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Home My WebLink About065-400-036A.P. OLDER J. TRAVIS 140 Twin Pines Rd., Magalia Permit 1774-73B (decks. (2).. for...mobile home,).- B07-0448 ome•) -B07-0448 065-400-036 RESIDENTIAL SFD-Mobile Home RET EX MH EX SITE PERM FN DN � 1248) 15088 TWIN PINE RD SHIELDS, ROBIN ETAL 614. [Uk tt �*w 46 ►, 0 l A.P. OLDER J. TRAVIS 140 Twin Pines Rd., Magalia Permit 1774-73B (decks. (2).. for...mobile home,).- B07-0448 ome•) -B07-0448 065-400-036 RESIDENTIAL SFD-Mobile Home RET EX MH EX SITE PERM FN DN � 1248) 15088 TWIN PINE RD SHIELDS, ROBIN ETAL 614. [Uk tt �*w 46 ►, 0 0 -- r 0 MAR -OB -2007 08:13 a I yr1'nA1 PACIFIC MORTGAGE 530 87 1790 I \ 06LZZGIB r N0151 -r0:) O01H7 P.02 MAR -08-2007 08:14 PACIFIC.MORTGAGE 530 872 1790 P.03 i-rA,e J TA 'n14 RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 16 -Mar -2007 2007-0013013 Has not been compared 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. SHIELDS, ROBIN ETAL BUTTE COUNTY BUILDING DIVISION REAL PROPERTY OWNER/LESSOR LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 5947 HAZEL WY 7 COUNTY CENTER DRIVE MAILING ADDRESS MAILING ADDRESS PARADISE BUTTE CA 95969 OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP CITY COUNTY STATE ZIP 15088 TWIN PINE RD B07-0448 (530) 538-7541 INSTALLATION MAILING ADDRESS, IF DIFFERENT BUILDING PERMIT NO. TELEPHONE NUMBER MAGALIA BUTTE CA 95954 3/15/2007 CITY COUNTY STATE ZIP SIGNAT OF (PCAL 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 AMBASSADOR 1974 1 UNKNOWN MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER U1227/ X1228 52'x 24' 109034/5 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION: ASSESSOR'S PARCEL NUMBER: 065-400-036 SEE ATTACHED HCD FORM 433(A) REV 8/91 2/28/2007 10:23 PAGE 003/004 'Fax Server Order No. 3-164726 0 SCHEDULE C The land referred to herein is described as follows: All. that certain real property situate in the County of Butte, State of California, described as follows: Lot 123, as shown on that oertai.n map entitled, "PARADISE PINEB UNIT NO. 3", which map was filed in the office of the Recorder of the County of Butte, State of California, on June 27, 1970 in Book 35 of Maps, at pages, 78, 79, 80, 81 and 82. EXCEPTING THEREFROM all of the valuable minerals beneath the surface of said land with the right.to mine and extract said minerals, it being agreed and understood that in all operations the surface of said land will be, protected against damage and that all 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 that certain Dead from the Magalia Mining Company,'a corporation, to E. D. Storts, et uK, recorded September 4, 1947 in. Book 423 of Butte County Official Records, page 385. AP No. 065-400=036 Ex. FOUNDATION SYSTEM CERTIFICATE OF OCCUPANCY BUILDING PERMIT NUMBER: B07-0448 Address or location of unit: 15088 TWIN PINE RD MAGALIA CA Legal Description of Real Property: 065-400-036 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: SHIELDS, ROBIN ETAL Owner's address: 5947 HAZEL WY PARADISE CA 95969 INSIGNIA OR HUD NUMBER: 109034/5 SERIAL NUMBER OR V.I.N.: U1227/X1228 MANUFACTURER'S NAME: AMBASSADOR YEAR: 1974 OFFICIAL APPROVING INSTALLATION: DATE: 3 I x5-107 PHONE: (530) 538-7541 H.C.D. 513 L/Gti/LVV! lU:LJ VAUt VU%/VV% rax Doivcr _.. ,_. _, DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT p�su+c yti 01v1sion of Codes and Standards , 04 Q 3 u� Title Search04 G Date Printed: 02/28/20117 Y pEv�� Decal #: LAV8047 Manufacturer: Tradename: AMBASSADOR Model : Manufactured Date: 00/00/1974 Registration Exp: First Sold On: 09/30/1974 Serial Number L; 1227 X1228 Record Conditions: Registered Owner: HUD Label / Insigni 109035 109034 PPF Exempt Voluntary Conversion to LFT Use Code: SFD Original Price Code: ADx Rating Year: Tax Type: LPT . Last 1LT Amount: Date ILT Fee Paid: ILT Exemption: NONE Length Width 52' 12' 52' 12' ROBIN SHIELDS 15088 TWIN PINES MAGALIA, CA 93954 Last Title Date- 06/30/1999 Last Reg Card: 06/30/1999 Sale/TranAirer Info: Price S 18,000M Transferred on 0 1/26/1994 Situs Address: 15088 TWIN PINES MAGALIA, CA 95954 Situs Couro: BUTTE Legal Owner: GREENPOINT CREDI T LLC 12250 KIRKHAM RD STE A POWAY, CA 92064 Last Title Date: 06/30/1999 Lien Perfected On: 10/14/1998 17:11:38 Inactive Decal/DMV DMV L08735, DMV LG8134 *** END OF TITLE SEARCH *** 9 2/28/2007 10;23 PAGE 002/004 Fax Server RECORDATION REQUESTED BY: Robin Shields 1263 Parque Drive Chico, CA 95926 WHEN RECORDED MAIL TO: Kim L. Addington 15088 Twin Pine Road Magalia, CA 95954 SEND TAX NOTICES TO: Kim L. Addington 15089 Twin Pine Road Magaha, CA 95954 IfIBUI lit tl�l l �llll�f fif 8l fll�f Recorded Official Records CouUnTtfEOf CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 12148PN 64-Jun-iNft I TAX FEE It. N I PES -PR E®. D0 I I I I Shauna I Page I of 2 SPACE ABOVE 1619 ME IB FOR RECORDER'S USE ONLY GRANT MED THE UNDERSIGNED GRANTOR(s) DELCARE(s) UTAT DOUCH NTARY TRANSFER TAX IS: COUNTY $ _ Ur 2'E [ ) computed on full value of property oonveyad, or [ X ] computed an full valueless value of liens or enctunbmites minoining at time of sale,.,.... r,e O [ X ] tutincorpordtcd area; } City of . and G'anb� Yrtery ah'P Stafomont wOT FOR VALUABLE CONSIDERATION, Receipt of which Is hereby acknowledged, F'Ied' (See- 480 RT Cod- to rr,,:1jrnq ROBIN SHIELDS, AN UNMARRIED WOMAN odcress.on drumont. hereby GRANT(s) to ROBIN SHIELDS, AN UNMARRIED WOMAN AND KIM L. ADDIMTON, AN UNMARIULD MAN, AS TENANTS IN COMMON The following descriacd real property In the fmioorporated are of the County of Batt@ - State of ralifornia; SEE LEGAL DESCRIPTION ATTACHED HERETO AND MADE A PART HEREOF Data Acid 22.?�02 Robin Shields STATE OF CALIFORNIA AS COUNTY OF $ 11TTTF ) On JUNE 4. 2002 before me ELYSE M. HOLTS NOTARY''PUBLIC a Notary Public in and for said State, pe rAlly appeared R n R T tv SHIELDS HrEi DS personally known to me (or proved to mom the basls of Wisfsetory evidence) to be the petsoa(s) whose naate(s) Wart subscribed to $te within instrument and acknowledged to me that hc/dtrhhoy executed the same in hivher/their authorized capecity(les) and that by hislher/their signature(s) on the Instrument the persons) or the entity upon behalf of which the paswt(s) acted, executed the instrument. WITNESS my d and official seaL Signature ELYSE M. MOI; NOTARY MiRL Q ORNIA tR Name' EL SE M. HOLT eumeoout+tn 0 Cryped or printed) COMM. tarp. Fria. t4, 000a " This area for official notarial seal. Mail Tax Staternents to: SAME AS ABOVE of Address Noted Below F®-27-2007 10:41 PACIFIC MORTGAGE BCHEDM C 7ha land rePwsrpd to heroin is deaOribed 00 86llaw8 530 872 1790 P.03 Ordaz No. 3-15473$ All that Certain real Mpasty Situate In the Cousrty oP Dutta. Btatm of CviIfnrnia. described as f011OwSr Lot 123, as shown On vhat certain roap entitled, "PARADIBR pZNv® UNty NO.. 30, which Way was filed in the office of =8 RGQ0C4sr of the County of uutto, Btaco at calLI rvr %ia, o,. June 17, 1970 is Book 35 of Nap$, at pages 78. 79, 90, 81 arta 82. rprTNG THEAEF9W all of the valuable m1raersls beneath tbA sous® Of aaid land with the right to rntnp mnd extract said mirnwa.Le, it being egread and understood that jA all 9powat4ono the gurtace of oaid land will be protdcted against damage end that all mi shall be O&VftGd on Cram turmel.s, shafts or drifts having their oriliae+s autsida of the surtwe area of the abov" described realty, all as axompted end ve"rVed in that burtalrr D"is trom the magalia Mining company, 'a aoa'Doration, to 11. D. itota, at un. vocordad Soptodmv 4, 1447 in Book 423 of gutta County Official RACrarAsB, page 385. AP ro. 063-400-035 i Ee►. I 2/28/2007 10:23 PAGE 004/004 Fax Server DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT vSG qti 01v1sion of Codas and StandardsVo 16'i��lkr �Title Search o Date Printed : 02/28/2007 t)E�� Decal #: LAV8047 Manufacturer: Tradename: AMBASSADOR Model : Manufactured Date:- 00/0)/1974 Registration Exp: First Sold On: 09/30/1974 Serial Number L. 1227 X1228 Record Conditions: Registered Owner: HUD Label / Insigni 109035 109034 PPF Exempt Voluntary Conversion to LPT Use Code: Original Price Code Rating Year: Tax Type: Last LLT Amount: Date 1LT Fee Paid: ILT Exemption: Length 52, 52' ROBIN SHIELDS 15088 TWIN PINES MAGALIA, CA 95954 Last Title Date: 06130/1999 Last Reg Card: 06/30/1999 Sale/Tranrrer Info: Price S 18.000.00 Transfenrd on 01/2611994 Situs Address: 151188 TWIN PINES MAGALIA, CA 95954 Situs County: BUTTE Legal Owner: GREENPOINT CREDIT LLC .12230 KIRKHAM RD STE A POWAY, CA 92064 Last Title ]Date: 06/30/1999 Lien Perfected On: 10/14/1998 17:11:38 Inactive Decal/DMV: DMV L08735, DMV LG8734 **" END OF TITLE SEARCH **' SFD ADX LPT NOIR E Width 12' 12' BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 3 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-0448 Issued: 03/08/2007 Address: 15088 TWIN PINE RD Area: MAGALIA Owner: SHIELDS, ROBIN ETAL APN: 065-400-036 Applicant: PREMIER BUILDERS Map Page: Permit Type: SFD-Mobile Home RET Description: EX MH EX SITE PERM FNDN (1248) Flood Zone: None SRA Area: Yes Front Setback: Side Setback: Rear Setback: Other Setback: Minimum Setback From Centerline of Street: f ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 3 d Inspection Type I IVR I INSP I DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 1.43 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 1 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 -Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Finals�gJ Publis Works Fina 538-7681 Fire Department/CDF 538-7111 Env. Health Final 538-7281 Sewer District Final **PROJECT FINAL 801 -rrolea anal is a l,ernncare of occupancy ror (xesiaennai umy) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspectcr 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: 15088 TWIN PINE RD Owner: Permit No: B07-0448 APN: 065-400-036 SHIELDS, ROBIN ETAL Issued Date: 03/08/2007 By KEJ Permit type: RESIDENTIAL 5947 HAZEL WY Subtype: SFD-Mobile Home RET PARADISE, CA 95969 Expiration Date: 03/07/2008 Description: EX MH EX SITE PERM FNDN (1248 Occupancy: Zoning: RTI Contractor Applicant: Square Footage: PREMIER BUILDERS PREMIER BUILDERS Building Garage RemdUAddn 1584 WAGSTAFF ROAD 1584 WAGSTAFF ROAD PARADISE, CA 95969 PARADISE, CA 95969 Other Porch/Patio Total (530) 872-1096 (530) 872-1096 FEE INFORMATION DBF MH Plan Check $219.96 DBMSC Mobile Home $329.94 Total Charged: $549.90 Fees Paid: $549.90 Balance Due: $0.00 Receipt No: B2094 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 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 03/08/2007 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND 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.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the STATE FUND 1127626-06 05/01/2007 Cartier: Policy Number: ExpDate: Contractor's License Law.). (This section nee not a competed if the permit is or one hum re ollars. ($100) or less. ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 03/08/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 03/08/2007 I hereby certify that I have read this application and state that the above information is torted. I agree to comply with 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 CML 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, in any way connected with the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND 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 property owner or am authorized to act on the property owner's behalf. 03/08/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner ❑ Contractor OR; DAgent for Owner Agent for Contractor INSPECTOR COPY Lender's Address City State Zip COUNTY OF BUTTE r BUILDING DIVISION r DEPARTMENT OF DEVELOPMENT SERVICES 'r~ 7 County Center Drive • Oroville, CA • (530) 538-7541 r' CORRECTION NOTICE z /9 S 1307 E+ OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of `z; work is completed. If you have any questions pertaining to this matter, or need additional r.; explanation, please contact the Building Inspector as indicated below. �s tf� ;sr � .41 :1 - r r :r - rew Ia e. V,. �r Date O Inspector , REV 4/05 Phone # FOR RE -INSPECTION CALL: ,:538-7636 OR 891-2834 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: 15088 TWIN PINE RD Owner: Permit NO: B07-0448 APN: 065-400-036 SHIELDS, ROBIN ETAL Issued Date: 03/08/2007 By KEJ Permit type: RESIDENTIAL 5947 HAZEL WY Subtype: SFD-Mobile Home RET PARADISE, CA 95969 Expiration Date: 03/07/2008 Description: EX MH EX SITE PERM FNDN (1248 Occupancy: Zoning: RTI Contractor Applicant: Square Footage: PREMIER BUILDERS PREMIER BUILDERS Building Garage Remdl/Addn 1584 WAGSTAFF ROAD 1584 WAGSTAFF ROAD PARADISE, CA 95969 PARADISE, CA 95969 Other Porch/Patio Total (530) 872-1096 (530) 872-1096 FEE INFORMATION DBF MH Plan Check $219.96 DBMSC Mobile Home $329.94 Total Charged: $549.90 Fees Paid: $549.90 Balance Due: $0.00 Receipt No: B2094 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 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divis' 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 force and effect. of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the c:N__ basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 03/08/2007 the applicant to a civil penalty of not more than five hundred dollars [$500); Please check one of the following: Contractor's bignature 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: 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 notintended 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.). 2h�Tl(�/E AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the STATE FUND 1127626th 05/01/2007 Cartier: Policy Number: Exp. Date: Contractors License Law.). (This section need not a competed if the permit is or one hun red dollars ($100) or ess. ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 03/08/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. n X L�CkI� /�� 03/08/2007 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building ��l 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 CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS $100,000 IN ADDITION TO THE COST OF COMPENSATION, ( ) including death, and property damage caused arising out of, or in any way connected with the , DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND isry, t is the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the proRe4y owner or am autho ' ed to act on the property owners behalf. CONSTRUCTION LENDING AGENCY t4: -1 JVAWt�l 03/08/2007 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) E] Owner ontractor OR. DAgent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND' SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buffecounty.net/dds "PLEASE PRINT CLEARLY* OWNER INFORMATION Last Name t j LD s irst Name R0 -B t Mailing Address I 50 RR `Z— l td I N Pt N E City ►4-C— L l l4 Stated Zip Phone Fax E-mail CONTRACTOR ARCHITECT/ENGINEER Name �u C PLOo -L-2-D Addressto 0 SS- T1Fd1 lS f PQ city a �i 5F State , Zip Phone S 2 Fax State C E-mail Lic. #3q Planner Class APPLICANT SIGNATURE X )�` lc�9jwa .. - - For office use only: ARCHITECT/ENGINEER Name MA t_R>v# Address Address City ZZ rZ cd77 UISTa9 State Zip Phone State C Fax E-mail Planner State License Number APPLICANT SIGNATURE X )�` lc�9jwa .. - - For office use only: APPLICANT INFORMATION Name MA t_R>v# P4-D0TzD Address Q S`S— ZZ rZ cd77 UISTa9 Cityelf D65C Subdivision Name State C Zip �6 Phone Planner Date Approved: Fax E-mail APPLICANT SIGNATURE X )�` lc�9jwa .. - - For office use only: Zoning Property Address sez'g-F -roil 0 PI K)E Flood Zone Cross Street COL—OM -B I ?,JE SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. � 9.0144� BIN # PROJECT LOCATION AP# O Property Address sez'g-F -roil 0 PI K)E City Mr4C—I4 /a Cross Street COL—OM -B I ?,JE WORKER'S COMPENSATION Policy Number Carrier S %3-4—T"E_ C (D Nhiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of pennit issuance. LENDING AGENCY Name Address Description or Scope of Work: (3tN,PrztL P:V-5-n C— lA�101�l LC� Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: Bldg SRA Receipt #: Sheriff SMIP Date: Other Total i2 Foundation System Installation Instructions for California for Ground A Concrete Systems HUD .Wind Zone I,' 15 PSF Wind Load Seismic 4 By fie Down Engineering Xi2 Concrete System Engineer Approval State Approval MANUFACTURFD HOME/MOB1LE HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE, SECTION 18551 APPROVED' f'sl,MJECT TO CORRECTIONS NOTED APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS AND REGULATIONS State of Cnlifornis Daparl UM Of Housing eed Community Development OF CODES AND STANDARDS DATE U 1 4 /1 ' •'� C- e Page 1 D8 [V'BUILDING DIVISION APPROVED . I M2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering REQUIREMENTS • These plans and specifications meet the requirements of Title 25 Section 1336.3 Sub Section A and 97 UBC Seismic Requirements, CBC 2001 addition. • Maximum vertical projection at sidewall is 9'. Higher walls may be used when the design loads are adjusted accordingly and approved by HUD. • Main rail spacing must.be 75.5" - 99.5" * Except single sections 95" minimum • Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, and rim plates. The longitudinal component of the Xi2 system replaces end frame ties. Check manufacturers set-up requirements. • Maximum pier height is 48" pier. *Except for single sections 36". • Steel piers must be fastened to the I-beam with clamps provided with steel pier: • Systems must be placed as evenly as possible, no more than 10' from end of home. • Designed for 7:12 roof slope. *Except single sections, (20° - 4.37 in. 12" pitch).- Additional- Requirements for Concrete Systems • Poured concrete must be 2,500 PSI. minimum at 28 days. • Square concrete pads minimum is 18" wide by 12" deep. Round concrete pads minimum is 18" wide by 14" deep. Strip footings minimum is 18" wide by 14' long by 6" deep. * Xi2 components exceed HUD code 3280.306g "Anchoring equipment exposed to 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...." Page 2 of 8 of C 0 Li 0 0 0 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 J -Bolt Nut & Washer Lateral Struts Strut (flag end) 1-1/2"Tube -#1/2x1" k Screws I -Beam Fig ,1ure 2 U -Solt &mounting Bracket Nome rt1d °f • .+%"1,54 ��5;�^Z;'. 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. T/E:: 'DOWN° ENGINEERING ,..__. 0 0 0 0 Kim> � A l>l ! - - Xi2 Gro.und'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-boIts with all nuts and bolts. Lateral and Longitudinal Combination Part Number 59333 Includes: 5' Strut, Pad, Longitudinal Strut (#59329), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Struts for Longitudinal Systems Part Strut Pier Height No. Length Up To: 59330-44 44" 4 Blocks or 32" 59330-65 65" 6 Blocks or 48" Ground Longitudinal Hardware Kit XT Ground Longitudinal Strut & Hardware Kit Ground Longitudinal Strut 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 4 of 8 C DOWN- EJJGINEFRlfJG- - • 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..-.r Drill two; 3/8"x 3" deep holes in the concrete using holes in galvanized bracket as .a guide. Attach bracket to concrete pad using 3/8"x3-1/2" wedge anchors provided. Place nut.'& washer on anchor, leave' enough room for 1 to 2 threads showing on top of bolt. Using a hammer, tap the wedge bolts into hole through bracket, leaving .nut & washer flush with bracket. Using a 9/16" socket wrench, tighten wedge/anchor bolt, securing bracket to the concrete. 5. Attach the end of the smaller tube to the bracket mounted on the pad, using the grade 5;.'112" x 2-1/2" bolt/nut provided. 6. Attach thelfag 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 i next page) 7. Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the. holes rovided in th I t It p e a eras rut so that the two tubes are connected together 8. Install frame bracket clamps on 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 ` TIE DOWN Ervcrru eau6 , 0 Ld R 0 9 Xi2 Lateral Concrete Systems Part#59307 Includes: 5' Strut, Bracket, & Hardware Kit #59315-1 with all nuts and bolt. Longitudinal Struts for "Concrete Systems" Part No. Length Pier Height . #59013 44" up to 4.Blocks #59015 65" up to 6 Blocks Longitudinal Hardware Kit Part#59263 (Includes 2 sets per kit: I-beam bracket, nuts, bolts and washers) Lateral and Longitudinal Combination Part #59332 Includes: 5' Strut, Longitudinal Strut (#59364), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Nut & Washer Figure 1 Beam Clamp Bracket J -Bolt Lateral Longitudinal L— � — � — I � — ----- L 1 -Beam Xi2 Installation Placement Xi2 Concrete Syotern Longitudinal 5trut fHome 888 01%0 tv Concrete Longitudinal Hardware Kit Page 6 of 8 r.. .. DOWN. ENGINEERING • p 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 A I I ( t � E i II I I i i I � I � I § I I � I i f 6 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 A 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. ' I I •I 1 I I I I I I 1 I 1 1 I ' I t � E i I I I I I I I E II 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. ' I I •I 1 I I I 1 I f ! I � I � I I Triple Section Home 0 -62' 4 Xi2 Systems 63' - 80' S Xi2 Systems Page 7 of 8 m 0 �i 0 0 �1�� fel ,-� +►�e. Hardware Breakdown #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 1/2 x 5-1/2 grade 5 zinc 2 10640 Push Nut 1/2 1 12107 Flat Washer 1x2" SS 1 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10519 Hex Nut 1/2" w/ Serr flange #59331 Longitudinal Hardware for 59306 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-12 x 1-1/4 10530 Full Thread 10 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10801 Carriage Bolt 1/2-12 x 2-1/2 59272-1 Grade 5 2 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread Beam Clamp Top Flange 1-3/4 zinc 4 10640 Push Nut 112 4 10519 Hex Nut 1/2" w/ Serr flange..* Full Thread zinc 2 # 59329 Hardware for 59333 Lateral and Longitudinal combination 1 59329-1 Hardware Kit 1 59272-1 Beam Clamp Base' 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-12 x 1-1/4 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 Grade 5 zinc . #59027 Hardware Kit for 59307 Lateral System 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 10530 Full Thread zinc 12 10646Y Hex Nut 1/2-13 Grade 5 zinc 4 10801' Carriage Bolt 1/2-13 x 2-1/2 59272-1 Grade 5 zinc ..J.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 TIE" DOWN ElJGINEERING 0 0 g FEB -27-2007 10:41 mi ei PACIFIC MORTGAGE "comolom REabimm BY: Rabin SMd& w t>rrgao D&B Oft CA 99D76 WHEN RACOR= MAIL TO: Kim L A IYM Twin Dine Rand MaS,olie, CA 9WA SrND TAX N0VCBR Td: Lica L Addingn lJW TWYA PUN Road LA.—.r6 CA 95934 530 872 1790 P. 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DxI Wdomr omwarea I D Olaf-.— ^a m O�Neh dno aenr~ Wor PIWtlK<sa4ST FQ0 YAW AMA Cppl MVRAIM't Roo*afr►teiab k rraeD� adotoe�+d� ap" s,ni +o Nf jp, q RQIh]li 8f MMM AN LYMARM WOUM hm6y GRAMO) b WMN %HIM= AN UNMARRIED WOUAN AHD KIM L ADMHOTOK AN UNMAI�1� MAK pg }�,Z1ANT6IN CObIMON the levov►� das�7lbod Tpl Pmpab' b tie tm4oaepm+Isd oro of ttr �' o'�—+� °f CMUfasfii 9P,i UWAL DUCRWWN A'ITACHO MIBZ'0 ANDMON A?AUT> REM STATR or CAlmolMA �,. bioasde Zky6—NOLT 11=1Y AdD90 la aoa eb<at1 SMa �� waes ee ab b 1 -ma re tee Naas e re ea Ire beeie of core lrb pq{k* cad tbo rr 1 almda)ondri ssp�oworoarf4"+ ar. aab gaaiel.«wwembeep' M►cTMR98 eribad and am" Md, ,ra w Y WN vel Tab eras in omw hmm d —L kw To amanvabt UM AS ABOW itAdd0teoW 9dod D2 2/28/2007 10:23 PAGE 003/004 Fax Server order Ko. 3-164726 SCHEDULE C The land referred to herein is described as follows: All. that certain real property situate in the County of Butte, State of California, described as follows: Lot 123, as shown on that oertain map entitled, "PARADISE PINES UNIT NO. 3", which map was filed in the office of the Recorder of the County of Butte, State of California, on June 27, 1970 in Book 35 of Maps, at pagers, 78, 79, 80, 81 and '82. EXCEPTING THEREFROM all of the valuable minerals beneath the surface of said land with the right to mine and extract said minerals, it being agreed and understood that in all operations the surface of said land will be protected against damage and that all 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 that certain Dead from the Magalia Mining Company, a corporation, to E. D. Storts, st ux, recorded September 4, 1947 in Book 423 of Butte County Official Records, page 385. AP No. 065-400-036 O7P PERMIT NUMBER _ B 1774-73B 34 P f` 1 E PERMIT EXPIRE6,126J 7 S OWNER Oliver J. Travis CONTR: , owner. LOCATION (A.P. 57-62-36 140 Twin Pines Rd.� Magalia 7 COUNTY OF BUTTE Deportment of Public Works BUILDING INSPECTION RECORD Zoning Setback ^h Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster_ Rein. Steel Gas Piping & Test Found. Vents _ Framing "/ j Plmg. Topout Rough Elec. W4:. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. _ _ Final �3 final Final DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Orovi lie, California 95965 Telephone: 534-4541 ' APPLICATfON AND PERMIT �4- 73 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X CAILP,3t ate NJ Signature of P OTtee or Agent % Receipt No. 7 -' a3 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. - DIR'IECTOR 0 PUBLIC WORKS By. f Date .5 Building permit expires Da% �D_ BUILDING Owner v9.r �� r�/v/S SQ. FT. OCC. BUILDING VALUATION :5-3, o0 Mailing Address le 0 Av LOS zfe ,Q,/ A Telephone N . 3 ~y Fireplace Contractor Total Valuation 7 j 3„s?a Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ S1,04 $ D� Building Address d �-�� PLUMBING No. @ FEE PERMIT FILING FEE $2.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 5 7— 6 Zoning & PlanningGas piping system 1 - 5 outlets .1.50 Each additional outlet .30 s alio ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. Plans Recd Parce Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. ' @ FEE PERMIT FILING FEE $3.00 05 A/ -Main service incl. 1 meter Additional meters, each 1.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures 20 bal_Ll0 • �20�f(da�3�3 Receps., switches & fix outlets--bal 010 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: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ 1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No.1 @ FEE PERMIT FILING FEE $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 OrdinancesTOTAL and State Laws relating to building construction, and hereby PERMIT FEE is 02 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X CAILP,3t ate NJ Signature of P OTtee or Agent % Receipt No. 7 -' a3 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. - DIR'IECTOR 0 PUBLIC WORKS By. f Date .5 Building permit expires Da% �D_