed and understood that irl all acini q operations, thr, y'[4.i.f'ace of said lands will be protected against damage and that all such mining shall be carried on fi'orn iunknel$, shafts or drifts having their orifices outside of the surface area of the above described really, ai l as excepted and reserved in the Deer.! frorn R'fagatia A:'ining Company, a corporation, to E. D, Stores, et uk, recorded September 4, 1947 in Book 423 of Butie County Official- Records, at page 385. Subject to; Co ,--nants, conditions, restrictions, reservations, rights, rights of way, and easements of record. Page 2 oft 03/';.12/07 10:23 _':�.X BIDIt'ELL TITLE Z002STATE OF CALIFORNIA - 5',eslNES5, TRANSPOi2rATiON AND HOU51NO AOENCV AFtYC .0 SCHWARZENEGGER, Gover PA}<TMENT CIF `r1OUSING AND COMMUNITY DEVEWPME NT �ysfivc y Division of Codes anc Seur,6<.-rds �, o Title Search 3�0�� J Date Printcd : 03/19/2007 Decal : AB'] 1846 Use Code: SFD Ma.nufkru dr: Original Price Code: AFB Tradc,name: SHC-RWOOD rating Year: 1976 Model: Tax Type- ILT i'rIasutfacturPci rsa[r.: 00/0011977 Last ILT Amounr. 321.00 Regisiratian Exp: , ;/;0/,OU, Date ILT Fee Paid: 10/13/2006 First Sold On: ;1/11,1 X16 ILT Exemption.- .-TONE Seria: 'Nun bar WS 1529E WS 1539A Record Conditions: Registered Cwrer: HC.:1"D Label / frisi4=r UrJmown Unknown PPF ExcrnDt Length Width 60' 11), 60' 12' EDWARD FORREST BR0CXEL5BY 15050 PIIJON RD MAGALIA, CA 95954-9122 Last Title Date: Last keg Card: Sale/Trausfer Info: Situs Address. - Legal Owner: 03/22/20044 10/1712006 Price 5.00 Transfcrrcd on 02i27/2004 14798-HOLMWOOD DR MA.GALIA, CA 95954-9346 Situs Counr7; BUTTE DO, ROTFY CLARK BROCKELSBY C-10 EGu1ARD FOR.REST B_KOCKELS$Y 15050 P1N01'Z RD ;WAC" TA, CA 95954-9122 Lasr'fiile Date: 0 +122;2004 Lien Te!iected On: 03/121;2004 16:32:51 Inactive. 0eca;!J\41V: I3�?V NA6649, DjMV NA96:i0 Title Searches: E IDt1� � Ll. 'tp.L h 145 PEARSO`r RU PARADISE, CA 95969 'f We Pile No- 330151 JF "*" END OF TITLE SEARCH **°` RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 3 -Apr --2007 2007-0016198 Has not been compared with original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. BROCKELSBY, VIRGINIA V & EDWARD BUTTE COUNTY BUILDING DIVISION REAL PROPERTY OWNER/LESSOR LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 15050 PINON RD 7 COUNTY CENTER DRIVE MAILING ADDRESS MAILING ADDRESS MAGALIA BUTTE CA 95954 OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP CITY COUNTY STATE ZIP 14798 HOLMWOOD DR B07-0616 (530) 538-7541 INSTALLATION MAILING ADDRESS, IF DIFFERENT BUILDING PERMIT NO. TELEPHONE NUMBER MAGALIA BUTTE CA 95954-, k/' q 1 -2 -) CITY COUNTY STATE ZIP SIGNATURE OF (L CAL AGENCY OFFICIAL DATE SAME NONE UNIT OWNER (if also property owner, write "SAME" DEALER NAME (if not a dealer, write "NONE") SAME NONE MAILING ADDRESS DEALER LICENSE NO. SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION UNKNOWN 1976 SHERWOOD MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER WS 1529A/B 60' X 24' UNKNOWN SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION: ASSESSOR'S PARCEL NUMBER: 065-340-056 SEE ATTACHED HCD FORM 433(A) REV o/91 Legal DesariptimYi Lot .124, as ox: that Certain znan entitled, "SIERRA DEL, URA ESTATES UNIT NO, 2", which map was recorded r; he office of de. Recorder of the County of Butte, State of California, ork October 19, 1955 in Book 34 of �iis a. at pages 27,28 and 29. EXCEPTING A^VT.D .RFSER-'INCi- THEREPROM, all of tine valuable winerals beneath the surface of the said land,with the rs l?t to arail;y, aiId :tract said minerals, it being agreed and understood thatiA all a -i r,g operations, the surface of s;dd lands wil': be protected against dEiniage and that all such n3irdrxg shall be carfi,:d on horn .�; Anels, shafts or drifts having their Orifices outside of the surface area of t -he above described ri;asfy., tit as e xccpt-ld and reserved in the Deed from Magalia -k:h2ing Com,,)ary, a corpum6oli, to E. D. Stores, et tr:Y, re-cordej September 4, 1947 in Book 423 of Butie County Official Rewrds, at page 385. Subject for Co i-marits, copdat:otis, rest-zotiom, reservations, rights, rights of way, and emmerits of record. pago 2 -,)f2 SIERSRE MOBILE A ERVICE RA ION LIC NO 470386 466 CIRCLE DR 530-534-0599 OROVILLE, CA 95966 PAY - co AMOUNT OF DATE TO THE ORDER OF US BANK EXPLANATION AMOUNT 90-2267/1211 3827 19868 Hl 6B Secu�lry I. I.- DOLLARS °;. MEDICARE CHECK GROSS INC. TAX SOC. SEC. ST. TAX TAX DESCRIPTION ------- AUTHORIZED SIGNATURE 112019868ii' t:1211226761: IS 3401WED 3925'in ;�*s +�'LF;4ist yr 'x%I aS'h 'a �'1 .7' frt ykv. 'i ..�.r e'`.l v:F �A 47�� }XYZ - �.�i�y+ ♦y h Yet �.S,�:���� X' r� 3 %.... �f jl!$i" L..:t^s .`F-� YY} 6 k yy. k�� Ail �'1 H �t y-fytT" �` :X•5 �'�,�,PF�B t� Yl , 1 �.. x �AIJ UNDATION SYSTEM f�� t�~' `� 2 ' e l _ z .t i �" A4.anlelAz �YG.XRk1,�Arw"i, r,Y M„ _ � ���#^Wt1`���j*w fiERFICA�T�EOF��t�OC �T�I l_k r 5 rs' =,,.^fs,�� .a�•.=- yrs , ..-.v��oc°� 4a.- 'u7fa�..,. :Ab , ' .� tS<wsia :::,,Y �a. aCa >Kr,�r<.�,sZu;;�::�4w,s ..:... _snt. { .s BUILDING PERMIT NUMBER: B07-0616 Address or location of unit: 14798 HOLMWOOD DR MAGALIA CA Legal Description of Real Property: 065-340-056 SEE ATTACHED (g) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: BROCKELSBY, VIRGINIA V & EDWARD Owner's address: 15050 PINON RD MAGALIA CA 95954 INSIGNIA OR HUD NUMBER:UNKNOWN SERIAL NUMBER OR V.I.N.: WS1529A/B MANUFACTURER'S NAME: UNKNOWN YEAR: 1976 OFFICIAL APPROVING INSTALLATION: Tfiattk DATE: q J-2— 10-7 4 PHONE: (530) 538-7541 H.C.D. 513 FOUNDATION SYSTEM CERTIFICATE OF OCCUPANCY BUILDING PERMIT NUMBER: B07-0616 Address or location of unit: 14798 HOLMWOOD DR MAGALIA CA Legal Description of Real Property: 065-340-056 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: BROCKELSBY, VIRGINIA V & EDWARD Owner's address: 15050 PINON RD MAGALIA CA 95954 INSIGNIA OR HUD NUMBER:UNKNOWN SERIAL NUMBER OR V.I.N.: WS1529A/B MANUFACTURER'S NAME: UNKNOWN YEAR: 1976 OFFICIAL APPROVING INSTALLATION: ]TaA�k � DATE: I� 10-7 PHONE: (530) 538-7541 H.C.D. 513 -,- rfi PERMIT NO. • 2200-77B PERMIT EXPIRES OWNER Ed Brockelsby CONTR. owner LOCATION (A.P. 65-34=56 32 Holmwood Dr.,magalia k� Temp. Power Pole Called PG&E Temp. Elea, Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (� (Date) (Signature) �✓�' COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RIECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. s Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa l l Garage Vents Insulation Water Htr. Heaters Slab Carport Footings handicar pehysically Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final 1W Sanitation Patio FIREPL CE Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY (JF BUTTE — DEPARTMENT OF PUBLIC WORKS + 7 -County Center Drive — t)roville,'California 95965 oO� Telephone: 534-4541 APPLICATION AND PERMIT a/ BUILDING $ Owner � O �' l� � C. S' SO. FT. OCC. BUILDING VALUATION Mailing Address 3� 04- m W ®d Q t,16 , Tel hone No. " f% Fireplace Contractor eLxjrq Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone Na. Permit Fee $ —7— Building Address 3 2 pLWI et!®®/f/C, PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 L ` Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.(a� — -3 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe W!. Sa FireDept. Fire Zone Use Permit Building sewer 5.00 EOA Parking Plans Parcel Declaration Parcel Ma p 60' R/W Im rovements p Lawn sprinkler system 2.00 Bldg. clans Recd I Parcel Ap r Plan pproval Permit Fee $ NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 V OR L Main service 1000 AMP ORSLESS 5.00 Main service EA. ADD'L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 00 AMP OR LESS 25.00 Main service EA. ADD•L too AMP 1.00 �� NEW CONST. DWELLING CCUP. OR ACDNS. ( LINO& ACC. LN GO 22Sq ft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS &) NON.RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) BAL@�t FIXED APPLNS. OR Ex. Occup. (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ $ 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 J$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. �r X ate Signature o Permitee or Agent Receipt No. I (I L?G White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant 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 By`/��� Datey Building permit expires Date — 7� W' t PERMIT NO. 3184-79B PERMIT EXPIRES• OWNER E. F. Brockelsby D & E. Const., Paradise CONTR. 65-34-56 LOCATION (A.P. ) -32 Holmwood Dr., Magalia P t t a u Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E joB q- 7% FINALED (Date) (Signature) .t_ COUNTY OF BUTTE — DEPARTMENT OF; PUBLIC WORKS BUILDING INSPECTION RECORD - ILDING BUILDING (Cont'd) Setback�'� Forms Main Bldg. Footings Stemwal I Slab Piers Garage Footin s Stemwa I I Slab Carport Footings Slab Patio Footin Masonry Walls Reinf. Steel - Bond Beam Framino %— '7 Firewall Soil Piping Parapets 1st Floor Restroom Finish 2nd Floor Windows 3rd Floor Siding To out Roof Sheathing — — f Water Piping Roofing -- `— 4a Sewer Fdn. Vents Fixtures Garage Vents Insulation Water Htr. Heaters Prov. for phy handicaooedsically, Appliances nce of ex. FIREPLACE FI Gas Piping & Test Temp. Gas Sanitation Final EL ING L btucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heallno Service Brown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) I 41 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, .-...-:.Orovi�,le, Cali''fornia 95965 Telephone: 534-4541 APPLICATION AND PERMIT 11 BUILDING OwnerG ^�S _ SQ. FT. OCC. BUILDING VALUATION q — Mailing Address Telephone No. Contractor Mai I i ng Address Fireplace Total Valuation T ephone N Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 _ Each TraD 1.50 Repair drainage or vent piping 1.50 A. P. No. (p �� �' �J� /"11'oning & Planning Water piping 1.50 Each gas water heater or vent 1.50 es a on Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvem nts Each additional outlet .30 Building sewer 5.00 B I d one Recd Parcel Approval PIApproval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 800V OR LESS100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER eoo25.00 V AMP ORv LESS Main service EA. ADD•L 100 AMP 1.00 NEW CONST, OR ADDNS. ( DWEACC L BLOGS.LING 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 style of: r1 /- C�, �Ltro !✓.f�� ��l/S� NEW CONSTR. MULTI.OUTL T NON•RESID ( BRANCH CIRCUITS 12.50ea. NEWCONSTR. POWER APPARATUS 8 NON -RESID. (SINGLE OUTLET CIR. Ex. QCCUD(OUTLETS OR FIXTIIRES g L@; Ex. Occup.(FIXED APPLNS. OR OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 � License No. r / Classification •l Misc. Wiring 6.25 ❑ I 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 relatino to building construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ �� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. � 0 X �cr 4 0 _Drt.' Date Signature of Permitee or Agent Receipt No. O!YO%/ 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. DIRECTO"F PUBLIC WORKS By Date 71f— Building fBuilding permit expires Date CPO PERMIT NO. 1822-77B } ., .. PERMIT EXPIRES OWNER Ed Brockelsby CONTR. Panorama Mile Home Serv., Chico LOCATION (A.P. 65-34-56 32 Holmwood Dr., 00#2, Magalia 1 Temp. Power Pole Called PG&E Temp. Elea Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date) (Signature) Bond Beam COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS ' BUILDING INSPECTION RECORD Motors BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd -Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures, Footings Stemwall Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping 8 Test Temp. Gas Slab Final Sanitation Patio FIREPIWCE Final Footings Footing ELECTRICAL Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heatinq Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping MS201LEH2ME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) 6OUN!4Y-0F" BUTTE - DEPART'; NT,OF PUBLIC WORKS �^ v 7 County Center Drive — Orovi Ile, Cal�fbrnia 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above -me tioned propeVy for inspection purposes. % X I I LVX,44 Date ` $ignot re o Permitee or Agent Receipt No. White-D.P.W. — Yellow-Asse so — ink -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-PPUBLIC WORKS By Date 7 26— Z7 ilding permit expires Date BUILDING Owner ZJ SQ. FT, OCC. BUILDING VALUATION 0 3 io.o� Mailing Address Telephone No. Fireplace p Contractor Total Valuation Mailing Address L Permit Fee Plan Checking Fee &/or Penalty Telephone No. 3 _ o � Permit Fee $ �j,o 0 oa Building Address � PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 W---+ Each Trap 1.50 c 2— Repair drainage or vent piping 1.50 Water piping 1,50 a Each gas water heater or vent 1.50 A. P. No.t Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Feed �,,�� W.C. Sa 1 on Fire Dept. FireZone Use Permit Building sewer 5.00 EQA I Parking ParcelParcel Plans Declaration Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans ec'd L rP rc pproval s Approval Permit Fee $ $ NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 100V DR LESS 5.00 100 AMP OR LESS Main service EA. ADO'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ® Others ❑ Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 �(qn. NEW CONST. DWELLING OCCUP. & OR ADONS. ( ACC. BLDGS. 20Sgft NEW CONSTR. MULTI.OUTLET NON-RESID. (BRANCH CIRCUITS)2.50ea NEW CONSTR. POWER APPARATUS &) NON-RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name s styl of:� - " _S�� Ex. Occup(OUTLETS OR FIXTURES) BAL@1¢ FIXED APPLNS, OR Ex. Occup. ( 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 $ $ 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 TOTAL PERMIT FEE $ dC authorize representatives of the County of Butte to enter upon the above -me tioned propeVy for inspection purposes. % X I I LVX,44 Date ` $ignot re o Permitee or Agent Receipt No. White-D.P.W. — Yellow-Asse so — ink -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-PPUBLIC WORKS By Date 7 26— Z7 ilding permit expires Date PERMIT NO. 192+-77B i PERMIT EXPIRES `OWNER Ed.Brockelsby CONTR. owner LOCATION (A.P, 65-34-w56 32 Holmewood Dr., Magalia Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB 'Z I/ / FINALED (Date) . (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Main Bldg. Parapets Restroom Finish list Floor 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping t�. ,,Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwal I Garage Vents Insulation Water Htr. Heaters S'l,ab Carport Footings Prov. for physically handica ed Conformance of ex. structure n. Appliances Gas Piping &Test Temp. Gas Slab Final 11 —2—L Sanitation Patio FIRE LACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h Relnf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service I Brown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOMEINSTALLATION--------------Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS j (NOTE: An entry must be made on this form each time you visit the job site.) I COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS y ? 7 Couhty Center Drive — Orovi lie, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT 1(041 /. c�/ 7 0 BUILDING Owner i VD SQ. FT. OCC. BUILDING VALUATION dim ,a Mailing Address � Telephone Fireplace Contractor ® Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 a Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. S Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W. Sa ( Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA I Parking Plans Parcel Declaration Parcel Ma p 60' R/W Improvements p Lawn sprinkler system 2.00 Bldg. Plan ec'd arcel Approval Ii Plans pproval Permit Fee $ $ NEW ® ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 5.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Main service OVER e00V 25.00 100 AMP OR LESS Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD•L 100 AMP 1.00 ,�pp _ (-i NEW OR ADDNST ( ACCLBLDGS.LING CCUP. &\ 20sq ft I NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS 2.50ea NEW CONSTPOWER APPARATUS &) NON.RESI R. D. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. OCCUp(OUTLETS OR FIXTURES) BAL 21 N 09 FIXED APPLS. OR Ex. Occup.(OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 icense No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. LaiMECHANICAL Permit Fee $ $ 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 .0 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 E2.00 Hood 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 relatino to building construction, and hereby TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X ate 7 Signature of Permiteeeor Agent Receipt No. 7 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 PUBLIC WORKS By Date ' -w ZS — 7 Buffding permit expires Date If -7-9_7 COUNTY OF BUTTE' DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLS, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number -- for the following location: Owner Owner's Address Mobilehome Mfg. Model Year Insignia No. �� �� ����> g Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date L By r THIS CERTIFICATE IS VOID WHEN-'MOBILEHOME IS RELOCATED a. Electrical A Is service large ellmigh to provide adcqu;ir_e amperage to mobilehome (must eclyal rating of mobilehome caitit aariiiu :um f 100 amp) and other facilities' oris lot, i.e. , water pumps, g..trat,e,caJ.1Ti3, etc Yes No B Is ther--� proper clearances around panels? Yesl No_ s power supply cord or feeder assembly, properly fused? Yes No_ Is continuity test satisfactory as per the following procedure? Yes No 1. De -energize electrical wiring system of the mobilehome at the ped st 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, havc� been disconnected, 3'. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one le—. -id of a test instrument to the mobilehome grounding conductor and app.L the oiiie lead to each riiUu lciioifte Supply culiiiucto'r, in%:luding neUi.Ycli. 1 5. All nor. -current, carrying metal parts of the mobilehome (aluminum siding, gas line.;.' -eater line), including- fixtures and appliances, shall be tested for continuity from—.'; such equipment and the grounding conductor. t 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 tes>t shall then be rade between the grounding electrode and the chassis of the riobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equi.ptnent may be approved for energizing. is job card signed by health Departit for water and sanitation? 11. Ii everything ol:ay, sign off card and) t.a; services. 'MOBILi:� .ME DATA Marnafacturer and/or Namestyle Length ( y - Width 2 . Vehicle Serial No. I S57q (0 C)q` State Identification No. ..dit;Ltional Information or Continents: 'MOBTi•"E.110lE INSTALLATION INSPECTION CHECK LIST 1. Is the.. mobilehbmt 'locmted wi."_h required separation from lot lines and buildings and generall.y conform to plot plan? Yes No 2• Doc'S the mabil.ehome have required clearances above ground? (Sec.5085)Y'" IL No 3. Are foot.in-,s and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes_ 4. Is the mobilehome level.? (Sec. 5088) Ycss�[No- 5. If m r than a' single unit, are crossover connections properly installed? (Sec. 5088) Yes_ E�'o . 5; Water A. Is fIe 31,le connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes •f " B. Test - Does water piping withstand working pressure or 50 lbs, air test? Yes o C. Backflow - If coa s not State of California approved, does station have backflow device and pressure-relie 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 �;" per foot slope and is it properly supported? Yes No 7� (:. Are any leaks detected in drainage system after running 3- llons of water through each ' futureincluding w shin machine standpipe? Yes No D. I:f coach is not State f California approved, does station have required trap and vent? Yes No Gas Piping and GA. \Vents*"* Connector - ehome connected to the gas supply with an approved 3/4" minimum mobilehome tnot more than.6 t. long? Note: All piping is to be at least as large as theome gas line in t without reductions other than the mobilehome connector. o B. Test OK as per followi�procedur/e? . Yes— No 1. Open all appliance nnecto valves. 2. Shut off•appliance bu 3. Air test with manometer 6oz.-maximum 8 oz.) ca� drop. 4. Connect: gas meter to soapy water. pilot valves. 10"-14" water column, or test with slope gauge (minimum b ated in tenth pound increments. Test for 10 min. without bileh with connector, turn, on gas, test connections with C. Are all appliance vent4 properly in\talled? Yes No util.,MH 1864'-76P,E 1. PERMIT NO. r PERMIT EXPIRES, lz OWNER Edward F. Rrockelch ' CONTR..-,' owner LOCATION (A.P. 65-34-56 ) 32 Holmwood Dr., Magalia , A v l . Temp. Power Pole Called PG&E _ Temp. Elec. Calle G&E all /Temp. Serv. PG&E (Date) (Sign ure) /i Slab Prov, for ph yrally Appliances handica ecc!! Carport Conformanc of ex. Gas Piping & Test G Footings structure Temp. Gas Slab Final Sanitation Patio v FIREPLACE Final — x"7 L Footings A Footing ELECTRICAL -Masonry Walls Throat Rou h — / > > "7 e, Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling - Temp. Pole Finish Ducts Underground -- Interior gath Ventilation Permanent Door 91roser Final Final �� t DATE REMARKS OR CORRECTIONS i 2 2- tSf o/A Alt) 10 �Jf"-Cit-' ,c p p L y 4' NQ%`v A L S© we C A a/ Gfl..4racarrry7, �sd>, (NOTE: An entry must be made on this .form each time you vislt the job site.) f"0 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback "le —T 6 Firewall Soil Piping�---- F&Vns Phrapets 1st Floor M In Bldg. Reshloom Finish 2nd Floor -i otin s Windo 3rd Floor Ste wall Sidin To out Slab Roof Sheathiwa Water PI in Piers Roofing Sewer ;7— /' Garage Fdn. Vents Fixtures - Footin s Garage Vents Water Htr. -�— StemwaII Insulation Heaters ---- Slab Prov, for ph yrally Appliances handica ecc!! Carport Conformanc of ex. Gas Piping & Test G Footings structure Temp. Gas Slab Final Sanitation Patio v FIREPLACE Final — x"7 L Footings A Footing ELECTRICAL -Masonry Walls Throat Rou h — / > > "7 e, Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling - Temp. Pole Finish Ducts Underground -- Interior gath Ventilation Permanent Door 91roser Final Final �� t DATE REMARKS OR CORRECTIONS i 2 2- tSf o/A Alt) 10 �Jf"-Cit-' ,c p p L y 4' NQ%`v A L S© we C A a/ Gfl..4racarrry7, �sd>, (NOTE: An entry must be made on this .form each time you vislt the job site.) Raw 4. a -• COUNTY OF BUTTE - D -E- ARTMENT OF PUBLIC WORKS • � 7 County Center Drive - Uroville,, California 95965 57,5.2 —7(oTelephone: 534-4541 APPLICATION AND PERMIT A a BUILDING toe Owner `_dam Aid ro�� ESR i5,du-) FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor SC -4 77' A4 6r Lm A/ovtk 5j. -vice. Total Valuation Mailing Address aV_ 142to S Permit Fee Plan Checking Fee&/or Penalty G� C O Telephone No. Permit Fee Building Address 3PLUMBING /�D tit WOO G; ^r No.1 @ I FEE PERMIT FILING FEE J$3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No.y J 3 `f — S Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parkin PlansBldg. D Parra ion Parcel Map 60' R/W Improve ents Lawn sprinkler system 2.00 Plans Recd Parcel A royal PI Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 /✓$ % LL -91`7_40 p r Q .IvrT ¢( Main service 100 AMP ORSLESS 5.00 Main service EA. ADD'L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service100 VEAMP oR LESS 25.00 Main service EA, ADD'L too AMP 1.00 NEW CONST. OR ADDNS. ( ACCLBLDGS.LING 0 CCUP. &) 2¢sgft NEW CONSTR. MULTI -OUTLET NON -REST D, BRANCH CIRCUITS) 2.50ea NEWCONSTR. (POWER APPARATUS & NON .RESID, SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of:Ex. EAA6 SC 6",x 6",x SFRU%CF Ex. Occup(OUTLETS OR FIXTURES)@@aC BAL@/ OCCU FIXED APPLNS. OR Occup. (RESID.) EA) 2:00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. I 3_23 t,� Classification C �Co Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No.1 @ FEE PERMIT FILING FEE J$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 authorize representatives of the County of Butte to enter upon the .ti,,,,e_. ...: -A ,f/ ZI-ii%10 ✓ 3U r 19 TOTAL PERMIT FEE $ az This permit is hereby issued under the applicable provisions of X Date ld-� Signature of Permitee or Agent Receipt No. kS 3 97 -�. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant ine tSutte county coae and/Or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date Ca- ? ► - a5- Buf(d ing permit expires Date l' - zT_ i BUTTE COUNTY DEPARTMENT OF PUBLIC -WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: S R O e X k Z .4 3� 2. Installer's name: C Z n/C 5 C .,� l -r I- .4" L { A P U. 3. Is the site currently'under permit? Yes / ✓/ 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 clear of all setbacks and easements? Yes /rte/ No ( If no, clarify 5. What is the mobilehome electrical rating? ----------- Y:�----------- j so Amps 3140 -- �� (7 6. What is the mobilehome site service rating?--------A�� t --w ,� Amps 7. What is the mobilehome site circuit breaker ratin ?------------- -- Amps' '8. Is there any other electric load to be served by the mobilehome site service? ------------------------------------------ t:-�-------- Yes /. / No 7_77. (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- (in.) 10. What is the type of gas service? ----------------------------- Natural /t/ • LPG 11. What is the gas pipe length from meter or tank to the mobilehome? to (ft.) 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This informatioiisnotlrequired if pipe length less than 6 ft. on natural gas or less than 50 -ft. on LPG.) �+ C4lf4�,;i�..;% �Ca x f MOBILEHOME SUPPORT.DATA + Mob ilehome Mfr. V, lie I? S Setup Model No, Year Width (ft.) ft Length (� E� . E • g ( ) xpando Size ft..x ft. (Draw support details below) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation_ manual and structural setup sheets (if not on .file with the County of Butte). *If center piers are other than drawn above, draw in locations, spacing, and dimensions. Footings-(check.one) P'A . Wood either pressure treated or fdn. grade. fj 2. Concrete pad. 3. Other,:specify � �Supports (check one) /7/ 1. Concrete block 2. Concrete piers 3. Steel piers 4. 0ther,.specify Typical Support Footing Size Max. Pier Spacing Max. Overhang BUTTE C.0' BUILDING DEPA'� A p p ROV E D' COUNTY OF BUTTE - QEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Urd'vrfle, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT / • BUILDI G OwnerSQ. FT. OCC. BUILDING VALUATION Mailing Address 3 C[ A yTo -j ed COAIC0-CAr F ic- Telephone No. -73�L-/5 Fireplace yAi5P -z y dZZ Contractor Total Valuation / Mai I i ng Address W Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address �' PLUMBING No. @ FEE PERMIT FILING FEE $3.00 3.00 p CA /-I' [ ® / L Each Trap 1.50 �if/� RA ✓7��� Oro i5���a Repair drainage or vent piping 1.50 Water piping k, t50 /0. U Each gas water heater or vent 1.50 A. P. No. _ 3 _ S 6 TZ Gas piping system 1 - 5 outlets lee /0, 0 Each additional outlet .30 F W. Sa i on FireDept. FireZone Use Permit Building sewer A- _54= 10-0 EQA Parking Plans Parcel Declaration arcel Ma P 60' R/W Im provements Lawn sprinkler system 2.00 Bldg. Plans Recd % P, cel f6 App val Plans pprovol Permit Fee $ ,o®$ 33 DO NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 ,Op Main service 100 AMPOR 5.00 -- O Main service EA. ADD•L too AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service 10 OEAMP oR LESS 25.00 Main service EA. ADD'L too AMP 1.00 �I NEW CONS. DWELING OR AODNST ( ACCL BLDGS.CCUP. &) 22 sq ft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CON ST R. (POWER APPARATUS &) NON -RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) BAL@11 Ex. Occu FIXED APP LNS. OR P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities v 15.00 /boli License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ :2,,1 D $ 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. D2/certify that in the performance of the work for which this permit is issuedI 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 TOTAL PERMIT FEE $ �� �O QULIIUI14C IC)JICACIIIQIIVU3 UI LIM: LUunlY UI MUILU IV enter upon Ine above-mentioned property for inspection purposes. X e _-Z %G Signature of Permitee or Agent Receipt No. 14,5 2a 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. I DIRECTOR OAPUBLIC WORKS By CDate _` -26-21 f(ding permit expires Date Gj_74 -/7% 065-340-056' PERMIT#95-2-299 BROCKELSBY, Edward' .14798'Holmwood Dr., Magal ia. Cont; Morehouse A/C Setvic6- Gas "Piping/MH 6. j. 'r ,.exp ;w:+c'ai?;Tw, 1.,?, JT,ZT^_ 7 &`v S: COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES BUILDINGDIVfglON 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538- 41 PERMIT No. APPLICATION ANLL PERMIT ASSESSOR PARCEL NUMBER 065-34-0-056 ZONING B LDING PERMIT EDWARD BROCRIrLSBY TELEPHONE SO. F-. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 14798 11OIA'41WOOD DR., MAGALIA CA 95954 CONTRACTOR'S NAME MOREHOUSE A/C SERVICE TELEPHONE 865-9100 CONTRACTORS MAIUNG ADDRESS 905 C ST. ORLVID CA 95963 Fireplace CONONE NSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Fling Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER NONE UCENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Ener Plan Checkin Fee $ Energy g Penalty $ BUILDINGADDRESS t 14798 11OU4WOOD DR. MAGALIA PERMITFEE $ PLUMBINGPERMIT Fling Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23,00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome 5 Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ulilities M Installation ❑ Other ❑ Describe Work: _ GAS PIPING Mobile Home S G W @20.00 PERMITFEE $ 40 Contractor ELECTRICAL PERMIT Filing Fee 20:00 Main Service 0V OR -Ess ( g"-oA OR LEss ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class ♦ C z 1 Lic. No. —. 25 9q 4 OWNER -BUILDER DECLARATI N 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. SO. OR ADONS. ( 8 ACC. ) 3.SQ FT. NEW CONST. MULTI-OUTLEUTLE T NON-RESID. ( BRANCH CIRCUITS ) @7.50 POWER APPARATUS (a SINGLE OUTLET CIS. ) Ex. Occup. (OUTLET OR FD(TURES) Q +.50 BAL SO �(, QCCU FIXED APPLNS. OR p• (OUTLETS (RESID.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE _ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 01:�1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier 009 6�%=9�T%AIM 10<4t A Ifa lr(tAlr) MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy N bei die; 'SIT ZQS (The above sections neecl-not lie completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 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 com ly with those provisions. X Date 9 Signature off scant - ❑ Owner CkContractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspectiorf Fee. Is occ coNST. TYPE TOTAL FEE $ 40.00 HA2. I D. FEES IMP I FLOOD I CDF PARCEL I PD I HO ISSUE 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. f) /% 9/19/95 By Date PERMITEXPIRESON 9/19/96 (Date) Receipt No. tlOjy3 I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DI ION 7 County Center Drive - Oroyille, 6alifornia 95965 - Telephone (916) 538- 4 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 065-34-0-056 ZONING BWfLDING PERMIT OWNER EDWARD BROOK: LSBY TELEPHONE SO, FT, OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 14798 HOL14WOOD DR., DIAGALIA CA 95954 CONTRACTOR'S NAME 14OREHOUSE A/C SERVICE TELEPHONE 865-9100 CONTRACTORS 9058TH LIST DRESORLAPiD CA 95963 Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is LENDER'S MAIUNG ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Ener Plan Checking 9Y g Fee $ Penalty $ BUILDINGADDRESS 14798 :I0LI-9-100D DR. 14AGALIA PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LAT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome 0 Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities D Installation ❑ Other ❑ Describe Work: (;QS PIPING Mobile Home ISIW @20.00 PERMITFEE Contractor ELECTRICAL PERMIT Filinq Fee 1 20.00 Main Service eoeA OR LESS ( zoooR LE ss ) 23.00 Main Service ( 200A TO ,000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class —?j �S (�(�(� C LiIL No. D +– OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.SO. OR ADDNS. ( 8 ACC. BUDS. ) 3.50 FT. NEW CONST. / MULTI -OUTLET NON-RESID. \ BRANCH CIRCUITS ) 97.50 POWER APPARATUS (a SINGLE OUTLET CIS. ) EX. Occup. (OUTLET OR FIXTURES) &AL 0'.50 Ex. Occup. OUTELETs w o.oEA ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. icl have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier J MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy N ber ®(a_S UMIT `QS (rhe above sections neednowt Fecompletedif the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 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. p X Date =/ q RSignature of App icant - ❑ Owner Contractor ❑ Agen An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee Is OCC CONST. - PE TOTAL FEE $ 40.00 HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL I PD HD ISSUE, This permit is hereby issued under the of the Butte County Code and/or indicated above fWwhiches have B PERMITEXPIRESON applicable provisions Resolu ' ns to do work a paid. 9/19/95 Date 9/19/96 (Date) Receipt No. 185393 I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT PERMIT NO. 333`4(-84R,E PERMIT EXPIRES OWNER EDWARD BROKELSBY CONTR. owner ASSESSOR PARCEL 65-34-56 LOCATION 32 Holmwood Drive, Magalia -" Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E j k Temp. Gas Service - Called PG&E JOB FINALE[ Signature '. J = OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL -(Single and Duplex) �E Date UND FLOOR Plans OK except #'a Date FRAMING Continued Zoning requirements -Setbacks -Easements Property Line Firewall & Openings 2. Ftg.,_Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth Ext. Doors -One 3' -Check Garage -3rd story, 2 exits g., Garage; Soils -Steel- " Ftg. Depth Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth §). P ywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab Sidin -.ailing-Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab ucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steelazing 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test-Anchors-Regulator-Seryice Test Area -Glass Protection -Skylights -Plastic _5ear Walls; Nailing -Bolts 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 Date Card -BI Date Card -BI Date Card -BI Date Card -81 Date Card -BI Date Date FINAL -(Plans) OK except q's Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except N's 57—.Smoke Detector 14. Water Ht.; Vent- Acces "-Combustion Air 58 Furnara;a/ents=Clearance-Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & chors-Nail Protection 16. D.W.V.; Test-Fttn & Anchors -Nail Protectionoom Exiting 17. Shower Pan; Tes , First Floor -Tub Access ath Fixtures & Tub Access 18. Test Tub & Sh er, 2nd Floor -Tub Access pec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Si - e & Anchors airs & Rails --62-F etf pTcce o� Stove; Clearances-Hearth -�4rEiet Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date •65--K+tc-FIXt'-87Appliance• Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. -Stec. OunUts &'Receptacles at Kit. Counter -67--9a aP ge Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except N's lB---Azrr. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection _r. r.; encs -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection Elec. Receptacles Spacing -Lights &Switches at Doors 1 Size Boxes & No. of Conductors -Stapled 70y& Mech. Equip. Li steel for Listed for Location &21! Romex Installed Close to Edge of Studs & C.J. 1 ec. Receptacles in Garage; Romex Protec. Equip. Ground made up w./Mech. Fasteners -Bond Gas & Water _Z2_ -Foam -Looked in Attic ❑Yes •�Z3�Raafci"Rails &Deck Construction -Post Caps •--25� p lance Circuits in Kitchen &Conductor Size 26!Subfeed Wire_Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al z4,r•FCfi-VenTs & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes -47: Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI,o Insulated Neutral ❑Yes ❑No owing instld.: Drive ❑ Yes ❑ No; Walks E] Yes ❑ No; Planters Oyes ❑No ice -Riser Conductors &Ground -Main Disconnect -Te -�; grown -Finish -29:-Equip. Clearances; Panels-Motors-Mech. Equip. 7�--A- -Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 36-.-Ciothes-Closet Light -Shower Light rove Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 78 r- ell; ell;, Disconnect, Electrical, Plumbing xterior Elec. Trim; G.F.I. Receptacle -Underground Card B- Date - and -BI Date -SI—.Ventilation throughout House ass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) 0 except H's rections from Previous Inspections 84--gTII"Test_Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulati & Support ater ewer Connected -C/0 to Grade -HD Approval 32. Vent Fan; Exhaus above Insulation 89-ftt�9y Compliance Certificate -Other Certificates 33. Condensate Dra• & Overflow; Size & Grade 34. Furnace -Vent• Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Acces & Platform if Furnace in Attic Card -B ✓ Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card 61 Date Card -BI Date Comments at Final: Date F NG Plans OK except q's Sills; Proper Material & Anchors Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fir Sto s; Furred Ceilin s -Stairs -Chases -Tub Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Ing. Joist-Rftr. Ties-Purlin- Roof _Brac.-Truss-Shthng.-Rfn_g_. 44.--F4eplace Ties or Type A Flue -Fireplace Throat -49-7Ttic' cess; Size & Romex Protection -Draft Stop -Ins. Baffles mWindows or Exiting Doors -Sill Hgt. & Dimensions ge Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) = 'OM 't = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements -Setbacks -.Easements 2. Soils; Special MH Support -Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete 2. Footings; Size -Depth -Spacing -Connectors 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; LocatiorrTest-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 #'s 1. Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except #'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 5. Drain; MH Test -Fall -Flex Connector 4. Elec.; Receptacles and Lighting; Distances-GFI 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/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater B. Gas and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'-Circulaiing 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-1 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 196 Memorial Way, Chico — Phona:,891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE M1 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 "tter, or need additional explanation, please contact this office immediately. Inspector Date JCOUNTY OF BUTTE - DEPARTME T OF PUBLIC WORKS 7 County Center Drive - OroviIte; California vJ5965 - Telephone 916/534-4541 APPLICATION ANQ PERMIT �PERMIT NO. ASSESSOR PARCEL NUMBER- �. ZO G i l BUILDING PERMIT OWNER _ T>G-0,,,V V 7 tS T5LEPHONE 8>-'i �7v / SQ.FT. OCC. BUILDING VAL ATION AcG OWNER'S MAILING ADDRESS 3-:Z 1-401,11, LonoD ` A/A1;,4L /4- CONTRACTOR'S NAME - TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKN�N� Y' Total Valuation $ 35a -- Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ 3J co ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Z ,-'(2 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ (Ji '-y�- BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO.SUBDI VISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome , Other SPECIFY Building sewer 5.00 Mobile Home S G W e _O.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ OtherX Describe work: r_V� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. I 1 •� 2/20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ElI 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 CONSTR MULTI -OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS NEW CONSTR. ( POWER APPARATUS &) NON-RESID, SINGLE OUTLET CIR, 20050a Ex. Occup(o OR FIXTURES XSAL®30 FIXEDTS APP LNS, OR Ex. Occup. OUTLETS (RESID,) EA,) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor 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. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 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 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 Ii lilies, dgments, costs, and expenses which may in any way accrue aga' s y i co se en a of the granting of this permit./ X Date 1© Q. ` Signature of Applicant — Owner Contractor ❑ Agentt 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 $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST, PARCEL PD HD SSU This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY Pr IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date o-�� _ Receipt No. a2d WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT � I i