HomeMy WebLinkAbout065-430-02265-43-22
Roy Coggins
#&0 Torey Pines Rd., lot 64, PP#3, M�a
bntr' ' Powersr'Con�t.', Magalii ga
Permit #2054-80P,E(util.
Z
ELEC.,
GA S :S-- Y)
SUPPORT STRUCTURE REQ.:..5�
COMPACTION TEST REQ..
65-43-22
Contr: Mobile Home Expo, Concord
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b'mitll,17 9-8 (�eck' H
4?U/Z- TOREY PINES Rr) -M,
AGALIA'
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OBILE SEpVTe�
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EX MH
PERM'
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UND
RECORDING REQUESTED BY:
_� I I I
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
E! 10 GD ell el a I 92� E3!5 -
Recorded
Official Records
County Of
BUTTE
CANDACE J. GRUBBS
Recorder
ROSEMARY DICKSON
Assistant
02:03PM 11 -Aug -2000
I REC FEE .00
I CONFORM .00,
1� Krist
I Page � of 2
SPACE ABOVE THIS UNE 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 1855 1. 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.
ROY G. COGGINS & JEWELL D. COGGINS
REAL PROPERTY OWNERILESSOR
15072 TOREY PINE ROAD
MAILING ADDRESS
MAGALIA, BUTTE, CA 95954
CITY COUNTY STATE ZIP
SAME
INSTALLATION MAILING ADDRESS, IF DIFFERENT
CITY COUNTY STATE ZIP
SANM
UNIT OWNER (if also property owner, write "SAME")
MAILING ADDRESS
cr�y 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
00-1829 (530)538-7541 -
BUILD G PERM] 0 - TELEPHONE NUMFIER
08/10/00
SIGNATURE OF LOCAL AGENC-Y-OVICIAL DATE
NONE
DEALER NAME (ifnot a dealer sale, write "NONE")
DEALER LICENSE NO.
SKYLINE 1980 UNKNOWN
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMFINUMBER
01750641A/BN 60' X 24' CAL189552/3
SERIAL NUNMER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUNMER
SEE ATTACHED
A.P. # 065-430-022
HCD FORM 433(A) REV. 8/91
WHITE -County Recorder CANARY-HCD PINK -Applicant GOLDENROD'.'Building Dept.
LEGAL DESCRIPTION
A.P.'#065-430-022
All that certain real pro
perty situate in the County of Butte, State:of California, described as follows:
LOT 62, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "PARADISE PINES UNIT NOA
WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF
BUTTE, STATE OF CALIFORNIA, ON JUNE 17,1970 -IN BOOK 3 5 OF MAPS AT PAGES 78, 79,
80, 91, AND 82.
APN: 065-430-022
C
*
Recorded, 1::--.l RE
RECORDING REQUESTED BY:
official. Reco
count 'Of
WHEN RECORDED MAIL TO: BUT�',
CANDACE J. GRUBBS
d
Recor er
Butte'County Building Diviiion ROSEMARY DICKSON
Assistant 1,Ciky I-
7 County Center Drive 49PM 23 -Aug -2m- I -Page 013)f 3
03:
Oroville, CA 95965
NOTICE OF MANUFACTURED HOME(MOBILEHOME)
OR COMMERCIAL COACH, INSTALLATION OF A�
FOUNDATION SYSTEM
THE ATTACHED DOCUMENT IS BEING RECORDED TO CORRECT ERROR IN THE
LEGAL DESCRIPTION ON NOTICE OF MANUFACTURED HOME (MOBILEHOME)
OR COMMERCIAL COACH; INSTALLATION OF A FOUNDATION SYSTEM,
RECORDED ON AUGUST 11, 2,000, UNDER SERIAL NUMBER 2000-0031285.
THIS ' PAGE ADDED TOP I ROVIDE ADEQUATE SPACE FOR RECORDING
INFORMATION.
RECORDINd'RE4�NSTED BY:
AND WHEN RECORDED MAIL TO: '
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
SPACE ABOVE THIS LINE FOR RECORDER USE ONLV
,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 185 5 1. 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.
ROY G. COGGINS & JEWELL D. COGGINS
REAL PROPERTY OWNEP/LESSOR
15072 TOREY PINE ROAD
MAILINGADDRESS
MAGALIA, BUTTE, CA 95954
CITY COUNTY STATE ZIP
SAME
INSTALLATION MAILING ADDRESS, IF DIFFERENT
CITY COUNTY STATE ZIP
SAME
UNIT OWNER (ifalso property owner, write "SANE")
MAILING ADDRESS
crry couKry STATE ZIP
UNIT DESCRIPTION
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMT and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILINGADDRESS
OROVILLE, BUTTE, CA 95965
CITY COUNTY STATE ZIP
00-1829 (530)538-7541
,^G,PEP,MIT4N
TELEPHONE NUMBER
08/10/00
CAL A,&
T". OF DATE
NONE
DEALER NAME (ifnot a dealer sale, write "NONE")
DEALER LICENSE NO.
SKYLINE 1980 UNKNOWN
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAIVMINUMBER
01750641A/BN 60'X 24' CAL189552/3
SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A.P. # 065-430-022
SEE ATTACHED I
HCD FORM 433(A) REV. 8/91
WHITE - County Record , er CANARY-HCD PINK -Applicant GOLDENROD -Building Dept.
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL: INSPECTION ITEMS'
.—VERIFY
—USE PERMIT CONDITIONS
SUB-STANDARb HOUSING LETTER
A
J
j,�013 FINALED
Signature
NOTES
RESIDENTIAL
065-43-02.022 00-1829
P E IT No. COGGINS. ROY
15072 TOREY PINES RD., MAGALIA
CONTR: SIERRA MOBILE SERVICEJ
EX MH ON PERM FNr3
(THE HCD FORM 433A FOR THIS MH CAN NOTTY.,
-BE RECORDED UNTIL ONE OF THE.FOLLOWING
AHAVE BEEN TURNED IN TO THE BLDG DIV:
(1) LICENSE PLATE(S) or DECAL(THE
INSPECTOR MUST RETRIEVE) %
(2) STATEMENT OF FACTS(ONLY ON
NEW MH'S) =��_ �7L
INSPECTOR TO VERIFY SERIAL & LABEL #.ls,
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL: INSPECTION ITEMS'
.—VERIFY
—USE PERMIT CONDITIONS
SUB-STANDARb HOUSING LETTER
A
J
j,�013 FINALED
Signature
./ = OK
0 = Not OK
NotApplicable
Not Ready
MOEULE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except If's
Zoning Require ments-Setbacks- Easements
1 .
Zoning Requirements -Setbacks- Easements
Footings; Soils- Size- Depth- Spaci ng-Connecto rs- Steel
2.
Soils; Special MH Support Sketch
Decks; Girders and/or Joists- Decki ng -Bracing- Stairs- Rails
3.
Sewer; Location -Test -Fall -C/0 -Concrete
Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Frg-Bracing
4.
Water; Location -Test- Easement Needed (Sketch)
Alum. Awn.; Columns -Connections- Splice- Decal- Enclosures
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
Carporls; Windows -Doors
6.
Gas; Location -Test -Wrap;-/ /" L 'ft.
P Nat. or / rL"ft.1 PLPG
Electric
7.
Well Clearance & Disconnect
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
8.
Utility Clearance
Siding; Nail ing-Veneer- Stucco- Mesh
10.
Roof; Shthg-Roofing
11.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILFHOME INSTALLATION (Plans) OK except #'s
bf
ZoKRequirements-Setbacks- Easements
4,400tings;
s ize- s paci ng- Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
1 .
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
2.
5.
Drain; MH Test -Fall -Flex Connector
3.
6.
Water; MH Test- Regulator -Con nector
4.
7.
Water and Sewer Connected -C/0 to Grade -HO Approval
5.
8.
Gas and -Electricity Tagged
6.
g.L;49'powns-Type-installation
Cert.
7.
10.
Exits; Insp.-Sketch
8.
11.
Cert. of Occupancy
9.
1�.
�Y'manent Foundation Only; License Decal
10.
Plumb.; Cir. Test -Water Supply Test
Date
"'41
Card 13-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s
1 .
Zoning Require ments-Setbacks- Easements
2.
Footings; Soils- Size- Depth- Spaci ng-Connecto rs- Steel
3.
Decks; Girders and/or Joists- Decki ng -Bracing- Stairs- Rails
4.
Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Frg-Bracing
5.
Alum. Awn.; Columns -Connections- Splice- Decal- Enclosures
6.
Carporls; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nail ing-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
FINAL (Plans) OK except #'s
1 .
Setbacks- Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Term inals- Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grouncling� Equip. w/5'Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Pan elboards- Ins. to Main in Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
1.
./ = OK
0 = Not OK
- = Not Applicable
* = Not Ready
RESIDENTIAL (14
Date
Underfloor (Plans) OK except #'s
Hangers -Post Caps-Anch3rs-Connectors
1
. Zon i ng -Setbacks- Ease me nts- Flood -Slope
Cling. Joist-Rftr. Ties- Purlin- Roff Brac.-Truss-Shting.-Rfng.
2.
Fig., Main; Soils-Elec. Grnd.-/ r Ftg. Depth
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
3.
Ftg., Garage; Soils-Sleel-Elec. Grnd.-/ r Ftg. Depth
Attic Access; Size & Romex Protection- Draft Stop -Ins. Baffles
4.
Ftg., Porches & Decks; Soils -Steel-/ r Fig. Depth
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
5.
Sternwalls, Main; Steel- Blockouts-Wrapped
Garage Fire Protection Framing
6.
Sternwalls, Garage; Steel- Blockouts-Wrapped
Property Line Firewall & Openings
6a.
Hold Downs and Special Anchors
Ext. Doors -One X -Check Garage 3rd Story, 2 Exits
7.
Slab, Steel -Wrapped
Stairs; Width- Headroom- R ise-Ru n- Landing- Fire Protection
8.
Piers -Fireplace Ftg.-Steel
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
9.
D.W.V.; Fall- Fitting -Test -2 Way C/0 -Sewer Test
Siding -Nailing Veneer
10.
LIF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
11.
Water Pipe; Test -Anchors- Reg ulato r- Service Test
Glazing Area -Glass Prote:;tion-Skylights-Plastic
12.
Electric Underground
Shear Walls; Nailing -Bolts
13.
Plenums & Ducts; Clearance -Material -Support -ins.
Brace Interior/Exterior Wall Panels
14.
Girders- Sills -Anchor Bolts-Joists-Vents-Crippies
Insulation -Walls -Ceilings
15.
Access & Ventilation
Infiltration-Walls-Winclows
16.
Insulation
Date
Date
Date
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
Ext. Steps -Door & Sidelight Protection -Landings
17.
Water Hir.; Vent -Access -Combustion Air Baffle
Smoke Detector
18.
Water Pipe; Test & Anchor -Nail Protection
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
Bedroom Exiting
20.
Shower Pan; Test, First Floor -Tub Access
G.F.I. & Balh Fixtures & Tub Access -Spa
21.
Test Tub & Shower, Second Floor -Tub Access
Elec. Trim & Subpanel, Breaker Sizes & Labels
22.
Gas Pipe; Sixe & Anchors
Stairs & Rails
70.
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
72.
ELECTRICAL (Permit) OK except #'s
23.
Fixture & Transformer Clearance -Ins. Protection
24.
Elec. Receptacles Spacing -Lights & Switches at Doors
25.
Size Boxes & No. of Conductors Stapled
26.
Romex Installed Close to Edge of Studs & C.J.
27.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
28.
2 Appliance Circuits in Kitchen & Conductor Size GFI
29.
Subfeed Wire Size / ga. Cu or Al-A.C. Wire Size / / ga Cu or At
30.
Range Circle / I ga Cu or Al -Oven Circ. / / ga Cu or At
Insulated Neutral Ij Yes El No
31.
Service -Riser Conductors & Ground Main Disconnect
32.
Equip. Clearances Panels- M otors- M ech. Equip.
33.
Clothes Closet Light -Shower Light -Spa Light
34.
Smoke Detector
84.
A.C. Unit Disconnect, Electrical- Plumbing
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Water Well, Disconnect, Electrical, Plumbing
MECHANICAL (Permit) OK except #'s
87.
35.
A.C. Ducts Insulation & Support
88.
36.
Vent Fan, Exhaust above insulation
89.
37.
Condensate Drain & Overflow, Size & Grade
90.
38.
Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet
91.
39.
Attic Access & Platform if Furnace in Attic
92.
Water & Sewer Connected -C/O to Grade -HO Approval
93.
Energy Compliance Certificate -Other Certificates
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Date
FRAMING (Permit) OK except #'s
Date
40.
Sits Proper Materials & Anchors
Card B-1 Date Card B-1
41.
Walls Studs -Nailing Spacing & Braces- Plates -Sound
42.
Bearing Walls over Girders & Floor Nailing
43.
Draft Stop in Walls (rat proof)
44.
Fire Stops, Furred Cei I ings- Stairs- C hasers-Tubs
45.
Headers & Beams -Size & Bearing
"ingle & Duplex)
'Daee
FRAMING (Continued)
46.
Hangers -Post Caps-Anch3rs-Connectors
47.
Cling. Joist-Rftr. Ties- Purlin- Roff Brac.-Truss-Shting.-Rfng.
48.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
49.
Attic Access; Size & Romex Protection- Draft Stop -Ins. Baffles
50.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
51.
Garage Fire Protection Framing
52.
Property Line Firewall & Openings
53.
Ext. Doors -One X -Check Garage 3rd Story, 2 Exits
54.
Stairs; Width- Headroom- R ise-Ru n- Landing- Fire Protection
55.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
56.
Siding -Nailing Veneer
57.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58.
Glazing Area -Glass Prote:;tion-Skylights-Plastic
59.
Shear Walls; Nailing -Bolts
60.
Brace Interior/Exterior Wall Panels
61.
Insulation -Walls -Ceilings
62.
Infiltration-Walls-Winclows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
63.
Ext. Steps -Door & Sidelight Protection -Landings
64.
Smoke Detector
65.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
66.
Bedroom Exiting
67.
G.F.I. & Balh Fixtures & Tub Access -Spa
68.
Elec. Trim & Subpanel, Breaker Sizes & Labels
69.
Stairs & Rails
70.
Fireplace or Stove, Clearance- Hearth
71.
Elec. Outlets at Wood Panel, Int. & Ext.
72.
Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance
73.
Elec. Outlets & Receptacles at Kit. Counter
74.
Garage Fire Door; Swing -Landing -Closure
75.
A.C. Duct in Garage-Darrper
76.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
77.
Plb., Elec. & Mech. Equip. Listed for Location
78.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
79.
Ins ulation- Foam- Looked in Attic
80.
Guard Rails & Deck Construction- Post Caps
81.
Fdn. VBents & Crawl Hole D2or Drainage & Wood -Earth
Clearance Looked under Floor Q Yes
82.
Following Instld./Drive :) Yes :1 No/Walks :1 Yes :1 NQ/Planters :1 Yes :1 No
83.
Stucco Brown -Finish
84.
A.C. Unit Disconnect, Electrical- Plumbing
85.
Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings
86.
Water Well, Disconnect, Electrical, Plumbing
87.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
88.
Ventilation Throughout House
89.
Glass Protection
90.
Corrections from Previous Inspections
91.
Gas Test -Meters Tagged, Gas -Electric
92.
Water & Sewer Connected -C/O to Grade -HO Approval
93.
Energy Compliance Certificate -Other Certificates
94.
Address Posted
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DI ISION
7 Copnty Center Drive Oroville,,California 95965 9 Telephone (530) 5381-7/41 PERMIT NO.
(Rev. 12/96) APPLICATION ANUPERMIT
ASSESSOR PARCEL NUMBER
065-43-0-022
__ )
ZONINGg r
BUILDINGPERMIT
OWNER ROY COGGINS
TELEPHONE
SO. Fr. OCC. BUILDING VALUATION
1440 R
77,760
OWNERS MAILING ADDRESS
15072 TOREY PINES ROAD, MAGALIA 95954
CONTRACTORS NAME SIERRA MOBILE SERVICE
ELEPHONE
T 877-8575
CONTRACTORS MAILING ADDRESS
8965 SKYWAY, PARADISE, CA 95969
CONSTRUCTION LENDER
Fireplace
LENDERS MAILING ADDRESS
Total Valuation $
7.760
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
Permit Fee 540.50/2
$ 270.25
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS 15072 TOREY PINES ROAD, MAGALIA
Energy Plan Checking Fee
$
PERMIT FEE
$ 9c;
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF 0 Duplex 0 Mobilehome 0 Other —
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00 15.00
Each gas water heater or vent
15.00
TYPE OF WORK
New 0 Addition 0 Remodel 0 Utilities 0 Installation 0 Other 0
Describe Work: EX MH ON PERM FND, ON EX SITE
Gas piping system I - 5 outlets
15-00 i c; - nn
Building sewer
-
5.00
Mobile Home I S I G WT-'
PERMIT FEE
$ go -nn
ELECTRICAL PERMIT
Filing Fee 20-00
Main Service "' Av OoRR LE::
23.00
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. NO. * '17L se 6
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
[1 1, asownerof theproperty, ormy employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
0 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
0 1 am exempt under Sec. Business and Professions Code for this
reason
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
0 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
Wormance, of the work for which this permit is issued.
0_1 have and will maintain workers' compensation Insurance, as required by Section
3700 of the Labor Code, forthe performanceof workforwhich this permitis issued.
MY workers' compensation * e carrier and policy number are:
g� insurang
Carrier 71-�
Policy Number Z�Cgg
(rhe above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
0 1 certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date Od
X yz --?/
Signature of Applicant - 0 Owner 0 'Ecritractor 0 AgeAt
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUP. so.
OR ADDNS. & ACC. BLDS. 3.50FT.
NEW CONST.
, �Rcuns @7.50
NON-RESID. mu LT, 0
OWM APUARATUS
PSING . T. C..
20 @ 1.00
Occup. OUTLET OR FIXTURES BAL @ .50
—Ex.
Ex. Occup. P(PM.) E
O.MED A - OR..
5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
PERMIT FEE $
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEt $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOT)AL FEE $ 3 Q 9
'C/1 FLOOD CDF
pD D YISSUV
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES
I
the applicable provisions
Resolutions to do work
been paid.
at. 06
7�
0/
/ (DAte)
ReceiptNo. 302352 / $363.25
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROD -APPLICANT
J),F PA V DE LOPMENT SERVICES - BUILDING DIVISION
CO UNTY OF B UTTE - Q_i�PA-R _'A
LE CN ORNIA 95965 - TELEPHONE (530) 538-7541
7 COUNTY CENTER
PEIRMIT", PLICA DATA SHEET
C
r�P
q MR -6 * Date: 4 a�7
OWNER: ASSESSOR P�R(':l 0 Oz�
Proposed Buil ing Sl*tLBuilding Inspecto
At time of permit application, I was advised the following data must,bg submitted prior to permit processing and/or issuance:
\�-V Date Received By
01. items have been submitted --------------------------------------------------------------------------------------
\X X plans, 3/4 sets, signed by the preparer of plans - ------------------------------------------------------------
113. Complete plans, 3/4 sets, signedby the preparer of plans - ----------------------------------------------------
�>Xngineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans - -------- -
0 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
06. Energy Design Compliance and supporting documentation - ----------------------------------------------
j i El 7. Statement of Intent. for Non -Heated and A/C Buildings.
El 8. Hazardous Material Form - ---------------------------------
09. Manufactured Home data and installation instructions including Tie Down Specifications.
G�Vees of $ -------------------------------------------------------------------
0 1-1. Impact fees as show'n on the attached schedule - -----------------------------------------------
El 12. California Department of Forestry plah appT6vZiees - ---------------------------------------
1113. Flood elevation certificate - -------
1114. Sanitation and plot plan approval
0 15. City of Chico plumbing permit.
.Healhi Department. -----------
El 16. Plot plan and business license approval from the City of Biggs.
El 17. Planning approval for (A) Use
(B) Parking:
0 18. Conta6t Land Development about 11 Improvements, 0 Drainage, 0 Legal Parcel - -----------------------
Encroachment Permit fb� (�riveway (construpti a] prio to occupancy) - ----------------------------
r tjon f
re- or 'u, gm= Request to Building Inspector on
ff
Co
2 Contractor's license information. (Number, Name Style, Classification) - ------------------------------------
1122. Workers' Compensation carrier and policy number - -----------------------------------------------------------
E123. Owner-Builder'Verification (Given to owner El, Mailed to owner 0) - --------------------------------------
El 24. Letter of signature authorization - -------------------------------------------------- : -----------------------------
E125. Recorded copy of Agricultural Acknowledgment Statement - --------------------------------------------------
I
D26. Letter of intent on building use - ------------------------------------------------------------ I ------------------------
E127. Manufactured Home utility clearance - ---------------------------------------------------------------------------
02 CD
.$,_EkistingviQlations and/or xpiredpermi --------------------- ------------------------------
eed, ---------------
('1!r29.0433A,tWantD W.H Title, Mxeclno H.C.D $
E130. Other: -------
W en you issu el74u lows 0 Mail to owner
and hold for pickup at
r
Copy of Haz-Mat form sent 0 Health Department, 0 Fire Depa"t�eftt-,
Copy of plans sent 0 Health Department, 0 Fire Department, 0 Other:
Index permit application for the above items numbered:
2. Additional items required:
Pollution
with inspector.
Date:
Date: BT
Date: By
N
IV�
0 Plan Check List
Contractor, designer, owner, was advised of the above required data by 13 phone, 0 mail, 0 Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by 11 phone, 0 mail, 0 Building Division counter, by,.,-' Date:
Contractor, designer, owner, was advised of the above required data by 0 phone, 13 mail, 0 Building Division counter, b , Date:
y_
Contractor, designer, owner, was advised of the above required data by 0 phone, ii mail, c3 Buildt5DivjDn counter, by ate:
Plans reviewed by: Date: Plans approved Date:
Sets of plans on hold *in 0 Plan Cabinet, 0 A.P. folder. Note transfer by: Nae Date:.
Yellow Copy - Department of Development Services, Building Division.
R EIN.
'SPECTION REPORT
OWNER:,
n
L r),S DATE:
LOCATION:
N -
A.P.
CONTRACTOR: a
-iONING:
PRE-INSPETION FOR:
DATE TO INSPECTOR:
PERMIT HISTORY:( NONE )AS F6LLOWS:
'BUILDING INSPECTOR'S REPORT
At
Building Description:
Commercial/Usage:
Residential/# of Units:
Currently Occupied
AbandonedNacant
Electric:
Yes No
Electric currently On Off
Condition of Electric
Gas.
Natural— Propane
None Currently On Off
Obvious Problem:
Sanitation:
Plumbing Working
Well Workin
Potable Water
Obvious SewageProblei�ns
-,Comments:
ACTION RECOMMENDED: ISSUE: ,40LD, FOR
Inspector:
Datem-_*
Sketch buildings on
reverse' and indicate location on-
property.
'peftit'
REQUEsT FO sPECT ,No
WT 1
B.i.N.
Location:
h(Downe
Contractor orTenant:
------
Cornplaint:
PLU B/MECH
ELECTRIC
M.H.,.,M.H.U-
PRE-
-I�SPECTION i,
BLDG.
Form
Rough
Top Out
Rough ce
Temp. Servi
Corrections
Final
Job status
Renewal
Frame/Underfl oor
stucco Lath
Gas Piping/Te st
Service
Underground
Permit
Verity utilities
stucco Brown
Fireplace
Temp.Gas
Sewer Piping
Water Piping
Well Circuit
Light Niche
OTHER
Bond Beam
Showerpan
insulation
Nailing
Corrections
Corrections
OR A.M.
C ections
Final
Final
MS
F ipn'a I
rime:
Note:
Date:
, Lot I
6- E,
/*
10 ( 6v
D
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center, Drive * Ordville, C'alifornia 95965 - Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96;' APPLICATION AND PERMIT
ASSESSOR PARCEL NUMMM
y 50 -0,
1
ZO NING
BUILDINGPERMIT
TELEP NONE
SO. Fr. OCC. BUILDING VA YATIqN
OWNER'S Awmo
or
E N
WArcj
VA-mtj LO',
C C)
CONSTRUCTION LENDER
Fireplace
LENDER'S "UNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
ENSE NO.
Filing Fee $ 20.00
Permit Fee
AACWTECT OR ENGINEER'S MAILING ADDRESS
Plan Checking Fee $
ne R�l
Energy Plan Checking Fee $
$
M 8EE�
AAA
PERMIT FEE $
LOTNO. ---PUBorvisIONS
NAME -
I PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF 0 Duplex 13 Mobilehome a/Other
SPEC"
Each Trap 7.00
—
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New 0 Addition 0 Remodel 13 Utilities 9 "llation 0
D *08 Wor L-U� M H nn
17ni S�&'.
Other 0
ocuonl
Gas piping system I - 5 outlets 15.00
Building sewer 15.00
Mobile Home I S I G I W C&20.00,
--tl
PERMIT FEE SZ�-
5D
ELECTRICAL PERMIT Filing Fee 20-00
'0 '
Main Service '.**.A..LE:s' 23.00
-7
k) ReceiptNo. .0
WHITE -1 C, RY-ASSESSOF iPECTO�.��DENAOD-APPLICANT
Main Service 200A TO 1000A 46.00
NEW CONST. OWELUNGffUP. so.
OR ADONS. & ACC. S. 3.54T.
NEW CONST. OUTLET
=LT." CIRCUITS @7.50,
—NO"ESID.
PSOMAPPARATUS I
rLET C'R.
Ex. Occup. OUTLET OR FIXTURES 2*
SAL @ .50
..FL4ED A "S
Ex. Occup. PCPRLM6.)021 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.001
PERMIT FEE $
MECHANICAL PERMIT Filing Fee 20.00
Heating 11
Cooling —
Hood 6.50
Ventilation
PERMIT F $
(_Mobile Home Installation Fee $
77e—
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $
0. FEESS IMP
I FLOOD
I COF
I PAACIEL
I PO
HD
SSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By Date
PERMIT EXPIRES ON
I /Data)
ines Rd., lot 04) rr v2a 4
!.00 Torey P
ontr: Powers Const., Magalia
ku
-80P,E(Util.-.�ffl)
Permit #2054
ELEC
GAS
SUPPORT STRUCTURE REQ "7-252)
COMPACTION TEST REQ.
-43-22
'e. Permit #2 55-80B(new open deck/MH)
A
65-43-22
concord
Contr: mobile Home Expo,
A A,
-80MHI
ermit#2918
Issued
6 5 4 3-d' ;r2
A0
Cgntr: Powers COnst
1j.
P(,
y gas�piping)MH
#2964-80
P rmit 5
%
6 -43-22
5
Permit#39 781B,E new 1mri garage)
v,
65-43-22
;L7�
Permit#1779-84B(deck cover/MH)
A-
A
7%.
A47 0-
4." -
v
4 jz
z
%
V
t
.7
4$
5
Cr
�m
Y of Document Recorded
COP
23 -Aug -2000
Has not been compar
I e with
I original
RECORDING REQUESTED BY:
BUTTE.*COUNTY RECORDER
WHEN RECORDED MAIL TO:
Butte County Building Division
7 County Center Drive
Oroville, CA 95965
NOTICE OF MANUFACTURED HOME(MOBILEHOME)-.
OR COMMERCIAL�, COACH, INSTALLATION OF A,
FOUNDATION. SYSTEM
THE ATTACHED DOCUMENT IS BEING RECORDED TO CORRECT ERROR IN THE
LEGAL DESCRIPTION- ON NOTICE OF MANUFACTURED HOME (MOBILEHOME)
'OR COMMERCIAL COACH, INSTALLATION OF A FOUNDATION SYSTEM,
RECORDED ON AUGUST 11, 2000, UNDER SERIAL NUMBER 2000-0031285.
THIS PAGE ADDED TO PROVIDE ADEQUATE SPACE FORRECORDING
INFORMATION.-
REC'ORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUN TY- 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. 1855 1. 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.
ROY G. COGGINS & JEWELL D. COGGINS
MAL PROPERTY OWNEMESSOR
15072 TOREY PINE ROAD
MAILING ADDRESS - %
MAGALIA, BUTTE, CA -95954
CITY COUNTY STATE ZIP
SAME
INSTALLATION MAILING ADDRESS, IF DIFFERENT
CITY COUNTY STATE ZIP
SAME
UNIT OWNER (ifalso property owner. write "SAME")
MAILING ADDRESS
crry COLNTY STATE' ZIP
UNIT DESCRIPTi6N
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
00-1829 (530)538-7541
T)gNG,PERMrr NQ^ TELEPHONE NUMBER
08/10/00
1 !k1GTiM1REOFL(3CALAGffyWlC-1A—L DATE
NONE -
DEALER NAME (ifnot a dealer sale, write "NONE')
DEALER LICENSE NO.
SKYL. INE 1980 UNKNOWN
MANUFACTURER'S NAME DATE OF MAMFACTURE MODEL NAIMEMMBER
01750641AJBN 60'X 24' CAL189552/3
SERJAL NUMBER(S) LENGTH X WIDTH fNSIGNIAILABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NLlMBER A.P. # 065-430-022
SEE ATTACHED
HCD FORM 433(A)�REV. 8/91
WHITE -County Recorder CANARY-HCD PINK -Applicant GOLDENROD- Building Dept.
RECORDING REQUESTEDAY:
AND WHEN RECORDED MAIL TO:
. I
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
COPY of Document Recorded
11 -Aug -2000
Has not been comp
ared with
original
BUTTE COUNTY RECORDER
SPACE ABOVE THIS LINt 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 1855 1. 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 r6l property and shall be deemed to give constructive notice as
to its contents to all persons thereafter dealing with the real property.�
ROY G. COGGINS & JEWEL L D. COGGINS
REAL PROPERTY OWNEMESSOR
15072 TOREY PINE ROAD
MAILrNG ADDRESS
MAGALIA, BUTTE, CA 95954
ZITY COUNTY STATE ZIP
SAME
INSTALLATION MAILING ADDRESS, IF DIFFERENT
CITY COUNTY STATE ZIP
SAME
UNIT OWNER (ifaiso property owner, write
MAILING ADDRESS
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMTr and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
OROVILLE, BUTTE, CA 95965
CITY COUNTY STATE ZIP
00-1829 (530)538-7541
BUILD G PE 0. TELEPHONE NUMBER
08/10/00
SIGNATURE OF LOCAL AGENCY.OVWJKL DATE
NONE
DEALER NAM[E (ifnot a dealer sale, write *NONE*)
DEALER LICENSE NO.
cm, COLW" TrATF
UNIT DESCRIPTION
SKYLM 1980 UNKNOWN
MANUFACTUREWS NAME DATE OF MANUFACTURE MODEL NA.MEINUMBER
01750641A/BN 60' X 24' CAL189552/3
SERIAL NUMBER(S) LENGTH X WIDTH rNSIGNLk4ABEL NUNMER(S)
REAL PROPERTY.LEGAL DESCRIPTION ASSFSSO'WS PARCEL NUMBER A.P. # 065-430-022
SEE ATTACHED
HCD FORM 433(A) REV. 8/91
WHITE -County Recorder CANARY-HCD PINK -Applicant GOLDENROD -Building Dept.
08/03/2000 09:07 MID VALLEY TITLE 4 87768?5 NO.466
Recorded I REC FEE
Official Records I
county Of I
BUrrE I
C"ACE J. RMS I
RECQRDIVG REQUESTED -By: Recorder I
ROMMARY DICKSON I
Assistant I Vickie
ROY G. COGGINS 69:02AM U-sep-1999 1 Page I of 2
JEWELL D. COGGINS
15072 Torey Pine Road
magalia, CA 95954
WHEM gECOgpZp, MAIL TO:
SAM AS ABOVE
MAIL TAX- STAT1ff=LXQ_:__1
SAla AS ABOVE SPACE roR RECORDER'S USE-
QUIT=33( DEED
THIS VORM FURNISH30 BY LXVINO TRUST DOCUMENTS
NOTICE: NO CONSIDERATION. R & T 11911
we, ROY G. COGGINS anc�,JEWELL 0. COGGIVS, do hereby remise# release and
forever quitclaim unt6LROY G. COGGIVS and JEWELL D. COGGINSr Trustees Of
THE ROY AND JEWELL CO ' GGINS REVOCABLE LIVING TRUSTOWhose trustee(s) and
successor trustee(s) are also named. in that instrument known as the
CERTIFIED ABSTRACT OF TRUST AGREEMENT Of said trust agreement,, further
identified as EXHIBIT -"A",, attached hereto and made a part hereof p the
following described -real property in the County Of Butte, State Of
California:
Lot 64, as shown on that certain Map entitled, "PARADISE PINES UNIT NO.
3", which Map was recorded in the office of the Recorder of the County
of Butte, State of California, on June 17f 1970 in Book 35 of Maper at.
pages 78, 79, 801 91, and 82.
APN: 065-430-022
DATED:&MW41
j At -
40, 1 Rft_G. C6GGIXS
State of.California so.
County of Butte
on thin 18th day of August ., in the year
1999 , before me, a Notary Public, personally appeared ROY Q. COWINS MO
jMLL v. coc=xs, and known to me (or proved to me an the basis of sati5taOtOry
evidence) to be the persons whose names are subscribed to the within instrument and
acknovledged that they executed the same in their authorized capacity and that by their
signatures on the instrument the persons, or I the entity upon behalf of which the
persons acted, executed the instrument.
wlTNzss my hand and official sea.
Pamela Sue ClaY
0j mm
comm. 41 12n2w
5
T
AllypustO CANIFOINMAJ
xv,rTl 0
Xv..-
Go".
my commission expires I __ / - ox
BUILDING PERMIT NUMBER: 00- 1829
Address or location of unit: 15072 TOREY PINE ROAD, MAGALIA, CA 95954
Legal. Description 'of Real Property: A.P. #065-430-022
SEE ATTACHED
(x) Mobilehome/Manufactured Home
()Commercial Coach
Has been affixed to the'real property above by installation on a founda.tion system
pursuant to Health and Safety Code'Section 18551.
Owner's,name: ROY G. & JEWELL D. COGGINS
Owner's address: 15072 TOREY PINES ROAD, MAGALIA, CA 95954
INSIGNIA OR HUD NUMBER: CAL189522/3
SERIAL NUMBER Ok V.I.N.: 01750641A/BN
MANUFACTURER'S NAME: SKYLINE. YEAR: 1980
OFFICIALAPPROVI NG INSTALLATION:
DATE: 08/10/00
PHONE: (530),538-7541
H.C.D. 513C
STAlt OF.CALIFORNIA
BUSIN'"ESS, TPA-N-SPOR-TATION AIND HOUSING AGENCY 4b;'F
NG AND COM�UNITY DEVELOPMENT
DEPAR TOF HOUSIN A V
-OF CODES AND STANDARDS
DIMSION &%hot.
REGISTRATION AND TITLING PROGRAM
STATEMFffr OF FACTS
This unit is a: Mobi ; lehome commercial Coach ED Floating Home E3 Truck CAmper
Decal (License) No -(s)
AAA4776
: � I Tra de Name
Skyl i.ne
I/We, the undersigned, hereby state:
Serial No.(s) �,
01750641AN/BN
De�al # AAA4776 'for the a'bove mobilehome has been lost.
I/We'further agree t . 0 indemnify and save harmless the Director of Housing and Community Development, St3t,
of California, and subsequent purchasers of saidunit, for any loss they may suffer resulting from registration c
the abovc-described unit in California, or from issuance of a California certificate of title covering. the same.
I/We certify under penalty of perjury that the foregoing. is true and correct..
Executed 0 t
(City) (Statc)
a t e)
Printed name(s).
Signature(s)
C\ I A 9- L I A ri, 6
Address-/-S--]Q
City
HCD 476.6 (REV 9191)
state K�A
08/03/2000
121
7
8
10
11
12
13
14
16
17
is
19
20
21
22
23
24
23
26
27
09:0? MID VALLEY TITLE 4 9??68?5
state of callfornla
county of BUtt*
EXNZBXT OAO
cmitnPuD AssrmcT OF TRUST AMRMW
jt0y G. COWZNS AND JMLL D. CO=ZNS
41
NO.466 007
The U=JrRSJrGNRD ', being duly sworn, depasOf and certifies:
1. Declaration of Trust Is entitled sw Wr AM JN*7zz COWZHS XZVOCAWX
LrVIM TWS7.
settlor and Trustee: JWY G. CWGZNS
settlor and Trustee: JMLL D. COWZNS
First successor Trustee: BLrZARKTH A. JOWS011i
second successor Trustee: WAIM J. McADMS.
sottlors and Trustees executed a Declaration of Trust and that said
Declaration of Trust is not of record In any court. d DOC2&r&tlon
2. That the present beneficiaries under the terms Of Sal
of Trust are the settlore so long 90 one or both are living, and the Settlor's
children or other as designs ' ted in the Declaration of Trust.
3. That the power and authority of the trustees with respect to the
trust property Include, by way of Illustration, the following:
A. 'To exercise without notice, hearing, confirmation -or approval of SAY
court, each and every power enumerated In the trustee's powers of the
Bottlors, Domicile state,s Frobate Code laws In effect at the date of this
agreement unless otherwise stated In this Declaration of Trust.
g. To sell.. convoy, exchange, partition, divide, lease, pledge for
security, to borrow money without or with security on real or personal ab ol
property, and exercise a2l the rights, powers and privileges which On 8 uts
owner of the same property would have regarding any property, which in hIs or
bar discretion the Trustee chooft0e to receive subject to this Declaration of
Trust and subject to the zettloro, Domicile Stat*18 lawa with respect to
ci i unity property and quasi -community property.
4. settlors are empowered to designate trustees and Successor trustees,
and have appointed iMrSABSTO A. JOWiSON, as successor trustee, and should the
named successor trustee become unable because of death, Incapacity, or any
other cause to serve before the natural to=inatlon of &22 the trWt(s), th0A
mama j. scamm, shall servias an alternate successor trustee-
sowever, should the above succession become unable to serve as trustee
.because of death, Incapacity or any other cause, a trustee shall be chosen by
the majority of beneficiaries by right of representation, If applicable. The
issue of any docoaaed beneficiary shall collectively have only one (1) vote
.With a parent or legal guardian voting for minor beneficiaries.
The Settlors reserve the 'right to appoint other trustees or Successor
trustees . and to remove any trustee or trust@" from office at any time VhJl*
they both shall live. Unless othorviso stated In writing by the Settlore, the
trustees and successor trustees of the Declaration Of Trust shall be
consld*rod to be those mentioned above..
nj= OjP JFXUZBX7 A w
08/03/2000 09:07 MID VALLEY TITLE 4.8776875
JUL-12-00 10:32 AM REAL PRO 8729039
NO. 466 (;01
p . es I
ATE (-W('A1Af'()R-N1A - DEPARTMENT OF HOUSING AND COMMUNITV RE VELOPMENT
REGISTRATION CARD
Mama fict tired I Ionic D,.v i I No: AAA4 776
Manufaciver tomame Trade Name Model DOM OFS �y Exp Date
SKYLINE OD/00/aG IS00 Jun 30. IVA
SerIal Numher Lab9l/Insignia Number Weight Length Width VC SCC Evempl: Ifi- Tvp*
31?S.^G I IAN APP 04
31'5Z'6418N ss 2., SF0 ILT
81 S -S,3
Issuod Total Pat* Paid
Jun Ig 1908 s2s.00
Addressee
ROY GRANT COGGINS
15072 TORREY PINE RD
MAGALIA. CA 95954-97,19
Registered Owner(s)
ROv GRANT COGGIN3
DEAN JEWLL TENCOM OR
15072 TORREY PINE RD
MAG AHA. CA 95954 -9719
Situs Address
15072 TORREY PiNE RD
MAGALIA. CA 95954-9719
I . 0A
Arm.N'TioN. OWNER:
1111S 1,; 1111, Rv.(;I%T14AT10N rAR() FOR TSIF UNIT
pl. V t., k%!! 111VI,11:, VNI 1'.
NvrRUCTIONS FOR RFNFWAI.:
aiiiii Rr vola 1*1114; VNI1- EXPIRES ON THE DATE
INDW:V1 EI)AROVE IN TIIF, RON LANFLED "I%xp. Ditto".
jw" THERF ARFsrw.,r.\\!'I IAL PENALTIES FOR
VLLINQUENCY. IFYOU DO NOT RECEIVE A RE.NENVAL
am %,c),rwF %k I i mN, 10 DAYS PRIOR TO TIIE EXPIRATION
1) %1 r.-C4,11N VAUCIt-C.D. FOR RENEWAL INSTRUCTIONS.
REMITTANCE ADVICE
SIERRA MOBILE SERVICE & SUPPLY
8965 SKYWAY
PARADISE, CA 95969 16734
530-877-8575 11-8078
3211
PAY
I -A= I DOLLARS'
W61 DATE TO THE ORDER OF GROSS
AMOUNT NET
AMOUNT
D E SC R I PT 10 tN
HOME SAVINGS OF AMERICA - PARADISE SKYWAY OFF.. EIR. 146
6848 SUITE 0 SKYWAY - PARADISE, CA 95969
�.11801[03tvul, 1:321il,8071301:03639210S86.11, -
v,
PERMIT NO. 1779-84B
PERMIT EXPIRES
OWNER ROY COGGINS
owner
CONTR.,
ASSESSOR PARCEL 65-43-22
15072 Torey Kne Rd, Magalia
LOCATION
Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
Temp. Gas Service
CalledPG&E
JOB FINALED (Date)
Signature
OK
0 = Not OK
— = Not Applicable MOBILEHOMES
* = Not Ready
,;.. " i
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except #'s
Date
DECO, COVERS, CARPORTS, ETC. (Plans) OK except #'S
1. Zoning Requirements—Setbacks—Easements
9V ZoFting Requirements—Setbacks�Easements
2. Soils; Special MH Support—Sketch
&#'o"Footings; Size—Depth—Spacing—Connectors
3. S6wer; Location—Test—Fall-C/0—Concrete
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Ra,�i-s
4. Water; Local I on—Test— Easement Needed (Sketch)
Ae'W-o-od Awn.; Po&9'—_BE&nf—'_P9w1Con&r--�- �—BrAelng
5. Electricity; Location—Clearances—Grnd.—/ Amp—Concrete
5. Alum. Awn.; Column�—Connections—Splice—Decal—Enclosures
6. Gas; Locatiorv--Test—Wrap: / /"L ft./ P'Nat.or/ P'LPG
6. Carporis; Windows-136ors
7. Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -Bl_
Date M15, C.rd-BI Date
Card -B I
Date Card -BI Date
Card-Bl�_�_
Date Card -BI Date
Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
Date
POMS (Plans) OK except #'s
1. Zoning Requ i reme nt s—Setbac ks— Easements
1 \4pthAr.Icq Easements
2. Footings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
3. Gas; MH Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
4. Electricity; MH Test—Crossovers—Breakers—Clearances
4. Elec.; Receptacles and Lighting; Distances—GFI
5. Drain; MH Test—Fall—Flex Connector
5. Elec.: Pool Lighting; 15 volts—GFI
6. Water; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
7. Water and Sewer Connected—C/0 to Grade—HD Approval
7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enc I osures— Pane I boards— Ins. to Main in Conduit
9. Exits; Insp.—Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
= OK
= Not OK
= Not Applicable
= Not Ready_ RESIDENTIAL (Single and Duplex)
Date
UNDERFLOOR (Plans) OK except #'s
Date
FRAMING (Continued)
-1. Zoning requ ire ment s-Setbac ks- Easements
48.
Property Line Firewall & Openings
2.
3.
Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
49.
50.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
Stairs; Width -Headroom -Rise -Run -Landing -F ire Protection
4.
Ftg., Porches & Decks; Soils -Steel- / - /" Ftg. Depth
51.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
52.
53.
Siding -Nailing -Veneer
Stucco Mesh -Drip Screed-Fdn. Vents-UnderfIr. Access
7.
Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protect ion -Sky I ights-Plast i c
8. D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test
55.
SRear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test-Anchors-Regulator-Sery ice Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
FINAL (Plans) OK except #'s
Card -BI Date Card -BI Date
Date
PLUMBING (Permit) OK except #'s
14. Water Ht.; Vent- Access -Combust ion Air
56.
Ext. Steps -Door & Sidelight Protecti on- Land i ngs
57.
58.
Smoke Detector
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -B I Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL (Permit) OK except #'s
67.
Garage Fire Door; Swing -Landing -C loser
68.
69.
A.C. Duct in Garage -Damper
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
20. Fixture & Transformer Clearance -ins. Protection
21. Elec. Receptacles Spacing -Lights & Switches at Doors
22.
Size Boxes & No. of Conductors -Stapled
70.
Plb., Elec. & Mach. Equip. Listed for Location
23.
Romex Installed Close to Edge of Studs & C.J.
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
Insulation -Foam -Looked in Attic [] Yes
25.
2 Appliance Circuits in Kitchen & Conductor Size
73.
Guard Rails & Deck Construct I on- Post Caps
26.
Subfeed Wire Size ga. Cu or AI-A.C. Wire Size ga. Cu or Al
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor El Yes
27.
Range Circ. / / ga. Cu or A[ -Oven Circ. ga. Cu or At,
Insulated Neutral E]Yes E]No
75.
Following instid.: Drive 0 Yes
Planters OYes E]No _]No; Walks nYes ONo;
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
Equip. Clearances; Pane Is-Motors-Mech. Equip.
77.
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumoing
80.
81.
82.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Ventilation throughout House
Glass Protection
Card B -I Date Card -BI Date
Card B -I
Date
Date Card -BI Date
MECHANICAL (Permit) OK except #'s
83.
Corrections from Pravious Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
31.
A.C. Ducts; Insulation & Support
85.
Water & Sewer Connected -C/O to Grade -HD Approval
32.
Vent Fan; Exhaust above Insulation
86.
Energy Compliance Certificate -Other Certificates
33.
Condensate Drain & Overflow; Size & Grade
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -61
Date Card -BI Date
Comments at Final:
Date FRAMING(Plans) OK except #'s
36.
Sills; Proper Material & Anchors
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
38.
Bearing Walls over Girders & Floor Nailing
39.
Draft Stop in Walls (rat proof)
40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
41.
Header & Beam -Size & Bearing
42.
Hangers -Post Caps -Anchors -Connectors
43.
Cing. Joist-Rftr. Ties-Purlin- Roof Brac.-Truss-Shthng.-Rfng.-
44. Fireplace Ties or Type A Flue -Fireplace Throat
45.
Attic Access; Size & Romex Protect i on -Draft Stop -Ins. Baffles
46.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
Garage Fire Protection Framing
(NOTE: An entry must be made each time youvisit jobsite)
COUNTY OF BUTfE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, Palifoxniia�95965 - Telephone 916/534-4541
1. APPLICATION AND PERMIT
PERMIT NO
ASSESSOR PARCE!4UMBER ZONING
BUILDING PERMIT / /
OWNER TELEPHONE
&0 �J 0 (SC,1A)3
ON/
SO. FT. OCC. BUILDING VALUAI
7
0
OWNER'S MAILING ADDRESS
/ �5-07?_" ng�j &,4LJ4
CONTRACTOR'S NAME TEL-EPHONE
CONTRACTOR -S MAILING ADDRESS
Fireplace :J
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ fZ=cI__6
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ -1_5�00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ 1,5_/oc
Penalt
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 5,Z), 6Q
BUILDING ADDRESS
Z <�—o /101A)15
PLUMBING PERMIT
FilingFee 10.00
Each Trap
2.00
Solar Water Heater
20.00
MA- A -AQ -A
Water piping
5.00
LOT NO. SUBDIVISION NAME
I
PARCIEL MAF5*
I
Each qas water heater or vent
5.00
Gas piping system I - 5 outlets
5.00
USE OF STRUCTURE
SF[—] Duplexf—I Mobilehomeg Other
SPECIFY
Building sewer
5.00
Home T_s7_G1w-1
110-00e�
—Mobile
TYPE OF WORK
New R AdditionNr Remodel[] utilities El InstallationD Other
Describework: i!nOtAtZoe 04152?_ E —971A) C,
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ACC -L 100 AMP
2.50
NEW CONST ( DWELLING OCCUP.&)
OR ADDNS. * ACC. BLDGS.
21/20sqft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
El I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and e ffect.
License No. Classification
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
F] I am exempt under Sec.—, Business and Professions Code
for this reason
NEW CONSTR. MULTI -.UT LET 2.50 ea
N.N.RESD, BRANCH CIRCUITS)
NEW CONSTR. POWER APPARATUS &'
NON-RESID. %SINGLE OUTLET CIR. )
0@50C
Ex. Occup(OUTLETS OR FIXTURES eAL@ 300
FIXED APPLISIS OR
Ex. OCCUP. OUTLETS (RESI'D.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 1500
Permit Fee $
Contractor
MECHANICAL PERMIT
Fi I ing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certifi cate
of Consent to Self-Inswe.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
Heating
Cooling
—
Hood
3.00
Ventilation
Permit Fee
$
Contractor
—
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against d Co ty in onsequence of the granting of this permit.
�� ;W / (71 J
X 9 __ . C/V Date 0 — /_ 0 1 7
Signotd9of �pplicont Owner.9 Contractor D Agent F1
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $
occUP _G70UP
P
P OVNST.
I PA71
I HD
I 1:�JdE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECT F PUBLIC
By-
PE,�WIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt NO. L?10
WHITE-D.P.W.. YELLOW -ASSESSOR, �INK-INSPECTOR. GOLDENROD-APPLI CANT
C_
NOTE:—All Materials & Workmanship Shall Be i T,147'ssef of
In plans an4j.specific
4; . f f h io6 of all fbes i ations
an :-.- -�, -
Accordance with Pecoanicd Good 'Practices �'d kep on e MUST be
ojn the :**. and it is; unl6wful to'
C, of a auciFfy prescribed for' Ae Specified 'us rrn!-- can, . f 9-rof
W s or -no,
w Uniform Building, Plumbing & Machanicol C --wriffe*n' rmissior
odes`-G'�d i fro 't
e D ' "' " . .7
Mirkt- -
fhe National Electrical Code. ..-PP9
-ounf
y of B'
u
db
01.
L
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cc Lj
Be, in
e d
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.4 17717
BUTTE-600NITY
ae
aiWILDING DEPARTA,4ENT
PP.
_%VED
Oki
A setback of 5 ft. fmm the - ------ 4
9�5
property lines and a setback
JI
t.7 9 E COUNTY
of '50ft. from the road
centerline shall bf? cl&af o� BUILDI DEPARTMENT
10 MENT
sttUduresor"u`pffi@jjf-dkdd0F
U
f -6 21 ft, gave @4 44 P D I
R
or
-,:E D
,tie
�4100 4( . , P R
(6
31 IAJ 1,9,""
Provide adequa - I . . .
te bracieng.
'N
F/?o 7- W
5� -wFa Cog C //V
11 M 7--t� 3 Lo7 \+
-BUTTE COUNTY
F'A R A D E m i�,
.15.4 r%lhl� DEPARTTN'fNT
ROVEP
c A, L /-F 7.
F, "I)
A A
11
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po
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PA
13UTTE Cai Ty
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M51 �)E
SUILM U I- I i -I .
I / �,T- / I
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 ements
of the California Administrative Code, Title 25, Chapter 5, permit
number...- for the following location:
X t
Owner
Owner's Address
T-1
Mobilehome Mfg. z-1 Model Year
Insignia No. f _,�, -Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Director of Public Works
Date I By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
1.
2.
3.
4.
5.
6.
7.
F_
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
Is the mobilehome located ' with required separation from lot lines and buildings and generally
conform to plot plan? Ye--,f\No
Does the mobilehom6 have required clearances above ground? (Sec.5085) Yes No.
Ate footings and supports properly sized, spaced, and braced as p r approved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes No
Is the mobilehome level? (Sec. 5088) Yes4_ No
If 7 than a single unit, are crossover connections properly installed? (Sec.'5088)
Yes 'No
Water
A. Is,,fTexible connector of adequate size and. pro . perly installed (1/2" ID min.)? (Sec. .5566)
Ye '�k No
S
B. Test -'Does water piping withstand working pressure or 50 lbs. air test? Ye�d,�j No
C. Ba I ckflow - f1coach is not State of California approved, does station hav6 backflow device
and pressu e elief valve? Yes— No—
i s
Wastes and Drai s
A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes—
M 0
B. Does it have 'inimum per foot slope a nd is it properly supported? Yes
C. Are any le'aks detected in drainage system after r 3 -gallons of water through each
fixture including washing machine standpipe?.YesLifnN
D. If coach is not State of.Californiaapproved, does station have required trap and vent?
Yes No
Gas Piping.'and Gas Vent ' s
A. Connector - Is mobilehome connected to the gas supoly�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 m eh . ome gas line ifilet without reductions other than the mobilehome
connector.* Ye No
B. Test OK as per fol lowing procedure? Ye S�_ No
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.)'.*c,.ilibrated in tenth pound increments. Test for 10 min. without
drop.
4. Connect gas meter to mobilehome with connector,
soapy water.
C., Are� all appliance vents properly insItalled? YV_
9
turn on gas, test connections with
No -
'44 -J -J-, re)
9. Electrical ego :�. i
'Ir
A. Is service . large enough to,provide adequate amperage -to mobile1iomd'(must equal rat - of
'�ties on lot, i.e., water pumps,
mobilehome with a minimum of 100 amp) and other facili
garage, cabana, etc.? Yes _�4 No
B. Is there proper clearances around panels? Yes No—
C. Is power supply cord or feeder assembly properly fused? Ye No—
D. Is continuity test satisfactory as per the following procedure? Ye kdes No
1. De -energize electrical wiring system of the mobilehome at the p des al.
2.' Make sure that the power supply cord or feeder assembly conductors, including neutral
conductor, have been disconnected.
3. switch all breakers and switches in the mobilehome to the "on" position.
4. Connect one lead of a test instrument to the mobilehome grounding conductor and
apply the other lead to each mobilehome supply conductor, including neutral.
5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line,
water'line), including fixtures and appliances, shall be tested for continuity from
such equipment and the grounding conductor.
6. Upon completion of the above procedure, the power supply cord or feeder assembly
conductors shall be connected to the site service equipment. A further continuity
test shall then be made between the grounding electrode and the chassis of the
mobilehome. Upon satisfactory ' completion of theelectrical tests, the lot or site
service equipment may -be approved for energizing.
10. Is job card signed by Health Department for water and sanitation?
11. If everything okay, sign off card and tag services.
MOBTLEHOME DATA
Manufacturer and/or Namestyle
Length & 0 W idth_09,1_
Vehicle Serial No.
State Identification No.
Additional Information or Comments:
6
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
BUILDING (Cont'd)
PLUMBING
SetXack
Flrhall
bQil Piping
ForA
Parapxts
'*Wt Floor
MalkBldg.
RestrooNd Finish
2n\ Floor
Fo)gings
W I ndows
3rAloor
Stem al I
Siding
Topout
Slab
Roof SheathJXq
Water Pip'log
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footinas
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Plab
Carport V
Footings A
Prov. for p�
handicap e isically\
Conformance of ex.
structure
Appliances
Gas Piping & Test V
Temp. Gas A
Slab
Final
Sanitation
Patio
P4REPL)4CE
Final
Footings
Footing
ALECTRIO&L.
Masonry Wa I Is/
Throat
Rouah
ReInf. Stee/
Final
Fixtures
Bond Bea
/FIRE SPRINKLERS\
Motors
Framina
Test
Water Htr.1
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. ult Prot
Scra h
Heatih
e
Servil
BrqAn
Cool(ng
'm-. Pole
Intirlor Lath )I gntilation Permanent
96or Closer rtinal [Winal I
MOBILEHOME UTILITIES eaxi�L-14,'Acl ------ Elec- ServiceY-d,?-,?-o 0 d,:>oA '1/',oAz--E1ec. Pedestal
WaterPiping J--lo-,f. A Sewer Opp Gas Piping 9-16-4-010 .16 -JK11
MOBILEHOIAE JUPTaLLATION ------- - - - - - - Support Elec. Continuity
:�tl Ifid"Al — LJI�CZ&�N-
Water Piping(0/1 Y -h- 0 Drainage / \0/ 11/ V - Gas Piping ( , / I /e-71 -�
DATE F E%,AR .1; OR CORRECTIONS
V F- 44rx
0�e Z� �"le A' 'A/ ^V5'
004F-(
JC
A
—J4 /4 -9 -
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BU_T_T9 - DEPARTKkENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California
Telephone: 534-4541
APPLICATION AND PERMIT
dumorize repretienumves oi ine tounty oi t5utte to enter upon ine
above-mentioned property for inspection purposes.
X Dateq - 13 -'F_0
Signature of Permitee or Agent
Receipt No. 1 '71 0S '
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Golden rod-Appl i cant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
which fees have been paid.
ECJQJR OF: PqE�,LIC WORKS
Iw-d -J-90
Date
Building permit expires Date
BUILDING
Owner Roy Coggins
SQ. FT. Occ. BUILDING VALUATIO
Mailing Address
Tel ephon e No.
Contractor Powers Construction
�
MailingAddress P.O. Box 776
Fireplace
Total Valuation
Magalia, Ca. 95954
I Td?yn IY30
Permit Fee
Building Address 80 Torey Pines Rd.
PlanChecking Fee&/orPenalty
Permit Fee $
$
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00 -1_00
Each TraD 1.50
PP. 3 Lot 64
Repair drainage or vent piping 1.50
A. P. �o. 65-43-22
oni- & Planning
Water piping X .5 10.00
Each gas water heater or vent 1.50
Fte <s U_e
S ion F i re Dept.'
Fi re Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Pians
P-a--rcel
I 'Declaration
I Parcel Ma
R/W
I Improvements
Each additional outlet .30
er ' * 5-00 10,00
BIA1YQT_Rec'd
I AM J/61
Plans Approval
_X
Lawn sprinkler system 2.00
__EaLel _
NEW ADDITION UTILITIES OTHER
Permit Fee $ 2-4-00
;$ 2-3-60
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE X 1 $3.00 3.00
600V OR LE
Main service 100 AMP ORSLESS X 5.00 5.00
Single Family Duplex E) Mobil Home R] Others E]
Main service EA. ADD -L 100 AMP X 2.50 2.50
OVER
Main service 100 AMIPOUR LESS 25.00
Main service EA. ADDIL 100 AMP 1.00
NEW CONST f DWELLING OCCUP. 5i
OR ADONS.' ( ACC. BLDGS. .20sq ft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Powers Constructi6n
NEW CONSTFL -.UTLET
.ON..ES,., (MULTI
CIRCUITS)LI2.50ea
-BRANCH
NEW CONSTR. (POWER APPARATUS a
NON-RESID. SINGLE OUTLET C 1R. J
Ex. Occuo(OUTLETS OR FIXTIIRES 50 @ 25�1
I BAL_ -
FIXED APPL OR
Ex. Occup.(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities X 15.00 15.00
License No. 386864 - Classification A
Misc. Wiring 6.25
I am exempt from the contractors License Laws of the State of Cal ifornia.
Permit Fee $ 5.50
$25.10
MECHANICAL No.1 FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions ot Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation. I
I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
-1 r ple certify that in the performance of the work for which this
rmit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
$ 4.5. 00
TOTAL PERMIT FEE
dumorize repretienumves oi ine tounty oi t5utte to enter upon ine
above-mentioned property for inspection purposes.
X Dateq - 13 -'F_0
Signature of Permitee or Agent
Receipt No. 1 '71 0S '
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Golden rod-Appl i cant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
which fees have been paid.
ECJQJR OF: PqE�,LIC WORKS
Iw-d -J-90
Date
Building permit expires Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Teleph6e 916/534-4541
APPLICATION AND PERMIT
PERMIT
L/
ASS SSO �nL N M B R
ZONING
P r J—
BUILDING P�RMA
J�,�
OWNP (11
_ - . I r) -S
TtLEPHONE
SQ.FT. OCC.1 BUILDING VALUATION
OWr4EF;F'S MAI -111-AD
q, Cnr-'I
_C 014rR �'T I R'S N
TE�LEPHONE_
CTO S WAILINQ E
Y�� h e, -n b
CONSTRUCTION LENDER 0 K
UNKNOWN
Fireplace
Total Valuation $
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILANG ADDRESS
Permit fee
$
BUILOIN,;�WESS z, rE
PLUMBING PERMIT
FilingFee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
Water piping
LOT NO.
SUBDIVISION NAME
IP ARCEL MAP
Each qas water heater or vent
2.00
Gas piping system' 1 - 5 outlets
USE OF STRUCTURE
SF n DuplexR Mobilehomek-_`Other SPECIFY
Building sewer
Lawn sprinkler system
2.00
TYPE OF WORK
New F1 AdditionE:1 FIQmodeIE1#ptiIities[:1 Instal ationL�?'Othdr
Describe work: '2
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 3.00_
Main service 600V OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD -L 100 AMR
2.50
NEW CONST DWELLING OCCUP,&)
OR ADDNS.' ( ACC. BLDGS.
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
Z' I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full fp[ce. and effect.
License Nola4�,i67,47,' — Classification 1 R,
El 1, as the owner, or my employees with wages as—their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
0 1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
NE (MULT'*OUTLET
W CONSTP 2.50 ea
NON-RESI., BRANCH CIRCUITS)
NEW CONSTSL I POWER APPARATUS &
NON-RESID. I SINGLE OUTLET CIR .
50 @ 254t
Ex. Occup(OUTLETS OR FIXTURES BAL@10�
oCCUP.( FIXED -APPLNS. OR
Ex. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15-00
Misc. Wiring
6.257
Permit Fee $
Contractor
MECHANICAL PERMIT
Fi I ing Fee 3.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
F-] The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the.W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shal I be deemed revoked.
Heating
Cooling
Hood
2.00
Ventilation
Permit Fee
$
Contractor
—
I certify that I have read this application and state that the above information
is.correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County�of Butte against
all Iiabilit.ies, judgments, costs, and expenses which may in any way accrue
against so_�d County �'�ponseque e of 0 fing of this permit.
Date Z -an
SignoP� reof Applicant OwnerEl Contractor [] AgenA /'
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
a of s "u ct
' n ct ures over 3 stories in height.
Mobile Home Installation Fee $ 40,
Land Development Fee $
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CONST.
IPARCELI
PD
I HD
I ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR 0 PUBLIC
By. A & =�r
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
6
_110 e2 1
R.e I ce I A�pt. N o. -J 4
T E- w. . YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDEN ROD-APPL I CANT
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
.-MOBILEHOME INSTALLATION SHEET
1 .
Owner's name:
2.-
Installer's name:
3.
Is the site currently under permit? YeI3
No
(If yes, furnish permit number
OR
Is the site an existing site?" Yes
No
(If'yes, furnish two (2) plot plans.)
4.
Will the mobilehome be Iodated at least 5 ft. away.
from septic tank
and1leach fields and
clear of all setbacks and easements? Yes
No
(If no, clarify
5.
What is the mobilehome electrical rating? ----------
---------
I Ae�--� Amps
6.
What is the mobilehome site service rating? ---------------------
Amps
7..
What is*the mobilehome sit e 6ircuit breaker rating ? ---------
Amps
8.
Is there any other electric load to be served by the mobilehome
siteservice? ----------------------------------------------------
Yes No
(If yes, identify th.e load and size:
(Load)
�Amp a)
a)
9.
What is the mobilehome site gas pipe size? -----------------------
10.
-*k
What is the type of gas service? ------- -----------------------
- Natural 77 L P G
Natu
11.
to
What is the gas.pipe length from meter or tank to
L
he o b me
the mobil e7
t
12.
What is the mobilehome gas demand? ------ ----------
------------
-(BTU)
information not required if pije 1 gth
less -.than 6 ft..
on natural gas
.(This
or less than 50 ft. on LPG.)
MOBILEHOME SUPPORT DATA
If other than single wide
Mobilehome Mfr.,�Zxz/_��tT furnish Setup Model No. Yeir.
Width (f t.) B ox Length (ft.) Tagalong or Expando Size 10"lol2e- ft. f t
(SHOW SUPPORT DETAILS BELOW)
On all mobilehomes manufactured after October 7, 1973,. furnish manufacturer's insta�llation
manual and structural setup sheets (if not on file with the County of Butte).
All center supports measured from front of
mobilehome'unless otherwise specified.
I /,: - [-� I
(ft.)(in;) in.) (in.)
Center support Center support
locations* footing sizes
. I (in.)
X
(ft.)(in.) n.
(ft.)(in.) (in.) (in.)
I . 1 1 L5�3x
(ft.)(in.) (in.) (in.)
r-5 x 3
(ft.)l (in.) (in.)I(in.)
Footings (check one)
Single FVI 1. Wood either
pressure treated or
A,_ foundation grade.
*If ce ' nter piers are other than drawn above,
drawlin.-locations, spacing, and dimensions.
I I [:] 2..Other' (specify)
Supports (check one)
I.; Concrete' block.
2i Other (specify)
*----Tagalong or Expando,'
show support details.
694-7) ,- _'%
- 7C,
J]gg�" � - - Typical Support
(in.) (in.) Footing Size
Max-. Pier Spacing
(ft.)(in.)
I It -I -- Max. Overhang
(f t.) (in.)
7'�
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED.
hi T* r R
P.O. Box 776 .-Magalia, Ca. 9
-1954
82 Terrace -Qt,,
916-873-1730 �877-7375
Concor-di Ga. 94518
415-681�0973- Lic. # 386864 A
within
4 ft. of the orn
directly. behind or within the rear -A
Utility connections shall be Unit 3 Lot 6T
mobileh * e, either C.,
half of the roadside0ft)-0i�-*e--
mpb ileh* WATER%
-LL
LL-------
STUB
X a4
+ U
1000 eAL
7'L 4-1
C arc, Q;A�Ar.
-
4
10
4ip.
Iftfect Will b
required e
for fh�- ve v
ig
Mob 01T
�&homee 1' . "i P
r 05
-3 {3
CTAV)DAVD
-T IR F- P I N r1-5 Rr.). APf W
N0TE.----LAll Materials & Workmanship Shall Be in
Accordance with Recognized Good Practices and
of a quality prescribed for the Specified use in the
Uniform Building, Plumbing & Machanical Codes and
the National Electrical Code.
This sef'of plans and specifications MUST be
kept on the job at all times and it is tinlawful ft
make any c6inges or alterations on same without
f Pubric
written permission from the Department a
Works, Coumty of Buffe.
A setback of 5 ft. f rom the
property lines and a setback
of 50ft. from the road
centerline shall be clear of
structures or equipment except
for a 2 ft. eave ov'erhang.
I
ago
Iry
BUILDING DEPARTMENT
APPROVED
a
691,
utl
&I OM 'DI 'b, , -
A
n,�thv
Od. m or'l
lbOl rr4., r-,j�41j%�j 10
31,11 C;ol �,r:l o
edi r,-io-ji Ill � jC, #.,
A-I.C1152 e b, , Ll;fl \Vec 1cp
S(4.- -nrjj
Xbr,') ioz)'11'IL:9
-ITTLIV
T! --I I
.4 ,,i'Ti2Aci--j' j,4
Cl o cl,.l q k, l2d T21'M
;D'Oqt 2"Olq 110 ist 64T
Yno
AWE 10
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO
ONO
ASSECOR PAqEL NUMBER
— 3 , Z -Z_-
ZQNING
PET I I
cl--*,
BUILDING PERMIT
IINER*Rr
JL
TELEPHONE
SO.FT. OCC.1 BUILDING VALUATION
OWNER'S MAI -WING ADDRS.�
CONST,0,,R,',SNAME
TELEPHONE
CON,�A ADDRESS
,��OR'S MAILING
I Oc- -7,7 �y kk 010—
CO STRUCTION LENDER
No V) tr
JUNKNOWN
Fireplace
Valuation Is
--Total
LENDER'S MAILING ADDRESS
Permit Fee
$
1RN:HI,TiECT,.,,0R ENGINEER
ICENSE NO.
Plan Checking Fee
$
Penalty -
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDLRESS
6
PLUMBING PERMIT
FilingFee 3.00
Each Trap
2.00
Repair drainage or vent piping
2.00
Water piping
LOT NO.
UBDIVISION N
I IXE
is
ARCEL MAP
1P
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF Duplex[:] Mobilehome%', Other -SPECIFY
Building sewer
Lawn sprinkler s�stem
2.00
.
TYPE OF WORK
Newn AdditionE:1 Remodel[:] UtilitiesO Installalionp. Other X
Describe work:
Gog-'s P
Permit Fee
$
Contractor PA ttN
ELEC�RICAL PERMIT
FilingFee 3.00
main service 600V OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&)
OR ADDNS. ACC.BLOGS.
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
V I am licensed under provisions of Chapt. 9, Div. 3 of the Business
r and Professions Code and my license, is in full force and effect.
I
License No. 14 10 Classification A-
F1 I. as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure' is not intended or offeyed
for sale. (Sec. 7044)
F1 1, as the owner, am exclusively contracting with licerrsed contract-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
NE W C ONSTR MULTI -OUTLET 2.50 ea
NO N -R S,., BRANCH CIRCUIT S)
NEW.CONSTFL POWER APT ARATUS.& )
NON RESID. SINGLE OUTLET CIR
50 @ 254t
Ex. Occup(OUTLETS OR FIXTURES BAL@10�
OCCUP.(IIXED APPLNS. OR I
Ex. OUTLETS (RESID.) EA.1 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you bec6me subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL.
Fi I ing Fee 3.00
-PERMIT
Heating
Cooling
Hood
2.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply tb'all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
ag 'd C t * f th nting of this permit.
X :M ony in con��ce o e gra ' '
QL1 1A 0 – Q1-1- — Date 11 —'/() �C 0
Signature of Applicant — Owner 0 Contractor CK Agent F1
An OSHA permit is required for excavotions.over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CO.ST.
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
OR OF PUBLIC
By
PERMIT 1XPIRES Date
the applicable provi-
resolutions to do
fees' have been paid.
WOR;,[
a
D_
r"
Receipt NO.
WH'ITE-D.P.W.. YELLOW-ASSESS;R, ;INK -INSPECTOR, GOLDENROD-APPL I CANT
2655-809
PE6T NO. -
PERMIT EXPIRES :5r12fM1
.5�OWNER Roy Coggins
owner
CONTR.
23MXKRMR 65-43-22
'�LOCATION (A.P.
80 Torey Pines Rd., lot 64, PP#3, Magalia
�'7"
A.
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.—
Called PG&E
Temp. Gas Servloo_or__��
C&Hed4ArA&e
JOB
FIN ED—
V OA�__
�Signature
COUNTY OF BUTTE —.DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
BUILDING (Contd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
Ist Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Sternwall
Siding
Topout
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa I I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Slab
Prov. for ;.islcafly
handicappe
Conformance of 'ex.
structure i P
Final (Olt V ? L
Appliances
Gas Piping & Test
Temp. Gas
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELEC/f RidAL
Masonry W lis
Throat
Rouah
ReInf. Steel
Final
Fixtures
Bond Beaq
FIRE SPRI$KLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MEdHANICAL
Grd. Faul0rot.
Scratch
Heatina
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
ME INSTAVILATION
-------------- S.pport F
Elec. Continui��
Water Piping
9�painage
Gas Piping
DATE
REMARKS OR CORRECTIONS
d4
(NOTE: An entry must be made on this form each time you visit the job site.)
-0 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Dri.ye - Oroyille, California 95965 - Telephone 916/534-4541 10
*APPOICATiN AND PERMIT
AA
ASSESSOR PARCEL NUMBER
S-- q 3 11�4
ZONING
AA -1.
BUILDING PERMIT
R
V, as
TELEPHONE
SQ.FT. OCC. BUILDING VALUATION
-
bd X64- ("OC-)
OWNER S MAIL NG fDgFRESS
iz T611-0—.4 C, tr ("0" 4 og- 0 .
CONTRACTOR'S AME TELEPHONE
CX)JWb1K1 I
CONTRACTOR'S MAILING ADDRESS
CJ%TRUCTION LENDER
OWN
Fireplace
Total Valuation G, no
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
Lst 0 ir"(ty , "
LICENSE �O_
I . I
Plan Checking Fee
$
Penalty
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
Stu -/--o X
PLUMBING PERMIT
FilingFee 3.00
Each Trap
1 2.00
Repair drainage or vent piping
2.00
Water piping
LOT NO.
SUBDIVISION NAME
43,
ARCEL MAP
1P
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SFED Duplex[] Mo'bilehomeg Other
SPECIFY
Building sewer
Lawn sprinkler system
2.00
I
TYPE OF WORK
,NewR Addition[:] Remodel[:] Utilities[:) Installationo Otherg
Describe work�
Permit Fee
$
Contractor
ELECTRICAL PERMIT
FilingFee 3.00
Main service 6001 OR LESSFSS
100 AMP OR L _
5.00
Main service EA. �'DD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ACC.1 BLOGS.
20 sq it
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification 4
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting -with licensed contract-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
NEW CON5TF;L MUL,TI-OUTLET 2.50 ea
NON . RESID. BRA'NCH CIRCUIT
NEW CONSTR. POWER APPARATUS &
NON-RESID. %SINGLE OUTLET CIR.
50 @ 25C
Ex. Occup(OUTLETS OR FIXTURES IBAL@ICC
OCCUP.(FIXED APPLNS. OR
Ex. OUTLETS (RESID.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $
Contractor
MECHANICAL PERMIT
Fi I Ing Fee 3.00
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
F-] The permit is for $100.00 (valuation) or less.
E] I -have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood -
2.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that ihe above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against Co ty virponsequence of the granting of this permit.
. 1 0?7
Jr,
X - 9V9, ( - � r/1111 h 11, C Date 46,_ —
Signature4/f Ap'plicant �-,Irl Owner' � Contractor Agent F-1
An OSHA permit is required for excavations over 5'0'' deep and demolition or construct-
ion of structures over-Istories in height.
Mobile Home Installation Fee $
Land Development Fee
$
TOTAL PERMIT FEE $ co
OaCC IP. GRjUP
T�F OF CONST.
IPARCELI
This permit is hereby issued under
sions of the Butte County Code and/or
work -indicated above for which
DIRECTOR OF PUBLIC
B
��9_lvl IT EXPIRES Date `�
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date, S, -7-57-,f,0
J-- F/
Receipt No. 38'6&&--
-
WHITE-D.!.W.. Y EL LOW- ASSESSOR, PINK -INSPECTOR, GOLD ENROD-APPL I CANT
-wing
9 �9-54
Ca'
P IU'.*,
1-N
*01
7,10
4
LI c 38L
'7
U'n i t 3 Lot .61'�
111 -VT
Ow El P,
lik"MxnAl go
cis c.
Qv ^"—p- arta
MccliOn C
A.
X, a4�
WDS F
WOO &At,
C, %A R P.6rc
-k
C
LA
T—
�3 Ell -L A'LA
Setback of 5 ft. fmm AM
Croperty lines and a m4a& 4
.1 rom the r6ad
f 50't' f
rituline shall bo clo'or of
n -
MOT be
�IA
e r, 'I !+ lj�.
IW� '"t
c.
CO. I
-P" Aie
V = OK
0 = Not OK
- = Not Applicable. MO�'ILEHOMES
* = Not Ready
MISCELLAIIS�'EOUS
v ..
Date
MOBILEHOME UTILITIES (Pid�rpOK except #'s
1. Zoning Req u i remenits-Setbac ks- Easements
Date
DECKS, COVERS, CARPORT�_Eft. (Plans) OK except'#'s
1. Zoning Requ i rements-Setbac ks- Easements
2. Soils; Special MH Support -Sketch
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/0 -Concrete
3. Decks; Girders and/or Joists-Decking-Bracing-Stgirs-Rails
4. Water; Local i on- Test- Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Sh'thg.-Rig.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
6. Gas; Location -Test -Wrap: L"ft./ /" Nat. or/ /"L"ft./ LPG
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec.
Card -BI
Card -BI
Date
Date Card -BI Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1 . Zoning Requirements -Setbacks -Easements
Card -BI
Card-Bil
Date
Date Card -BI Date
Date Card -BI Date
POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compact i on -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH Test-Crcissovers-Breakers-Clearances
4. Elec.; Receptacles and Lighting; Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7., Water and Sewer Connected -C/O to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghig.
Boxes- Enc losures-Pane I boards -.I ni. to Main in Conduit
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
.Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -131 Date
10
%I = OK
0 = Not OK
- = Not Applicable
= Not Rgady -4 RESIDENTIAL (Single and Duplex)
At
Date
UNDERFLOOR (Pl�nsy-OK_e5pe6e�
Date
F4AMING (Continued) .;w. 1 -1
1 .
Zoning requirements-se"s�-Easements
4
Property Line Firewall 9 8'penings
2.
Ftg.,/ain; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
A
Ext. Doors -one 3' -Check Garage -3rd story, 2 exits
3. F�r GWge; Soils -Steel- / /" Ftg. Depth
4. Ftg., Porchi3s & Decks; Soils -Steel- / / Ftg. Depth
5. Sternwalls, Main;,Steel-Bl�Skouts-Wrapped-Slab
X
1___NZ7_52
0
JA1
Stairs; W idth-Headroom-R i se -Run- Land i ng -F ire Protection
_Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Sid ing-Nai I ing-Veneer
6. Stdwra-lls, EPI -rage; Stee--B lockouts -Wrapped -S lab
53
Stucco Mesh -Drip Screed-Fdn. Vents-UnderfIr. Access
7.
Piers -Fireplace Ftg.-Steel
54
Glazing Area -Glass Protection -Skylights -Plastic
8. D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10. Water Pipe; Test-Anchors-Regu lator-Sery ice Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
4L,
Date --I Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -Bir )I,
Date'l /I 'e 14 Card -BI Date
Date
FIN
(Plans) OK except #'s
Card -BI Date Card -BI Date
Date
PLUMBING (Permit) OK except #'s
14. Water Ht.; Vent�Access-Combustion Air
56.
'txt. Steps -Door & Sidelight Protection -Landings
57.
Smoke Detector
58.
Furnace; Vents -C I eara nce-C omb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
15. Water Pipe; Test & Anchors -Nail Protection
16.
DXV.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower Pan; Test, First Floor -Tub Access
60.
6.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
JElec. Trim & Subpanel; Breaker� es -Labels
19.
Gas Pipe; Size & Anchors
62.
IStairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.,
Card -BI
Date Card -BI Date
65.1
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.1
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL (Permit) OK except #'s
67.1
Garage Fire Door; Swing -Landing -C loser
68.1
A.C. Duct in Garage -Damper
Fixture & Transformer Clearance -Ins. Protection
691
Wtr. Htr.; Vents -C learance-Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
2A.
Elec. Receptacles Spacing -Lights & Switches at Doors
70
Plb., Elec. & Mech. Equip. Listed for Location
24
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
231
Romex installed Close to Edge of Studs & C.J.
7
1 nsu lat ion -Foam- Looked in Attic E] Yes
241
Equii . Ground made up w/Mech. Fasteners -Bond Gas & Water
7
Guard Rails & Deck Construct ion -Post Caps
21
2 Appliance Circuits in Kitchen & Conductor Size
7
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor El Yes
21. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size ga. Cu or Al
Range Circ. ga. Cu or A[ -Oven Circ. ga. Cu or At,
Insulated Neutral E]Yes E) No
Following instid.: Drive El Yes No; Walks E) Yes C1 No;
Planters Dyes 0No
Service -Riser Conductors & Ground -Main Disconnect
Stucco; Brown -Finish
29.
Equip. Clearances; Pane Is-Motors-Mech. Equip.
47.
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
f(�_Iothe$ Closet Light -Shower L'
18.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
9.
Water Well; Disconnect, Electrical, Plumbing
0.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -B I Date
1.
k
Ventilation throughout House
Card B -I
Date alliZ, Card -131 Date
182.
Glass Protection
Date
MECHANICAL (Perrnit) OK except #'s
31. A.C. Ducts; Insulation & Support
183.
Corrections from Previous Inspections
184.
Gas Test -Meters Tagged; Gas -Electric
85.
Water & Sewer Connected -C/O to Grade -HD Approval
32.
Vent Fan; Exhaust above Insulation
86.
Energy Co pliance Certificate -Other Certificates
33.
Condensate Drain & Overflow; Size & Grade
34.
35.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
Attic Access & Platform if Furnace in Attic
Card -Bi
Date Card -BI Date
Card -BI
Card -BI
Card -BI Date
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FRAMING(Plans) OK except #'s
Comments at Final:
t.
Sills; Proper Material & Anchors
3
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof)
Fire Stops; Furr d Ceilings -Stairs -Chases -Tub
Heade & Beam -Size & Bearing
42
4141
43
4.
Hangers -Post Caps -Anchors -Connectors
6 1_ng. joi st--Rf-tr. Ties-Purlin- Roof Brac.-Truss-Shthng.-Rfnp.
Fireplace 'Fies or iype A Flue -Fireplace Throat
Access; Size & Romex Protect i on -Draft Stop -Ins. Baffles
__45.
46.
-Attic
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
Garage Fire Protection Framing
(NOTE: An entry must be made each time you visit jobs ite)
11
COUNTY OF BUTTE , , I ,
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 Couw,*'Center Drive, Orovi Ile — Phone: 534-4541
Skyway and ElliottjRoad, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
1-1 -- A *1
BUILDING/
,�IH PROPERTY ADDRESS
A routine inspection Indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
]gap IVA
WC 00�=
Inspector Date
.4
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BUILDING DEPARTMENI Qj
IL
APPROVED
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BUILDING DEPARTMENI Qj
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APPROVED
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BUILDING DEPARTMENI Qj
IL
APPROVED
C
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racing.
iequate b
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Z
Top rail to be4M in. high with
intermediate'-ra-if
s to be nof
over 9 in. apart.
7
Top rail to'be 36 in..high with
intermediate rails'to be not
ove"r 9
in.
apart.
PA
J-?
A
Top rail to'be 36 in..high with
intermediate rails'to be not
ove"r 9
in.
apart.
PA
J-?
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS, PERMIT
7 Couniy Center Drive - Oroville, Ciliforn'ia'*,965 - Telephone 916/534-454
APPLICATION AND PERMIT. AA
ASSEStR PARCELAUMBER
ZONING
477
BUI - ILDING PERM/iII
OW E
Co 0!;e
TELEPHONE
SQ. FT. OCC. B�ILDING
VALUATION
VY00
OWNEYS MAIL -4 AVDFVESS
t,2 61k,&02i ta-' t. 111V
CONTRACTOR'SNAMF
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CO TR CTION LENDER
Z�
UNKNOWN
11
Total Valuation
Filing Fee
$ 10.00
LENDER'S M.�ILING ADDRE,SS
Permit Fee
$
ARCHITECT -OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDPZSS
PLUMBING PERMIT
FilingFee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO. SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
Other VIA 5m:�
SF [I Duplexo Mobilehorn 4 1 SPEC=
Building sewer
Lawn sprinkler system
5.00
--
71
TYPE OF WbRK
NewV Addition Remodel[] Utilities[] InstallationEl Other [I
Describe work:
Permit Fee
$
Contractor�
ELECTRICAL PERMIT
Filing Fee 1 10.00
600V OR LESS
Main service 100 AMP OR LESS
5.00
Main service EA. AOD'L 100 AMP
2.50
NEW CONST. I DWELLING 0 al
OR ADDNS. VACC.BLDGS kt—a
20 sq it
CONTRACTORi LICENSE LAW
I d3ecl�are under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, 'Div. 3 of the Business
and Professions Code and my license is in' full force and effect.
License No. Classification
1, as' the owner, - or my employees with wages as their sole'compen-
LAN sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusi�ely contracting with licensed contract-
ors. (Sec. 7044)
I am exempt under Sec.—, Business and Professions Code
for this reason
—NEW CON,STR. ( MULTI-.UTL:ET
N.RES D� BR ANCH CIRCUITS) 2.50 ea
—NO
NEW CONSTF;L (POWER APPARATUS 6 1
NON.RESID. SINGLE OUTLET CIR. /
50 @ 250
Ex. Occup(OUTLETS-OR FIXTURES BAL@10t
(OFIXE:D APPLNS OR
Ex. Occup. UTLETS (RESI'D.) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANIC AL PERMIT
Fi I ing Fee 10.00
--)4 WORKMEN'S COMPENSATION INSURANCE
c lare under penalty of perjury (check one):
F] The permit is for $100.00 (valuation) or less.
I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subjIict
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith Comply with such
provisions or this permit shal I be deemed revoked.
Heating
Cooling
—
Hood
3.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the aboveinformation I
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.
I also agree to save, indemnify and keep h - armless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
again;t 'd C t 9quence of the granting of this permit.
X o
,�,in consi
Date
Signo - ture ofapplicant - A4er Contractor Agent Fj
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of str ctures over 3 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE, $ T 07
ocCUP. rROUP
114-1
I TYPE,OF CONST.
-vrw
IP CELJ-;�
i7
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRE OF PUBLIC
. -11, 1
By <_
ly 0�4�
P IT EXPIRES Date
I i
the applicable provi7
resolutions to do
fees have been paid.
WORKS
Date v2— 47-1?/
Receipt No. (d2 -
WHITE-O.P W.. YELLOW-ASSESSO�, PINK -INSPECTOR, GOLDENROD-APIL I CANT
gi'll, el; W� ill illf 1! 1 OR !P1111
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BUIL ING D�PARTMENT
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APPROVED
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