HomeMy WebLinkAbout065-350-039I
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G.
Alfred Gedney
1285 Holmwood, SDO#2, lot 108, Magalia I
1 65 -39
ALFRED GEDNEY
1285 Holmwood Dr, SDO##2, lot 108 —
Magalia A 1sud r/�g - C
Contr: Murray, Cain, Mag"alilaf 1
Permit ##1781-78E (ele ser ch),MH
ELEC -5/1 -7 L5
GAS f
COMPA T ON TEST REQ iYLO
SUPPORT STRUCTURE 'REQ' ---`
5-35-39
TContr: SOS MH Ser Pd 'N
ara lse.
Permit, #1599-78 I
>Issued. _ --------------
065-350-039 99-1325 r
ALVAS, William Jr.
14859 Holmwood Drive, Magalia
Comr: Sierra Motor Home Servicel
MH on Perm Fnd, Ex site �� YIa '141
065-350-039 99-1909 �1
TAIT, LAWRANCE SR.
14859 HOLMWOOD DRIVE, MA
CONrR: OWNER _: _ -FILE
1NSTAL`L' GAS LINE — _
rte'
A
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541✓ ERJMIT 0.
(Rev. 12/96) APPLICATION AND PERMIT �0
ASSESSOR PARCEL NUM -!1 ¢i S_ 350 _0 39
ZONING
BUILDING PERMITHO
OWNER „-
_( (^
TELEPNE
S1'
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILINGADDRESSq(R 5 Q'W '. `� I b1' � f�(• 1
CONTRACTOR'S NAME
TELEPHONE
CONTRACTORS MAIUNG ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
SUIL.DINGADDRESS
Energy Plan Checking Fee
$
G1Q2►.L l,+-
PERMIT FEE
S
LAT NO.
SUBDIVISIONS NAME JPARCEL
MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome X Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑r, Utiliitiesn ❑ Installation 0 Other d
Describe Work: (_M_:Ll l X �t.CD,�i C •IL -L
J6 U `
%J6 IAAtr -i .sem fS ?,1 _ill.) 1r,*& -�1
Gas piping system 1 - 5 outlets
{ 15.00 fj • rnj
Building sewer
15.00
Mobile Home I S I G W
@20{00
PERMIT FEE
$ 3
r
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 2o0A OR LESS
23.00
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.PSING
License Class Lic. No.
OWNER -BUILDER DECLARATION
I 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.
CJ,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
Main Service 200A TO 1000A
46.00
NEW CONST. DW EwNG OCCUP.
OR ADDNS. ( 8 ACC. eL S.
SO
3.50Fr.
NO..EOSIIDMULT
D I -OUTLET
@7,50
8 E OUfI£T CIR. OWERLAPPARATUS
Ex. Occup. ourLFT OR FIXTURES
20 @ 1•00
BAL @ .50
APPLNS
Ex. Occup. OtntE R p,OEp
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring23.00
PERMIT FEE
$
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.
❑ 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
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
Q� 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 workers'
Compensation laws of California, and agree that 4 1 should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
/�
X [� 'r ,:,.A �i� . / �#+ Date .- G'�- (/
Signature of Applicant - P Oviner ❑ Contractor ❑ Agent • '
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee I $
Energy Inspection Fee $
Occ
CONST. TVP,
TOTAL FEE $ rc)
HAZ.
D. FEES IMP
FLOOD
CDF
PARCEL
PD
HD
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.
��//� /� ' �I r Q�
By J P A t,..E.Y / 3 E�t�.t" Date
PERMIT EXPIRES ON
Date
Receipt No. A7::;41'-71
I
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
i
I
065=350-039'' '.9)-1909
TAIT, LA WRANCE SR.
14859 HOLMWOO.D DRIVE, MAGALIA
CONTR: OWNER
INSTALL GAS.LINE
4 �e
a
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"'""''�4a�`.'r'1ri�'^�vr+..�Y�'-��-r-'.'Y"1.r��'V�i+R.^-s.,-., ... _ . -��. �. _�...r '�: ,.,•.`..�;`.,�y Z. ,.":.--":.s:
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES-'
411 Main Street • Chico, CA • (530) 891-2751 -
7 County Center Drive • Oroville, CA-* (530) 538-7541
CORRECTION NOTICE
ER
:01
A routine inspection indicates that the following violations of butte county Ordinances exist at the,
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
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Date Inspector
V10 2 . -\
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COUNTY 6F ■UYTE .
4
BUILDING DIVISION
l\
DEPARTMENT OF DEVELOPMENT SERVICES
;4
- 411 Main Street -Cha$ CA -$3)891-2751
%
\� 7County C me Drive - Oroville, CA -(53)538-7541
&
CORRECTION NOTICE .
/
OWNER PERMITNO
Aroutine inspection indicates thtthe following vl&oaek» county Ordinances egk�h
above address and should wcorrected. Please notice this office when correction @ work &q
com@ed iyou have ryquestions pertaining to this matter, « need k&kpm explanation,'
pleasecontac lbao a b_d«e¥
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Date Inspector
V10 2 . -\
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NOTES
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1
)
RESIDENTIAL
065-350-039 99-1538
PERMIT NO. , ALVAS'William Jr:
14859 Holmwood Drive, Magalia
Contr: Sierra Motor Home Service
MH on Perm Fnd, Ex site
THE HCD FORM 433A FOR THIS MH CANNOT
BE RECORDED UNTIL ONE OF THE FOLLOWING,
HAVE BEEN TURNED IN TO THE BLDG DIV:
J) LICENSE PLATES) or DECALkTHE
INSPECTOR MUST RETRIEVE)
I �2) STATEMENT OF FACTS,ONLY ON
NEW MH'S)
INSPECTOR TO VERIFY SERIAL & LABEL #'S
II SPECIAL CONDITIONS 11
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
JOB FINALED (Date)
Signature
CHECKED
BY
J = OK
0 = Not OK
= Not Applicable
= Not Ready
RESIDENTIAL'(!
Date
Underfloor (Plans) OK except #'s
Hangers -Post Caps -Anchors -Connectors
1.
Zoning -Setbacks -Easements -Flood -Slope
Cling. Joist-Rttr. Ties- Purl in- Roff Brac.-Truss-Shting.-Rfng.
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
3.
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
4.
Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions ,
5.
Stemwalls, Main; Steel-Blockouts-Wrapped
Garage Fire Protection Framing
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped
Property Line Firewall & Openings
6a.
Hold Downs and Special Anchors
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
7.
Slab, Steel -Wrapped
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
8.
Piers -Fireplace Ftg.-Steel
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
9.
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
Siding -Nailing Veneer
10.
UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
11.
Water Pipe; Test -Anchors -Regulator -Service Test
Glazing Area -Glass Protection -Skylights -Plastic j
12.
Electric Underground
Shear Walls; Nailing -Bolts
13.
Plenums & Ducts; Clearance -Material -Support -Ins.
Brace Interior/Exterior Wall Panels
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
Insulation -Walls -Ceilings
15.
Access & Ventilation
I of iltration-Walls-Windows
16.
Insulation
Date
Date
Date
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
Ext. Steps -Door & Sidelight Protection -Landings
17.
Water Htr.; Vent -Access -Combustion Air Baffle
Smoke Detector
18.
Water Pipe; Test & Anchor -Nail Protection
Furnace Vents -clearance -Comb, Air-Connectoi-
In Garage; Above Floor -Ducts -Mach. Protection
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
Bedroom Exiting
20.
Shower Pan; Test, First Floor -Tub Access
G.F.I. & Bath Fixtures & Tub Access -Spa
21.
Test Tub & Shower, Second Floor -Tub Access
Elec. Trim & Subpanel, Breaker Sizes & Labels
22.
Gas Pipe; Sixe & Anchors -
Stairs & Rails
70.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
Elec. Outlets & Receptacles at Kit. Counter
23.
Fixture & Transformer Clearance -Ins. Protection
Garage Fire Door; Swing -Landing -Closure
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
A.C. Duct in Garage -Damper
25.
Size Boxes & No. of Conductors Stapled
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor -Mach. Protection
26.
Romex Installed Close to Edge of Studs & C.J.
Plb., Elec. & Mech. Equip. Listed for Location
27.
Equip. Ground made up w/Meth Fasteners -Bond Gas & Water
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
28.
2 Appliance Circuits in Kitchen & Conductor Size GFI
Insulation -Foam -Looked in Attic
29.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or At
Guard Rails & Deck Construction -Post Caps
30.
Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or At
Insulated Neutral ❑ Yes O No
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
31.
Service -Riser Conductors & Ground Main Disconnect
Clearance Looked under Floor O Yes
32.
Equip. Clearances Panels-Motors-Mech. Equip.
Following Instld./Drive ] Yes ] NoMalks O Yes Q No/Planters,:) Yes Q No
33.
Clothes Closet Light -Shower Light -Spa Light
Stucco Brown -Finish
34.
Smoke Detector
A.C. Unit Disconnect, Electrical -Plumbing
85.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
87.
MECHANICAL (Permit) OK except #'s
35.
A.C. Ducts Insulation & Support
36.
Vent Fan, Exhaust above insulation
37.
Condensate Drain & Overflow, Size & Grade
38.
Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet
39.
Attic Access & Platform if Furnace in Attic
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Date
FRAMING (Permit) OK except #'s
Card B-1 Date Card B-1
40.
Sits Proper Materials & Anchors
Card B-1 Date Card B-1
41.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
42.
Bearing Walls over Girders & Floor Nailing
43.
Draft Stop in Walls (rat proof)
44.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45.
Headers & Beams -Size & Bearing
jingle & Duplex)
Date
FRAMING (Continued)
46.
Hangers -Post Caps -Anchors -Connectors
47.
Cling. Joist-Rttr. Ties- Purl in- Roff Brac.-Truss-Shting.-Rfng.
48.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
49.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions ,
51.
Garage Fire Protection Framing
52.
Property Line Firewall & Openings
53.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
-
54.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56.
Siding -Nailing Veneer
57.
Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
58.
Glazing Area -Glass Protection -Skylights -Plastic j
59.
Shear Walls; Nailing -Bolts
60.
Brace Interior/Exterior Wall Panels
61.
Insulation -Walls -Ceilings
62.
I of iltration-Walls-Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
63.
Ext. Steps -Door & Sidelight Protection -Landings
64.
Smoke Detector
65.
Furnace Vents -clearance -Comb, Air-Connectoi-
In Garage; Above Floor -Ducts -Mach. Protection
66.
Bedroom Exiting
67.
G.F.I. & Bath Fixtures & Tub Access -Spa
68.
Elec. Trim & Subpanel, Breaker Sizes & Labels
69.
Stairs & Rails
70.
Fireplace or Stove, Clearance -Hearth
71.
Elec. Outlets at Wood'Panel, Int. & Ext.
72.
Kit. Fixt. & Appliance; Giound-Air Gap -Cooking Clearance
73.
Elec. Outlets & Receptacles at Kit. Counter
74.
Garage Fire Door; Swing -Landing -Closure
75.
A.C. Duct in Garage -Damper
76.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor -Mach. Protection
77.
Plb., Elec. & Mech. Equip. Listed for Location
78.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
79.
Insulation -Foam -Looked in Attic
80.
Guard Rails & Deck Construction -Post Caps
81.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor O Yes
82.
Following Instld./Drive ] Yes ] NoMalks O Yes Q No/Planters,:) Yes Q No
83.
Stucco Brown -Finish
84.
A.C. Unit Disconnect, Electrical -Plumbing
85.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
86.
Water Well, Disconnect, Electrical, Plumbing
87.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
88.
Ventilation Throughout House
89.
Glass Protection
90.
Corrections from Previous Inspections
91.
Gas Test -Meters Tagged, Gas -Electric
92.
Water & Sewer Connected -C/O to Grade -HD Approval
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
V= OK
0 = Not OK
= Not Applicable
= Not Ready
MOBILE HOMES `
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1.
Zoning Requirements-Setbacks-Easements
2.
Soils; Special MH Support Sketch
3.
Sewer; Location-Test-Fall-C/O-Concrete
4.
Water; Location-Test-Easement Needed (Sketch)
5.
Electricity; Location-Clearances-Grnd-/ /Amp-Concrete
6.
Gas; Location-Test-Wrap;-/ /" L'ft.
/ P Nat. or/ /"L"ft./ /'LPG
7.
Well Clearance & Disconnect
8.
Utility Clearance
FINAL (Plans) OK except #'s
1.
Setbacks -Easements
2.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date MOBILU:nME INSTALLATION (Plans) OK except #'s
Z cdng Requirements-Setbacks-Easements
Footings; Size-Spacing-Marriage Line
3.
Ods-MH-Test-Demand-Valve-Connector
lectricity; MH Test-Crossovers-Breakers-Clearances
rain; MH Test-Fall-Flex Connector
ater; MH Test-Regulator-Connector
ate, and Sewer Connected-C/O to Grade-HD Approval
A -8.
Gas and Electricity Tagged
9.
a Downs-Type-Installation Cert.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
t"fl-rmanent
Foundation Only; License Decal
Date Card B-1 02t3 Date Card B-1
Date Card B-1 Date Card B-1
Ufa s o-ffkr.L�- lfzr�
4;),r &Qc�--
�j�r5
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Beams- Rftrs.-Connectors
Shthg.-Frg-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card 3-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Pane lboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Liaht Niche
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
COUNTY OFiBUTTE - DEPARTMENT Ot DEVELOPMENT SERVICES - BUILDING DIVISION
-7 Count Center Drive Oroville, California 95965 Telephone (5301-538-75p,; P MI No.
(Rev. 12/96) f Y APPLICATION AND PERMIT (,�� �r!
ASSESSOR PARCEL NUMBER
065-35-0-039
ZONING
'RMTT
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
. OWNERS MAILING ADDRESS
u
COWR4!ffV,M MOTOR HOME SER
TELEPHONE
877-8575
cONTRA9n5"1ffM', PARADISE CA 95969
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee 450.50/2
$225.25 N XM X
ARCHITECT OR ENGINEERS MAULING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
14859 �
Energy Plan Checking Fee
$
$
PERMIT FEE
S
LAT NO.
SUSDNISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome 6 Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.0015.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Ulilities ❑ Installation ❑ Other rK
Describe Work: PERK: FDN/MH EXISTING MH
Gas piping system 1 - 5 outlets
15.00 15.00
Building sewer
15.00
Mobile Home I s I G 1W
@20.00
PERMIT FEE
$ 50.00
ELECTRICAL PERMIT
Fling Fee 20.00
OOOVOR LES
Main Service A OR LESS
23.00
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.POWER
License Class (S Lic. No. y7038 6
OWNER -BUILDER DECLARATION
I 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 See. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
ave 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 St41,£ Fu u.P
Policy Number C/C- 99
(The above sections need not be 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 comply with those provisions.
X 4�� n�., 9
ae Date % % 9 (
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agen An OSHA permit is required for excavations over 5'0" deep a emolition or constructionJ�
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP. SO
OR ADONS. a ACC. BLD S. 3.5QFr:
NOON -EW REOSID. MULTI- clacurm OUTLET
eG 7,50
APPARATUS
a SINGLE OUTLET CIR.
EX. OCCU OUTLET OR FIXTURES .00
BAL @ 1. 0
FLI
Ex. Occu . oinlets AM.oEl 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc.-Wiring23.00
PERMIT FEE _
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEI: $
Mobile Home Installation Fee $
—777
Energy Inspection Fee $
[: ;OCC
jCONST. TYPE
TOTAL FEE $ - 318/25
D PEES IM
I FLOOD
CDP
I PARC
I PD
I HD I IWUF_
This permit is hereby issued under
of the Butte County Code and/or
indXaer which fees have
BY
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Dat 6
ate
Receipt No.
WHITE-D.D.S.-B.D. CANSCIR PINMNSPEC R GOLDEN R D -APPLICANT
Y Al
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - D DIVISION
7 COUNTY CENTER DRIVE - OROVILL"E, CALIFORNIA 95965 - TELEPHO (5 538-7541
PERMIT "PLICATION DATA SHEET
OWNER: IVA-S..ASSESSOR PARCEL ER:
�G
Proposed Building Use• Building Inspector: Date:_'t7
At time of permit applieat<o ,' was advised the following data must be submitted prior to permit processing anil/or issuance:
Date Received By
❑ Jl items have been submitted --------------------------------------------------------------------------------------
Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------
3 . Complete plans, 3/4 sets, signed by the preparer.of plans. ----------------------------------------------------- a
❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. --------
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
06. Energy Design Compliance and supporting documentation. ----------------------------------------------------
117. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
138. Hazardous Material Form.------------------------------------------------------------------------------------------
Anufactured Home data and installation instructions including Tie Down Specifications .------------------
. Fees of $ -------------------------------------------------------------------------------------
11.Impact fees as shown on the attached schedule. ---------------------------------- r-------------------------------
❑ 12. California Department of Forestry plan approval/fees.
1113. Flood elevation certificate. ----- -----1-_ - --------
1-114.
-------
11
❑ 14. Sanitation and plot plan approval Health Department. -----------------------------------
❑ 15. City of Chico plumbing permit. - -----'----------- --`----------------------------------------------------
Plot plan and business license approval from the City of Biggs. ---------------------------------------
r _
0 17. Planning approval for (A) Use: (B) Parking: ------------------
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------
❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). --------------------
020. Pre -inspection for
required. Request to Building Inspector on
021. Contractor's license information. (Number, Name Style, Classification).
022. Workers' Compensation carrier and policy number. -----------------------
❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). -.
❑24. Letter of signature authorization. --------------------------------------------
025. Recorded copy of Agricultural Acknowledgment Statement. -------------
Cl 26. Letter of intent on building use. ----------------------------------------------.
"anufactured Home utility clearance. --------------------------
la- d/or ex fired permiitts�--, t Deed ZH. Title, Lr7 Check to H.C.D $
NOTIOXAME".Z/A
(Date)
❑30. other: ------
Wh eyou issue thy, ermit rocess as4bllows ❑ Mail to owner, ❑Mai o co tractor.
�UTelephone� �7 VSs 7j and hold for pickup atc';Vl office. ❑ Deliver with inspector.
Applicant: Date: f
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By:
1. Index permit application for the above items numbered: ❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buil g Division counter, by Date:
Plans reviewed by: Date: Plans approved by:. Date:
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
'eatte, County
OF NATURAL WEALTH A N D BEAUTY
August 2, 1999
Sierra Mobile Home Service
8965 Skyway
Paradise, CA. 95969
William Alvas Jr.
Assessor Parcel Number: 065-350-039
Building Permit Number: 99-1538
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE •,OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (530) 538-7541
. FAX: (530) 538-2140
This office reviewed the above referenced building plans. Please respond in writing to
each comment by creating a response letter. Indicate which detail, specification, or
calculation shows the requested information. Your complete and clear responses will
expedite the re -check and approval of this project. Provide additional information and/or
make revisions to plans, specifications and calculations as follows:
1. Building permits are required for the open decks that appear to have been built
without obtaining permits.
2. Check to HCD for $22.00.
3. Balance of Building Permit fees' $255.25.
If you wish- to discuss any requirements, you may contact me at (530) 538-7541 between
the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday.
Sincerely,
Glenn Gibbons
Plans Examiner
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
. ; C oyoc�
6Y , cl� t_ vac �• o
1 C� C(ci = Q!)0
6-(1- 91
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.
WILLIAM ALVES, JR.
REAL PROPERTY OWNER/LESSOR
14859 HOLMWOOD DRIVE
MAILING ADDRESS
MAGALIA, BUTTE, CA 95954
CRY COUNTY STATE ZIP
SAME
INSTALLATION MAILING ADDRESS, IF DIFFERENT
CITY COUNTY STATE ZIP
SAME
UNIT OWNER (if also property owner, w rite'SAME7
MAILING ADDRESS
CRT COVHrr Mrs W
UNIT DESCRIPTION
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
OROVILLE, BUTTE, CA 95965
CITY COUNTY STATE ZIP
99-1538 (530)538-7541
BLRULDINGPERMITY TELEPHONE NUMBER
8/11/99
SIGNATURE OF LOCAL C CIAL DATE
NONE
DEALER NAME (d'not a dealer We. write 'NONE')
DEALER LICENSE NO.
FUQUA 1978 PARKLANE
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER
7897AB 44'X 24' 101779/80
SERIAL NUMBER(S) LENGTH X WIDTH INSIGNUI/LABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A.P. #065-350-039
SEE ATTACHED
HCD FORM 433(A) REV. 8/91
WHITE -County Recorder CANARY - NCD PINK - Applicant GOLDENROD- Budding Dept.
LEGAL DESCRIPTION
A.P. #065-350-039
All that certain real property situate in the County of Butte, State of California, described as follows:
LOT 108, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "SIERRA DEL ORO
ESTATES UNIT NO. 2", WHICH MAP WAS RECORDED IN THE OFFICE OF THE
RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON OCTOBER 19,
1965 IN BOOK 34 OF MAPS, AT PAGES 27,28 AND 29.
EXCEPTING ALL OF THE VALUABLE MINERALS BENEATH THE SURFACE OF THE
SAID LANDS WITH THE RIGHT TO MINE AND EXTRACT SAID MINERALS, IT BEING
AGREED AND UNDERSTOOD THAT IN ALL MINING OPERATIONS, THE SURFACE
OF THE SAID LANDS WILL BE PROTECTED AGAINST DAMAGE AND THAT ALL
SUCH MINING SHALL BE CARRIED ON FROM TUNNELS, SHAFTS OR DRIFTS
HAVING THEIR ORIFICES OUTSIDE OF THE SURFACE AREA OF THE ABOVE
DESCRIBED REALTY, ALL AS EXCEPTED AND RESERVED IN THE DEED FROM
MAGALIA MINING COMPANY, A CORPORATION, TO E.D. STORTS, ET UX,
RECORDED SEPTEMBER 4, 1947 IN BOOK 423 OF BUTTE COUNTY OFFICIALS
RECORDS, AT PAGE 385.
BUILDING PERMIT NUMBER: 99-1538
Address or location of unit: 14859 HOLMWOOD DRIVE, MAGALIA, CA 95954
Legal Description of Real Property: A.P. #065-350-039
SEEATTACHED
(z) Mobilehome/Manufactured Home
O 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: WILLIAM ALVES, JR.
Owner's address: 14859 HOLMWOOD DRIVE, MAGALIA, CA 95954
INSIGNIA OR HUD NUMBER: 101779/80.
SERIAL NUMBER OR V.I.N.: 7879AJB
MANUFACTURER'S NAME: FUQUA YEAR: 1978
OFFICIAL APPROVING INSTALLATION:
DATE: 8/11/99
PHONE: (530) 538-7541
H.C.D. 513C "
STATE OF CALIFORNIA-DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT
REGISTRATION CARD MOBILEHOM oECALNO. 39°
MANUFACTURER NAMUIO TRADE NAME MODEL DOM DOT OF$ spe I E%PIRATIO?
FUQUA/. PARKLANE 00/00/78 05/09/78
SERIAL NUMBt
LABEL/INSIGNIA NUMBER WEIGHT LENGTH WIDTH ISSUE SCC E E
7897A UMPT US
101779 000000 000528 000144 11/20/87 04 SFO
y 7897A 101780 000000 000528 000144 TOTAL
3 'FEES
a PAID:
s $40.00
6
• F
A ALVES WILLIAM JR
o 202 E POLO
0 ORLAND CA 95963
a
a ALVES yILLTAM JR '
•
X A 14659 HOLMWOOD
E MAGALIA .4.95954~
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0 oAS.y14; y\fat:>",� �.a:•r.:::, ..Z ik i;�Qo
o s 14859 HOLM1i00D
E u MAGALIA CA 95
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laf� F 3 , � � I n^Yf.•, \. ?14,�p,.,i„y Cy ��vyr�Y yw a
L ALFREDAVA GEDNEY JTRS
A 221 INCLINE ,41Yf s h ; �'i���°� •�"n� \��>' R
.CA 9Si39g+
o SAN .LOSE *
w OATS= 10/29/87 16 8'•04r
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I
IMPORTANT 03-321-02073
THE OWNER IfNFORMATION`SHOWN ABOVE MAY NOT REFLECT ALL LIENS RECORDED WITH'TME
DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT.
s THE CURRENT TITLE STATUS OF THE UNIT MAY BE CONFIRMED THROUGH THE DEPARTMENT. 034111
Td W06E:OT 666T"LU '1'•I1 ON 31-10Hd A1_103d si-m3d Tc :8nIN33 WC
ovisommoss
i
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.'
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tLotI
108,.as shown on that certain Map entitidd, "SIERRA DEL ORO ESTAT95
IT ?10. 2", which Map was recorded in the office of the Recorder of the
County or Butte State of Calirornia, on October 19, 196$ la Book 34 of
Haps, at pago$.�7, 28 sad 29.•
EXCEPTING-all or the valuable minerals beneath the surface or the said
lands with the right to mine and extraot said minerals, it being agreed
and understood that. in all mining operations, the surface of the said
lands will be protected against damage and that all such mining shall be
carried on from. tunnels-, shafts or drifts having their orifices outside
of the surface. area of. the above-described realty, all as excepted and
reserved. in the Deed frog Magalia•Mining Company, a corporation, to E. 0.
Stortsi etux, recorded September 41, 1941 in 130ok'473 of Butte County
i
'Official Records, at page 385'
REMITTANCE ADVICE
SIERRA MOBILE SERVICE & SUPPLY 16275
8965 SKYWAY 11-8078
PARADISE, CA 95969 3211
530-877-8575 L - F
DOLLARS
PAY NET
GROSS AMOUNT
TIME DATE TO THE ORDER OF AMOUNT
WK'D
` eco
DMU b.6.
HOME SAVINGS OF AMERICA -PARADISE SKYWAY OFF., BR. 146
6848 SUITE 0 SKYWAY - PARADISE, CA 95969
DESCRIPTION
1190 1 6 2 7 5II' 1: 3 2 1 180 7801:0 36 39 2 10.58611'
0 9--v
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1. Is the mobilehome located with. required separation from lot lines and buildings and generally
conform to plot plan? Yes_ No
2. Does the mobilehome have.required clearances above ground. (Sec.5085) Yes_ No
3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes - No_
4. Is the mobilehome level? (Sec. 5088) Yes p' No
5. If mo than a single unit, are crossover connections properly installed? (Sec. 5088)
Yes VNo
6. Water
A. Is fl9kible connector of adequate size and properly installed (1/2" ID min.)? (Sec: 5566)
Yes No /
B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes v 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" per foot slope and is it properly supported? Yes v No
C. Are any leaks detected in drainage system after running 3allons 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. Gas Piping and Gas Vents
A. Connector - Is mobilehome connected to thega supply with an approved 3/4" minimum
mobilehome connector not more t an 6 ft. to ? Note: All piping is to be at least as
large as the mobilehome gas line iiilet wit out reductions other than the mobilehome
connector. Yes No
B. Test OK as per following procedur Ye _ No
1. Open all appliance connector v lve
2. Shut off appliance burner and pilot valves.
3. Air test with manometer to 10"-1 ' water column, or test with slope gauge (minimum
6oz.-maximum 8 oz.) calibrated 'n tnth pound increments. Test for 10 min. without
drop.
4. Connect gas meter to mobileho 'e with c\nnector, turn on gas, test connections with
soapy water. 1C. Are all appliance vents properly installedes No
9. Electrical
A. Is service large enough -to provide adequate amperage -to mobilehome (must equal rating of
mobilehome with a minimum of ).00 amp) and other facilities on lot, i.e., water pumps,
garage, cabana, etc.? Yes No
B. Is there proper clearances around panels? Yes tl/No_
C. Is power supply cord,or feeder assembly properly fused? Yes No
D. Is continuity test satisfactory as per the following procedure? Yes "No -
1.
No1. 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 theelectrical tests, the lot or site
service equipment may be approved for energizing. ,
10. Is job card signed by Health Department for water and sanitation?
11. If everything okay, sign off card and tag services.
MOBILEHOME DATA
Manufacturer and/or Namestyle ,�%-•�
Length_ `f Width
Vehicle Serial No.
State Identification No.
Additional Information or Comments:
f y
•PERMIT NO. 1781-78E (MH)
PERMIT EXPIRES 4/21/79
-OWNER AT,FRFn MONEY
CONTR. Murray Cain
LOCATION (A.P. 65-35-39 -
x285 Holmwood•Dr, Magalia SEO#2, lot 108
x.
j
I •
. b
Temp. Power Pole
Called PG&E
Temp. Elea Serv.
pCalled PG&E -finIle
Temp. Gas Serv.
1(Called PG&E
OB
11NALED
(Date)
(Signal `�
Setback
Forms
Main
Stemwa I I
Slab
Piers '
Garage.
Footings
Stemwa I I
Slab
Carport
Footings
Slab
Patio
COUNTY OF BUTTE — D.EPARTM61T OF' PUBLIC WORKS
" BUILDING INSPECTION=RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Firewall
Soil Pipin
✓
Parapets
1st Floor
Restroom Finish
2nd Floor
Windows"
3rd Floor
Sidina
To out
Roof Sheathing
Water Piping
Roofing -
Sewer
Fdn. Vents
Fixtures
Garage Vents
Insulation
Water Htr.
Heaters
Prov. for physically
handica ed
Conformance of ex.
structure
Appliances
Gas Piping & Test
Temp. Gas
Final
Sanitation
FIREPLACE
Final
Footing
ELEC1
Throat
Rough
Final
Fixtures
Bond Beam I FIRE SPRINKLERS I Motors
Brown Cooling
Finish Ducts
Interior Lath Ventilation
Door Closer Final
MOBILEHOME UTILITIES - - - - - - Elec_ Service j�Ao hi
Water Piping Sewer j 7
BI E OME INSTALLATIO - - - - - - Support
Water PipingS — ._ Drainage
DATE REMARKS OR CORRECTIONS
8
1
Grd. Fault Prot.
Service
Temp. Pole
Permanent
anal
Elec. Pedestal
Gas Piping
Elec. Continuity
Gas Piping
(NOTE: An entry must be made on this form each time you visit the job site.)
L
f COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS - 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the California -Administrative Code, Title 25, Chapter 5, under permit
number for the following location:
Owner
Owner's Address
Mobilehome Mfg. Model Year X
Insignia No. 1/a i 7 ;t — Serial No. `
It is hereby certified for occupancy at the above described location and
unay be occupied.
Director of Public Works
Date
By , .. -4
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
COUNTY OF BUTTE:. = D-EPAR•TMENT OF PUBLIC WORKS
7 County Center Drive = OrovAle, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
M�
authorize representatives of the County of Butte to enter upon the
above -men 'oned property for inspection purposes.
X Date
Sig ature of P& itee or Agent
Receipt No. Z 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.
z-0 DIR.ECTOA.@F PUBLIC WORKS
BUILDING
Owner �l, &'D
SQ. FT. OCC. BUILDING VALUATION
Mailing Address /2, 857 JJol w p a p 1J4� r
G�
CA
Telephone No.
Contractor
Mailing Address 3/ Cf&=_� lOy 04
Fireplace
Total Valuation
4?q ��'Dn��,,
&A4 /}�. aq �e
Tele hone a
---/Y,
Permit Fee
Building Address II -VV /C-
Plan Checking Fee&/or Penalty
Permit Fee
E9611 4- l fs
PLUMBING No.1 @ I FEE
1-0-7
1O % 0�
PERMIT FILING FEE $3.00
Each Trap 1.50
-�
Repair drainage or vent piping 1.50
7�
A. P. - c,.J
Zoning & Planning
Water piping 1.50
Each gas water heater or vent 1.50
Pkfe-s
Saai•e+ft , Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
I ParcelEach
I Declaration
I Parcel Map'
60' R/W
I Improvements
additional outlet .30
Building sewer 5.00
Parcel A a
P s Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
is
G? /t/ d p A41,0 �-46; C �(p/tet
ELECTRICAL No. @ FEE
'0 p� M/' �.7L�� SL-_X6'LcCr
1
PERMIT FILING FEE $3.00 3
100v OR LE
Main service SS i
100 AMP OR LESS 5•�D V
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service EA. ADD•L 100 AMP 2.50
Main service OVER 25.00
100 AMPP OR LESS O
Main service/ EA. ADD'L 100 AMP 1.00
NEW CONSTOR ADD... \ ACCDWELBLDGS.LING CCUP. 1�\ 20Sq It
I
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of: y�
f't (/)` R��� �'1 /A
NEW CONSTR MULTI -OUTLET
NON.R ESID BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS 8
NON-RESID. SINGLE OUTLET CIR.
Ex. Occuo(OUTLETS OR FIXTURES 5 L�
FIXED APLNS.
Ex. Occup. ( OUTLETS P(RESID.)REA) 2•00
Temporary service 10.00
�LjCTXJCAe CZA1?,RACTai
Mobile Home Facilities 15.00
/
License No.// d_37 Classification —110
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$ f'f
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 $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
$
TOTAL PERMIT FEE
$ Q 3'i
authorize representatives of the County of Butte to enter upon the
above -men 'oned property for inspection purposes.
X Date
Sig ature of P& itee or Agent
Receipt No. Z 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.
z-0 DIR.ECTOA.@F PUBLIC WORKS
COUNTrY OF#-6UTTE• ID EPAATM NT OF PUBLIC WORKS
7 County.Center Drive OroOille, California 95965 A-5
Telephone: 534-4541
APPLICATION AND PERMIT
BUILDING
Owner L ro 6� SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Contractor _ /r/ (N `
Mailing Address �� / Lis -0- Fireplace
/Telephone No. Total Valuation
Permit Fee
Building Address
Plan Checking Fee &/or Penalty
-
C Permit Fee
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
V I j�' Repair drainage or vent piping 1.50
r Water piping 1.50
A. P. No.. J�4 s– — j 3 9 Zoning & Planning Each gas water heater or vent 1.50
Fer,.9dtib. Santetierr Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50
Parking Parcel Each additional outlet .30
EQA Plans Declaration Parcel Map 60' R/W Improvements
Building sewer 5.00
g. - ans ec Parcel rovaI Plan proval Lawn sprinkler system 2.00
NEW ❑ ADDITION UTILITIES ❑ OTHER
Permit Fee $ $
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00
Main service 10000 AMP ORSLESS 5.00
Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2'.50
Main service 100
OVER AMP s00vOR LESS 25.00
Main service EA. AOD'L 100 AMP 1.00
NEW CONS. I DWELLING
OR ADDNST %ACC. BLDGSCCUP. S) 20sgft
CONTRACTORS LICENSE LAW NEW RESID. BRANCHMULTI-O CIR T
NON RESID. ` BRANCH CIRCUITS) 2.50ea
NEW CONST R.POWER APPARATUS 9 Ji
I am licensed under the provisions of Chapter 9, Div. 3, of the NON RES D. (SINGLE OUTLET CIR.
State of California Business & Professions Code under the name Ex. QCCUD(OUTLETS OR FIXTIIPES a 'L @'100 0
p•�
st le of: Ex. Occup. FIXED APPLNS. OR
y OUTLETS (RESID.) EA) 2.00
6: Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
License No.t_i�9� 0Classification
❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE PERMIT FILING FEE $3.00
1 am aware of the provisions of Section3700 of the California Labor Heating
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 Cooling
Workmen's Compensation Insurance.
❑I certify that in the performance of the work for which this Ventilation
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of Hood 1 2.00
California. 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.
X Dated %
Signoture of Permitee or
Receipt No. t —7 �J
White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant
nd DevolnnmPnt.Fee f `t $ 13()_
TOTAL PERMIT FEE Is :30
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.
D rOF PUBLIC WORKS
By Date
Building permit expires Date
PNS
co.JNZ\ c.o'DE r
- - -= - -
-75-00
Q
49
UST be ..
� X20 { ns an speci 'cations �
Phys S . $ f p' � raw fU{ fi.0
tj #'rues and it is U
o
` t o
` 1
a Q71 ' ! .e fob at
k p
nor..
a.
f
a. same withou
aerations on
o r•" of Pub -
` N
j I
17,
m4�-„ �H I
✓
jrom
, ent
t{ie Departm
. � S Iz- : i
�lorl s, Co
int
of
ti . 3 L
lic
'
CL�sTERJa
�S
J
f
Lo
100
I OAK
( c ivsrR.� 10
> FI0
JoOA. UTiL.
Po i c
I
` G
,I
be 5 ft. from the
100A
The . Setback shall
_ +
S a P; ►c—
s line and 50 ft. from the
sills proper,y
centerline of the road, permitting a maxi -
y„,�� ER N�
1
mum of.a 2 ft. eave overhang but entirety
�ut of all easements.
—
75-e oo •
L IIj �� our �� �VA)
BUTTE COUNTY
BUILDING DEPARTMEN`i
ellAFROVED.
U
4 BOUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 RMI o.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSORPARCELNUAUi i
ZONING
BUILDING PERMIT
OWNER
T LEPHONE
r3 '0905
SO. FT. OCC. BUILDING VALUATION
. OWNERS MAILING REQS,
`U 11
CONTRACTOR'S NAME
TE NONE
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$
ARCHITECT OR ENGINEERS MAIUNG ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS
5 �
Energy Plan Checking Fee
$
$
Q
PERMIT FEE
$
LOT NO.
SUBDIVISIONS NAME UPARCEL
MAP
PLUMBING PERMIT
Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome O( Other
sPECIFv
Each Trap
1 7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other 0
Describe Work:
r 1
Gas piping system 1 - 5 outlets_]_15.00
�'J • 00
Building sewer
15.00
Mobile Home I S I G I W
@20.00
PERMIT FEE
$ 3'S. OD
�7
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service 2bIA OR LESS
23.00
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 Lic. No.
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.
yr las 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
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.
❑ 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
Main Service TO t000A
46.00
WEE200A
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. BLDS.
SO
3.50FT.
NOPI.pESlpT� MULTI.OUTLET
. CIRCUITS
@a 7,50
POWER APPARATUS
a SINGLE oLmtr cIR.
EX. Occup. OUTLET OR FIXTURES
.00
BAL 20 I. 0
Ex. Occu . DUTLFIXEE°TSA R °�
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring23.00
PERMIT FEE
S
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE
$
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
I/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 workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date �
X ure
Si atof pplicant - caner ❑ Contractor ❑ 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
$
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 35. co
HAZ.
I D. CE,5,S 11IMP
FLOOD
I CDF
I PARCEL
I PO
I HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicate above for which fees have been paid.
By 4 Date
PERMIT EXPIRES ON p - 100-,:Q000
ate
Receipt No. A7:54171 C05--00
WHITE-D.D.S.-B.D. CANARY -A SESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
' 7 County Center Drive • Oroville, California 95985 • Telephone (530) 538-7541P q r
(Rev. 12/96) APPLICATION AND PERMIT ��
5- 356-03
aD1eNO
BUILDING PERMIT
FA4oRrARCLNUl
Vo$�ooS.
�� �
�'
rsup"CAIN '.�
,
SQ. FT. OCC. BUILDING VALUATION
MWO MAJA
OTORI MOAAG AOOIas
TV.01MMt
UMM 100 1
uoostrs wvtsra Atmos
Fireplace
Total Valuatlon is
ARCIfrwr on
AACWTWT oR MORM" Vaasa Aooiess I
uta No.
Fiffna Fee Is 20.0
Permit Fee i
Plan Checking Fee i
MULDMA°°Ilea
1142 5 9
'b�..
Energy Plan Checking Fee i
i
PERMIT FEE _
PLUMBING PERMIT Filing Fee 20.00
USEOPSTRUCTURE
SF O Duplex 17 MobiNrome )( Other
spowv
Each 7.00
Soler or heat m wader heater 23.00
Water 15.00
Each water heater or vent 15.00
Now O Addition O
Describe Work:
TYPE OF WORK
RenTodel L7 ULU** O hsl "oq O
Other O
Gas poft system 1 - 5 outlets 15.00 pscp
Building awwer 15.00
Mobile Home 13 1 G I W 020.00
PERMIT FEES 36 -OU
ELECTRICAL. PERMIT Rin Fea 20.00
_
Main Service a dpi LM 23.00
Main Service 20M To t000A Y 46.00
OR ADOUL ' W=3.S6R
won Raio ' wtTFouner 07.50
rower i
Ex. Occup. ounar oil:o a ..w
aw w
Ex. Occup. re® all 5.00
Temporwy Service 23.00
Mobile Hans FadUU 20.00
Mies. WItI 23.00
PERMIT FEE
MECHANICAL PERMIT Filing Fee 20.00
Heating
Coolie
Hood 6.50
Ventilation
PER IT FE! S
Mobile Home Installation Fee =
Energy Inspection Fee f
00NWs rrw TOTAL FEES
S
Eocc
KAZ
O. KO I [Mr
I ;G
COQ
I VAACOL
I r0 rO
puE
This permit Is hereby Issued under the applicable provisions
of the Butte County Code and/or Resclutlons to do work
Indicated above for which fees have been pald.
By Date
PERMIT EXPIRES ON
f�N1
i
COUNTY OF BUTTE - D PEVELO MENT SE V ES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Te ephone (530) 538-7541IT No.
(Rev. 12/96) APPLICATION AND PERMIT
�� M��
ASSESSOR PARCEL NUMBER
065-35-0-039
ZON' I
BUILDING PERMIT
OWNER
V ALVES) JR
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
96 0 672
. OWNERS MAILING ADDRESS
DAM 14FIZICK
CONTRACTOR'S NAME
TELEPHONE
O
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee
$ 19.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 23.00
BUILDING.(C} nb , HOLT400D DRMAGALIA
j
Energy Plan Checking Fee
$
$
PERMIT FEE
$ 62.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other OPEN DFICWater
IFr
Each Trap
7.00
Solar or heat pump water heater
23.00
piping
15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New ff Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: NEW OPEN DECK/MH
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home I S I G I W
920.00
PERMIT FEE
S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 200A OR LESS
23.00
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.s
License Class Lic. No. �� C^ %
OWN WILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ 1, 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
Main Service zooA
46.00
NG CCU000A
NEW CONST. DWEWNG OCCUP.
OR ( e Acc. BIOS.
SO
3.50'
CNS.
NOWROESID NST.MULTI.OUTLET CIRCUITS
97,50
POWER APPARATUS
a SINGLE OUTLET CIR.
EX. Occup. OUTLET OR FDCTURES
BAL O I.50
Ex. Occu . ouT Ers AFIXa D°ERn
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMIT FEE
S
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑. 1 have and will maintain a dertificate 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.
❑ 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
Policy Number
(rhe above sections need not be completed H the permit is for work of a valuation
of one hundred dollars ($100) or less.)
11' 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 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.
X Date
Signature of App icant Owner ❑ Contractor ❑ Ag n
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
MECHANICAL PERMIT
Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 6 .00
D. FEES IMP FLOOD
_
CDF
PARC
ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
Date
Receipt No. 27 499/
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT �c
ASSESSOR PARCEL NUMBERO _
v
ZONNo
BUILDING PERMIT
OWNER
v �/e
TELFPN°NE
SO. FT. OCC. BUILDING VALUATION
.
OWNER'S MAXIM ADDRESS
S
C.- e> 9,.�
Q 2—
CONTRACTORS NAME
TELEPHONE
Co s MAUNG ADDRESS
37-e
CONSTRUCTIONLENDER
Fireplace
LENDERS MAILWG ADDRESS
Total Valuation b
ARCHITECT OR ENEER
LICENSE NO.
Filing Fee b 20.00
Permit Fee b . U v
ARCNTTECT OR ENOWEERS MALING ADDRESS
Plan Checking Fee b Z v
BUILDING ADDRESS %
S.
� a �- •
Energy Plan Checking Fee b -
b
PERMIT FEE : 2. 430
IDT NO.
SusDN61ON!Smum
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome Other
Each Tr 7.00
Solar or heat pump water heater . 23.00
Water piping 15.00
Each gas water heater or vent 15.00
New ❑ Addition ❑ Remodel ❑
Describe Work:%g�,�
TYPE OF WORK
Utilities ❑ InstaOation ❑ Other ❑
� "G
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home S G W Q20.00
PERMIT FEE $
ELECTRICAL PERMIT Filing Fee 20.00
Main Service zow ORR s 23.00
-
+
— -------Main
'
Service 200A70 1000A 48.00
NEW CONST. OWEtll1G OCCUP. 3.5¢so.
OR ADONS. 6 ACC. elD,.
NOKRESIG. • MULTFOIlTLET @7.50
POWER APPAMTUII
8 SWOLE OVTLET dR
20
OUTLET OR FKTURES O +•50
EX. OCCU gAL 0 yp
APPU NsEx. Occup. OUTLhTS 610, E. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE _
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee b
Energy Inspection Fee b
OCC
CONST. TYPE TOTAL FEE $
NAZ.
I D. FEES I IMP
I FLOOD
I CDF PARCEL
PD
ND 63UE
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.
By Date
PERMIT EXPIRES ON
Doral
: ,+{.�t:���Mlrt%«�1".y9 hi•-.f«s1.:.,i"w`,y+1�t �+Rt'if�'��y+jto'Zirr;�t wq' nx•,t rW ''`i v,4, 4 ' ;, { ems, '"„�+`f,r+'°!Y'��
'4 ef)UNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER: � L . 11yes ASSESSOR PARCEL NUMBER:
Proposed Building Use: rj7�v� �. Building Inspector: it Date: R -<- q
At time of permit applica�was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
❑ 1. All iiems have been submitted .-------------------------------------------------------------------------------------
❑2. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------
❑ 3 . Complete plans, 3/4 sets, signed by the preparer of plans. -----------------------------------------------------
04. Engineered plans, 3/4 sets, with wet signature on plans..All engineering must be shown on plans. --------
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
116. Energy Design Compliance and supporting documentation. ----------------------------------------------------
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
El 8. Hazardous Material Form. ------------------------------------------------------------------------------------------
❑9. Manufactured Home data and installation instructions including Tie Down Specifications .------------------
❑ 10. Fees of $-------------------------------------------------------------------------------------
❑ 11. Impact fees as shown on the attached schedule. -------
❑ 12. California Department of Forestry plan approval/fees.
❑ 1 . .lood elevation certificate.---------------------------------------------
<�ff Sanitation and plot plan approval —OLS Health Department.
❑ 15. City of Chico plumbing permit. ---------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ---
❑ 17. Planning approval for (A) Use: Q k_" . (B) Parking: _
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel.
❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---
020. Pre -inspection for
required Request to Building Inspector on
❑21. Contractor's license information. (Number, Name Style, Classification). --------------------
El 22. Workers' Compensation carver and policy number. -------------------------------------------
❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner D) - ----------------------
❑24. Letter of signature authorization. -----------------------------------------------------------------
❑25. Recorded copy of Agricultural Acknowledgment Statement. ----------------------------------
❑26. Letter of intent on building use. -------------------------------------------------------------------
❑27. Manufactured Home utility clearance. ------------------------------------------------------------
❑28. Existing violations and/or expired permits. ------------------------------------------------------
❑29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $
D30. Other:
When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor.
6Telephone 0 73-2-3 and hold for pickup at Q/ -O office. ❑ Deliver with inspector.
(Date)
KApplicant: Date:
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By:
1. Index permit application for the above items numbered: ❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, p mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, wasadvised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Sets of plans on hold—m— ❑ Plan Cabinet, krA.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
1. Owner's name:
'T4 -.-4j,
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
2. Installer's name: ,S'�_,�'�j„l Lf?ot�✓_
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 � No
? .( If no, clarify )
t
5. What is the mobilehome electrical rating? ----------------------- 24:1n Amps
6.. What is the mobilehome site service rating? --------------------- Q� Amps
7. What is the mobi-lehome site circuit breaker rating? ------------ ,� �d Amps
8.
Is there any other electric load to be served by the mobilehome
site
service? --------------------------------------------------- Yes / /
No
(If yes, identify the load..and size: (Load)
(Amps)
9.
What
is the mobilehome site gas pipe size? ----------------------
(in.)
10.
What
is the type of gas service? ----------------------------- Natural / /
LPG-/ /
11.
What
is the gas pipe length from meter or tank to the mobilehome?
(ft.)
12:.
.What
is the mobilehome gas demand? -----------=------------------
(BTU)
(This information not required if pipe length less than 6 ft. on natural
gas
or less than 50 -.ft.. on LPG.)
MOBILE3U'ORT DATA
Mobilehome Mfr. Setup Model No. O65-0 Year
Width _(ft.) Length (.ft.) . Expando.Size ft.x ft.
(Draw support details. below)..
On all mob ilehomes manufactured after October 7; 1973, furnish manufacturer's installation
manual and structural setup sheets..(.if not onfile with .the. County of Butte) .
VV
*If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED
a
Sin le
GLh/6 Footings -(check -one)
Z --l-% Wood. either
pressure treated or
Center
Center Support A
fdn-. grade.
Support
Footing Sizes W
Locations
(in.)
L;j 2..Concrete pad.
r..
x�
/ / 3. Other,: specify
(�ft.)kIn.
1
Supports (check one)
/ 451'1. Concrete block
ft..�
2. Concrete•piers
(� in�L—..
(in.)(in.)
3. Steel piers
4. Other, specify
r
L_ X---�
(
Typ ical Support
x Footing Size
.(in.
.)(In
'ill
_
in. (in.)
` 6
MSpacingr
(f 3.n.)
(ft. in.)
(in.)(in.) 4.
'
[
Overhang
in
*If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED