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071-190-012
71-19-12 'MERLE VAN DYKE 109 Cedar -Tree Lan Feather Falls.=` = PErmit#3489-87P,E('uti ISI) ELEC t. _ GAS ��',"CTIOIl� -'TEST SUPPORT STRUCTURE RE �? 2' 222Mx 071 19-0=012 ,.. ;• , VANDYKE Merle 109 ''Cedar Tree; 'Or idle 'S ` •j' • •'�... �.: Y y ,fit f+ �. ..� 1 Y 1 t t� 71-19-12 'MERLE VAN DYKE 109 Cedar -Tree Lan Feather Falls.=` = PErmit#3489-87P,E('uti ISI) ELEC t. _ GAS ��',"CTIOIl� -'TEST SUPPORT STRUCTURE RE �? 2' 222Mx 071 19-0=012 ,.. ;• , VANDYKE Merle 109 ''Cedar Tree; 'Or idle 'S ` •j' • •'�... �.: Y y ,fit f+ �. ..� 1 Y c -1 ' u PSI Q RESIDENTIAL 92-4222MH1. 071-19-0-012 Merle VANDYKE, Oroville r 109 Cedar Tree, r• r i ��� Z-- • � t raope, P�A i If r• '� -OFFICE COPY .t Addre s !` GAS Meter By Da ELECTRI r 'Meter By Date JOB FINALED 3� (D v t , Signature. } 0 V=OK O = Not OK`~ =Not Applicable Not Ready MOBILE HOMES t ' =- Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements j 2. Soils; Special MH Support Sketch r 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L" ft. / /"Nat. or/ /" L"ft./ /"LPG 7. Well Clearance & Disconnect t 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE E INSTALLATION Plans OK except #'s oning equirements-Setbacks Easements otings;-Size-Spacing-Marriage Line as; LI-Test-Demand-Valve—Connector lectri MH Test -Crossovers -Breakers -Clearances j r H Test -Fall -Flex Connector ter H Test -Regulator -Connector _.:_Plrter and Sewer Connected -C/O to Grade -HD Approval as and Electricity Tagged s; InsSeetch of Occupancy Dal V7,:V7,:ft 7,card B-1 Date Card B-1 Dat -7L Card B-1 Date Card B-1 1f l s 3 l A MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK ©xcept #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) 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-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir: Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O = Not OK = Not Applicable Not Ready , RESIDENTIAL (: ' = Date UNDERFLOOR (Plans) OK except ft's { 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-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 -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12 Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except ti's 16. Water Htr.: Vent -Access -Combustion Air -Baffle --------- ---- ---------------------------- 17. Water Pipe: Test & Anchor -Nail Protection 18. D.W.V.: Test -Fittings & Anchor -Nail Protection ------------------ - ------------------- 19. Shower Pan: Test. First Floor -Tub Access 20. Test -Tub & Shower, Second Floor -Tub Access - ----------------------- ----------------- -- 21. Gas Pipe: Size & Anchors ---------------------------------------------------------------- Date Card B-1 Date Card B-1 --------------------- ------------------------------------------- Date Card B-1 Date Card -B-1 Date ELECTRICAL (Permit) OK except ti's 22. Fixture & Transformer Clearance -Ins. Protection --------------- --------- -------------------------------------------------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors ------------ ----------- ----------------------------------------- 24. Size Boxes & No. of Conductors-Stapled --------------------------------------------------------------- ----- 25. Romex Installed Close to Edge of Studs & C.J. ------------------------------------------------------ ----- 26. Equip. Ground-made-up-w/Meth.---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 ! 1 ga. - Cu or At -------------- -------------------------------------------------- 29. Range Circ. ! / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No - ---------------------------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect -------------------------------------------------------------- 31. Equip. Clearances Panels-Motors-Mech. Equip. ------------- -------------------------------------------------------- 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector --------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 -------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) Ok except ti'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 ---------------------------------------------------------------------------------- i Date Card B_1 Date Card B_1 - ------- --------- ----------------------- Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except ti's E 39. Sils. Proper Material -Anchors ` 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound j ------------------------------------------------------------ ------------------- 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) ----------------------------------------------------------------- 43. Fire Stops: Furred Ceilings-Slairs-Chases-Tub 44. Headers & Beam -Size & Bearing A0- jingle & Duplex) , Date FRAMING (Continued) _ 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-root Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50.- Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -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 Walls: Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Date B-1 Date Card B-1 _______ Date -Card Card B-1 Date Card B-1 Date FINAL (Plans) OK except ti's 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. ---------------------- 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. 71. Elec. Outlets & Receptacles at.Kit. Counter 72. -Garage -Fire Door; Swing -Landing -Closer K ---------------------------------- 73.--A.C.-Duct in -Garage- Damper - 74. Wtr. Hir.: Vents -Clearance -Comb. Air-Connector-P.R.V. , In Garage: Above Floor-Mech Projection 75. Plb__Elec. & Mech. Equip. Listed fob Location -------------- 76.-Elec. Receptacles in Garage; (G.F.I.)