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065-410-001
65-41-1 David' Clancy Via/ 270 Jack Pine Way, lot 26, PP#3, Maga, j i contr: Tri V Const.,' Paradise Permit'# 95 77P,E(util ,MH) ELEC. �J GS Y11411 -Y2 *1 SUPPORT ';,STRUCTURE, REQ..>,Zo } i COMPACTION TEST REQ. 41 65-41-1 contr: Fisci Bros., Magalia Permit #919=77B,E,(new ..nr.ivate garage) 65-41-1 ontr: Paradise Modular Concepts Par Permit #199-77MHI Issued 065-410-001 05-1775 CLANCY, BERYL 15068 JACK PINE WY, MAGALIA Cont: SIERRA MOBILE SERV EX M/H PERM FND 065-410-001 06-1980 DARIEN, DEANNA 15068 JACK PINE DR, MAGALIA Cont: JOHN MURRAY DECK(W/ WHEEL CHAIR RAMP) 40/ 0 oj t� A f RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 2005®0043153 Recorded I Official Records I County of I Butte I CANDME J. BRIBBS I County Clerk-Recorderl I 1 811:46M 25 -Jul -2005 I REC FEE 13.00 CONFORMED COPY LN TB Page 1 of 3 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. BERYL R. CLANCY FAMILY TRUST REAL PROPERTY OWNER/LESSOR , 15068 JACK PINE WAY MAILING ADDRESS MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP SAME INSTALLATION MAILING ADDRESS, IF DIFFERENT SAME CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME' MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 05-1775 530 538-7541 ,BUILD PERMIT NO., ELEPHONE NUMBER S S ATURE OF LOCAL A N Y FFICIAL DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. GOLDEN WEST 1977 GOLDEN WEST MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER 12771A/B/C 60'X 24'/24'x 10' ORE014636/7/8 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER 065-410-001___.. SEE ATTACHED S 15 E C- x N' Eli r X ✓ HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept. � lilt!llllilllllllll!lINIlllfl!!!I - RECORDING REQUESTED BY: Recorded I REC FEE Official Records i 10.00 Donald R. Travers Couunty Of I WHEN RECORDED RETURN TO: CANDACE J. GRUBBS I rderI ROSEMARecoRY Donald R. Travers Assistant I Shauna 09:02AM 14 -Nov -2003 I Page i of 2 Law Offices of Donald R. Travers 529 Pearson Road Paradise, California 95969-5113 A. P. N. 065-410-001 QUITCLAIM DEED The undersigned quitclaimor declares: - Documentary transfer tax is NONE. No consideration given. Change in formal title only. (See Note 1 below) FOR NO CONSIDERATION, BERYL R. CLANCY does hereby REMISE, RELEASE AND . FOREVER QUITCLAIM to BERYL R. CLANCY, as Trustee of the BERYL R. CLANCY REVOCABLE INTER VIVOS TRUST initially created on July 3, 2003, all her right, title and interest in and to the following described real property in the unincorporated area, County of Butte, State of California: SEE EXHIBIT "A" ATTACHED HERETO AND INCORPORATED HEREIN Commonly known as 15068 Jack Pine Way, Magalia, California NOTE # I: Conveyance Transferriniz Quitclaimor's Interest into a Revocable Liviniz Trust: This conveyance transfers the quitclaimor's interest in the described property into the , quitclaimor's revocable living trust which is not pursuant to a sale and is exempt pursuant to Rev. and Tax. Code section 11930. NOTE #2: Conveyance Chan ine Manner in Which Title is Held: This is a conveyance to a revocable trust and, pursuant to Rev. and Tax. Code section 62(d)(2), does not constitute a change in ownership and does not subject the property to reassessment. Executed this --li— day of K)O Vf Mb Lo fz , 2003, at Paradise, California. "Quitclaimor" R. CLANCY MAIL TAX STATEMENTS TO: BERYL R. CLANCY, Trustee, 15068 Jack Pine Way, Magalia, Califomia 95954 CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC State of California ) ) ss. County of Butte ) On _ S , 2003, before me, Et -(-Q t-(, i�,�y�r�s , a notary public in and for the State of California, personally appeared BERYL R. CLANCY, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal. ,,.,. •4AAAAAA60 "'"'I ELLA H. TRAVERS COMM. 4 1253663 t� Ai ROTARY PUBLIC -CALIFORNIA 4 / Q COUNTY OF BUTTE w Comm. Expires March B, 2004 Notary Public EXHIBIT "A" LEGAL DESCRIPTION ADDRESS: 15068 Jack Pine Way Magalia, California 95954 A.P.N.: 065-410-001 Lot 26, as shown on that certain Map entitled, "PAR.ADISE PINES UNIT NO. 3", which was recorded in the office of the County Recorder of Butte County, on June 17, 1970 in Map Book 35 at pages 78, 79, 80, 81 and 82. Subject to covenants, conditions, restrictions, reservations, rights of way, easements, bonded indebtedness, assessments, and other matters of record. EXCEPTING all minerals, as excepted of record. D:\wpdocs\CLANCY.David—Beryl\Tmnsfers\dctd.2.wpd END OF DESCRIPTION 1 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: 15068 JACK PINE WAY Owner: Permit No: 06-1980 APN: 065-410-001 DEANNA DARIEN Issued Date: 09/29/2006 By KCG Permit type: MISCELLANEOUS 15068 JACK PINE DR Subtype: Wood Deck MAGALIA, CA 95954 Expiration Date: 09/24/2007 Description: DECK(W/ WHEEL CHAIR RAMP) (530) 873-3982 Occupancy: Zoning: Contractor Applicant: Square Footage: J & S CONSTRUCTION EXTERIORS JOHN MURRAY Building Garage Remdl/Addn PO BOX 1951 PO BOX 1951 PARADISE, CA 95967 PARADISE, CA 95967 Other Porch/Patio Total (530)877-0140 (530)877-0140 640 640 FEE INFORMATION Deck (wood) $90.00 Fund 10 BLDG $60.00 SMTP - Residential $0.64 Total Charged: $150.64 Fees Paid: $150.64 Balance Due: $0.00 Receipt No: B325 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class /. Expires 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License J & S CONSTRUCTION EXTERI CSLB-774716 / / 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 UN R PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 ct (commencing wi h Se. n 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) s in full force a effa 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 09/29/2006 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Con to SI ature Date J 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' OMPENSATION 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 Contractor's License Law.). Cartier: Policy Number: Exp. Date: (This section nee not be completed if the permit is or one a hundred dollars ($100) or ess. ❑ I AM EXEMPT under Section B. & P.C. for this reason: M: 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 Californ' , and agree that if I should become subject to the workers' X 09/29/2006 compensation provisio s of S coon 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 09/29/2006 1 hereby certify that I have read this application and state that the above information is cored. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signat a Date WARNING: FAILURE TO ECURE W KERS' 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 EMPLOY TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, in any way connected with HUNDRED THOUSAND DOLLARS ( 100,000 ), IN ADDITION TO THE COST OF COMPENSATION, 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 Up above mentioned property for inspection purposes. I hereby certify that I am the propehorize rty Wert m autd to act )jhpro ownefs behalf. CONSTRUCTION LENDING AGENCY o khe Y i'a 09/29/2006 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for N91frip7bVifirmitte IGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner Contractor OR Agent for Owner ❑Agent for Contractor FILE COPY Lender's Address City State Zip .G� 14:50. C.0 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR R.SPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834, OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: A,ww.buttecounty.net/dds "PLEASE PRINT CLEARLY"' APPLICANT INFORMATION Name T I e OWNER INFORMATION Last Name-irst 0 e Name -,P— 6t N Address 1 s o G J 0.,Je_ P t e DA City p l State f t J -e Phone 3 _ 3 q �Z Fax E-mail Fax APPLICANT INFORMATION Name T I e CONTRACTOR Name —- J o /'I N Ul r lr A` Address o e I q S I City Po.Y'o, f t J -e State Zp I4 6-7 Phone 7 7 Fax E-mail lio # Class APPLICANT INFORMATION Name T I e ARCHITECT/ENGINEER Name State Address Phone City E-mail State Zip Phone Page Fax E-mail State License Number APPLICANT INFORMATION Name T I e Address City State Zip Phone Fax E-mail _ APPLICANT SIGNATURE ow "len ffice use only: g E Flood Zone it aL I� SRA es No ! Type Const Subdivision Name h/lap Book Page Lot n Planner Date Approved: Uvt_K t -UK 5UbiV1l I IAL REQUIREMENTS L, K:\FORMSI5UILDING FOR1%4S\BldgApp1SubRgmts.doc Page 1 of 3 PERMIT �P BIN # PROJECT LOCATION [ cc AP# 00 f Property Addr ss � � T4e �I�•e � it aL I� Cross Street Lc cn i K e. WORKER'S COMPENSATION Policy Number , Carrier. If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of penntt issuance. LENDING AGENCY Name Address Description or Scope of Work: ec X +e.�S J ori -,t 57 ...S _. _ ... _ . Sq FT- Living Garag' Open Dov V� 0 Structure Built without Permits O 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. (4CJ -yU%U/1 7000 Received by --TPI Amount_6(J Bldg Receipt t: " D 6 ? 0 .)- Nn Date: S j-7 v( SRA Sheriff SIJIP Other Go' Total REV 8-12-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISfbN 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140/ _ 1 t �fJ PERMIT APPLICATION DATA SHEET & OWNER: a r 1 ii , D22 r) ai_ ASSESSOR PARCEL NUMBER Proposed Building Use: "(1&�rts_W) Permit Technician: 1� c Date: Items required in order to apply for a permit. All,boxes MUST be checked OR marked NA in order to apply. ,,V 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. Jl 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other RemaininP6Fire ms needed to issue the permit. (May require additional plan review upon receipt of the following items.) ��� Sanitation and site plan approval from the Environmental Health Department in ❑ Chico 111.07 ville, as applicable ( AA< ❑ Sprinklers............................................................................................ ,. 3. 17. -Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ' ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑.�r Erosion Control Plan Required .......................................... . &Fees as shown on the attached Schedule of Fees Due Sheef .. ... ro........... ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: � le 24. Planning approval for (A) Use: QK(B)Parking: (C) Parcel Check: ..,..✓....., 0(, 25. Contact Land Development about _ Improvements, _ Drainage .......................fi . 26. NPDES Form...........,.................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... Cl 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone �9 9 -�t' J/�/( i(-�t ° /1 and hold for pickup. 1 have been informed Ff the abo a items and requirements for obtaining a building permit. r O Applicant: Date: 1. Index permit appli,ata for t e above itLQ numbered: Plan Check Letter 2. Additional items required 6 ontracto esigner wne , was advised of the above data by phone, ❑ mail, ❑ counter, by -&?- Date:B 30.66, 90 V4)/E6 ConTractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: J vSY tZ i�tq Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: it--) . 64 Plans approved by: /&Nj1 Date: Q. S Co" . Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division 70 BUTTE COUNTY SEP 9 b E.H. use ;dv Piot Pian Attached Roar Plan Attachad Santo B.C. TO: Building Department DEVV FROM: Environmental Health sERVIC7 SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwelling. Other v1 /]eC'A::�5 Hold final for: g Final cleqlan a O.K. for: � NOTE: �f •c�� /� S J� ✓ f��4� �i2o �v l�ot�riL� 7 - we - e5 -x,/ 5;r- vironmental Health ialist Date 8/96 0&469 E50 1% 0 I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner DARIEN, DEANNA APN No: 065-410-001 Permit Type: Subtype: App Date: 8/17/2006 Permit No: BP Permit Desc: 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $150.00 Plan Check portion of Permit Fee $60.00 $90.00 Balance of Building Permit Fee 2 FEMA []Yes Flood Elevation Review $109.98 0 3 SRA* Yes Fire Plan Check - Non -Refundable $95.00 0 (State Responsibility Area) Building Inspection $109.98 0 1 - $204.98 NUN-KttUNUAt3Lt portion of tees clue at application $60.00 FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $60.00 FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT $90.64 RECEIPT DATE Tech/Asst 460914 8/17/06 Tammie At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. Applicant: Date: sF — / 7 - 0 K Pursuant to Government cg Se)ktiof 66020, you re hereby notified those Items followed by an "*" may have been imposed on your project. You have 90 days from the date of approval of the porject or from t impostion of the above referenced items during which you may protest. The requirements for a protest are specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 041506 Butte CountDeparLment of-Developinel�t Sel-Wces °�`'TrF° s:. 7 County Center Drive ° Oroville, CA 95965 ° .,a ° (530) 538-7601 Telephone °C -, y (530) 538-7785 Facsimile �UN� BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other, regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: 0 I need to submit applications for septic and/or well to Butte County. Environmental Health immediately. • I ani required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained a I am responsible for notifying Development Services, in. writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division.. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. ' - Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required perrrits/clearances include, but are not limited to, verification the parcel was legally created, adherence to.all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print:�J �,,,,�� IS L& Y v c� Applicant Name: VV - Building site address: / h if. DA Permit No.: /v� a�aa I have read, understood and accept the terms and co�i'ditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNATURE OF APP ICANT DATE o� /• ^ �U T TF O&\\ Department of Public Works C o u m y o f B u t t e a ' LAND DEVELOPMENT DIVISION J. Michael Crump, o � Storm Water Management Program Director 7 County Center Drive Oroville, CA 95965 Ovett�"� 1530) 538-7266 (FAX) 53B-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm. Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE] Project Description: Project Location and/or Parcel Number: �`y By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB I acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: -.—_Date- .. �— 17—o6 170 o6S 440 60 l._ T1 G PLYWOOD CC EYE, tlr _ _ �---------- LIT — �/— ! �I FRMm G. • .: CLI P� _ �• - � STAIR STRIIJGER. hf3'a.o. Mnx. • 17'xi2'PI� 5 ?OP VIEW ' (on 11041F4 ►ti.e- 1ror+tl•,� H RI.ID�IIIL : N DT 5110U1 ti •FDR CI.AKIT'f. 2"K� DECI(IIJG '(ELTa 3/6 13DI: S paced -,3a 4hcL a- ,� r(a DF 2• GIRDERS '1 canno y s here .19a' TIG PLYWOOD CC EXT. ,. 2"u9' - doa n�J -{ h re) ui h , MOBILE IIOMC m oft DELK r J.11 � • hrl�l• POST • • ` —T 3S F z r— GUIIRPRAIL "q -DF. .-�— B----�-+` � 7Rr4Trl' A o : - i COPY of.Document Recorded 25 -Jul -2005 2005-0043153 RECORDING REQUESTED BY: Has not been compared with original BUTTE COUNTY COUNTY RECORDER AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 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. BERYL R. CLANCY FAMILY TRUST REAL PROPERTY OWNEMESSOR 15068 JACK PINE WAY MAILING ADDRESS MAGALIA BUTTE CA 95954 CITY COUNTY STATE ZIP SAME INSTALLATION MAILING ADDRESS, IF DIFFERENT SAME CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 05-1775 530 538-7541 BUILDPERMIT NO., r j TELEPHONE NUMBER / / StG ATURE OF LOCAL AGENCY OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO GOLDEN WEST 1977 GOLDEN WEST MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMEINUMBER 12771AJB/C 60'X 24'/24'x 10' ORF014636/7/8 SERIAL. NUMBER(S) LENGTH X WIDTH INSIGNIAILABEL NUMBER(S) MAL PROPERTY LEGAL DFSCRIPTIO SEE ATTACHED ASSESSOR'S PARCEL NUMBER 065-410-001 S'rE fXMiLTIT A urn I7nVhA nz'ArA1I?PV Riol RECORDING REQUESTED BY: Donald R. Travers WHEN RECORDED RETURN TO: Donald R. Travers Law Offices of Donald R. Travers liiiIIIIIIIIIIiiiIl�NllllilN�lli z��3-0rb84J6?� Recorded I REC FEE Official Records I County Of I BUTTE I CPMACE J. 6RUBBS Recorder I ROSEMARY DICKSON f Assistant I Shauna 09:02AM 14 -Nov -2003 I Page 1 of P- 529 529 Pearson Road Paradise, California 95969-5113 A. P. N. 065-410-001 QUITCLAIM DEED The undersigned quitclaimor declares: Documentary transfer tax is NONE. No consideration given. Change in formal title only. (See Note 1 below) FOR NO CONSIDERATION, BERYL R. CLANCY does hereby REMISE, RELEASE AND FOREVER QUITCLAIM to BERYL R. CLANCY, as Trustee of the BERYL R. CLANCY REVOCABLE INTER VIVOS TRUST initially created on July 3, 2003, all her right, title and interest in and to the following described real property in the unincorporated area, County of Butte, State of California: SEE EXHIBIT "A" ATTACHED HERETO AND INCORPORATED HEREIN Commonly known as 15068 Jack Pine Way, Magalia, California NOTE # I: Conveyance Transferring Quitclaimor's Interest into a Revocable Living Trust: This conveyance transfers the quitclaimor's interest in the described property into the quitclaimor's revocable living trust which is not pursuant to, a sale and is exempt pursuant to Rev. and Tax. Code section 11930. NOTE #2: Conveyance Changing Manner in Which Title is Held: This is a conveyance to a revocable trust and, pursuant to Rev. and Tax. Code section 62(d)(2), does not constitute a change in ownership and does not subject the property to reassessment. Executed this ,� day of K)0 Uf-me rk , 2003, at Paradise, California. "Quitclaimor" / ''/ ■R. 6LANCY MAIL TAX STATEMENTS TO: BERYL R. CLANCY, Trustee, 15068 Jack Pine Way, Magalia, California 95954 10.00 12, NO CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC State of California ) ss. County of Butte } On _ S , 2003, before me, ���Q � � ?.e,¢v� , a notary public in and for the State of California, personally appeared BERYL R. CLANCY, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her authorized capacity, and that by her signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal. ELLA H. TRAVERS COMM. 11253663 �► NOTARY PUBLIC-CALIFORNIA 4 / COUNTY OF BUTTE W „���+�u�`✓ Comm. Expires March 8, 2004 Notary Public EXHIBIT "A” LEGAL DESCRIPTION ADDRESS: 15068 Jack Pine Way Magalia, California 95954 A.P.N.: 065-410-001 Lot 26, as shown on that certain Map entitled, "PARADISE PINES UNIT NO. 3", which was recorded in the office of the County Recorder of Butte County, on June 17, 1970 in Map Book 35 at pages 78, 79, 80, 81 and 82. Subject to covenants, conditions, restrictions, reservations, rights of way, easements, bonded indebtedness, assessments, and other matters of record. EXCEPTING all minerals, as excepted of record. D:\wpdocs\CLANCY.David—Beryl\Transfers\detd.2.wpd r END OF DESCRIPTION r, EXPLANATION AMOUNT 90-2267/1211 3827 SIERRA MOBILE SERVICE 19224 SIERRA FOUNDATION LIC NO 470386 H188 466 CIRCLE DR 530-534-0599 OROVILLE, CA 95966 PAY AMOUNT14�Q UCS s«anoeaWreq t aae OF L Dalnaai s m" back. I I DESCRIPTION I US BANK AUTHORIZED SIGNATURE 11901922411' l:L2LL226761: L5340L40392511' DATE, TO THE ORDER OF GROSS INC. TAX SOC. SEC. ST. TAX MEDIACXARE NUMeEA SoS oonn as.—. 14c.9 I I Is, 3 to6 , ► .. _ ........ ._..._ 1 I I DESCRIPTION I US BANK AUTHORIZED SIGNATURE 11901922411' l:L2LL226761: L5340L40392511' FOUNDATION SYSTEM CERTIFICATE OF OCCUPANCY a.., BUILDING PERMIT NUMBER: 05-1775 Address or location of unit: 15068 JACK PINE WAY, MAGALIA CA 95954 Legal Description of Real Property: AP# 065-410-001 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: DAVID L. AND BERYL R. CLANCY TRUSTEE Owner's address: 15068 JACK PINE WAY, MAGALIA CA 95954 INSIGNIA OR HUD NUMBER: ORE014636/7/8 SERIAL NUMBER OR V.I.N.: 12771A/B/C MANUFACTURER'S NAME: GOLDEN VEST YEAR: 1977 OFFICIAL APPROVING INSTALLATION: famlqi� &Z& - DATE: 7-1 q -os PHONE: (530) 538-7541 H.C.D. 513C STATE OF CALIFORNIA • BUSINESS, TRANSPORTATION AND HOUSING AGENCY ARNOLD SCHWARZENEGGER, Governor DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT '3stNG q Division of Codes and Standards O NQ p...z W Title Search�0 Y nEv Date Printed : 06/30/2005 Decal #: ABD6060 Use Code: SFD Manufacturer: GOLDEN WEST Original Price Code: AHF Tradename: GOLDEN WEST Rating Year: 1977 Model: Tax Type: ILT Manufactured Date: 00/00/1977 Last ILT Amount: $26.00 Registration Exp: 06/30/2006 Date ILT Fee Paid: 06/27/2005 First Sold On: 06/21/1977 ILT Exemption: NONE Serial Number 12771B 12771A 12771C Record Conditions Registered Owner: HUD Label / Insignia O1tE014636 ORE014637 ORE014638 PPF Exempt Length Width Unknown Unknown Unknown Unknown Unknown Unknown BERYL R CLANCY REVOCABLE INTER VIVOS TRUST 070303 15068 JACK PINE WY MAGALIA, CA 95954 Last Title Date: 12/08/2003 Last Reg Card: 06/29/2005 Sale/Transfer Info: Price $.00 Transferred on 11/07/2003 Situs Address: Inactive Decal/DMV: 15068 JACK PINE WY MAGALIA, CA 95954 Situs County: BUTTE DMV SF3448, DMV SF3449, DMV SF3450 * * * END OF TITLE SEARCH NOTES RESIDENTIAL PERMIT NO. ' 065-410-001 05-1775 CLANCY, BERYL 15068 JACK PINE WY, MAGALIA Cont: SIERRA MOBILE SERV EX M/H PERM FND SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE- REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) / Signature (,Lj (1d 4 � l ay "') Z'�l� o =Not OK = Not Applicable RESIDENTIAL (Single & Duplex) `1 = Not Ready Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Felting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62.- Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows ' Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Ele6. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking -clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.El.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18: Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Cana B-1 Date Card B-1 1 Date Cana B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -0.C. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62.- Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows ' Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Ele6. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking -clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.El.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Following InstldJDrive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: = OK =Not OK = Not d Readyy MOBILE HOMES = Not Rea Data MOBILE HOME UTILITIES (Plans) OK except #'s i' 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch ; 3. Sewer, location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. ..Electricity; Location-Clearances-Gmd=/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L W P LPG. 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date . MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity, MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test-Regulator-Connectoe 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Cana B-1 Date Card B-1 Date PER ENT END SYSTEM (ONLY) Hing Requirements -Setbacks -Easements 4.600-tings; Size -Spacing -Marriage Line . Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test '7. Water and Sewer Connected 8. as and Electricity Tagged 10. License Decals 11. Verify #'s with Office DatesCj Dates Card B-1 (;J Date Card B-1 Date Card B-1 Card B-1 V 3% MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams=Rftrs-Connectors- Shthg-Frg-Bracing 5. Alum: Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors ' 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting, 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8: Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 .BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT. NO. BPO51775 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 07/08/2005 APN: 065-410-001-000 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.Site License Class: License Number: ?O -C Address: 15068 JACK PINE WAY MAG ,� - n Map Index: Date: % 8 0 Contractor:/ Description: EX MH ON PERM FND OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Owner: CLANCY DAVID L & BERYL R FAMILY Business and Professions Code: Any -city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior TRUST to its issuance, also requires the applicant for such permit to file a CLANCY DAVID L.& BERYL R TRUSTEES signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 15068 JACK PINE WAY 7000) of Division 3 of the Business and Professions Code) or that he or MAGALIA, CA 95954 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 Applicant: SIERRA MOBILE SERVICE Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does BILL REID such work himself or herself or through his or her own employees, 466 CIRCLE DRIVE provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one OROVILLE, CA 95966 year of completion, the owner -builder will have the burden of 530-534-0599 proving that he 'or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: SIERRA MOBILE SERVICE and who contracts for such projects with a contractor(s) licensed BILL REID pursuant to the Contractors' State License Law.). 466 CIRCLE DRIVE ❑ I am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 530-534-0599 Date: Owner: License #: 470386 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: carne`: slla4 9-L,. % Total Square Ft: 0 S. F. y2 Policy #: -S7 Valuation: $0.00 O I certify that in the performance of the work for which this permit is Census Code: 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 7 G r Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of / compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. q// CONSTRUCTION LENDING AGENCY This permit iereby issued under a plicable provisions of the Butte Cnunty Code ?nrYor I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolution do work Indicated ove or which fees have been paid. - -� Name: BY: Date: Address: PERMIT EXPIRES ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, arid that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives offBButtee County to enter upon the above mentioned property for inspection purposes.. A-�`�+' Print Name: Signature: /t Date: 0 Owner Ei—c-ontractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREIVIENTS 24 ]-LOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 535-7541 A FEE f VILL BE REQ UIRED AT TIME OF APPLICATION "PLEASE PR1NT CLEARLY -- CONTRACTOR Name OWNER Last Name A 1iFirst City x 1A Name Address StateZIP l5 b 6 S 5i.. City M >a CrA t. A Stale �. zip's 9S Phone Fax i E-mail CONTRACTOR Name ARCHITECT/ENGINEER Address City x 1A city StateZIP Phone Shy Stale Fax E-mail Stale - Zip Lic. # '� cuss �4 Slate License Number E-mail APPLICANT SIGNATURE X vvcrc rum �UtjlVll I IAL REQUIREMENTS PERMIT NO. BPd5-- 177 BIN # LOCATION ARCHITECT/ENGINEER Name City x 1A Address Address City — Stale Zip Phone Stale - Zip Fax E-mail Slate License Number APPLICANT SIGNATURE X vvcrc rum �UtjlVll I IAL REQUIREMENTS PERMIT NO. BPd5-- 177 BIN # LOCATION APPLICANT NAME Name City x 1A :? Address WORKER'S COMPENSATION — city LC?— LENDING AGENCY Stale - Zip Phonej S3�! oSQ Fax E-mail APPLICANT SIGNATURE X vvcrc rum �UtjlVll I IAL REQUIREMENTS PERMIT NO. BPd5-- 177 BIN # LOCATION AP# Properly Address IS06 P 3Ack A,VE wy City x 1A Cross Street F WORKER'S COMPENSATION Policy Number Carrier c t If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footage ❑ Structure Built out Permits ❑ Proposed Change of Occupancy (Note previous use): T13ATION 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 #: f 3�1 — Sheriff SMIP Dater ��� ----- Other Total ,�,t^+ .�.�•.,,.• �a. �-....ti -. � :n...r _ .. n'.,-�+•r....i=.,c+,.•�+^LJi •rv^...,,-,�..vr'r.� � 9 � , r.f` /'-77 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISfON 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax'(530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: (i ��r ' v - ASSESSOR PARCEL NUMBER v �F l /'Q _ OO/ Proposed Building Use: X 04 N S1 7 -Z-1 pfi- ermit Technician: C&_ Date: �� G Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. \ ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. �❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan rc-view upon receipt of the following items.) ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ .( 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... 4 N ❑ 19. Erosion Control Plan Required........................................................................ / �j 20. Fees as shown on the attached Schedule of Fees Due Sheet........ ... ... ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 26. NPDES Form............................................................................................... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. r ❑ 33. Existing violations and/or expired permits......................................................... \ ❑ 34. Deed Restriction..................:....................................................................... 35.116 Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ~--� ❑ 37. Other: When issued Telephone R;I t l Pe -i D and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. W,�Gs Applicant: 4 J Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was Advised of the above data by ❑ phone, ❑ mail, ❑ count , Date: Plans reviewed by: Date: -Plans approved by: Date: ' Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division r �.r Vector Dynamics Foundation System INSTALLATION INSTRUCTIONS for the State of California Version 9/2/2003 INDEX Approval PAGE RELEASE SECTION NUMBER DATE MANUFACTURED HOME/MOBILE HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE. SECTION 18551 APPROVED INTRODUCTION 2 9/2/03 GENERAL INSTALLATION ,3 9/2/03 SUBJECT TO CORRECTIONSNOTED kPPROVAL DOES NOT AUTHORIZE OR APPROVE ANY PARTS LIST 4 & 5 9/2/03 MISSIONS OR DEVIATION FROM REQUIREMENTS OF LONGITUDINAL DEVICES 6 9/2/03 APPLICABLE STATE LAWS AND REGULATIONS State of California ' PIER HEIGHTS 7 9/2/03 t fin and Community vel Doopraent SET-UP INSTRUCTIONS 8 9/2/03 N DES AND STANDARDS DATE g (aignaturo) SPA FOOTER SIZES TWsP nuApproval Expires WIND ZONE I -SINGLE 9 9/2/03 - DOUBLE 10 9/2/03 -`TRIPLE 11 9/2/03. ` - HIGH PIER. 12 9/2/03 WIND ZONE II - SINGLE 13 9/2/03 �oQjk0FESS/0/k� - DOUBLE 14 9/2/03 - TRIPLE 15 9/2/03 No.6 245 P. V -DRIVE & PIER SYSTEMS 16 9/2/03 q � OFF CAAA -W SOIL CLASSIFICATION 17 9/2/03 CONCRETE INSTALLATION 18 & 19 9/2/03 dU TTE COUN I COMPONENT PARTS AVAILABLE UPON REQUEST ILDINGpPARTA�.;�; 4PPR0Vr co Lq M 0 N O m O • 't Tie Down Engineering, Inc. VECTOR DYNAMICS INSTALLATION DESIGN INSTRUCTIONS Introduction These instructions describe the proper use of the lateral and longitudinal foundation system. You may also refer to the home manufactirrer's installation manuals that include the Vector Dynamics system as an alternate foun- dation system. General The Vector Dynamics Foundation System provides the support to resist lateral, longitudinal and over -turning movernent of the honrre as required by the Federal Manufactured Home Construction and Safety Standards in a specified wind zone when the system is used as described in these instructions. Please verify state or local wind load requirements prior to installation of the home. The Vector Dynamics Foundation System resists lateral & longitudinal wind & seismc loads by anchoring the two longitudinal main rails. The system is approved to be used on single or multi section homes: Nominally 12 fret to 16' feet wide- (single section) with main rail spacing of 95 inches or greater on center; multi section main rail spacing of 75 inches or greater on center. Nominal 8 foot or less top plate height at sidewalls with main rail depth of 12" or less. Maximum roof slope of 20 degrees (4.4" in 12" slope). • r Maximum eave �,/idth (roof overhang of sidewall) of 12" for Zone I, 8" fo Zone II Maximum pier height under main rails -see page 7. The Vector Dynamics Foundation Systems may be used as a part of the vertical or gravity support system con- sidering that each Vecior Dynamics pad has two (2) or (3) square feets bearing area. To inquire about the use of the Vector Dynamics Foundation Systems with homes of four or more sections, other widths, or on homes reiluiring pier heights which are not included in these instructions, contact Tie Down Engineering, Inc. at 1-800-241-1806. The Vector Dynamics Foundation System has not been designed for use on exposure "D" homes within 1500 feet of the coastline. 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, end frame ties and rim plates. Page 2 California 9/2/0 z GENERAL INSTALLATION INSTRUCTIONS SITE PREPARATION It is necessary that the Dome site be properly graded and sloped to prevent water and moisture from standing or flowing beneath the holfw'. FOOTINGS AND FROST LINES The Vector Dynamics Foundation System was designed to be placed directly on top of the ground (or poured concrete) after clearing aii loose vegetatioll. In areas with frost heave, use Vector for Poured Concrete (see pages 20 & 2,1) to compiv with local requirements for footer depth. FOUNDATION/FOOTING SPECIFICATIONS FOR VECTOR PADS Vector Pads are used in 1)1lace of conventional foundation pads. One Vector pad provides two or three square feet of bearing support. V1.,ctor Systerns should be spaced as symmetrically as possible along the length of the home. For pier locations in between the Vector Systems, use the normal foundation pads. LUMBER/MOISTURE -TERMITE SHIELD To cut PVC or lumber (2 - '?x4's,1 - 4x4 or 1 adjustable steel commpression member per Vector system) for the center compression section,when using concrete blocks for piers, measure center to center frame (I-beam) dis- tance and subtract 16". Uk/hen using METAL PIER STANDS, measure center to center frame distance and add 16". ALL WOOD MUST BE PRESSURE TREATED, GROUND CONTACT RATED . Tip: Pre-cut your lumber 2nd mask as to brand or model of homes you will be installing. If frame widths are the same,. the pre-cut boards vill also be the same length in each Vector set-up. STRAP INSTALLATION All frame ties and diagonal straps must go from the anchor to r the top of the I -Beam. See illustration below. 1. Attach frame hook to top inboard location of "I" beam. (Frame hook must be attached to frame at points closest to floor support.) 2. Keeping in line with the hook, wrap galvanized strap completely around "I" beam. 3. Pull strap past anchor head approximately ten inches before cutting to allow enough strap to give a minimum of five turns around the slotted anchor bolt. 4. Thread loose end through slotted bolt so that the strap is flush with the other side of the bolt. 5. Tighten slotted tensioning bolt a minimum of five full turns. Page.3 California9/2/03 C Longitudinal Stabilizer Devices The use of LSD systems on a single or multi section home replaces longitudinal anchors, stabilizer plates and straps. The Longitudinal Stabilization Device (LSD) is used with the Vector Dynamics System to resist loads in the longitudinal direction (short dimension) of home. The number of LSD required is shown on pages 10-13. D LS _ .. ._ zV :1 :.... IYi�E—(4 ) 1. Longitudinal Foundation Pad 2. Beam Clamp (2 per _ystem) 3. Longitudinal Strut (2 per system) 4. Tie Bracket (2 per o'ystem) Combine Vector Dynamics & LSD Note: Two struts = 1 L.s,D, system. Can be used on one pad or slipt on opposite ends of the home, Examples of Possible placement: (Contact TIE DOWN for placment in other Wind Zones) Wind Zone I Single Section 18 Ft. Max. Wind Zone I Double Section .32 Ft. Max. _ For greater widths use triple section design. Page 6 Wind Zone I Triple Section Wind Zone .I Tag Section .. 48 Ft. Max. California 9/2/03 M 50 in max. Maximum Pier Height Vector Dynamics Foundation Systems may be used on single section homes in Wind Zone I which require pier heights (from surface of Vector pads to top of concrete or metal pier) not to exceed 50 inches under one or both main rail(s). Note that aground anchor must be used at each Vector system location where the pier height exceeds 24 inches for single section homes. On multi -section homes in Wind Zone I, an anchor must be used at each Vector System location with pier heights above 46 with the following exception: double section homes that are 24' wide, in Wind Zone I, have a maximum pier height without anchors of 38". See page 12 for double section home high pier set instructions. 50 it max. Unequal Pier Heights Maximum Homes with unequal pier heights are limited to 50" maximum pier height. The difference between the taller pier and the shorter pier cannot exceed 26". Page 7 Californ�-�� ia; 9/2/03 ,Set -Up Instructions for Vector System #59018 Long U -Bolts 1. Set Vector Pads Clear all vegatation where pads will rest. Place a long U -bolt in pad as shown. Press or ham- mer pad into the ground. 2. Set Block or piers on pads. Center foundation blocks or piers on pads. Place pre-cut center compression member between blocks, resting on pads; centers between U -bolts as shown. 3. Outside Tension Bracket Attach- outside tension bracket as shown to out- side of pads. Page 8 4. Inside brackets & straps Attach the inside tie brackets to the U -bolts over the compresion member. Attach a strap w/hook or swivel strap w/nut & bolt. Place other end of the strap over opposite I-beam & down to out- side tension bracket. Cut strap 12 - 15 inches past bracket. Attach strap & slotted bolt in bracket. Tighten strap until tight with 4-5 wraps around bolt. Repeat with opposite strap. Califor � 9/2/03 WIND ZONE I, SEISMIC ZONE 4 - - "nhomeems "- Vector Dynamics Systems Required for - - - " - - - mU�tl Setvect°r sys - " " - Triple Section Homes " " - _ - _ - - ' e o{ a etas 9.10( I -v..... . ♦ ♦ i ♦ ♦ \ (Materials Required) - - - -F ♦ - _ _. .�,. ..�n:.x:�-fir-� .. — — ._ _.....c�� �..u�. �',. ''"`'rf_ ... I .. _ ♦ . ....._ ` c� NOTE: co When a pier height at Vector locations exceeds 46", an anchor must be used on the outside wall/beam at that approximate location. NOTE: Vector Systems should be spaced as symmetrically as possible along the length. of the home. Pier spacing must be consistent with home C-) manufacturers' instructions and/or state requirements. a� 0 Tag ori full triple S " 2 sq. ft. pad 2 sq. ft. pad A Soil Classifications: 2, 3, 4A, & 4B Soil Bearing Capacity: 1,000 PSF minimum Anchors Required*: None (*Marriage wall anchors may be required by home manufacturer.) Home Length Vector Systems Required Anchors Required Per Side LSD Main TAG 0to48' 2+2 on Tag 0 2 1 49' to 71' 3+ 2 on Tag 0 2 1 72'to84' 4+2 on Tag 0 2 2 85'to90' 5+2 on Tag 0 2 2 Each Vector System requires one of the following: 1-44 or 2-2x4's pressure treated wood compression member, Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) VECTOR DYNAMICS INSTALLATION DESIGN INSTRUCTIONS Vector Dynamic Foundation Systems may be used only on homes set on soils classified as Class 2, 3, 4A and 4B as described in the table belov SOIL CLASSIFICATIONS Soil Class Types of Soils Blow CountASTM ( Soil Test Probe (1) D2586) Torque Value (2) 1 Sound hard rock...... NA NA Very dense and/or 40 -up More than 550 lbs - in. cemented sands, coarse 2 gravel and cobbles, preloaded silts, clays, and corals Medium -dense coarse 24-39 350-549 lbs - in. 3 sands, sandy gravels, very Stiff silts and clays 4A Loose to medium dense 14-23 275-349 lbs - in. sands, firm to stiff clays 4B and silts, alluvian fill 175-275 lbs - in Peat, organic silts, 0-44 175 lbs - in. 5 inundated silts, loose fine and lower sand, alluvium, loess, N/aried clays, fill, fly ash. (1) The purpose of the soil test probe is to gauge the strength of the soil below the surface and near the anchor's helical plate. The strength of the soil is estimated in terms of its resistance to penetration (flow) under load by means of the torque probe and is measured in Ib -in. The test probe has a helix on it. The overall length of the helical Section is 10.75 in.; the major diameter is 1.25 in.; the minor diameter is 0.81 in.; the pitch is 1.75 in. The shaft must be of suitable length for anchor depth. (2) A measure synonymous with moment of a force when distributed around the shaft of the test probe. Vector Foundation Pads Equivalent to Footer Pads* Footer Size: Footer Size: _ 16x16 = 256 sq. in. - - - 20x20 = - " or 16x18 = 288 - " - 400 sq. in. sq. in. or 17x25=425 sq.- - - in. EQUALS 2 -Vector Pads # 59275 -__ _ - EQUALS - 288 sq.. in. or 1 -Vector Pad # 59271 - -_ 1 Vector Pad # 59130 432 sq. in. Vector Pad(s) exceed the surface area reiluired when used as the equivalent liste above. 'Foundations in soil with a beiiing capacity of less than 1,000 PSF must be designed by a Registered Professional En in r ' 4ar with site conditons Pae 17 California 9 9/2/03 S 695-77� P PERMIT NO. E • PERMIT EXPIRES Ya OWNER David Clant!y f t �CONTR. Tri V Const., Paradise LOCATION (A.P. 65-41-1 NO Jack Pine Way, lot -26, PP#3, Magalia moo: she �r 4'.. J M tr ,1 w. -14 d r I Temp. Power Pole Called PG&E _ Temp. Elec. Serv. 7 3 i Called PG&E to 77 Temp. Gas Serv. F Called PG&E ,., ry �� VINALED (Date)Y r-77 , (Signature) Mailli, Bldg. Fo tin s Stem all Slab Piers Garage Footings Stemwa I I Slab Carport Footings Slab Patio Footings Masonry Wall! Stucco COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) F ewall ski Piping Pahtpets 1 t Floor Rest om Finish 2n Floor Fdn. Vents Garage Vents Insulation Prov. for phy Test Final 3rd N oor To out 19 Water Pi i Sewer Fixtures Water Htr. Heaters sical Appliances of ex. Gas Piping & Temp. Gas Sanitation REP ACE Final Mesh ff MECHANICAL X Grd. Fafilt Prot. Scratth Heatl ServI96 Bro n Coo ng T mo. Pole F ish D is nder round In rior Lath entllation /Pennanent a or Closer Final l MOBILEHOME UTILITIES Elec. Service — -7/7_ Elec. Pedestal Water Piping— Sewer ---— Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS 7-7 (NOTE: An entry must be made on this form each time you visit the job site.) PLUMBING N t • �: 'PERMIT NO. •919-77B,E ' PERMIT EXPIRES OWNER David Clancy CONTR. Fisci Bros.,'Magalia LOCATION (A.P. 65-41-1 ) 270 Jack Pine Way, lot 26, PP#3, Magalia _r !L r 1 r i j Temp. Power Pole r Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB 1-7'7 FINALED L (Date) (Signatur ) 9. Electr. ical '` A. Is service Large eno<tglk to provide adequate amperage to mobileliome. (must equal rating of mobilehome (dith a I'linu-:um of 100 amp) an:1 other faciliti_c!s on lot, i.e., water pumps, garat,e, cab.lna, etc.:, Yes ✓ No� B. is ther�-� proper clearances around panels? Yes ��No_ C. Is power supply cord or feeder assembly properly fused? Yes:: D. Is continuity test satisfactory as per the following procedure? Yes —IN o__ 1. De -energize electrical wiring syste:�i of 'the mobilehome at the pedestal. 2.. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. .Connect one load of: a test instrument to the mobilehome grounding conductor and app.L tine Gt ief 'lead to eacil Ilioui'l I DLit supply CGftUuCtGr, lni eiillitg tiEULrd1. 5. All nor. -current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity tett shall then be made between.the grounding electrode and the chassis of the Mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. I,;job card signed by Health' Departmeat for water and sanitation? ' If everything okay, sign off card and ta; services. MOB TLE11Ot ll:_DATA Manufacturer and/or Namestyle AO_1VJ4___ Length t! Width.) -y Vehicle Serial No. State Identif.icati.on No. 01!!f G I.ddi.tional Information or Comments: i• i0BT!,1:It0.1E;' RiS`CALLATIOU INSPECTION CHECI` LIST 1'.. Is the mobilehome 1ocated.wi.t_h required separation from lot lines and buildings and generally conform to plot plan? Yes*✓No 2. Does the mobilehome have -require-d. clearances above ground? (Sec. 5085) Yes --No 3. Are foot:in�,s and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring, shackles.) (Sec. 5082"& 5083) Yes v No 4. Is the mobilehome level.? (Sec. 5088) Yes 9-�No 5. If more than a single unit, 'are crossover connections properly installed? (Sec. 508 8) Yes ,/ No 5, Water A. Is flexible connector of adequate -size and properly installed (1/2" ID min.)? (Sec. 5566) Yes✓ N B. Test - Does water,piping withstand working pressure. or 50 lbs, air test? Yes 1 ---No C. Backflow - If coach is not State of California approved, does station have backflow device and, pressure -relief valve? Yes 'No 7. Wastes and Drains A. Is connection made with. Schedule 40 DWV and have flex connectors at each end? Yes L-�No B. Does it have minimum z," per foot slope and is it properly supported? Yes ✓ No C. Are any leaks detected in drainage.system after running 3 -gallons of water through each fixture including washing machine. standpipe? Yes No L/ D. If coach is not State -of California approved, does station have required trap and vent? Yes No 1. 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes ✓ No B. Test OK as per following procedure? Yes V-111,40 1. Open all appliance connector valves: 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8.oz.) calibrated in tenth pound increments. Test for 10 min: without drop. 4. Connect: gas meter to *mobilehome with connector, turn. on gas, test connections with soapy water. C. 'Are all appliance vents properly installed? Yes,/ No COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number for the following location: Owner �r Owner's Address Mobilehome Mfg. e/0 — 1,'- Model /5'k Year 77 Insignia No. 6/t/I.? / - 3 % - 3SSS Serial No. /2 2 2 1 It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED c: r. M Setback Forms Main Bldg. Footings Stemwal I Slab Piers Garage Footings Stemwal I Slab Carport Footings Slab Patio Footings t COUNT1 OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) �U — Firewall Soil Piping Parapets 1st Floor Restroom Finish 2nd Floor Windows 3rd Floor Siding To out Roof Sheathing Water PI inj Roofing Sewer Fdn. Vents Fixtures Garage Vents Insulation Water Htr. Heaters Prov. for physically handicapped Conformance of ex. structure Appliances Gas Piping Temp. Gas LACE I Final Fixtures PLUMBING ELECTRICAL Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOMEINSTALLATION--------------Support( '% Elec. Continuity Water Piping S sj 1— Z Drainage Gas Piping A; - DATE DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) Owner MAwa Mai I i ng Address COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Orovi Ile, California 95965 - /yam �% • Telephone: 534-4541 62� / 3 7 / APPLICATION AND PERMIT _ BUILDING SQ. FT. I OCC. I BUILDING VALUATION I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon,the above-mentioned property for inspection purposes. X�7�93'` Date Signature of Permitee or Agent Receipt No. t Z White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant FEE L- 7— FEE FEE TOTAL PERMIT FEE $ LA I This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS Date— permit ate permit expires Date" Telephone No. Fireplace /� Contractor Total Valuation Mailing Address 1, 0. .8 � � Permit Fee Plan Checking Fee &/or Penalty %j& 4 Tel hone No. Permit Fee $ Building Address PLUMBING No. @ PERMIT FILING FEE $3.00 0 t. w Each Trap 1.50 0 7— 2 4, % Repair drainage or vent piping 1.50 Water piping 1.50 P No /;� L! Each gas water heater or vent 1.50 A. P. No.J _ / Zoning & Planning Gas piping system 1 - 5 outlets _1 _tf Each additional outlet .30 Fees � SH'Tlr 'TJTM Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im provements Lawn sprinkler system 2.00 ane ec'd Parcel Approval Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER'tg ELECTRICAL No. @ PERMIT FILING FEE $3.00 0V OR L Main service 80000 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Y_ Others ❑ Main service OVER 6 00V25.00 100 AMP OR LESS Main service .EA. ADD -L 100 AMP 1.00 NEW OR ADDNST ( ACCLLING OCCUP. & BLDG ) 2¢sq ft NEW CONSTR. MULTI -OUTLET NON•RESID. ( BRANCH CIRCUITS) 2.50ea �, NEWC% NON.RESID R. (SINGLE OUTTLETPOWERTUSCIR.& CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the - State of California Business & Professions Code under the name st le of: Y Ex. Occup(OUTLETS OR FIXTURES)50 @250 BAL@104 EOFIXED APPLNS. OR x. ccuP-( OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 `�, Classification License No,T 0--z (/ Misc. Wiring 6.25 ❑ I am exempt from. the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE • I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. FX'fhave placed on file with the County of Butte a certificate of Workmen's Compensation Insurance., F]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. @ PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon,the above-mentioned property for inspection purposes. X�7�93'` Date Signature of Permitee or Agent Receipt No. t Z White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant FEE L- 7— FEE FEE TOTAL PERMIT FEE $ LA I This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS Date— permit ate permit expires Date" n • COUNTY OF BUTTE • — DEP4141TMEhIT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 Telephone: 534-4541 - f• -APPLICATION AND PERMIT authorize representatives of the county of Butte to enter upon the above-mentioned property for inspection purposes. nature Permit or Agent /) Recei t No. White-D.P.W. —el ow-A,ssess r — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF)PUBLIC WORKS By Date q_1 S_— 77 Building permit expires Date �� ' �� BUILDINGr I Owner ° ILlano i SQ. FT. OCC. BUILDING VALUATION Mailing Address FM I Telephone No. Fireplace n Contractor e_ Owe Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty T e hone No. Permit Fee $ Building AddressPLUMING I No. @ FEE PERMITTILING FEE $3.00 ,Z 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.z.5,—, �.�Gas Zoning $ Planning piping system 1 - 5 outlets 1.50 Each additional outlet .30 F W. . Sarl ation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel De aration Parcel Ma p ' R/W Im r p oveme Lawn sprinkler system 2.00 Bldg. Plans Re 'd Parcel Appr aloo' Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE ' PERMIT FILING FEE $3.00 Q Main service 6001 OR LESS 5.00 100 AMP OR LESS Main service EA. ADD•L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 6001 25.00 100 AMP OR LESS Main service// EA. ADD•L 100 AMP 1.00 NEW CONS.T ACCLBLDGOCCUP. (DWELING OR ADDNS&) 22Sq ft NEW CONSTR. MULTI.OUTLET NON- (MULTI-OUTLET BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON.RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: /� // /'� PA11124(413E 1 ' /Oci(s(1l41P l .o`Y1 e46 Ex. Occup(OUTLETS OR FIXTURES) BAL 21 FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification 0—(,/ Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby r 421, AW, �O ob TOTAL PERMIT FEE $ �d �O authorize representatives of the county of Butte to enter upon the above-mentioned property for inspection purposes. nature Permit or Agent /) Recei t No. White-D.P.W. —el ow-A,ssess r — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF)PUBLIC WORKS By Date q_1 S_— 77 Building permit expires Date �� ' �� COUNTY OF BUTTE" — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT 69-6--77 authorize epresentatives of the County of Butte to enter upon the above- Tonedproperty for inspection purposes. X411"" 1 Date 2 �� ignature of Permitee-or Ag nt 0or Receipt No. f S { ZY White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of `the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. . . DIRECTOR PUBLIC WORKS By Date ZZ— 7 7 Building permit expires Date Z -Z -"t--- 7 BUILDING Owner VA ulto[_ iq n Gz' SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor Con 37—. , Total Valuation Mailing Address 57 & Permit Fee Plan Checking Fee&/or Penalty cc S¢ �j Uen�7 Permit Fee $ Building Address .1. %Q��.i f, PSN (y PLUMBING No. @ FEE - PERMIT FILING FEE $3.00 r X Q% 02 .. /0 3. Each Trap 1.50 L Repair drainage or vent piping 1.50 Water piping .1.a8' O� Zoning Verification Only Each gas water heater or vent 1.50 A. P. No. COS " 4 f r: z Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 FeebT-W.6-.fS90tX7,on Fire Dept. Fire Zone Use Permit Building sewer 01— EQA Parking Plans arcel Declaration P el Ma p 60' R/W Improvements p Lawn sprinkler system 2.00 Bldg, — c'd 6_5 0 Parcel Approval Plan pproval ,— Permit Fee $ -. NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ NEW No. @ FEE PERMIT FILING FEE $3.00 J Main service 600V OR LESS 5.00 S " 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 OVER 600V Main service 100 AMP OR LESS 25.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 1.00 � Soo 1 , " r, ) FOR MOBILES ' NEW CONST. DWELLING OCCUP.& DCONST L A ) 22sq ft NEW MULTI.OUTLETUP. NON•RESID, ( BRANCH CIRCUITS) 12.50ea NEW NON-RESIESID. (SINGLE OPOWER UTLETTCIR.& D, CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style Of: y ,� Ex. Occup(OUTLETS OR FIXTURES) BA@L@�1 FIXED APPLNS, OR Ex. OccupJOUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 S' License No. :307—.70 / AMisc. Classification — Wiring 6.25 .4 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. R-certify that in the performance of the work for which this , is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby 1 1,400 /! TOTAL PERMIT FEE $ 3 authorize epresentatives of the County of Butte to enter upon the above- Tonedproperty for inspection purposes. X411"" 1 Date 2 �� ignature of Permitee-or Ag nt 0or Receipt No. f S { ZY White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of `the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. . . DIRECTOR PUBLIC WORKS By Date ZZ— 7 7 Building permit expires Date Z -Z -"t--- 7 site service? ----------------------------- ------ Yes / / (If yes, identify the load and size: (Load) 9. What BUTTE COUNTY DEPART11MNT OF PUBLIC WORKS the mobilehome site gas pipe size? ---------------------- 7 County Center Drive, Oroville,. CA. 10. What PHONE: 534-4541 the type of gas service? ---------- ,------------------- MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: �.52� r� o01i.4r2 L�IP� 3. Is the site currently under permit? Yes No the gas pipe length frog. net:er or tank (If yes, furnish permit'number ) OR What Is the site an existing site? Yes / / No the mobilehome gas demand.'? -- ------------ (If yes, furnish two (2) plot plans.) 4., Will the mobilehome be located at least 5 Wit. away from septic tank and leach fields and clear of all setbacks and easements? Yesit No (If no, clarify -5. What is the mobilehome electrical rating? ----------------------- Zoo' Amps 6. What is the mobilehome site service rating? --------------------- /Q O Amps 7. What is the mobilehome site circuit breaker. rating? -------------- Amps 8. Is there any other electric load to be served by the mobil.ebome site service? ----------------------------- ------ Yes / / (This information �lenot require if Pipe length less than 6 or ss..50 n LPG.) ft, o _ thanGASP, No / / ._(Amps) . on natural gas (If yes, identify the load and size: (Load) 9. What is the mobilehome site gas pipe size? ---------------------- 10. What is the type of gas service? ---------- ,------------------- ! Na 11. What 'is the gas pipe length frog. net:er or tank to the mobilehem . 12. What is the mobilehome gas demand.'? -- ------------ -------------- (This information �lenot require if Pipe length less than 6 or ss..50 n LPG.) ft, o _ thanGASP, No / / ._(Amps) . on natural gas MOBILEHOMB SUPPORT DATA Mobilehome Mfr. �Olp J Setup Model No. ��`�v - Year %lp Width a'/ (ft.) Length . (ft.) - Expando`Size /0ft.x ---2,.-//- ft. (Draw support details below) . On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not .on file with the County of Butte). Sin le —t> Footings (check.one; i i / 1. Wood :either p essure treated 'or Center Center Support fdn.`grade.:- Support Footing Sizes 1/ �.Concrete pad. Locations (in.) S.--Other,--specify in. in. in. Supports (check one; Concrete block �0 %�x ' 2. Concrete piers (t J� int 3. Steel piers 1 / / 4. Other, specify i �/. T ca 1 port 02 x�C7 Foot i Siz D /o2x 3� In. .(in.)(in.) .....i....... ff j ear! 5 4e ..............l.... s— Max. Pier. Al _ Spacing ft. in.) .,. in. 11 . ) (in .) (in .) Max. ,,,Overhang *If center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COUNTY BUILDING DEPARTMENT APPROVED �, C' D• r! COUNTY OF B&TE — DEPARTMENT OF PUBLIC WORKS _ �� 7 County Center Drive — proville, California 95965 / Telephohe:534-4541 9 / APPLICATION AND PERMIT W r, I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X ___—DateL Signature of PVi e or ent Receipt No. C White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant TOTAL PERMIT FEE $ 32 I== This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF UBLIC WORKS By Date7"3--77 uilding permit expires Date ?�-7 BUILDING Owner SQ. FT. OCC. BUILDING VALUATION J Mailing Address Telephone No. Fireplace Contractor �1S C fZ OS yn Total Valuation �2 Q Mailing Address V C/0 9. A � JZ_ Fee 1.10 Plan Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ 4^7Q^ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 _ V -7 Q ,J zs t 1' Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 CL, f4 Each gas water heater or vent 1.50 A. P. No. — Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F FireDept. FireZone 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. P�Rec'd Parcel Approval I Approval Permit Fee $ NEW IXADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 J— Main service 600v OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others Main service OVER 100 AMPP OR LESS O 25.00 Main service EA. ADD'L 100 AMP 1.00 1,n t.J V V NEW CONST. DWELLING OC �.g OR ADDNS. ACC. BLDGS. (J 2�syft r/ NEWCONSTR. MULTI -OUTLET NON .RESID. (BRANCH CIRCUITS 2.50ea NEW CONSTR. POWER APPARATUS &) NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name sstt Ie of: Ex. Occup(OUTLETS OR FIXTURES) BAL21 FIXED APPLNOR Ex. Occup.(S. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Q_14 _ Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $42 WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ I FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X ___—DateL Signature of PVi e or ent Receipt No. C White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant TOTAL PERMIT FEE $ 32 I== This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF UBLIC WORKS By Date7"3--77 uilding permit expires Date ?�-7 f�SSSb W2 vr7y'1d1nl ,c VM 3r4d )+I vs 890 -SI 1S'ny1 A'Jndl'� �J I/V3� I o0 o S 7 0 Sh I t �.J 6z I '1. r r ' I '1. 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