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` 66-49-17 ' Ken Waters. 16 Yahi Ct., lot'86, Indian Meadows,. MagaliaAI contr: Charles E. Hancock,'Paradise Permit82-76P,E(util.,M§, ELEC. � •$-0& GAS SUPPO T TRUCTURE REQ. ArO t COMPACTION TEST REQ. A/10 6T+9-17 "contr,: Carrell Bbs:", CH'ico. Perm it'#2285=7.7MHIr�/� d,/ __ S 3057. Issued St/%_ �7 • - - - - 66-49-17". i; contr: Mari -John Const., Ma lia Permit #366,1=77B E(new priv7- r garage/) -3D/ 7.. rk 66-49-17iajid/1contr; Frank Vasquez,•Migal ck Permit #3764-77B(new:open &' co MH) }' 6 49-17'`. , 'covered deck/MH) E - Permit#2868 81B(new 7 o 1 { - - -�- j �.�� } ��� � � � Q� � �. + }e. PERMIT NO. 3764-77B +� PERMIT EXPIRES OWNER Ken Waters CONTR. Frank D. Vasquez, Magalia `LOCATION (A.P. 66-49-17 ) 16 Yahi Ct., lot 86, I.M., Magalia Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp: Gas Serv. Called PG&E JOB y ;� _ FINALED / _ r (Date) ./ (Signature) >> Setback Forms Main Bldg. Footings Stemwal I Slab Piers Garage Footings Stemwal I Slab Carport Footings Slab Patio Footings Masonry Walls Reinf. Steel COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION, RECORD BUILDING BUILDING (Cont'd) Firewall Soil Piping Parapets 1st Floor Restroom Finish 2nd Floor Windows 3rd Floor Sidina To out Roof Sheathing Water Piping Roofing Sewer. Fdn. Vents Fixtures Garage Vents Insulation Water Htr. Heaters Prov. for physically handicapped Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Final' Sanitation FIREPLACE Final rooung Throat Final FI F Framinn I Tem• 1 W_.__ �._ UMBING ELECTRICAL Stucco Final Sub anels 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 MORILEHOME INSTALLATI N - - - - - - - - - - - - - - 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.) • A COUI1TY';0F BUTTE — DEPArlTMENT OF PUBLIC WORKS 7 County Center Drive— Uroville, California 95965 761-1-77 a Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X /z v/7, Signature of Permitee or i—.ent,/-7-() 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 resolutions to do work indicated above for which fees have been paid. DIRECTOR OF IMC WORKS ey B ding permit expires Date �� 7� BUILDING Owner leg Ze SO. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor Total Valuation Mailing Address r '' Permit Fee Plan Checking Fee&/or Penalty T lephone No. Permit Fee $ Building A dress PLUMBING No. @ FEE PERMIT FILING FEE $3.00 a- Each Trap 1.50 Repair drainage or vent'piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. I . Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe W.C. t 'o Fire Dept. Fire Zone Use Pennit Building sewer 5.00 EOA Parking Parcel Plans Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Bldg. PltlFs Recd Parce Approval Plans Approval Permit Fee $ $ NEW � ADDITION UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 5.00 100 AMP OR LESS Main service EA. ADO'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 Co �.AV �! " C'1 n10NEW NEW CONST. DWELLING OCCUP. & OR ADDNS. ACC. BLDGS. 20Sq ft , CONSTR. MULTI -OUTLET NON.RESID. (BRANCH CIRCUITS) 2.50ea - NEW CONSTR. (POWER APPARATUS & NON.RESID. SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: d Ex. Occup(OUTLETS OR FIXTURES) 50 BAL� FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile.Home Facilities 15.00 License No -4-354002— 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. @ FEEPERMIT FILING FEE$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby • TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X /z v/7, Signature of Permitee or i—.ent,/-7-() 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 resolutions to do work indicated above for which fees have been paid. DIRECTOR OF IMC WORKS ey B ding permit expires Date �� 7� INNMENEM■■■■■� MMMMM ■■■■■■■■■■®�®MEI ■M■ SEE O MON■■■■■■■■■■MI 1 ■■ M■■ ■■■ Ilmmm ■MM MMM■■■■■■ 1 1®■■ ■■ MOO■ ME N ■ ■■■■■■■■■■■■® 1 IN I®1 M■ M■ MEM M■■ ®■■■ ■■■ ;'�;% e ■ :. : - �� ; - - . ® OEM NMI NEI Elm IN ■ ■■■■■■NEEM■■■ ■■ICM■M■oN■■oI a■N ■ ■ MEN■■ - ■ 1 1 1■ ■O■ NONE ■NONE ®■■■ M■!1 ■■ MI 1 I■ ■EON 11IMMUMM■© ■®■ ■ OEM ■ MEN ■ ■ I 1 O■■MEM■M■M■ 1■■■M■E■■■M■■■ ... .. _ = ■■ ■ ■® I IM■■N■MO■O■NOON ■ :.. _ . .., :.. , . , ■®■®NNii■ 1 NONE 0 EMMENE NMI 1 • 1® •. • • • •. n • ri , • • • _ • o , • ■■■■N■1■ . • ■m■■■■■ MEMO ■ NEI NONE NM■, 1 ■ IN ■ �� ®®■■NEMIsmNINE ,. ■ ■' M1 Mool ., 1 I1a11m ii1=1 111"Um _ � e■O ' -SEMEN ,• 1 INN :A AL *Q i. , " :- / ' • r ■M � �, ■NMI INNN s■IE �� .._ . , „■■■NMN ■M■■■NI IMM■■NN■� •: ; - :: � - + • �■®■■■■■N■■N■Ns�M■NM■M■MMS IMMENSE :. _ ; , _ : .. _ . MEMEMME I■■M■N • • • ■ ■■■■■■■N ■® ■ t '{ ' 1J_ r __ __ _ ___ i ,r ,r _ n � _, e_• _ � .