-Romex Protection ------------------- - 7 -Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & De_ck Construction -Post Caps 79. Fdn Vents & Crawl Hole Door -Drainage & 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. --- -- --.... 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 - ------------------ Date ---------------------------------------- ---------------------- --- -- Card B-1 Date Card B-1 Date --- - Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please c'amact this office immediately. Date 3 — A Inspector REV 11/91 COUNTY OF BUTTE s }DEPARTMENT OF PUBLIC,WOYRKS , •= 1469 Humboldt Road, Chico, 'CA - (916) 891-2751 7 County, Center Drive, Oroville, CA - (916) 538-7541 X747 Elliott Road, Paradise, CA - (916) 872-6307 _ CORRECTION NOTICE OWNER I PERMIT NO. - A routine inspection indicaEtes that the following violations of Butte County Ordinances exist at. the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, . please cont is office immediately. C' n G ec 0V } J N r ' x y • -2 Date t Inspector REV 11/91 t COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 1469 Humboldt Road' Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE M 1:10uIII i►Fla A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. LrL�- 1 7 e-',' -Inspector REV 11/91 MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT NO. 'lc -'�Z � s Address or location of mobi lehome Owner's name yka: Owner's address Insignia or hud number 5/ L ) L '�� Manufacturer's name / % Serial number of V.I.N. : J %� Year of manufacture (Official A prdving Inst ate IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS .' 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT N r� ASSESSOR PARCEL NUMBER 071-190-012 ZONING FR -5 BUILDING PERMIT OWNER Merle Van Dyke 510 TELEPHONE 693-1750 SQ. FT. DCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 109 Cedar Tree Lane Oroville 95965 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 15.00 Permit Fee Plan Checking Fee $ 20.00 $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $35.00 109 Cpdnr Tree Tane, v' lle PLUMBING PERMIT FiIingFee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME 133 PARCEL MAP r Z --- Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G J W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation[X Other ❑ Describe work: MHT <?X yt.4 51i:Cl Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury p y p jy (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 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 Main service 200ATO1000A, 37.50 NEW CONST./ DWELLING OCCUP.Iy) OR ADDNS. l ACC. SLOGS. 3.64 sq.ft. NEW CONSTR ULT'-OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occu p OUTLETS OR FIXTURESRAI 20 76 8 ARA FIXED ALINIS Ex. OCCup. OUTLETS P(RESID )KEA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring -15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject 11"to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood t6.50 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 County Ordinances and State Laws relating to building construction, and here horize representatives of the Countyot Butte to enter upon the above- tion e property for inspection purposes. I also agree to ave, in y and ep harmless the County of Butte against all liabil' .. jud S, d expenses which may In any way accrue agains ou y ' ns ue a the granting of this permit. %� - G�T Date Mobile Home Installation Fee. S 70.00 Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $105.00 HAZ DFEE IMP FLOOD CDF PARCEL V PD HD ISS This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do indicated above for which fees have been paid. DI 'TOR OF PUBLIC WORKS By Dat�'Xr PERM( E IRES Date Signature of Applicant — caner WContractor ❑ Agent ❑ An OSHAwork permit is required for excavations over S'l)" deep and demolition or construct- ion of structures over 3 stories in height. Receipt No. 129976 ' WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT .•.,f-•�t..•'-.-�.iR;.t+%,-T 'l �l..,o! �. ��-�.f �'^ti'j` �v "1"..L h...-ti-cry.:�l,.,-1q'l.'•-ri..+.•i.'r...+�,�..��,:.�y�,�.,�41/...-, COUNTY OF BUTTE - DEPARTMENT OF DEVE OPMENTSERVICES - BUILDING DIVISION 7 COUNTYCENTER DRIVE - OR®VILL•E, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER Z1V A. P. No. D - e)/ . Proposed Building Use - Z Building Inspector Date /->-/,7 9 �- 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 $ . ............... 11. Impact fees as shown on attached schedule. Q ......� 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval 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 about (A) Improvements (B) Drainage. .......... 19. Driveway permit (construction approval required prior to occupancy). ..... . Preanspe on request 20. Pre -inspection for required. . to Building lnspedor (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. ..... 2 . Letter of intent on building use . ....................................... . Mobilehome utility clearanc............................. .....................: :::::: ::::: 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 check list . .................................................... 33. '34. When you issue the permit, process as follows: Mail to owner. Mail to contra Telephone and hold for pickup at office. eliver with inspector. Other Parcel CreationA4�4-(7 �- Acreage Applicant Aaw ? 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 r to permit issuance: (Circle new item not checked above). -1. Index permit for above items No. �(g 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 required data by _ phone _ mail Counter by _ Date. Plans checked by Date Plans approved by _ Dates Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works 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. y 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) ee 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 :�V/- Property Owner Social Security Number Date 1s2 "2 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 per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT' OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CDRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541 OWNER 4&41f A,)J Z)c k ?ROPOSED BUILDING USE � t A.P. NO. Q 7 % - /50 - U( Z DATE 2 /-2 lam_ REC. # DATE REC ��. School Distric Fees 0 �210 U ; ( 057 (paid at District Office) —Qi— 2. Sheriff Fees (paid at Building Department) Residential X 99 unit amt. Commercial(per sq.ft.) X sq.ft. amt. 3. Urban Area Fees (paid at Building Department Residential (per unit) X units amt. Commerical(per sq.ft.) X =$ sq.ft. amt. 4. Recreation District Fees (paid at District Office) 5. Drainage District Fees (Contact Land Development) ......................... 6. Other 7. Other At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. APPLICANT i 1- DATE COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBERZONING O%l- 00-01L:/� �C BUILDING PERMIT OWNER 2f/Z��" l SY TELEPHONE 1093 ' /75 $O. FT. OCC. BUILDING VALUATION OWNER'S ,uy1N G/A�OQR CONTR CTOR'S N TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN — Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $C7 -moo ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS JO / / Permit fee $ 3 _ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 1 7.00 USE, O,F% STRUCTURE SF ❑ Duplex❑ MobilehomeOther tT SPECIFY Gas piping system 1 - 5 outlets 1 5.00 Building sewer 7715.00 Mobile Home I S I G JW 1 015.00 TYPE OF WORK New ❑ Addition Remo el ❑ Utilities ❑ InstallationlL,;► Other ❑ Describe work: lJ�' Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 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. fSec. 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 Main service 200ATO1000A1 37.501 NEWC ONST. / DWELLING OCCUP.✓y\ OR ADDNS. l ACC. BLDGS. / 3.64 sq.ft. NEWCONSTR ULT' -OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS el SINGLE OUTLET cIR. / Ex. Occup(OUTLETS OR FIXTURES A0 76d FIXED APLNS.I, Ex. 0i OUTLETS IPRESID 1REAJ I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor Mobile Home Installation Fee Energy Inspection Fee S $ 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 against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- f ion ostructures over 3 stories In ei ht. height. OCC CONST TYPE TOTAL FEES HAz 1 0FEES IMP FLOOD COF PARCEL PO HO ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. NN ITE-O.P.W.. YELLOW-ASSE3 SOA. PINK -INSPECTOR. GOLUENROD-APPLICANT �ay+�i, �."�, �'�Y`��a�f'G7'Y. .. ti�iatt'.".'�ui�'�iY�`�'.`.a"'"4ri4v%&' •r4-it^YiKin„v.�-},��"'�..slti'w.�.�a�er.�•t�r+' s:ieG 3:A'Yti��;�''°Li��1'M+'A•nE"h`""`x BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Per Building) School District 0&— , T A.P. Number % 190-0/2—Jurisdiction Property Owner . Property Location/Address Subdivison, Building Department No. City /, County No. Residential Development 0 No. of Living Addition Units i. Commercial/Industrial 0 0 New,, :: Addition Sq, Footage �G1J (Group R) Sq. Footage ' ' (Including Exterior Roofed Areas) /217- Building Depa ment Representative Date (FlororPtarWs-reviewed-"- ohool-Bistfiet Perseraaej) District Identification No. 9 0624 R 0 School District certifies that Q„c% (Applicant) -(Street Address) (Phone Number) (City) (Zip has complied with the requirements of Resolution No. d -7 by payment of $ representing '7'0 v square feet. School District Representative Date Paid by Check Number ���� Remarks: Bank Number - Paid by Cash _ If, subsequent to the School District Representative -signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Duality Act (CEQA), this;project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.Al (4/92) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 Merle Van Dyke DATE December 4. 1992 109 Cedar Tree Lane. Oroville, CA 95965 RE: Building Permit #92-4222 Dear Mr. Van Dyke: A.P. # 071-190-012 With reference to the above subject: Attached is: Application for permit Building Plans Engr. Calcs . Owner -Builder Verification Form OTHER Mobilehome Utilities Installation Sheet Mobilehome Installation Information Sheet Typical Plan Sheet List of Codes Enforced. We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption.statement. Complete plans in including plot plans. Plot plans in Structural details in - Complete.plans and calcs in . by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section _(DPW). sets of plans in accordance with the changes marked in red. _.Sanitation approval from Butte.County Health Department at:. 1469 Humboldt Road, Chico 7 County Center -Di., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive,- Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. AXk OTHER (1) Pay School Fpps Should you have any questions concerning the above, please contact of this office._between 3:00 and 5:00.ppm weekdays. -: Yours very truly, Tom May William "Cheff " Director of Public Works /J.F. Glarder JFG/aj / BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: .2. Installer's Name: �K/��U�i( 3. Is the site currently under permit? Yes N No (If yes, furnish permit number 3 G��% 8�) OR Is the site an existing site? Yes F-1 No (If yes, furnish two plot plans.) 4. Will•the-mobilehome.be located at leas.t,5 ft. away from sept'c tank and leach fields and clear of all setbacks and easements? Yes No F-1 (If no, clarify 5. What is the mobilehome electrical rating? --------------- 5-C> Amps 6. What is the mobilehome site service rating? ------------- �© Amps 7. What is the mobilehome site circuit breaker rating? ----- 5-v Amps 8. Is there any other electric load to be served by the mobilehome site service? -------------------------------- Yes No (If yes, identify the load and size: & (Load) C,_ (Amps) 9. What is the mobilehome site gas pipe size? -------------- y (in.) 10.' What is the type of gas service?------=-------=----- Natural F Y' LPG 11. What is the gas pipe length from meter or tank to the 2.0/1 mobilehome?--------------------------------------------- (ft.) 12. What is the mobilehome gas demand? ---------------------- (BTiJ.) BUTTE UOUIM *(This information not required if pipe len lolfI U �o '�°'��NT natural gas or less than 50 ft. on LPG.) �p p► p p 0'V E NEXT PAGE MUST BE COMPLETED TO PROCESS PERMIT APPLICATION. MOBILEHOIE SUPPORT DATA If other .than tingle.wide, Mobilehome Mfr. furnish` Setup Model No. Year /a2 Width (ft.) Box .Length (f Tagalong or- Expando Size ft. X ft. —7' On all mob-ilehomes-manu-factured.-after October 7,-1973,. furnish manufacturer -'s installation. manual and stiudtural setup sheets (if .-not..on-.f-il6. witif "thC County of Butte). El - FOOTINGS (check one) 1. Wbbdw-pres - Sur_e,.tr.eated'or foundation grade. F 2. Other (specify) SUPPORTS (check one) F -I 1. Concrete -block. 2'. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Line I i Line I Line 2 7— !! Line 2 Main Beams > Line 2 Line 2 Main Beams Tag or Triple Line Line -1 Piers: Line 1 Openings: Size -Min. ------------- Size -Min. --------------------- &ac_h-Side . of . -Openings Spacing -Max. From Ends -Max. ------- With Width Over--------- s '� Line ver--------- Line 2 Piers:' Size -Min.------------ /) „x �\ Spacing-Max. ize-Min------------- Spacing-Max. From Ends -Max. 777 -7 - Line 3 Piers: (Under Bearing Wall Only) Size -Min------------------- `x Spacing-Max ize-Min------------------- Spacing-Max---------------- From Ends -Max. ____7 -------- Line-3 Roof Loads: Size -Nin. ------------ I.x x k"A "A Location (Prom Front). Line 4 Piers: - - ------ 71 Line, .5. Piers (Under,ZeAring. Walls Onlyj Size -Min------------- Size -Min------------------- Spacing -Max.--------- Spacing -Max Max.--------------- From Ends -Max.------- From Ends -Max.------------- - " Line nds-Max-------------- Line 5 Roof Loads: Size -Min. ------------ x k =..,xIx x .. �I Ix Location.(Prom Front) . AP #k / I 7 OWNER G t PERMIT Nii i UT IL . CLEARANCE DATE INSPECTOR ELECTRIC GAS Support Struc. Compaction Test-Req.- estRe .Size Service Size Other Load Type Pipe Size Length YES NO YES NO �V t'a r } t k • PERMIT NO. 3489-87P,E(MH) ` = PERMIT EXPIRES OWNER MERLF. VAN DYKE t CONTM ��krnPr ASSESSOR PARCEL 71-19-19 LOCATION =�' 9��dar. Trpe Lane, Feather Falls r t�- C /L/u .96 �r '� c a Temp. Power Pole Called PG&E Temp. Elec. Service `. Called.PG&E t Temp. Gas Service Called PG&E JOB FINALED (Date) i Signature ! 'J = OK 0 =Not OK ' Applicable NotMOBILE HOMES * r MISCELLANEOUS 4 Date MOB . HOME UTILITIES Plans OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK e,cept #'s ing Requirements=Setbacks-Easements 1. Zoning Requirements -Setbacks -Easements Soils; Special MH Support- tch , 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel ). 3. Sewer, Location-Test-FaJ 'g jovtoncrete, 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. ater; Location sement Needed (Sketch) + 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing . Electricit • abon-Cleara ces-Grnd.-/ / Amp -Concrete 6. Gas' o io r /"L"ft. • or /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures. ; 6. Carports; Windows -Doors Utility Clearance 7. Elea 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -B1 Date Card -B1 Date 10. Roof; Shthg-Roofing Card -B Date ,/.'. Card -B1 Date 4"' 11. Ext.; Steps -Doors -Landings Date OBILEHOME IN TALLATION Plans OK exce? f:#'s i t 1. Zoning Requirements -Setbacks -Easements V jCard-B1 Date Card -B1 Date 2. Footings; Size -Spacing -Marriage Line ^Card -B1 Date Card -B1 Date 3. Gas; MH Test -Demand -Valve -Connector i 4. Electricity; MH Test -Crossovers -Breakers -Clearances 1 Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector # 2. Soils; Compaction -Structure Stability 7. Water. and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 1 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures- Panel board s -Ins. to Main in Conduit Card -131 Date Card -61 Date Card -B1 Date Card -81 Date ( 9. Health Department Approval . 10. Plumb.; Cir. Test -Water Supply Test M i Card -61 Date Card -131 Date Card -B1 bate Card -131 Date 4 e = OK 0 = Not OK - = Not Applicable = Not Ready " RESIDENTIAL (Single and Duplex) Date " UNDERFLOOR (Plans) OK except #'s Date ' FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 44. Hangers -Post Caps:Anchors-Connectors 2. Ftg., Main; Soils -Steel -Elect Grnd.-/ /" Ftg. Depth 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 1 46. Fireplace Ties or Type A Flue -Fireplace Throat 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth 47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel-Blockouts-Wrapped ,, 48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Sternwalls, Garage; Steel-Blockouts-Wrapped 49. Garage Fire Protection Framing 7. Slab; Steel -Wrapped r 50. Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel 51. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 54. Siding -Nailing Veneer 12. Electric; Underground 55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 56. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 57. Shear Walls; Nailing -Bolts 15. Insulation 58. Insulation-Walls-Clg. 59. Infiltration-Walls-Wndws Card -B1 Date Card -B1 Date Card -131 Date Card -B1 Date : Card -61 Date Card -B1 Date Card -B1 Date Card -131 Date- -Date PLUMBING (Permit) OK except #'s. 16. Water Ht. Vent -Access -Combustion Air Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchors -Nail Protection 60. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 61. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 62. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors 63. Bedroom Exiting 64. G.F.I. & Bath Fixtures & Tub Access -Spa 65. Elec. Trim & Subpanel; Breaker Sizes -Labels Card -61 Date Card -131 Date 66. Stairs & Rails Card -B1 Date Card -B1 Date 67. Fireplace Stove; Clearances or -Hearth Date ELECTRICAL (Permit) OK except #'s 68. Elec. Outlets at Wood Panel; Int. & Ext. 22. Fixture & Transformer Clearance -Ins. Protection 69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Elec. Outlets & Receptacles at Kit. Counter 24. Size Boxes & No. of Conductors -Stapled 71. Garage Fire Door; Swing -Landing -Closer 25. Romex Installed Close to Edge of Studs & C.J. 72. A.C. Duct in Garage -Damper 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 27. 2 Appliance Circuits in Kitchen &Conductor Size 74. Plb., Elec. &Mech. Equip. Listed for Location 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or At 75. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 76. Insulation -Foam -Looked in Attic ❑ Yes 77. Guard Rails & Deck Construction -Post Caps 30. Service -Riser Conductors & Ground -Main Disconnect 78. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yea 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 79. Following instid.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 80. Stucco; Brown -Finish Card -61 Date Card -B1 Date 81. A.C. Unit; Disconnect, Electrical, Plumbing Card -B1 Date Card -B1 Date 82. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 83. Water Well; Disconnect, Electrical, Plumbing 33. A.C. Ducts Insulation & Support 84. Exterior Elec. Trim; G.F.I. Receptacle -Underground 34. Vent Fan; Exhaust above insulation 85. Ventilation throughout House 35. Condensate Drain & Overflow; Size & Grade 86. Glass Protection 36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Corrections from Previous Inpections .37. Attic Access & Platform if Furnace in Attic 88. Gas Test -Meters Tagged; Gas -Electric 89. Water & Sewer Connected -C/O to Grade -HD Approval 90. Energy Compliance Certificate -Other Certificates Card -131 Date Card -B1 Date Card -131 Date Card -81 Date Card -B1 Date Card -B1 Date Date FRAMING (Plans) OK except #'s Card -B1 Date Card -B1 Date 38. Sills, Proper Material & Anchors Card -B1 Date Card -B1 Date 39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Comments at Final: 40. Bearing Walls over Girders & Floor Nailing 41. Draft Stop in Walls (rat proof) 42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 43. Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit job site) I COUNTY OF BUTTE ry DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE Y OWNER PERMIT NO. :i 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 a itlonal.explanation, please contact this office immediately. i"ol Z �G r Inspector /j��///��l Date V ki COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT, AS ESSOR PIRG L NUMBER / ZON� fiS BUILDING PERMIT O N /` Q ��J` TELEPHONE — SO. FT. OCC. BUILDING VALUATIOW OWN R'S MAILING DRESS CO +A'CTOR'S NAME u_ V no YN T LEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CON T UCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHI ECT OR ENGINEER Pt 14- LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS /402 Cet,14LY C1 I Z11 L Permit fee $ S PLUMBING PERMIT Filing Fee 10.00 -2 Each Trap 2.00 laolPARCEL Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME MAP Water piping 5.00 Each pas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeX Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home W 10.00 ea TYPE OF WORK New❑ Addition El Remodel❑ Utilit'esX Installation[] Other❑ Describe'work: _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 /Q Q Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): `�" ' "'•d ❑ I am licensed under provisions of Chapt. 9; Div. 3 of the Business/POWER and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. / DWELLING OCCUP.eII 1/20sgft OR ADDNS, \ ACC. BLDGS. NEW CONSTR. MULTI -OUT LET U TI -OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS APPARATUS e (SINGLE OUTLET CIR. I zo®soe Ex. OCCUp(OUTLETS OR FIXTURES 20@930 FIXED APPLNS, OR Ex. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 00 Misc. Wiring 15.00 Permit Fee $ , Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): W 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..Ventilation Notice to Applicant: If after making this sttement,. should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Permlt 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, indemni k p harmless the County of Butte against all liabili ' dg a expenses which may in any way accrue against u I s e o e granting of this permit. /Q� /G'j_ X '�' Date s I Signature of Applicant — Owner ❑ Contractor E] Agent ❑ An OSHA permit is required for excavatio s over 5'0" dee and demolition or consqct- ion of structures over 3 stories in heigh Mobile Home Installation Fee $ Energy Inspection Fee $ ^ , TOTAL PERMIT FEE $ Y OCCUP. CONST.TYPEJ JSCH.01.11`7.� PD H IS ue This permit is hereby issued under sions of the Butte County Code and/or work indicated ab ve for which IRE TO F PUBLIC PERMIT E PIRES Date ' the applicable provi- resolutions to do fees have been paid. WORKS vc Date ` _ _ 20 iBy Receipt No. &Gqa�d WNITC-O.P.W.. TCLLOW-ASe[e30R, PI N9PCtTOR, GOLDCN D -APPLICANT Kl COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - QROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 / G f PERMIT APPLICATION DATA SHEET Permit No. OWNER / A. P No. Proposed Building Use Buildi:rig Inspectorza Date , 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 sub Lri �Iicate, . . . . . . . _��. Plot plans in duplicate igned by preparer of plans. X1,/0 y7 Gl 3. Complete plans in duplicate/triplicate, signed by preparer of plans, 4. Complete engineered plans and calcs, with wet, signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . //C—. 9. Letter of signature authorizVron•(.,0. Sanitation approval from ro1%1Health Dept. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) _14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . Pre-Inspec.request to (Date) 7. Pre -Inspection for------- ..._-._- _ Required. Building Inspector 18. orded copy of Agricultural Acknowledgment Statement. �"O-a7--y� Q'S' riveway Permit, — 2 Plot plan approval from city ofell _ (22. — -- When, you issue the permit, process as follows: � Mail to owner, Mall to contractor. Telephone and hold for pickup at office, —Deliver w/inspector. Other Applicant Date Copy of plans sent Health Dept., Fire Dept., Other Date - The following data must be submitted pri er a e: Ci c new item not Ithecked above). 1. Index permit for above items No. ----. 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone --- nail_counter b date _ Contractor, designer, owner, was advised c? above required data by—phone —ma il_counte date Plans checked by DatePlans approved by Date 42DO' Sets of plans on hold in File cabinet AP folder Copy—DPW C TO Building Department FROM:, Environmental Health SUBJECT: Sanitation Clearance Owner T Location AP# Plan Approved for: Sewage Disposal Vater Supply Hold final for: Water Supply. Final clearanc 0 . for: Water Supply Clearance fdr 3 bedroo mobile ome. Other NOTE ** Eb Sanitarian Dat TO: Building Department FROM: Encroachment Permit Section RE: Driveway Clearance er l - Vo �� . l� r9 Ce4-- Zee lawqv 7/ owner _ location AP # Driveway permit 10,t�k4 dj��&P/ has been issued for the above 'property. sign ure date 'COUNTY OF BUTTE , Department of Public Works 7 County Center Drive,.Oroyille., 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) �S 2. I (have/have not) a v e 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...1 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 i/ Z Social Securit Number `v Date /a - / - E% NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832ofthe California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. Return to DPW AGR;-QULTURAL STATEMENT OF ACKNOWLEDGEMENT ` FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledv'eme RECORDED BUTTE be recorded prior to issuance of a building permit. g nt OFFICIAL R`CORnO�IyTY 157-40363 The property described herein is adjacent to land, or included PA�Rt�'(SHOWN within an area zoned for agricultural purposes, and residents of this 1387 OCT 2 7 property may be subject to inconveniences or discomfort arising from AMID 17 the use of agricultural chemicals, including, but not limited to herbicide,@ANVACti�� and fertilizers; and from the pursuit of agricultural operations includi}j�� but not �'i�RCd Ped, to cultivation, plowing, spraying, pruning, and harvesting which occasio9 RJQQ aE smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real as follows: property situate in -the County of Butte,, State of California, described a� �. FT. evidence. PAMELA J.EtJTs1Ep to be the person(s) whose name(s) is subscribed to NOTARYPUSUCCo-uAUFOANIA m Buffe,MyCo'T'mission'TxPires the within instrument Page -SEE-ATTACHED LEGAL DESCRIPTION* executed the same for the .purposes therein contained. i IN WITNESS WHEREOF; I hereunto set my hand Date: 10/27/87 P PROP 0 Notary eke State of California ) On this the 97th day of ortnhPr 1987_, before Butte ) SS. me, the undersigned Notary Public, personally appeared County of ) Merle,Van Dyke Present A.P. No. 21 / /Personally known. to me. / Aa3roved to me on the basis of satisfactory evidence. PAMELA J.EtJTs1Ep to be the person(s) whose name(s) is subscribed to NOTARYPUSUCCo-uAUFOANIA m Buffe,MyCo'T'mission'TxPires the within instrument and acknowledged that executed the same for the .purposes therein contained. SePt'7'isa1 IN WITNESS WHEREOF; I hereunto set my hand and official seal. Notary Public Present A.P. No. 21 All f.a.t _ _n ; �.,I F� c�,rtty s14.:::,.',a in -'"he CO%LIty of autte,_ State of Cz'►ifori.ia, <;,5a0rJbed =3 .�;�11j w.31 A Portion of the Scutb-fest quarlter of Section 29, Tau:,ship 20 North, Range 6 East, -D•D. �., described as follows: C%t'�TW IJING at a point in the -kdrth line of said Souths:eat quar-ter of said Section 29, from which point the Northeast corner of said Southwestguarter bears North 89° 321 37" Fast, a distae'e.of 594.0 -eet, said point beiagalso the Northwest corner of ghat certain parcel of land described in Deed to E• R. Cook, recorded February 20, 1956 in Book 814 of Official Records, at page County, California; thence along the W- 3t line of said Cook ayrecords of South 010 361 2 t 1" East, a distance of 549.02 feeto 8 Parcel, thence leaving said Cook �'�t � the line of Lampkin Road; parcel line, and along said road center line, South 280 121 West, a distance of 131,88'feet to a tangent curve concave to the Northwest; -hav- Ing a radius of 120 feet; thence along said curve, through a central aavle of 36° ^ 7# (the Long chord bears South 46 35r 36" wrest' a distance of a distance of 77.04 feet; thence South 64'° � 75.72 feet), for a tar^Pnt 591 WaPt, a distance of'S3.17 feet to L- eu;�ve concave to the Southeast, having 'a radius of 150 feet; thence 2lon,g said curve, th.: ou,zh a central angle of 21° 44, (the long. chE)rd' burs South 54* 07' Fest, a dis`n .ace of 56.56 feet), for a distance of 56.90 feet; thence South 43° 15 best, a distance of 67.00 feet; t?fence leaving said Lt mpxin Road center line, Korth 35° oil west, 203.61 Peet;'�thence South 89°'231 16" West, a distance of 1356 09 feet to the tr�ie point of beginning for the ' ec'nt: n ce of ---,r t,i S 4 G 021 I'l t A• of "55-12 f,, et; thence Noil,-h 110 --,,,,41 'Itlic,-ice S,:v,.jth 370 1" 24" West, a dis"ance t-, -- di--.�Ience of In of 14 feet; -I[.h_-nce !:orth 05* 47256" Wests a of 104.03 feet; t"hence" I.outh 73* 1,0' 54^ t distance of 200 feet to IVILIe end of the herein described crnter line. all that portion of said right of way ly --g within the bounds ,7 les of the above described Property. FJ(,-T,'.?TING 'rdE7R-EFP01*'L an undivld4-d 1/2 interest in all mineral --ights* as contained in Deed from Lou.i3 W. Flengel, et al,.to William C. Denton, et ux, dated March 259 1968 and recorded May 2. 1968 in Book 1515,,-Ot Official Records, at Page 564 re— cords of Butte County, California,. 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-754.1 Merle Van Dyke DATE_. OrtohP 1. 1997 2050 Arnold Dr. Martinez, CA 94553 RE:Building Permit Application #3489-87 for mobilehome utilities A.P. # 71-19712 With reference to the above subject: Attached is: . OTHER L_ 1_ Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in , including plot plans. Plot plans in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage .improvement plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 196 Memorial Way, Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. X_ Recorded copy of deed showing _ 60' right-of-way t nuhlic road Recorded.copy of agricultural acknowledgement statement. Should you have any questions concerning the above, please contact this office. JFG/aj Yours very truly, - William Cheff Director of Public Works .F. Glander Chief Building Inspector 4TTE COUNTY DEPARTMENT OF HEAL DIVISION OF ENVIRONMENTAL HEALTH 196 Memorial Way 7 County Center Drive 747 Elliott Road Chico, California 95926 Oroville, California 95965 Paradise, California 95969 891-2727 538-7281 872-6308 'APPLICATION AND PERMIT TO CONSTRUCT OR DESTROY A WELL (Application for: Public Water Supply ❑ Individual Well ❑ Well Destruction ❑ iType of`Construction: ❑ New Construction ❑ Repair or Deepen Owner's Name: Assessor's Parcel No. Applicant's Name: Phone No. Mailing Address: Site Location: T. R. S. SKETCH ON HOW TO LOCATE PROPERTY WORKMEN'S COMPENSATION INSURANCE ❑ 1 have placed on file with the County of Butte a certificate of I am aware of the provisions of Section 3700 of the California Labor Code have Compensation Insurance. Which requires every employer to be insured against liability for Work- ❑ 1 certify that in the performance of the work for which this permit men's Compensation. is issued I shall not employ any person in any manner so as to be- come subject to the Workmen's Compensation Laws of California. COM„P,LETE�FOR NEW CONSTRUCTION Driller's Name: Driller's Address Well Driller Contractors License Number Proposed Depth Proposed U COMPLETE FOR WELL ABANDONMENT Name of individual responsible for work: Address: Scale Plot Plan is to be furnished on reverse sides of both applications. I hereby state that the information above and on the reverse side hereof or attached hereto is correct and true to the best of my knowledge. I understand that the permit must be obtained before any construction is begun. I further state that I am ❑ the owner of the property, ❑ the owner's authorized representative, ❑ a Licensed Well Drilling Contractor Date: " Signed: PERMIT. To be completed by the Health Department. Permit to Begin`,Work Approved by Additional Permit to Destroy Dry Hole Prior to Site Abandonment ❑ Special Conditions Fee received: Receipt No.: Date Issued Expires one year from date of issuance NOTE: 1. -Provide a minimum twenty-four (24),hour notice prio oto installing or placing sanitary seal or drilling a well expected to be completed in less than twenty -foci (24) hours. 2. A satisfactory inspection by the Health Department and rexeipt by the Health Department of a Driller's Report or a satisfactory abandonment report and a disinfection statement is required for final approval of work. 1 $1 . Copy 1 -Applicant Zone & Req. SB Copy 2 - Health Department Pcl. Status PREPARE IN DUPLICATE COUNTY OF BUTTE - DEPARTMENT OF'PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 71-19-12 - ZONING I BUILDING PERMIT OWNER Merle Van Dyke - 415 TELEPHONE 229-1683 SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 2050 Arnold Dr. Martinez 94553 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 15-00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 109 Cedar Tree Ln. Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 -USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeQ{ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home T_S7 G I W 1 110.006 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installations Other ❑ Describe work: _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification {-y `_IpY�ll 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason CCUP.N� LIN / ADDNS oR CONST \ DDELGS 2yzQsgft NEW CONSTULTI-OUTLET NO N.R ESID BRANCH CIRC ITS Z.SOea /POWER APPARATUS 6 .(POWER OUTLET CIR. Ex. EOCcu Occup(OUTLETS OR FIXTURES 201@ s0a eAL030 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. IVirin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate pf Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentio rty for inspection purposes. 1 also agree o s e, inde a keep ha less the County of Butte against all liabil' dg t ts, a d exp ses which may in any way accrue against aunt in quen of nting of this permit. X / . Date Signature of Applicant — Owner W Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ 45.00 Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 70.00 HAZ CUA PARK scHL FLD PAR Po Ho ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT 44 'COUNTY OF BUTTE,- DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE+-:.QILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 J PERITPPLICATION DAAAN" HEfT " _ Permit Nom, G OWNER MF/UE VAV A. ..No U -.••.�• t • �� . -9d Proposed Builaing s 42:— Building Inspector C_ Date At time of permit application, I was advised the following data must be submitted prior -to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ..................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Materia Form ............... .......... ................. -6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate�tequired priorto plan check) 9. Mobilehome installation data including manufacturer's installation instruction 0 0. ......................:................. iL 10. Fees of $_76 ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. - �5rA-r 9 9 E SE-chool District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit.... ) 16. Plot plan and business license approval from City of (see City for other requirements) ` 17. Planning approval for (A) Use: (B) Parking: 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to ' ' Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classification) ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to caner. Mail to contractor. _ Telephoneg19 j/Q%and hold for pickup at office Deliver w. /inspector. Other Applicant_ ;�Wt S�M .Date 6 %/-yam Copy of Haz-Mat for 'mfsent % Health Dept. Fire Dept. Air Pollution Date Copy of plans sent ; Health Dept. Fire Dept. �/ Other Date By.. The following data rust be submitted prior to permit issuance: (Circle new item not checked above). t 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone--nail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved, by Date Sets of plans on hold in • File cabinet AP folder Copy—DPW r �.., . 14r��-% BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Orov >lle,' CA PHONE: 538=7541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name : /'`�� 6i/V GS 2. Installer's Name: /'1L� cLey 3. Is the site currently under permit? Yes © No (If yes, furnish, permit number Z O �" �{ OR Is the site an existing site? • Yes ® No (If yes, furnish two 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?---� MOBILEROME SUPPORT DATA If other than single wide, Mobilehome Mfr. a�ii furnish Setup Model No. e a Width- (ft.) Box Length 1 6 (ft.) Tagalong or Expando Size Year ft. x ft. 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). FOOTINGS (check one) 1. Wood -pressure treated or foundation grade. 2. Other (specify) _ t SUPPORTS (check one) 1. " Concrete block �'� 2:;�490er,( pecifyti) Pier Foo'ting,,S,izes`- and "Locations,\ SINGLE -WIDE MULTl-WIDE Line 1 Piers: - Size -Min. -i k Spacing -Max. From Ends -Max. ------- �_ Line 1 Openings: Size -Min. ------------------ „x Each Side of openings With Width Over --------- Line 2 Piers: Line 3 Piers: (Under Bearing Wall Only) Size -Min. ------------ „x „ Size -Min. ------------------ Spacing-Max ---------- Spacing -Max.--------- ,_ „ Spacing -Max .--------------- From Ends -Max -------- From Ends -Max .------------- line 3 Roof loads: Size-Mlo.-- _ __-� � „r x „x n ,k 'k,� Location (From -Front) _ '- e 4 !'Sera' Size -Min .------------ ,k n Spacing -Max.--------- From Ends-Max.-=---�- e S Roof loads: Size -Mia .------------------ „x „ Spacing -Max.--------------- From Ende-Max.------------- Size -Min. ------------ „x „ 1 I „ ,k „ „x „ ,k „ ,x „ „a Location (From Front) - 11 _ I _ „ , COUNTY OF BUTTE— bepartment of Public Works 7 County Center Drive, Orovil.le, CA 95965 Phone: 916-53877541 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) 2S 2. I (have/have not) v 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: _ d Property Owner Z Social Security umber Date- -/d - Y4 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 per- mitted to issue the permit. t i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7.County Center Drive, Oroville, CA 95965 PHONE:. 916-538-7541' Merle Van Dyke j DATE May 21, jg o 2050 Arnold Drive RE: Permit appPln for Mobilehome installa- Martinez, CA 94.553 tion A.P. 71-19-12 With -reference to the above subject: 1�'Attached is: Application for permit Mobilehome Utilities Installation Sheet. Building Plans Mobilehome Installation Information Sheet. Engr..Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER We need the following information: Permit application signed and completed where indicated with all copies returned. XXX Fees of $. 7n.nn payable to Butte County Treasurer. Certificate of Workmen's Compensation -Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in including plot plans. Plot plans in Structural details in Complete -plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section'(DPW). sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 196 Memorial Way,'Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, .Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. 1� XXXX Oroville Union High School District.Fees PAid Should you have any questions concerning the above, please contact Tom Coleman of this office. (916-538-7541) Yours very truly, William Cheff' Director of Public Works. j .F. Glander JFG/aj Chief Building Inspector