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065-370-045
i .�4 1. 65-37-45 Chaarles Blackman /Z1 $9 Denise Dr:,lot-264,SDO#4;Mag B06-2859 co.: wesidential Homes, Para. 065-370.045 RESIDENTIAL' SFD-Mobilq Ho Permit #782-81P,E(uil. ,MH) ELEC. Q-2 / e RET Retro fit mh perm fnd ��122� 20014 GAS_ LAC DENISE BLACKMAN, Ia - 2d -00 SUPPORT STRUCTUR$ REQ. • H CHARLES S & WILMA E COMPACTION TEST RE,. Permit # 2786��-8-2MHI 65-37--45/2 contr: Be.rnies MH Sery P �W;/O Issued - - aradise /9—zo -pZ Pe ml� 7�4B g COv�deck5&3car5ort - carport) I 065-370-045 PERMIT#97-0752 BLACKMAN, Charles 14770 Denise Dr., Magal' Cont. Morehouse A/C Sery ce Gas Line for Furnace/MH F r i 1 i e.iaa;, 3�4-k,�FR�i . Illlllllllilllillllllllilllill�ll RECORDING REQUESTED BY: cQ10E.-00E.E.81 5 Recorded I REC FEE 10.00 Official Re�S CountyofI CMFORMED COPY 1.N AND WHEN RECORDED MAIL TO: Butte I ONACE J. BRIIBBS I County Clerk-Recorderl BUTTE COUNTY BUILDING DIVISION 1 7 COUNTY CENTER DRIVEI MZ OROVILLE CA 95965 010:N M 21 -Dec -2006 I Page 1 of 2 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. BLACKMAN, CHARLES S & WILMA E BUTTE COUNTY BUILDING DIVISION REAL PROPERTY OWNER/LESSOR LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 14770 DENISE DR. 7 COUNTY CENTER DRIVE MAILING ADDRESS MAILING ADDRESS MAGALIA .BUTTE CA 95954 OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP CITY COUNTY STATE ZIP 14770 DENISE DR B06-2859 (530) 538-7541 INSTALLATION MAILING ADDRESS, IF DIFFERENT BUILDING PERMIT NO. TELEPHONE NUMBER I MA.GALIA BUTTE CA 95954 &,aW 12/20/2006 CITY COUNTY STATE ZIP SIGNATURE 0 OC L 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 Golden West Homes 1982 Calypso MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER GW06CALCA75026A/B 24'X52" CAL244778/9 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION: ASSESSOR'S PARCEL NUMBER: 065-370-045 SEE ATTACHED HCD FORM 433(A) REV 8/91 WHITE —County Recorder CANARY — HCD PINK—Applicant GOLDENROD— Building Dept. 6 aGo�da � OMM Cc a$am T"m aain ''Vera a mean* • um IndIWd) M QrSM -gold .wswar �wv� *+Rr ab,.+apn 65-�%-43 lu ae.eT a ow*bbe�e i. -L - f -Mpuw SOUR vain va% fw •atm it &a tad mW m &U ma "mid" el dw of S& M A VAt.iU= Q61f3iMA'tl K �.iPd q( aKi E, 6"* . G�ACT C. BZt:�l�IID .a" SRKUA A. 3 .p,. bpmfiy MUMS) . baaba�d eeS Iiia er falwvleC *-Qw tied p0qer y is At Wda corpotsuid obutte . 9ua d C%Wmu a: Lot 264$ as she wG QR that certain FAp, entitled "BIER [WL Sg0 ESTATE. UNIT Ito. 4" vhieh vas ir"Ordld 33eptember g9$ 1969, im yap pages k8s 4; s,ad �. Book 35$ at ZXCEPTING AND RBSERVTNO TfQiiWAOM 811 of the valuablo minerals bet�ath the surface of the $aid land with the right to �e and "tra oop�ct 11414 thesssuurrfacetoff S&VICA"Ma ad wiillnd mbe prouatedaega rot damaremining ana' that oft all such m1ning shall be carried on fma tunnels -shafts or drifts having. their ariricts cutmid* of the surfaee area o} the above deseribe4 realty$ all as excepted and reserved in the Deed from Magalia MiAlA Go�ap4j a eorporation$ to Z. D. Storta et im recorded September �$ 1947$ in boot 423 of Butte•Comaty Orficlal 8aeords$ at gage . mdd __ 99-Algar -4. 1977 STATE OF CAUFORMU �'errra d M% as .aisr b%W4 C ►rabli� V ai (w �' c LR C.I+� IJP D —ups_ S-64jr 1 L p A. rr a u ��p raA4 MAL k,.,s „• o. ARTHUR T. NOIAti w ►, rA. M'+ai_-rYw, ,.wed-.` ..►wile+ u "rhe Mil «O*�w�rvuWC-awraw �..a.e..M ..� .:►..r.� tAnt.�ry g — - 00 sum. s w YATSD eouwTr timweas ., ►.....� ,� ..� �o*•ww•:+p+wk/rtl.leil PA"uoL`A rt..'w..+Mwww-. Tfi{e Oricr No F..cfaw Or lona V -- J - WA TAX STATEMMV% A3 0114CMD we®ai OF Documed ;.'1S'!f. �1 Hr, N ll{"Noll' 'S10Vu'dd 31.Li1 n31 IA +j W NO w000aewa a"Untso er Oroville Title 0"vW .Wvm . m=PU.. mna Cav oft"" !°l�"a;>�t's� f o it mmam� man 0. S. VLiAt �. B'daelee� ►1913$e �Li1L�YC� iOMMYrABCQ� .;�: 29+38 tliZs� Dzip [ ltidwond, (A l4dti6 .a►� ► L � + �e a, �. $am as abm A: aGo�da � OMM Cc a$am T"m aain ''Vera a mean* • um IndIWd) M QrSM -gold .wswar �wv� *+Rr ab,.+apn 65-�%-43 lu ae.eT a ow*bbe�e i. -L - f -Mpuw SOUR vain va% fw •atm it &a tad mW m &U ma "mid" el dw of S& M A VAt.iU= Q61f3iMA'tl K �.iPd q( aKi E, 6"* . G�ACT C. BZt:�l�IID .a" SRKUA A. 3 .p,. bpmfiy MUMS) . baaba�d eeS Iiia er falwvleC *-Qw tied p0qer y is At Wda corpotsuid obutte . 9ua d C%Wmu a: Lot 264$ as she wG QR that certain FAp, entitled "BIER [WL Sg0 ESTATE. UNIT Ito. 4" vhieh vas ir"Ordld 33eptember g9$ 1969, im yap pages k8s 4; s,ad �. Book 35$ at ZXCEPTING AND RBSERVTNO TfQiiWAOM 811 of the valuablo minerals bet�ath the surface of the $aid land with the right to �e and "tra oop�ct 11414 thesssuurrfacetoff S&VICA"Ma ad wiillnd mbe prouatedaega rot damaremining ana' that oft all such m1ning shall be carried on fma tunnels -shafts or drifts having. their ariricts cutmid* of the surfaee area o} the above deseribe4 realty$ all as excepted and reserved in the Deed from Magalia MiAlA Go�ap4j a eorporation$ to Z. D. Storta et im recorded September �$ 1947$ in boot 423 of Butte•Comaty Orficlal 8aeords$ at gage . mdd __ 99-Algar -4. 1977 STATE OF CAUFORMU �'errra d M% as .aisr b%W4 C ►rabli� V ai (w �' c LR C.I+� IJP D —ups_ S-64jr 1 L p A. rr a u ��p raA4 MAL k,.,s „• o. ARTHUR T. NOIAti w ►, rA. M'+ai_-rYw, ,.wed-.` ..►wile+ u "rhe Mil «O*�w�rvuWC-awraw �..a.e..M ..� .:►..r.� tAnt.�ry g — - 00 sum. s w YATSD eouwTr timweas ., ►.....� ,� ..� �o*•ww•:+p+wk/rtl.leil PA"uoL`A rt..'w..+Mwww-. Tfi{e Oricr No F..cfaw Or lona V -- J - WA TAX STATEMMV% A3 0114CMD we®ai OF Documed ;.'1S'!f. �1 Hr, N ll{"Noll' 'S10Vu'dd 31.Li1 n31 IA +j W NO BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD 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: B06-2859 Issued: 12/18/2006 Address: 14770 DENISE DR MAGALIA APN: 065-370-045 Permit Subtype: SFD-Mobile Hi Owner: BLACKMAN, CHARLES S & WILMA E Applicant: PREMIER BUILDERS Description: Retro fit mh perm fnd MUST BE ON JOB SITE JOB SHALL BE READY PRIOR TO CALLING FOR INSPECTION. THE INSPECTION CARD AND APPROVED PLANS MUST BE AVAILABLE FOR EACH INSPECTION OR THE INSPECTION WILL NOT BE MADE AND A RE -INSPECTION FEE MAY BE ASSESSED. ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations /Footings ° l,. 111 p C.. i2-20 -6 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not PO4qXWncrete Until Above are Signed Pre -Slab NA 124 Gas Test NC I -R2 pIZ_ 404 O -C— 12-26 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 Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Roof Nail 129 Shower Pan/Tub Test 408 Fire Sprinkler 702 Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Gas Test 404 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Project Final 801 ® C_ (2 Zp I 7 r1 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HA COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy 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: 14770 DENISE DR Owner: Permit NO: B06-2859 APN: 065-370-045 BLACKMAN, CHARLES S & WI Issued Date: 12/18/2006 By GLB Permit type: RESIDENTIAL 14770 DENISE DR Subtype: SFD-Mobile Home RET MAGALIA, CA 95954 Expiration Date: 12/18/2007 Description: Retro fit mh perm fnd Occupancy: Zoning: RMH Contractor Applicant: Square Footage: PREMIER BUILDERS PREMIER BUILDERS Building Garage RemdVAddn 1584 WAGSTAFF ROAD 1584 WAGSTAFF ROAD PARADISE, CA 95969 PARADISE, CA 95969 (530)872-1096 (530)872-1096 Other Porch/Patio Total FEE INFORMATION Mobile Home $329.94 Mobile Home Plan Check $219.96 Total Charged: $549.90 Fees Paid: $549.90 Balance Due: $0.00 Receipt No: B1232 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License PREMIER BUILDERS 343173 / B / 09/30/2007 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 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of DivisioFQ of the Business and Professions Code, and my license pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full ce and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 12/18/2006 penalty [$500); Please check one of the following: Contractor's Signature Date ❑ 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 WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Law does not apply to an owner of the property, who builds or improves thereon, and who does HAVE AND the work himself or herself or through his or her own employees, provided that such improvements ❑I WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). 211HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 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; The Contractor's 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 Carrier: STATE FUND policy Number: 1127626-06 Exp. Date:05/01/2007 Contractor's License Law.). (This section nee not a competed if the permit is or one hundred dollars ($100) or less. ❑ 1 AM EXEMPT under Section B. & P.C. for this reason: 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' X 12/18/2006 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 12/18/2006 1 hereby certify that I have read this application and state that the above information is coned. I agree to comply wilh'all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, 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 AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused arising out of, o,o in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the t is a use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the pro�oer uth i d to ad n the property owners behalf. pbAb 91 M X12/18/2006 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Nam of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner D�tractor OR. Agent for Owner ❑Agent for Contractor FILE COPY Lenders Address City State Zip FS G 0 ascaao+ea w Orawlum Title maw i sr- ..w rnA eo Charles S. iliaetro o � i7ilma X. Blaelaam 29ao 011M Drive RiCfmond, C-4 94W "4• gain as obm � A J. .I seFWM erg . eECORQf t" b' ZiacJit �Y • Lams u�knsu�a A00Mr4s ung 'me meane=r. wwa es.o.w.vaa,a�� sea�a *ma aw.eiw 63•$7-45 camel sae b��r.��, a—Pak1J an fedi ""of!^If OWNP4. ar e!opwad'a� frill ♦aAft )eu •aba of Maas ad am -*&—No PWMb4 od time ot aah ilad.o.. wooi .hai { ) CIV d ofi 1?OSt a YlLB.iIA� �l3EfSi9CfiAi1CM. wd�� ai a�6a � I�� eL. ralwav • lhasba�r4 a� Itth GRAW(S) w CKAI,$Ad . tf modal g. barsband aid VIN, ad joint tenants 09 ted0w�&—Aw ftj pmany Is the UnIncorpora" t to . sake dFC4WWW a3 Lot 264, as shown on that eertaid Map. entitled "SMMA ML ORO BSTATE9 UNIT '00. 41, whiea was i►dmordsd 8aptenber 299 pages 4; gad 50. ��69, 1st Sip Bo®1t 359 at k8r EXCEPTING Ara PMUVTWO TIMaFROM all of the valuable alneralls be nth �narals,cItoboihe agroad and waders land with the gthatoIA all sietOgraopeors ions the surface of said lands will be proteated agairrat dm&Fre and that all such x1nLng shall be carried oA from turonals shafts or drifts having. their orifices Outside of the surfaee arra or the above described realtyy 411 as excepted and reserved in the peed from Xagalia Kialn`` C ry/ a ea ration' to S. O. Storte et uxv recorded Saptaabea $ 1947, in Boot 423 of Butte• County orficIal Reeordsr at psje ,, . e Dad __ Ngvaaaber -4. .1977 . E 3YAiE Of rur- N r or o„ Bb E.a tr �� i600 rte. \` .ate - e„wa k, w Sm rJ1• k&ma r•o. ARTHUR T. /1' w k. Ike pw..61_- ba" NNW bed to the odic WT"V PUBM C�WfDraVa4 swd,ae.m -m+.a.eWLftW SAN wvre COUNTV t`. «�.• tl�4rn«►�+.�t+P�wk/rtt.sar wme"s .r `.aa wd -met ..� ThLe Ordr No __ 1O4334- fwcror a t.oea Ne.y L �l �+ �1--p • -. I I AM TAX sTA(t�F�IdTIS( As I IDISWM ABOW 8 08,-,, 't �l.(' '0N,'.% Q,". � i ,15 1 �. � � : ��VL J - {� / \I��li) 3SI d 31111 n311'dn 11W NO i2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Fie Down Engineering __._-........._.... _....._.._.__....... ._.............._......._._...._............_.._......._._..............._........._.. r i— ♦.Uia IN aif37a•ii Xi2 Concrete Syst BUTTE C®U.NTY UILDING DIVISION APPROVED Engineer Approval State Approval MANUFACTURFD HOME/MOBILE HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE, SECTION 185SI APPROVED c_':;:w TOC'RRECTIO;v�NOiED APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS AND REGULATIONS State of California Department of Housing and Community Developmrnt _. V1V1S1qN OF CODES AND STANDARDS DATE —lit is ANO. PlsaApprovalEzpiroa 6 Page 1 of 8 „ o 0 , i2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Fie Down Engineering __._-........._.... _....._.._.__....... ._.............._......._._...._............_.._......._._..............._........._.. r i— ♦.Uia IN aif37a•ii Xi2 Concrete Syst BUTTE C®U.NTY UILDING DIVISION APPROVED Engineer Approval State Approval MANUFACTURFD HOME/MOBILE HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE, SECTION 185SI APPROVED c_':;:w TOC'RRECTIO;v�NOiED APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS AND REGULATIONS State of California Department of Housing and Community Developmrnt _. V1V1S1qN OF CODES AND STANDARDS DATE —lit is ANO. PlsaApprovalEzpiroa 6 Page 1 of 8 „ o 0 Aro i2 Foundation System EWl Installati®n Instructions for Calif®r WL for Ground &' Concrete systems HUD Wind Zone 1, 15 PSF Wind Loa REQUIREMEMTS • 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 weathering shall have a 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...." m Page 2 of 8 - o LO 1561 �Ca� Installation of Xi2 Ground Systems 1.• Identify the number of systems to be used on the home using the chart provided. 2. Identify the location where the systems will be installed. 3. Clear all organic matter and debris from the pad site. 4. Place U -bolts through holes in pan provided. 5. Place pad centered under beam with the lateral strut bracket towards the inside of the home. 6. Press or drive pan into ground until level and flush with prepared surface. 7. Build pier according to State, Local or Home Manufacturers guidelines. (Figure 1) 8. Attach the end of the smaller tube to the inside of pan using U -bolt & nuts provided 9. 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) 10. 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) Figure 1 1-3/4" Tube Lateral 5trut5 r-1-1/2" Tube a*1:��4 Tek 5crew5 U -Bolt & mounting Bracket HOW Nut & Washer of aA1 Strut :::•��'' a t F 1�1 1-6eam Figure 2 v O J -bolt Nut & Washer aA1 Strut (flag end) F 1�1 1-6eam Figure 2 11. Install frame bracket clamps to I-beam on in side of block/pier. Do not tighten nuts at this time. 12. Attach longitudinal strut to U -bolt in pan using nuts provided. 13. Insert strut in the frame bracket clamp, attach with nut and bolt. Do not tighten at this time. 14. Pull the frame bracket clamp with the fastened strut outward to remove any slack. 15. Tighten all nuts and bolts on the struts and beam.clamps. >DDWN ENGINEFRlAtG me 0 Ln 'U U G Xi2 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 Lorgitudinal 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 Oyo t e m 1 Longitudinal Strut & Hardware Kit 4 O� 0 Ground Longitudinal Strut Xi2 Stabilization Pier Placement for Ground or Concrete 8 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 Page 4 of 8 DOWN - ENGINMING'' - - Installation of Xi2 Concrete Systems 1. Identify the number of systems to be used on the home using the chart provided. 2. Identify the location where the.systems will be installed. 3. Build pier according to State, Local or Home Manufacturers guidelines. 4... 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"0-1/2" 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 g a 9/16 socket wrench, tighten wedge/anchor bolt, securing bracket to the concrete. 5. 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. 6. Attach the`f(ag 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 t next page) 7. 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 8. Install frame bracket clamps ori I-beam on the inside of block/pier. 9. Insert strut in frame bracket clamp and attach with nut & bolt. Attach opposite end to concrete bracket. 10. Pull the frame bracket clamp with fastened strut outward to remove any slack. 11. Tighten all nuts and bolts on system. Page 5 of 8 1%F DDWN ENGINFERIIJG=• 0 LO 0 0 O :Xi2 Lateral Concrete Systems Past #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. Figur 1 0 Nut & Washer Beam Clamp Bracket Longitudinal 1 -Beam Xi2 Installation Placement Longitudinal Strut Xi2 Concrete 5yotem F F r @r b dr .ftako Concrete Longitudinal Hardware Kit nd o �0me77 Page 6 of 8 .* 0 C LOO O 11 c > ,L 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 Xi2 Pier Placement Single Section Home Double Section Home 0 -80' (76' Box) 4 Xi2 Systems 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 Page 7 of 8 = 0 Li 0 1 I p 0 MV #59329-1 Hardware for 59306 Lateral System 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread 4 59272-2 1-3/4 zinc 4 10556 Tek Screw #12 x 1" 1 10631Z J Bolt 1/2X 5-1/2 grade 5 zinc 2 10640 Push Nut 1/2 1 12107 Flat Washer 1 x2" SS 1 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10519 Hex Nut 1/2" w/ Serr flange #59331 Longitudinal Hardware for 50,306 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-12 x 1-1/4 2 10646Y Full Thread 10 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10801 Carriage Bolt 1/2-12 x 2-1/2 4 10926 Grade 5 2 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread 2 10801 1-3/4 zinc 4 10640 Push Net 1/2 4 10519 Hex Nut 1/2" w/ Serr flange . # 59329 Hardware for 59333 Lateral land 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 full thread 5 10646Y Hex Nut 1/2-13 Grade 5 zinc 1 10801 Carriage Bolt 1/2-12 x 2-1/2 Grade 5 zinc 1 84533Z U -Bolt 1/2-13 x 2.63-x 2.19 Thread 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 It 10801 Grade 5 zinc #59027 Hardware Kit for 59307 Lateral Systern 2 59264 3 Wav 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 It 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 Page 8 of 8 FlJG1NEfXlNG G O U STATE OF CALIFORNIA • BUSPM5, TRANSPOWATION AND MOUBMS AGENCY ARNOLD SCHWARUNiGGER, Go", DEPARTMENT OF 14OUSING AND COMMUNITY DEVELOPMENT .�.Q P. I '--' ,% . DivbsIon of Co&s mnd SUndmot rybj� • Title Search 04 Dete Printed : 11120/2006 Dt: Decal -: LASWI Manufacturcr: 9248 GOLDEN WEST 1-IOMES T-adeharne: CALYPSO Model; (;A 47A 7 Manufactured .mate: 09/15/1982 Registration Exp: First Sold On: 10/08/1982 Serial Number GW06CnLCA75026A GW06CALCA75026B Registered Owner; HUD label / Insigrli CAL244778 CAL244779 Use Code: SFD Original Price Code: AHL Rating Year; Tax Type: L•PT Last ILT Anvunr Date IL'F Fee Paid: ILT Exemption: NONE Length Width 52' I2' 52' 12' CHARLES S BLACKMAN WILMA E BLACKMAN (TGnants in Common Or) 14 770 DENISE DR MAGALIA, CA 959549311 Last Title Date: 11/02/1982 Last Reg Card., 11/02/1992 Sale/Transfer Info: Price $28,074.00 Trmferred'on 10/08/1982 Situs Address; 14770 DENISE DR MAOALIA, CA 95954-9311 Siras County: BUTTE *** END OF TITLE SEARCH'*� E e g 9i0g6t l 1.0S '0 N/ l l '1S1ei;:1 ! 900Z 0Z L ! (N 01W I Od��'d -'_ I i A' i1VA 011,4 N0�' RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document lRecorded 2'1 -Dec- 2@X-0@66815 H" not keen colPared with original BUTTE COUNTY 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. BLACKMAN, CHARLES S & WILMA E BUTTE COUNTY BUILDING DIVISION REAL PROPERTY OWNER/LESSOR LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 14770 DENISE DR. 7 COUNTY CENTER DRIVE MAILING ADDRESS MAILING ADDRESS MAGALIA BUTTE CA 95954 OROVILLE BUTTE CA 95965 CITY— -COUNTY- STATE ---- •-ZIP----------- CITY---.-------- COUNTY---.---- --..-STATE- -ZIP-.--------..___. 14770 DENISE DR B06-2859 (530) 538-7541 INSTALLATION MAILING ADDRESS, IF DIFFERENT BUILDING PERMIT NO. TELEPHONE NUMBER MAGALIA BUTTE CA 95954 12/20/2006 CITY COUNTY STATE ZIP SIGNATrJRE OUOCAL 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 Golden West Homes' . 1982 Calypso MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER GW06CALCA75026AB 24'X52" CAL244778/9 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPER'L'Y LEGAL DESCRIP'T'ION: SEE ATTACHED ASSESSOR'S PARCEL NUMBER: 065-370-045 (z %h , Ir :..� •.� Y HCD FORM 433(A) REV 8/91 WHITE—County Recorder CANARY—HCD PINK—Applicant GOLDENROD—Building Dept. Maaewewa !eaoa+onso w 0twille Title Cxpam)+ Charles 9. Slacioaa -i Vilma X. Bia.eJimela .°. ►>L iniad, CA 94808 .I 94mt as ob e 7� u ams ' tie to�aT� eit+�. 11ECORQS . b' S1fC �lY • ►arise gin CpypTr AECQA f *'� "� v�+r � 'sect a;semaeeae • we -w tidhddwi COW '$fit r,..... ��- +wsswrMwn.�nMM+.tsrab*+atao 6S- �f� . .�f wm�wd.s ist �•d.. et �itE r - =rod (aY ♦alp 1w Ulm d` Bees baeoa"Mme" nnidq d "0 Qe a& t1id�+RMW d M A VALUAKE CO(( MATM 3p4 et a1Ei b 6"* r"N&1*4 GEDWt C.. FERMa acrd. SR&WA A. p=,U bnbuW sed bide BUMliasband �aitd vi a n • die tetM►tS -9w sad ualtwooti "d tte� .9w.1�Fl(a.rtes �t 2649 as shower 04 that Certain Map•antItled aBIOI ML 0 $8'f�S UNIT'3(•d. 4" which ass 1"Ordod Septeeber g9, 1969, let Map Book 3S• at p sea 48, � *ud 5o. ECkPfING AND RF.'SUVTNC THEWWiDN all of the velltuablo einarals bOngath the turf&Oe or the said land with the right to ai,ae'and extract•maid stheiaa't!aaes nd ueraa aU eo�idg�urtelands will dngrtaa'adthat all such Miaing shall be carried on fpm tunnexa •aha�fts or drifts haring. their orifices Outside of Us surfaee arca or the above deteribed realty, all as dxoepted and rasdrud in the Deed from Magalia kinin CqWary, a corporation, to S. D, 6torts et nz, recorded Septembers 1947, in Boot 423 of Wtto•County Cffielal Records, at page,,". t.d __ November A. 1977 A #tet were o®cAURM NU Me 1A A. FeLTAIA ps_30fK i P' a Ja r- �.� Llae �., eo. r�i:• .. .ti..4 +�w�r �d,li. r ..� Iw ..u• A W'wA _4_t&LrVL ux !A (i�•w h.iM 111W/ M WA TAX iW MMT$ AS DIIWM EM OF 9OC1Md1A�'�� 1 Q0 7 =SIGV%'dd 311i1 QFF!CA4 3R�1 rA..M r ar ARTHUR T. MCIAN w W ti. Pis---AAMf aawcs. .a_.ajjp N the trliia WrAmpusuc-ow DWMA %MMM.M sa.. *W *,K_td aS.th. G" "TMC LGA MW -SA4 V" Oil _4_t&LrVL ux !A (i�•w h.iM 111W/ M WA TAX iW MMT$ AS DIIWM EM OF 9OC1Md1A�'�� 1 Q0 7 =SIGV%'dd 311i1 ♦l FOUNDATIONSYSTEM CERTIFICATE OVOCCUPANCY BUILDING PERMIT NUMBER: B06-2859 Address or location of unit: 14770 DENISE DR MAGALIA CA 95954 Legal Description of Real Property: 065-370-045 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: BLACKMAN, CHARLES S & WILMA E Owner's address: 14770 DENISE DR MAGALIA CA 95954 INSIGNIA OR HUD NUMBER: CAL244778/9 SERIAL NUMBER OR V.I.N.: GW06CALCA75026A/B MANUFACTURER'S NAME: Golden West Homes YEAR: 1982 OFFICIAL APPROVING INSTALLATION: &� DATE:/ I -2-0 /0 iQ PHONE: (530) 538-7541 H.C.D. 513 065-370-045 PER.MIT#97-0752 BLACKMAN, Charles 14770 Denise Dr., Magalia Cont: -Morehouse A/C Service Gas Line for Furnace/MH 'mov OFFICE COPY -16 Address ----------------- GAS AS Date Meter By ELECTRIC Date 'Meter By COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISIO 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 �+ �P RMLNO. (Rev. 12/96) APPLICATION AND PERMIT ZONING BU$JKNGPERMIT ARLES BLACKMAN TELEPHONE SQ. FT. OCC. BUILDING VALUATION DR., MAGALIA CA 95954 ' GOJlrRA6T®A;dVo A/C SERVICE L nrx� TELEPHONE COffjtill_C,TOR'S MAILING ADDRESS CONSTRUCTION IENOER %UaJMAILING -ADDRESS ll�'ttltJJTT1l Fireplace Total Valuation $ ARCHMECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ _ ,t A,�iCf 7JUI,E� rySif[ If,J'•IMbli ADDR�S�$� GALIA j4 1J6(�1 fi , I'7A Plan Checking Fee $ BUILDING ADDRESS 1 Energy Plan Checking Fee $ _ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE v SF ❑ Duplex ❑ Mobilehome © Other SPECIFY Each Trap 7.00 Solar or heat um water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑� Installation ❑ Other ❑ GAS LINE FOR XU FURNACE Describe work: Gas piping system 1 - 5 outlets 15.00 Buildin sewer 15.00 200( Mobile Home S G W @20.00 • PERMIT FEE 4U.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Service 20DA 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 I force and effect. Q License Class ie;R) Lic. No. 6� ( 4t 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 Sec. Business and Professions Code for this reason To 46.00 Main Service ( 200ADWELLING NEW CONST. DWELLING OCUP. SO CCU OR ADDNS. ( 6 ACC. BLDS. 3.5,so MULTI-OUTLET 97,50 NON-RESIIDT BRANCHCIRCUITS ) POWER APPARATUS 8 SINGLE OUTLET CSI R. Ex. Occup. OUTLET OR FDrrURES BAL @ ',SO Ex. Occup. ouTLEEDTS RELNSIOOEA 5.00 Teinporary 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 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' n ber are: Carrier AI o Policy Number—NI a7(` W 7L (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) C3I 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 .1 should become subject to the workers' compensation provisions of1fsection 3700 of the Labor Code, I shall hwith omply with those provisions. //q�� X ___ Date /T �___ Signature o Applicant - ❑ Owner ❑ Contractor ❑ Age An OSHA permit is required for excavations over 5'0" deep and demolition or constructioWwo 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 $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ • HAZ. I D. FEES IMP I FLOOD I CDF PARCEL PD I HD 1 ISSU 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 Date Receipt No. r - 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, CO liforni^95965 - Telephone (916) 538-7541 PER IT NO. . 0. (Rev. 12/96) APPLICATION AD PERMIT ASS SSORPARCELNUMBER 05-370-045 ZONING BUI NG PERMIT OWNER CHARLES BLACKMAN TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS DR., MAGALIA CA 95954 �p14q4T77p�p77�Cq7TTi07ppa ggTDT�N�ENNISE lY1UK1;t1VUJ1;E A/C SERVICE TELEPHONE CONTRACTOR'S MAILING ADDRESS NONE CONSTRUCTION LENDER LENDER'S MAILING ADDRESS NONE Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS 14770 DENISE DR., MAGALIA Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome & Other SPECIFY Each Trap 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 C� Installation ❑ Other ❑ Describe Work: GAS LINE FOR XX0 FURNACE Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS JXG I W 1 920.00 PERMIT FEE $ 0. ELECTRICAL PERMIT Filing Fee 20.00 Main Service 2. OV oa 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.qq License Class C-20 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. ❑ 1, 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 I000A 46.00 NEW CONST. DWELLING OCCUP, OR ADDNS. ( d ACC. BUDS. SO 3.50FT. NEW CONST. M ULTI-OUTLET NON-RESID. .0 c @7.50 POWER APPARATUS d SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FocruREs BAS @'.550 R. Ex. Occup. oUIXTE�°�" RES,6.1 E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 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 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 n ber are: Carrier !�`A Policy Number (The above sections need not be completed if the perm) 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' 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 f hwith omply with those provisions. X _______ Date l� Signature -Applicant - ❑ 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. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 40.00 HAZ. D. FEES IMP FLOOD CDF PARCEL Do HD 1;7compensation This permit is hereby issued under the applicable of the Butte County Code and/or Resolutions indicated ove for which fees haye an By Date PERMIT EXPIRES ON iivm ate provisions to do work paid. / Q / Receipt No. 218858 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 -.Telephone (916) 538-7541 APPLICATJCNO ND PERMIT PERMIT NO. ASSESSORPMCELNU t6 s _go MaENt - ©Y5 ZONING BUILDING PERMIT ' OWNER A, r�� aI �/ac M et � TELEPHON! SO. FT. OCC. BUILDING VALUATION aNNER9 DRESS P I s ; G 4 COISRaCigR �C �I O �l�� Y' V I C � n TELEPHONE CONTRACTOR'S MAULING ADDRESS :,COt�TRryCnoNl�►IDEA _ . Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS )• T � ,/�D Y, Energy Plan Checking Fee $ b i� PERMIT FEE _ Cat No. SUBDIVISIONS NAMEPARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF Cl Duplex ❑ Mobilehome X' Other 'SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New O Addition O Remodel O Utilities 1 /Installation O Other O Describe . Work: C, -C4 5 Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home S W @20,.00 .00 PERMIT FEE $ - ELECTRICAL PERMIT Filing Fee 20.00 so V OR LESS Main Service 400A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter N n 7 s 4 C 9 (commencing with Section 700C) o Civisic—n. 3 c.:he Business and Professions Code, and my license is in full force and effect. License Class LIc. No. OWNER -BUILDER DECLARATION I herebyaffirm under penalty of perjury that I am exempt from the Contractors License P H P 1 rY P Law for. the following reason: O 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. O 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A To I000A 46.00 NEN CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. SLOS. a SO 3.5tsFTJ NEW CONS . MULTI.OUTLET NCN aEslo. ANC `�C 7.GO POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FWWAES SAL4 .50 Ex. Occup. FIXED APPLNS. OR P• 0uTEDS RETS EA 5.00 Temporary Service 23.00. Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE _ WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 4 I 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. Myworkers' 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.) O 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, 1 shall forthwith comply with those provisions. X Date Signature of Applicant - O Owner ❑ 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 S Mobile Home Installation Fee 5 Energy Inspection Fee $ occ TYPE 1L TOTAL FEE $ Z� jZ. . FEES IMP FLOOD coF PARCEL Po Ho rssuE 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 (Data) ReceiptNo. N / X9,J WHITE •0.O.S.-8.0. CANARY -ASSESSOR ' PINK -INSPECTOR GOLDENROD -APPLICANT i ,,P �S I Mc,,(,2a- f PERMIT NO. 1183-87B PERMIT EXPIRES---- OWNER XPIRES OWNER Cbnrleg R1nrkmnn _ CONTR. Mike Jakob r ASSESSOR PARCEL 65-37-45 LOCATION 14770 Denise Drive, Magalia Y ' l Temp. Power Pole Called PG&E Temp. Elec. Service Called•PG&E Temp. Gas Sei Called PG JOB FINALE[ Slg lure 09 J OK - O = Not OK Not Applicable MOBILEHOMES MISCELLANEOUS * = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except q's DateVER ARPORT JTC. (Plans) OK except #'a. 1. Zoning Requirements–Setbacks–Easements t,.?—oniag Requirements–Set s–Easemem9 2. Soils; Special MH Support–Sketchootings 3 D eks; Girders and/or Joists–Decking–Bracing–Stairs–Rails _ 3. Sewer; Local ion–Test=Fall-C/0–Concrete 4. 4. Water; Local ion–Test–Easement Needed (Sketch) ood Awn.; Posts–Beams–Rftrs.–Connec.–Shthg.–Rfg.–Bracing 5. Electricity; Location–Clearances–Grnd.–/ / Amp–Concrete – 6. Gas; Location–Test–Wrap:/ /"L"It./ /"Nat.or/ /"L"ft./ /"LPG 6.Aarports; windows–Doors 7. Utility Clearance Card -BI Date Card -BI Date Card -BI f4b Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements–Setbacks–Easements Date O S (Plans) OK except rs 1. Setbacks–Easements 2. Footings; Size–Spacing–Marriage Line 3. Gas; MH Test–Demand–Valve–Connector – 2. Soils; Compaction–Structure Stability 3. Pool Structure: Steel–Connections–Thickness–Dead Men–Lining 4. Electricity; MH Test–Crossovers–Breakers-Clearances 4. Elec.; Receptacies and Lighting: Distances–GFI 5. Drain; MH Test–Fall-Flex Connector 5. Elec.; Pool Lighting; 15 volts–GFI i 6. Water; MH Test–Regulator–Connector 6. Elec.: Enclosures; Conduit Entries–Terminals–Listed 7. Water and Sewer Connected–C/O to Grade–HD Approval 7. Elec.: Bonding; Metal w/5'–Circulating Equipment–Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'–Circulating Equip.–Pool Lghtg. Boxes–Enc losures– Pane lboards– Ins. to Main in Conduit 9. Exits: Insp.–Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test–Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J 01c O Not OK - = Not Applicable Nol ReadyeadyRESIDENTIAL (Single and Duplex) = Date UNDERFLOOR Plans OK except N's ;, - •,.L Dale FRAYING (Continued), - - 1. Zoning requirements-Setbacks=Easements ,. , . n. 2. Ftg., Main; Soils -Steel -Elie. Grnd.- / /" Ftg, Depth- 3. Fig., Garage; Soils -Steel- /_. /;' FIG. Depth 4. Ftg.; Porches &Decks; Soils -Steel- / /" Fig. Depth - 5. Slemwalls, Main; Sleel-Blockouts-Wrapped-Slab _ _ 46. Property Line Firewall.& OpeMngs 4g. Ext. Doors -One 3' -Check Garage -_3rd story. Baits 50. Stairs; Width -Headroom: Rise-�Ru_n-_Landing=Fire Protection 51, Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Si- Siding -Nailing -Veneer - --`_ - - 6. Stemwalls, Garage; Steel-_Biockouts-Wrapped-Slab -7. Piers_Flreplaco F[p.-Steel - - - --_ 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 53. Stucco klesh-Drip Screed-Fdn. Vents-Undefflr, Access 54. Glazing Area -Glass Protection -Skylights -Plastic 55. Shear walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors _- 10. Water Pipe; Test -Anchors -Regulator -Service Test _ - 11. Electric: Underground - 12. Plenums & Ducts; Clearance -Material -Support -Ins. ~Card 13. Girders -Sills -Anchor Botts -Joists -Vents -Cripples Card -BI Dale -BI Date _ .A -• Card -BI Date Card -BI Date Card -BI Date Card -BI Date Cerd-BI Date Date Card -BI Date FINAL (Plans) OK except N's Card -BI Date Card -81 Date 56. Ext. Steps -Door & Sidelight Protection -Landings Date PLUMBING (Permit) OK except N's 57. Smoke Detector 14. Water Ht,: Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - 15. Water Pipe: Test & Anchors -Nail Protection In Garage: Above Floor-Ducts-Aiech. Protection 16. D.W.V.: Test-Fttn_gs &_Anchors -Nall Protection 59. Bedroom Exiting 17. Shower Pan: Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel: Breaker Sizes -Labels 19. Gas Pi_p_e_:_siz_e_&_ Anchors 62. Stairs & Rails - 63. Fireplace or Stove: Clearances -Hearth 64. Elec. Outlets at Wood Panel: Int. & Ext. Card -BI _ _ Dale. - Card -81 Date 65. Kit. Fixt. & Appliance: Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter Card -Bt Date Card -BI Date 67. Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Permit OK except N's 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wir. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- 21. Elec. Receptacles Spacing -Lights & Switches a1 Doors In Garage; Above Floor -Meth. Protection 70. PID.. Elec. &Mech. Equip. Listed for Location 22. Size Boxes & No.of Conductors -Stapled 71. Elec. Receptacles in Garage: (G.F.I.)-Rornex Protec. -_ �-ed 23. Romex Installed Close to Edge of Studs '& C.J. _ 72. Insulation -Foam -Looked in Attic ❑Yes _24. Equip, Ground made up w/Mech. Fasteners=Bond Gas & Water 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. Guard Rails &Deck Construction -Post Caps 74• Fan. Vents & Crawl !-tole Door -Drainage & Wood -Earth Clearance Looked antler Floor C Yes 26. Subfeed Wire Size %- / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI, Insulated Neutral _ Yes 'No 28. Service -Riser Conductors &_Ground -Main Disconnect 75, _ Following instill.: Drive Yes ❑ No: Walks [ Yes [ No: Planter s (_ Yes J No --78. 76. 77, Stucco:Planter Brown -Finish A.C. Unit: Disconnect-Clrnces-Brkr. & Cond. Size -1115V Outlet - _ - 29. Equip. Clearances: Pane ls-Motors_Mecn. Equip.- _ 30. Clothes Closet Light -Shower Light Vents Above Root: Plbg,-Appliance-Firepi.-Clearance to Opngs. -- _- __ 79. Water Well. Disconnect, Electrical, Plumbing - • - • - -------------- 80. -81. _ Exterior Elec. Trim: G.F.I. Receptacle -Underground Card B -I Cara B -I Date Card -81 Date Dale Card -Bl-- - Date - - --- -82. Ventilation throughout House Glass Prosection _ Date ' MECHANICAL (Permit) OK except it's 3t. A.C. Ducts. Insulation &Support- - - - 32. Vent Fan: Exhaust above Insulation 33. Condensate Drain & Overflow. Size Grade 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric g5, water & Sewer Connected -C/O to Grade -HD Approval 86. Energy Compliance Certificate -Other Certificates - -- __•__ _& _ 34. F,unace-Vent. Access -Comb. Air -Return Air Vent -115V outlet ---"-"-- ------ - - -" -" 35. Attic Access & Platform it Furnace in Attic - - - - --' ---- -- - Card-BtCard-BI Card -BI Date Caid-BI Date Datc Card -BI - Date --- Card -81 Card -BI - - - Oate Card•BI - Date _. ---- -- --- -D_a_te -Card-BI Date Card -BI Date Dmt, FRAMING(Plans) OK except P's Comn-ents '----._ at Final: --- - _ . -.-- .-.-----'--- - J6. Sills. Proper Matetrat & Anchors 37. Walls. Stuns -Nailing. Spacing & 8racing-Plates-Sound - - - - - ---- --- -- -- 38. flearmg Wally river Girders & Floor Nailing 39. Otall Slop or Walls (rat proof) -- 40. r uc Stops Funetd Ce_tlinys-Slaes-Chases-Tub - .11 Header & Real -Site K 8ea,mg_---- .Q. 1611ytrrs-Poul C,q>s-AnC hot •:-ConneClois - - - - - - -' -- -- .1J. Clnlr. Jo,sl-Hill. Tivs- PutIm- Roof Biac.-Ttuzs--Slithnq.-Rhtq,-- a.L f ue•placo 1 rrs of 1 ype A Flue-Fuepl,ice Thtoai-- 4`,. Atli Ar i vs Stti• & Rohr. Ptuleclioii-Di.lft Slop -Ins. Balite, . 46. H.Jnu. Wniilk'AS U. F.xituiq Doors -Sill 1191. & Dimensions - - ... .,•. i'1 • t vv Pial , uv;, Fim,• .;I...._..- 1: COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PE MIT NO. 7 County Center Drive - Oroville, California -95965 - Telephone 916/534-4541 7R P APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER C' ✓ �- ✓ ZONI BUILDING PERMIT OWNE TELEPHONE SO. FT. OCC. BUILDING VAL ATIO OWNER'S AI LI ADDRESS CONT A TOR' NA TELEPHONE ✓ S CONTRACTOR'S MAqL1NG ADOESS Fireplace CONSTRUCTION LEN ER AJ UNFK1TO N Total Valuation $ ZYCOJ_M (� Filing Fee $ 10.00 LE D 'S MAILING ADDRESS Permit Fee $ 0 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 1 —� Energy Plan Checking Fee $ ARCHITEC OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS A Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCE MAP Water piping 5.00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Oth, L/ PECIFV Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W - 0.00ea TYPE OF WORK New Addition ❑ emodel ❑ U/tilities ❑ Installation❑ Other ❑ � Describe work: � _ Fz Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service R LESS 100 P OR 00 AMP OR 10.00 Main Service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): • � I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Profess' s Code and my license is in full force and effect. License No. Classification f ? El 1, as the owner, or my employees with wages as -their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) E:1 1, as the owner, am exclusively contracting with licensed contra ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.y , DR ACDNS. ACC. BLDGS. /zQsgft NEW CON5T.ES'D. U NCH C LET 2.50 ea NO N•R ESID BRANCH CIRC ITS POWER APPARATUS 6 SINGLE OUTLET CIR. EX. OCcup�OUTLETS OR FIXTURES 20®e0t eAL930 FIXED Ex. Occup. OUTLETS P(RESID )REAJ 2.00 Temporary service 10.00 Home Facilities 15.00 Mobile Hoct- Misc. g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 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 I provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIirig Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in c asequence of the granting of this permit. X�Li0 Date Signature of Applicant Owner ContractorW Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ O OCCUP. CONST.TTPE P o P EL go S This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC By PE EXPIRES Date the applicable provi- resolutions to do fees have been paid. 'WORKS Date f � over Receipt No. �D ,Z 7 WHITE-D.P.W.. TELLOW-AS8E880R, PINK -INSPECTOR, GOLDENROD -APPLICANT PM COUNTY OF BUTTE - DEPARTME'NT,OF PUBLIC. WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVI LLE. CAbiFORNIA 95965 - TELEPHONE: 916/534-4541 OWNER Proposed Building U PERMIT, APPLICATION DATA SHEET �/11A, r Building Inspector Permit No. I A. P. No. Date At time o ermit application, I was advised the following data must be submitted prior to permit processing and:/Or SSUance: DATE RECEIVED APPROVED 1. All items have been submitted. 2. Plot plans in duplicate./triplicate, signed by preparer of plans. , 3. Complete plans in duplicate. /triplicate, signed by preparer of plans, 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance_Statement . 6. CUSD "Fees Paid" Stamp on Floor Plan 7 Statement of Intent for Non -Heated and AC Buildings. R. Fees of $ , 9 Letter of signature authorizati 10. Sanitation approval from . Health Dept. • 11. Planning approval for (A) Use: (B) Parking: 12, Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif,) 14. Owner -Builder Verification (Given to owner❑, Mail to ownerE]). _15. Improvements may be required. , 16. Mobilehome Installation Data. Pre-Inspec. request to (Date) 17. Pre -Inspection for Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of ' 21. 22. When a sue the ermit, process as follows: Mail towner, Mail to contractor. y Telephone and hold for pickup a�u,21 office, Deliver w/inspector. Other Applicant Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder — Flours: 10:00 a.m. - 3:00 p.m. G Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder — Flours: 10:00 a.m. - 3:00 p.m. TO: Building Department FROM: Environmental Health SUBJECT: SANITATION CLEARANCE. 0 WN ER LOCATION AP # Plans approved for: Sewage Disposal Water Supply Hold final for: Water Supply Final Clearance O.K. for: Water Supply Clearance for bedroom mobile home. Other ' r r Clearance for addition of No tj**/� 0� D ARIAN /WGCDo�� _r- • DATE / L/ 7J 4 f��.vi fi This set of plans and specifications MUST be kept on the job at all times and it is unlawful to make any changes or alterations on some without written permission from the Department of Pu6lic Works, Cour.#y of Butte.-- Z Exts'tiN(r .tY)o8It6 14off)E W1 CAIr-I?S'T Q.Qmr ROOF tutor wglo A setback of :] rt. ;►ril 1 I"its property lines and a setback of 50ft. from the road centerline shall be clear of structures or equipment except for a 2 ft. eave overhang. I BurrE COUN.� .y W.AING DERARTME PPP0"'VED I� 7i 1p 6' 1 yL a, 1 278 2-81P,E PERMIT NO. {/ PERMIT EXPIRES - OWNER Charles Blackman CONTR. Presidential Homes; Para. x ASSESSOR PARCEL 65-3745 LOCATION Denise Dr . , L•t 264, SDO#4,Mag Temp. Power Pole Called PG&E Tem . Elec. Service_L Called PG&E yah. Temp. Gas Service CalledPG&E- r �+ gf/® JOB FINALED (Dale)", -�� Signature IC r� V = OK ! r 0 - Not OK — - Not Applicable MOBILEHOMES * - Not Ready r MISCELLANEOUS A Date MOBILEHOME UTILITIESr(Plans) OK except #'s Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s 1rning Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—Easements 2-? Soils; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors V,eifwer: Location—Test—Fall-C/0—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 44�a 4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing Electricity; Location—Clearances—Grnd.'—/.3-90 AmpConcre 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors tiIity Clearance 7. Elec. Card -BI ate Card -BI Date Card -BI Date Card -BI Date Card -BI ate — and -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALL ION (Plans) OK except #'s Date POOLS (Plans) OK except #'s 1. XoqLng Requirements—Setbacks—Easements 1, Setbacks—Easements Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability —Demand—Valve—Connector 40-ET—ectricity; MH Test—Crossovers—Breakers—Clearances 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4• Elec.; Receptacles and Lighting; Distances—GFI r MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI .-ZajqX.�.MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 71and Sewer Co ed—C/O to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8o=Qe9 and Electr Sty Tagged B. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Health Department Approval xits; Insp.—Sketch of Occupancy 10. Plumb; Cir. Test—Water Supply Test Card B -I to and -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable Read = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK exc8 t#'s _Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel -B lockouts -Wrapped -S lab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel -B lockouts -Wrapped -S lab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except #'s 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date _. PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. 17. D.W.V.; Test-Fttngs & Anchors -Nail Protection Shower Pan; Test, First Floor -Tub Access 59. Bedroom Exiting 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels - 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. 64. 65. Fireplace or Stove; Clearances -Hearth Elec. Outlets at Wood Panel; Int. & Ext. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except N's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21, Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. _ 24. 25. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen & Conductor Size '72. Insulation -Foam -Looked in Attic ._ ❑Yes73. 74. Guard Rails & Deck Construction -Post Caps Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑Yes 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size - / / ga. Cu or AI 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes (:1 No 75. Following instld.: Drive ❑ Yes El No: Walks F1 Yes E) No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except #'s 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. 34. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 86. Energy Compliance Certificate -Other Certificates 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING(Plans) OK except q's 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing _ 42. 43. 44. 45. Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnp.-Rfnp. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrri Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) 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-73Z/--k2-for the following location: �y ��1 %/ � ��,��e v �i •lam-.a's3 J�/.�+, Owner Owner Mobilehome Mfg. -�)V-)VA t Model �`-t�` 5 Z' Year Z - Insignia No, Z' V 77-�i~ 7c1 Serial No. "' 4:3 It is hereby certified for occupancy at the above described location and may be occupied. { Director of Public W rks � Date /- -- By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. 13 COUNTY OF BUTTE Z•,, DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70 7 County Center Drive, Oroville — Phone 534-4541 Skyway and Elliott Road, Paradise ---Phone Oil? -5435 � + �p� S72-24�.� XS� C R E C ® 10 ®�C30TICE /g770 �t BUILDING OR PROPERTY ADDRESS �- A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. X c 0/y 'o 7osl��i d ©� h4! 75 &2 U i 4t -d Inspector COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville;, California 95965 - Telephone 916/534-4541 '` Ir APPLICATION'AND PERMIT PEQRMIT NO. akv ASSESSOR PAR9E�`MBER ZONING BUILDING PERMIT O WNFjR. /^ l/�/ rL/L/._L,l TELEPHONE S0. FT. Ope. BUILDING VALUATION OWNER'S MAILING11 ADDRESS CW 2 CXgT ACST O ® R' S iJ�,jyt A l lyl NldA E65 d� n ��iJ /J C3•----- �/-7it/7/s6 Fireplace CONSTRUCTION LEND UNK OWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING DD ESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO.--PHIPlan Checking Fee$ Penalty $ ARCHITECT OR ENGINE 'S MAILING ADDRESS Permit fee $ BuIL ol`td, V ESSDE�/SC �� , PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 "141Lf Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 5,00 Gas piping system- 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY _1 Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilitpi �saw In's tion Other ❑ Describe work: F- %-7 L, YC�1y1 �2 f Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eo0v OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW OR ADDNST (ACCLBLDGS.LING CCUP.y\ / 20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): F1 I am licensed under provisions of Chapt.9, Div. 3 of the Business and Professions Code and y license is in full f rce and effect. License No. �s 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 -OUTLET NON -REBID BRA CH CIRC ITS 2.50 ea tr\ NEW -CONSTR POWER APPARATUS , / NON RESID. SINGLE OUTLET CIR 250 soL@1 Ex. OCCUR(OUTLETS OR FIXTURES BAL IXED APP LNS, OR Ex. Occup.(oUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. F-L/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 forthwitn comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3,00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, a enses which may in any way accrue against 'd County in q e o e granting of this permit. y %� D to �/ - ignature of Applicon — O e Contractor gent ❑ 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 $ S_®O tn TOTAL PERMIT FEE $ l!i ov occuP. GROUP I TYPE OF CONST. PARCEL I PD I ND SSOE� This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIREC R OF PUBLIC By PE2(V Date the applicable provi- resolutions to do fees have been paid. WORKS Date IF," —Y e L/V Receipt No.�ZQ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OFPUBLI C PER IT NO. 7 County Center Drive - Oroville, California 95965 - Teleph APPLICATIbN AND PERMIT ASSESSOR PMBER (pA _ 7- vs ' ZONING BUILDING PERMIT OWN Ja f2 L,L TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CORACTOR'S-NAME a` 4t TELEPHONE -7 -333 CO'NTRACTOR'S MAILING ADDRESS (( V. PA ?IL VAIrVOISIr Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ LE DER'S MAILING ADDRESS Permit Fee $ AR HITE T OR ENGIN ER 'CENSE NO. ,�1���� nL"Ol� 1J S 1 1; 1 `i' Plan Checking Fee $ Lv—" Penalty $ ARCHITECT OR ENG EER'S MAILING ADDRESS Permit fee $ BUILDING AD.DR SS O PLUMBING PERMIT Filing Fee 10.00 ' Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping CO— LOT NO. SUBD VISION NAME 14L yGas PARCEL MAP Each gas water heater or vent 5.00 piping system 1 - 5 outlets USEOFSTRUCTURE SF ❑ Duplex❑ MobilehomelV( Other '7r/ SPECIFY Building sewer /d"' Lawn sprinkler system 5.00 TYPE OF WORK New❑ Addition❑ Remodel El Utilities Installation[] Other❑ Describe work: Permit Fee $ Contractor f61/Jwna►� ELECTRICAL PERMIT Filing Fee 10.00 Main service DOOV OR LESS 100 AMP OR LESS 5.00 Main service EA_ ADD'L 100 AMP 2.50 .1$m NEW CONST. DWELLING OCCUP.51 2�sgft OR ADDNS. ACC. BLDGS. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑NON-RESID. I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. .31 (_84 3 Classification AEx. ❑ 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. I MULTI -OUTLET 2.50 ea NON-RESID BRANCH CIRCUITS) NEW CONSTFL ( POWER APPARATUS 6) SINGLE OUTLET CIR, 50 @ 25¢ Ex. OCCUp OUTLETS OR FIXTURES BAL�1 IXED APPLNS, OR Occup.(OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 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 shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I als ee to save, indemnl and keep harmless the County of Butte against all )abili ies, judgm is c ts, and expenses which may in any way accrue ag i t s C unty i c qu ce of the granting of this permit. X Date ��Z3'�l Si n ure o pp ica t - 0 n Contractor Er Agent ❑ An SHA permit is required fo cavations over 5'0" deep and demolition or construct- ion of structures over 3 stories i height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ -7 OCCUP. GROUP TYPE OF CONST, PARCEL PD N ISSU This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to dD work indicated above for which fees have been paid: D=0,R'(0 F ELIC WORKS By '�-� --- Date r PERMIT EXPIRES Date�i T Receipt No. 'S—>!J ' WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT • Y r f < 2 Me, ONAPCFs 24,2�:izlvlAH bdaw � t�,, h1� Ft �A iso f3 i i O FN/fF' �Y. SQA • 0 b e,�,tC �A%�•r I�✓ . i��•��'•C�adPoRT x�Q wkpoS73 $�c/C.M�9X• �1y Moo 7�6 W A lrEk 8oj . ,To/ STAjj *t 15 Lk, FELT vN06� ��O �a. Comp• sN,NSt.ts P� cry 3z L C- - , �' RR PTEAs _ �� YG �. #p- % ov. D, l=. — C 44 3l LvE;2 easT "P- 4x�1 Pos7s 7 �% mA� - cvtrW- MIN 1"Remo Pf Pos^c te"ette-M Crrv, -W ff`f slLVFR PosT AOC -POPS @ PrU- P" �savAR5 CONcpzrs 17- 9 Yu S 4 :CgRpok 89� SPLICE a,rQ pons 4 2 's-14 s-rr2� 14 X 'a"i3CA^ of the Ty�` "f Ns pwo w 4 L� ocr ro Po -1s parT, 4. €ate C-WrQANte Roos