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Home My WebLink About069-110-017. i "r CvA.P. jam/ UAS WHITE 6.9-/1-17 4 Silverle f D L t 121 K a r . 'qo , - e lly Rid Est es, Orovlle. ... a `\ Permi 2451-72P,E (utilit s for mobi home) 7 SILAS WHIT ' 434 Silve"..\E 21, Kelly Ridge EstPermit 267e�/�;7 3(carport &se th M.H) A.P. _ Silas White (09\IR 34"Silv6f16af'Dr: ( of 121'Estates), Oroville Permit 867-73 (po h, two w & covered walk for mobile home) /j/ZW 4WXAV 69-11-17 Everett Gilbert . f,.;w 434 Silver lea Dr., Oro ville eontr: Horner Const., Oroville < r.Permit 41039-82B(breezeway/MH) EPERM 06-2221 Y DR, ORO�VILLE X) _ /) 9- 2Z -0L 0 u �Gfll . �I � �1 �� IN RECORDING REQT„; STPD BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 2006-0052111 Recorded I Official yyRecords I CoButteof I MOU J. 6RMS I County Clerk-Recorderl I I 011:3VA 04Oct-M I REC FEE MW COIFORIED COPY 1.00 MZ Page i of 2 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. HARRY V. HANSEN 1972 REAL PROPERTY OWNERILESSOR MANUFACTURER'S NAME PO BOX 168 MODEL NAME/NUMBER MAILING ADDRESS . 60'X 24' OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 434 SILVERLEAF DR. 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 06-2221 530 538-7541 BUILD G PERMIT N0. TELEPHONE NUMBER S ��J// Ld V NATURE OF LOCAL AGENCY OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO UNKNOWN 1972 UNKNOWN MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER S5696XX/U 60'X 24' A23815/6 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 069-110-017 HCD FORM 433(A) REV. 8/91 . WHITE -County Recorder CANARY - HCD PINK -Applicant GOLDENROD- Building Dept. Title No. 05 -107885 -BEE Locate No. CAFN 0958-0958-0001-0000107885 LEGAL DESCRIPTION EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: Lot 121, as shown on that certain Map entitled, "Kelly Ridge Estates Unit One", filed in the Office of the County Recorder of Butte County, Califomia, 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 of Butte County. APN: 069-116-017 RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DMSION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 4 -Oct- e16 2*06-0t 552111 Has not been compared with original BUTTE COUNTY COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the .request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. HARRY V. HANSEN REAL PROPERTY OWNER/LESSOR PO BOX 168 MAII G ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 434 SILVERLEAF DR. 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 06-2221 530 538-7541 BUILD G PERMIT N0. TELEPHONE NUMBER NATURE OF LOCAL AGENCY OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write 'NONE") NONE DEALER LICENSE NO. UNKNOWN 1972 UNKNOWN MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER S5696XX/U 60'X 24' A23815/6 SERIAL. NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSORS PARCEL NUMBER 069-110-017 HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD- Building Dept. f FOUNDATION SYSTEM CERTIFICATE OF OCCUPANCY i BUILDING PERMITS NUMBER: 06-2221 Address or location of unit: 434 SILVERLEAF DR. OROVILLE CA 95966 Legal Description of Real Property: 069-110-017 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: HARRY V. HANSEN Owner's address: PO BOX 168 OROVILLE CA 95965 INSIGNIA OR HUD NUMBER: A23815/6 SERIAL NUMBER OR V.I.N.: S5696XX/U MANUFACTURER'S NAME: UNKNOWN YEAR: 1972 OFFICIAL APPROVING INSTALLATION: DATE: 10-)1-C)(,0 PHONE: (530) 538-7541 H.C.D. 513C STATE OF CALIFORNIA - DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT REGISTRATION CARD Manufactured Home Decal No: LAM8597 Manufacturer ID/Name Trade Name DAHLL Model DOM ODIOW1972 DFS 1 09119/1972 RY Exp. Date Serial Number Labetllnsigr Number Weight Length Width SPC SCC Exempt Use Type S5696XX A23815 60' 17 04 SFD LPT S5696XXU A23816 69' 17 Issued Total Fees Paid !t Oct 05, 2005 $97.00 Addressee ,SING , HARRY V HANSEN PO BOX 168 p o _ ... z OROVILLE, CA 95965 3ril oil Uj a G 0 Y D > Registered-.Owner(0) ..__._..__..:._......—..__. _.. - ------ - -HARRY V HANSEN PO BOX 168 OROVILLE, CA 95965 Situs Address 434 SILVERLEAF DR OROVILLE, CA 95966 Legal Owner(s) DOROTHY H DUNN REVOCABLE TRUST AGREEMENT 032690 PO BOX 5142 - OROVILLE, CA 95966 Lien Perfected On: 10/03/05 10:20:05 IMPORTANT THE OWNER INFORMATION SHOWN ABOVE MAY NOT REFLECT ALL LIENS .RECORDED WITH THE DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. THE CURRENT TITLE STATUS OF THE UNIT MAY BE CONFIRMED THROUGH THE DEPARTMENT. DTN: 4109990 10052005- 207 \ RECORDING REQUESTED BY: N Fidelity National Title Company of California Escrow No.:' 05 -107885Z -TG Locate No.: CAFNT0958-0958-0001-000107885Z Title No.: 05-1078852 When Recorded Mail Document To: Dorothy H. Dunn, Trustee P.O. Box 5142 Oroville, CA 95966 Recorded - I REC FEE 26.88 Official Records I County of 1 Butte i CANDACE J. ORiIBBS 1 County Clerk-Recorderl I 1 Cp 62:Iij M 0c-Sep-21NI5 I Page 1 of 5 APN: 069-110-017 SPACE ABOVE THIS LINE FOR RECORDER'S USE SHORT FORM DEED OF TRUST AND ASSIGNMENT OF RENTS THIS DEED OF TRUST, made August 31, 2005 ; between Harry V. Hansen, an unmarried man herein called TRUSTOR, whose address is 434 Siivedeaf Drive Oroville, CA 95966, Fidelity National Title Company of California, a California corporation, herein Called TRUSTEE, and Dorothy H. Dunn, Trustee of the Dorothy H. Dunn Revocable Trust Agreement, dated 3/26/1990 herein called BENEFICIARY, WITNESSETH: That Trustor IRREVOCABLY GRANTS, TRANSFERS AND ASSIGNS to TRUSTEE IN TRUST, WITH POWER OF SALE, that property in Butte County, California, described as: See Exhibit "A" attached hereto ADDITIONAL SECURITY HEREIN BEING THAT CERTAIN MANUFACTURED HOME LOCATED ON PROPERTY DESCRIBED ABOVE BEARING DECAL NO. LAM6597. Anything herein to the contrary notwithstanding, In the event of a voluntary sale, transfer or conveyance of all or any portion of the property described herein, any indebtedness or obligation due under the Note seared hereby, shall at the option of the holder hereof, immediately become due and payable. TOGETHER WITH the rents, issues.and profits thereof, SUBJECT, HOWEVER, to the right, power and authority given to and conferred upon Beneficiary by paragraph (10) of the provisions incorporated herein by reference to collect and apply such rents, issues and profits. For the Purpose'of Securing: 1. Perforinance of each agreement of Trustor incorporated by reference or contained herein. 2. Payment of the indebtedness evidenced by one Promissory Note of even date herewith, and any extension or renewal thereof, in the principal sum of $100,000.00 executed by Trustor In favor of Beneficiary or order. 3. Payment of such further sums as the then record owner of said property hereafter may borrow from Beneficiary, when evidenced by another note (or notes) reciting it Is so secured. INITIALS FD -221C (Rev. 9/94) SHORT FORM DEED OF TRUST WITH ACCELERATION Page 1 of 4 (deedoftax09-04) t` APN: 069-110-017 To Protect the Security of this Deed of Trust, Trustor Agrees: By the execution and delivery of this Deed of Trust and the note secured hereby, that provisions (1) to (14), inclusive, of the fictitious Deed of Trust recorded in Santa Barbara County and Sonoma County October 18, 1961, and in all other counties October 23, 1961, in the book and at the page of Official Records In the office of the county recorder of the county where said property is located, noted below opposite the name of such county, viz: COUNTY BOOK PAGE COUNTY BOOK PAGE Alameda 435 684 Kings 792 833 Alpine 1 250 Lake 362 39 Amador 104 348 Lassen 171 471 Butte 1145 1 Los Angeles T2055 899 Calaveras 145 152 Madera 810 170 Cotusa 296 617 Marin • 1508 339 Contra Costa 3978 47 Mariposa 77 292 Del Norte 78 414 Mendocino 579 530 Et Dorado 568 456 Merced 1547 538 Fresno 4626 572 Modoc 184 851 Glenn 422 184 Mono 52 429 Humboldt 657 527 Monterey 2194 538 Imperial 1091 501 Napa 639 86 Inyo 147 598 Nevada 305 320 Kern 3427 60 Orange 5889 611 COUNTY BOOK PAGE -COUNTY BOOK PAGE Placer 895 301. Sierra 29 335 Rumas 151 5 Siskiyou 468 181 Riverside 3005 523 Solano 1105 182 Sacramento 4331 62 Sonoma 1851 689 San Benito 271 383 StanWaus 1715 456 San Bernardino 5567 61 Sutter 572 297 San Francisco A332 905 Tehama 401 289 San Joaquin 2470 311 Trinity 93 366 San Luis Obispo 1151 12 Tulare 2294 275 San Mateo 4078 420 Tuolumne 135 47 Santa Barbara 1878 860 Ventura 2062 386 Santa Clara 5336 341 Yolo 653 245 Santa Cruz 1431 494 Yuba 334 486 Shasta 684 528 San Diego Series 2 Book 1961, Page 183887 which provisions, identical In all counties, (printed on the attached unrecorded pages) are hereby adopted and incorporated herein and made a part hereof as fully as though set forth herein of length; that Trustor will observe and .perform said provisions; and that the references to property, obligations and parties In said provisions shall be construed to refer to the property, obligations, and parties set forth in this Deed of Trust. The undersigned Trustor requests that a copy of any Notice of Default and of any Notice of Sale hereunder be mailed to him at his address hereinbefore set forth. STATE OF CALIFORNIA r; COUNTY OF ON GCI.L 9 - .3 /. _,rn^ F- before me, e un—de 'i ned Nota Pu lic personally appeared /1 rry I n e n personally known to me (or proved to me on the basis of satisfactory evidence) 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 his/her/their authorized capacity(les), 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 instrument. Witness my ha and official seal. Signature Harry V. Han n TERRIGEROY Commission #14420210 Notary Public-Califorrda W My Comm Exp.00CT. 24, 2p07 INITIALS -AL &. FD -221C (Rev. 9/94) SHORT FORM DEED OF TRUST WIT1H ACCELERATION Page 2 of 4 (deedoftd) APN: 069-110-017 DO NOT RECORD The following is a copy of provisions (1) to (14), Inclusive, of the fictitious deed of trust, recorded in each county In California, as stated In the foregoing Deed of Trust and Incorporated by reference In said Deed of Trust as being a part thereof as if set forth at length therein. TO PROTECT THE SECURITY OF THIS DEED OF TRUST, TRUSTOR AGREES: (1) To keep said property in good condition and repair, not to remove or demolish any building thereon; to complete or restore promptly and in good and workmanlike manner any building which may be constructed, damaged or destroyed thereon and to pay when due all claims for labor performed and materials furnished therefore; to comply with all laws affecting said property or requiring any alterations or improvements to be made thereon; not to commit or permit waste thereof; not to commit, suffer or permit any act upon said property in violation of law; to cultivate, irrigate, fertilize, fumigate, prune and do all other acts which from the character or use of said property may be reasonably necessary, the specific enumerations herein not excluding the general. (2) To provide, maintain and deliver to Beneficiary fire insurance satisfactory to and with loss payable to Beneficiary. The amount collected under arty fire or other insurance policy may be applied by Beneficiary upon any Indebtedness secured hereby and in such order as Beneficiary may determine, or at option of Beneficiary the entire amount so collected or any part thereof may be released to Trustor. Such application or release shall not are or waive any default or notice of default hereunder or Invalidate any act done pursuant to such notice. (3) To appear in and defend any action or proceeding purporting to affect the security hereof or the rights or powers of Beneficiary or Trustee; and to pay all costs and expenses, including cost of evidence of title and attorney's fees in a reasonable sum, In any such action or proceeding In which Beneficiary or Trustee may appear, and in any suit brought by Beneficiary to foreclose this Deed. (4) To pay: at least ten days before delinquency all taxes and assessments affecting said property, including assessments on appurtenant water stock; when due, all incumbrances, charges and liens, with interest, on said property or any part thereof, which appear to be prior or superior hereto; all costs, fees and expenses of this Trust. Should Trustor fail to make any payment or to do any act as herein provided, then Beneficiary or Trustee, but without obligation so to do and without notice to or demand upon Trustor and without releasing Trustor from any obligation hereof, may: make or do the same in such manner and to such extent as either may deem necessary to protect the security hereof, Beneficiary or Trustee being authorized to enter upon said property for such purposes; appear In and defend any action or proceeding purporting to affect the security hereof or the rights or powers of Beneficiary or Trustee, pay, purchase, contest or compromise any Incumbrance, charge or Tien which in the judgment of either appears to be prior or superior hereto, and, in exercising any such powers, pay necessary expenses, employ counsel and pay his reasonable fees. (5) To pay Immediately and without demand all sums so expended by Beneficiary or Trustee, with interest from date of expendfiure at the amount allowed by law In effect at the date hereof, and to pay for any statement provided for by law in effect at the date hereof regarding the obligation secured hereby any amount demanded by the Beneficiary not to exceed the maximum allowed by law at the time when said statement is demanded. (6) That any award of damages In connection with any condemnation for public use of or Injury to said property or any part thereof Is hereby assigned and shall be paid to Beneficiary who may apply or release such moneys received by him in the same manner and with the same effect as above provided for disposition of proceeds of fire or other Insurance. (7) That by accepting payment of any sum secured hereby after its due date, Beneficiary does not waive his right either to require prompt payment when due of all other sums so secured or to declare default for failure so to pay. (8) That at any time or from time to time, without liability therefore and without notice, upon written request of Beneficlary and presentation of this Deed and said note for endorsement, and without affecting the personal liability of any person for payment of the Indebtedness segued hereby, Trustee may: reconvey any part of said property; consent to the making of any map or plat thereof; join in granting any easement thereon; or join in any extension agreement or any agreement subordinating the pen or charge hereof. (9) That upon written request of Beneficiary stating that ail sums secured hereby have been paid, and upon surrender of this Deed and said note to Tnustee for cancellation and retention and upon payment of its fees, Trustee shall reconvey, without warranty, the property then held hereunder. The recitals In such reconveyance of any matters or facts shall be conclusive proof of the truthfulness thereof. The Grantee in such reconveyance may be described as "the person or persons legally entitled thereto." five years after issuance of such full reconveyance, Trustee may destroy said note and this Deed (unless directed in such request to retain them). (10) That as additional security, Trustor hereby gives to and confers upon Beneficiary the right, power and authority, during the continuance of these Trusts, to collect the rents, issues and profits of said property, reserving unto Trustor the right, prior to any default by Tnnbor in payment of any Indebtedness secured hereby or In performance of any agreement hereunder, to collect and retain such rents, Issues and profits as they become due and payable. Upon any such default, Beneficiary may at any time without notice, either In person, by agent, or by a receiver to be appointed by a court, and without regard to the adequacy of any security for the indebtedness hereby secured, enter upon and take possession of said property or any part thereof, In his own name sue for or otherwise collect such, rents, issues, and profits, including those past due and unpaid, and apply the same, less costs and expenses of operation and collection, Including reasonable attorney's fees, upon any Indebtedness secured hereby, and In such order as Beneficiary may determine. The entering upon and taking possession of said property, the collection of such rents, issues and profits and the application thereof as aforesaid, shall not cure or waive any default or notice of default hereunder or Invalidate any act done pursuant to such notice. (11) That upon default by Trustor In payment of any Indebtedness secured hereby or In performance of any agreement hereunder, Beneficiary may declare all sums secured hereby immediately due and payable by delivery to Trustee of wd ten declaration of default and demand for sale and of written notice of default and of election to cause to be sold said property, which notice Trustee shall cause to be filed for record. Beneficiary also shall deposit with Trustee this Deed, said note and all documents evidencing expenditures secured hereby. t V - FD -221C (Rev. 9/94) SHORT FORM DEED OF TRUST WITH ACCEERATION Page 3 of 4 (deedofta) APN: 069-110-017 DO NOT RECORD After the lapse of such time as may then be required by law following the recordation of said notice of defaulL and notice of sale having been given as then required by law, Trustee, without demand on Trustor, shall sell said property at the time and place fixed by it in said notice of sale, either as a whole or in separate parcels, and In such order as it may determine, at public auction to the highest bidder for cash of lawful money of the United States, payable at time of sale. Trustee may postpone sale of all or any portion of said property by public announcement at such time and place of sale, and from time to time thereafter may postpone such sale by public announcement at the time fixed by the proceeding postponement. Trustee shall deliver to such purchaser its deed conveying the property so sold, but without any covenant or warranty, express or Implied. The recitals in such deed of any matters or facts shall be conclusive proof of the truthfulness thereof. Any person, Including Trustor, Trustee, or Beneficiary as hereinafter defined, may purchase at such sale. Atter deducing all casts, fees and expenses of Trustee and of this Trust, Including cost of evidence of title in connection with sale, Trustee shall apply the proceeds of sale to payment of: all suns expended under the terms hereof, not then repaid, with accrued Interest at the amount allowed by taw in effect at the date hereof; all other sums then secured hereby; and the remainder, If any, to the person or persons legally entitled thereto. (12) Beneficiary, or any successor in ownership of any indebtedness secured hereby, may from time to time, by instrument in writing, substitute a successor or successors to any Trustee named herein or acting hereunder, which Instrument, executed by the Beneficiary and duly acknowledged and recorded In the office of the recorder of the county or counties where said property is situated, shall be conclusive proof of proper substitution of such successor Trustee. or Trustees, who shall, without conveyance from the Trustee predecessor, succeed to aA Its title, estate, rights, powers and duties. Said instrument must contain the name of the original Trustor, Trustee and Beneficiary hereunder, the book and pages where this Deed is recorded and the name and address of the new Trustee. (13) That this Deed applies to, Inures to the benefit of, and binds all parties hereto, their heirs, legatees, devisees, administrators, executors, successors and assigns. The term Beneficiary shall mean the owner and holder, Including pledgees, of the note secured hereby, whether or not named as Beneficiary herein. In this Deed, whenever the context so requires, the masculine gender includes the feminine and/or neuter, and the singular number Includes the plural. (14) That Trustee accepts this Trust when this Deed, duty executed and acknowledged, Is made a public record as provided by law. Trustee Is not obligated to notify any party hereto of pending sale under any other Deed of Trust or of any action or proceeding In which Trustor, Beneficiary or Trustee shall be a party unless brought by Trustee. REQUEST FOR (FULL RECONVEYANCE Fidelity National Title Company of California, a Callfamle corporation, TRUSTEE: The undersigned Is the legal owner and holder of all indebtedness secured by the within Deed of Trust. AD sums secured by said Deed of Tent have been fully paid and satisfied; and you are hereby requested and directed, on payment to you of any sums owing to you under the berme: of said Deed of Tent, to cancel all evidences of Indebtedness, secured by said Deed of Trust, deMred to you herewith, together with the said Deed of Trust, and to reconvey, without warranty, to the parties designated by the temps of said Deed of Trust, all the estate now held by you under the same. Dated By: By: Please mail Reconveyance to: Do not loge or destroy this Deed of Trust OR THE NOTE which it secures. Both original documents must be delivered to the Trustee for cancellation before reconveyance will be made. STATE OF CALIFORNIA COUNTY OF ON before me, the undersigned Notary Public personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) Is/are subscribed to the within Instrument and acknowledged m me that he/she/tfiey executed the same in his/her/their authorized capaclty(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 Instrument. Witness my hand and official seal. Signature FD -221C (Rev. 9/94) SHORT FORM DEED OF TRUST WITH ACCELERATION Page 4 of 4 (deedofta) 4 Title No. 05 -107885 -BEE Locate No. CAFNT0958-0958-0001-0000107885 LEGAL DESCRIPTION EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: Lot 121, as shown on that certain Map entitled, "Kelly Ridge Estates Unit One", filed in the Office of the County Recorder of Butte County, 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 of Butte County. APN: 069-110-017 r 69-110-01706-22�1-ANSEN HARRY •. _.. L --M : NOTES ,,434'sILVERLEAF.DR,,oRovILLE I' MH PERM FND(EX) lij - RESIDENTIAL APH: Permit No. Owner. Site Address: Contractor. Type of Permit: r i . I . } r SPECIAL CONDITIONS CHECKED BY Q SRA Q FI_OOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED . SPECIAL INSPECTION ITEMS VERIFY H MR USE PERCONDMNS SUBSTANDARD HOUSING LETTER HENCROACMENT PERMIT REINSPECTION FEE PAID Q ENV HLTH CLEARANCE O cy ez�5.�. DATE J08 F94AL.ED: SIGNATURE: BUTTE COUNTY .DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR. INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWdls PERMIT NO. BP062221 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/14/2006 APN: 069-110-017-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: ' Site Address: 434 SILVER LEAF DR ORO Date: Contractor: Map Index: Description: EX MH EX SITE PERM FNDN (1440) OWNER -BUILDER DECLARATION I hereby affirm under penally' of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: HANSEN HARRY V permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the.applicant for such permit to file a PO BOX 168 signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95965-0168 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: HANSEN HARRY V Code: The Contractors' State License Law does not apply to an PO BOX 168 owner of property who bulld.s or improves thereon, and who does such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for 95965-0168 sale. If however, the building or improvements are sold within one 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 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Stale License Law does Contractor:. not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). O I am Exempt under Article 3J thp Business and Psofegsions Code / L 6 Date: '/ -'a Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ' Engineer: ❑ 1 have and will maintain workers' compensation insurance, as 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. Valuation: $0.00 Census Code: Policy #: 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 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 withthoseprovisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees.' CONSTRUCTION LENDING AGENCY This permit its hereJ�ad der the applicable provisionsof the Butte Cmunty Coda ?nrUor I hereby affirm that there is a construction lending agency for the - of the work for which this permit Is issued (Sec 3097 Civ.) Resoiulions todo aled above' which fees have been paid D performance J\ BY Name: /Date: 0 PERMIT EXPIRES ON: ' Address: Date O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 6 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 owner or the duly authorized agent of the owner. I agree to comply with all cofinty and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official for or ocument of Butte County. I hereby authorize represents fives of Butte County to enter up n the above mentioned for inspection purposes. \/property Print Name: ' V Signature: Date:_: Owner O Contractor ❑ Agent for Owner ❑ Agent for Contractor . =OK a = Not OK MANUFACTURED HOMES DATE I LPERMANENT FOUNDATION 'SOFT -SET 4r -Easements 2 Soils; Special MH Support Sketch • 3 Sewer; Loctn Test; FallICIO-Concrete 4 Wtr, Loctn-Test-Easeinent Needed -Regulator 5 Elec Loctn-CImcs-Grad Amp -Concrete 6 Yard Gas; Loctn Test Wrap Nat ❑ or LPQ Inch Sz Ft Lngth 7 Blckng; SzSpacing-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 -CIO to Grade 12 Gas and Electricity Tagged le Downs Q Foundation 14 Exits 15 Cert of Occupancy 16 HUD Labellinsignia Numbers Serial Numbers ' P MISCELLANEOUS --DATE IDECKS`COVERS'CARP0RTS•GARA GES 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-OpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dddng-Brcing Stairs-GuardlHandratis 4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs d Carports; Wndws-Doors 7 Electric 8 Fang; Sills-Anchrs-Stvds-Rftrs Tnisses' 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof 5hthg-Roofing 11 E.�t Steps -Doors -Landings 12 Braced Wali pnis uwrr: IrvvE-. f 1 Setbacks -Easements t 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctrts Thidtness Dead Men4Jning 4 Elec RcptdstUng; Distance-GFI 5 Elec Pool L;Ung; 15 volts-GFi 6 EIec.Endsrs; Conduit Entries -Terminals -Listed 1 7•Elec Bonding; Metal wIT-Crdtng EgpHtr i 8 Elec Grndng; Eqp w/T Crdtng Eqp-Pool Ightg i Saxes-Encisrs-pnlboards4nsultn•to Main Conduit 9 Health Dept Apprvl 10 Pimb: Cir Test-Wtr Supply Test 11 U Niche ; 12 Endsr; Fending -Alarms 13 Bor)dmg, Diving board or Slide d oa 4s' t Pool Drawing , Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Gmd Ftg Dptfr 54 Wtr Pipe; Test & Anchr Nail Prtctn 3 Ftg Garage; So&Steel-Flet Gmd Ftg Dpth 55 DWV; Test Fittings & Anchr Nail Prfctn 4 Fig Parches/Decks; Soils -Steel Fig Dpth 56 Shwr Pan; Test, Fust flr--Tub Acc 5 Stemwalls Main; Steet-Blockouts Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 Fire Sprinkler, Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc FtgSteel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test a a` 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test Anchm-RgltrService Test 12. Elec Undrgmd DATE IMECHAKICAL 13 Plenums & Ducts; Cimc-materialSupport-insultn 61 AC Ducts InsuRn & Support " 14 GirdersSlits-Anchr Bolts-Joists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insulin 15 Acc & VnUtn 63 Condensate Drain & Ovrflw, Sz & Grade - 16 Insulation 64 Furnace -Vent Acc-Comb Air RbmNent 115 Outlet 65 Attic Acc & Pltfrm if Furnace In attic a' vTa dd o�� DATE jFrRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 18 Wills Studs -Nailing Spacing & Braces-PlatesSound 66 Ext Steps -Door & SIdeL.f Prtctn-landings 19 Bearing Walls over G-u'ders•'N fir Nailing 67 Smoke Detector 20 Draft Stop In Walls (rat proof), 68 Furnace Vnts-Cimc-Comb, Air•Cnnctr 21 Fire Stops; .. .il CeilingsStairs�hasers Tubs In Garage; abv-flr-Ducts-Meth Prtctn 22 Headers & BeaihsSi &•Bea.nng' 69 Bedroom Exiting 23 Hangers-Posf'Caps Anch !s-Cnncfns 70 GFl 8� Bath Fxtrs &Tub Acc-Spa 24 Ceiling Joisf r T'ies-Pu ."oof Brac TnissShthg ' 71 GFl Arc Fault 25 FrpIc Tie's'or i'ype A FI F��p' I� Throat Cimc 72 Elec Trim & Subpnl, Breaker Szs &Labels 26 Attic Act Sz &'Rmz Pitefp-b6ft Stop -Ins Baffles 73 Sta irs, GuardlHandrails 27 Bdrm Wndws or Exiting Doors -Sig fit & Dimensions 74 Frplc or Stove, Cimc-Hearth 28 Garage Fire Prtctri Framfng-RC Channel 75 Elec Outlets at Woos) PnL Int & Ext 29 Prprty Line Firewall & Opngs' . 76 Kuhn, Fxtr & AppinC Grnd-Air-Gap-Cooking Cimc 30 Ext Doors -One 3' -Check Garage 3r4 Story, 2 Exits 77 Elec Outlets & Rcptcis at Ktchn Counter 31 Stairs; Width-Hdrm-Rise4bm4.anding-Fire Prtctn 78 Garage Fire Dobr, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic VntsWr Outrgm 79 AC Dud to Garage -Damper. 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Cimc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass PrtdnSkyLts•Piastic • 81 Pimb; Elec & Mech Egp Listed for L.octn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GF) Ramex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insults Walls -Ceilings 84 Guard Rails & Deck Cnstrcbt-Post Caps 39 infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Cimc Dmge Planters Q Yes Q No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Ptmb 89 Vnts abv Roof, PImb�lppinc-Frplc-Cimc to Opngs DATE ELECTRICAL 90 Wtr Well, Dscnnct, Elec, Pimb 40 Fxtr & Tmsfrmr Cirnc-Ins PRctn 91 Ext Elec Trim, GFl Rcptc-Undrgmd 41 Elec Rcptcts Spacing-Lts & Switches at Doors 92 Vntitn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex installed Close to Edge of Studs & CJ 94 Corrections from previous hispctrts 44 Eqp Gmd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas�Elec 45 Gmdng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl 46 2 Appinc Cires to Kichn & Cnddr Sz GFl 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz o, OCU or DAL AC Wire Sz - ❑ o 98 Address Posted CU or AL 99 Fire Sprinkler 48 Range Circ o. D CU or[::] AL il or D AL Oven Circ 9aRNo Insulated Neutral es D ,p.� o,� o,.• s` °T 49 Service -Riser Cndctrs & Gmd Main Dscnnct 50 Eqp Cimcs pnls-Motors-Meeh Eqp 51 Clothes Closet UShwr Lt -Spa Lt 52 Smoke Detector BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netlidds PERMIT NO. BP062221 LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 09/14/2006 APN: 069-110-017-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 434 SILVER LEAF DR ORO Date: Contractor: Map Index: Description: EX MH EX SITE PERM FNDN 1440 p OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: HANSEN HARRY V permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the.applicant for such permit to file a PO BOX 168 signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95965-0168 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: HANSEN HARRY V Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does PO BOX 168 such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for 95965-0168 sale. If however, the building or improvements are sold within one 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 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 Contractor:. not apply to an owner of property who builds or improves thereon, . and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3t Business and Prore sions Code 3iv.-a 60wner: Date:�L: � License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as 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 a: Valuation: $0.00 Census Code: 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 workers' compensation laws of California. and agree that if I should. become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: v Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages s provided for in Section 3706 of the Labor code; interest, and attorney's fees. CONSTRUCTION LENDING AGENCY— This permit is here i ed der the applicable provisions of the Butte County Coda anrVor - I hereby affirm that there is a construction lending agency for the Resolutions to do •n 'ted above which fees have been paidC, - \ performance of the work for which this permit is issued (Sec 3097 Civ.) Name: J\ By: DDa\`te. V Address: PERMIT EXPIRES ON: Date ❑ 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 owner or the duly authorized agent of the owner. I agree to comply with all co0nty and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official for or ocument of Butte County. I hereby authorize represents fives of Butte County to enter up n the above mentioned property for inspection purposes. Print Name: L V Signature: Date: "Owner 0 Contractor ❑ Agent for Owner 0 Agent for Contractor 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" OWNER INFORMATION Last Name ' ,r U �) _ / irst Name r f Address �3 G sL Vo, ///I L 1 -2 Fax E-mail APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail I ' APPLICANT SIGNATURE ` -- _ I X For office use only.:—_ Zoning AN(') Flood Zone _____---"-SRA- ❑ Structure Built without Permits IYes -No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. Ue . XQ--1 BP BIN # �/ DescP tion o Scope of Work: PROJECT LOCATION AN(') Sq FT- Living 77 �dre (� ❑ Structure Built without Permits City Cross Street l 1 l 1 WORKER'S COMPENSATION Policy Number Carrier Nhiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address DescP tion o Scope of Work: 0 Receipt Sq FT- Living Garage J 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. [I_Reeeiva—'CbvD Amount: i ' _ Bldq 11 OVER FOR SUBMITTAL REQUIREMENTS II K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 8-12-05 SRA Receipt Sheriff 4j t SMIP Dat [ Date ` Other l 1 l 1 _Total REV 8-12-05 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 /N 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 faxesl ❑ 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 bidgs: (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 permits refunds 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 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES � NO [ ]. 2. I HAVE �X ] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: DATE: �— / V, NOTE: This Owner -Builder verification is required by Section 19831_ and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.netldds OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner-builder"building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321-CSLB (2752) or by accessing their website at www.CSLB.ca.gov. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Manager, Building Divikion NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. V6ctor Dynamics "Foundation System" by TIE DOWN ENGINEERING, Inc. Installation Instructions for the State of California, Wind Zone 1, 15 PSF Wind, Seismic Zone 4 Introduction These instructions describe the proper use of the lateral and longitudinal foundation system. General The Vector Dynamics Foundation System resists lateral & longitudinal wind loads by anchoring the two longitudinal main rails. The system is approved to be used on single or multi section homes: • These plans and specifications meet the requirements of Title 25 section 133$' and c C,66' requirements. • Maximum eave width (roof overhang of sidewall) of 12" for Zone I. The Vector Dynamics Foundation System has not been designed for use on exposure "D" homes within 1500 feet of the coastline. Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, end frame ties and rim plates. QROFES \ �O . 26070,1) AR 312006 `J>gjF F Civil O CA Engineer Approval State Approval UMMACrURED MME/MONO Et M FOUNDAMN SYSTEM =a= AM SMVff CODE. SECnW ISS! "MovW MmjscrToomnmoNSNOTsn OMMAL DM NO? AUTAORIZB OR AMMWM ANY OMISSIONS 0A DEVIATION FROM REQUIREMENTS 011 APHJCA= STATE LAWS AND RBOULATWM &gee of Cdffibmu M JPS (W COM AMID STAND4M Eli BUIL ` "�. " APPPOk/ . YX GENERAL INSTALLATION INSTRUCTIONS Site Preparation It is necessary that the home site be properly graded and sloped to prevent water and moisture from standing or flowing beneath the home. Footings and Frost Lines The Vector Dynamics Foundation System was designed to be placed directly on top of the ground (or poured concrete) after clearing all loose vegetation. In areas with frost heave, use Vector for Poured Concrete.to comply with local requirements for footer depth. Foundation/Footing Specification for Vector Pads Vector Pads are used in place of conventional foundation pads. One Vector pad provides 2 sq. ft. on single block and 3 sq ft. double block pads of bearing support. Vector Systems should be spaced as symmetrically as possible within 10' of end of home. For pier locations in between the Vector Systems, use the normal foundation pads. Maximum Pier Height Vector Dynamics Foundation Systems may be used on single section homes in Wind Zone I which require pier heights (from surface of Vector pads to top of concrete or metal pier) not to exceed 36 inches under one or both main rail(s). Multi -section homes limited to 50 inches. Unequal Pier Heights Multi -section homes with unequal pier heights are limited to 50" maximum pier height. The difference between the taller pier and the shorter pier cannot exceed 26". Vector Dynamics Foundation Systems Component Parts List Vector Foundation Systems for the State of California Page 2 Vector System Part # 59018 Single piece pads with straps and slotted bolts Vector/LSD Kit Part # 59013K for single block pads c 11 /28/2005 r� t ,.y1 �Y 6 K..E�u. n`.k.:®f®Jy� , � � • � �� VOWyg.FgR- °�° Concrete Vector System o P Part # 59036 . (for single stack blocks) 190 NT ;0 t faffill Concrete Vector S stem 6 6 6o -System Part # 59049 — _ (for double stack blocks) maim °�°.. _Longitudinal 4 Stabilization Hardware Kit - 0 0 8` for Concrete - ®� fall ®� gg00 Part #59023 ----------------------------------------------------------------------------------------------------------- a Vector 20003 Sq. Ft. Pad Part # 59276 for Double Block r: sets with strap and hardware ZIP- °eMo ms o� ® Longitudinal .o, o Hardware Kit Part # 59026 (for use with 59271) . 45 hl Ye�� d ®M Struts for Longitudinal Systems Part Strut Pier No. Length Height ` 59013 44" up to 4 Blocks Center Compression Strut. 59015 65"- 516.6 Blocks # 48612 - 627- 108" Strut �. #. 48613 - 34 60" Strut,. Vector Foundation Systems for: the State of California Page,3 '11/28/2005 Set -Up Instructions for Vector System Beam Clamp Longitudinal Strut Long U -Bolts �'al.,. Longitudinal13racket as C` Vector 2 sq. ft. � Pad for single block set ~---., � y 1. Set Vector Pads Clear all vegetation where pads will rest. Place a long U -bolt in pad as shown. Attach longitudinal bracket to pan. Press or hammer pad into the ground. 2. Set Block or piers on pads. Center foundation blocks or piers on pads. Place metal strut between blocks, resting on pads, centers between U -bolts as shown. 3. Outside Tension Bracket Attach outside tension bracket as shown to outside of pads. Vector foundation Systems for the State. of California 4. Inside brackets & straps Attach the inside tie brackets to the U -bolts over the compression member. Attach a strap w/hook or swivel strap w/nut & bolt. Place other end of the strap over opposite I-beam & down to outside tension bracket. Cut strap 12 -15 inches past bracket. Attach strap & slotted bolt in bracket. Tighten strap until tight with 4-5 wraps around bolt. Repeat with opposite strap. 5. Longitudinal Install beam clamp to I-beam and attach longitudinal strut to pan using nuts and bolts provided. Pull beam clamp outward to remove any slack and tight"!I,. nuts and bolts. Page 4 11 /28/2005 :� ��' � -� is '� ��, �` �Y P r "v ay "� � 9, / / / � 1 re' 1 y�� ttygg'+• � y��qp � 1 � � � ,/ +� Metal Pier Foundations For metal piers, place the piers in the center of the Vector pad. Set the strut through the piers so that it butts up against the tension bracket. Inside tie bracket mounts upside down as shown in drawing. Metal piers on Vector can only be used on level ground sets. Conventional pier adjusters must be placed under beam with head fastened to beam. Pier spacing must be consistent with home manufacturers' installation instructions and/or state requirements. Vector Foundation Systems for the State of California Page 6 c 11/28/2005 WIND ZONE I for Single Section'Homes Using Vector Dynamics Foundation Systems Example of a Single 5ection 14'x 72' Home I--———————————————————————————————--——--- — — — I u LTJ -- --- --- ---U' --- ----U --- — — - --- .I LSD Soil Bearing Capacity: 1,000 PSF Minimum Home Length Vector Systems Required Longitudinal Stabilization (LSD) 0 to 80' 4 2 NOTES: For use on 14' & 16' wide homes. Main rail spacing on single wide must be 95" or more. Pier hieghts cannot exceed 36". Roof slope no greater than 20° (4.37 in. 12" pitch). Vector Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers instruction and/or state requirements. Two Struts =1 LSD System. Can be used on one pad or on opposite ends of home Vector Foundation Systems for the State of California Page 7 c •� 11/28/2005 WIND ZONE I for Double Section Homes Using Vector Dynamics Foundation Systems -------------------------------------------- I I I I LSD Example of a Double Section 26'x 72' Home I Vector System LSD I Soil Bearing Capacity: 1,000 PSF Minimum Home Length* Vector Systems Required Longitudinal Stabilization (LSD) 0 to 62' 3 2 63' to 80' 4 4 * Up to 7:12 Slope NOTES: Vector Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers instruction and/or state requirements. Two Struts =1 LSD System which can be used on one pad or on opposite ends of the home. Diagram represents example of a double section offset. Total size is determined by the length of unit plus offset. Vector Foundation Systems for the State of California Page 8 lot-- 28' � 72' Example: 28'x 72' 11/28/2005 WIND ZONE I for Double Section Homes (High Pier Sets) Using Vector Dynamics Foundation Systems ir°1 L J III� �I n T 1� n n �� L_ ---- -- — ---- — — —- — — —— -- — — — — Soil Bearing Capacity:.1,000 PSF Minimum Home Length Vector Systems Required over 24" Longitudinal Stabilization (LSD) 0 to 80' 4 4 NOTES: Pier height is measured from top of the Vector Pad to the bottom of the I-beam. Vector Systems should be spaced as symmetrically as possible along the. length of the home. Pier spacing must be consistent with home manufacturers instruction and/or state requirements. Two Struts =1 LSD System which can be used on one pad or on opposite ends of the home. Vector foundation Systems for the State of California Page 9. c 11 /28/2005J��— WIND ZONE I for Triple Section Homes Using Vector Dynamics Foundation Systems -----------------------------------------------I LLEJ LM M LM I I I Example of a Triple Section 32'x 72' Home I vuc;wr aysvem& — y LOV I I W _j F. -I r. --i rl rl — W N.7 rl rl I ------- -- ---- --IIF--,---------------j I ! n n n n n n I Tag or Full Triple ----------------------------------- Soil --------------------------------Soil Bearing Capacity: 1,000 PSF Minimum 32' Home Length Vector Systems Required Longitudinal Stabilization (LSD) 'Tag Or 3rd Section 0'to80' 4+2onTag 2 2 NOTES: Vector Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers instruction and/or state requirements. Two Struts =1 LSD System which can be used on one pad or on opposite ends of the home. 72' Diagram represents example of a triple section offset. Total size is determined by the length of unit plus offset. Vector Foundation Systems for the State of California Page 10 11/28/20 0 Vector Dynamics* System for Concrete Applications Insfructions Read and follow all applicable instructions and guidelines in the Vector instructions and home instal- lation manual. The Vector system'for concrete pads applies to concrete footers, runners acid slabs. Minimum size of concrete per Vector pier is 24"x24" x 4" or 18" round (min) x 10"-deep.'The bottom�of footers must be below the frost line or a minimum of 4" below finished grade whichever is greater. Concrete must be sufficiently cured and set to accommodate an anchor bolt to its' full load resistance. 1.: Determine location of pier sets where the Vector systems will be located. 2. , Place one Vector concrete pad (galv.,metal) on the concrete where.the pier Will be,located, centered " under,the I-beam of the home. Place the upturned edge towards the center of the home -and directed to the opposite Vector pier. ,Do the same for the opposite Vector pier. 3. Place a long u -bolt through the holes of the Vector pad as shown. 4. Place the concrete pier blocks on the Vector pad. Center the blocks under the frame. The upturned edge. end of the Vectorpads should be up -against the inside of the pier blocks. 5*. ° Build vector piers but do not wedge at.this time.. , 6. Using a concrete drill bit, drill two holes into the concrete using, the two holes in the rear end of the Vector pad as a guide. Drill the 3/8" diameter holes..3 inches deep. 7.: Place an outside tension bracket on the Vector pad as shown in Illustration one. Line up the holes in the bracket, Vector pad.and concrete pad. Illustration One: , Single Block Set -Up Part #59036 Double Block Set -Up Part #59049 Vector pay for concrete Wood Cap and wedge Outside Tension Bracket Wedge Bolt • footer .Vector Foundation Systems for the State of California Page ll 4 Vector Dynamics System . r for Concrete Applications I - 8. Put a washer and nut on one of the 3/8" x 3-3/4" wedge anchors. The nut should be screwed on enough to have 1 or 2 threads showing on the top of the bolt. Place the wedge end of the bolt into one of the holes, going through the.outside tension bracket, metal Vector pad and into the concrete. 9._ Using a hammer; tap the wedge bolt into the -hole. Maximum height for expansion bolt above concrete is 2". 10. Repeat for the other hole in the outside' -tension bracket and the two holes on the other Vector system pier set: . 11. Place an inside tie bracket over the u -bolt so that the lip of the bracket is between the Vector plate and concrete blocks. Place washers and nuts on each U -bolt. Do not tighten yet. 12. Attach a strap w/hook or swivel strap w/nut & bolt. Place other end of the strap over opposite I-beam & down to. outside tension bracket. Cut strap 12 - 15 inches past bracket. Attach strap & slotted bolt in bracket. Tighten strap until tight with +5 wraps around bolt. Repeat with opposite strap. 13. Tighten inside u -bolts at this time. 14. Use the outside tension brackets to remove any space between the outside tension brackets, concrete blocks and the inside edge of the Vector pad, by tapping the brackets with a hammer. Wedge. the pier set at this time. 15.. Using -a 9/16" socket wrench, tighten all of the wedge/anchor bolts, securing the outside tension bracket and Vector pad to the concrete. 16. Using.a slotted bolt in the outside tension brackets, insert strap through slotted bolt with end of strap aligned with outside edge of bolt. Turn slotted bolt until straps are tight using at least five turns on the slotted bolts. Illustration Tv Single Block Part #59036 Double Block Part #59049' Inside Tie Bracket meet compression U -bolt Strut Vector Foundation Systems for the State. of California Vector pad for concrete Concrete footer c Page 12 11 /28/2005 nairiics� #59018-1 Hardware Kit for #59018 & #59276 Lateral System 2 10019 Flat Washer 1/2" zinc 4 10502 Flat Washer 3/8-16 zinc 4 10624 Hex Nut 3/8-16 Grade 5 zinc .2. 10646Y Hex Nut 1/2-13 Grade 5 zinc 2 10925 Carriage Bolt 1/2 x.1 Grade 5 zinc 2. 59135 Slotted Bolt w/Nut 2 59232. Protecto Strap 2 59279 Diagonal Connector 2 59288 Vector Tension Head 2 83044Z U Bolt 3/8-16 x 4.06 x 4.88 zinc #10732 Hardware Kit Longitudinal 4 10804 Carriage Bolt 3/8-16 x 1 Grade 5 zinc 4 10502 Flat Washer 3/8-16 zinc 4 10624 Hex Nut 3/8-16 Grade 5 zinc #10732-1 Hardware Kit Longitudinal 8 10926 Carriage Bolt 1./2.13 x 1-1/4 full Thread 1210646Y Hex Nut 1/2-13 Grade 5 zinc 4 10801 Carriage Bolt 1/2-13 x 2-1/2 Grade 5 zinc #10733 Longitudinal Hardware for #59013 Kit 1 10732 Hardware Kit 1 10732-1 Hardware Kit 2 59282 Tension Link 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange, #59036-2 Vector Sub Kit for Concrete 4 10502 Flat Washer 3/8-16 zinc 4 10530 Hardware Anchor wedge 3/8 x 3.50 4' 10624 • Hex Nut 3/8-16 Grade 5 zinc 3 83004Z 'U Bolt 3/8-16 x 4.56 x 5.50 2 59282 1-3/4 Thread zinc 2 59135 Slotted Bolt w/Nut 2 10926 Carriage Bolt 1/2-13'x 1-1/4 Full Thread 2 10646Y Hex Nut 1/2-13 Grade 5 zinc 2 10019 Flat Washer 1/2 zinc Vector Foundation Systems for the State of California Parts Breakdown #590361 Hardware for #59036 and #59049 Lateral Concrete System 1 59036-2 Sub Kit 2 59279' Diagonal Connector, 2 59282 Tension Link 2 59232 Protecto Strap #59023 Longitudinal .Hardware 4 10530 Hardware Anchor Wedge.3%8 x 3.50 1 10732-1 Hardware Kit 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange" 2 59282 Tension Link ' #59026 Longitudinal Hardware 2 59272-1 Beam Clamp Base, , 4 59272-2 Beam Clamp Top Flange 2 59288 Vector Tension Head 1 10732-1 Hardware Kit #48612-1 Compression Strut Hardware 2 10999 U Bolt 3/8-16 x 4:06 x 2.75.1-3/4 Thread zinc 4 10502 Flat Washer 3/8-16.zinc 4 10624 Hex Nut 3/8-16 Grade 5 zinc 6 10556 Tek Screw #12 x 1 r c Page 13 11/28/2005 tl r. PERMIT NUMBER - B 2679-72B,E P E PERMIT EXPIRES `73 OWNER Silas White x, CONTR:.1 owner ' LOCATION (A.P. 34-64-17 43/+ Silverleaf Dr., Lot 121, Kelly Ridge Estates, Oroville PERMIT NUMBER - B 2679-72B,E P E PERMIT EXPIRES `73 OWNER Silas White x, CONTR:.1 owner ' LOCATION (A.P. 34-64-17 43/+ Silverleaf Dr., Lot 121, Kelly Ridge Estates, Oroville _r, k A COUNTY OF BUTTE Department of Public Works BUILDING INSPECTIO,� RECORD Zoning Setback e Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing c3 -� — Plmg. Topout Rough EIec. ` Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final Final Final 01Z 3 '— DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE — DEPARTMENT OF PUBLIC 7 County Center Drive — Orovi lie, California 95965 Telephore: 533-,230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above -me 'oned property for ins p tion purposes. y X ✓ Date b Signature offPermite�e or Agent Receipt No. ! � 'Y 7 White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 _t-"�4�&_2e&_ Date % --// i "-- Building Permit Expires Date/O—//— 72 BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mai I i ng Address - Fireplace Contractor Total Valuation Mailing Address Permit Fee otl Plan Checking Fee&/or Penalty Permit Fee $ $23 fe Building Address lj-Z,r P PLUMBING No. @ FEE PERMIT FILING FEE $2.00 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. 3L�� p �- tl Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation Planning Building sewer 5.00 Fees W. C. R/W Encroachment Lawn sprinkler system 2.00 NEW ADDITION ❑ OTHER ❑ Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 \ �L y Main service incl. 1 meter Additional meters, each 1.00 Sub -pane 2 or less) more than 12) �6 U USE OF STRUCTURE Single Family ❑ Duplex ❑ Others ❑ Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures ;P DOI sc� Receps., switc es & fix outlets alffli 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 Misc. wiring License No. Classification _41 am exempt from the Contractors License Laws of the State of California. Permit Fee $ S $ J." S( 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 Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby jjPermit Iris rumentationtrlgn a anion $0.07/$1000 Evaluation $ a� i TOTAL PERMIT FEE $�C ` o authorize representatives of the County of Butte to enter upon the above -me 'oned property for ins p tion purposes. y X ✓ Date b Signature offPermite�e or Agent Receipt No. ! � 'Y 7 White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -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 _t-"�4�&_2e&_ Date % --// i "-- Building Permit Expires Date/O—//— 72 0 �. JPERMIT NUMBER — B 867-73 B P c n E I PERMIT EXPIRES Silas White OWNER owner CONTR:. d .34-64-17 LOCATION (A.P. 434 Silverleaf Dr., Oroville . I COUNTY OF BUTTE Department of Public Works BUILDING INAPECTION RECORD Zoning Setback 7 Forms Foundation Piers & Girders Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing — —'7 Plmg. Topout Rough Elec. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final Final Final DATE REMARKS OR CORRECTIONS r COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 / Tel ephorie: 534-4541 / APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentio property for in/spect�ion purposes. X D ate Signature ofPermitee or Agent Receipt No. Q White-D.P.W. — Yellow -Assessor — Pin -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date Building permit expires Da a ._. BUILDING Owner4/ L SQ. FT. OCC. BUILDING VALUATION d Mailing Aress !� 6-L42 G Telephone No Fireplace Contractor Total Valuation Mailing Address Permit Fee ` Plan Checking Fee &/orPenalty Telephone No. Permit Fee $ G $ Building Address mer.. PLUMBING No. @ FEE PERMIT FILING FEE $2.00 _ YZ 4 -e Each Trap 1.50 Gel Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. .�! Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W. C. Sanitation FireDept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 � � Bldg. Planb�Rec'd Parcel A oval ( Pla proval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER [ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 J 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 Z20 Water Heater or Space Heater 1.00 @25 Light fixtures bal__610 Receps., switches & fix outlets �2�lM@1255 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 k'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. �j I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that 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 $ �G authorize representatives of the County of Butte to enter upon the above-mentio property for in/spect�ion purposes. X D ate Signature ofPermitee or Agent Receipt No. Q White-D.P.W. — Yellow -Assessor — Pin -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date Building permit expires Da a ._. Ii t /'A I PERMIT NO. 1039-82B PERMIT EXPIRES— OWNER Everett Gilbert CONTR. Horner Const., Palermo ASSESSOR PARCEL 69-11.47 LOCATION 434-Silverleaf Dr oroville i. Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOF VIN A /D(D (Date) e) Signature --15 V = OK 0 = Not OK Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s Date DECKS VERS, CARPORTS, ETC. (Plans) OK except It's 1, Zoning Requirements—Setbacks—Easements . Zon g Requirements—S acks—Easements 2. Soils; Special MH Support—Sketch _ ' ootings; Size—De —Spac' —come orsI 3. Sewer; Location—Test—Fall-6/0—Concrete8 Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) �4, Wood Awn.; Posts=Beams—Rftrs.—Codnec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete -&r—A um. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG -&.—C'a'rports; Windows—Doors ..' 7. Utility Clearance r—IEfec. Card -BI Date Card -BI Date Card -BI Dat - if-; rd -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1, Zoning Requirements—Setbacks—Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1, Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 4. Electricity; MH Test—Crossovers—Breakers—Clearances 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/O to Grade—HD Approval 7, Elec.; Bonding; Metal w/5'—Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers _ 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. 8. Piers -Fireplace Ftg.-Steel D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date _ Date Card -BI Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech, Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. 63. Stairs & Rails Fireplace or Stove; Clearances -Hearth Card -BI Date Card -BI Date 64. 65. Elec. Outlets at Wood Panel; Int. & Ext. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Date Card -BI Date ELECTRICAL Permit OK except N's 66. Elec. Outlets & Receptacles at Kit. Counter 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes73. 25. 2 Appliance Circuits in Kitchen &Conductor Size Guard Rails & Deck Construction -Post Caps _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral CYes ED No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Perrr,it) OK except p's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86, Energy Compliance Certificate -Other Certificates _ 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI _ _Date _ - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING Plans OK except q's Comments at Final: 36. _Sills; Proper Material & Anchors _ 37._ 38. 39. _ Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing _ Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Puriir -Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles _ 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. _ Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 0 APPLICATION AND PERMIT A`SSESSQFc/O-PARCEL NUMBE� WING BUILDING PERM OWNE 5 S C. p. T L PHONE SQ. FT. OCC. BUILDING LUA ION OWNER'S MAILING ADDRESS CONTR TQO�R'S NAME v'r TELEPHONE r COTRAC DR'S t./,A�LING ADDR Fireplace CONSTRUCTION CONSTRUCTION LEN E ®'n UNKNOWN Total Valuation Is Filing g Fee $ 1.0.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ 4.`7 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ , BUILDING ADDRES r PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomee--l"other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ emodel ❑ Utilities ❑ Installation ❑ Other Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service OOOV OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.y) OR ADDNS. \ ACC. BLDGS. 20 sq ft 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 an my license is in full rce and effect. License No.1Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. -OUTLET 2.50 ea NON-RESID BRANCH CIRC TS NEW CONSTR /POWER APPARATUS S NON-RESID. %SINGLE OUTLET CIR. / 50 @ zsc Ex. Occup OUTLETS OR FIXTURES BALB1 Ex. OCCup.(OUT ETS FIXED P(RESID )LINIS REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIIng Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against liabilities, judgments, costs, and expenses which may in any way accrue�t,_ agai aid County in onse ue c of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP /'7 TrP I ;VNST. NST. PRCEi Pall This permit is hereby issued under sions ofthe B County Code and/or work indica d ab ve for rUBLIC DJRE TOR 0 By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. (✓ WHITE-D.P.W., FELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent Date This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. By DIRECTOR OF PUBLIC WORKS Date Receipt No. — I Building Permit Expires Date White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Permit Fee $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $2.00 — ,y = 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. Zoning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation Planning Building sewer 5.00 Plans I Fees W. C. I R/W Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER ❑ Permit Fee 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) USE OF STRUCTURE Single Family ❑ Duplex ❑ Others ❑ Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures 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 Misc. wiring License No. Classification ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby fn5frumenraaron r gromion $0.07/$1000 Evaluation $ TOTALY PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent Date This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. By DIRECTOR OF PUBLIC WORKS Date Receipt No. — I Building Permit Expires Date White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS e 7 County Center Drive — Oroville, California 95965 Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Permiteeeor Agent �7 Receipt No. / 13( r — White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By _ Date_ l — z.., --7 Z Building Permit Expires Date L--2— BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mai I i ng Address ' Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee PI an Checki ng Fee &/or Penalty Permit Fee $ $ Building AddresPLUMBING No. @ FEE PERMIT FILING FEE $2.00 , ` Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 f, Each gas water heater or vent 1.50 A. P. No. — — Zoning T— Gas piping system 1 - 5 outlets 1.50 Eac ditional outlet .50 Building sewer IV 5.00 ,p Fire Zone Fire Dept. Sanitation PI nning Plans Fees W. C. P/ IR /W Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION OTHER ❑ Permit Fee $ ,Or ry $ 70, - ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 , 9Z Main service incl. 1 meter 10-0 Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) USE OF STRUC E Single Family ❑ Duplex ❑ Others ❑ Range, dryer or water heater 1.00 " n ��C J Oven, Cook -top or space heater 1.00 Light fixtures 20925 Receps., switches & fix outlets _E 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 Misc. wiring License No. Classification '® I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 77 $ 77, WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ 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 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby State Fee for Strpng Motion $0.07/$1000 Evaluation In Strumentation rogrom $ TOTAL PERMIT FEE 0� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date Signature of Permiteeeor Agent �7 Receipt No. / 13( r — White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By _ Date_ l — z.., --7 Z Building Permit Expires Date L--2— SITE PLAN .i.. .. .. .. .. .. .. .. .. .. .. ' .. .. .. .. .. _. .. .. .. .. .. ............. .. .. .. ...e... } ..... '.. .. . .. .. F . . - .. .. .. .. .. ........... ..1.. .......................... ... .: ...... .. .. .. .. .. ............ .. 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