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066-030-019
� 1 66-03-19 - JCo o n &Pau in ttingham 145 So.Park Dr., lot 93, PPCC#l, Maga. contr: J-/ McGregor, Paradis Permit j fl06-79P,E(util _,MH) ELEC GAS fiom- SUPPORT STRUCTURE REQ,b 0 W E COMPACTION TEST REQ. NOW L- 6 66-03-19 �ontr: Cal GAS, P Paradise yy p,Ermit #1940-79 ( as line/= H�-03-1 n Cor : SOS MH, Chico P 'erm't #1937-79MHI Issued ` .& `-7 ' 66-03-19 Permit #358 80B(nI/w open deck/MH) I tF 066=030-019 00-;405 COTTIGHAM; JOHN i; �\\\'j ) DO 1.3858 SOUTH PARK OR.. MAGALIA CONTR: rSIERRA MOBILE HOME EX MI -I ON PERM FND, ON EX SITE 066.030=019/. 0 52 - COTTINGHAM U % 13858 SOUTH PARK DR. MAGALIA + CONTR: SIERRA MOBILE HOMES 7'' COVERED DECK'12X22' '�" I 1 f 1 f � , • � r r { RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 16 -Nov -2000 2000-0044212 Has not been compared with original BUTTE COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. JOHN A. COTTINGHAM & PAULINE COTTINGHAM BUTTE COUNTY BUILDING DIVISION REAL PROPERTY OWNERILESSOR LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 210 WEST 8T" STREET 7 COUNTY CENTER DRIVE MAILING ADDRESS MAILING ADDRESS ANTIOCH, CONTRA COSTA, CA 94509-1730 OROVILLE, BUTTE, CA 95965 CITY COUNTY STATE ZIP CITY COUNTY STATE ZIP 13858 SOUTH PARK DRIVE 00-2405 (530)538-7541 INSTALLATION MAILING ADDRESS, IF DIFFERENT B Q PERMIT NO TELEPHONE NUMBER MAGALIA, BUTTE, CA 95954 11/15/00 CITY COUNTY STATE ZIP SIG ATURE OF LOCAL AGET FFICI DATE SAME NONE �iI:G /i1e�� UNIT OWNER (if also property owner, write 'SAME') DEALER NAME (if not a dealer sale, write'NONE') MAILING ADDRESS CrrY COUNTY STATE LP UNIT DESCRIPTION DEALER LICENSE NO. FUQUA 1979 PRKLD 400B MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMEMMBER FH148032A/B 43' X 24' CAL130168/9 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIAILABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER A.P. # 066-030-019 SEE ATTACHED HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD P[NK - Applicant GOLDENROD -Building Dept. KAM �� CGUP�A►TY3r , BUILDING PERMIT NUMBER: 00-2405 Address or location of unit: 13858 SOUTH PARK DRIVE, MAGALIA, CA 95954 Legal Description of Real Property: A.P. #066-030-019 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: JOHN A. & PAULINE COTTINGHAM Owner's address: 210 W 8TH ST., ANTIOCH, CA 94509-1730 INSIGNIA OR HUD NUMBER: CAL130168/9 SERIAL NUMBER OR V.I.N.:FH148062A/B MANUFACTURER'S NAME: FUQUA YEAR: 1979 OFFICIAL APPROVING INSTALLATION.C& - /%4Aje(,e/2 �/j 7 DATE: 11/15/00 PHONE: (530) 538-7541 H.C.D. 513C LEGAL DESCRIPTION A.P. #066-030-019 All that certain real property situate in the County of Butte, State of California, described as follows: Lot 93, as shown on that certain map entitled, "PARADISE PINES COUNTRY CLUB ESTATES UNIT NO. 1 ", recorded in the Office of the Recorder of the County of Butte, State of California, on September 14, 1971 in Book 33 of Maps, at pages 57, 58, 59 and 60. EXCEPTING THEREFROM all minerals, oil, gas, asphaltum and other hydrocarbon substances, with provision that any and all mining operations shall be done from orifices outside the surface area of the land described herein and that no damage shall be done to the surface of said land. S'1'ATF. OF C:AI,IP"0101A - DEPARTMENT OF I•IOUSING AND COMMUNITY DEN'I;LOPNIENT II GIS'1'RA 110N CARD milnurntul-c(I 11ennc Occal No: SP8280 ManvWturer 1D/Name Serial Number 8032A 60328 Addressee JOHN A COTTINGHAM 210 W 8TH ST ANTIOCH, CA 94509-1730 Trade Name Model DOM OFS RY PRKI.O 00/00/1979 04/12/1979 1979 1.30elrtnsignla Numbcr Weight t,ength Width SPC SCC Exempt AEF 04 Issued Mar 22. 2+00 Exp. Date Apr 30.200' Use Type UNK ILT Total Fees Paid E68.00 Registered owner(s) 4R Ree4►'RRR4e dR MRRa erR4►►►AA kRRR ewA RR 4R►6A*RR**A •ARRA Ra JOHN A CO T TINGHAM A'i" i'L•'N'VION ONVNER: PAULINE COTTINGHAM TENCOM OR 210 W 8TH ST THIS 15 THE REGISTRATION CARD FOIL TIIE UNIT ANTIOCH, CA 94509-1730 DESCRIBED ABOVE. PLEASE KEEL' THIS GURU INA SAFE P[.ACE WITHIN THE UNIT. Situs Address INSTRUCTIONS FOR RENEWAL: 13858 S PARK DR MAGALIA, CA 95954-9598 REGISTRATION FOR THIS UNIT EXPIRES ON TI(E DATE INDICATED ABOVE, IN THF BOX LABELED "ENO. I)atc". THERE ARE SUBSTANTIAL PENAL'T'IES FOR Legal Owner(s) DEIANQUENCY. IF YOU 00 NOT RECCIVE A RENEWAL UCB NOTICE WITHIN 10 DAYS PRIOR 1'0 THE EXPIRATION 6848 SKYWAY DATE, CONTACT H.C.D. FOR RENEWAL INSTRUCTIONS. PARADISE, CA 95969-3936 i444A**yR RRRR RR*44*.**���Y 4**RR Yb**k*r. vAR****a1 MA***M*NR oy f IMPORTANT THE OWNER INFORMATION SHOWN ABOVE MAY NOT REFLECT ALL LIENS RECORDED WITH THE DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. ' THL CURRENT TITLE STATUS OF THE UNIT MAY BE CONFIRMED'I'HROUGH T14C DEPARTMENT. 397 .. 136110 ..O MN1N •160110.0 NAI♦ 10 H.-• r John A. Cottingham 111..1 Pauline Cottingham ~I 210 West 8th St. EI; a LAntioch, Calif. 94509 J N.11 1.1 11.11.11,/1 TO Aur«1 game as above co, l sLI. L An 29 II 26 AF..19Tp v COUN11 RELI t•i t 5;x,$43 SPACE ABOVE THIS LINE FOR RECORDER'$ USE Individual Grant Deed TN1a FORM FU11NISHEO BY TICOR TITLE INSURERS A•F.N._,_66-03=19._._ .. The undersigned grantor(s) declare():60 •"K r"1D Documentary transfer tax ie E • ( ) computed on full value of property conveyed, or ( X) computed on full value less value of liens and encumbrances remaining at time of sale. ( X) Unincorporated area: ( ) City of and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, JOHN M. DRABIK and BERNICE D. DRABIK, husband and Wife hereby GRANT(S) to JOHN A. COTTINGHAM and PAULINE COTTINGHAM, husband and Wife, as Joint Tenants the following described real properly in the County of Butte / State of California: Lot 93, as shown on that certain me:p entitlac% 11PAWISE PINES COUNTrZY CLUB EST ATZS UINIT NO. 111 1 recorded in the Office of the Recorder of the County of Butte, Str.te of California, on September 14,1971 in Book 33 of Maps, at pa -es 57, 581 59 and 60, EXCEPTING T1C .'_'Fit0?.11 all minerals, oil, ,^,as, asphaltlmt and other tr; dro- carbon substances, With pec;,Asion that any and all mining operations shall be done from orifice. outside. the surface area of the land de- shall herein and that no damaCe shall be done to the surface of said land. - Au ust I4 n,t. rl >i-- Drs bik ..MDQ FT:�TF, nF C:U.tFORNtA Ice • Drs Santa_ Clara _ }``• C0UN R' OF—_ -- f --_.— ugust 1-7 r 9J %8 — IN•(nre me. III. under. ,JOhn MLryf'idilt'kanI (,a •aid Stnl.•, per�mnlly nl.t.•ured an _ Ber............ _ .J1_iCe_D..—Drah�]c �__... ._..—.• -•— knnwn In nm I,, L• the• prrrrm 8 .who►r naml•8 are ►u11... (Ard III the within in>trumrm and arknnwledµrvl thm thE'y._.....rteeutrd the same. WITNESS my hand and nRirial ►ell. sigiluillre Title Order N11. ___1073b3 -. -1. A. MAIER 11:7- Y FUlt10 • CALIFORNIA :S1.la clue Covah m hs;oa Wires Mu. 11. I9V�rviT�WA i% ITI11..— NI ..ln.•Id 1 4.00 ..•.1• __. .._.. H.!•l'i11N .;If 1.111111 NII.—__---__—_ MAIL TAX STATEMENTS AS DIV.NJED ABOVE END OF DOCUMEN) NOTES RESIDENTIAL PERMIT N0. 066-030-019 00-2405 COTTIGHAM, JOHN 13858 SOUTH PARK DR. MAGALIA CONTR: SIERRA MOBILE HOME EX MH ON PERM FND ON EX SITE oa 14?�f 1,6 " 11 SPECIAL CONDITIONS 11 SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALE Signatur CHECKED BY ,/ = OK 0 = Not OK - = Not Applicable MOBILE HOMES = Not Ready Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements MISCELLANEOUS Date 2. Soils; Special MH Support Sketch 1. 3. Sewer; Location -Test -Fall -C/O -Concrete 2. 4. Water; Location -Test -Easement Needed (Sketch) 3. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 4. 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /"L"ft./ PLPG 5. 7. Well Clearance & Disconnect 6. 8. Utility Clearance 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rttrs-Trusses Date _ Siding; Nailing -Veneer -Stucco -Mesh Card B-1 Date Card B-1 Date Roof; Shthg-Roofing Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line Date 3. Gas; MH Test -Demand -Valve -Connector Date 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 12. Permanent Foundation Only; License Decal 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit Date 9. Card B-1 Date Card B-1 Date 10. Card B-1 Date Card B-1 11. Light Niche MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rttrs-Trusses 9. _ Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-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 V= OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (%4 Date 23. Underfloor (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. 3. 4. Ftg., Main; Soil 'ec. Grnd.-/ /" Ftg. Depen Fig., Garage; zioils-Steel-Elec. rnd.-i /" Ftg. Depth Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. 6a. 7. 8. Stemwalls, Garage; Steel- Blocko,,ts-Wrapped Hold Downs and Special Anch,•s ~ Slab, Steel -Wrapped Piers -Fireplace i ,.-Steel 9. 10. D.W.V.; Fall-Fittir.J-Test-2 Way C/0 -Sewer Test UF, Gas Pipe; Size Anchors - Yarm Gas r ,ping Size Test 11. 12. 13. 14. Water Pipe; Test -Anchors -Regulate r -S, ice Test Electric Underground _ Plenums & Ducts; Clearance-Material-;iupport-Ins. Girders -Sills -Anchor Bolts-Joists-Vent-Grippies 15. Access & Ventilation 16. Insulation 32. Equip. Clearances Panels-Motors-Mech. Equip. Date Date Date 33. r-ard B-1 Date Card B-1 nrd B-1 Date Card B-1 PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Wa,ar Pipe; Test « Anchor -Nail Protection Date 19. D.W.V.; Test Fittings & Anchor -Nail Protection Date 20. Shower Pan; Test, First Floor -Tub Access Date 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 36. Vent Fan, Exhaust above insulation Date 37. Card B-1 Date Card B-1 Date 38. Card B-1 Date Card B-1 Date 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/Meth Fasteners -Bond Gas & Water 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI 30. Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or Al Insulated Neutral O Yes O No 31. Service -Riser Conductors & Ground Main Disconnect 32. Equip. Clearances Panels-Motors-Mech. Equip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector 58. Glazing Area -Glass Protection -Skylights -Plastic Date 59. Card B-1 Date Card B-1 Date 60. Card B-1 Date Card B-1 Date 61. MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation Date , 37. Condensate Drain & Overflow, Size & Grade Date 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet Date 39. Attic Access & Platform if Furnace in Attic 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector Date 65. Card B-1 Date Card B-1 Date 66. Card B-1 Date Card B-1 Date 67. FRAMING (Permit) OK except #'s 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs .73. 45. Headers & Beams -Size & Bearing jingle & Duplex) Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Ring. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date , Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; 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 -Damper 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. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 82. Following Instld./Drive D Yes No/Walks ;1 Yes Z) No/Planters O Yes J No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT V :A�5 ASSESSO R PARCEL NUMBER 066-030-019 ZONING BUILDING PERMIT OWNER COTTINGHAM JOHN TELEPHONE SO. FT. OCC. BUILDING VALUATION 1056 R 57,094-00 OWNERS MAILING ADDRESS 13858 SOUTH T DRI. MAQAT.TA CONTRACTOR'S NAME SIERRA MOBILE HOME TELEPHONE 877-8575 CONTRACTORS MAILING ADDRESS 8965 SKYWAY PARADISE 95969 CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation is ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee 4SQ 5019 $ 22 ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ 2300 BUILDINGADDRESS same Energy Plan Checking Fee $ $ PERMIT FEE S 268.2 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 -p Water piping ing 15.00 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: EX MN ON PERM END ON FX STTF Gas piping stem i - 5 outlets 15.00 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S 50.00 ELECTRICAL PERMIT Fling Fee 20.00 Main Service ZDOA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Y7C �6 License Class OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the �ormance of the work for which this permit is issued. B-1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compew tion insL�ance ca ier and policy number are: Carrier 5Z; � �f Policy Number V6 7 X (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, 1 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 rovlsions. X � Date /a12-10© Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service TO tOaoA 46.00 NEW CONST. DWELLING OCCUP. SO DWE200ALLING OR ADDNS. ( 8 ACC. BLOS. 3.5¢FT. MU@7,50 =R.IDT LTI-OUTLET POWER APPARATUS 8 SINGLE Oun ET CIR. Ex. Occup. OUTLET OR FD(TUREs BAL p 1.5500 LNS Ex. Occup. onx�eFD�A RES p,OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 318.25 HAZ. D. FEES IM . _. FLOOD --- CDF PARC PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON _�4 the applicable provisions Resolutions to do work been paid. ate 10119106 l t10 Dae Receipt No. 308582 7318.25I WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OFD .Yui ' :'. ° ,,MENT SERVICES - BUILDING DIVISION , 7wCOTJNTY CENTER DRIVE - OROVELE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 F r. PERMIT APPLICATION DATA SHEET G OWNER: Cd ASSESSOR PARCEL ER: Proposed Building Use: j= Building Inspector: Date: Z 0 `3 — C7 C) At time of permit application, I was advised the following data must be- submitted prior to permit processing and/or issuance: Date Received By 111. All items have been submitted ----------------- 7-------------------------------------------------------------------- Mezot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ ❑6. Energy Design Compliance and supporting documentation.--------- 1:17. -------- ❑7. Statement of Intent for Non -Heated and A/C Buildings. -------------- ❑ 8. Hazardous Material Form. ----------------------------------------------- ❑9. anufactured and insta at�'on insttuctions incl Tie . Fees of $-=(`�---- - R ❑ 11. Impact fees as shown on the attached sche4ule- ---------------------- ❑ 12. California Department of Forestry plan approval/fees.-------------- ❑ 13. Flood elevation certificate. ❑ 14. Sanitation and plot plan approval Health Department: ---=-----=-= =-- r. El 15. City of Qhico plumbing permit. ---------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------- ❑ 17. Planning approval for (A) Use: (B) Parking: _. ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). --- 020. Pre -inspection for required. Request to Building Inspector on 112 1. Contractor's license information. (Number, Name Style, Classification). ❑ 22. Workers' Compensation carrier and policy number. ----------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). -• 024. Letter of signature authorization. -------------------------------------------- E125. ------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. ------------- 026. Letter of intent on building use. ----------------------------------------------. (Date) ❑27. Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑2 E sting viol ons and/or expired' perrm _--------------------------------------- 0.12--------------------------- 29. 433 A�L ant DH. Titlek to H.C.D $ .----------- --- _ ��0.Other: � � _ YVYou Issue tkle enrut, process as C3 Mail to owner, a' contractor. Telethon and hold for pickup at office. ❑ Deliver with inspector. Applicant: Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Dep ent, 11 Air Pollution Date: By: Copy of plans sent ❑ Health Department, ClFire Departure r: By. 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above 6prired datA by ❑ phone, mail, ❑ Build' rvision counter,,by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Divisiori counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, n mail, ❑ Building Div counter, by Date: Plans reviewed by: Date: Plans approved by: Date: / DEQ f) Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: i Voll.,.., f'...... ne.....-a�..._...rn----'------` "---. - ,-, . . 15) :SAV f Cot" oG 5 tz MO131 Ittiurin "U,•---- other than single wide, If oth lla�y� year ., furnish Setup Model No. 3bilehome Mfr-. ft. x ft. i idth�(ft•) Box Length 2Z_(ft. Tagalong or Expando Size (SHOW SUPPORT DETAILS BELOW) 1973; manufactured after October 7, furnish manufacturer's installation ?� in all mobilehomes man with the County of Butte), ianual and structural setup sheets (if not on file 111 center supports measured from front of nobilehome unless otherwise specified. , Footing (check one) Single 1. Wood either pressure treated o /� A � / \ foundation grade. (ft.) in:) (in.) in.) rater s ppo. Cente support locat ons* foots g sizes (' .) (ft )(in.) I (in.1 (in.) t. 2. Other (specify) Supports (check one; 9--n-"Concrete block. 2. Other (specify) ----------------- ragalong`or Expando, show support detail: (ft.) in.) (in.) (in.) 7.n.. Typical Support ) Footing Size x Max. Pier Spacing (in. (in.) ) - x (ft. Pin.) 31 max..Overhang Le�d� (f t.) (in.) v '4 *if center piers are other than drawn above,. draw in.:locations, spacing, and dimensions. PRE-INSPECCTION REPORT OWNER: DATE:_�O LOCATION: -(3 R Ste' J�P� /YG I A.P. #• . 030 f y CONTRACTOR: < } ZONING: v PRE•INSPETION FOR:5,-_M�4 cryl DATE TO INSPECTOR Building Description: Commercial/Usage: Residential/# of Units: Currently Occupied Abandonec< Ccant> Electric: .. Y." PERMIT HISTORY:( ) NONE BUILDING INSPECTOR'S REPORT FOLLOWS: Yes No Electric currently On Off Condition of Electric_A(� 2 o r Gas: Vo-«�,� 4e� e-1 Natural Propane None Currently On Off_ Obvious Problems: A/y Sanitation: Plumbing Working ;,4,o0 5 Well Working_ cJ 0/v Potable Water V'- + Obvious SewageProblems__4Z 0 a i2/ Lt .4 Ute.` h / - o / Z©d e✓ r,/,0 a ACTION RECOMMENDED: ISSUE: MOLD FOR_ Oe Inspector: VI $ Date D y O Sketch buildings on reverse and indicate location on property. �A i S ItH� AVC Cv T TT I3BS8 S, PAPK DC (�FGAtA Cs� OPM �M 66 -0 PI 3 19 ..X Fauli6gCY Cottingham 145 So .Park Dr., lot 93, ppCC#I, Maga- contr: J.,A. McGregor, Paradis 'i*1:!; Permit 4/106-79P,E(ub1 MH) 007 ELEC GA SUPPORT ST jj 0 N COMPACTION TEST REQ.N0WZ ........... 66-03-19 Paradise tr: Cal GAS# line/ (clas on -79P 40 Krmit #19 66-03-1 Y-1 Igo SOS MH, Chico Co Perm' Nt #1937 79MHI Issued 71: 66-03-19 Permit #358Ar.80B(nf, open deck/MH) Y1. )14 Al X . . . . . . . ...... 2:1 rw 10 Y 4- Fiy 1� NOTES RESIDENTIAL PERMIT NO. — 066-030-019 00-2552 E COTTINGHAM 13858 SOUTH PARK DR. MAGALIA CONTR: SIERRA MOBILE HOMES COVERED DECK 12X22 co q R 1 i 1t t { t s j y 11 SPECIAL CONDITIONS 11 SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) Signature CHECKED BY V= OK 0 = Not OK - = Not Applicable * = Not Ready MOB&E HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /"L"ft./ /'LPG 7. Well Clearance & Discohnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 12. Permanent Foundation Only; License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVEP9, CARPORTS GARAGES (Plans) OK except #'s ZgAng Requirements -Setbacks -Easements F gs; Soils -Size -Depth -Spacing -Connectors -Steel Decks ' ers and/or Joists -Decking -Bracing -Stairs -Rails d,AV6`od Awn.; Posts- Bea ms- Rftrs.-Con nectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof g- Roofing IcUelfxt.; Steps -Doors -Landings 12. Braced Wall Panels Datei+� CarDate Card B-1 d Dates Card B -f Date Card B-1 Date FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Liqht Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 / = OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (� Date 46. Underfloor (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Ste el- Blockouts-Wrapped 6. Stemwalls, Garage; Steel- Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 63. PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 70. Fireplace or Stove, Clearance -Hearth Date 71. Card B-1 Date Card B-1 Date 72. Card B-1 Date Card B-1 Date 73. 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 AI-A.C. Wire Size / / ga Cu or AI 30. Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or At Insulated Neutral ❑ Yes O No 31. Service -Riser Conductors & Ground Main Disconnect 32. Equip. Clearances Panels-Motors-Mech. Equip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector 85. Vents Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings Date 86. Card B-1 Date Card B-1 Date 87. Card B-1 Date Card B -1 Date 88. - MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Comments at Final: 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing jingle & Duplex) Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-Rolf Brac.-Truss-Shting.-Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 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. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; 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 -Damper 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. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Constructiort-Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor E) Yes 82. Following Inslld./Drive ] Yes ❑ No/Walks :1 Yes :1 No/Planters ] Yes ] 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 -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNT)rOF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDINGDIV ION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7 1 PMN (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 066-0-10-019 ZONING BUILDING PERMIT OWNER COTTINGHAM TELEPHONE SO. FT. OCC. BUILDING VALUATION 312 co 4056-00 OWNERS MAILING ADDRESS 158 SOLTM PARK MAGALIA CONTRACTOR'S NAME TELEPHONE e CONTRACTORS MAILING ADDRESS 8965 PARADISE CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 4 56-00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $72.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $46-80 BUILDING ADDRESS SAID Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome W Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other M Describe Work: COVERED DECK Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 LESS Main Service zo..OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is it f II force and effect. License Class LIC. No. Y7 -TX 6 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 have and will maintain workers' compensation Insurance, as required by Section I 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compns� ation ins' cagier and policy number are: Carrier Mfr, ZP �. y(/ Main Service zooTo L000A 46. NEW CONST. DWEWNG =UP. OR ADONS. & ACC. BLDS. So SO 3.5¢FT. NEW CONST. MULTI•oUTLET NO.RESID. C 97.50 POWER APPARATUS a SINGLE CIS. OUTLET OR FD(TURES Ex. Occup. R FIXTURES @ 1.00 B20AIL 00 FIXED APPLE. OR Ex. Occup. OUTLETS RESID. EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 3.00 PERMIT FEE $ 43.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES $ Policy Number —©y�T -- C (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. _leeof X Date /o/ C 0 Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 181.80 HAZ. _ I D. FEES IMP ..— FL000 CDF r-- PARCEL _ PD HD SUE This permit is hereby issued under the applicable provisions the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. /J} By / Date `v PERMIT EXPIRES ON I P—) Receipt No. 308817 /$181.80 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ' CQUNTr OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION. b 7 County Center Drive • Oroville California 95965 • Telephone (530) 538-75AI PERMIT NO. KV(Rev.12/96) APPLICATION AND PERMIT ASSESSORPARCELNUMM ZOMNO BUILDINGPERMIT OWNEA ,y ( TELEr"°"E SO. FT. I OCC, BUILDING VALUATION v OWNER'S MAILING ADDRESS CONTRACTOR'S NAME ELEP/WNE CONTRACTOR'S MAUNO ADDRESS CONSTRUCTIONIENDER IENDER*S MNUNG ADDRESS ARCHITECT OR ENGINEER LICENSE NO. ARCHITECT OR ENGINEER'S MANJNO ADDRESS BUI DWGADDRESS IDT NO. I SUODNLSIONS NAME I PARCEL MAP USEOFSTRUCTURE SF ❑ Duplex ❑ MobilehomeOther sPEcicv TYPE OF WORK New ❑ Addition ❑ Remodel ❑ lities ❑ Installation ❑ Other Describe Work: 0 l� *PERMIT FEE PAID SRA SHERIFF OTHER AMOUNT RECEIVED $ 159,�?b *RECEIPT NUMBER ,3MS/I * TO BE PUT INTO COMPUTER Fireplace PERMIT FEE $ ELECTRICAL PERMIT Total Valuatlon Is Main Service Q 23.00 Flinq Fee $ 46.00 20.00 Permit Fee $ o NON-R61D. ,� Plan Checking Fee L 41,60 Energy Plan Checking Fee S b PERMIT FEE _ • S PLUMBING PERMIT Fling Fee 20.00 Ea Trap 7.00 Solaro eat pump water heater 23.00 Water i in 15.00 Each gas water ter or vent 15.00 Gas piping system 1 - tiets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 Ex. Occup. R ES PERMIT FEE $ ELECTRICAL PERMIT Fling Fe Main Service m°wv1 oA mss 23.00 Se ry e ( 200A TO 100oA 46.00 NEW CEWNO OR ADON . OCCUP. ACC. BIDS. SO 3.50FT. o NON-R61D. UITI•OUTLET @ 7.50 /?,,POWER APPARATUS \ Ex. Occup. R ES ez a";; PP Ex. Occup. 0U�rLt°rs Es °EA 5.00 Temporary Service •23.00 Mobile Home Facilities 20.00 Misc. Wirina 3.00. PERMIT FEE _ :S MECHANICAL PERMIT Fling Pee 20.00 Hea Cooling Hood 6.50 PERMIT FEE S Mobile Home Installation Fee S _ Energy Inspection Fee $ p OCC CONST. TTPE TOTAL FEE $ .� JUE HAZ. D. FEES IMP FLOOD COF PARCEL PD HD 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 '+'.��Si yt~ r�J`�A�}Y�.1�^+-r-'MyI3I-7�'`~�f��1,.w,TnHf n'�'.KIYF41� "Y^ �-."1�"fe'�'� ~� � -:.. .+.fi�_yr �1•v'11.Y / � ' rynT1"�'1 H'� rr�v a���� ♦ � n h. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: & Q�J{��j�% ASSESSOR PARCEL NUMBER: D 106 - 0 -DP9 Proposed Building Use: �.I ,!°.,C Building Inspector: /,. I- - Date: /Q - Ig 40 to At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- . Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ �j? Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- V 0 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ ❑ 6. Energy Design Compliance and supporting documentation. 117. Statement of Intent for Non -Heated and A/C Buildings. ---- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑ 9. ufactured H me data d installation instructions including Tie Down Specifications.------------------ S of $-------------------------------------------------------------------------------� 11. Impact fees as shown on the attached schedule. ----------------------------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees----------------------------------------------------------- Flood ------------------------------------------------------- Flood elevation certificate. ----------------------------------------------- --------------------------------------- Sanitation and plot plan approval %d� Health Department. ------------------------------------------- v�- ❑ 15. Ci hof Chico plumbing permit ----------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- ❑ 17. Planning approval for (A) Use: (B) Parking: -------------------------- ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---------------------------- 0 20. Pre -inspection for required Request to Building Inspector on (Date) ❑21. Contractor's license information. (Number, Name Style, Classification). ------------------------------------ 0 22. -----------------------------------❑22. Workers' Compensation carrier and policy number. ----------------------------------------------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- -+ ❑24. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- ❑ 26. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑ 27. Manufactured Home utility clearance. -------------------------------r ------------------------------------------- 028. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. 11433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ . --------------- 30 Other: (° g 6krA ji fj h5t'------- en you issue the emrit, process as follows ❑ Mail to owner, ❑MaQ to contractor. Telephone D 77- ac7 '75 and hold for pickup at office. ❑ Deliver with inspector. Applicant: AC/i4-' %� Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By. Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: kA ❑ Plan Check List 2. Additional items required: el ontractor esigner, owner, was advised of the above required data byRphone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was asivised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: V Date: 16 -e -1 -al Plans approved by: Date: Sets of plans on hold M' ❑ Plan Cabinet,xk.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. E.H'UStp.NLY Plot Plan Attached O Floor Plan Attached Ai o Sent to S.D. TO: Building Department FROM: Environmental Health V SUBJECT: Sanitation Clear nce j1r� d sl, s'. a tk Cl(v - 30 - 0 19 Owner Location AP# Plan Approved for: Sewage Disposal -,Y Water Supply: Public Private Well Clearance for dwelling. Other C. uc4-eel Ad � /2 ')f /13 ` � 2 �. Hold final for: Final clearance O.K. for: NOTE: mac. A-eW /XPi A tv Am� 24hz,4.. c.4? / 2EHT Environmental Health Specialist Date 8/96 PERMIT NO. 3589-80B PERMIT EXPIRES John Cottingham OWNER CONTR. Owner LOCATION (A.P. 6603-19 ) 145 So.Park Dr., lot 93, PPCC#I, Magalia. J ti r I S .F ;I . E y k Temp. Power Pole 4 Called PG&E Temp. Elec. Serrv. Called PG&E Temp..Gas�'Serv. Called PG&E l O' ! NALED i (Date) (Signature) FIRE SPRINKLERS Stucco CftiTl.•OF BQTTE — DEPARTMENT OF PUBLIC WORKS ' BUILDING INSPECTION RECORD Subpanels BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwal I Insulation Heaters Slab Carport p Footings Prov. for phsically handicaped Conformance of ex. structure Appliances Gas Piping $ Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footinq ELECTRICAL FIRE SPRINKLERS Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ----------•------- Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - • - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) �---- -*COUNTY OF; BUTTE DEPAHTMENT*OF PUBLIC WORKS 695 Oleander Avenue, Chico —,,Phone 343-4211, Ext. 70 7 County Center Drive, Oroviile — Phone 534-4541 Skyway and Elliott Road, Paradise — Phone 877-3435 CORRECTION NOTICE -3�g�- � BUILDING OR PROPERTY ADDRESS A routine Inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. ol Inspectoroe"4 Date,"7_—'97 v COUNTY OF BUTTE -`DEPARTMENT OF PUBLIC WORKSPERfAIT NO. 1 + 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-454 APPLICATION AND PERMIT / ASSESSOP RCEL NUMBER ��� Qom_UILDING ZO ING PERMIT OWNER- TELEPHONE SQ. FT. OCC. BUILDING VALUATION C� D OWNER'S MAI LItJ ApDF2E55 qy CONTRACTOR'S NAME YELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ 0 LENDER'S MAILING ADDRESS Permit Fee $ Q j) ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS K, PLUMBING PERMIT Filing Fee 3.00 Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO. SUBDIVISION NAME IOeo 0 % PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USEOF ST SPECIFY UCTURE L - SF El Duplex❑ Mobilehome Oth Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: (,yAZfZ ,aEG/L — Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 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 OCCUR.&) OR ADONS. ACC. BLDGS. 20 sq CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I 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 ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ] I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason .R BRANCH CIRCUITS 2.50 ea NEW NON-RES'. NEW CONSTR.( POWER APPARATUS &� NON-RESID. SINGLE OUTLET CIR. ExOccup(ourLETsoR FIXTURES 50@� . US BAL@10t FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6,25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ® I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 3.00 Heating Cooling Hood 2.00 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 coses which may in any way accrue agains said ounty i coesof this permit. all liabilitie ,judgments8�2tt=% %� d ate Si lure of Applicant — Owneriig_,'�Cn tractor ❑ Agent ❑ 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 $ Land Development Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE OF CONST. PARCEL PaJ.71 ISOSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE OR OF PUBLIC BY P T EXPIRES Date/�� the applicable provi- resolutions to do fees have been paid. WORKS Date b' Receipt No. �,5 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE — DEPARTMrNf OF PUBLI&WORKS — BUILDING DIVISION .. � 7 County Center Drive — Oroville, California 95965 —Telephone: 534-4541 PERMIT APPLICATION DATA SHEET ;I 4 ,..•`V9 f�0 Permit , OWNER -. q�� ft A.P. No. 67JI''" ty Proposed Building Use '14 Permit fee based upon: Complete Contract Price DPW Valuation 0ther•(explain) Building Inspector /'9 P" ml ./i✓Date At time of permit application, I was advised th"e following data must be submitted prior to permit processing and/or issuance: '� DATE RECEIVED APPROVED 1. All items have been submitted................................................................... 2. Plot plans in duplicate/triplicate............................................................... 3. Complete plans in duplicate/triplicate................................................... 4. Complete engineered plans and calcs..................................................... 5. Plans with Energy Design Compliance Statement ............................ 6. State Energy Forms No. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $.................................................. , 9. Letter of signature authorization....4.................................................... 10. Sanitation approval from Health Dept.... 1 /G 11. Planning approval for ............. -1 Certificate of Workmen's Compensation Insurance WZ�13. C 5 Informati n (n �, name style, y� wa j'Jed V" 6WPPcation) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow) . ..................... _......................................................................... 15. Pre -inspection for required. Pre-inspec. request to (date) bldg. inspector 16. Other When you issue the permit, process as follows: Mail to owner Mail to contractor. Tel phone and hold for ick at office. Deliver w/inspection. �0 e Appdcant Copy of plans sent Health Dept., Fire Dept., Other Date— During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of appli ati , Wcleem.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer,9�njw) was advised of above required data by —je�elephone / Mai I Other By Date Plans checked by Date Plans approved by 4_z� Date OTHER: Copy/DPW To: Building Department From: -Environmental Health Subject: Sanitation Clearance c' Owner Location Plans approved for: Sewage Disposal _ Water Supply Hold final for: Water Supply 0 K f Water Supply Final Clearance . . or. Clearance for bedroom moble home; Clearance for addition of( Note** Sanitarian Other ! Da t COUNTY OF BUTTE - Department of Public Works 7 County'Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIF ICAT ION Attention Property Owner: An "owner -builder" building permit has been applied for in your nameand bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed.property improvement (yes or no) -- 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide th roposed co struction: Name Addre City Phone ors se No. 4. Iplap provide portions- is work, b Ave h the following person to c su ervise, a ovide the major work: Name Address City Phone ontractors License No. 5. I wil workRlil S igned Pr So Da NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. l q�vo g � i PERMIT APPLICATIOA WORK SHEET OWNER Zoning Use Proposed Permit fee based upon: `l. Complete contract price. 2. Partial contract price (explain). 3. DPW Valuation (show): Permit No. A. P. No. Approved Not approved At time of permit application, the applicant was advised the following data or information must be submitted prior to permit processing and/or issuance: Date received 1. All items have been submitted. -------------------------- 2. Plot plans in duplicate/triplicate. --------------------- 3. Complete plans in duplicate/triplicate. ----------------- 4. Complete engineered plans and calcs. -------------------- 5. Fees of $ -------------------- 6. Letter of,signature authorization. ---------------------- 7. Sanitation approval. ------------------------------------ 8. Planning approval for 9. Workmen's Compensation Insurance Certificate. ----------- 10. Contractors license information. ------------------------ 11. Parcel declaration, recorded copy. ---------------------- 12. Access declaration. ------------------------------------- 13. Aunt Minnie information. -------------------------------- 14. Deed of access, recorded copy. -------------------------- 15. Deed of parcel creation, recorded copy. ----------------- 16. Parcel map, recording data. ----------------------------- 17. Pre -inspection request for -- Improvements - plans equire & D approval - ----------- 19. Other ------ uJ et a7 By 14, Date Bldg. ector. During plan checking process, the following data or information must be submitted prior to permit issuance: 1. Index permit for items above and in addition the following: 2. Applicant advised by Telephone Mail Other 3. Plans checked by Date 4. Plans approved by Date When permit is issued, process as follows-, 1. Mail to owner. 2. Mail to contractor. 3. Deliver with inspection. 4. Telephone and hold for pickup @ office. �5. Other��5'j. Before permit issuance,- all of the following items must be signed or marked NA: 1. Zoning use 2. Legal parcel 3. Envir.Health - Date Plans Sent A. Sanitation B. Restaurant C. Other 4. Public Works - Date Notice Sent 'A.. Street Imp. B. Drainage C. Permits & Fees D. Other 5. Planning A. Use Permit B. Variance C Other 6. Other Agencies - Date Plans Sent A. Fire Dept. B. Other. COUNTY OF BUTTE —Department of Public Works 7 County Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: _ An "owner -builder" building permit has been applied for in you nameand bearing your sig\e Plee and return this information in the envel a provided at your earliesty to avoid unnecessary delay in processi and issuing your build- ing permlding permit will be issued'until this erif ication is received. 1. ly plan to provide the major labor a d materials for construction osed property improvement (yes or o) 2. I have/have ot) a signed application for a building permit for the roposed work. 3. I have contracted with the following rson (firm) to provide the proposed construction: /pil1K� Name Address 5-62 Phone 4. I plan to provide port person to coordinate, Name Address It tors' }L�bse No workll but I hav tors Ci mired tIvAllowing or woc. v 5. I will provide some of wor bu I co t`cted (hired) the following persons to provide twork ind cate �` Name �7_ dress bne Type of Work S igned Pr So Da NOTE This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Phis set of <,� z,C7 / 9 3 lans an p d specifications cept on the jea at II MUST be Pa!?aQl3�_ n a tirr, s and it is unlawful to t'`•-P' ; .1 TE' CT.'U AL ,C0 . , . q A .rake any cli;�ng;:s_or al;�r,�tions on same without ; t.;/;M �'"e L COl�9MITiEE 'vritten permissan fro n' ;he io E Norks, County' of; $utte. prtmert of Public i7h -FE: _ LJT.— 'ARPirJt1`D Sy LOT DEV; `�r. E�s.4:lOitlS UST 9c�ii PNLY° SUS+�l1lTTED PRIOR,.... �1L_ RP POVAL. ZZ�G% PRO FNt Top rail fc be 36 in dpi. (i�//�� Intermediate rails .t(be x� a 9.irL '0,0&4.4 } �+,� 16 rtiip Shall Be in NOTE:— All .40 �srls ,.;f Ear �tices an th ' of a han codes Uniforn) a j°.i;r: �e ; ,� the- National E cctrtca z2jS i L. PERMIT NO. 1106-79P,E Y PERMIT EXPIRES �- V OWNER John & Pauline Cottingham CONTR.J. T. McGregor, Paradise 66-03-19 -LOCATION (A.P. ) 145 So.Par k Dr., lot 93, PPCC#I , Magalia a i s r � 1 0 I. • Temp. Power Pole Called PG&E Temp. Elea Serv.���7`i Called PG&E Temp Gas Serv. n E /FINALED (Date) (Signature) 41q 45MUCTED COPY COUNTT OF RUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter• 5, under permit number. 193773 for the following location: 145 SD. Park Dr.. Lot 93, PPCC$'1, Magalia, .CA. 95954 Owner John & Pauline Cottingkaut Owner's Address alt} W. 8th St, Antes}19 CA. 94509 Mobilehome Mfg. Fuqua Model 24x43 Year 79 Insignia No. CAL 130168 & 69 Serial No.FH148063 S-78 FH14803 . A-78 It is hereby certified for occupancy at the above described ocation and may be occupied. Director of"Public Works May 14, 1979 N`/ 7`� Date By THIS CERTIFICATE IS VOID WHEN MOBILEHOME I3 RE OCATED White - Owner, Yellow - Installer, Pink - O.P.W. COUNFY -0F .PUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number for the following location: Owner Owner's Address ` c Mobilehome Mfg. Insignia No. x It is hereby -terrified for may be occupied. Director ofPubli Works By � t RTIFICATE IS VOID WHEN M` 611LEHaME IS RELOCATED Date Model Year -- Serial N-,-2 . )ancy at the above described,/ISoc tnoq,�4-4d White - Owner, Yellow - Installer, Pink - D.P.W. Seltack For Main Bldg. Foo n s StemII Slab Piers Garage Footings Stemwal I Slab Carport Footings Slab Patio Footings Masonry Walls Reinf. Steel Mesh FJhIsh In rior L.atl or Closer MOBILEHOIi Water Piping MOBILEHO Water Piping COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING` BUILDING (Cont'd) _ PLUMBING rewal I Pa pets Res oom Finish Windo s Siding Roof She thing Fdn. Vents Garage Vents Insulation Prov. for phsica handicaMed Conformance of ex. FIREP1,ACE Footing Throat Final IRE SPRINKLEI Test Final MECHANICAL Heatin Cooli II Piping No Floor 2n Floor 3rd Noor To out Water Pi i Sewer Fixtures Water Htr. Heaters Appliances Gas Piping & Test Temp. Gas Sanitation Final Subpanels Gird. Faul Pro Service Te . Pole Uqderground ermanent yinal r I kVnal ------------------ Elec_ Service )G V Elec. Pedestal 3 / 79 L, IL Sewer Gas Piping 'ION .............. SupportElec. Continuity 2 Drainage Gas Piping DATE REMARKS OR CORRECTIONS 3 � a`' (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — ,DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 14 Date 'Signature of Permitee a nt Receipt No.( a! 22 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated abov r hich fees have been paid. ECT OF PUBLIC WORKS L Date Building permit expires Date BUILDING In/ L-100 OwnerSO. FT. OCC. BUILDING VALUATION Mailing Address Xe Telephone No. Contractors,S' Mailing AddressJ,;p/ .P Fireplace Valuation C Telephone No. s , is Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 P Repair drainage or vent piping 1.50 A. P. No. —. JZ ping & Planning Water piping 1.50 Each gas water heater or vent 1.50 3aa"a4en Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvem s Each additional outlet .30 Building sewer 5.00 Bldg. P Recd Parcel A al PI s Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER �, Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 100 AMP OV OR RSLESS 5.00 Single Family ❑ Duplex ❑ Mobil Homeprr Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service/ EA. ADD•L 100 AMP 1.00 OR ADDNSNEW T C ACCLBLDGS.DWELING CCUP. 4'\ 20Sgft 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: / NEW CONSTR. BRANCH CIR T NON-RESID. � BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS 6 NON-RESID. SINGLE OUTLET CIR. Ex. Occui)(OUTLETS OR FIXTIIRES BAL@T BAL�1 Ex. Occup.(FIXED APPLNS. OR OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No._� 4 �.��2� Classification �'=� �� Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. LJ 'have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. @ MECHANICAL No. FEEPERMIT 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 herebyInc e TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 14 Date 'Signature of Permitee a nt Receipt No.( a! 22 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated abov r hich fees have been paid. ECT OF PUBLIC WORKS L Date Building permit expires Date ' rF r rte,► , (JUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS — BUILDING DIVISION 7 County Center Drive — Oroville, California 95965 — Telephone: 534-4541 OWNER V Proposed Building Us( k PERMIT APPLICATION"DATA SHEET Permit fee based upon: 41W4 Building Inspector At time of permit issuance: 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. r �r" Permit No. A.P. No. Complete Contract Price ziDPW Valuation Ot er'-explain) J� Date .4w�l 7�r on, I was advised—the following data must be submitted prior to permit processing and/or DATE RECEIVED APPROVED All items have been submitted ................. Plot plans in duplicate/triplicate............ Complete plans in duplicate/triplicate. Complete engineered plans and calcs..................................................... Plans with Energy Design Compliance Statement ............................ State Energy Forms No. .................... Statement of Intent for Non -Heated & AC Buildings ................... Feesof $.................................................. Letter of signature authorization............................................................. Sanitation approval from Health Dept.... Planning approval for ............. Certificate of Workmen's Compensation Insurance Contractors License Information (no., name style, classification) ............................... Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow).................................................................................................. Pre -inspection for required. Pre-inspec.request to Other bldg. -inspector (date) When you issue the permit, process as follows: Mail to owner Mail to contractor. Telephong� g7�? � `f and hold for pick-up atf0'02eA41'S_office. Deliver w/inspection. s Other Applicant / lew"I Date %`9 Copy of plans sent Health Dept., Fire Dept., Other Date_ During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other y By Date / Plans checked by Date Plans approved by Date —r, OTHER r•,...., snow V1012IViC1 aV7IC3_IBU i — 2?It9C�W I.�aUq 0 TiA3€VITFIA93Q — 3TTU8 l0 YTIIUCVj . rA2 ,4,F8 9noricis19T -- ;aeae sinioliis`J„wivoi0 - 3vii0 191n93 Yin uo� C ':3381 ATAV MOITA IIA9A TIIVISM .C) l Jim"ss9 _ _ ---- ——^------ 00 .9 . 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I ..... . .2pnibhA DA >S bgJ6si-I-noV'i iot Jnslnl to Menisls2' -.._._. ................................................. to ne l - _................... ..................... ................. noifSShOrfiius 9-i(tl(,:npi2 to 19119a 16vo-iggs noiJS:iinc-2 —..._._............. —------- —_.----..—______.—_._.—._—_7at isvoiggp, prsinnhl9 _...— ......... .............. sanmuzni rioiJs2n9grr]o3 e'nsm..� ioW to eis:)Ml"isO ,9l'y/l2 9rnsn ,.On) noilumotn S2n90iJ 'ZioSas'3moD ............. ............._..lnoit63iti22slo bni;.i 1381noD .bgiiL;p„,7 9d ysm 21n9rnsvoigml y92) 2 1.o'vN ::;ildt,q .tg50 to noilas2l Sn9rngol,3vgG 1i ” bt .r .8 .a A .8 .e .or Jr .r �r SWO(.iC 2281 16 c:1Y231:j1Jl.ISI'j2n1 9.9 b:ailu�;7l-._.._._,...._...__...._.—_____..10t nOIJ�Sg2ns q"19 Gr-- letsblc,tE,� - - -i5r170 tir--- .7oJ✓s7lnoo of iif3fvl -_._._._.. 191".wo Os iis,6,4 ._..__— :2vvollot 2s usooiq ,Jiryneq sril suz i uoy nsriW roiJasgzni\vv 7svilgC].saitto_ _-. -ss qu-iaiq iot blod bn6 (Eofigsl9 a —�- 19HI O ,..«tsG 91i9 _—_._._..—___ ;.JgsG rillsaH _____—_ Jns2 2ns€q to ygoo :sonsu22i Jimieq of iofnq b9JJi ndu2 ed Jaunt mfib pniWollot sr?J ,u53o-iq pnblloarla nslq sril pni7ur. t.m9li slaiia ..noifir:)dggb t(1 enniJ 1(:. evods beAasr1a fon 2mg1i be-liup9-s •sol) ----.-----_.—_—.___._.____-_..�-..-------.----•---- _ ----_-._._ .oVI 2rn9Jl 3vod,6'iol Jirmgq x9bril .i _......:bsiiupsi 2meli IsnoiJibbA S snoriggleT ___-yd 9vrds to bs2ivbs 2svv (7snwO ,ienpias(l ,-io"-lominoO) I i sIVI _.__—_. 91s0 Yd bsAasrla 2nslq -83HTO BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET u 1. / Owner's name: ��,1 Av 2. Installer's name: 3. Is the site currently under permit? Yes No (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No / (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes /-z7----.No / / ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- 0,6 Zs' Amps 6. What is the mobilehome site service rating? --------------------- �Z 61,C Amps 7. What is the mobilehome site circuit breaker rating? ------------- cZ Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes / / No (If yes, identify the load and size: (Load) .(Amps) 9. What is the mobilehome site gas pipe size? ---------------------- 10. What is the,type of gas service? -=--------------=------------- Natural / / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than,SA ft. on.LPG.) S 0 MOBILEHOME SUPPOkT DATA . �If other than single wide, Mobilehome Mfr.�t/q�� furnish Setup Model No. k2es Year WidthafV (ft.) Box Length y�(ft.) Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. Footings (check one) Single Wood either pressure treated o foundation grade. (ft.) in:) Center s pport locat'ons* (ft )(in.) (ft.)j in.) (ft.)(lin.) (ft.�j ((in.) BUTTE COUNTY :30ILDING DEPARTMENrt APPROVED *If Center piers are other than drawn above,. draw in -A ocations, spacing, and dimensions. . Other ( specify) Supports (check one) Concrete block. . Other (specify) agalong or Expando, how support details. pport ze Spac ing ang 3 4�� 7 417<a �'NThD i�%����i'�CJL/�//if Ve it //ob-7� or N COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO S 7 County Center Drive - Oroville, California 95965 l Telephone: 534-4541 APPLICATION AND PERMIT aumonze represenittuves or the county or tsutte to enter upon the above-mentioned propert inspection purposes. X Date , %nature of Permitee or Agen Receipt No./-7—�d�7/y White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. IR!F PUBLIC WORKS By Date •7-1 Z -2i i ding permit expires Date—/ Z— BUILDING Owner G' SQ. FT. , OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor Mailing Address 5 l� ! Fireplace Total Valuation Telephone No. Permit Fee Building Address "r Plan Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 O Each TraD 1,50 G �G L o < l Repair drainage or vent piping 1.50 A. P. No. `- a — Z ing & PI Hing Water piping 1.50 Each gas water heater or vent 1.50 F s S n re Dept. FireZone Use Permit Parking Parcel o EQA Plans Declaration P E;� 60' R/W Improvement Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Building sewer 5.00 Q, Bldg. PI s Recd Parc Ap roval Plan pproval Lawn sprinkler system 2.00 NEW ADDITION UTILITIESP_OTHER ® permit Fee $ $ ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 a,OC� Main service 600v OR LESS 100 AMP OR LE5•�� SS iO Single Family Duplex Mobil Home14 Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service O100VERAM600PORv LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST % ACCLBLDGSCCUP. '6)2¢Sgft 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: M®YL. NEW RESID. BRANCH CIR T NON-RESID, BRANCH CIRCUITS 2.50ea NEW CONSTR. POWER APPARATUS &) NON.RESID. SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTIIRES 5D@ , FIXED APPLNS, OR EX. QCCUp. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities15.00 ,Q(7 License No_2-7le0 Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 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 $ d0 TOTAL PERMIT FEE $ 77 aumonze represenittuves or the county or tsutte to enter upon the above-mentioned propert inspection purposes. X Date , %nature of Permitee or Agen Receipt No./-7—�d�7/y White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. IR!F PUBLIC WORKS By Date •7-1 Z -2i i ding permit expires Date—/ Z— .A;..,,COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION o,:r It -t cT 7 County Center Drive — 0roville, California 95965 — Telephone: 534-4541 rte/ PERMIT APPLICATION DATA SHEET _ ---�- Permit No. "OWNER ,�� �b C, r9 An A.P. No. 6+a -- Proposed Building Use Permit fee based upon: Complete Contract Price �� DPW Valuation OlVer (explain) Building Inspector �.--z- �. Date ..5 At time of permit aPlioation, I was ady,�sed the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted.................................................................... 2. Plot plans in duplicate/triplicate.........................................................•...... 4 3. Complete plans in duplicate/triplicate................................................... 4. Complete engineered plans and calcs..................................................... 5. Plans with Energy Design Compliance Statement ............................� 6. State Energy Forms No. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $.................................................. 9. Letter of signature authorization............................................................. Sanitation approval from/ d' � � Health Dept.... 1. Planning approval for :. 12. Certificate of Workmen's Compensation Insurance ........................ 13. Contractors License Information (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see address below) ................................. - 15. Pre -inspection for required. Pre-inspearequest to (date) e. bldg. inspector 16. Other When you issue the permit, pr cess as follows: Mail to owner Mail to,contractor. X Telephone 77 r �76 2 and hold for pickup atl/oewob szs office. Deliver w/inspection. Other /I Applicant Date 3 �- 7 Copy of plans sent Health Dept., Fire Dept., Other Date - During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of appl' tion, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail Other By Date Plans checked by Date 3 - 9-79 Plans approved by Date --3-9-7q OTHER: COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 ?�/� Telephone: 534-4541 /APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. .,01.n) q-, I Date — Ay nature of Permitteeee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or reso tions to do work indicated above for whic ees have been I ECTOR IC WORKS BY Date g permit expires Date BUILDING ' Owner .),j C? p � FT. OCC. BUILDING VALUATION Mailing Address/%,6r --pYK109TT7p j ee4T Telephone No. Contractor Ya d r Mailings- ��. v�® Fireplace Fireplace Total Valuation p + �y T ephone N Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 / Each Trap 1.50 AX�r Repair drainage or vent piping 1.50 A. P. No. 'Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 ge s Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 Uu EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 ans eed Parcel A royal Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ ��— ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 600V OR LESS Main service 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L loo AMP 2.50 Main service OVER 600v 25.00 100 AMP OR LESS Main service EA. AOD'L 100 AMP 1.00 NEW CONST. DWELLING OCCUP. S� 2�sgft OR ADDNS. ACC, BLDG.. 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: r �a\ /Gas ? j 1V- (r`�] .� �. NEW CONSTR MULTI -OUTLET NDN.RE.ID BRANCH CIRCUITS)l 2.50ea NEW CONSTR. (POWER APPARATUS .&, NON-RESID. `SINGLE OUTLET CIR. EX. OCCUD(OUTLETS OR FIXTIIRE. I BAL@i EX. Occup ( FIXED TS (RESAPPLINIS. OR \ 2.00 OUTLETS (RESID.) EA/ p y• Tem ora' service 10.00 Mobile Home Facilities 15.00 �! License No. �� � � I T Classification l-- C Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ISI I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. .,01.n) q-, I Date — Ay nature of Permitteeee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or reso tions to do work indicated above for whic ees have been I ECTOR IC WORKS BY Date g permit expires Date MOBILEHOME INSTALLATION INSPECTION..CHECK LIST 1. Is the mobilehome located with required separation from lot lines and buildings and generally conform to plot plan? Yes No 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes4--�No 3. Are footings and supports.properly sized, spaced, and braced as pep approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes_ No 4. Is the mobilehome level? (Sec. 5088) Yes= No_ 5. If more than a single unit, are crossover connections properly installed? (Sec..5088) Yes t)<No i 6. Water A. Is flex' e connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes t/ No B. Test - Does water piping withstand working pressure or 50 lbs. air test? YesG/No C. Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No Al 14- 3. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes t`� No B. Does it have minimum k" per foot slope and is it properly supported? Yes ✓No.. C. Are any leaks detected in drainage system after running.3- ons of water through each fixture including washing machine standpipe?,.Yes No D. If coach is not tate of California approved; does station have required trap and vent? Yes No_ 8. Gas Piping and Gas Vents. A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is.to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes_ No B. Test OK as per following procedure? Yes_ No 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test ;Yith*manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes_ZNo_ 9. Electrical , A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating cif mobilehome with a minimum of 100 amp) and other�faciflties on lot, i.e., water pumps, garage, cabana, -etc.? Yes moo_ B. Is there proper clearances around panels? Yes L--lTo C. Is power supply cord or feeder assembly properly fused? Yes D. Is continuity test satisfactory as per the following procedure? Yes,- No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to.the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from , such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord br 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 everythin okay, sign -off card and tag services. .. MOBILEHOME DATA Manufacturer and/or Namestyle Length e Width C' Vehicle Serial No. ,F#JY i? �3 �'%� / tt' �YY �1-3 State Identification No. Additional Information or Comments: n- cne.,) ` M ITI • E) .• : �7' '• � rye' M , , s•'► • ,,..,. , . )%• rr` �'� •� ti"� p�.� �: � ;i � ', � "'moi 05 C I � `• ��, 'may, �r .. � � i } � . ✓. • ': r i .. .. �*'R� �� , �� `� i rS"V, }� '!.�', f _ 4if. i*t 'y ,� .,fit, '• f.. fY,•,. ly to 941 e �' 't R i ' !y -• /,R �...1 � - °���� v" - ° v} �rry i ro %S i�lr�,�,{i t,�., tY�, ,' � ,, { f� M .. `'C� ` ./ •��>�'. 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