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069-310-041
f � � �-V7 YLaw ce R. Johnson �' `~U y� t ��' +' 5393 Hig Rocks Ct. , lot 476, KRAC,usO Oroville Permit ��1653-80P, uti1MH)6 ;} ' ` ti= 'fie• ELEC.S' —& v GA S SUPPORT STRUCTURE REQ.) COMPACTION TEST REQ. Contr : Mob • e Home Ce to Lrmit�2�3 04-80MHI ` 1 1 00- -5--4?-do G9- 3/- 4/ Permit #5545-89B(new patio cover/MH) 69-31-41 Permit #3093-81B(new open deck/MH) ,069-31-0-041 93-3313 B JOHNSON;' LAWRENCE '5393} HIGH ROCKS CT,,-OROVILLE .G `{`• COVER 'EXISTING DECK/MH v G ' R I� } T 1�5 j I V= OK O= Not OK ` Not eeaadyable MOBILE HOMES Date/Initials MOBILE HOME UTILITIES (Plans) OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Solis; Special MH Support Sketch 3. Sewer; Location -Teat -Fall -C/O Concrete 4. Water; Location -Teat -Easement Needed (Sketch) S. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Teat -Wrap: / /" L"ft. / /"Net. or/ P'L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date/Initials MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3.. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy MISCELLANEOUS Date/initial DECKS, COVERS, CARPORTS GARAGES, Plana OK except #'a J,f2-Zjy Wing Requirements -Setbacks -Easements Footings ;Soils -Size -Depth -Spacing -Connectors -Steel 3. s; Griders and/or Joists -Decking -Bracing -Stairs -Rails . Wood Awn.; Posts-Beams-Rftrs.-Connectors ZZ� Shthg -Rfg -Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Truases 9. S g; Nailing-Veneer-Stucco-Mash L� . Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date/Initials POOLS (Plana) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ina. to Mein in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test V=OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date/Initials UNDERFLOOR (Plans) OK except #'a 1. Zoning -Setbacks -Easements -Flood -Slope 2. Fig., Main; Soils-Elec. Grnd. / P' Fig. Depth 3. Fig., Garage; Soils-Steel-Elec. Grnd./ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -teat 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance -Materiel -Support -Ina. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date/Initials PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor-Naii Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date/initials ELECTRICAL (Permit) OK except #'a 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mach. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels -Motors -Mach. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date/Initials MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date/Initials FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Wells (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing Date/Initials FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brec-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ina. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Wells; Nailing -Bolts 59. Insulation -Wells -Ceilings 60. Infiltration -Walls -Windows Date/Initials FINAL (Plans) OK except #'a 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd: Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Lending -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor -Mach. Protection 75. Plb., Elec. & Mach. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drain e & Wood -Earth Clearance Looked under Floor Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg -Appliance-Fireplace :Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Comments at Final: I COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVI ILDING DIVISION 7 County Center Dijve - Oroville, California 95965 - Telep one (91 ) 538-7541 PERMIT NO. APPLICATIGN AND PERMI 93-3313 ASSESSOR PARCEL NUMBER 069-310-041 ZONING RT1 BUILDING PERMIT _ OWNER LAWRENCE JOHNSON TELEPHONE 589-1033 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 5393 HIGH ROCKS CT OROVILL E 95966 828 C 10 764 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 126.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 81.90 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 5393 HIGH ROCKS CT OROVILLE PERMIT FEE $ 227.90 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome 6 Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition IN Remodel ❑ Utilities ElInstallation ❑ Other ❑ Describework: COVER EXISTING DECK PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( 2"" OR LESS ) GOA OR LESS 23.00 Main Service ( 200A TO t000A ) 46.00 NEW CONST. DWELLING OCC U OR ADDNS. ( & ACC. BLDS. ) SO,P. 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification XI, as the owner, 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) ❑ 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ lam exempt under Sec. Business and Professions Code for this reason NEW CONST. MULTI -OUTLET -NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWERAPPARATUS ) & SINGLE OUTLET CIN. Ex. Occup. ( OUTLET OR FIXTURES ) B20AL. @ ).00 Ex. Occup' (OFIXED APPLNS. OR UTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 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 Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County i onsequence of the nting of this permit. X Date 6 3 / Igna re of Applicant - ner ❑ Contractor ❑ Agent J An OSHA permit is required for excavations over 5"0" deep and demolition or 1 construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST. TYPE TOTAL FEE $ 227.90 HA2• D. FEES `� IMP "'"-- I FSO PARCEL PD HD IS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have bee aid. DIRECTO IC WORKS By Date PERMIT EXPIRES ON /Date! Receipt No. 153103 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ..,_..,,i,.y,ti,+•..rin--:vY°T,.-,_„w�%M..%�'v `�.t/7..-:.%s/1.>� "'Y�K'j,lT/'�ywA'7f'` tw�.`�_:..�.'„:.�ir �.'„.;sM COUNTYOF BUTTE - DEPARTMENT OF DEVELO�PMENT,,SE VICE - BUILDING DIVISION. iJ fi 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATASHEET OWNERle--A&U-Q'ill e 0h Al Son% .. A. P. No. 60 - 310 • o L/ / Proposed f3uilding Use G= -ver DcX-K, .�. Building Inspector P> Date _lb S/ S At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ....................................... . 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3_ Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5.,Hazardous Material Form. ........,...................... . 6. Energy Design Compliance and supporting documentation . .................... 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... - 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $......................................AE20 11. Impact fees as shown on attached schedule. . 12. California Department of Forestry plan approval/fees. j-,13 13. Flood elevation letter (100 year flo d) by California Engineer. 14. Sanitation and plot plan approval; A- Health Department . ............ 15. City of Chico plumbing permit . ......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............ . 17. Planning approval for (A) Use: (B) Parking: . ....... .- 18. Contact Land Development.a bout (A) Improvements (B) Drainage. ........... 19. Driveway permit (construction approval required prior to occupancy). . -,20. Pre -inspection for PBa"ding Inn reyueeT� - P required. . . to Building �"$Pada. t (Date) 21. Contractor's license information. (No., Name Style,. Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _ )............ 24: Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .... ....................... . 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan ch --L, list. ...... 33. •34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. 6 Telephone`,599 - Ing,7S and hold for pickup at u' e, office. Deliver with inspector. Other Parcel Creation f / OF -s 43 Acreage Applic t __ Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution -"Date Copy of plans sent - Health Dept. Fire Dept. Other Date •.. By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above kequired data by _ phone _ mail Co b _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works ti COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and -issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner) Social Security um er Date /6 Zs- 9 ;k NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must becompleted.and returned to our office before we are per- mitted to issue the permit. } COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 - TELEPHONE (916) 538-7541 OWNER 4 %JL Uj01QCe- c�)U{�1J Sc9� A. P. # /149 PROPOSED BUILDING USE d°e�D�)je_9�r,p CC4 DATE REC. # DATE REC 1. SCHOOL DISTRICT FEES (paid at District Office) ......................... 2. SHERIFF FEES (paid at Building Department) Residential...... x =$ unit amt. Commercial (sqft) x =$ sq.ft. amt. 3. URBAN AREA FEES (paid at Building Department) Residential (per unit) x =$ # units amt. Commercial (per sq.ft) x =$ sq.ft. amt. 4. RECREATION DISTRICT FEES (paid at District Office) ......................... 5. DRAINAGE DISTRICT FEES (Contact Land Development Division) .............. 6. SRA FIRE INSPECTION AND PLAN CHECK = $89.00...... 15-3 !63 (paid at Building Department) 7. OTHER OSS3 At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. APPLICANT DATE r PERMIT NO. 3093-81B PERMIT, EXPIRES OWNER L. R. Johnson CONTR. owner_ ASSESSOR PARCEL' 69-31-41' , LOCATION 5393 High Rock Ct., lot 476,KR#' C, Oroville s Y 1 Y ( s 4 ,1 Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E f JOB FINALED (Date) Signature n J OK 0 = Net OK = Not Applicable MOBILEHOMES r MISCELLANEOUS = Not Ready Date MOBILEHOME UTILITIES (Plans) OK except N's Date DE S, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zbning Requirements—Setbacks—Easements.. Zoning Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch ootings; Size-Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (sketch) 4, Wood Awn.; Posts=Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 6. Gas; Location—Test—Wrap:/ ,/"L"ft./. /"Nat.or/- /"L"ft./ /"LPG 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Carports; Windows -Doors" 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except H's 1. Zoning Requirements—Setbacks—Easements Card -BI Date Date Card -BI ' " ' Date _ POOLS (Plans) OK except N's 1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 4. Electricity; MH Test—Crossovers—Breakers—Clearances 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Elec.; Receptacles and Lighting; Distances—GFI, 5. Drain;'MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI. . 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals-Listed 7. Water and Sewer Connected—C/0 to Grade—HD Approval . 7. Elec.; Bonding; Metal w/5'—Circulating.E4uipment—'Heater 8. Gas and Electricity. Tagged B. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghig. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch _ 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK i = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) 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 Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except q's Card -BI Date Card -BI Date Date _ PLUMBING (Permit) OK except N's 14. Water Ht.; Vent -Access -Combustion Air 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. 59. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Bedroom Exiting 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 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 Gas Pipe; Size & Anchors 62. Stairs & Rails _ _19. 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except p's 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. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72, Insulation -Foam -Looked in Attic ❑Yes 73. Guard Rails &Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes El No 75, 76. 77, Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No Stucco; Brown -Finish A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 28. Service -Riser Conductors & Ground -Main Disconnect 29. Equip. Clearances; Panels-Motors-Mech. Equip. 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. 81. Exterior Elec. Trim; G.F.I. Receptacle -Underground Ventilation throughout House Card B I Date Card -BI Date Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except ti's 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval _ 32. _33. 34. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade Furnace -Vent; -Access -Comb. Air -Return Air Vent -115V outlet 86, Energy Compliance Certificate -Other Certificates 35. Attic Access -& Platform if Furnace in Attic Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Card -BI - ----- Date -_ Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING Plans OK except q's 36. Sills; Proper Material & Anchors 37. Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. 39. _Walls; Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub Header & Beam -Size & Bearing _ _41. 42. 43. 44. Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat 45. _Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles _ 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) COUNTY OF BUTTE -rDEPARTMENT OF PUBLIC WORKS PERMIT NO 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-454 APPLICATION AND PERMIT r /� ASSESS ji PARCEL NM - ZO ING (/U / .—. �p�- BUILDING PERMIT OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRES \_610 5_3`T3 C 1 CONTRACTOR'S NAME VTELEPHONE CONTRACTOR'S MAILING ADDRESS �-- Fireplace CONSTRUCTION LENDER OK. NKN UOWN Total Valuation $ Filin g Fee $ 10•00 LENDER'S MAILING ADDRESS '—� Permit Fee ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Z��d Penalty $ ARCHITECT OR ENGINEER'S AILING ADDRESS Permit fee $ 0 BUILDING ADDRESS�3 e ` PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 © ff Water piping LOT NO.SUBDIVISION 47 6 NAME kr 4 —ef PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex[] MobilehomeL?�. Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New❑ Addition(, Remodel❑ UtilitiesInstallationOther Describe work: m b o- ❑ ❑ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main seryice 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.DI) OR AODNS. ACC. BLDGS. _ 20 sq it CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the. Business and Professions Code and my license is in full force and effect. License No: Classification I, as the owner, or my employees with wages as their sole compen- s 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 NE NON•RESID PLBRANCH CIRCTITS2.50 ea NEw CONSTR. (POWER APPARATUS DI NON•RESID, SINGLE OUTLET CIR, Ex. Occup OUTLETS OR FIXTURES BAL50 6 �1 FIXED APPLNS, OR Ex. Occup.(OUTLETS (RESID,) EA.) 2:00 Temporary service 10.00 r Mobile Home Facilities 15.00 Misc. Wiring 7.50 , - Permit Fee $ Contractor MECHANICAL PERMIT FiIirig Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agr a to save, indemnify and keep harmless the County of Butte against all Iia ities, judgments, sts, and expenses which may in any way accrue a in s d County ' co s qu a of the granting of this ermit. / X Dat Sign ture of Applicant owner Contractor ❑ Agent An OSHA permit is r u' ed for excavations over 5'0" deep and demolition or construct- ion of structures over ttoorriies in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE=P ST, V✓/�' PARCEL V PC ISS E This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT R^OF PUBLIC By PE IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. s� / WHITE-D.P.W.. YELLOW -ASSESSOR, INK -INSPECTOR. GOLDENROD -APPLICANT ' G COUNTY OF BUTTE - Department of Public Works 7 County Center give:; Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BU ILDEIR VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed prope y improvement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the.work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type'of Work Signed: Prop Soci Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILtE, CALIFORNIA 95965 - TELEPHONE: 916/5344541 PERMIT .APPLICATION DATA SHEET Permit No. OWNER �/` r rC . V/� rl -40 `rA. P. No. l - �� - Z Proposed Building Use 0,3 oC-t t Permit Fee Based Upon: Complete Contract Price -- DPW Valuation C� Other (Explain) Building Inspector - -/�2Y Date C__9_ At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate./triplicate. . . . . . . . . . . 3. Complete plans in duplicate. /triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval fromP vim- Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner0, Mail to owner ❑•) 15. Improvements may be required. . . . . . . . . . .. 16. Mobilehome Installation Data. . . . . . . . •. . Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector (Date) 18. Other When you issue the permit, process as follows: Mail to oyvner. _ e/ Telephone, -,/_0�3 and hold for pickup at 7 office. Other M Mail to contractor. _Deliver w/inspector. Date Copy of plans sent Health Dept., Fire Dept., Othery 4. Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone By Plans checked by. Plans approved by Other Copy—DPW Date Date Mail Other Date J 'OMW z PERMIT NO. E PERMIT EXPIRES_ ;OWNER Lawrence R. Johnson CONTR. owner 34-89-41 'LOCATION (A.P. ) 5393 High Rocks Ct., lot,476, KR#4C, Oro. } r 6 i Temp. Power Pole Ca01. PG&E Temp. Elec. Serv. �alled PG&E 3 Temp. Gas Serv. Cabled PG&E JOB OB (D e (Signature) otings St wall Slab Piers Garage Footings Stemwa I I Slab Carport Footings Slab Patio Footings isonry Walls Reinf. Steel COUNTY OF BUTTE — DEPARTMENT 0'F PUBLIC WORKS = BUILDING INSPECTION RECORD, BUILDING BUILDING (Cont'd) PLUMBING FI wall S I Plping Par ets At Floor Restr om Finish 2n Floor Windo 3rd loor "Sidin To out Roof Sheahing Water Plpvg Roofing Sewer Fdn. Vents Fixtures Garage Vents Insulation \ Water Htr. Heaters Prov. for ph sica y handica ed Conformance of ex. \\ A liances [GassPI in & Test Foot Thro Fina FIRE Mesh I MECHANICAL ` ScraAh Heatl BrAn Coolfng nish D is erior Lath ntllation oor Closer anal MOBILEHOME UTILITIES ------------------ Elec. Service Water Piping — S —� t�� Sewer s i J4QJ16EtJOIVIE INSTALLATION - - - - - - - - - - - - Support Water Piping/ — © Drainage DATE `� '�� REMARKS OR CORRECTIONS T--® 0OPS401 Temp. Gas Sanitation Final E CTRI Rough Fixtures Motors Water Htr. Subpanels/ Gird. Fai Prot. Servic Te p. Pole LiAderground 'Permanent inal lec. _Pedestal Gas Piping 17 Elec. Continuity�,— Gas Piping (NOTE: An entry must be made on this form each time you visit the job site.) L COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS - v 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 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. x/45 4�0C11A.Fano Z4 Inspec Date �5 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 51 under permit number kill for the following location: Owner.. 1 .pit.,.ekn/C %z 2Zn/-%C_/{Q,/ Owner's Address Mobilehome Mfg. Ate'.S1/ 66-O'M QS 1 - wry 21Year �Q Insignia No.( -41, /J'7 233 — -?C/ Serial No. It is hereby certified for occupancy at the above described location and may be occupied., Directo of Public Works Date '/�i D By la 1�/ _ �f/�...ilf _ J i - THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White -Owner, Yellow - Installer, Pink - D.P.W. MOBILEHOME INSTALLATION INSPECTION CHECKLIST 1. Is the mobilehome located -wit equired separation from lot lines and buildings and generally conform to plot plan? Yes No 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yes_ No 3. Are footings and supports properly sized, spaced, and braced as peer approved plans? (Note possible variation at spring shackles,.) (Sec. 5082 & 5083) Yes 4 No 4. Is the mobilehome level? (Sec. 5088) Yeses No_ 5. If mor han a single unit, are crossover connections properly installed? (Sec. 5088) . Yes_ No— ' 6. Water A. Is fle�le connector of adequate size and properly installed (1/2" ID min.)? (.Sec. 5566)' Yes ti No B. Test -.Does water piping withstand working pressure or.50 lbs. air test? Yes`No lackfl'ow - 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 Z-�N o B. Does it have minimum" per foot slope and is it properly supported? Yes_ No C. Are any leaks detected in drainage.system after conning 3- lons of water through each fixture including washing machine standpipe? .Yes_ No IV Acoach is not State of California approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Ve A. Connector - Is mobil ome' connected to the g' supply with an approved 3/4" minimum _ mobilehome connector n t more than 6 ft. to g? Note: All piping is to be at least as large as the mobilehome as line inlet wi out reductions other than the mobilehome connector. Yes_ No B. Test OK as per following'p cedure? es_ No 1. Open all appliance conne for va es. 2. Shut off appliance burner n pilot valves. 3. Air test with manometer t 1 "-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) Cali rate in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to obilehome wi h connector, turn on gas, test connections with soapy water. C.' Are all appliance vents properly installe Yes_ No 9. Electrical A. Is service large enough to provide adequate amperage -to mobilelome (must equal rating -of mobilehome with a minimum of 1001amp) and other facilities on lot', i.e., water ptimps, garage, cabana, etc.? Yes t/ Io_ B. Is there proper clearances around panels? Yes il No_ C. Is power supply cord or feeder assembly properly fused? Yes�o_ D. Is continuity test satisfactory as per the following procedure? Yes [/No Y. De -energize electrical wiring system of the mobilehome at the pedestal. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. �Switch 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. s/ 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. Ef/. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be^approved for energizing. PJ*rs job card signed by Health Department for water and sanitation? 1'1/ If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle P�i�% iG ��N� � ���7, S 0 � � ro Length j�1 Width -) 4 ?.cJ�O. Vehicle Serial No. State Identification No. (rL /x%73 - 3 CV 3s--- Additional Information or Comments: 5 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 �� Telephone: 534-4541 APPLICATION AND PERMIT l authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. —Date '0 7:-$d Signature of Per ee�e oAr ent Receipt No. 349 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provision's of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR O'FIPUBLIC WORKS By Date 4-7—,? O wilding permit expires Date q- %, ,p% BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address fC' D C / U _ x Telephone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee 11 /!✓ 'y� PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00,�j0 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. / - �4% �� Zoning & anning Water piping 1.50 Each gas water heater or vent 1.50 es I kCJSeljkon I Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Parcel Plans Declaration Parc ap 60' R/W Improvements Each additional outlet .30 ding sewer 5.00 (?, Bldg. PI s Recd I Plans Approval Lawn sprinkler system 2.00 _.Po,rk1"'AEErova1 NEW ADDITION ❑ UTILITIESIg OTHER ❑ permit Fee $ �cc) .$E` ELECTRICAL No.1 @ I FEE PERMIT FILING FEE $3.00 rj,C�O Main service S00V OR LESS 100 AMP OR LESS 5•�� Single Family ❑ Duplex ❑ Mobil HomeOthers ❑ Main service EA. ADD'L 100 AMP 2.50 ,5d Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 1.00 NEW CONST OR ADDNS. I DWELING ACCLBLDGS.CCUP. Y\ 20 Sq ft I CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Y NEW RESID. MULTI -OUTLET NON RESID. � BRANCH CIRCUI2.50ea TS) NEW CONSTR. (POWER APPARATUS fil NON RESID. SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXTIIRES; 5 L ,2 -Ex. Occup. FIXED APPLNS. OR p• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 j,Qp License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that 1 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 $ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. —Date '0 7:-$d Signature of Per ee�e oAr ent Receipt No. 349 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provision's of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR O'FIPUBLIC WORKS By Date 4-7—,? O wilding permit expires Date q- %, ,p% COUNTY OF BUTTE —" DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 ,Telephone: 534-4541 �� /�// a� APPLICATION AND PERMIT _ v�/C a Owner Mailing Address Telephone No. ContractorAIB9iZ.- /AM,- &AMIIr/L eJ�wJCJ Mailing Address -Al T�phone No. Building Address 3 93�s &7- C- resC, L.c T Y7 CS1G%li�sy�L� A. P. No. — (Zon1ing & Planning FVs ""W FireDept.1 Fire Zone Use Permit EQA Parking I Parcel Parcel Ma 60' R/W Improvement - Plans Declaration P P Bldg. PI ns Recd Parcel AEp roval Plans Approval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Single Family ❑ Duplex ❑ Mobil Home Others ❑ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: /1 RnD 131 /S_ � ? i ( �,>('. Al rLA cLiJy License No. :26/yes, Classification _ C-0 ❑ I am exempt from the Contractors License Laws of the State of California. 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. have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives the County of Butte to enter upon the above-mentioned prope ty fo inspection purposes. Date Signatur of fermitee or Agent Receipt No. ,? ��? e- White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant _ BUILDING SQ. FT. I OCC. I BUILDING VALUA ION Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee '''0 BAL91 ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER e00v 100 AMP OR LESS Main service EA. ADD•L 100 AMP NEW CONST./ OR ADDNS. \ DWELLING OCCUP. 5 ACC. BLDGS. NEW CONSTR. NON.RESID_ T (MULTI -OUTLET l\ BRANCH CIRCUITS $3.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 )2saft FEE FEE EX. OCCUp(OUTLETS OR FIXTURES '''0 BAL91 / FIXED APPLNS. OR EX. Occup.((RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee MECHANICAL PERMIT FILING FEE Heating Coo I i $3.00 Venti lation Hood 1 1 2.00 Permit Fee $ $ ee $ Ali 00 TOTAL PERMIT FEE $ Am TV This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated a for which fees have been paid. D R OFX LIC WORKS i eM�41) DateQ Building perms expires D4at "e I ` MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. /t1�,F��, ✓�,u ..� S7� furgish Setu Model..No: D/i►' Year 9� Width(ft.) Box Length c �- (ft:.): ,:Tagalong or}-Expando Size ft. x�4 --ft. (SHOW SUPPORT DETAIL'S 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). r All center supports measured from front of mobilehome unless otherwise specified. Footings (check one) Single 1. Wood either A A pressure treated or foundation grade. (ft.).(in.) (in.) -(in.) DD er (specify) ��Hzr��Jf-, Center support Center support locations* footing sizes f' f Supports (check one) /-11. rm �8 1: Concrete block. a29iy x�l .�.j /�� G `' oZy�x r, , ❑ 2: Other (specify) (ft:)(in.) (in.) (in.) y.y'� yk, <--Tagalong alon or Ex endo itH /aY.1! � g g P � �xZ� 3�' yo �, $�� show. support details. (ft.)(in.) (in.) (in.) Typical Support (in.) (in.) Footing Size r 4u (ft.)(in.) (in.) (in.) Max. Pier Spacing (ft.)(in.) Max. Overhang (ft.)(in.). Burg COUN� BUILDING . . DEpAA PPR RTMENI OV p *if center piers are other than drawn above, Q draw, in l nratinna _ anar3na an.a r�ime„c inre BUTTE'COUNTY "DEPARTMENT OF PUBLIC -WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: NAuJ�PF,JC� 1DlSoA) 2. Installer's name: #OM .• &G,y7,e,:-*c" 3. Is the site currently under permit? Yes No (If yes, furnish permit number ) OR Is the / / site an existing site? Yes No / Y/ (If yes, furnish two (2) plot plans.). 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No ( If no, clarify ) 5. What is the mobilehome electrical rating.? ----------------------- ,�a, Amps 6. What is the mobilehome site service rating? --------------------- -26Q Amps 7. What is the mobilehome site circuit breaker rating? ------------- x;00 Amps 8. Is there any other electric load to be served by the mobilehome siteservice? ---------- .------------------------------- ------- Yes No yes, identify the load and size: (Load) (Amps) `(If 9. What is the mobilehome site gas pipe size? ---------------------- ��%/ AIVAJ r (in.) 10. What is the type of gas service? ----------------------------- ;iatueft14 / t?G--/— / 11. What is the gas pipe length from meter -or tank to the mobilehome? 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.) 5 n N' + H LOT 476 This saf ^ p1c.ns and $jan,.; MUST be I UNIT 4C kcvy!�f on t�le i0b of 011 �Irnes and "t is 'Aaw ful �0, chmivc% orcsaie 7s1�:1on soniv wA 6 'p a Depvtrn%ani of wriffen permiss;on fro WT%S'�A-p ,k -%r orks, Co y of Suite. .1 IPTC% eS *%n klf%e Spec-, OVA Oc3keT,esCA. k\A- 0 U& -,aor%�e Rhe�,'IOr pTe.,\nq P'ccol A04 Ok 0 qL1 \3v;jjorr(\.0(%0x 114' 3_C'49' z=tea = 4o. co' -5-2, 13 '/5 '5 S"' L 3 of ft. from setback 285, d a setback proT:)ertY lines a L 1. 5, 98, 1 u3.01 of 5()ft. from" -0 road centerline shall6� , clear of S ent except /--i CRIAL—_ structure6 or equipment for 3.2 ft,save over�ang, ____ OD SQ. e 11, 50 0 MOBILES Z_ EO% ILI re 16 0(\ �e '�Io ;a Col I NN o i0v 01 -tea�o 6 \Qe Cqx- fed\w , \,d* \1 19\ e d\je vl\\ AL& "Vee �j tCOUNTY -BUILDING DEPARTIVIENI PPROVED' \ < . Telephone 533-2000 t North Burbank Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95965 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION 32-80 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. 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: LAWRENCE R. JOHNSON Applicant Address: 131 ROSE COURT, #8, CAMPBELL, CA. Applicant Phone No.: 408-379-2704 Property Location(s): KELLY RIDGE ESTATES UNIT 4C, LOT 476 A. P. No. (s): 034-8970-041-0 Fees Paid: SCOR FACILITY CHARGE OF $700.00 (TO 7/1/80) DUE. NBPUD,,����CONNECTION FEE PAID IN ADVANCE BY SOUTHERN CALI Application for service approved-\, 6y' North Burbank MARCH 25, 1980 Public Utility District Inspection(s) made and successful test(s) -observed: Location: Date: M North Burbank Public Utility District release to close permit: Date: By: COOK ASSOCIATES ENGINEERING CONSULTANTS 2060 PARK AVENUE OROVILLE. CALIFORNIA 95965 PHONE (916) - 533.6457 May 5, X1980 REPORT OF CONTROLLED COMPACTED FILL PROJECT:" Kelly Ridge Estates Unit 4C Lot 476 Johnson Re: 80559 GENERAL Compacted fill was placed to provide support for a mobile home. The maximum depth of compacted fill is about 2.5 feet." DESCRIPTION OF FILL Prior to placement of fill, the area to receive structural fill was cleared of weeds and debris. The material used' -for the fill was sandy clay. Fill was placed in loose layers about six inches in thickness and compacted by track rolling. Water was added to the fill prior to placement of additional fill. During construction of the mobile home pad, fill was "placed outside the structural fill. This fill was not tested during grading and is considered to be a non-structural fill. A typical cross-section (Plate 1) depicting this condition is attached. The -approximate extent of.the grading is shoran on the attached drawing "Location of Density Tests". TESTING Field density tests were taken at frequent intervals near the fill surface.. Representative samples of the soil were taken to the laboratory for compaction tests. -'The compaction tests were performed in accordance with the laboratory standard ASTM 1557 Method A The relative density of the fill was. determined from the compaction tests. Where tests indicate insufficient compaction the material was removed, "recompacted and retested. The location of the field density.tests are shown on the attached drawing. The results of the tests are given on the table "Summary of Tests". CONCLUSIONS Based on intermittent observation, it is concluded that the structural fill was placed in an orderly and efficient manner. and that the field density tests are representative of the structural.fill placed. It is our opinion that all portions of the structural fill are compacted to at least 90% of the maximum density, in accordance with the requirements:of the County of Butte. SUMMARY ,0F TESTS PROJECT: Ed Nieto Kelly Ridge Estates Lot 476, Unit 4C. Johnson FIELD DENSITY TESTS: Field Test Density Percent Maximum .Degree of No. Date Elev. pcf Moisture Density Compaction Remarks'. 1 4-9-80 1.5'Fill 112 13 126 89. Fail 2 4-10 1'Fill 116 12 126 92- Pass 3 4-10 .2.5'Fill 118. 10 126 94 Pass COMPACTION TEST: Maximum dry density, pcf: 126 Maximum size tested: #4 Optimum moisture, percent: 11 VISUAL CLASSIFICATION: Soil type: Clayey Sand . N64883 7 A/SEN LOUR 7," N 5ME I"= Z01 1 .105 _ ' K X ) K X k t •.fY. �� X. X. m LE6END qa • 1 Lcxs-rrow of Q3 vemA OF rt (-I-- LLim LimWT OF RLL 51.oc _. ::... . SUBJECT : LOCATION OF DENSITY "CCSrS !✓O NIETO 80559 CLIENTS NAME JOB NO. UNIT 4C' LOT 47(o COOK ASSOCIATES 5-5-'W JOB• DES `C 1RIPTION2o6oEERPNORK ONSAU;T NNVSE DATE ♦..1 O�j�iSO� OROVILLE.CAUFORMA 95905 SHEET OF SHEETS 6' j. a 16 PERMIT NO. 5545-80B PERMIT EXPIRES /z, r� 4` OWNER L. R. Johnson ft t CONTR. owner ASSESSOR PARCE�4-89-41 z LOCATION 5393 High Rocks Ct., Oroville (lot 476, KRIM) t . i Temp. Power Pole Called PG&E / Temp. Elec. Service Called PG&E 3 Temp. Gas Service I Called PG&E_ JOB FINALE[ Signature J = OK 0 = Not OK — = NotAppiicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's '-T--Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Size -Depth -Spacing -Connectors 4" d - 3. Sewer; Location -Test -Fall -C/0 -Concrete "3 -Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete ood Awn.; Posts- Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing --5—Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ P'Nat.or/ /"L"ft./ /"LPG -4--Carports; Windows -Doors 7. Utility Clearance Card -BI Date Card -BI Date Card -BI � Date, / 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 '_-6ate Card -BI Date POOLS (Plans) OK except q'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 S. 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/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch _ 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date V = OK 0 = Not OK - = Not Applicable * = Not Ready RESIDENTIAL.(Sing-le and Duplex) Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except k's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 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 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except p's 67. 68. Garage Fire Door; Swing -Landing -Closer 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. 71. Plb., Elec. &Mech. Equip. Listed for Location Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 22. Size Boxes & No. of Conductors -Stapled 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes73. Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size - 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes 0 N 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Pane I S-Motors-Mec h. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Date Card -BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except N's 31. A.C. Ducts; Insulation & Support 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates _ 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FRAMING Plans OK except q's Card -BI Date Card -BI Date Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. 39. Bearing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) _ _40. 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.-Rfnp. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: Anentry must be made each time you visit jobsite) d COUNTY OF B)JT *= -_DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Groville, Californis3 95965 - Telephone 916/534-4541 APPLICATION AND' PERMIT PER MI NO. ASSESSOR PARCEL NUMBER NING BUILDING PEANVige.�� O NEELEPHONE 49Ct (y SO. FT. OCC. BUILDING VALUAT ON WNER'S MAILING AD RESS 3 YD t CO ACTO A - TELEPHONE PI V� ' CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation Is 4 LENDER'S MAILING ADDRESS Permit Fee $ .40 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ �— BUILDING ADDRESS S 'l,:_ Ur PLUMBING PERMIT Filing Fee 3.00 Each Trap Repair drainage or vent piping Water piping V2.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome� Other SPECIFY Building sewer Lawn sprinkler system 2.00 i+ TYPE OF WORK New ❑ Addition e del ❑ Utilities ❑ Installation❑ Other ❑ Describe work: � � I'D 0� it e.Y Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service j00 AMP OR00V OR LESS5.00 Main service EA. ADD'L too AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. SLOGS. 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CO ID R. BRANCH UC lrs 2.50 ea NEW CONSTR. (POWER APPARATUS &1 NON -R RES D. SINGLE OUTLET CIR. 1 RESOCCD. SINGLE Ex. OR FIXTURES 50@� BAL@toc FIXED APPLNS. O Ex. Occup.(OUTLETS (RESID.)'E A.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor 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. MECHANICAL PERMIT FiIingFee 3.00 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 save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue ag ins s id County in se nc the granting of this permit. Date v M-6 Signature of Applicant — wner Contractor ❑ Agent ❑ An OSHA permit is requir d for excavations over 5'0" deep and demolition or construct- ion of structures ove//r,,3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP ��//J I TYPE NST. PARRcrL v I HD I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECT OF PUBLIC By PT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date //—/) _22 Receipt No. y`7�� / WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT