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069-110-021
John R. Hofferbet E Lodgeview Dr.,app.1/10,fmi.N.of Hil crest Ave., Oroville Perml 45 -77P,E(util.,NH) EC;- 7,77 UP ORT STR CTURE REQ, COMPACTION -TE REJ Contr: Gene.Schmit MH Se',(, is Permit #46 1-77MMHI 77 Issued___ 44-6 1 4:W14 contr: Holmes-..M6bl:r6-..14o-`m`e 'Seie. angor Permit -15927-77B(new decks & awn s MH) /;JZd &;'�c'e/lJ 69z11�= George McGuire 20 No:LbdgeView 1. Dr lot - 1 #r' Oroville Permit in #M 4-1B new awn� 2 069-110-021 06-0947 MEDUED, VANESSA 332 LODGEVIEW DR, OROVILLE Cont: SIERRA MOBILE MH PERM FND (EX) RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 2006-0024021 Recorded I EC FEE 10,00 Official Records I County of I CONFORMED COPY 1.4a Butte I CMM I 6RUBBS I County Clerk-Recorderl I I 010:52AM 10 -May -209 I Page 1 of 2 '(�II"IIII'II�'�III"III�I'IIII�'� 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. VANESSA M. MEDVED REAL PROPERTY OWNERILESSOR 3120 LIVE OAK BLVD # 83 MAILING ADDRESS . YUBA CITY YUBA CA 95991 CITY COUNTY STATE ZIP 332 LODGEVIEW 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 06-0947 530 538-7541 BUIL E NO EPgNUMBER y SIGNA OF OCAL AGENCY OFFICIAL DATE NO DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. SHERWOOD 1977 - UNKNOWN MANUFACTURER'S NAME WS 1994A/B DATE OF MANUFACTURE 60'X 24' MODEL NAMEINUMBER CAL069672/3 SERIALNUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED LENGTH XWIDTH _ ASSESSOR'S PARCEL NUMBER 069-110-021 INSIGNIAILABELNUMBER(S) HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept. �.. Escrow No. 103662 -TR Title Order No. 00103662 EXHIBIT ONE Parcel I: Lot 127 shown on that certain Map entitled, "Kelly Ridge Estates Unit No. 1 ", filed in the Office of the County Recorder of Butte County, California, on October 30, 1970, in Book 38, of Maps, at Pagels) 5, 6, 7, 8, 9 and 10. Parcel II: A portion of Lot 128 shown on that certain Map entitled, "Kelly Ridge Estates Unit No. 1 ", 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, 6, 7, 8, 9 and 10, more particularly described as follows: Beginning atthe Southwesterly corner of Lot 127 of said Kelly Ridge Estates Unit One; thence South 670 12' 20" East, 160.97 feet to an iron pipe tagged L.S. 4085; thence South 77 ° 47' 42" East 111.21 feet to the Southeasterly corner of said Lot 127; thence North 71 ° 31' 47" West, along the Southerly line of said Lot 127, 271.06 feet to the point of beginning and the end of this description. Basis of Bearings for this description is the same as that as shown on said Map of Kelly Ridge Estates Unit One, Book 38 of Maps at pages 5 through 10. The above Parcels I and II are pursuant to a Boundary Line Modification approved by the Butte County Advisory Agency on February 8, 1988. Escrow No. 103662 -TR Title Order No. 00103662 EXHIBIT ONE Parcel I: Lot 127 shown on that certain Map entitled, "Kelly Ridge Estates Unit No. 1 ", filed in the Office of the County Recorder of Butte County, California, on October 30, 1970, in Book 38, of Maps, at Pagels) 5, 6, 7, 8, 9 and 10. Parcel II: A portion of Lot 128 shown on that certain Map entitled, "Kelly Ridge Estates Unit No. 1 ", 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, 6, 7, 8, 9 and 10, more particularly described as follows: Beginning atthe Southwesterly corner of Lot 127 of said Kelly Ridge Estates Unit One; thence South 670 12' 20" East, 160.97 feet to an iron pipe tagged L.S. 4085; thence South 77 ° 47' 42" East 111.21 feet to the Southeasterly corner of said Lot 127; thence North 71 ° 31' 47" West, along the Southerly line of said Lot 127, 271.06 feet to the point of beginning and the end of this description. Basis of Bearings for this description is the same as that as shown on said Map of Kelly Ridge Estates Unit One, Book 38 of Maps at pages 5 through 10. The above Parcels I and II are pursuant to a Boundary Line Modification approved by the Butte County Advisory Agency on February 8, 1988. yl _n 6u) 5-4 4 T cl BUILDING PERMITS NUMBER: 06-0947 Address or location of unit: 332 LODGEVIEW DR., OROVILLE CA 95966 Legal Description of Real Property: 069-110-021 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: VANESSA M. MEDVED Owner's address: 3120 LIVE OAK BLVD. #83 INSIGNIA OR HUD NUMBER: CAL069672/3 SERIAL NUMBER OR V.I.N.: WS1994A/B MANUFACTURER'S NAME: SHERWOOD YEAR: 1977 OFFICIAL APPROVING INSTALLATION: DATE:4,6� PHONE: (530) 538-7541 H.C.D. 513C i RECORDING REQUESTED BY: Fidelity National Title of California Escrow No. 103662 -TR Title Order No. 00103662 When Recorded Mail Document and Tax Statement To: Mrs. Vanessa M. Medved 332 Lodgeview Drive Oroville, CA 95966 (I�1 ��� ��� � �'�� ((il�' I��1 � 1■ III II 2003—�'�08�81 Recorded Official Records County yyTTE f CANDACE J. GRUBBS Recorder ROSEMARY DICKSM Assistant 09:00AM 07 -Feb -2003 I AEC 16.00 TAX FEE 137.50 I I 1 I 1 Kathy I Page 1 of 2 AM: UOU-1 IU-U"LI GRANT DEED SPACE ABOVE THIS LINE FOR RECORDER'S USE The undersigned grantor(s) declare(s) Documentary transfer tax is $ /,37.0 ( X I computed on full value of property conveyed, or ( ) computed on full value less value of liens or encumbrances remaining at time of sale; I X 1 Unincorporated Area rYL FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, " Betty Rivinius, surviving Joint Tenant hereby GRANT(S) to Vanessa M. Medved, A Married Woman as Sole and Separate Property the following described real property in the unincorporated area of Oroville County of Butte, State of California: SEE EXHIBIT ONE ATTACHED HERETO AND MADE A PART HEREOF DATED: February 3, 2003 STATE OF CALIFORNIA COUNTY OF BUTTE ON -) -A) t "Z, ap!f5 before me, THE UNDERSIGNED NOTARY personally appeared _. BETTY RIVINIUS personally known to me for proved to me on the basis - - of satisfactory evidence) to be the persons) 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(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 Betty Rivin' s TER A. RUST)N ,. Commission #1239620 Notary Public Butte County, Calitomia Q My Comm. Exp. OCT 244;p MAIL TAX STATEMENTS AS DIRECTED ABOVE FD -213 (Rev 7/96) GRANT DEED STATE OF CALIFORNIA - BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT Division of Codes and Standards Title Search Date Printed: 04/20/2006 ARNOLD SCHWARZENEGGER, Governor Decal #: LAL9822 Use Code: SFD Manufacturer: Original Price Code: AEX Tradename: SHERWOOD Rating Year: Model: Tax Type: LPT Manufactured Date: Last ILT Amount: Registration Exp: Date ELT Fee Paid: First Sold On: 00/00/1977 ELT Exemption: NONE Serial Number HUD Label / Insignia Length Width WS 1994A CAL069672 60' 12' WS 1994B CAL06973 60' 12' Record Conditions: PPF Exempt Voluntary Conversion to LPT Registered Owner: VANESSA M MEDVED 332 LODGEVIEW DR OROVILLE, CA 95966 Last Title Date: 04/14/2003 Last Reg Card: 04/14/2003 Sale/Transfer Info: Price $90,000.00 Transferred on 02/07/2003 Situs Address: 332 LODGEVIEW DR OROVILLE, CA 95966 Situs County: BUTTE Legal Owner: FLAGSTAR BANK FSB PO BOX 7026 -TROY, MI 48002 Lien Perfected On: 04/02/2003 16:24:32 Inactive Decal/DMV: DMV SU4504, DMV SF8887, DMV SF8888, DECAL AAK8486 *** END OF TITLE SEARCH *** Ov51NG p ®®� .uz 3r1''a rr�w DE�`�� r ANEW Butte County Department of Development Services. ova>c IN ,0 1 C S 7 County Center Drive, Oroville, CA 95965 - (530) S38-7601 -.4yttgcountynetidds RESIDENTIAL APN: Permit No. / Owner.06-0947 069-110-021 i MEDUED, -VANESSA— Site Address: 332 LODGEVIEW DR, OROVILLE Contractor '�MH Cont:•SIERRA MOBILE"'-" PERM FND (EX) Type of Permit CHECKED -BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: 1 �� SIGNATURE: 7 c``��d- = OK i 0 = Not OK MANUFACTURED HOMES NT FOUNDATION 1 .1 SOFT -SET 2 Soils; Special MH Suppoft Sketch 3 Sewer; Loctn-Test; FaIUC/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Dlrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat Q or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test -Cross overs -Breakers -Cl rncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -/O to Grade 12 G' 'end Electricity Tagged YSTi Downs Foundation Q Exits 15r.Wof Occupancy 1'9 -HUD LabeUlnsignia Numbers Serial Numbers T MISCELLANEOUS DATE IDECKS•COVERS'CARPO RTS'GARAGES 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-Dpth-Spacing-Cnnctrs-Steel 3 Decks, Girders/Joists-Ocking-Brcing S tai rs-D ua rdl Handra i Is 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brr ng 5 Alum Awn; Columns-CnntdnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills=Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls r 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Dnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 1 5 Elec Pool Lting; 15 volts-GFI C 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w15-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bokes-Enclsrs-pnlboards-Insulin to Main Conduit i 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide Drawing s tea` T MISCELLANEOUS DATE IDECKS•COVERS'CARPO RTS'GARAGES 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-Dpth-Spacing-Cnnctrs-Steel 3 Decks, Girders/Joists-Ocking-Brcing S tai rs-D ua rdl Handra i Is 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brr ng 5 Alum Awn; Columns-CnntdnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills=Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls r 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Dnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 1 5 Elec Pool Lting; 15 volts-GFI C 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w15-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Bokes-Enclsrs-pnlboards-Insulin to Main Conduit i 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide Drawing = OK Not OK t _ 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 Grnd Fig Opth 54 Wtr Pipe-, Test & Anchr-Nail Prtctn 3 Fig Garage; Soils-Steel-Elec Grnd Ftg Opth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Fig Porches/Decks; Soils -Steel Ftg Dpth ' 56 Shwr Pan; Test, First fir -Tub Acc. 7 5 Stemwalls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub-Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 1 6a Hold Downs and Special Anchrs 59 Fire Sprinkler- Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test °'• °� o'`• 0�� 1•t Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE MECHANICAL 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 61 AC Duds Insulin & Support 14 Girders-Sills-Anchr Bolts Joists-Vnts-Crippies 62 Vent Fan, Exhaust abv Insulin 15 Acc & Vntltn 63 Condensate Drain & OvrfIw, Sz & Grade 16" Insulation 64 Fumace-Vent Acc-Comb Air RtrnfVent 115 Outlet 6S Attic Acc & Pitfrm if Furnace in attic m DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE FINAL 18 Walls Studs -Nailing Spacing & Braces-PlatesSound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-CImc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage- abv-fir-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnc ns 70 GFI &Bath Fxtrs &Tub AccSpa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TrussShthg 71 GFl Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clmc 72 Elec Trim & Subpnl, Breaker Sts & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Cimc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinr, Gmd-Air-Gap-Cooking Cime 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clmc-Com Air Cnncfr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrtlr Acc Mech Prtctn- LPG Appince Undr House 3- drain 35 Glazing Area -Glass Prtctn-Skyl-ts-Plastic 81 Plmb; Elec & Mech Eqp listed for Lottn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑Yes ❑No o'• m o' �3' 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clmc to Opngs DATE JELECTRICAL 90 Wtr Well, Dscnnct, Elec, Pimb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 40 Fxtr & Tmsfrmr Cirnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn 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 Inspctns 44 Eqp Grnd 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 in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz to ❑CU or❑AL 98 Address Posted AC Wire Sz Ira ❑CU or❑AL 99 Fire Sprinkler 48 Range Circ ea ❑Cu or ❑AL 'Oven Circ 930 cuor ❑AL Instilated Neutral ❑Yes EJ No o` ec 49 Service -Riser Cndctrs &Grnd Main Dscnnct o'• e` 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr USpa 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 PERMIT NO. BP060947 B. C. BuildinD Permit 01-16-04 Dc 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 04/27/2006 APN: 069-110-021-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. p332 J 3N6 Site Address: LODGEVIEW DR ORO LicenseClass: License Number 7 a�' Map Index: Date: Contractor: /C2 Description: EX MH EX SITE PERM FNDN (1440) OWNER -BUILDER DECLARATION 1 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: MEDVED VANESSA M permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 3120 LIVE OAK BLVD #83 signed statement that he or she is licensed pursuant to the provisions of YUBA CITY, CA the Contractors State License Law (Chapter 9 commencing with Section 95991-8870 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 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: SIERRA MOBILE SERVICE Code: The Contractors' State License Law does not apply to an BILL REID owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 466 CIRCLE DRIVE provided that such improvements are not intended or offered for OROVILLE, CA 95966 sale. If however, the building or improvements are sold within one 530-534-0599 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' State License Law does Contractor: SIERRA MOBILE SERVICE not apply to an owner of property who builds or improves thereon, BILL REID and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 466 CIRCLE DRIVE' OROVILLE, CA 95966 ❑ 1 am Exempt under Article 3 of the Business and Professions Code 530-534-0599 Date: Owner: License #:.470386 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: ❑ I 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: 2� F-� Total Square Ft: 0 S. F. Policy #: `l z 5-7 Valuation: $0.00 Census Code: ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' 1 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:(- Applicant: r�- .1n 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 is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutio s o do work indicateq above for which fees have been paid. L! _�']-0 6 Name: By: Date:/^ 1 I Address: PERMIT EXPIRES ON: Date ❑ 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 & 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 county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representativesof Butte County to enter upon the above mentioned property for inspection purposes %s Print Name: , \ E (9 Signature: Date: y I Id e 6 ❑ Owner O-fontractor ❑ Agent for Owner ❑ Agent for Contractor B. C. BuildinD Permit 01-16-04 Dc 1 c BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (30) 538-7636 CHICO: (530) 891-2834 OFFICE #. (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLIC,4TION **PLEASE PRINT CLEARLY** OWNER Last Name first Address 33z I,"State ,a (9gOU[aA E Phone Fax E-mail Name Address City Phone E-mail Name Address City Phone E-mail PERMIT 1 a q BP BIN # LOCATION .VE SSA M , AP# e96'? / / t7 O / Property Address C4EHEJ 33 ,Z IC G UG e' ✓ t E W U' vi G 4 E Cross Street CONTRACTOR State Zip 5--f Y-711 E6 S.7y oS9 9 Fax Lic. #Y�65.94- Class ARCHITECT/ENGINEER State Zp Fax State License Number APPLICANT NAME Name 1�eZQ Address City Lam Phone S3�/ p� E-mail State "p 9 S%66 Fax APPLICANT SIGNATURE For office use only: Zoning Flood ZoneSRA Yes - No Occ. �Typeonst. Subdivision Name Map Book I Page Lot # Planner Date Approved: OVER FOR SUBMITTAL RFnt lltat=nnc:P Frc WORKER'S COMPENSATION Policy Number Cartier �e--� �-,.fin; l✓wo . If hiring anyone other than license contractors, a certfBcate of worker's compensation must be shown at the time of permit Issuance. LENDING AGENCY rAdd-ress Description or Scope of Work: fo��-�-- .c•w,�, Q^`. _T r�•ze�z r Sq. Footage I ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a pemlit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: 4�r Receipt #: 4596 Date: I I Amount J Lrj• I U SRA Sheriff SMIP Other �� 6 _ . COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: 1 " "�� ASSESSOR PARCEL NUMBER U I l Q)• Proposed Building Use:A-bCM -D) n \ rJq�-Permit Technician: Date: Aems required in order to apply for a permit. 0 boxes MUST be checked OR marked NA in order to apply. 11. Site plans, 3 or 4 sets, signed by the preparer of the plans. �0 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan,.gTie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ .15., Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑ 18. Erosion Control Plan Required........................................................................ . ❑ 19. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 20. City of Chico Plumbing permit ...................................................... •................. ❑ 21. Site plan and business license approval from the City of Biggs .............................. ❑ 22. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 23. Planning approval for (A) Use: (B) Parking: (C) Parcel Check: ............ ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ .29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. D ed Restriction......................................................................................... 1� 35 Legal description?r M. I.TT'tle, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone �� G-1 `I and hold for pickup. have been informed of the above items and requirements for obtaining a building permit. Applicant a t// '' - 0--s Date: 1. Index permit application or the above items numbered: Plan Check Letter 2. Additional items required signer, owner, was advised of the above data by p one, mail, ❑ counter, by Date: -Ll• OCD Coontractor, signer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ contef, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 14 G1/11! LGGO 1L:1�L ylb-.il4-bl`Jb WESTLAND X12 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone b 15 PSF Wind Load Seismic 4 By Tie Down Engineering PAGE 01 X12 Concrete System Engineer Approval tw fill son soK„ rur►� sYsr� ateart�ta sw�anr DDDR, aerira� tai . A�aveu MlsriCt to COR+�ecnootR f10�Y AMAM MM Wit AMOMM de AMOV2 ANY 4NUMOM OR 05v1sUM FROM MKMMDM or AtrJOAKA UATS 1AW5 AXa &MRAIXIN Mw.rca�. OyRw�r! tea.l� rl � Dn.la�ar�R; .eu t St m Pape 1 of 8 BUTTE COUNTY BUILDING DIVISION APPROVED e ✓J1/ 11/ Lelbb '1L: U:z ylb-J/4-b151J WESTLAND PAGE 02 Xi2 Foundation System installation instructions for California for Ground & Concrete Systems Aw V__04 HUD Wind Zone iv 13 PSF Wind Load Seismic 4 By Tie Down Engineering REQUIREMENTS • These plans and specifications meet the requirements of Title 25 Section 1336.3 Sub Section A and 97 UBC Seismic Requirements, CBC 2001 addition. • Maximum vertical projection at sidewall is 9'. Hlaher walls may be used when the design loads are adjusted accordingly and approved by HUD. • Main rail spacing must be 75.5" - 99.5" • Except single sections 95" minimum • Additional vertical anchor ties that are unique to a.home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, and rim plates. The longitudinal component of the X12 system replaces end frame ties. Check manufacturers set-up requirements. • Maximum pier height is 48" pier. "Except for single sections. 36". • Steel piers must be fastened to the I-beam with clamps provided with steel pier. • Systems must be placed as evenly as possible, no more than 10' from end of home. • Designed for 7:12 roof slope. "Except single sections, (20' - 4.37 In. 12" pitch). Additional Requirements for Concrete Systems • Poured concrete must be 2,500 PSi minimum at 28 days. • Square concrete pads minimum is 18" wide by 12" deep. Round concrete pads minimum is 18" wide by 14" deep. Strip footings minimum is 18" wide by 14' long by 6" deep. Xi2 components exceed HUD code 3280.306g 'Anchoring equipment exposed to weathering shall have a resistance to weather deterioration at least equivalent to that provided by a coating of zinc on steel of not less than 0.30 ounces per square foot of surface coating....' Page a of 8 SPA ial - r �'' 11)6(: J Ui/ 111 _/UU?z lL: UZ 'jib -:i /4-Mbb WESTLAND PAGE 03 1. 2. 3. 5. 6. 7. 8. 9, 10. installation of X12 Ground Systems Identify the number of systems to be used on the home using the chart provided. Identify the location where the systems will be installed. Clear all organic matter and debris from the pad slte. Place U -bolts through holes in pan provided. Place pad centered under beam with the lateral strut bracket towards the inside of the home. Press or drive pan into ground until level and flush with prepared surface. Build pier according to State, Local or Nome Manufacturers guldelines.(Flgure 1) Attach the end of the smaller tube to the inside of pan using U -bolt & nuts provided Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 2) Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the holes provided in the ,lateral strut so that the two tubes are connected together. (Figura 1) 1-3/4" Tuba Lateral 5trute 1.9/2" rube 4-#12xI" Tek Omwe U -Bolt & mow vne Figure 1 SrdckOt '��` e ✓Clic e-y� J-Bok Nut Washer strut (flag end) !-9earn Figure 2 �1 11. Install frame bracket clamps to I-beam on in side of block1pler. Do not tighten nuts at this time. 12. Attach longitudinal strut to U -bolt in pan using nuts provided. 13. Insert strut in the frame bracket clamp, attach with nut and bolt. Do not tighten at this time. 14. Pull the_ tram e. bracket clamp.with the fastened strut outward to remove any slack. 15. Tighten all nuts and bolts on the struts and beam clamps. fi TIE DOWN tv 4 b1/11/'Lbbb 1'L: U y1b-314-0150 X12 Ground Parts Detail Xi2 Ground Lateral System Part Number 59306 Includes: 5' Strut. pad & hardware kit (#59329-1 includes all nuts and bolts). Longitudinal Hardware Kit Part Number 59331 Includes: 2 I-beam brackets & 2 U -bolts with all nuts and bolts. Lateral aid Longitudinal Combination Part Number 59333 Includes: 5' Strut, Pad, longitudinal Strut (#59329), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Stnrts for Longitudinal Systems h WESTLAND X12 Ground Longitudinal btrut & Hardware Kit PACE 04 rill I Strut No. Length P Icl U HOW To: t 3li! �.m:ajl Ground Longitudinal g p Strut 59330-44 44" 4 Blocks or 32' Ground longitudinal 59330-65 65" 6 Blocks or 48' Hardware Kit Xi2 Stabilization Pier Placement for Ground or Concrete &__XI2 Pier Placement Single Section Home Doubts Section Nome 0.80' (76' Box) 4 Xi2 Systems 0.62' 3 X12 Systems' 63' - 80' 4 Xi2 Systems '2 Xi2 systems can be placed at either end of the home. Triple Section Home 0-62, 4 XI2 Systems W, - 80' 5 X12 Systems M3* �s coAl21�F �i11/ b1/11/lbbb 12:b1 '31b -J74-0150 WESTLAND PAGE 05 Installation of X12 Concrete Systems 1. Identify the number of systems to be used on the home using the chart provided. 2. Identify the location where the systems will be Installed. 3. Build pier according to State, Local or Home Manufacturers guidelines. 4. Drill two 3/8"x 3" deep holes in the concrete using holes in galvanized bracket as a guide. Attach bracket to concrete pad using 3/8"x3-1/2' wedge anchors e,} provided. Place nut & washer on anchor, leave enough room for 1 to 2 threads showing on top of bolt. Using a hammer, tap the wedge bolts into hole through,. bracket, leaving nut & washer flush with bracket. Using a 9/16" socket wrench, A tighten wedge/anchor bolt, securing bracket to the concrete. 5,t mounted on the pad Attach the end of the smaller tube to the bracket 9 the using �.`. •; .1<-: grade 5,12" x 2-112" boll/nut provided. 6_ Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the -I-beam with the nut & washer provided. (Figure ! next payee)_ _ .. 7. Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together 8. Install fame bracket clamps on I-beam on the inside of block/pier. 9. Insert strut in frame bracket clamp and attach with nut & bolt. Attach opposite -end to concrete bracket. 10. Pull the frame bracket clamp with fastened strut outward to remove any slack. 11. Tighten all nuts and bolt$ on system. Page 5 of 8 I TIE D6-1wN lnrlr�Eeh�:�r s pn O oil 11/ Zurjo 1L: t7L 'jlb-J/4-ulbu X12 Lateral Concrete Systems Part $59307 Includes: 5' Strut, Bracket. & Hardware Kit #59315-1 with all nuts and bolt. Longitudinal Struts for "Concrete Systems" Part No. Length Pier Height 459013 44" up to 4 Blocks 059015 65" up to 6 Blocks Longitudinal Hardware Kit Parl #69263 (Includes 2 sets per kit: I-beam bracket; nuts, bolts and washers) Lateral and Longitudinal Combination Part #$9332 Includes: 5' Strut, Longltudinal Strut (#59364), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Nut & Washer Frgure ! Beam Clamp ..._.-Bracket L0 Xi2 Installation Placement WE5TLAND M Concrete _ system phi Longitudinal Strut 'Cnd �� 14an,e '�Y•iPr PAGE 06 t i Concrete Longitudinal Hardware Kit A, 30336 tj'r1'F4.9-0401 U1/11/'Lobb 1'4: U2 , ytb-J/4-bl5b WESTLAND PAGE 07 Offset Placement Diagrams represent examples of double and triple section offsets. Total size is determined by the length of unit plus offset. X12 Stabilization Pier Placement for Ground or Concrete Xi2 Pier Placement Single Section Home Double Section Home 0 -80' (76' Box) 4 Xi2 Systems 0 -62' 3 X12 Systems, 63' - 80' 4 Xi2 Systems '2 Xi2 systems can be placed at either end of the home. f ILI Single Section Home Double Section Home 0 -80' (76' Box) 4 Xi2 Systems 0 -62' 3 X12 Systems, 63' - 80' 4 Xi2 Systems '2 Xi2 systems can be placed at either end of the home. IRple Section Home 0 -62' 4 X12 Systems 63' - 80' 5 X12 Systems 1, ;s-040-1 DOWN f IRple Section Home 0 -62' 4 X12 Systems 63' - 80' 5 X12 Systems 1, ;s-040-1 DOWN b1/11/21J0b 12:02. 916-374-0150 WESTLAND PAGE 08 A� Hardware Breakdown *59329.1 Hardware for 59306 Lateral System 1 845332 U -Bolt 1/2-13 x 2.63 x 2.19 thread 4 59272-2 1-3/4 zinc 4 10556 Tek Screw 112 x 1" 1 10631Z J Bolt 1/2 x 5-1/2 grade 5 zinc 2 10640 Push Nut 1/2 1 12107 Flat Washer 1x2" SS 1 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10519 Hex Nut 1/2" w/ Serr flange 459331 Longitudinal Hardware for 59306 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Boit 1/2-12 x 1-1/4 2 59272-2 Full Thread 10 1064BY Hex Nut 1/2-13 grade 5 zinc ' 2 10801 Carriage Bolt 1/2-12 x 2-1/2 5 10646Y Grade 5 2 845332 U -Bolt 1/2-13 x 2.63 x 2.19 thread 2_10801 _ 1-3/4 zinc 4 10640 Push Not 1/2 4 10519 Hex Nut 1/2" w/ Serr flange 0 59329 Hardware for 59333 Lateral and Longitudinal combination 1 59329-1 Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-12 x 1-1/4 4 10801 full thread 5 10646Y Hex Nut 1/2-13 Grade 5 zinc 1 _10801 Carriage. Bolt 1/2,-12-x 2-1/2 _ 2_10801 _ Grade 5 zinc 1 845332 U -Boit 1/2-13 x 2.63 x 2.19 Thread 6 10646Y 1-3/4 zinc 2 10640 Push Nut 1/2 2 10519 Hex Nut 1/2" w/Serr Range #59315-1 Hardware for Lateral System 1 10631Z J Bolt 1/2 x 5-112 Grade 5 zinc 1 12107 Flat Washer 1/2" SS 4 10556 Tek Screw #12 x 1" 2 10646Y Hex Nut 1/2x-13 Grade 5 zinc 1 10626 Carriage Bolt 1/2-12 x 3 4 10801 Grade 5 zinc , #59027 Hardware Kit for 59307 Lateral System 2 59264 3 Way Concrete Bracket 4 10530 Wedge Anchor 318 x 3.50 . 1 59315-1 Hardware Kit #59268 Longitudinal Hardware for 59307 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-13 x 1-1/4 1 59315-1 Full Thread zinc 12 10646Y Hex Nut 1/2-13 Grade 5 zinc 4 10801 Carriage Bolt 112-13 x 2-1/2 4 10926 Grade 5 zinc #59364 Hardware for 59332 Lateral and Longitudinal combination 1 59264 3 Way Concrete Bracket 2 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Lateral Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Fiance 4 10926 Carriage Bolt 1/2-13 x 1-114 Full Thread zinc 2_10801 _ , Carriage_Bott 1/2-13 x_2.1/2 Grade 5 zinc 6 10646Y Hex Nut 1/2-13 Grade 5 zinc Page 8 of 8 �b G 1 1 cpa rel -P ll� PERMIT NO. 3054-81B PERMIT EXPIRES OWNER George McGuire CONTR. owner ASSESSOR PARCEL 69-11-11 LOCATION 20 N..Lodgeview Dr., lot 127, KR#1, Oroville Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service/ Called PG' &E JNALED (Date) a Signature /Salwkjs:� V = OK 0 = Not OK - = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's 1. Zoning Requirements-Setbacks-Easementsoni�Requirements-Setbacks-Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 2. Soils; Special MH Support -Sketch ootings; Size=Depth-Spacing-Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3�rs and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4, Weed.Awa- Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete um. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; LocatiorrTest-Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG fi r.a4= windows -Doors 7. Utility Clearance 3 -, Card -BI Date Card -BI Date Card -BZC�y—Date3-�S Card -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 -Bl- 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 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater - 8. Gas and Electricity Tagged B. 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-1 Date Card -BI Date Card B1 Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date r J = OK ' O = Not OK Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protecti 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 7. Piers -Fireplace Ftg.-Steel 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Tes 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 -Cripple: 52. Siding -Nailing -Veneer 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 54. Glazing Area -Glass Protection -Skylights -Plastic 55. Shear Walls; Nailing -Bolts 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. 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 N's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels _ 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth Card -BI Date Card -BI Date 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date 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 70. Plb., Elec. & Mech. Equip. Listed,for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 72. Insulation -Foam -Looked in Attic F1 Yes 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 73. Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes []No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters Dyes ❑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 Card B -I Date Card -BI Date Date Card -BI Date 81. Ventilation throughout House 82. 83. 84. 85. Glass Protection _ Corrections from Previous Inspections Gas Test -Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval Date MECHANICAL (Permit) OK except q's 31. A.C. Ducts; Insulation & Support _ 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. 40. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. Header & Beam -Size & Bearing _ Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat _ 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles _ 46. 47. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsile) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT 7 County Center Drive - Oroville, California 95965 - Telephone 916/534 APPLICATION AND PERMIT All ASSES OR PARCELNUMBERZO - BUILDING PERMIT OWNER w TELEPHONE •eon SQ. FT. OCC. BUILDING VA UATION OWNER'S MAI IN ADORES •e frt e W P,--. O#- c) - CONTRACTOR'S NAME``-- 'Of..v L�i••0 1� TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filin Fee g $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ -.Lo vo ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ .00 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS —i Permit fee $ ad—Q �� BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. Z SUBDIVISION NAMEPARCEL , -�11 MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome[N- Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe work: wu cc�� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6011 OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. (DWELLING OCCUP.N) OR ADDNS. ACC, BLDGS. 20 Sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): ❑NON-RESID• 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) [] 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR.-Ou LET 2,50 ea NON-RESID BRANCH CIRCUITS) NEW CONSTR./ POWER APPARATUS 6 (SINGLE OUTLET CIR. 50 @ 25¢ Ex. OCCUp OUTLETS OR FIXTURES BAL@100 UTLETS FIXED P(RESID )REA. 2.00 Ex. Occup.(. Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 1 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. 1 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 I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue in consequence of the granting of this permit. ,e� against said County �Date X L"p/�(- /Lt�l/t9 %j�� y 19 % Signature of Ap licant - Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3ststoriries in height. Mobile Home Installation Fee $ oG TOTAL PERMIT FEE $,0 OCCUP. GROUP I TYPE OF CONST. V_ Al I 1PARCIL111 v 1/ MD ISSUE This permit is hereby issued under sions of the County Code and/or work indicated above for which DIRECTOR OF P10BILIb E' By PERMIT EXPIRES Date the applicable i- resolutions to do to Butte fees have been paid. WORKS Date ®� / it Receipt No. 1 JCJ ;70 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 004 130 -- —! --�— NOTE ll -.Mfi s- o i i 1 .; ►`f I)'VolIt i!m r�s.,'i0 h0 a toC!--,!as r1 s . i i guc�li y >re� ,r, ._ use' In �th� ai.n�a _ ��J.e:' iiaciianl al Co.and91 tioal_ od_ an -- - '-1 �A setback of 5 ft. from tile' praperaty fine, and a setback -•-�-T .-�---i � i ;�_ � i of 50fti. from t eFi` road' ----ir� 2-1--* s-�` i centerline sha-l-l-be-ctela-r-of. f tsr_'stur-es r_ �q.u.i�m at -ex $ora 2 ft. dv4 ot�erhanq� �C-- i Wit. SV O + t CoLi! ers ,��n 9 z 1 ee ��eo�s�e{�ent.o 1 1 ► tri ep • rte °�� enrn-�`° gU§-fie' � �. `r`_�-' --�" (� C � � , ^ ;l e: ate-n-'� S t . �l�iMIN �� �� I H � /`ie�t�'� �v0/�brG l�O�o; �''V�=R_ i4�N_G-�✓_D_Op C��VE'R�p�!�,�' n UNT A 7 'it D Nps L•a 6.EVI V./ �2' 2 %� RCL No. oG9_11`0-oPl-4 _ C I�q Jade _ d e— � N I } T IM d' �zg _l I 11•�I I I I I I z'I DING G DPA - q —� • � II _ � � la'_—� L �� 'A'-- --�----�- I j li �F--=�---Viiir-..---------««« • 4 --;— —+-- I T .nom --+__--.-I-.-1-.--.i t ...--t--.� �-"�`_-. A .._j.-' ^ __ _-�'"_ l 1 -_ r_ �- - _•_5•-�- _r.--�. ql._.:.m _8-�-i.._ PERMIT NO. 5927-77B PERMIT EXPIRES OWNER Bob Hofferbert `CONTR. Holmes Mobile Home Service, Bangor LOCATION (A.P. 34-64-11 20 North Lodgeview Dr., lot 127, KR#l, Oroville Temp. Power Pole C led PG&E Te p. Elec. Serv. Called PG&E T mp. Gas Serv. Called PG&E JOB FINALED COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING I BUILDING (Cont'd) PLUMBING Setback 3 Firewall Soil Piping Forms Service Parapets / 1st Floor Main Bldg. Finish V Restroom Finish 2nd Floor Footings Ventilation Windows X 3rd Flo Stemwa I ISiding Final MOBILEHOME gTILITIES To out Slab �� Roof Sheathing Water Piping Piers Support Roofing Sewer Garage Gas Pioina Fdn. Vents Fixtures Footings Stemwa I I Garage Vents • Insulation Water Htr. Heaters Slab Carport Footings r ehysically handicaConformancdde of ex. ' structure F ITemp. Appliances i Gas Piping & T t as Slab Final tz 411 774Sanitation Patio / FIREPLACE Final Footings 4 Z Z :3-3 Footing 1 ELECTRI AL MasonryWalls Throat Rough Relnf. Steel Final Fixtures Bond Beam FIF& SPAI KLERS Motors Framing f % 7 Test Water Htr. Mesh I'MEcAANICAL JUw 41101.E Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish V Ducts Underground Interior Lath Ventilation Permanent Door Closer 1,4 Final Final MOBILEHOME gTILITIES Elec_ Service Elec. Pedestal Water Piping '� Sewer Gas Piping MOSILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Pioina DATE .L. / / / REMARKS OR CORRECTIONS l //_2 9?2 (NOTE: An entry must be made on this form each time you visit the job site.) V COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Uroville, California 95965 � �✓J`�� Telephone: 534-4541 / APPLICATION -AND PERMIT l� BUILDING Owner \� SQ. FT. OCC. BUILDING VALUATION Mailing Address r 7 Telephone No. Fireplace Contractor ® Mi I! ° t,Total Valuation Mailing Address o Permit Fee Plan Checking Fee&/or Penalty T le6o=eo,�' Permit Fee $ tis Building Address �� I� © a� t PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 9 L®I to —f Repair drainage or vent piping 1.50 Water piping 1.50 11 Calm Each gas water heater or vent 1.50 A. P. No. �u 1� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet 30 F 51 Sa itatl n I Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Parc Approval I Pla pprovol Permit Fee $ $ NEWT ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 100v OR LESS- 5.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50 Single Family [j Duplex ❑ Mobil Home Others ❑ OVER 600V Main service 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 r NEW CONST. DWELLING OCCUP. & OR CONST. ACG. BLDGS. 20sgft NEW CONST- NON .RESID R. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON.RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name styyyI of:OCCU 14J1 L (� 'YI IIID � il(� Ex. Occup(OUTLETS OR FIXTURES)@L@- BAL�1 FIXED APP LNS. OR Ex. P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. � 2-I I Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ Is WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ,"I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $3 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X1 a � ! o er _y-�+ % Date Signature of Permitee or Agent ZWhitReceipt No. 11 ri? 9"2— White-D.P.W. e-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR 00ftBLIC WORKS BY Date Z. Building permit expires Date % �LCl<G3c7'C% - ' (�, 1. ''•ii/{'ts This sef of plans and; specificatinns MUST be ker+t • nn the iob at all times and it is unlawful to ��� y F^ C mrr:-r, t nv ckmnrtes or cjltr r --dens on same without �Q wriiten permission from the Department of -Public I Works, r^i "uY of Butte. LIJ 1 6 C `V NOTE:—AII Materials & Workm ns i Shall Be in Accordance with � Recognized G o . ti s- and of a quality pr6kriz-ad for the Yi ed use in the 4 Uniform Qui-iding, Plumbing & M cfl n' al Codes and P u the Notional `Electrical Code. N s 610,4 c _ , S C'< Se. Master Pla n He UI In Darns. c _ - G144 a� ! yrR, /d 0� -594-7'77 3 BUTTE COUNTY"!. The Bldg. Setback shall be 5 ft. from the • /side property line and 50 ft, from the BUILDING DEPARTMENT. centerline of the road , permitting a maxi= , mum of a 2 ft, eave overhang but entirely APPROVED - �..' out of all easements. r`s • .€ , _ ��I417-7 t rtr fr!. PERMIT NO. 04451-77P,E PERMIT EXPIRES OWNER JOHN R. HOFFERBERT CONTR. owner LOCATION (A.P. 34-64-11 ) E/S Lodgeview Dr- app 1/10 mi. N*pf,, Hillcrest Ave, Oroville r c J Temp. Power Pole Called PG&E Temp. Elec. Serv. % J Called PG&E Temp. Gas Serv. Called PG&E 7 JOB --7 j FINALED / (Date .Af (Signature) ( J a F* J COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS -BUILDING INSPECTION RECORD - ,N,_,BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil PipingV Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Aof"10001, : Footings `. } Windows 3rd Floor k Stemwall Siding To out Slab Roof Sheathing Water PI in Piers Roofing Sewer Garage dn. Vents Fixtu Footings StemwaII G e Vents Insula n W r Htr. eaters Slab Carport Footings Prov. for'okkslcally handicapped Conformance of structure Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREP E Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Te er Htr. Stucco '' finalSub els Mesh MECHANICAL Gird. Faullvorot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilation Permanent Door Closer F Final Final MOBILEHOME LITIES--------------•--- Elec_ Service Elec. Pedestal Water Pipin—+� Sewer Gas Piping — ME INSTA CATION - - - - - - - - - - - - - - Support Water Piping Drainage Elec. Continuity Gas Piping DATE REMARKS OR CORRECTIONS SWIV7_ 7-0 0/e 0 aon A2 ;26 ' 19;71-1,, A,o�� T. � .suds wo ' ooni; ' (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLS, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number 416.51 -77 for the following location: /,0 Lj )&-/, / K)/e— (---> Owner _761414 2 AAA 1LF)E.,? R7— Owner's —Owner's Address k 07)ew E-0/ ,F -w Mobilehome Mfg. 5/ L 061L 5AARS7— Moder 70 V, / YearZ Insignia NoAAC (I li Serial No. C:� 1 � di It is hereby certi ied for occupancy at the above described location and may be occupied. q Directo of ublic Works- < - r Date O . THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED ii0}3:La.L;liOL1G INS7'ALLA'1 R)N INSPECTION CHECK LIST 1. Is the mobilehome 1oc;�!tcd wiLh.r.-eduired separation from lot lines and buildings and generally conform to plot plan?. Yes�No� ?. Does the mobilehome have requir<.d clearances above ground? (Sec.5085) Yes ---'No 3. Are footinl;s and supports properly sized, spaced, and braced as pewapproved plans? (Note possible varication at spring shackles.) (Sec. 5082 & 5083) Yes _[/_. No_ 4. Is the mobilehome level.? (Sec. 5088) Yes t/ No 5. If more t -Han a single unit, are crossover connections properly installed? (Sec.. 5088) Yes No 5, Water. A. Is flexZz connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes '� No' B. Test - Does water piping withstand working pressure or 50 lbs, air test? Yes le_No $�kflow - If coach is not State of California approved, does station have backflow device nd pressure -relief valve? Yes No 7. Wastes and Drains A. Is connection made with. Schedule 40 DWV and have flex connectors at each end? Yes �No B.- Does it have minimum per foot slope and is it properly supported? Yes No • e C. Are any leaks detected in drainage system after running 3,gallons of water through each fixture including washing machine standpipe? Yes No DAf coach is not State of California approved, does station have required tiap and vent? N►Ybs No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least.as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes_ No .1: Open all appliance connector valves. Shut off appliance burner and pilot valves. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min, without drop. 4: Connect: gas meter to mobilehome with connector, turn. on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yeses No I 9. Electrical A Is service .Large enoiigh to provide -adequate amperage to mobilehome (must equal rating of mobilehome <aith a. ::;in.ii::um of19.0 arnp) and other faciliti.E!s on lot, i.e., water pumps, ,,arat,e, cabana, etc.':' o_ B. Is there proper clearances around panels? Yes= No C. Is power supply cord or feeder assembly properly fused? Yes 141 G_ D. Is continuity test satisfactory its per tate following procedure.? Yes No ,I,-- De -energize electrical wiring,, syste;a of the mobilehome at the pedestal. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, Have been disconnected. 3,,e- Switch all b-realcers and switches in the mobilehome to the "on" position. 4. Connect one lo... -id of a test instrument to the mobilehome grounding conductor and apply rite of ier lead t:o each TOOID LCLWIIIt J'ltpilly CGYiuuctG'r, illi iiuLltg Yte�lLrdt. 5! All nor. -current, carrying metal parts of the mobilehome (aluminum siding, gas line, ,,alter line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity te::;L :shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. ;,0, Is job card si-ned by Health Departmeat for water and sanitation? ll.. If everything olray, sign off card and tag services. MOBTLEiTOME DATA Manufacturer and/or Namestyle Jr/� (%E?G��S� Length &D W idth Vehicle Serial No. 06// State Identificati..on No. C;/-)- Fk2� r.&',Ltional Infoi-oar..ion or Comments: 9OUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS %7 County Center Drive - Oroville, California 95965 t Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date2- 7 -2- Signature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF(TBLIC WORKS en—/ . ll )) By Date 7- i -:; B ding permit expires Date 7,? BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor Total Valuation Mai I i ng Address Permit Fee Plan Checking Fee &/or Penalty q el phone _ Permit Fee $ Building Address ` Le6v PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 ' nLk_,& Zi 4 41 a I Repair drainage or vent piping 1.50 Water piping 1.50 Q(/ Each gas water heater or vent 1.50 A. P. No. - 06 ( Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F - W. Sa ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Bldg. PI Recd Parcel Ap "al Plans A proval Permit Fee $ NEW AD ITION UTILITIES OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 "Q/d Main service 1101 OR LESS 5•00 100 AMP OR LESS77 Main service EA. ADD -L 100 AMP 2.50 Main service OVER 800"100 AMP OR LESS 25.00 Single Family Duplex Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 1.00 NEW CONST DWELING OR ADDNS. ( ACCLBLDGS.CCUP. &) 2¢sq ft NEW CONSTR. MULTI -OUTLET NON-RESID, ( BRANCH CIRCUITS) 2.50ea NEW CONST R. (POWER APPARATUS & NON -RES ID, SINGLE OUTLET CIR, CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: (' .E Al IG 5�,�/YI/T 4 Xj'R✓# Ex. Occup(OUTLETS OR FIXTURES) 'BOA L@1' FIXED APP LNS. OR Ex. Occup.(OUTLETe (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 7 / License No. e7�oZ �3 a� .� Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. QI'have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date2- 7 -2- Signature of Permitee or Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF(TBLIC WORKS en—/ . ll )) By Date 7- i -:; B ding permit expires Date 7,? MOB ILEHOME SUPPORT DATA, Mobilehome Mfr, S11- y,6P.e R 6 S T Setup Model No.r 70 W Year Width ,2 41 (ft.) Length .. /o-,O(ft:)' Expando' Size ft.x ft. (Draw support details below) , On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not.on .file with .the County of Butte). *If center piers are other than drawn above,.. draw in locations, spacing, and dimensions. BUTTE COUNTY BUILDING; DEPARTMENT APPROVE Sin Ae - Footings (check -one) _ /7/"1. Wood.: either . pressure -treated or Center Center Support fdn. grade. Support Footing Sizes Locations (in.) % 2. Concrete pad. *1. j( nn. 3. Other,: specify • n. 711Supports (check one) o�c r 1. Concrete block 4/ 2. Concrete piers ftS-�.in� ` (in.)(in.) x S 1Sy 3. Steel piers l C 4. Other, specify Typical Support K3 IP3. .Footing Size C .(in.)(in.) P/f. Q Max. Pier Spacing in.) ax [�Z' 04 1� (in.) (in.) . 4'. ( i _ Overhang g *If center piers are other than drawn above,.. draw in locations, spacing, and dimensions. BUTTE COUNTY BUILDING; DEPARTMENT APPROVE �d 2 o'D6kV/ AF 1-0 1> R. DfZoVILki� R,�)40 . 0 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive; Oroville, CA. PHONE: 534-4541 1. Owner's name: -TO 2. Installer's name: 6 ) MOBILEHOME INSTALLATION SHEET n -1-i ,e R T -S IE- R 7- k k 5e,. T 7 s,CRI) 3. Is the site currently under permit? Yes / TV . No (If yes, furnish permit number ) OR , Is the site an existing site? Yes / / No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes /7 No (If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- / SO Amps 6. What is the mobilehome site service rating? --------------------- Q(0 Amps 7. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes / / No /'r/ (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- (in.) 10. What is the type of gas service? ----------------------------- Natura AJ LPG 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) n„ COUNTY OF BUTTE — DEPAfITMENT OF PUBLIC WORKS `' ►y �� 7 County Center Drive — Uroville; California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date !'1117 ?eipt gnature toff P r itee or Agent RNo.16Kaa 0 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been Id. DIRECTOR 0 PIDBLIC WORKS By- nate 7 —7 7 wilding permit expires Date ��6 7� BUILDING N 000— Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Te ephone No. Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address 5PLUMBING No. @ FEE PERMIT FILING FEE $3.00 , Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 �ding Verification Only Each gas water heater or vent 1.50 ' A. P. No. T Za n Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s q l Fire Dept. Fire Zone Use Permit Building sewer 5.00 igQ EQA Parking Plans Parcel Declaration Parcel M 60' R/W Im rovem nts P Lawn sprinkler system 2.00 Bldg. Plo Recd Parcel Approval Plans Approval Permit Fee $ $ 73 NEW 01 -ADDITION ❑ UTILITIES e OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE J$3.00 0V OR L Main service 80000 AMP ORSLESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 1.00 �jyJ .,``- `:..AINIMUM NEW OR ADDNSCONST ( ACC`BLDGS.DWELLING CCUP. &) 22sgft NEW CONSTR. MULTI.OUTLET NON.RESID. ( BRANCH CIRCUITS) 2.50ea Lux J NON-RESID R. (POWER SINGLE OUTLET TCIR.US & 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: Ex. Occup(OUTLETS OR FIXTURES)50 @25Q BAL@1 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT EE $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date !'1117 ?eipt gnature toff P r itee or Agent RNo.16Kaa 0 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been Id. DIRECTOR 0 PIDBLIC WORKS By- nate 7 —7 7 wilding permit expires Date ��6 7� Moteriais & 'i orkrn+anship Shrs l Be ire ,,rda ice v�'th 2ecognized Goua Practices on -di . quolitjrr�scribed rrr the Specificrd use in the Uniform Building, Plumbing & Mechanical Codes and =-Ahe National Electrical Code. r� rais set of plan,* and specifications MU -'S !ie job at all times and it is unlawful ; ma ,.> eny changes or alterations on same withoud wrihte;r p.-rmission from the Department Qr Pub. R:c Worizz, County of Butte® • •t A hN- F, �✓o FFer bgr7" 7T't 27 UeL),7— 5_, .A ,.. 3 . BUTTE CCOI iN BUILDING DEPARTMENT MSH i The . S&b ck shall be 5 ft_ side property '.ine and 54 ft: frc ., cent-arline of th , road, permittino mum of a 2 f °. ave overhang bl' C7. out of an met lents Septic syst yam ar d location Buffo, Cc n, Y to be aser Health Dept. Re. W quiremen f `O(` J s Tri a c 3,0 o E me- pi S `�. yys/ 77.:. All uti ity located�i�hin 4�ft.. oLit51r . hirrsi s tn o$ th m ML -1,.-1, o e n-1- on the I ft road.) Ede Of thy, �-ol 'I,, home. o. ,.. 3 . BUTTE CCOI iN BUILDING DEPARTMENT M W 4-1 BUTTE COUNTY BUILDING DMSION APPROVE®