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069-120-038
Michail Muria' ` 476 Sil�erleaf Dr. , lot ��� KR��1, Oro., Permit,#2 0-80P,E util',MH) ELEC. GAS SUPPORT STRUCTURE RE COMPACTION TEST REQ. , z Contr. Oro R ge Pro -Inc. tOr • Permit # 6-80MHI I Iss X63-.49-�2 . •38 r_A contr: Holmes Mobile Home Serv.,Bango, Permit #4330-80B(new deck, awning & pri.det.garage)MH) r w F � COI O71 r•. � I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES ARIEA INSPECTION CARD MUSTS ON JOB SITE 24 Hour Inspection Line (IVR) : (530) 538-4365 (Cut off time for inspections is 2pm) Due to recent reductions in staffing our department cannot guarantee inspections on the date requested Office: (530) 538-7601 Fax- (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B10-0905 Address: APN: Owner: Permit Type: SFD-MOBILE HOME RET; Description: EX MH ON PERM FND J .t F' j. } i n J ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING .r Inspection Type IVR. 'INSP 'DATE Setbacks 131 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 112 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House or Yard 404 ' Gas Piping House.or Yard 403 ' Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 'Do Not Install Floor Sheathing or Slab Until Above Signed Straps/Holdowns 154 Shearwall/B.W.P.-Interior 134 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 153 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 4 -Way Rough Framing 128 ' Gas Piping House or Yard 403 Shower Pan/Tub Test '408 Fire Sprinkler Test or Final 702 Do Not Insulate Until Above Signed Permit Final 802 Electrical Final 803 - Mechanical Final 809 Plumbing Final 813 , Swimming Pools Setbacks Inspection Type IVR INSP DATE T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Brown 144 Swimming Pools Setbacks 131 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 131 Blocking/Underpining_ 612. Tiedown/Soft Set System 611 Permanent Foundation System 613 Site Utilities/Trench Insp. :137 Gas Test Yard 404 Manometer Test 605 Continuity Test . 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: 13L !i 7 - -Insignia: Public Works Fina 538-7681 Fire De artment/CDF 538-6226 Env. Health Final 538-7281 Sewer District Final "PROJECT FINAL i k*Project Final is'a Certificate of Occupancy for (Reside ntia Only PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF MIJANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspec':or Copy �V T tF BUTTE COUNTY �• DEPARTMENT OF DEVELOPMENT SERVICES • BUILDING PERMIT • • 24 HOUR INSPECTION (IVR)#. (530) 538-4365 cOUINd OFFICE #: (530) 538-7601 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds a PROJECT INFbRMATION Site Address: 476 SILVER LEAF DR Owner: Permit NO: BIO -0905 APN: 069-120-038 MURRAY MICHAEL P & E, Issued Date: 6/23/2010 By: AAM Permit type: RESIDENTIAL 476 SILVERLEAF DR Subtype: SFD-MOBILE HOME RET OROVILLE, CA 95966 Expiration Date: 6/23/2011 Description: EX MH ON PERM FND .(530) 589-1341 Occupancy: Zoning: RT1 ' Contractor Applicant: Square Footage: TOM'S MOBILE SPECIALTIES TOM'S MOBILE SPECIALTIE Building Garage Remdl/Addn 6366 LINCOLN BLVD 6366 LINCOLN BLVD OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530)533-9117 (530)533-9117 FEE INFORMATION . DB CA BLDG STANDARDS SB 1473 $1.00 DBMSC Mobile Home Permit Fee. $380.40 DBMSC Splmntl PC/Hr 4+ Pre/Pos $127.00 Total Charged: $508.40 Fees Paid: $508.40 Balance Due: $0.00 Receipt No: B002859 LICENSED CONTRACTOR'S DECLARATION' _`, " ' OWNER /BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for TOM'S MOBILE SPECIALTIES 865359 / C47 / 10/31/2011 the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions is in full force and effect, of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the X 6/23/2010 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).): Contractor's Signature Date I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does COMPENSATION DECLARATION _ ;;WORKERS' ,., not apply to an owner of property who, through employees' or personal effort, builds or I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations improves the property, provided that the improvements are not intended or offered for sale. If, I have and will maintain a certificate of consent to self4nsure for workers' ❑ however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or compensation, issued by the Director of Industrial Relations as provided for by Section improved for the purpose of sale.). - 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. I, as owner of the property, am exclusively contracting with licensed Contractors to ❑, I have and will maintain workers' compensation insurance, as required by Section 3700 construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who of the Labor Code, for the performance of the work for which this permit is issued. My workers' contracts for the projects with a licensed Contractor pursuant to the Contractors' State License 000653 3/1/2011 Cartier. State Fund Policy Number. 461-0Date: Exp. Law.). I am exempt from licensure under the Contractors' State License Law for the following ❑ ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not reason: 6/23/2010 X 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. Owner's Signature Date r, P.ERMITiAP.PLICANT DECLARATION X 6/23/2010 Signature Date ` By my signature below, I certify to each of the following: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS I am U a California licensed contractor or U the property owner' or U authorized to UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES act on the property owner's behalf'". AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN I have read this construction permit application and the information I have provided is ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN correct. SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I agree to comply with all applicable city and county ordinances and state laws relating to building construction.' I authorize representatives of this city or county to enter the above -identified property . for inspection purposes. California Licensed Contractor, Property Owner' or Authorized CONSTRUCTION -LEND_ ING AGENCY DECLARATION. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). X 6/23/2010 Lender's Name and Address Name of Permittee [SIGN] Print Date INSPECTOR COPY ' Lender's Name & Address City State Zip STATE OF CALIFORNIA-'DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DE MANUFACTURER NAME/ID15 CALAO. 3TRADE NAME MODEL DOM DOT DFS SPC EXPIRATION HW!IAID HW HWNTAIN HH 00/00/80 00100/80 AJC 06/30/91 RY- 80 U SERIAL NUMBER LABEL/INSIGNIA NUMBER" - WEIGHT ' LENGTH WIDTH ISSUED SCC .. EXEMPT . USE r T'3c 3004A 19ZZ83 000000 000792 000144 .07/06/90 M, SFD, FLa 2 30048 192284 000000 000792' 000144 TOTAL- 5 FEES PAID: S162.00 , _A. MICHAEL PATRICK- MURRAY/ `a, , 0 EILEEN KATHLEEN MURRAY RELEASE oP DEALER a .TRUSTEES NEM REGISTERED OWNER, FILL IN ITEMS .4 - 9 R 476 SILVERLEAF DR. E OROVILLE CA 95:966 4.a):. s A E OR B ). R NAME PLEAS RINT P HICHAEL.Pffik`lm HURRAY! ' EItiEN: HATHLEEN HURRAY I A 476 SILVERLEAF DR. --- — - 8 I ' CITY CNTY 8T is ZIP-_ T L E OROVILLE 95966 6. R FUTURE' L-616 ADDRESS E 1... a D RELEAfiki 16 F REGISTERED OWNER 7 e xx LOCATIONS ADD 3 o a 476' SILVERLEAO� - 6 z N T CNTY" ST ZIP y. OROVILLE E U CA 95966 R S t r Q PUP . PRICE DATE % i4twREOISTERED OWNER SIG'NlATURE t L IIwFx NEW LEG LOINER� FILL IN I7EMSX 0 - 12 3HHE .. p> YO�` Lou w. e ` N f • NAME - PLE?iSE,aPRINT E 2. A) .,z t.,.,P::fi��z> R RELEASE F LEGAL OWNER 11. 6) ESw RETENTION05F L AL OWNER 12. _..C_}�. �-�_._-__—__,:.- r� :'.'.:. 'i.: •:.: ,'. -NE3C-1ST JR-_1.2=NFl�DE� CITY �NTY 3 ZIP R „„_;•7 a acacac ASSIGNMENT OF LEQAL tilNER J 13. $ U F. rumv I NAME - PLEASE PRINT .. N I . I R !' O.8 ADDRESS R T 15. CITY CNTY ST ZIP L' Wit* NEW 2ND JR. LIENHOLDERP FILL IN ITEMS 16 - 18 stat Z E IN 8 E NAME - PLEASE PRINT M O C 17. L O D N ADDRESS .E O 18. .R CITY CNTY ST ZIP IMPORTANT ' 01-383-00074 THIS`CERTIFICA'TE OF.tITLE 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. 0100015 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR)9.. (530) 538-4365 OFFICE #: (530) 538-7601 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds r PROJECT INFORMATION , Site Address: 476 SILVER LEAF DR Owner: Permit NO: B10-0905 APN: 069-120-038 MURRAY MICHAEL P & E, Issued Date: 6/23/2010 By: AAM Permit type: RESIDENTIAL 476 SILVERLEAF�DR Subtype: SFD-MOBILE HOME RET OROVILLE, CA 95966 Expiration Date: 6/23/2011 Description: EX MH ON PERM FND (530) 589-1341-. ,, Occupancy: Zoning: RTl Contractor Applicant: - Square Footage: TOM'S MOBILE SPECIALTIES TOM'S MOBILE SPECIALTIE Building Garage RemdVAddn 6366 LINCOLN BLVD 6366 LINCOLN BLVD OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530)533-9117 (530)533-9117 INFORMATION ' DB CA BLDG STANDARDS SB 1473 $1.00 DBMSC Mobile Home Permit Fee. $380.40 DBMSC Splmntl PC/Hr 4+ Pre/Pos - $127.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires TOM'S MOBILE SPECIALTIES 865359 / C47 / 10/31/2011 -1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect X 6/23/2010 rnntrartnr's Sinnahrrp rlato ;WORKERS` COMPENSATION DECLARATION__,_- _ I HEREBY -AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:, ❑I have and will maintain a certificate of consent to seff4nsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which his permit is 'issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Carrier. State Fund Policy Number: 461-0000653 Exp. Data: 3/1/2011 ❑I certify that, in the performance of the work for which this permit is issued, I shall not e y any person in any nner so as to become subject to the workers' c m nsation laws of Cal ifom1 and agr a that, if I should become subject to the workers' m nsation provision�e n 3709of the Labor Code, I shall forthwith comply with 6/23/2010 SIVature Date • RN/NG:LURE T CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHA SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($.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 DECLARATION I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders Name and Address Lender's Name & Address City State Zip _ Total Charged: $508.40 Fees Paid: $508.40 Balance Due: $0.00 Receipt No: B002859 - — OWNER/.BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct„ alter, ,improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure 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 (S500).):, I, as owner of the property, or. my employees with wages as their sole compensation, will do U all of or U portions of the work and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or . improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). I am exempt from licensure under the Contractors' State License Law for the reason: 6/23/2010 ���t'ilyll_T;Z;1�L�T►�1�7��i�_17_ti>iC� t. By my signature below, I certify to each of the following: am U a California licensed contractor or U the property owner' or U authorized to act on the property owner's behalf". I have read this construction permit application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to bu���(((Iding•construction. Iorize representatiyps of this city or county to enter the above -identified property f In oection ourelo est/CaNPomia Licensed Contractor. Property Owner* or Authorized FILE COPY' 6/23/2010 • BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.neVdds PLEASE PRINT CLEARLY PERMIT NO. B/0- o fo BIN # "When Sled, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name Dst Narm L Mailing Address '1 City State Zip 66 Phones – W Fax / E-mail ip- A Iqt/// ARCHITECTIEN&NEEW CONTRACTOR Name Q. S M,;b 1••e % Address L -, Cd 1A i3Z -Z City I State ZPCj,S� Phone l�-� Faxs -0107 E-mail I C� Ur- Gass % A Iqt/// APPLICANT INFORMATION ARCHITECTIEN&NEEW Name- - C', I c- Address ZP City Fax S�33Col d State Zip Phone Fax Email State license Number APPLICANT INFORMATION N Add b6 C'v l� �L� C', I c- State ZP Phone c ' c� Fax S�33Col d E-mail W 127 Jr -11911V PROJECT LOCATION AN d �� Property Address C''Crtwr' ) WORKER'S COMPENSATION Policy Number / �- 00 vk Z - () 9 34111 Carrier IZ .A n ff hLdng anyone other than licensed contractors, a cerBfrcate of worker's compensation must be shown at the time of permit Issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK.- 4 ORK:4 yu Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only. Zoning I Flood ZonPT,—.e SRA Yes No Occ. Const. e w v� 'max - �qelan �; Qa, '"Oa all Ic O. m S cy 7s C $ Ks og ll-' _ 9=a 'i' 7 aiFv� he'd C o •� ^I 14 : 8�• wtJ plig fill,8� -$ts w N yAwG ' C NI$N � •" In t �0S; A 11 IF 41 , a 4 +� �. z r Y �PA : F 2rp 1 UP � _gn S S R rs ClioM .e� O v ❑ rn7��oa 70 a z• � y PI Mon 'MI xx LL C7o to g � F s - �, 9 dFQ ao 1 _ El❑ __ S v p $ v sii `S 7oI0g� a Nri ❑ ❑ ❑� a $ & ❑ • I 9 A 1 `N gill ct loci ICA 6JA i Er" ( N a EM 1010 =a O :10 ~�i M � Q b a� �a A f�1 w r y CIS r� Na gags ON* y� M> Q� 0,�. Epao No. Loci Ito. Fii:ZL COED+-�?L�'tB^� •• o r-sm _ =414 $IECOAOEO MAIL TO: 5 S� Ntehwal P. and Eilcon K. WaZA;;a,._ t.L„ WIMPAT f�f&4-e't 7TR 676 Silvorleaf Drive j Orovtlle. CA. 959bS mVl7'y� i avam memo Tea- U= P= C.tt.6C3m 4= MAIL TAX STATEKEMS TO. � Gjww TQZ== j Htchael P. and Mean G. 11 IM"T o C 676 Slivorieat Drive .ae. Oroville, CA. 95965 "o esfsA�,t `Eft -"war i 6RA13T big@ of iOR A VALUABLE COPMDERATCU. at a" b Poier t=o�. �a NKFAEL P. '=RAY and BILEOt K. PM2PAY, husband and rife, as JoiLIT I-MAMS j h=!w GRPNT¢I to 141C1lAEL P. KURRAY end 3ILMR K. %7MY. as Trastasa Ute I;D:I praxertY in Cle6„t-{ e4 =incorporated arca of .t= t Camay of butt: Sm oa Cys -cis C= n "Lot 100, 00 abmra on that certain oap entitled. "MMAN 01= &rTMS U141T R0. 1". mbich tap was filed in the office of the Eeeordar of the CoL"+tT of B«tta, State of California. Ottober 30. !970 in Barb 38 of maps. at pagos S. 6. 7, B, 9 and 10." OMCXAL SEAM. MAY F tau arorm pude , rAwas? u SLIM cv- DOW October 5,_1996 -- - -Y COL-AA ButtC m o... OtEa]er S. 1986 x'az .�. ^c ..' :..t.:. ^ ::'. o^ n.eC ly mm 9�ss x.• aoA'"�o_s m !tt••hee! P. Murry and ZSleen K. tfurray t ti�LAArLi. � i6 LF" R. r; .y EIlt:P17 X. tiU9RNY OFFICIAL SEAL :¢aaAAe, t+e.n �o re vu.�c m ae on as Cao R Y i:AY F 7-v l oYdm.col pfaryw�acm e*oeu KmgJl cJcro e.0oacaonao ItaTlWr LftC-CALO"WA e.. t ,n -, .enw .cvw.m.�co acw.wwa�wfb a. a.t Rv� ..meoo ab a*-� .-,r. a�G t K7 ra 0 Mu�.��j7T W,ft! ! I W �S�r // �wa ro W Mrt.e ....sal a. ,j 1LrJY .b•o2` ,/ MAIL TAX STA7EK£NTS AS DIREZTED AOOVE B�D06� O COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 dOUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 (..,d..��. CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code,- Title 25, Chapter 5, under permit number for the following location: --moi/ -oc /P Owner /'1'1 //'I,i�r r` -J *Arf /// ,1' A Owner's Address Mob ilehome Mfg. /11,7^ // j'L�� //��f SMode l;2;1L'y- Year Insignia No!'d/. { Serial No. R �- It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date By THIS CERTIFICATE IS VOID WHEN MOBILEHOME,IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. j' °t `2680=80P,E PERMIT NO. PERMIT EXPIRES OWNER i Michael Murray owner C CONTR. i LOCATION (A.P. 34-63-38 x 476 Silverleaf . Dr., lot 100, KRlt1, Oroville u s; i� C�c fc :a , :i Temp. Power Pole Called PG&E 6. Elec. Serv.Called PG&Ep. Gas Serv. Called PG&E JT ALED (D e C. f (Signature) /i i 4 t Y S � i, � � 1 i � � � t ' � 1 rraming i COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD 111, BUILDING BUILDING (Cont'd) PLUMBING tback FI wall Soll iping F ms Par ets 1 SA Ioor In Bldg. Restripm Finish 2nd F or ootin s Windowk 3rd Floo S mwaII Sidin To out Sla Roof Shealting Water Piping Pier Roofing Sewer Garage Fdn. Vents Fixtures Footinax Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for ph sica handicapped Conformance of ex. V structure V A liances Gas Piping & Test Temp. Gas Slab A Final Sanitation Patio FAEACACE Final Footings Footing E CTRICAL Masonry Walls Throat Rou h Reinf. Ste Final Fixtures rraming i X Test Water Htr. Stucco Final Sub anel Mesh MECHANICAL Grd. Fawft Prot. Scr ch wn IHeatlnf(Servic8 g ol T ' p. Pole finish s oder round erior Lath ntllation Permanent oar Closer anal NFinal MOBILEHOME UTILITIES ----------------- Elec. Service __20014Pedestal Water Piping l/ - C' 4—_ Sewer —L --C---)C ___ Gas Piping BI E OME INSTALLATION - - - - - - - - - - - - - -Support _ Elec. Continuity �,S^ Water Piping xi Drainage Gas Piping _ DATE REMARKS OR CORRECTIONS 70 n<O 6,A-� "6 /ado Copes (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70 7 County Center Drive, Oroville — Phone 534-4541 Skyway and Elliott Road, Paradise — Phone 877-3435 CORRECTION NOTICE IV �c, his F.a-i r BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office\ when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. MOBILEHOME' INSTALLATION INSPECTION CHECKLIST ' 1.- Is the mobilehome located with required separation from Tot lines and buildings and generally conform to plot plan? Yes 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes No 3. Are footings and supports properly sized, spaced, and braced as pe pproved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes— No - 4. Is the mobilehome level? .(Sec. 5088) Yes Z No - 5. If more_,n a single unit, are crossover connections properly installed? (Sec. 5088) Yes_f1" No_ 6. Water A. Is flexibl connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)' ,Yes B. Test -,Does water piping withstand working pressure or 50 lbs. air test? Yes _C/Backflow - If coach is not State -of California -approved, does station have backflow device and pressure -relief valve? Yes— No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have, flex connectors at each end? Yes— No— B. Does it have minimum" per foot slope and is it properly supported? Yes— No, C. Are any leaks detected in drainage system after running 3-g ons of water through each fixture including washing machine standpipe? Yes— No— D. _If coach is not State of California approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gae supply with anapproved3/4" minimum k t 1 mobilehome conn for not more than 6 ft. to ? Note: All piping is to be at -least as large as the mob,i ome gas line inlet wi out reductions.,her•than the mobilehome connector. Yes No B. Test OK as per following pro dure? es— No 1. Open all appliance connecto va ves. 2. Shut off appliance burner a pi valves. 3. Air test with manometer 10"•-14" wat column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) ca brated in tenth p ind increments. Test for 10 min, without drop. 4. Connect gas met/ntsproperly bilehome with connector, t n on gas, test connections with soapy water. ,C. Are all appliance v installed? Yes— No 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal i o of mobilehome with a minimum of amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc'.? Yes_/ No_ B. Is there proper clearances around panels? Yesc/No_ Is power supply cord or feeder assembly properly fused? Yes 1-1 No_ D. Is continuity test satisfactory as per the following procedure? Yes A- o De -energize electrical wiring system of the mobilehome at the pedestal. a lMake sure that the power supply cord or'feeder assembly conductors, including neutral conductor, have been disconnected. witch all breakers and switches in the mobilehome to the "on" position. [Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. Upon completion of the above procedure, the mower supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of.the mobilehome. Upon satisfactory completion of- theelectrical tests, the lot or site service equipment may be approved for energizing, }9—Is job card signed by Health Department for water and sanitation? 1 If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle paAa%3-l" Length Width_ Vehicle Serial No. State Identification No. Additional Information or Comments: - , COUNTY OF'BUTTE - DEPARTMENT OF PUBLIC WORKS +� 7 Ct�unty Center Drive - Oroville, California 95965 1 Telephone: 534-4541 APPLICATION AND PERMIT x�; autnonze representatives or the county of tiutte to enter upon the above-mentioned property for inspection purposes. ORO RI PERTIE NC. r � X ate 7/ Signature of Permiteee�.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. DIRECTO PUBLIC WORKS By /� Date 6,'& T- � O BuiKing permit expires Date 6 -L 3 - P/ BUILDING Owner Michael P. & Eileen MURRAY SQ. FT. OCC. BUILDING VAL 10 Mailing Address 2632 Grizzly Hollow Way Stockton CA 95207 Telephone No. 209-957-3387 Contractor ORO RIDGE PROPERTIES INC. Mailing Address 5263 Royal -Oaks Drive FireplaceTotal valuation Oroville, CA 95965 Telephone No. 916-589-0152 Permit Fee Building Address 476 Silverleaf Drive Plan Checking Fee&/or Penalty Permit Fee Oroville CA 95965 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 KELLY RIDGE ESTATES Lot 100, Unit 1 Repair drainage or vent piping 1.50 A. P. NO- 34 - 63 - 38 Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 f �aaiair Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Parcel lar Plans Decation Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. Pla aced Parcel Ap roval Plans Aprovol Lawn sprinkler system —.4-2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ INSTALLATION for ELECTRICAL No.1 @ FEE Utility Permit #2680-80 PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5•Q� Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1,00 NEW OR ADDNST V ADWECCLBLDGSLING CCUP. 9i) 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: %� Oro Ridge Properties, Inc. NEW CONSTR.MULTI H CII T NON-RESID, � BRANCH CRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS 6 NON.RESID. SINGLE OUTLET CIR, Ex. Occuo(OUTLETs OR FIXTIIRES) B L@@1 EQFIXED APPLNS, OR p• OUTLETS (RFIXED Ex. CCU 2.00 EA) Temporary service 110.00 Mobile Home Facilities 15.00 License No. 295666 Classification B=Gen. Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit 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. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby 200MINJUDUMM Mble Home Install $ 40.00 TOTAL PERMIT FEE $ 40. 0 autnonze representatives or the county of tiutte to enter upon the above-mentioned property for inspection purposes. ORO RI PERTIE NC. r � X ate 7/ Signature of Permiteee�.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. DIRECTO PUBLIC WORKS By /� Date 6,'& T- � O BuiKing permit expires Date 6 -L 3 - P/ 0 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME•INSTALLATION SHEET 1. Owner's name: Mr. & Mrs. Michael P. Murray 2. Installer's name: ORO RIDGE PROPERTIES, INC. 3. Is the site currently under permit? Yes /XX/ No ( If yes, furnish permit number (0 0 — $ (7 " ) OR " Is the site an existing site? Yes / / No •/XX/ (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 /XX/ No (If no, clarify 5. What is the mobilehome electrical rating? ----------------------- 200 Amps 6. What is*the mobilehome site service rating? --------------------- 200 Amps 7. What is the mobilehome site circuit breaker rating? --------=-- 200 .Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes / / No /kX / (If yes, identify the load and size: (Load) -(Amps) 9. What— is the mobilehome site gas pipe size? --------------- -0 (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG./ / 11. What is the gas pipe length from meter or tank to the mobilehome? -0- (ft.) 12. :What is the mobilehome gas demand? ------------------------------ -0- (BTU) (This information not required if pipe length less than 6 ft. om natural gas or less than 50 ft. on LPG.) 6U.UTTE-CQUN9 r :ROVED _ SPP � 476 Silverleaf Drive MOBILEHOME SUPPORT DATA If other than single wide', Mobilehome Mfr. MOUNTAIN VALLEY HOME. furnish Setup Model No. 2BDR,LPK w/ Year 1980 Bonus U.R. Width 24 (ft.) Box Length 66 (ft.). Tagalong or Expando Size -0- ft.. x -0- ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973;.furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). A11 center supports measured from front of mobilehame unless otherwise specified.' Center support locations* / /c � (ft.)(in.) (ft.)(in.) 1391.-41 (ft.)(in.) (in.) (in.) Center support footing sizes (in.) (in.) (in.) (in.) (in.) 36x3a (in.) (in.) 3&x; Q (in.) (in.) .2�/x30 _ Single *If center piers are other than drawn above, draw in --locations, spacing, and dimensions. Footings (check one) 1. Wood either pressure treated c foundation grade. 2. Other (specify) Supports (check one) 1: Concrete block. 2-w Other (specify) Tagalong or Expando,' show support details. x o -- Typical Support in, (in.) Footing Size 16,_ 6 I -- Max. Pier Spacing (ft.)(in.) n -- Max. Overhang COUNTY OF BUTTE — DEPARTMENT OF PU13LIC WORKS 7 County Center Drive - Oroville, California 95965 ' Telephone: 534-4541 s� F��Q APPLICATION AND PERMIT �� Q authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date Signature of Permitee r Age Receipt No. eHtlo White-D.P.W. - Yellow -Assessor - ink -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. DIRECZOR OF PUBLIC WORKS By I Date 6-2-2-0 uilding permit expires Date BUILDING Owner U SQ. FT. OCC. BUILDING VALUATI Mailing Address d1lo / Telephone NIS. Contractor 040 n Mailing Address - Fireplace Total Valuation Telephone No. Permit Fee Building Address ZO Plan Checking Fee&/or Penalty Permit Fee Q PLUMBING No. @ FEE V PERMIT FILING FEE $3.00 .Q Each Trao 1.50 Repair drainage or vent piping 1.50 A. P. N o r� 4/0-38 - �/{�{�_ ' `on/ g &Panning Water piping 1.50 Each gas water heater or vent 1.50 F s Wte_f Sante on I FireDept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 Parking EQA Plans Parcel Declaration Parcel lap 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 aoo /� Bled pa b ec d Parcel A royal Plans Approva Lawn sprinkler system 2.00 NEW �. ADDITION ❑ UTILITIES C3 OTHER ❑ Permit Fee $ Q3-00;$ 0.0 ELECTRICAL No. @ 1. FEE PERMIT FILING FEE $3.00 , Q 0 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD•L 100 AMP 2.50 Main service OVER e00V 25.00 too AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST % ACCLBL GS.LING CCUP, 4) 2P.Sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: NEW CONSTR. (BRANCHMULTI-OCIR T NON -REBID `BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON-RESID. SINGLE OUTLET CIR, 25 Ex. OCCUD(OUTLETS OR FIXTIIRES 5 L 0 100 FIXED APP LNS, OR Ex. Occup.(OUTLETS (RESID•) EA) 2.00 Temporary service 10.00 Mobile Home Facilities License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of Cal ifomia. 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. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood I J 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction. and hereby Land Development Fee $ TOTAL PERMIT FEE Is authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date Signature of Permitee r Age Receipt No. eHtlo White-D.P.W. - Yellow -Assessor - ink -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. DIRECZOR OF PUBLIC WORKS By I Date 6-2-2-0 uilding permit expires Date %bOM �IlOntl a� 'li4r�Q b n� dQ AlNn©o NOTE; cordo lcell w OteRols : �or� uniform B -Id! rescr;bed fo1ed G odh'P $hall awona/ m6in3 $t�e $ Practic Be e Al .9. Plu Peci f e a Electrico ®s -- T 0 _CO -2 zl�— _._ 20.0 O'01 - 5E4✓EI__ _ - LOT 100 UNIT I 24 " < 6 6 ' NE T_ P.. ti• \ lyil� R A � O ..2100 .� I t— SQ. Fl. MIN I ,� �pBItES H P l V;1 TE•e --N a6- 3o' -00 -71/O_TE- Z/T/G/TY LOCAT/ON.S NO T 70 S'CA I— . Th is set of plans and. specifications MUST b8 kept on the job at all times and it is unlawful to make any changes or tpra+ions on sorne without the Dep artment of Public written permission from Works, County of butte. Ql C A setback of 5 ft. from the property lines and a setback of 50ft. from t road I a clear of I y for a 2 ft. eave OJ� A per �9snsta tow®f the quired for A6/ mobilehome, I / � I � ►MO � I I t— SQ. Fl. MIN I ,� �pBItES H P l V;1 TE•e --N a6- 3o' -00 -71/O_TE- Z/T/G/TY LOCAT/ON.S NO T 70 S'CA I— . Th is set of plans and. specifications MUST b8 kept on the job at all times and it is unlawful to make any changes or tpra+ions on sorne without the Dep artment of Public written permission from Works, County of butte. Ql C A setback of 5 ft. from the property lines and a setback of 50ft. from t road centerline sha a clear of structures or equipment *except for a 2 ft. eave verhang. =::5Ci4LE /=20� 247 ��d BUTTE COUNTY BUILDING DEPARTMENT -:, i9 �OEO MOB/GE��•6-BO i.'I�6'. _:AeiiG ¢-/4.7-7 �. ►• Telephone 533-2000 North Burbank, Public Utility .District 1960 Elgin Street OROVILLE, CALIFORNIA 95965 117-80 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works - Building Department prior to issuance of a building or occupancy permit, whichever' is applicable.: t Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North Burbank Public Utility District, must be submitted to Butte County. Applicant: W. P.' MURRAY Applicant Address: 2632 Grizzly' Hollow Way,, - Stockton, *CA 95207 Applicant Phone No.: 209-957-2175 Property Location (S): 476 Silverleaf Drive, Oroville, CA 95965 Kelly Ridge Estates Unit 1, Tot 100 A. P. NO. (S): 034-63-0-038-0 Fees Paid: All feefi na.i rl in arlvanr e hV Snuthern Cal i fnrni a Financiai.Corp. Application for service approved: June 2, 1980 North Burbank Public Utility District Inspection(s) made and successful test(s) observed: Location: Date: North* Burbank Public Utility District release to close permit: Date: By: L 4330-80B i PERMIT NO. /�• T/ PERMIT EXPIRES �J Michael Murray OWNER Holmes Mobile Home Serv., Bangor `CONTR. LOCATION (A.P. 34-63-38 476 Silverleat Dr., lot 100,KRli1, Oroville o tY 7 ti F` j I -P Temp.ower Pole Called PG&E Temp. Elea Serv. PG&E Galled TerrlI Gas Serv. •i Called PG&E JA r FINALED � (Date) Ij (Signature) �. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD - BUI DI G BUILDING (Cont'd) PLUMBING Setback Firewall Soil Pipin Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows W9 3rd Floor Stemwall Siding To out Slab Roof Sheathing (f Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings UZ Stemwa I I Garage Vents Insulation L Water Htr. Heaters Slab Car ort p Footings Prov. for ph sically handica ed Conformance of ex structure Appliances Gas Piping & st Temp. Gas iV Slab Final - Sanitation Patio FIREPLACE Final Footin s Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANIQAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pol Finish Ducts Underorodnd Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLALUN .............. Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSES OR PA, CEL NUMBERN 'Gt 'Pt L4IJBUILDING E T ;0— -OWNER OWNER TELEPHONE -k:i-1311/ SO. FT. OCC. BU VA DATION p M®.®O OWNER'S AILING ADDRESS CONTRACT 'S NAME 6' btc,5 r(ODs�CE hl ��tF,'t>lCb' TELEPHONE 5 �/� s>rs-oI CONT ACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ /0, 00 LENDER'S MAILING ADDRESS Permit Fee $ W,00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 0.610 Penalty $ ARCHITECT OR ENGINEER'S MAI NG ADDRESS Permit fee 0 $ 70-00 BUILDING ADDRESS PLUMBING PERMIT Filing Fee 3.00 220v Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO. I ao SUBDIV�ISIION NAME r eea6 Ick Gi fiq ,, PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex F1 Mobilehome❑ Other �yP--4C-4 SPECIFY Building sewer Lawn sprinkler system E2.00 TYPE OF WORK New Addition [D Remodel Utilities❑ Installation ❑ Other ❑ Describe work: R X 3 2 DEGC %X%!o' Awn1. p� �• 0 �Ys� 7 C -T24 rGN� Com• /3e/9Cy 1I Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 ,2 Main service EA. ADD'L 100 AMP 2.50 NEW CONSOR ADDNST ( ACCLBLOGS.DWELING CCUP.&� 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. 3_-1�-371 Classification C. —&,1 ❑ 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 LF NON •RESID RCONSTBRANCH CIRCUITS 2.50 ea NEW CONSTR. POWER APPARATUS & NON-RESIO. (SINGLE OUTLET CIR, ) Ex. Occup(o XTs OR FIXTURES 50 @ c a BAL@105 FIXED PR Ex. Occup.(OUTLETS (RESID,)EA.� 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 3.00 WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 2.00 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 sa e, indemnify and keep harmless the County of Butte against all liab' it'es, j •gments, cos d expenses which may in any way accrue ag ty in co se of the granting of this permit. O '/G ._f//) X i� Date / ��yy Signatur of Applicant — Owner ❑ Contractors Agent ❑ An OS A permit is required for ex vatio s ove "deep and demolition or construct- ion of structures over 3 stories in h ght. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ p 7� DO occu . GROUP TYPE OF CONST.Tqt4l���UE � This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR -DmF LIC By PERMIT EXPIRES Date the � I ro i - s o s do fees have been paid. WORKS Date 7 Receipt No. WHITE-D.P.W., YELLOW -ASSESSOR, P NK -INSPECTOR, GOLDENROD -APPLICANT i Y ' SITE PIAN Assessor's Parcel. Number: ..a Owner Name: Address / Phone: L Site Location:. Ll Contact Name: all Permit #: -• BUTTENTY 1� BUILDING DIMS APPROVED Of f-fIVj Scale 1" o�uTrFo � o 0 S — G17 CJSlig Z3 t-.;? 2,4 S Phone: