HomeMy WebLinkAbout069-100-038El
6
log -•/D- 38 A.P. _
VIRGINIA YULTHO �Q.2 ��- 7
18 Greenbrier Dr K.R.,�Oroville
Permit 3401-73P, (utilities for MH)
A. P.
W. E. FULTHORP
18 Greenbriar, Orovil.le
Kelly Ridge Lot
Permit 2246-74B 7(eck & Awning`
for MH)
_ AP-.
FULTHORP , W.E.
18 Green Briar, O-r-ovi1=1- 1 lot -2#6
Kelly Ridge
>Pemmit # 2444-74B C
(metal _ storage. _shed,-.MH)�
Cgn4j r j 6r _ n 3 0�5
Cont: ,-,,.L...• lRY
%�Prmi_t-.ikl_SaL-87B_(_onen deck/M) - �
69-10-38 2630-91B
LESSA, Sandy 9.)
18 Greenbrier Dr, Orovil_le (� f
(add to deck/sf) 1 .
069=100-038 06-0915
PLATT & HARRASSEN,.
18 'GREENBRIEN DR, OROVILLE
Cont: CHICO M.H.S
M/H PERM FND (EX) '
911
048
19
RECORDI4ftEQ ESTED BY:'
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
2006-0022857
Recorded I REC FEE 10,00
Official Records I
County of I CONIES 2.50
But I CONFORMED COPY 1.00
CANDACE J. GRUBS I
County Clerk—Recorderl
1
i DD
IN:039N 04-fty—M i Page 1 of 2
IIII ISI III � II�' � III ISI I III "I'I I'I
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.
RHONDA PLATT AND IAN HARASSER
REAL PROPERTY OWNERILESSOR
603 CRYSTAL DRIVE
MAILING ADDRESS
EAGLE POINT JACKSON OR 97501
CITY COUNTY STATE ZIP
18 GREENBRIER DRIVE
INSTALLATION MAILING ADDRESS, IF DIFFERENT -
OROVILLE BUTTE CA 95966
CITY COUNTY STATE ZIP
SAME
UNIT OWNER (if also property owner, write "SAME")
SAME
MAILING ADDRESS
SAME
CITY COUNTY STATE ZIP
UNIT DESCRIPTION
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
OROVILLE BUTTE
CA 95965
CITY COUNTY
STATE ZIP
06-091
530 538-7541
BUIL RMIT N
TELEPHONE NUMBER
49 :3 i 4-
SIG AT A AGENCY OFFICIAL
DATE
NO `
DEALER NAME (if not a dealer sale, write "NONE")
NONE
DEALER LICENSE NO.
SKYLINE HOMES 1973 UNKNOWN
MANUFACTURER'S NAME . DATE OF MANUFACTURE MODEL NAME/NUMBER
2173S4170U/X 60'X 24' 128447/8
SERIALNUMBER(S) LENGTH X WIDTH INSIGNIAILABELNUMBER(S)
REAL PROPERTY LEGAL DESCRIPTION
SEE ATTACHED
ASSESSOR'S PARCEL NUMBER 069-100-038
HCD FORM 433(A) REV. 8/91
WHITE- County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept.
RECORDING REQUESTED BY: MID VALLEY TITLE COMPANY
Order No.
Escrow No. t 55 169-3AM 96-0-3207 1
t
Loan 1\11o.
WHEN RECORDED MAIL TO: Oro -G
RANDY D. AND CHARLOTTE GILMORE
18 GREENBRILR DRIVE
OROVILLE, CA 95966
I
Recorded 1
official Recorda I
County of 1
Butte 1
Cdhdace J. Grubbe 1
Recorder 1
8:OOam 29 -Aug -9h I
DOCUMENTARY TRAN%FER TAX 5...6.6..9.0.0... ,.tndb.LJe.........
.RgComputed on the oonsiderntlon or value of proporty conveyed; OR
...... Computed on the consideration, or value less liens or encumbrances
remaining at time of sale. .
AP# 069-100-038
SPACE
Rec Fee 6.00
DOC 66.00
Check 72.00
MVTC CA 1
FOR RECORDER'S USE
THE UNDERSIGNED DECLARES
Signature of DWwM or Agent determining tax — Firm Name
GRANT DEE®
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
SANDRA LESSA, A MARRIED WOMAN AS HER SOLE AND SEPARATE PROPERTY
hereby GRANT(S) to
RANDY D. GILMORE AND CHARLOTTE A. GILMORE, HUSBAND AND :FIFE AS JOINT
TENANTS I
Corr. ;
the real property in the 12JXR L UNINCORPORATED AREA
County of BUTTE — ---i State of California, described as
.LOT 266, AS SHOWN ON THAT CERTAIN MAP ENTITLED. "KELLY RIDGE ESTATES UNIT
ONE", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF
BUTTE, STATE OF CALIFORNIA, ON OCTOBER 30, 1970, IN BOOK 38 OF MAPS,, AT
PAGE (S) 5 THRU 10.
CERTIFICATE OF CORRECTION RECORDED MARCH 17, 1971, IN BOOK 1663 PAGE 624
OFFICIAL RECORDS.
Dated JULY 3 1 , 1996
}' RA LESSA
STALE OF CAt RMMA— ARIZONA )ss.
COUNTY OF PIMA }
On AUGUST 12TH , 1996 before me,
BABETTE M CLARK
personalty appeared SANDRA LESSA
personalty known to me (or proved to me on the basis of satisfactory
evideno^) to be the person (s) whose name(s) Islare subscribed to the withl.i
Instrument and acknowledged to me that ho/sho/they executed the same
In hlsIh&Aheir authorized capactty(�es), and that by hle/herRheir signa-
tures) on the Instrument the person(s) or the entty upon behalf of which
the person(s) acted, executed the Instrument.
WITNESS my hand and official seal.
Signator�# lMe Lt'
MAIL TAX STATEMENTS TO:
SAME A,S ABOVE
OFFICIAL SEAL
oggnt Qq)BABETTE M . CLARK
NOTARY PUBLIC - ARIZONA
PIMA COUNTY
Mr Coes . Eapkes May 1 , 2000
(rMa area for official notarial soaq
1002 (1/94)
r
RECORDING REQUESTED BY:
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE CA 95965
COPY of Document Recorded
4 -Play -2006 2006-0022857
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 Wall persons thereafter dealing with the real property.
RHONDA PLATT AND IAN HARASSER
REAL PROPERTY OWNER/LESSOR
603 CRYSTAL DRIVE
MAILING ADDRESS
EAGLE POINT JACKSON
OR 97501
CITY COUNTY
STATE ZIP
18 GREENBRIER DRIVE
OROVILLE BUTTE CA
INSTALLATION MAILING ADDRESS, IF DIFFERENT
CITY COUNTY STATE
v
OROVILLE BUTTE
CA 95966
CITY COUNTY
STATE ZIP
SAME
:dlo
UNIT OWNER (if also property owner, write "SAME")
DATE
SAME
MAILING ADDRESS
SAME
CITY COUNTY
STATE ZIP
UNIT DESCRIPTION
BUTTE COUNTY BUILDING DIVISION
LOCAL AGENCY ISSUING PERMrf and CERTIFICATE OF OCCUPANCY
7 COUNTY CENTER DRIVE
MAILING ADDRESS
OROVILLE BUTTE CA
95965
CITY COUNTY STATE
v
ZIP
06-091 530
538-7541
B RMIT N TELEPHONE NUMBER
:dlo
SIG A 0 AGENCY OFFICIAL
DATE
NO
DEALER NAME (if not a dealer sale, write "NONE")
NONE
DEALER LICENSE NO.
SKYLINE HOMES 1973 UNKNOWN
MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMEtNUMBER
2173S4170U/X 60'X 24' 128447/8
SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S)
REAL PROPERTY LEGAL DESCRIPTIO ASSESSOR'S PARCEL NUMBER 069-100-038
SEE ATTACHED
HCD FORM 433(A) REV. 8/91
WHITE- County Recorder CANARY - HCD PINK - Applicant GOLDENROD- Building Dept.
FOUNDATION SYSTEM
CERTIFICATE OF.00CUPANCY
BUILDING PERMITS NUMBER: 06-0915
Address or location of unit: 18 GREENBRIER DRIVE, OROVILLE CA 95966
Legal Description of Real Property: 069-100-038
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: RHONDA PLATT AND IAN HARASSER
Owner's address: 603 CRYSTAL DRIVE, EAGLE POINT, OREGON 97501
INSIGNIA OR HUD NUMBER: 128447/8
SERIAL NUMBER OR V.I.N.: 2173S4170U/X
MANUFACTURER'S NAME: SKYLINE HOMES YEAR: 1973
OFFICIAL APPROVING INSTALLATION:
DATE: :'2 b�
PHONE: (530) 538-7541
H.C.D. 513C
a: _ ? `J t r
RECORDING REQUESTED BY: MID VALLEY TITLE COMPANY
Order No.
Escrow No. 155 169-3AM 96-0320711
Z loan Nlo.
WHEN RECORDED MAIL TO:
RANDY D. AND CHARLOTTE GILMORE
18 GREENBRILR DRIVE
OROVILLE, CA 95966
I
Recorded I
Official Record3 I
County of I
Butte I
Cdhdace J. Grubbe I
Recorder I
S:OOam 29 -Aug -96 1
Rec Fee
DOC
Check
HVTC
6.00
66.00
72.00
CA 1
DOCUMENTARY TRANSFER TAX $...6.6....&0.. ,.tnob..Je......... SPACE ABOVE THIS LINE FOR RECORDER'S USE
.RgComputed on the consideration or value of proporty conveyed; OP.
...... Computed on the consideration, or value less liens or encumbrances THE UNDERSIGNED DECLARES
remaining at time of sale.. Slgnarirre of Declarant or Agont determining tax — Firm Name
AP# 069-100-038. DEE® . ..
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
-SANDRA LESSA,:A MARRIED WOMAN AS HER SOLE AND SEPARATE PROPERTY'
hereby GRANT(S) to
RANDY D. GILMORE AND CHARLOTTE A. GILMORE, HUSBAND AND :LIFE AS.JOIN7
TENANTS
the real property in the>C21KAM UNINCORPORATED AREAExqg
County of BUTTE . ----j State of California, described as
LOT 266, AS SHOWN ON THAT CERTAIN FLAP ENTITLED. "KELLY RIDGE ESTATES UNIT
! ONE', WHICH NAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF
BUTTE, STATE OF CALIFORNIA, ON OCTOBER 30, 1970, IN BOOR 38 OF MAPS., AT
PAGE(S) 5 THRU 10.
CERTIFICATE OF CORRECTION RECORDED MARCH 17, 1971, IN BOOK 1663 PAGE 624
OFFICIAL RECORDS.
Dated ` JULY 3 1 , 1996
STATE OF CAWWRGIIA.- ARIZONA }
}ss.
COUNTY OF _PIMA }
On AUGUST 12TH , 1996 before me,
BA9ETTE M CLARK _
personally appeared SANDRA LESSA'
personally known to me (or proved to me on the basis of satisfactory
evidence:) to be tho person (s) whose name(s) Is/are subscribed to the within
Instrument and acknowledged to me that ho/shoAhey executed the same
In hlslh&/their authorized capecity(ies), and that by his/herAheir Signe-
ture(s) on the Instrument the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signatyr
MAIL TAX STATEMENTS TO:
SAME AS ABOVE
RA LESSA
OFFICIAL SEAL
BABETTE M . CLARK
NOTARY PUBUC - ARIZONA
PIMA COUNTY
Ill Coag . Eapku key t i 2(100
Mgs arae for oflldal notarial soa11
1002 (11134)
..
Butte County Department of Development Services. 0a7%c aREw
N O T C S 7 County Center Drive, Oroville, CA 95965
(530)S38-7601 - vr+nv.(7uttecountyneVdds coow<y• I
f
RESIDENTIAL
APN:
Permit No.
Owner
069-100-038 06-0915
PLATT & HARRASSEN,— — M
Site Address:
j
18 GREENBRIEN DR, OR_OVILLE
j
_
Cont: CHICO M.H:S ' p
Contractor.
KM/H PERM FND (EX)
r
Type of Permit
�. . - -. _ _ _ _
CONDITIONS -
CHECKED BY
SRA
FLOOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUBSTANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
DATE JOB FINP.LED:
1'
SIGNATURE: �'M
= OK
Not OK
MANUFACTURED HOMES
- MISCELLANEOUS
DATE PERMANENT FOUNDATION SOFT -SET
1 Zoning -Setbacks -Easements
2 Soils; Special MH Support Sketch
3 Sewer; Loctn-Test; FalUC/O-Concrete
4 Wtr; Loctn-Test-Easement Needed -Regulator
5 Elec Loctn-Clrncs-Grnd Amp -Concrete
6 Yard Gas; Loctn-Test-Wrap . Nat Q or LP❑
Inch Sz Ft Lngth
7 Blckng; Sz-Spacing-Marriage Line
8 Gas; MH Test-Demand-Valve-Cnnctr
9 Elec MH Cntnty Test-Crossovers-Breakers-CIrncs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -C/O to Grade
12 Gas and Electricity Tagged
13 Tie Downs Q Foundation 0
14 Exits
15 Cert of Occupancy
16 HUD LabeUlnsignia Numbers Serial Numbers
DATE D E C K S'C O V E R S`C A R P O R T S 'GARAGE S
i Zoning -Setbacks -Easements
2 Ftgs; Soils-Sz-Dpth-Spacing-Cnnctrs-Steel
3 Decks, Girders/Joists-Dcking-Brcing
Stairs-Guard/Handrails
4 Wood Awn; PostsSeams-Rftrs-Cnnctrs-Shthg
Frmg-Brcng
S Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs
6 Carports; Wndws-Doors
7 Electric
B Frmg; Sills-Anchrs -Studs -Rftrs-Trusses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof; Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wall pnls
y e s`
lie
DATE . POOLS
1 Setbacks -Easements
2 Soils; Compaction -Structure Stability
3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptcls/Lting; Distance-GFI
5 Elec Pool Lting; 15 volts-GF1
6 Elec Enclsrs; Conduit Entries -Terminals -Listed
7 Elec Bonding; Metal w/5'-Crcltng Egp-Htr
8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool lghtg
Bokes-EncisrsTrilboards-Insultn to Main Conduit
9 Health Dept Apprvl
10 Plmb; Cir Test Wtr Supply Test
11 Lt Niche
12 Enclsr, Fencing Alarms
13 Bonding, Diving board or Slide
r s�
Pool Drawing
= OK
= Not OK
RESIDENTIAL (Single. & Duplex)
DATE JUN. DERFLOOR
1 Zoning -Setbacks -Easements -Flood -Slope
2 Ftg Main; Soils-Elec Grnd Ftg Dpth
3 Fig Garage; Soils-Steel-Elec Grnd Ftg Opth.
4 Ftg Porches/Decks; Soils -Steel Ftg Opth
5 Stemwalls Main; Steel-Blockouts-Wrapped
6 Stemwalls Garage; Steel-Blockouts-Wrapped
69 Hold Downs and Special Anchrs
7 Slab, Steel Wrapped
8 Piers-Frplc FtgSteel
9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
tt Wtr Pipe; Test-Anchrs-Rgltr-Service Test
12 Elec Undrgrnd
13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn
14 GirdersSills-Anchr Bolts Joists-Vnts-Cripples
15 Acc & Vntltn
16 Insulation
C
DATE (FRAMING
17 Sills Proper Materials & Anchrs
18 Walls Studs -Nailing Spacing & Braces-PlatesSound
19 Bearing Walls over Girders & fir Nailing
20 Draft Stop in Walls (rat proof)
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
22 Headers & Beams-Sz & Bearing
23 Hangers -Post Caps-Anchrs-Cnnctns
24 Ceiling Joist-Rffr Ties-Purlin-Roof Brac TrussShthg
25 Frplc Ties or Type A Flue-Frplc Throat Clmc
26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
28 Garage Fire Prtctn Framing -RC Channel
29 Prprty Line Firewall & Opngs
30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits
31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn
32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs
33 Siding -Nailing Veneer
34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc
35 Glazing Area -Glass Prtctn-SkyUs-Plastic
36 Shear Walls; Nailing -Bolts
37 Brace Int/Ext Wall pnls
38 lnsultn-W alts -Ceilings
39 Infiltration -Walls -W ndws
s`
DATE JELECTRICAL
40 Fxtr & Tmsfrmr Clmc4ns Prtctn
41 Elec Rcptcls Spacing-Lts & Switches at Doors
42 Sz Boxes & No Of Cndctrs Stapled
43 Romex Installed Close to Edge of Studs & CJ
44 Eqp Grnd made up w/Mech Fstnrs
45 Grndng Electrode Bond Gas & Wtr
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
47 Subfeed Wire Sz 9a ❑CU orQAL
AC Wire Sz 9a ❑ CU or M AL
48 Range Circ ga MCU or MAL
'Oven Circ ga M CU or Q AL
Insulated Neutral 0 Yes M No
49 Service -Riser Cndctrs & Grnd Main Dscnnct
50 Eqp Clrncs pnls-Motors-Mech Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
DATE IPLUMBING
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
54 Wtr Pipe; Test & Anchr-Nail Prtctn
55 DWV; Test Fittings & Anchr Nail Prtctn
56 Shwr Pan; Test, First fir -Tub Acc
57 Test Tub & Shwr, 2nd fir - Tub-Acc
58 Gas Pipe; Sz & Anchrs
59 Fire Sprinkler; Test
60 Yard Gas Piping
41
DATE IMECHANICAL
61 AC Ducts Insulin & Support
62 Vent Fan, Exhaust abv Insulin
63 Condensate Drain & Ovrflw, Sz & Grade
64 Furnace -Vent Acc-Comb Air RtrnfVent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
'e 4
DATE IFINAL
66 Ext Steps -Door & SideLt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-CImc-Comb, Air-Cnnctr
In Garage; abv-fir-Ducts-Mech Prtctn
69 Bedroom Exiting
70 GFl & Bath Fxtrs & Tub Acc-Spa
71 GA Arc Fault
72 Elec Trim & Subpnl, Breaker Sts & Labels
73 Stairs, Guard/Handrails
74 Frplc or Stove, Clmc-Hearth
75 Elec Outlets at Wood Pnl, Int & Ext
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking CImc
T7 Elec Outlets & Rcptcls at Ktchn Counter
78 Garage Fire Door, Swing -Landing -Closure
79 AC Duct in Garage -Damper
80 Wtr Htr; Vnts-ClmcCom Air Cnnctr-PRV; abv fir
Mech Prtctn; LPG Appince Undr House 3" drain
81 Plmb; Elec & Mech Eqp Listed for Lottn
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
83 Insultn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Clrnc Drnge Planters MYes MNo
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Plmb
89 Vnts abv Roof, Plmb-Appinc-Frplc-CImc: to Opngs
90 Wtr Well, Dscnnct, Elec, Plmb
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
92 Vntitn thru House
93 Glass Prtctn
94 Corrections from previous Inspctns
95 Gas Test -Meters Tagged, Gas-Elec
96 Wtr & Sewer Cnnctd-010 to grade -HD Apprvl
97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99. Fire Sprinkler
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP060915
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 04/26/2006 APN: 069-100-038-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
.the Business and Professions Code, and my license is in full force and
effect. �'YS/o3
Site Address: 18 GREENBRIER DR ORO
License Class : (_� L umber:
Date: y Z6�?- Contractor:
Map Index:
Description: EX MH ON PERM FND
DECLARATION
OWNER-BUILror
I hereby affirm under penalty oerjury that I am exempt from the
Contractors' State License Law the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: PLATT, RHONDA & HARASSER, IAN
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
603 CRYSTAL DR
the Contractor's State License Law (Chapter 9 commencing with Section
EAGLE POINT, OR
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
97501 -
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: DOREMUS, GERALD GLEN
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
P O BOX 4121
sale. If however, the building or improvements are sold within one
CHICO, CA 95927-4121
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
530-895-1774
sale.).
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
Contractor: DOREMUS, GERALD GLEN
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
P O BOX 4121CH
❑ I am Exempt under Article 3 of the Business and Professions Code
ICO, CA 95927-4121
Date: Owner:
530-895-1774
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #: 445103
❑ 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.
Architect:
❑ I have and will maintain workers' compensation insurance, as
Engineer:
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Total Square Ft: 0 S. F.
Policy #:
Q 1 certify that in the of the work for which this is
Valuation: $0.00
performance permit
Census Code:
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
s�
Date:
Applicant:
WARNING: F lure to secure workers' compensation coverage is/
// /n/
unlawful, and all subject an employer to criminal penalties and one
/�►
hundred thou and dollars ($100,000), in addition to the cost of
compensatio , damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
/ m ,j��
�! q4
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the able • rovisions of the Butte County Code and/or
Resolutio to do indicated for /hich have
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)VF
ark abo a ees been paid.
Name:
BY / Date:
PERMIT EXPIRES ON:��(/)
Date
Address:
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the own or the du y authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the su stan a of an official form or document of Butte County. I hereby
authorize representativ sof Butte County to enter upon the above mentioned property for inspection p se
Print Name: �%fF/�'� l/ Signature: r.�
�Z /
Date: ,o L/
❑ Owner ontractor Agent for Owner ❑ Agent for Contractor
B. C. Building Permit 01-16-04 pg 1
1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING'PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
APPLICANT INFORMATION
OWNER INFORMATION
Last Name
�Pat?I1�
first Name
Address , o
C11ST,QL
Ciiy,
O 7*a
State��
Zip
Phone
Fax
Fax
E-mail
State License Number
APPLICANT INFORMATION
CONTRACTOR
Name
-
Address
CU
Address
`O - 1- Z
City
G
State
Zip
Fax
r o
Planner
State License Number
Phone
S 7 7
Fax S /77-/
.77-/
E-mail
Lic. .S�o3
Clar
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Book
Fax
E-mail i
Planner
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
—`fCANTSIGNATURE
__W - MAW���
For offic useOnly:
Zoning
Pro erty Address <-
" Q i✓s>
Flood Zone
I
SiiAT
Yes INo
Carrier
Occ.
Type Const.
Subdivision Name Map
Book
Page__j
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
BP6P
BIN #
PROJECT LOCATION
Pro erty Address <-
" Q i✓s>
Cit
�l/i �L
Cross Street
WORKE 'S COMPS SATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Page 1 of 2
Description or Scope o Work:
d :Q
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: `•/DSD r'` Amount: Bldg
CC,,��
L� SRA
Receipt #: q Go I I � Sheriff
SMIP
Date: #/� 0(, Other
ii J_19 -42(n Total
REV 8-12-05
A
SUBMITTAL & PERMIT,REQUIREMENTS.
The following drawings and specifications must be submitted to the Building Division in order to apply for a
`permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3. California Department of Forestry plan approval (if required).
❑ 4. NPDES Form.
❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6. Contractor's license information. (Number, Name Style, Classification).
❑ 7. Worker's Compensation Carrier and Policy Number.
❑ 8. Owner -Builder Verification (if required).
❑ 9. Letter of Signature authorization (if required). ;
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑ 12. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
�,'REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permitsArefwids'can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
www.buttecounty.net/dds
OVINER: ` A _
OQ -O�
Proposed Building Use: Permit Technician: Date:
Items required in order to apply for a permit. All boxes FVST be checked OR marked NA in order to apply.
1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxesl
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
8. Manufactured homes: (A) Inelallation mential, ' fo n or fnd plans, all in
duplicate.
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate.
❑ 11. Hazardous Material Form.
❑ 12. Acknowledgement of building permit application without required clearances.
❑ 13. Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑. 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable
❑ 15. Fire Sprinklers
❑ 16. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office
❑ 17. Soils Report and/or Engineered Foundation required.
❑ / 18. Erosion Control Plan Required.
Ci 19. Fees as shown on the attached Schedule of Fees Due Sheet. 3�f
.4?
❑ 2 . City of Chico Plumbing permit.
❑ 21. Site plan and business license approval from the City of Biggs.
❑ 22. California Department of Forestry plan approval ❑ paid.
❑ 23. Planning approval for (A) Use: (B)Parking: (C) Parcel Check:
❑ 24. Contact Land Development about _ Improvements, _Drainage.
❑ 25. Fire Marshall Review (commercial projects only).
❑ 26. NPDES Form
❑ 27. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 28. Contractor's license information. (Number, Name Style, Classification).
❑ 29. Worker's Compensation Carrier and Policy Number.
❑ 30. Owner -Builder Verification (_ Given to owner, _ Mailed to owner).
❑ 31. Letter of Signature authorization.
❑ 32. Recorded copy of Agricultural Acknowledgment Statement.
❑ 33. Existing violations and/or expired permits..
❑ 34. Deed Restriction.
-TV7 35. -.J�egal description'M H. Title, title search, registration or MCO
❑ 36. Other:
❑ 37. Other:
When issued Telephone b 77 7 and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant:
Date:
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one-year after date.of application. In order to renew action on an application after
expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee
payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be
made if no construction work has been done. Filing -fees, plan check fees, and other department costs are not refundable.
Original -Applicant
K/Building/Plan Check/Data Sheets/data sheet page 19.27.05
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION "
_ 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
#
OWNER: TLt V- ASSESSOR PARCEL NUMBER Q loo v
Proposed Building Use: �� ,// 1 Permit Technician: Date: '11,2 a
Items required in order to apply for a permit. II boxes M„ UST be checked OR marked NA in order to apply.
1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxesl
❑ 5: Letter from Engineer or Architect for truss design review.
❑ 6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
8. Manufactured homes: (A) InstallatiewmantmHneleding-rnamiage ' e info C).F.I.00LWaRr(g)-�Pe.dQwn or fnd plans, all in
duplicate. ,
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate.
❑ 11. Hazardous Material Form
❑ 12. Acknowledgement of building permit application without required clearances.
❑ 13. Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable
❑ 15. Fire Sprinklers............................................................................................
❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ 17. Soils Report and/or Engineered Foundation required ..........................................
18. Erosion Control Plan Required ..........................................• -��--
19 Fees as shown on the attached Schedule of Fees Due Sheet.:
❑
20. City of Chico Plumbing permit................................................................
Cl 21. Site plan and business license approval from the City of Biggs.......... .....................
+' ❑ 22. California Department of Forestry plan approval ❑ paid. Sent by: .............
❑ 23. Planning approval for (A) Use: (B) Parking: (C) Parcel Check: ............
❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................
❑ 25. Fire Marshall Review (commercial projects only). Sent by: ......................
❑ 26. NPDES Form.............................................................................................
❑ 27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Contractor's license information. (Number, Name Style, Classification): ..................
❑ .29. Worker's Compensation Carrier and Policy Number ..........................................
❑ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .....................
❑ 31. Letter of Signature authorization ......................................... .j...
....................
❑ 32. Recorded -copy of Agricultural Acknowledgment Statement ...... :......... :................
❑ 33. Existing violations and/or expired permits.........:..............................I.................
❑ 34. Deed Restriction..............::........................................................:........
_15' 35. -&Legal description; C M.H. Title, title search, registration or MCO..... .:'..
❑ / 36. Other:
❑ 37. Other:
When issued Telephone b 15�5_" % % `7- and hold for pickup. +
I have been informed of the above items and requirements for obtaining a building permit.
Applicant: - Date:
1. Index permit application for the above items numbered: + Plan Check Letter
2. Additional. items required
Co, _ _ ., __•_,
ntractor, designer; ovuner;'was advised of the above data by ❑ `phone, 0 mail' `l7 counter, by bate:
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, owner was advised of the abo a Pata by ❑ phone, ❑ mail, ❑ counter, by Date:
Plans reviewed by: Date: 2 06 Plans approved by: Date;
Structural reviewed by: Date: Structural approved by: Date:
Note transfer by: . -�� Date: L D6 # �.'•
Yellow: Building
�l K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05
301 Hillcrest Street
Ashland, OR 97520
F 3 20 7/
Di)l
Creel: Falls Investments,
LLC
To: Jerry Doremus From: Ian Harrasser
Fax: (530) 895-1774 Pages: 10 (including cover sheet)
Phone: (541) 324-3185 Date: 4/18/2006
Re: Grant Deed & Title Info. CC: NIA
Jerry,
Per our conversation today I would like to have you do the work in putting the foundation under the
mobile home located at 18 Greenbrier Drive in Oroville. I have your original bid to Randy in the
amount of $2,500.00 for the labor, materials, and permits necessary to complete the job. Please fax to
me a current bill in the same amount with my name on it for my tax records. Also, here is the contact
information for the Gilmores so you can coordinate your schedule with theirs.
Randy & Charlotte Gilmore
Home: (916) 218-6073 .
Randy's cell: (530) 624-4070
Thank you,
Ian
(541) 324-3185
If you do not receive all the pages sent pertaining to this fax, Please call me at my number listed above.
Also, if you have received this fax in error please call me at my number listed above and destroy this
fax immediately.
T •d S6i0-zee [ IbSI jassejJeH-....... el[):oT 90 Bi Jdd
And when recorded mail to: R EA
Name �, 1�honA Fl171 S'NE
Address 'Flo. t�, ✓X 3-73
Zip
L
J
Official yyRecords I TAX 11.8@
AND APPROVED CQ58
Butteot i PMR-PRELININAR MIN
MMNM L GRUBBS i PENAL -N PER PAGE LIN
County Clerk-Recorderl
I
Iw
012-- 27 -Jan -M I Page i of 2
Space above this line for recorders use
GRANT OR WARRANTY DEED
wve, �ord� Cr%aa�r� & CHo.r%ott� Gi�MorP_
NAME OF f,RM roNs)
residing or having a principal place of business at S G re 2 rt d r r P r �7r d ro vi It �, Cod 95 6 6
for and in consideration in the sum of $ dollars, in hand paid, receipt of which is hereby acknowledged,
CF.arar a c: O
&jaresz^ un JoC!rk!:,`
has granted, bargained, said, conveyed, and)(does or 0 does not warrant the title against all persons whomsoever to
1?hor,da P!Atf -.7 nn
NAME OF GRANTEEts) j
resiting at or having a principal place of business at 603 C r S fa f Drive ' LEgale- l� P�� �� ` 09
all that real property situated in the City of ro Vi U e (or in an unincorporated area 00
Baff-e County, State of G��: r-� da , described as follows:
INSERT LEGAL DESCRIPTION
WT.'.266,.:.AS.•.�.'�►r' Os gtlzrE:S'r�s:°� tia;i.)ZZQ1�i?A:
30 ,1170 fi>CM•• t rri►F&
.,'>000log: Mom ��1Z:7
0/yy'%/e. CA
Assessor's parcel No. 6169_111110_031q_-000
Dated ��mErrr l `5,
at Oro 1/i 11f' Ca 1. 1 'Fo r17 /cz
CrrY AND STATE
Mau Tax Statement to: K h olia t
Po 3?3.
rri-Fo r d
Neither Wolcotts, Its resellers nor agents makes any representation
or warranty, express or implied, as to the fitness of this form for
an intended use or purpose. if you have any concerns, consult
an attorney before using this form.
G►I'm f;:f -e
Ura r
6*1 kmo.'�e
DQCUMENTARY TRANSFER TAX 5 1 t ' y"
Computed on full value of property conveyed. or
❑ Computed on full value less liens and encumbrances remaining at time of sale
❑ Exempt -
Autograph of De or Agent Determining Tax
Firth Name
\ C2004 WOLCOTTS FORMS, INC:
t�
7 67775 00778 7
CLAc-s 03 #778 REV. 2-04
z•d S6i0-z6� (T4Sl jasseijeH e2o:ol 90 81 aclu
Mul2MMUdl
STATE OF
COUNTY OF u i' SS.
On this ��day of a in the year» , before me,
a Notary Public, duly
commissioned and qu died in above said Coun a d t
e.
personally appeared '�� ��
0 personally known to me or�proved to me on this basis of
satisfactory evidence consisting of an identifying document or
o the oath of to be the
person(s) whose name(s) is/are subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in
histher/their authorized capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s) or the entity upon
behalf of which the person(s) acted, executed the same.
WITNESS my hand and official seal.
AUTOGRAPH
Corporate or Partnership
STATE OF
SS
COUNTY OF
On this day of in the year before me,
a Notary Public, duly
.commissioned and qualified in above said County and State,
personally appeared
0 personally known to me or 0 proved to me on this basis of
satisfactory evidence consisting of an identifying document or
O the oath of to be the
persons) whose hame(s) Ware subscribed to the within instrument
and acknowledged to me that helshe/they executed the same in
his/her/their authorized capacity(ies), as .
and that by hislher/their signature(s) on the instrument on behalf of
a
organized under the laws of
executed the same.
WITNESS my hand and official seal.
AUTOGRAPH
g•.d SSTO-28b (1�1S)
M. E. CHATMAN
Commission 81366761
Notary Public - Calitomia
Contra Costa A a:4
My Comm Expires
jassej.jeH e20:o' 90 Bi ,,dd
JAN -31=1999 10:09A FROM: TO:48MI95 P:4,,5
Rhonda P—lafr Ian Harrasser
ADDRESS: 16 Greenbrier
Oroville, [A 95965
r •'S
a
page 4 of 4
0T'd S6T0-Z6*, (TbS) jassejjeH eb0:0T 90 ST -idH
Xi2 Foundation System
Installation Instructions for California
for Ground & Concrete Systems
HUD Wind Zone 1,
15 PSF Wind Load Seismic 4
By Tie Down Engineering
Xi2 Concrete System
Engineer Approval
State Approval
MANUFACTURED HOME/MOBILE HOME
FOUNDATION SYSTEM
IMAL=AND SAFETY CODE, SECTION 18551
APPROVED
SIIB = TO CORRECTIONS NOTED
APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY
O 4MMONS OR DEVIATION FROM REQUIREMENTS OF
APFLWAOLB STATE LAWS AND REGULATIONS
Somme of Califomis
GfRousinS
c
BUTTE COUNTY
BUILDING DIVISION
AND STANDARDS
.
E°.
i GA, 30336 , _ _ _TIE -
X12 Foundation System
Installation Instructions for California
, , for Ground & Concrete Systems
HUD Wind Zone 1,.15 PSF Wind Load Seismic 4
By Tie Down Engineering
REQUIREMENTS
• These plans and specifications meet the requirements of Title 25 Section 1336.3 Sub Section A
and 97 UBC Seismic Requirements, CBC 2001 addition.
• Maximum vertical projection at sidewall is 9'. Higher walls may be used when the design loads are
adjusted accordingly and approved by HUD.
• Main rail spacing must be 75.5""- 99.5" * Except single sections 95" minimum
• Additional vertical anchor ties that are unique to,a home's design may be required by the home
manufacturer: These locations may include shear walls, marriage line ridge beam support posts, and rim
plates. The longitudinal component of the Xi2 system replaces end frame ties. Check manufacturers
set-up requirements.
• Maximum pier height is 48" pier. *Except for single sections 36".
• Steel piers must be fastened to the I-beam with clamps provided with steel pier.
• Systems must be placed as evenly as possible, no more than 10' from end of home.
• Designed for 7:12 roof slope. *Except single sections, (20° - 4.37 in. 12" pitch).
Additional Requirements for Concrete Systems
• Poured concrete must be 2,500 PSI minimum at 28 days.
• Square concrete pads minimum is 18" wide by 12" deep. Round concrete pads minimum is 18" wide by
14" deep. Strip footings minimum is 18" wide by 14' long by 6" deep. Mal> -j
✓7
* Xi2 components exceed HUD code 3280.3068 "Anchoring equipment exposed to weathering sha1I have+a�
resistance to weather deterioration at least equivalent to that provided by a coating of zinc on steel of not
less than 0.30 ounces per square foot of surface coating...." Page 2 of 8 0
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DATE: WIM/fU8-151
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' R ADOVE MAY NOT .REFLEC'T ALL LIENS RECORDED WITH THE0300205
THE ONNER LNFORMATION SNOH10
DEPAR7MEKT OF HOUSING Al19 TME UNIT PAYE BEP CONFIRMED TTMRO�HATH�RDEPARTMENT
,1 THE -CURRENT TITLE STA
TUS
b'd S6T0-Z64 r(TbSI. �assejjeH eZ0=0i 90 8T Jdd
MMPARY� polio, Nurmper: 103 - 0642485734. - 02
AMO M9A6. �A(d110�N
A Stodt OOPWPr
MOBILE HOME
DECLARATIONS PAGE
YOU AS NAMED INSURED AND YOUR ADDRESS:
RANDY D GILMORE
CHARLOTTE A GILMORE
18 GREENBRIER DR
OROVILLE CA 95966-3915 .
•� " < Policy Period: From 08/79/0270 08/29/03 12*1 A.M. STANDARD 11ME
Po ioy Number. 103-0642485734-02 Renewal OL- 103-0642485734=01'
Park Name: KELLY RIDGE ESTATES
in City Limits: NO
Address: 18 GREENBRIER DR
OROVILLS CA 95966 County: BUTTE
Length: 64 Serial Number: 437P .
�
�
Mnufacturer/ SK LINE
oa 1173 Maodel:
UNDER 50
Castemer Age Group:
use: PRIMARY e: Z9 Years
�.r. Auf[ltf Neetitlg Dovl0a: YES Tied DOwa: YES Age Of Nom
Approved Park: YES �►
TELEPNoNE: (530) 534-7700
YOUR POLICY IS SERVICED BY: Age/ey code: 04-4002-065-0
SHIRLEY GINGER WITCHER
DBA FEATHER RIVER INS
683 ORO DAM BLVD
ORVILLE CA 95965
IF PAYMENT IS RECEIVED BY 08./29/02 THIS WILL BE YOUR RENEWAL DECLARATIONS PAGE.
g•d 9610-28b (TbS) JassejjeH e20:0T 90 81 add
JAN -31-1999 10:09A FROM:
70:4820195 P:5o5
' ;•.�..� o.� �ouoonrr
ACOR�� EVIDENCE OF PERSONAL PROPERTY INSURANCE n2102=06TH EVIDENCE THAT INSURANCE As IDENTlFiED BEUUW HAS 9�EN IS8U60,15 IN FOh7CE. ANU CUNVEYS All— 1_ME
RIGHTS ANU PRIVILEGES AFFORDED UNDER THE POLICY.
,w.�„-" ,,�satoes4-7roo American Modem insurance Group
Leather River Insuranaa Agency
684 Oro Dam Blvd. E
Orawla. CA 95965
NC; -, ruri'tMX. KDu�M1 wrence _ -
couc
MC)tN► ....._ �---� pOf;Jc'►MitMOEN
' I,OM�M MUMON+
�rrJuaco 0045537665
Rhonda Ptah, an unmarried woman and I181I Hatr366e1. Un t ECtiveaA�t "emkIP P���Tm
EDUNM
unmarried men as tanants in eommom 02/02!2006 021OW20*�" '¢o
16 Greenbrier Dr. 7M ItoP6M .:w0FJ1uC OAT[DI
0mvllic, CA 95966
18 Greenbrier or., Orvvillo. CA 95050
1973 24X64 SKylinc Mobile Home Sr#437P
S2Vr-MGE INFORM+wr�un toYw►atl► +'tl + - 5 75,000
$2500
—'
8750
Dwelling 300,000
Other Structures
Premises Liability
Dates
;AHCCLLATIOK FOFM5, AND RULES IN tFFeu i rvr% --- - --"- - DAYS
THE POLICY IS StldlECT TO THE PREMIUMS, �D
paI ICY BE TERMNATEDINi LCSCOMPANY
D Nor WILL 'ON OF ANYDCH (NOES TO THE POLICYTHATWOULD AFFECT THAT
WRITTEN NOTICE, AND
INl CREST. IN ACCORDANCE Ylf lT'H THE POLICY PROVISIONS ORAS p6gVIRCO BYLAW.
ADDITIONAL prrlRHST MURTOROCr- Atxm n>K%L NSUM
MWE AW ADOMaa LorA PAVER -
Privstn Lander 081e granfey, Trualee of the Dale Brantley UA149 —
[•rust, dated /April 7,1989 & Shelly Branitey, 9 singlC WOman. OS24357801
1314 B Street AvrnoRaeu
Chico. CA 95928 eY
9•d S6T0-Zf3b (ibS) jesseJJeH eE0=01 gO ST idd
JAN -31-1999 10:07A FROM:
TO:4820195 P:1,15
MOBILEHOME/MANUFACTURED HOME SECURITY AGREEMENT
TO: Dale Brantley, Trustee of the Dale Brantley Trust, dated April 7, DATE: January 30, 2006
1989 A Shelly Brantley, a single woman
I GRANT YOU A SECURITY INTEREST IN THE FOLLOWING MOBILENOME/MANUFACTURED MORE:
Year:
Manufacturer.
Model:
1973
SKYLINE CORP
She: 74X60 -
DOH, HUD or HCO/Insignia No. 128447, 128448,
Serial No. - 2173S4170U, 2173S417OX,
Ucense/Decal No. LAT6572
Located and to remain at 18 Greenbrier, in the City of Oroville, County of BUttbe, California, ("the Location'),
togetfier with all equipment, parts, and accessories I own, or will own, that are Installed in or affixed to the
Mobilehome/Manufactured Home.
I GRANT THIS SECURITY INTEREST TO SECURE THE PAYMENT OF:
A promissory note In the original principal amount of seventy five thousand, DOLLARS ($75,000.00),
dated January 31, 2005, which Is payable by Rhonda Platt and Ian Harrasser to you, ("the Note*).
All extensions, revisions, or renewals of the Note; All late charges on the Note; 'Collection and PrvteMn Costs" -
including attorney's fees, court costs, and any other money you spend In collecting the Note; or in finding, taking
possession of, repairing, protecting, insuring or storing the Mobilehome/Manufactured Horne, or returning the
Mobilehome/Manufactured Home to the Location or to the place of Its sale If you Find It necessary to sell the
Mobilehome/Manufactured Home pursuant to this Security Agreenent
I. This Security Agreement will rcmaln In effect until the Note and any other sum secured hereby has been
completely paid and I have done everything else I have agreed to in this Security Agreement.
2. I am the owner of the Mobilehome/Manufactured Home, and I have exclusive control of It. No one else, other
than you, has any superior claims to the Mobilehome/Manufactured Home except: none.
3. I will not use and will not permit anyone else to use the Mobilehome/Manufactured Hcmc for any unlawful
purpose.
4. I will register, use and control the Mobilehome/Manufactured Home as speclfled in the laws and regulations
dealing with the registration, use and control of Mobilehome(Manufactured Home.
5. With regard to Lhe Mobllchome/Manufactured Home, I will: -
Obtain fire required Ilcense(s) and registration(s); give you the number of each license and registration; and
deliver to you the certificate(s) of legal ownership showing you or your assignee as legal owner or, If there is one
or more superior liens shown above, I will deliver a current registration card showing you as a )unlor lien holder.
fta.iof4
L•d S6T0-ZBb (ibS) �asse.u�eH +e60:01 90 BI idd
JAN -31`1999 10:08A FROM: TO:4820195 P:2/5
6, I will give you proof satisfactory to you of every recording, registering, and filing requested by you and will do
all things and execute all papers as you may specify for the purpose of carrying out this Security Agreement and
its intent.
7. I will not remove or permit anyone else to remove the Mobllehome/Manufactured Home from the Location
without your prior written permission.
8. I will:
Show you the Mobilehome/Manufactured Home whenever you want; keep the Mobilehome/Manufactured
Home In as good condition and repair as it is now, ordinary wear and hoar accepted; pay within 30 days all bills
for repairs or storage of the Mobilehome/Manufactured Home; and pay promptly all taxes levied or assessed on,
and all liens which may attach to the Mobilehome/Manufactured Home.
9. I agree that the loss, damage, or destruction or the Mobilehon*Manufadured Horne or any part of the
Mobilehome/Manufactured Home will not, to the extent permitted by Jaw, release me from any duties under this
Security Agreement or under the Note.
10. I agree to obtain, pay for, and keep In full force a policy or policies of insurance on the
Mobilehome/Manufadured Home, satisfactory to you and issued by an Insurance caller approved by you, naming
both you and me as insureds for the hazards of fire, theft, total or partial destruction, collision and such
additional hazards, including public liability, and including flood, as you may reasonably require. Each such policy
shall be delivered to you and held by you during the term of this Securtty Agreement. The mss under each such
policy shall, as between us, be paid first to you or your assigns, up to the amount of everything I owe you which
Is secured by this Security Agreement, and the balance, If any, to me, as specified in a loss payable endorsement
satisfactory to you.
I grant you a security interest in, and assign to you, the proceeds of any insurance on the
Mobilehome/Manufactured Home whether paid by reason of loss, damages, return or refund of premium, or
otherwise. You shall use such proceeds at your option to replace the Mobllehome/Manufactured Home or pay
what I owe you that is secured by this Security Agreement. I assume all risks of damage to or loss of the
Mobilehome/Manufadured Home whether or not insured against.
if I should ever fail to deliver the required pollcy or policies to you or take out of the insurance specified above,
or pay for that Insurance, you may, at my cost and expense, but without any duty to do so, obtain and pay
for insurance covering the hazards of fire, flood, theft, total or partial destruction, collision, and such additional
hazards as you may reasonably choose to insure against and naming as the insured, at your option, either both
you and me or you only and any money you sperm to obtain and keep such insurance shall be secured by this
Security Agreement and shall be repayable by me in the manner set out In Paragraph 11 as Advances(s) for the
protection of your security Interest in the Mobilehome/Manufactured Home. Any sums you receive upon
cancellation of any such policy may be applied by you to any sum I owe you that is secured by this Security
Agreement.
11. 1 authorize you, but do not require you to pay any amount(s) as you believe are necessary to protect or
preserve your security interest in the Mobilehome/Manufactured Home. The amount(s) shall be called
Advance(s). All such Advance(s) and all sums desm-bed in this Security Agreement as "Collection and Protection
Costs" shall, at your option, be immediately due and payable to you by me with interest at the rate of ten percent
(10%) per year or be added to the balance of the Note together with a finance charge computed for the
remainder of the term of the Note at the rate otherwise applicable to the Note, in which case you may Increase
each of the then unpaid monthly installments not then due by an amount suffident to provide for payment of
these Advance(s) and this finance charge over the remainder of the term of the Note.
When I make a payment under the Note or under this Security Agreement, notwithstanding any contract
provision in the Note, you are to apply it as follows:
First, to pay any unpaid interest on "Collection and Protection Gosts", and on Advanoe(s) as described in this
Paragraph 11; second, to pay such Advance(s) and "Collection and Protection Costs"; and third, the balance, if
any, to the Note as provided in the Note.
page 2 of 4
8'd S610 -28t, (TbS)
Jasse.jjeH
eco=0T g0 8T JdH
JP44.-31-1999 10:068 FROM: T0.41320195 P: 3,15
If any payment is not large enough to pay for all of these things, including the amounts then due under the Note,
I will Immediately make an additional payment to make up the difference, and if I do not, you may, at your
option, make the Note and all other sums secured by this Security Agreement immediately due and payable, and
you may exerdse any of the rights under the Security Agreement, including those specified in Paragraphs 12 and
13.
12. If (a) I fail tv pay you as provided in the Note, (b) I fail to pay anything else I owe you or come to owe you,
(c) I fail in any way to keep any promise or agreement I have made in this Security Agreement, (d) I abandon
the Mobilehome/Manufadured Home, or (e) the Mobilehome/Manufactured Home is attached or any type of
bankruptcy petition is filed by or against me or I commit any ad which will entitle my creditors to file a
bankruptcy petition again me, then (i) the entire unpaid balance of the Note and any other sums I ^W other
Burns whether or not then due, including advances made by you as provided In this Security Agreement
I owe you that are secured by this Security Agreement and unpaid interest on all such sums, shalt Immediately
become due and payable at your option without notice to me and (II) you may at once proceed to foredose this
Security Agreement according to law, and you may, to the extent permimed by law, enter the premises where the
MobllehomeJManufaetured Home may be located, take possession of it and remove and sell and dispose of it at a
public or private sale, every demand and every notice being expressly waived by me.to the extent permitted by
law.
Any foreclosure action shall, to the extent applicable, be in compliance with the MobNehome-Manufactured
Housing Act of 1980 "as amended, supplemented and changed from time to time (California Health and Safety
Code, Division 13, Part 2, commencing with Section 18000), including all notice requirements contained therein
and including Section 18039.1 if security for the Mobilehome/Manufactured Home loan includes the real property
It Is affixed to or Installed upon.
13. I Irrevocably appoint and authorize you to act as my true and lawful agent to make all necessary transfers of
ownership of the Mobilehome/Manufadured Home sold as provided in Paragraph 12 and to make, execute, and
deliver all necessary instruments, assignments, and transfers of ownership. I promise that if you ask me.[ will
sign and deliver to such purchaser(s) of the Mobilehorne/Manufactured Horne at any sale hold under this Security
Agreement, any instruments requested by you to confirm to such purchaser(s) all my rights to the
Mobilehome/Manufactured Home sold. From the proceeds of any such sale you may first keep an amount equal
to the sums owed you by me that are secured by this Security Agreement. You shall. at once pay me (or
whomever Is lawfully entitled) the remainder of such proceeds if there is a surplus.
Any failure on my part to do anything I have promksed or agreed to in this Security Agreement or Note may be
regarded by you, without notice to me, as a default and you shall have all rights and remedies of a secured party
under the California Commercial Code, or other applicable law, including, but not limited to the Mobilehome-
Manufactured Housing Act of 1980, and all rights and remedies shall, to the extent permitted by law, be
cumulative. You or your agent may bid and purchase at any sale made under or authorized by this security
Agreement, or at any sale made upon foreclosure of this Security Agreement.
14. Please send all notices to me at the address shown below my signature.
15. This Security Agreement has been signed in, and shall be governed by the laws of, the Slate or California.
16. If more than one person signs this Security Agreement we will be jointly and severally liable. You may
collect from or sue any one or more of us without giving up any of your rights against the others. Each of us
who is married and signs the Note and this Security Agreement expressly agrees that his or her separate property
shall be liable for payment on the Note and all other suras secured by this Security Agreement, to the extent
permitted by law.
Page 3 cf 4
6'd 96TO-28t, (TVS) JasseiieH et►0=0T g0 ST add
OLA
0�-
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Dive - Oroville, California 9596'►,' - Telephone: 916/536-7541 2630-91
r APPLICATM AND PERMIT '
4SSESSOR PARCEL NUMBER
69-10-38
OWNER
SANDY LESSA
ZONING
RTI
TE EPHONE75
BUILDING PERMIT
SO. FT. OCC. BUILDING VALUATION'
200 0 1400
OWNER'S MAILING ADDRESS
18 GREENBRIER OROVILLE 95966
CONTRACTOR'S NAME TELEPHONE
CESAR NERCADO
CONTRACTOR'S MAILING ADDRESS
UNKNOWN
Fireplace
CONSTRUCTION LENDER
NONE
UNKNOWN
Total Valuation $
Filing Fee $
10.00
LENDER'S MAILING ADDRESS
Permit Fee $
23.50
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee $
15.00
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
18 GREENBRIER DR OROVILLE
Q
Permit fee $ 48.50
PLUMBING PERMIT Filing
Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
Water piping
5'00
LOT NO.
SUBDIVISION NAME
PARCEL. MAP
Each qas water heater or vent
5.00
rYtY USE OF STRUCTURE
SFV• Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home
10.00 ea
TYPE OF WORK
New ❑ Addition}f Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: ADD TO EXISTING DECK
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
Main service 6001 OR LF -55
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
' 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 CONST.- / DWELLING OCCUPM
OR ADDNS. ( ACC. BLDGS. /
yz2sgft
NEW CONSTR. ULT'-OUTLET
NON.RESID BRANCH CIRC ITS
2.50 ea
(PO
PjNGWER LE OUTLETTCIR.el
Ex. Occup (ouT LETS OR FIXTURES
zoesoe
ew�030
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION— INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.'
❑I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you 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
FilirgFee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Permit Fee
$
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agr to save, indemnify and keep harmless the County of Butte against
all liabil es, judgments, costs, and expenses which may in any way accrue
against id County in cons uence of the granting of this permit.
�J c G,
�71 ' Date '/ ��/�
Signature of App t.)? — Owner Contractor 11Agent❑
An OSHA permbt is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ 48.50
HAz
CUA ( PARK SCHL
FLD CDF
tsA I
PAR
PD i HD. ISSUE
6�
This permit is hereby issued urger the applicable provi-
sions of the Butte County Code and/or resolutions to do
work indicated above for which fees have been paid.
M�DIR S OF PUBLIC WORKS -
By �' _' C• 1-.'" Date
PERMIT EXPIRES Date ��, ' 1 "f6 l
Receipt No. S}7�� -- - -
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Dftive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
2630-91
ASSESSOR PARCEL NUMBER
69-10-38
ZONING
RT1
BUILDING PERMIT
OWNERS �T7�V �+SSA
TELEPHONE
533-7375
SQ. FT. OCC. BUILDING VALUATIO
200 0 1400
OWNER'S MAILING ADDRESS
18 GREENBRIER OROVILLE 95966
CONTRACTOR'SNAME
CESAR I`d.ERCADO
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
UNKNOWN
Fireplace
CONSTRUCTION LENDER
NONE
UNKNOWN
Total Valuation Is
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 23.50
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee
$ 15.00
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING 8ADDRESS GREENBRIER DR OROVILLE
18
Permit tee
$ 48.50
PLUMBING PERMIT Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping *
5.00
Each qas water heater or vent
5.00
r�Yy1�Yy USE OF STRUCTURE
SFO Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S FG W
0.00ea
TYPE OF WORK
New ❑ AdditionfM Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: ADD TO EXISTING DECK
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 500V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
C6N.76ACTORS LICENSE LAW o���
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 CONST.. DWELLING OCCUP.N
OR AODNS. ACC. SLOGS.
21AOsgit
NEWCONSTR ULTI.OUTLET
NON.R ESID BRANCH CIRC ITS
2,50 ea
POWER APPARATUS e1
SINGLE OUTLET CIR. I
Ex. OCcup(OUTLETS OR FIXTURES
20050!
DAL@30
FIXED APLNS
Ex. OCCup. OUTLETS P(RESID )REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. 1Yirin 9
15.00
Permit Fee
$
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.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
perrnit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agr to save, indemnify and keep harmless the County of Butte against
all liabil es, judgments, costs, and expenses which may in any way accrue
against id County in cons uence of the granting of this permit.
p
�% Date "��� /,�
ignature of App a t — 0Wner Contractor ❑ Agent ❑
An OSHA per is required for excavations over 5'0" deep and demolition or construct-
ion OF structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
E E
TOTAL FE $ 48.50
HAZ.
can
PARK
SCHL
FLD
PAR
I HD. ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated above or which fees have been paid.
DIR OF P C WORKS
Q ,p
By Date a
PERMIT EXPIRES Date "
eceipt No. ,
FR
WNIT E-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPAR;TMtNf OF PUBLIC WORKS - BUILDING DIVISION
• 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: 916/538-7541 'v)
,-PERMIT APPLICAT IONDATA'SHEET-A,
I Permit No. o
OWNER �A /V p` L SSS/� r � A
. P. No.
Proposed- Building Use 11/L"w ZX'C1Zf Building Inspector Date 7 �%
At time of permit application, I was advised 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, signed by preparer of plaris ........
3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans and calcs, with wet signature on plans ..
5. Hazardous Material Form .................... .
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions.......................................................
10. Fees of $
11. Chico Urban Area fees paid .......................................
12. Park fees paid
13• School Di tr' t fees paid .............. 4
14. Sanitation approval from flf� 'U Health' Department
15. City of Chico plumbing permit .....................................
16.Plot plan and business license approval from City of --
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking:
18. Improvements may be required. Contact Land DevelopmentSectionDPW
19. Driveway permit (construction approval required prior to'occupancy)
20. Pre -Inspection for required Pre-Inspec.request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22.,. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ...................................
26.
27.
When you issue the permit, process as follows: Mail to owner. Mail to contractor..
---J,,--Telephone 533-7375 and hold for pickup at OPS office. Deliver w/inspector.
Other
Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air %Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other \ Date By
The following data must be submitted prior to permit issuance: (Circle new item�not checked above).
1. Index permit for above items No.
2. Additional items required:
a
Contractor, designer, owner, was advised of above required data by_phone---rnail—counter by ..date
Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date
Plans checked by �4Date _Plans approved by • 0 Date Q19IC11
Sets of plans on hold in File cabinet AP folder
Copy—DPW
L 0A-r9o/D
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center.Drive - Orovllle, Cailfornia 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBERZONING
•669 - 0D ' 035
Ole 77 7
BUILDING.PERMIT
OWNER
Air-* Le—S5�
TELEPHONE
533-7375
OCC. BUIL/DING VALUATION
�SjO./`FS1T.
21JV
OWNER'S MAILING A.p DAB;� ` �4e GAeO e '
GG-- f/4
CONTR AC OR'S NA((//M�r/�E
1���`
TELEPHONE
CONTRACTOR'S MAILING ADDRESS/ JqC/Ic
Fireplace
CONSTR UC TIQN�EItIp
IF
✓/v/ i/r/l/,Ll/
UNKNOWN
Total Valuation I $
L
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ -)-3,5-0
ARCHITECT OR ENGINEER
AlUN,a--
LICENSE NO.
Plan Checking Fee
$ V �
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS /7� /a/ev eA
Permit fee
,\
$ Sv
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF,ET Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home I S I G JW I
10-00ea
TYPE OF WORK
New ❑ Additionk Remodel ❑ Utilities ❑ Installll(ation❑ Other ❑
Describe work: 0� �� �S i (ifs
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
.
Main service 6001 OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑NON-RESID
I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER
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)
El I,
1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEWC ONST DWELLING OCCUR.&
OR ADDNS. ACC. BLDGS. !
,zts
2/ qft
NEW CONSTR ULT' -OUTLET
BRANCH CIRCUITS
2.50 ea
ea
APPARATUS a
ISINGLE OUTLET CIR.
EX. OCCup\/ OUTLETS OR FIXTURES
eAL 30¢
ALO 30¢
FIXED
EX. DCCUp. OUTLETS P(RESID.)REA.)
2.00
Temporary service
10.00
Home Facilities
Ho
15.00
Misc. 9
15.00
Permit Fee
$
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 subjectpertnit
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
g
Hood
3.00
Ventilation
Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X
Signature of Applicant — OwnerEl' Contractor ❑ Agent ❑
An OSHA Permit is required for excavations over 5'0" deep and demolition Or construct-
ion of structures ovier 3 stories in height..?
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ f
HqZ.
CUA PARK
SCHL
PLo
coP PAR PDi
HO•
ISSUE
This permit is hereby issued unser
sions of the Butte County. Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
ov
Receipt No. / 7O(/
' HITE-D.►.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT
0
0
Of
U.'llfcar,
E ',%,trillCc
,"a.
rhi.; set Of plans at.
kep, Specu. MUST be
7
-Toils
10" lhe i,06 ai. ou
-rngn k ry
Orly Chan -I'm'.
an fron, fha
Of 0i public
gath.a, ofrom
5 ft. f tho
property lines and a sotback
of Soft. from the rca'd
centerline shall bee clear os
structures or equiPmPN"t excer"
far a 12 ft. etave, ove+nnn- +
C&CU, op 6L(t
60
-Q�
PM 39- 7
t-lue copy
S t 38 5-16
'Vc
0
0
Of
U.'llfcar,
E ',%,trillCc
,"a.
rhi.; set Of plans at.
kep, Specu. MUST be
7
-Toils
10" lhe i,06 ai. ou
-rngn k ry
Orly Chan -I'm'.
an fron, fha
Of 0i public
gath.a, ofrom
5 ft. f tho
property lines and a sotback
of Soft. from the rca'd
centerline shall bee clear os
structures or equiPmPN"t excer"
far a 12 ft. etave, ove+nnn- +
C&CU, op 6L(t
60
-Q�
PM 39- 7
t-lue copy
S t 38 5-16
not, -I
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To rnoe iL.E
CoW,eO Top ral to be 36 in. high with
P -A t i , intermediate rails to be not
over -9 In. apart.
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CoW,eO Top ral to be 36 in. high with
P -A t i , intermediate rails to be not
over -9 In. apart.
aU'
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f}a/e q,tLR�e i X �f BRAGes
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-P•
PERMIT NO. 1891-87B
4.
{
PERMIT EXPIRES
OWNER V. FULTHORP
J, CONTR. — r. � L %
± ASSESSOR PARCEL F-10-38
LOCATION 18 GrPPnbrier Dr.,* Oroyille
cl
t
�I
t
i
�4.
t
t
1 ,
t
{
i
1
Temp. Pon
Called
1 Temp. Elec
Called
Temp. Gas
-, Called
JOB FINAI
Signet
= OK
0 = Not OK
Applicable
= Not Rd
MOBILE HOMES MISCELLANEOUS
Date
MOBILE HOME UTILITIES (Plans) OK except #'s'
Date
D KS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
V.,46ning Requirements -Setbacks -Easements
12. Soils; Special MH Support -Sketch
�6otings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Sewer; Location -Test -Fall -C/O -Concrete
d3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
„Wood Awn.; Posts-Beams-Rftrs.-Con_ nec.-
Shthg.-Rfg.-Bracing
-5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
6. Gas; Location -Test -Wrap: / P1 ft.
/ /"Nat. or/ PV'ft./ /"LPG
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
o9?Tarports; Windows -Doors
7. Utility Clearance
Alec.
1R5;Frmg; Sills-Anchors-Studs-Rftrs-Trusses
iding; Nailing -Veneer -Stucco -Mesh
Card -B1
Date' Card -B1 Datec4
. -of; Shthg-Roofing
t.; Steps -Doors -Landings
Card -B1 Date Card -B1 Date
Date
MOBILEHOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
Card -B1
Card -81
Date Card -B1 Date
- DateZ Card -B1 Date
2. Footings; Size -Spacing -Marriage Line I
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
Date
POOLS (Plans) OK except #'s
5. Drain; MH Test -Fall -Flex Connector
1. Setbacks -Easements
6. Water; MH Test -Regulator -Connector
2. Soils; Compaction -Structure Stability
7. Water and Sewer Connected -C/O to Grade -HD Approval
3. Pool Structure; Steel -Connections -Thickness -
Dead Men -Lining
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
4. Elec.; Receptacles and Lighting, Distances-GFI
10. Cert. of Occupancy
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
Card -B1 Date Card -B1 Date
Card -B1
Date Card -B1 Date
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Card -61
Date Card -131 Date
Card -B1
Date Card -B1 Date
= OK
0 = Not
- =Not Applicable RESIDENTIAL (Single and Duplex)
= Not Ready
Date UNDERFLOOR (Plans) OK except #'s
Date FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
44. Hangers -Post Caps -Anchors -Connectors
2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth
46. Fireplace Ties or Type A Flue -Fireplace Throat
4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth
47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
5. Stemwalls, Main; Steel- Bloc kouts-Wrapped
48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
49. Garage Fire Protection Framing
7. Slab; Steel -Wrapped
50. Property Line Firewall & Openings
8. Piers -Fireplace Ftg.-Steel
51. Ext. Doors -One T -Check Garage -3rd story, 2 exits
9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test
52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
10. Gas Pipe; Size -Anchors
53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
11. Water Pipe; Test -Anchors -Regulator -Service Test
54. Siding -Nailing Veneer
12. Electric; Underground
55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
13. Plenums & Ducts; Clearance -Material -Su pprt- Ins.
56. Glazing Area -Glass Protection -Skylights -Plastic
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
57. Shear Walls; Nailing -Bolts
15. Insulation
58. Insulation-Walls-Clg.
59. Infiltration-Walls-Wndws
Card -61 Date Card -61 Date
Card -131 Date Card -B1 Date
Date PLUMBING (Permit) OK except #'s
16. Water Ht. Vent -Access -Combustion Air
17. Water Pipe; Test & Anchors -Nail Protection
18. D.W.V.; Test-Fttngs & Anchors -Nail Protection
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower, 2nd Floor -Tub Access
21. Gas Pipe; Size & Anchors
Card -61 Date Card -61 Date
Card -131 Date Card -81 Date
Date ELECTRICAL (Permit) OK except #'s
22. Fixture & Transformer Clearance -Ins. Protection
23. Elec. Receptacles Spacing -Lights & Switches at Doors
24. Size Boxes & No. of Conductors -Stapled
25. Romex Installed Close to Edge of Studs & C.J.
26. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
27. 2 Appliance Circuits in Kitchen & Conductor Size
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga.
Cu or Al
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral Yes No
30. Service -Riser Conductors & Ground -Main Disconnect
31. Equip. Clearances Panels-Motors-Mech. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
Card -131 Date Card -131 Date
Card -131 Date Card -131 Date
Date MECHANICAL (Permit) OK except #'s
33. A.C. Ducts Insulation & Support
34. Vent Fan; Exhaust above insulation
35. Condensate Drain & Overflow; Size & Grade
36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet
37. Attic Access & Platform if Furnace in Attic
Card -131 Date Card -131 Date
Card -131 Date Card -81 Date
Date FRAMING (Plans) OK except #'s
38. Sills, Proper Material & Anchors
39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
40. Bearing Walls over Girders & Floor Nailing
41. Draft Stop in Walls (rht proof)
42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
43. Header & Beam -Size & Bearing
Card -81 Date Card -81 Date
Card -B1 Date Card -81 Date
Date FINAL (Plans) OK except #'s
60. Ext. Steps -Door & Sidelight Protection -Landings
61. Smoke Detector
62. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Mach. Protection
63. Bedroom Exiting
64. G.F.I. & Bath Fixtures & Tub Access -Spa
65. Elec. Trim & Subpanel; Breaker Sizes -Labels
66. Stairs & Rails
67. Fireplace or Stove; Clearances -Hearth
68. Elec. Outlets at Wood Panel; Int. & Ext.
69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance
70. Elec. Outlets & Receptacles at Kit. Counter
71. Garage Fire Door; Swing -Landing -Closer
72. A.C. Duct in Garage -Damper
73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
74. Plb., Elec. & Mech. Equip. Listed for Location
75. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
76. Insulation -Foam -Looked in Attic ❑ Yes
77. Guard Rails & Deck Construction -Post Caps
78. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
79. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
80. Stucco; Brown -Finish
81. A.C. Unit; Disconnect, Electrical, Plumbing
82. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to
Openings.
83. Water Well; Disconnect, Electrical, Plumbing
84. Exterior Elec. Trim; G.F.I. Receptacle -Underground
85. Ventilation throughout House
86. Glass Protection
87. Corrections from Previous Inpections
88. Gas Test -Meters Tagged; Gas -Electric
89. Water & Sewer Connected -C/O to Grade -HD Approval
90. Energy Compliance Certificate -Other Certificates
Card -61 Date Card -B1 Date
Card -131 Date Card -B1 Date
Card -131 Date Card -81 Date
Comments at Final:
(NOTE: An entry must be made each time you visit job site)
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
PERMIT N0.
7 County Center Drive - Oroville, Qalifornia 95965 - Telephone: 916/538-7541 _
APPLICATION AND PERMIT
AS E OR PARCEL NUMBER
- in_
2
BUILDING PERMIT
O NER
r
TELEPH NE
SO. FT. OCC, BUILDING VALUATION
);
O ER'S MAIL NAD
,e e.►��o
RES S
r' r
113 T CT R'S NA E
S 163�2
TE PHONE
—9 41
C TRAC 'S MAILING AD 'ESS
Pea ,k -ry,L,0
Fireplace
CONSTRUCTION ENDER
UNKNOWN/
y/
Total Valuation is
O
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ ,
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
r
Each Trap
2.00
1�
i v VLA
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome Other SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
10.00 ea
TYPE OF WORK
New P Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work:
� f
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100V DR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check.one):
1 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. 9391 Classification
EJ 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed 'contract-
ontract-
ors.
ors.(Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.N ,
NEW CONSTR.� A LDGS 1 �z¢sgft
ULTB OUTLET
NON•RESID BRANCH CIRAC ITS 2.50 ea
POWER APPARTUS e
(SINGLE OUTLET CIR.
BAL@I 20050t
Ex. Occup(ouTLETs OR FIXTURESALoao
30
FIXED APLNS
EX. Occup. OUTLETS PRESID IREA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. �Virin 15.00
g
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you 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 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify nd keep harmless the County of Butte against
all liabil'ties, jud ments cos and expenses which may in any way accrue
again id C uence of the granting of this permit.
/-
X Date to of /
Signature of Applicant — Owner ❑ ContractorA Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures ov`eere-3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
TOTAL PERMIT FEE $
occuP.
CONST.TYPE
FLOOD
ARCEL
✓
PD
_
ND
33U
This it is hereby issued under the applicable provi-
sio s of he Butte unty.Code and/or resolutions to do
w k in abd a for which fees have been paid.
OR OF PUBLIC WORKS
By Date tot
PERMIT EXPIRES Date -7 IUA
Receipt No. D /� ��
WHITE-D.P.W.. YELLOW-Ae SE330R. PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE ,OF - DEPARTME TPUBLIC WORKS - B F
� � o. � _ UILDING DIV°I�SION /
7 COUNTY CENTER DRIVE - OROVILLE;O!IFsQRN�A 95965 - TELEPHONE: 916/5343541
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER 1Z A -i./ A. P. No. / q— If
Proposed Building Use //.�90f11 Building Inspector Date �/q
At time of permit application, I was advised the following data must be submitted prior to permit processing
and:/or issuance: DATE RECEIVED APPROVED
. Y
1. All items'have been submitted. . . . . . . . . . . .
12 jqol_'�2. Plot plans in duplicate./triplicate, signed by preparer of plans. .
3. Complete plans in duplicate. /triplicate, signed by preparer of plans.
4. Complete engineered plans and calcs, with wet signature on plans.
5. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . .
7 Statement of Intent for Non -Heated and AC Buildings.
8. Fees of $ I ,
9,.—Letter of signature authorization.
��10. Sanitation approval from � .
pp � �Heath Dept.
11. Planning approval for (A) Use: (B) Parking:
12, Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner[:], Mail to owner ❑ ).
_15. Improvements may be required. . . . . . . . . .
16, Mobilehome Installation Data. . . . . . . . . .
17. Pre -Inspection for Pre-Inspec. request to Required. Building Inspector (Date)
18. Recorded copy of Agricultural Acknowledgment Statement,
19. Driveway Permit.
20. Plot plan approval from city of
21.
22.
When wu issue the permit, process as follows: Mail to owner, Mail to contractor,
--.n-Telephone CaV t/ ,51 and hold for pickup at���`o'ffice, Deliver w/inspector.
z
Copy of plans sent Health Dept., Fire Dept,, Other Date
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
r
2. Additional items required: ( E,Z� -
Contractor, designer, ow " , was advised of above required data by Vphone__nail_counter by
Contractor, designer, owner, was advised of above required data by—phone —mal l_counter by
Plans checked by
Sets of plans on hold in
8'7i 63
Copy—DPW
Date Plans approved by
File cabinet AP folder
date
date
— Flours:, 10:00 a.m. - 3:00 p.m.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville,-California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
12� 1 -- S'`7
ASSES OR RCEL NUMBER
3K,
ZON Cs/ y� )
/
BUILDING PERMIT
OWNER V
TELEPHONE
SOS FT. OCC. BUILDING VALUATION
�C
OWNER'S MAILING ADDRESS
1-21
_
CONTRA OR•SN ME_
TELEPHONE
CONT ACTORS MAILING ADDRESS
e) IFireplace
CO RUCT N LEND R
-
UNK O
Total Valuation $
Filing Fee
$ 10,00
L ND,F,i 5 MAILING ADORE r
, t. ��� �+/
/1J Q ,4 / �g
Permit Fee
$ —_
V13,
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ •—
Energy Plan Checking Fee
$ .
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
Z.E. 100`
Each Trap
2.00
Flo/
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE /�
SF ❑ Duplex❑ Mobilehome❑ Other L -a e, A
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S G W
10.00 ea
TYPE OF WORK
NewX Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
00V OR
Main service 10000 AMP LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
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
1, as the owner, or my employees with wages as their Sole Compen-
l sation, will do the work,and the structure Is not intended or offered
for sale. (Sec. 7044)
1, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.& ,/ZQSgft
New CONSTFL AUC
MULTI -OUTLET
NON.RESID BRANCH CIRCUITS) 2.50 ea
POWER APPARATUS e
SINGLE OUTLET CIR.
20050t
Ex. Occup OUTLETS OR FIXTURES eAL030
FIXED APPLNS. OR \
EX. Occup. OUTLETS (RESID.I EA./ 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you 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
FiIingFee 10.00
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of�
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
again?t said County in c asequence of the granting of this p rmit.
�J�
X u Date /
Signatur f Applicant – OwnelL Contractor ❑ 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 $
Energy Inspection Fee $
r—
TOTAL PERMIT FEE $
OCCUP.
CONST.TYPEJ
FLoKDAtcEJ
PDND
ISSUE
This permit is hereby issued under
sions of the Butte County. Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. lI ,�3
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
l;
This set of plans and specifications MUST be
`
kept on the jq6 at all times and it isvunlawful to
j; make any changes or alterations on same without LOT 266
vmtten permission from the Department of .Public : } ; U N I T Warks. County of Butte.
Ye 4/0.00'
a CL•t': L - 9 0.74
{ 0' \—SEvVEIe C o.
0 �'.. A;
h 0 r o=Aiad� of
' q
Pampa ftes'"and a setback
•! ,: ` J E'en erll f nom the road
0 shall be clear of
st�uct r,�s or.equipment except
i,,, /for (ft, eave overha
-/4A aterials $ Workm 1 ' � � 0 • •. ,?. �,.
ACcbrdance M►iih R o ed ans shall $� o ° / 0
+,...,... ec gniz Good Prances and 0
•„ _ , .,'; v' cwali Described for the 0
Specified use in the ° /
t.. Ui�i#orm Building; ' ,bin °J
' 9 & Machanical
#� Wafional lectri a e Codes ate!
j1j,;
T, .TSL, Co.-v.v.
!$' p / LVA..TE'2 CONN
WILPN18� b ARTMEN?
$ , GIeEEN.;9 T�iE ;A r'.��71'
GO
^'-•-: Cfl T/ONS i4?E" ,
TO .6 CA L E
Y00011
!T i ! i M I I -I
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I la/1
T T7- 117 [ T
,tiwbi.•� ..n. -^�.+y. , 1++p.:K�++►1�-V .-,t,'�" Yr�S`��:a �fi-�ib��-.��4 .+yM. _ yJ.:w+�.Cv-�:.+_s�.�i': .. - ... ,. "-.�-- ..�' �:v,.._ ... : �,
•r / /D�$�G/I9 fl C.0 Ow/�/r/�.
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4
COUNTY OF BUTTE — DEP RTMENT OF PUBLIC WORKS
7 County Center Drive —I Oroville, California 95965
Telephone: 534-4541
APPLICAVON AND PERMIT
authorize representatives of the county of t3utte to enter upon the
above-mentioned property for inspection purposes.
r
X A - •' ' �f C cr '- Dater
Signature of Permitele 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 resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By 1' - Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$
$
Building Address
PLUMBING
No.1
@
FEE
PERMIT FILING FEE J$2.00
r
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. -
' 1 I
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
, -_j
Each additional outlet .30
Fees
W. C.
Sanitation
Fire Dept.
FireZone
Use Permit
Building sewer 5.00
-
EQA
Parking
Plans
I Parcel
Declaration
parcel Ma P
60' R/W
Improvements
p ovements
Lawn sprinkler system 2.00
Bldg. Plans Rec'd
Parcel Approval
Plans Approval
Permit Fee
$
"
$
r
NEW ❑ ADDITION ❑ UTILITIES Q OTHER ❑
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
�-
Additional meters, each
1.00
Sub -panel (12 or less) (more than 12)
Single Family ❑ Duplex ❑ Mobil Home Q Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures 2u1 5
Receps., switches & fix outlets m in7
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: 1
Hood, Ex. Fan or F.A. Furn. Motor
1.00
Evap. cooler, gar. disp. or D.W. _ 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp.'Power Pole 5.00
License No. Classification
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑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
E2O
Hood
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
TOTAL PERMIT FEE
n
$
authorize representatives of the county of t3utte to enter upon the
above-mentioned property for inspection purposes.
r
X A - •' ' �f C cr '- Dater
Signature of Permitele 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 resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By 1' - Date
COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORK J),3"
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 in n purposes.
Date
Signature of Permitee or Agent
Receipt No. ff ;/ Z2 _
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 Date41
Building permit expires Date ._g._
BUILDING
Owner
SO. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
T elephone No.
Permit Fee
$
$
Building Address
PLUMBING
No.1
@
FEE
PERMIT FILING FEE $2.00
Q e z
Each Trap 1.50
Repair drainage or vent piping
1.50
Water piping 1.50
, y�
Each gas water heater or vent 1.50
,�//
A. P. No.'S`, GO^g
Zoni n
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
Fee
Sanitation
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
�8fd'g. Plans Recd
Parcel Approval
Plans Approval
Permit Fee
$
219,ns
e
O
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each
1.00
r-�
Single Family ❑ Duplex ❑ Mobil Home LJ Others ❑
Sub -panel (12 or less) (more than 12)
Range, Cook -top or Oven 1.00
Gt
Water Heater or Space Heater
1.00
Light fixtures 20 Z I_ @10
Receps., switches & fix outlets
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F.A. Furn. Motor
1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
211'am exempt from the Contractors License Laws of the State of Cali fomia.
Permit Fee
$
7
$
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
Wo en'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.
MECHANICAL
No.
@
FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for in n purposes.
Date
Signature of Permitee or Agent
Receipt No. ff ;/ Z2 _
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 Date41
Building permit expires Date ._g._
r
• COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Orovi Ile, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
- .... I+'....a.,i.u., �L, vvUllty vl oully lv UlltCl UPUII IIIC
above-mentioned p>roper�tr inspection purposes.
Signature of Permitee or Agent
Receipt No. / 2—
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By
Date
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant I Building permit expires Date ............................................
BUILDING
Ownerrll �4
SQ. FT. OCC. BUILDING VALUATION
Mailing Address L.,p�
e ehone No.
Fireplace
ContractorC:/&
Total Valuation
Mai I i ng Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$ C
Building Address ` r.etT ' u 44
PLUMBING
No.
@ FEE
PERMIT FILING FEE $2.00
,e� /
( ) _n
Each Trap 1.50
Repair drainage or vent piping
1.50
Water piping 1.50
�C: t 49 6-e (�y
Each gas water heater or vent 1.50
A. P. No. v�� (�
Zoning 8 Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
F
Sanitation
I Fire Dept.
I Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
I ans Re d
Parcel Approval
Plans Approval
Permit Fee
$
$
NEW ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL
No.
@ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each
1.00
Single Family ❑ Duplex ❑ Mobil Home' Others ❑
Sub -panel (12 or less) (more than 12)
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixturesbal�d2o
Receps., switches & fix outlets
Eh -1010
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under. the name
style of:
Hood, Ex. Fan or F.A. Furn. Motor
1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
— I am exempt from.the Contractors License Laws of the State of California.
Permit Fee
$
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of'the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ 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.
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.
@ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
TOTAL PERMIT FEE
$
- .... I+'....a.,i.u., �L, vvUllty vl oully lv UlltCl UPUII IIIC
above-mentioned p>roper�tr inspection purposes.
Signature of Permitee or Agent
Receipt No. / 2—
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By
Date
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant I Building permit expires Date ............................................
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS�� —/
` 7 County Center Drive — Oroville, California r955965
Telephone: 534-4541
APPLICATION AND PERMIT
Owner �(/, 4�
Mailing Address/
Contractor
Mai I ing Address
Building Address
rL //a
R/2 f v:
one No.
Telephone No.
A. P. No. — .3 Zoning & Planning
F i ion FireDept. FireZone Use Permit
_!QAJ Parking arcel Parcel Ma 60' R/W Improvements
Plans Declaration P P
Bldg. Plans Recd I Parcel Approval Plans Approval
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Single Family ❑ Duplex ❑ Mobil Home
Others ❑
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:
License No,
I am exempt from the Contractors License Laws of the State of California. Permit Fee
WORKMEN'S COMPENSATION INSURANCE MECHANICAL
PERMIT FILING FEE
I am aware of the provisions of Section3700 of the California Labor Heating
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 Cooling
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this Ventilation
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of Hood
California.
Permit Fee
Classification
_ BUILDING
SQ. F T.7 OCC. I BUILDING VALUA
Fireplace
Total Valuation
Permit Fee
Plan Checking Fee &/or Penalty
Permit Fee
PLUMBING
PERMIT FILING FEE
Each Trap
Repair drainage or vent piping
Water piping
Each gas water heater or vent
Gas piping system 1 - 5 outlets
Each additional outlet
Building sewer
Lawn sprinkler system
Permit Fee
ELECTRICAL
PERMIT FILING FEE
Main service incl. 1 meter
Additional meters, each
Sub -panel (12 or less) (more than 12)
Range, Cook -top or Oven
Water Heater or Space Heater
Light fixtures
Receps., switches & fix outlets
Hood, Ex. Fan or F.A. Furn. Motor
Evap. cooler, gar. disp. or D.W.
Air conditioner or heat pump
Water pump
Mobil Home Facilities
Temp. Power Pole
Misc. wirina
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 f inspection purposes.
Dat
Signature of Permitee or Agent
Receipt_�W2_1_6_ 1
White -p W//yIJ0ssor — Pi ns�tor enrod-Applicant
`mss J,
@ FEE
$2.00
1.50
1.50
1.50
1.50
1.50
.30
5.00
2.00
2.00
TOTAL PERMIT FEE is
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
BY Date
Building permit expires Date .................
0
%z
.
Po
s pRX11I HARRHSo.J
BUILDING PERMIT #06.0915 The 2001 CB` _
tl C, CMC, CPC, 2004
ASSESSOR'S PARCEL # 069 -1Oo • 038 :CEC, and 2005 California Energy
Standards as amended by the
-BUTTE COUNTY
€ ULDING DIVISION
APS OVFD
y 3
APPROVED PLANS AND
PERMIT SHALL BE ON SITE
FOR ALL INPECTIONS
is is ion apply to this project
0
V/"
F1 L F- COPY
BUILDING PERMIT # M - Oql
ASSESSOR'S PARCEL # 0 1070 038