♦.> - +` .� .' �. .a s• � '. - S, y; -�i' ___ � .. ' t �_ 1 w^ s + � � d: � r �_ i f } ^ • V �✓ 1.' `1 - � ' t � 4rY ..- { t. d � � K eT �_ �� f i Y ��� .Y � � .. , ' . r _ r � ,. �� 4 -i < �� _� � t � .,,.� ,. a:r; �� �'•- � _ m •�•s� y� ,§� s- ���y s ' r e.,it' X�'d a , 4 `T f• .'•.? .., - ,�. i y t r� .s i[' r• , - ��3� :—=-A�� Materials WoArn" nsb' Sball $e it :Accordairce with .Recognized, Good .Eractices and'. . a 'quality prescribed for the Specified' use in the a!�,�,�. y Uniform Building, Numbing &Mechanical Codes and _ . • t t tho National Electrical Code. It,�_ 1't ' •e r . t• - •i 'J• ' t j 9 ',,,', y t 2 t v 4's �{ „, t•a' 3' t C _ `. .1 r .. 1 .. ' '� , • r 1 , sa � 7 . " .,, "�'} +f � A a = ' 1• L; �' } ��Ytv } ..,,. •.� t.t. a.•�. ' f: r�i♦ �k . .., iet of'plan' `' ' L&ty Hca #ke o6 } s , MUST be;, -at a;-1 t!mes and ht+aynnrl •tit 'is' awful #' Cl eilteralions on sAMA �eifl'17'�T___— !ic V'�crks, Counja�m�'T Of B Vif e. ©eparfinent' of Pub. } r fr I , e. t ;>~. �,r i' �"f.lrl 7�;�,.� (/� I t"C� !r� i•• is ar J. ;•, , � �I`• s at r CV \ • •• , \ 1.• • .., ' rl k 2; si4e Cent Pertacf s o , e�f . ne o Y /ine ha/� be ,S : 196 oT02� he"Ooc/ 50.{f� {r0� r d r9 L, . ' F� ` r r. °{ ai! a eoye P Per f {�o - erho IV the IVY alvr- w r ' 5j'�i , •,v . y, •t r ma;J •�d. - Pim a� 41 e/' ' y'.1'•�3111++•. ,_•'.L'�• ` .3•x:7 '' :.,i••. S'�..; c ' .. �. � • \ a �'J"r a Sf»:. ., �,,, ., � :':.! •�t •'fir' �y' • - •Y It�. k 1. t,J ;` �, . �', �. , �, . � "} ' 8 U TTE COUNTY. • •� � � '`_,• �� Rte. � ''' •. E _. - .. 8UIL©ING C) PART'-6Nl � p .._. _. y P�•\ i }',`. F j{ tl:,.'„ 11. \''�.. i r, 's•h}c +,• ri Sru, .r { ;1'+ ��'..11`. Gi �' CHLOR! :�.�:- r-�- 13UiLDER, LIC. NO. 12695I .7043 MC;Iokci Drive ` paradise,Ca. 9596( 1916) 877-1420 g , PERMIT NO. 3661-77B,E s } PERMIT EXPIRES OWNER Ken Waters CONTR. Mari -John Const., Magalia LOCATION (A.P. •66-49-17 16 Yahi Ct., lot $6, I.M., Magalia t ;4 x F Temp. Power Pole Called PG&E Temp. Elea Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB r� FINALED (Date) (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BU DMG 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 Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handicapedy Conformance of ex. structure Appliances Gas Piping & Test Temp. as Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h Relnf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent l' Door Closer IFinal Final MOBILEHOMEUTILITIES ------------------ Elec- Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS y, ✓O/11/V�-� � VY ✓ j C�r1 1 (NOTE: An entry must be made on this form each time you vislt the job site.) Col. No.. Manufacturer--Model--4Location Type of Occupancy Insignia NO. Serial No. Insp. Fee $ 3Z Insig. Fee $ Alt. Fee $ PROGRAM HOURS M/H Mfr. M/H Dir. M/H Other R/V Mfr. %/ R/V Dlr. R/V Other FBH Mfr. FBH Other Page one of DEPARTMENT OF HOUSING AND -COMMUNITY DEVELOPMENT > PSN -No. DIVISION OF CODES AND STANDARDS ID "i -I 7 - ACTIVITIES REPORT NORTH AREA OFFICE SOUTH AREA OFFICE 700 L, ROOM 300 28 CIVIC CENTER PLAZA SACRAMENTO, CA ROOM 639 95814. SANTA ANA, CA 92701 Date Inspected by-, Firm/Person Location PIIll A**"'- FTS CPT CPT No. DOM -77 DOP Legal C/NA # Insp. # Comp. Violations S E M P Insignia No. Issued No. Voided V Owner and Address if other than above NOTICE: Items indicating corrections are violations of the California Administrative Code, Title 25, Chapter F] 3 0 4, Sections indicated. Copies of these regulations may be obtained from the.State of California, Documents Section, P.O. Box 20191, Sacramento, CA 95820. It is unlawfol to sell, offer for sale, rent, or lease any noncomplying mobilehome, recreational vehicle, or commercial coach, or to sell or offer for sale any noncomplying factory -built housing unit or component system thereof. Upon receipt of,a notice of violations, the person served shall notify the department in writing within 10 days of the action taken to correct the violations. A person so served shall not move or cause to be moved said vehicle, unit,. or component system until the deportment has been notified of its destination and disposition. A� person served with the'notice of violation contained in this activities report has the right to request, and shall be granted, a hearing on the matter before i Director of the D ' epartment or his authorized representative. A request for such hearing shall be in writing and shall set forth a brief'statement as to the grounds refor. Requests for such hearing must be presented to the Department by mail or in person at 1807 13th Street, Sacramento, CA .95814. VIOLATIONS INDICATED SHALL BE CORRECTED AND A REQUEST FOR FURTHER INSPECTION FILED WITH THE AREA OFFICE INDICATED -ABOVE ON OR BEFORE THE REQUEST FOR -INSPECTION -SHALL BE ACCOMPANIED BY MINIMUM FEES OF $ P/A No. Manufacturer--Model--4Location Type of Occupancy Insignia NO. Serial No. L 9� -7 %/ ,-2/ .Received byze;!4 Tith- CC: \E] Mfr. E] Dlr. E) Plant CSI E) CCs Mailed [-].Other. 32008,141M 4�15; Z2.jUQQ TPji? QU Q31? N. I COUIQTY OF BUTTE .• — DEPARTMENT OF PUBLIC WORKS • 7 County Center Drive ^'— Urdville, California 95965 61,7 Telephone: 534-4541 / APPLICATION AND PERMIT -- •�.�..�� ��r. BUILDING Owner Ile }2 S, SQ. FT. OCC. BUILDI G VALUATION Mailing Address Telephone No. Fireplace Contractor Oe -1 r,/ 0 ii sZ Total Valuation LCY Mailing Address 7/0 !-/Z- 12 Permit Fee Plan Checking Fee &/or Penalty hone No. 6TA Q Permit Fee $ r Building Address /y% PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 7' (0 _Td► 00 tr1 Each Trap 1.50 w Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 4—V? -17 Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Faee I *_1C. Sa t ion ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA I Parking Plans Parcel Declaration Parcel Ma P R/W Improveme Lawn sprinkler system 2.00 BIdg:4'Tans Recd Parcel Appr al Plans Approval Permit Fee $ $ EJ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 OR Main service 10000 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others Main service 1100EAMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 Y T VZ NEW CONST. DWELLING '' & OR ADONS. ACC. BLDGS. d ) 20sgft �- NEW CONSTM!TIOUTLET NON-RESID R ( BRANCH CIRCUITS) 2.50ea NEW CONST. tPOWER APPARATUS & NON- R RESID. ISINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style Of' Y y�/ L • Ex. Occup(OUTLETS OR FIXTURES) BAL@A FIXED APP LNS. OR Ex. Occup.(OUTLETs (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 / License No331�sCmJ� lfa+ Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 17 $ 7 t 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. fC�l I have placed on file with the County of Butte a certificate of j� 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. 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 f9J�ating to building construction, and hereby MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ TOTAL PERMIT FEE 1 $ ! W. c v U11LY V1 pli— LU OIIICI U)JUII tllC above-m;erty f r ction purposes. X Date 211 - Signature a1 -Signature of Permiitee or Agent eceipt No. /67602. Nhite-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. BYJ4IRE ORo F BLIC WORKS ,Date Building permit expires Date :7, MOBILE464E SUPPORT DATA Mobilehome Mfr. L11 1 xjL4 Setup Model No. yla� 'Year �1 Width (ft.) LengthExpando Size ft.x ft. (Draw support details.below) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets -(if not on file with the County of Butte).. (f_1 I (in.)(in.) Sin,gle 1 *If center piers are other than drawn above, draw in locations, spacing, and dimensions. ts. Footings (check.one) 1. Wood either pressure treated or fdn. grade. �. Concrete pad. / / 3. Other, specify Supports (check one) 1. Concrete block 2. Concrete piers 3. Steel piers 4. Other, specify -S, --- i Typical Support _ Footing Size 1( ili'O (in. ) 4. Max. Pier Spacing (ft.) j t Max. _! Overhang 13U�E COUNT1 BUILDING pEPARTiEN°r AP Center Center Support Support Footing Sizes Locations (in.) Ci IC I� x_(. GI WO in (in.)(in.) (f_1 I (in.)(in.) Sin,gle 1 *If center piers are other than drawn above, draw in locations, spacing, and dimensions. ts. Footings (check.one) 1. Wood either pressure treated or fdn. grade. �. Concrete pad. / / 3. Other, specify Supports (check one) 1. Concrete block 2. Concrete piers 3. Steel piers 4. Other, specify -S, --- i Typical Support _ Footing Size 1( ili'O (in. ) 4. Max. Pier Spacing (ft.) j t Max. _! Overhang 13U�E COUNT1 BUILDING pEPARTiEN°r AP 1, Owner's name: 2. Installer's n, BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 3. Is the site currently under permit? Yes / No ( If yes; furnish permit number S23' 7-7 ) 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 / / No ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- 0� Oy Amps 6. What is the mobilehome site service rating? --------------------- Z06 Amps 7. What is the mobilehome site circuit breaker rating? ------------- 8. Is there any other electric load to be served by the mobilehome Amps site service? --------------------------------------------------- Yes / / No / (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- """" ` (in.) 10. What is the type of gas service? ----------------------------- Natural 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 50 ft. on LPG,) CZ <Z )<Z All utility connezfions shall be located within 4 ff. outside the rear third section of the mobile home on the left ft (road) side of the mobile home. P U -E The BlI*- Setback shall be 5 ff. from the side property line and 50 ft. from the centerline of the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely out of all easements. 0� . � Pte' qe7,17 NOTE:—All Materials & Workman ship Shall Be in Accordance wilrh Recognized Good Practices and CID ]2. ;1 of a qualify prescribed for the Specified use in the C\j Uniform Building, Plumbing & Mechanical Codes and the National Electrical Code. permit will be required for the 0 installation of the mobilehome. This set of plans •d., MUST be 0 i kept on the job at all times and it is unlawful (\j make any changes or alterations on same wifliou, U-) wrififon permission from the Department of Pub - U) lic Works, County of Butte, Septic system a to be as per Butte County Health Dept. Re- quirements. BUTTE COUNTY 'M BUILDMG DLPARTENI Sol APPROVEDe �I' CHARILES HANIODG-11 PUIDER, LIC. NO. 126951 7043 Drive Paradise, Co. 9596(?. (91 E) 877-1420 2 74 'jYf PERMIT NO. 5827-76P,E j PERMIT EXPIRES OWNER Ken Waters CONTR. Charles E. Hancock, Paradise r• LOCATION (A.P. 66-49-17 ) x 16 Yahi Ct., lot 86, Indian Meadows, Magalia ' Y+i • �i yF lj q�q Temp. Power Pole Called PG&E Temp. Elec. Serv. L5 -23' 79 ' Called PG&E }. Temp. Gas Serv. if Called PG&E JOB !y3 7 FINALED z� (Date) (Signal ) bC COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION REC..ORD. 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 + L 9 7 to Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Slab Prov. for physically handica edy Conformance of ex. structure Final Appliances Gas Piping & Test Temp. Gas Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fivhirac bond Beam I IFIRE SPRINKLERS I Motors Stucco Final Sub anels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service /37 Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DA TE REMARKS OR CORRECTIONS 9 ' -7 f �� .c e- �tJ� ! Co N N a cT 1 C Co>-®cr,v d is NA (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, 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 C *) -7-moi for the following location: 4/ a_x A u _ Owner Owner's Address v Mobilehome Mfg. �� ���_ -• ; .- Model —Year Insignia No. Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date 5 _ - By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED 9. • Electrical. . A. Is service Large enough to provide adequate ampc>rage ta. mubi? eliome. (must equal rating of mobilehome with a of 100 amp) and other faciliti_as on lot, i.e., water pumps, C,iraGe, cabana, etc.? Yes V" No 1� Is ther,-� proper clearances around panels? Yes No C. Is power supply cord or feeder assembly properly fused? Yes i No- D. Is continuity test satisfactory as per the following procedure? Yes i 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. Swi.rch gill breakers and switches in the mobilehome to the "on" position. 4. Connect one lo., -id of a test instrument to the mobilehome grounding conductor and , _. , . �j�Y1)' t't'�e Gi.t��'t i�au %o each niuul.�Citiiuie si,pp�y CuriuuuLGr, laic uulltg rLeui.ra'�. 5. All nor. -current, carrying metal parts of the mobilehome (aluminum siding, gas line, writer 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 i:ioirilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. ;.vi, Is job card signed by health Department for water and sanitation? 1.1. If everything (Alay, sign off card and tag services. MOBIL is i 1U! ^.LDATA Manufacturer and/or Namestyle Length 6,4 Width )- Vehicle Serial No. 7 T y7 State Identification No. 4&,litional Informar..ion or Comments: iiUt3.Ti,iliU:1G INSTALLATION INSPECTION CHECK LIST 1. Is the. mobilehome located wiji-required separation from lot lines and buildings and generally conform to plot plan? Yes ✓ No ?. Does the mobile -home have required clearances above ground? (Sec.5085) Yes _No 3. Are footing;s and supports properly sized, spaced, and braced as per 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 1% No 5. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes ✓. No' B.' Test - Does water piping withstand working pressure or 50 lbs, air test? Yes ✓ No C. Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes ""No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes ---No B. Does it have minimum 41' per foot slope and is it properly supported? Yes -- No C- Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes_,No r% D. If coach is not State 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 with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect: gas meter to mc�bilehorne with- connector, turn. on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yeses No COUNTY OF�BU*E — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Orovifle, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize repry ntatives of the County of Butte to enter upon the above-mentio d►property for ' ,'spection purposes. x Xa-l'- K Date Signature of Pe'rrmiteee or Agent' Receipt No. / 7 !J / X1 ' White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY ��.�Dal e S -17-7Z Building permit expires Date BUILDING Owner�� ����� SQ, FT. OCC. BUILDING VALUATION Mailing Address Telephone No. _ 9 Contractor ��� �' Fireplace Total Valuation - Mailing A dress �- yj� Permit Fee Plan Checking Fee &/or Penalty f C_CU . -/ Zele �nq.N�'; �fPErR�M, emt Address f �17t7t1Gt�j y1�62`t�� !ee�Building LUMBING No. @ FEE T FILING FEE $3.00 d/"o fi (p Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 9 .� - A. P. No. lJ Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe W. . -6effka4en Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma 60' R/W Improvements- Lawn sprinkler system 2.00 Bldg.`Pfans Recd ��'�P Parcel ppprovol PI pproval Permit Fee $ $ NEW ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 � � Q r ti-�l� Main service 600V OR 100 AMP ORLESS5.00 �. t 7 - Main service EA. ACO'L loo AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service 10 0 AMP OR LESS 25.IIR 600V 00 Main service EA. ADD'L loo AMP 1.00 NEW OR ADONST /DWELLING ACCBDGS.CCUP. &) 2¢sgft NEW CONSTR. MULTI -OUTLET NON-RESID, BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS &) NON-RESID. (SINGLE OUTLET CIR, CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: a > C it/0/a, �/��ltP Ex. Occup(OUTLETS OR FIXTURES)@Sa BAL@1 EX. QCCU FIXED APPLNS. OR P'(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities15.00 X10 y 2,v License No. 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 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby y��77 719 , e 1 t f0 ' 1j�(I. o e, TOTAL PERMIT FEE $����) 3_; authorize repry ntatives of the County of Butte to enter upon the above-mentio d►property for ' ,'spection purposes. x Xa-l'- K Date Signature of Pe'rrmiteee or Agent' Receipt No. / 7 !J / X1 ' White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY ��.�Dal e S -17-7Z Building permit expires Date A% COUNTY OF BUTTE — DEATMENT OF PUBLIC WORKS � 7 County Center Drive — (Poville, 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. Date 4— Signature of Permit e r 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 resolutions to do work indicated above for which fees have been paid. DIRECTOR 017�UBLIC WORKS uitding permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VAL ATION Mailing Address Telephone No. Fireplace Contractor co Total Valuation Mai Iing Address L 1)Permit ' Fee Plan Checking Fee&/or Penalty 1 T l ephone No. 4—.--- LO Permit Fee $ Building Address ` PLUMBING No. @ FEE PERMIT FILING FEE $3.00 ad ltJ _ Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1,648 v U� Zoning Verification Each gas water heater or vent 1.50 `` A. P. No. (O•- -ZoTrrn•g-&—P- nin Gas piping system 1 - 5 outlets 1.50 ach additional outlet .30 FW . I Fire Dept. Fire Zone Use Permit Building sewer �,pa EQA I Parking Plans Parcel Declaration` ce a 4!c p 60' R/W Im provem nts Lawn sprinkler system 2.00 Ions Recd For?el�fipproval Pia pproval Permit Fee • $ tcp $ r), NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service io00V OR o AMP ORSLESS 5.00 Main service EA. ADD•L 100 AMP 2.50 �, 5 Single Family Duplex Mobil Home Others 9 Y ❑ P ❑ ❑ Main service OVER 600V 25.00 10o AMP OR 0 AM Main service EA. ADD'L 100 AMP 1.00 IM SO ET MINIMI %A NEW CONS. DWELING OR ADDNST ( ACCLBLDGS. OCCUP. &) 12t sq ft NEW CONSTR. MULTI -OUTLET ( BRANCH CIRCUITS) 2.50ea FOR FOR MOBILES NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of C apter 9, Div. 3, of the State of Cali 'rnia Business & Profess* s Code under he name st le of Y e, License Nof Classification 5 Ex. Occup(OUTLETS OR FIXTURES) 50 BAL 20 109 FIXED APPLNS, OR Y . Ex. Occup. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 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. 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. 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 MECHANICAL No.1 @ FEEPERMIT 4h, FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ TOTAL PERMIT FEE $ authorize representatives of the county of Butte to enter upon the above-mentioned property for inspection purposes. Date 4— Signature of Permit e r 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 resolutions to do work indicated above for which fees have been paid. DIRECTOR 017�UBLIC WORKS uitding permit expires Date • N PERMIT NO. 2868-81B PERMIT EXPIRES Z13/r-7 OWNER KEN WATERS CONTR. owner ASSESSOR PARCEL 66-49-17 LOCATION 13644 Yahi Ct, lot 86, I.M.44,Mag h� Temp. Power Pole A�. Called PG&E • �'•Temp. Elec. Service Called PG&E {. Temp. Gas Servi¢ Cal led PG&E JOB IN LED (Date) _/ // "r Signature V = OK 0 = Not OK = Not Applicable MOBILEHOMES = Not Ready P MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s _Date DECKS, COV AR PORTS, ETC. (Plans) OK except #'s 1. Zoning Requirements—Setbacks—Easements 1— equirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch 2. ooti s; ' —Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete ec , Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4.r'rfood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows=Doors _- 7. Utility Clearance 7. Elec. Card -BI Card -BI ate Card -BI Date nx=E2to Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements—Setbacks—Easements Date POOLS (Plans) bK except #'s 1• Setbacks—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/O to Grade—HD Approval • 7• Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 9. Exits; Insp.—Sketch 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable RESIDENTIA1 (SiN'gl'e and Duplex) = Not Ready Date UNDERFLOOR Plans OIC except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except #'s 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except #'s 14. Water Ht.; Vent -Access -Combustion Air 57. Smoke Detector 58. 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 Card -BI Date Card -BI Date 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. 67. Elec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closer Date ELECTRICAL Perrt.it OK except #'s 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic E] Yes 73. Guard Rails &Deck Construction -Post Caps _ 25. 2 Appliance Circuits in Kitchen &Conductor Size 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes ❑No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. 30. Equip. Clearances; Panels-Motors-Mech. Equip. Clothes Closet Light -Shower Light 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except #'s 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. 86. Water & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates _ 32. 33. Vent Fan; Exhaust above Insulation 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 -BI Date Card -BI Date Date FRAMING(Plans) OK except #'s 36. Sills; Proper Material & Anchors Comments at Final: 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38 Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) _ 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing _ 42. 43. 44. Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat _ 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Windows or Exiting Doors -Sill Hgt. & Dimensions 47, _Bdrm. Garage Fire Protection Framing (NOTE: Anentry must be made each time you visit job site) COUNTY OF BUTTE,- DEPARTMENT OF PUBLIC WORKS PERMIT N 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-45 ' APPLICATION0AND PERMIT ASS S OR PARCEL NUMBER .• ,• ZONING BUILDING PERMIT OWNER / (�� l/�/sa7'�/LS ELEPHONE , �72 l SO. FT. OCC. BUILDING VALUATION � � v OWN 'S MAI LDDR ESS A 3 /`* Q t/ CONTRACTOR'S NAME O �• TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ rC 1, Filing Fee • $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ !® ARHIC TECT OR ENGINEER I/ • LICENSE NO. Plan Checking Fee .$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 3 a ^ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 1.0.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAM* fy /�l , PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE O STRUCTURE SF ❑ Duplex ❑ Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 5.00 L ..I TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe work: Permit Fee $ " Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 10001 OR 0 AMP ORLESS5.00 Main service EA- ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.51) OR ADDNS. ACC. BLDGS. 2¢sgft 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 ' I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR -OU LET 2.50 ea NON-RESID BRANCH CIRCUITS) NEW CONSTR POWER APPARATUS tr NON-RESID. (,SINGLE OUTLET CIR. so@2g¢ Ex. Occup OUTLETS OR FIXTURES BAL@1 Ex. OCCup.(OUTLETS P(RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ i have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify a eep,harmless the County of Butte against all liabilities, ju ents, costs, an exp nses which may in any way accrue against i Co ty i "nse uenc f e ranting of this perm'• 01 X Date /� Signature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ o ---, occuP. GROUP M TYPE OF CONST, PARCEL PD HO ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT " PUBLIC BY PERM EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date —yq� p `3/stories Receipt No. � Y oo WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT