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Home My WebLink About072-080-029' � Ci AP 72-08=2g MICHAEL DAVIS w1s'Mt. ' Ida Rd, 4 mi: a E. of 'Wyandotte ,Miners Ranch Rd., Oroville pt# 2109-75P,, E util. , �a I ASC. SUPPORT RUCTURE REQ. ` COMPACTION TEST RBQ. ' AP 72-08-29 �• CONTR: Earle Towne MH Service, P rade Permit,# 2152-75MHI Un Issued 72-08-29 CONTR: Gerald L. Hal , Oroville Permit #730 Issued i It r L 1+ � L 1� �y CD oD,l PERMIT NO. 2109-75P,E { { P E M MH UTIL. PERMIT NO. PERMIT EXPIRES i OWNER Michael Davis 9' jQON TR. ",LOCATION (A.P. 72-08-29 (old) s/s Mt..Ida Rd., app. 4 mi. E. of Wyandotte Miners Ranch Rd., , Oroville Y a. L 'i Temp. Power Pole Called PG&E i Temp. Elec. Serv. _ Called PG&E a=s Temp. Gas Serv. Called PG& JOB FINALED (Date) (Signature) 9. Electrical A. Is service large enough to prow'de adequate amperage -to mobilehome (must equal rati;"of mobilehome with a minimum of 0amp) and other facilities ori lot, i.e., P water pum s` garage, cabana, etc.? Yes No,, B. Is there proper clearances around panels? Yes L''140 i C. Is power supply cord or feeder assembly properly fused? Yes D. Is continuity test satisfactory as per the following procedure? Yes No 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord -or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches'in.the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, eater line), including fixtures and appliances,'shall be tested for continuity From such equipment and the grounding conductor. 6.:. Upon completion of' the -above: procedure, the power:'supply. cord or-feed'er assembly conductors -.shall- be--connected:-to the: site'service equipment.- A further continuity . test shall.'then be made, between- the_ grounding _electrode arid: the: chassis of the - mobilehome. Upon satisfactory. completion of .the electrical _tests, the lot ors ite service.. -equipment may be .approved -- for .ene.rgizino.. . 10.' Is job card signed- by7He'alth"Department 'for water and sanitation? If everything okay, sign -off card and tag services. Al MOBILEHOME DATA Manufacturer. and/or .Names.tyle Length Widths Vehicle Serial No. State Identification No. ��d 2 Additional Information or Comments: t r MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with 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) Ye �o q sl-- 3. Are footings and supports properly sized, spaced, and braced as pe approved plans? (Note possible variation at spring shackles.) (Sec. 082 & 5083) Yes No 4. Is_the mobilehome level? (Sec. 5088) Yes No 5. If ri than a unit, are crossover connections properly installed? (Sec:.5088) Yes �`'' No 6. Waay A,,ViN e connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes(/ No C. Backflow - If coach is not State o ifo approved, does. station have.backflow device and pressure -relief valve? Yes N 7.. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Ye • No B. Does it have_.,minimum 4" .per foot slope and is' it properly supported? Yesl" No C. Are any leaks detected in drainage system after running 3 -gas of water through each fixture including washing machine standpipe?.Yes No L/ 1 D. If coa inot State o aapproved, does station have required. trap and vent? Yes Nslifor No 8. Gas Piping and Gas Vents A.. Connector - Is mobilehome connected to the gas supply with an approved 3/.4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as ome gas. line iiilet without reductions other than the mobilehome large as the mobil connector. Yes// No B. Test OK as per following procedure. Yes No . 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Ye No- DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback -2 rr Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Pipin— Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structur Gas Piping & Tes Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing1 L Test Water Htr. Stucco Final Sub anels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Finalr 0 A.— A� DATE REMARKS OR CORRECTIONS COUNTY OF BUTTE L� DEPARTMENT OF PUBLIC WO KS 7 County Center Drive - Orovi lie, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. J__ /5 - ?� X �� I�i�h't/�.Q- Date Signature of Permitee or Agent Receipt No. D — White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR PUBLIC WORKS By Date —1' Wilding permit expires Date .................? r�..."".. BUILDING Owner 4/1 /G Qe 00ecN 's SQ. FT. OCC. BUILDING VALUATION Mailing Address d J-0 inHf �/ ay 3 'f-3 Telephone No. - Fireplace Contractorf6 /YOJ_ Total Valuation Mailing Address.5-03s- Permit Fee Plan Checking Fee &/orPenalty TeN e �� -permit Fee $ Building Address a— PLUMBING No. @ FEE PERMIT FILING FEE $2.00 �j / a,40 O / /ACU — 0,ilr-Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 m' Each gas water heater or vent 1.50 A. P. No. 9 -- Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 P'Ele—srW . ire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im r p o ments Lawn sprinkler system 2.00 Bldg. Plans Rec'd I Parcel Appr I I Plan Approval Permit Fee $ $ N W ❑ ADDITION ❑ UTILITIES ❑ OTHERJR ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 DA) D e Main service incl. 1 meter O� Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home a Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures_bai1010 Receps., switches & fix outlets 2 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: `, f�LE loa/.Ut' lore/LE 1101 -ye Xg/Q✓!CE Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No.2 1J f Classification �,^ Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ®I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information -is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby ISZ- � 30, CSI TOTAL PERMIT FEE authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. J__ /5 - ?� X �� I�i�h't/�.Q- Date Signature of Permitee or Agent Receipt No. D — White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR PUBLIC WORKS By Date —1' Wilding permit expires Date .................? r�..."".. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WO �, `�� 7 County Center Drive — Orovi Ile, California 95965 v Irel ephone: 534-4541 v APPLICATION AND PERMIT BUILDING Owner- SQ. FT. OCC., BUILDING VALUATION 0& Mailing Address vkz� ephone No. U L — 30 8 Fireplace Contractor Total Valuation Mailing Address Permit Fee Telephone No. Plan Checking Fee &/or Penalty Permit Fee Building Address C /c PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 �` /illGf2 A Water piping Each gas water heater or vent 1.50 A. P. No. ZoZ Gas piping system 1 - 5 outlets 1.50 Q �O Each additional outlet .30 Sl ri tiF Fire Dept. Fire Zone Use Permit Building sewer 5.00 p,6 v EQA Parking ani cel parcel M 60' R/W Improvements Lawn sprinkler system 2.00 Plans e�jaq 0,0 dg. Plans Recd Parcel pproval Plans rovol Permit Fee $ -33�coC).$ 3 �8 ELECTRICAL No. @ FEE NEW ❑ ADDITION ❑ UTILITIESIR OTHER ❑ PERMIT FILING FEE $3.00 (j Main service incl. 1 meter �j O Additional meters, each 1.00 — Sub -panel (12 or less) (more than 12) Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00. Light fixtures 99Receps„ switches & fix outlets CONTRACTORS LICENSE LAW Hood, Ex. Fan or F.A. Furn. Motor 1.00 I am licensed under the provisions of Chapter 9, Div. 3, of the Evap. cooler, gar. di sp. or D.W. 1.00 State of California Business & Professions Code under the name Air conditioner or heat pump style of: Water pump Mobil Home Facilities 5.00 , (j Temp. Power Pole 5.00 Misc. wiring License No. Classification KIA I am exempt from the Contractors License Laws of the State of California. Permit Fee MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE PERMIT FILING FEE $3.00 1 am aware of the provisions of Section3700 of the California Labor Heating 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 Cooling Workmen's Compensation Insurance. 1��I certify that in the performance of the work for which this Ventilation permit,is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of Hood 2.00 California. $ $ Permit Fee I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for ins purposes. .11(_X Date �Ie —7S Sig ature%%of PeimiAAtee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant TOTAL PERMIT FEE $ _6_7f 1Q� This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF BLIC WORKS By Date B ding permit expires Datea /�� + (his.. set of Plans MUST be kW ;dn the job'. at oil times and if is unlawful to make any changes dr al I terations on same without wri"en permisson from the Department of Public Works, County of Butte. the e*7 Setback shall be 5 ft. from the side proper' line and 50 ft. fro'm. the centerline of the road, permitting 1, maximum of a 2 ft. epvp. overha'np All utility connections shall be located within 4 ft. outside the rear third section of the mobile home on the left (road) side of the mobileX pb.rrnit will be required for the home. Installation of the moWehorne; j 010 s eptic system and locat ion to be,, Butte County Health Deot,6S eP tl? P quirements. 23 2 4.6 ,v� , �� 'BUTTE COUNTY BUILDING DEPARTMENT PVPROVED DTCLARATION I;i:CARI) NN,G 1 OTS OR PARCh-L'i X certify that as owner of the property acquired by deed in ' Volume, Page : 7 official icial Rccords of Butte County, (AP. 0 �y,;tc� ) X arri re uesting permission to build or install jan additional living unit on this ,operty. I will not divide the afor.e- t mentioned property for sale, lease, rent, or financing unless all appIicableT-land-division -laws.-anidl ,-iiap -requirements :are •complied -with. l aim conversant with the present zoning regulations affecting the • afore-aentioned property, and declare that I shall not violate same. I represent that the proposed use of the additional living unit is CL t03,6 e Md and -that -further I -shall -not. change -this : proposed- use 70 -the--additional, - living ,unit unless and 'until 'i . receive written' approval therefor from. 1 :'= the County of Butte:' I fully understand that pursuant to Chapter 20 of the Butte County Code and §11535 et seq of the Business and Professions Code -that if I, in the future, sell, lease, or finance the area on or adjacent to said ;nprovz-nent without fully complying with the applicable laws and ordinances, that I shall be -guilty of a misdemeanor and therefore, subj ect to the aforesaid penalties and.imprisonnent pursuant to law. Further, .i -this state ment-shall •be-•properly--ac.<nowl edged and. -recorded. at the request :i------oi- .he_.County_af.--Bixtte, 29772 - er 0.=1i,tAl. fi C4Rf)S , If ov Mu I q 429 N 1975 ; . � :Address FEE Date ' - - _ xaxnnnunxmuutuwauwuutuwarauuw� _ _ _ _ OLENE MORENO' � - NOauBICALIFORNIA CSTATZ O: CALIFORNIA PRINCIPAL OFFICE I1LTHE SS. COUNTY OF BUT CON i 07C Mr Cominlaaron Expires May 18, 1976 ' _i uuwnnunuun��munuunxtmnununmua� On this day Qf �j "z2 c 197.v before me, �.otary Publ ii'1 and,, for the COI::, `' O�: Setc0L Cali rornia, residing therein, C k. y c:�:r.litisionc� and s�rorn, perso;�ally appeared _ 1.1-1nto ,-,e to be tile person_ whose n;,-. ;1117 ,C l ei LO tho :i tC;li1 .lnjirL'l2il.ti end ack-no-to rite ti a L� -----,-- t e cxccuLcd the same. Y.'i +!_Til Sj il:.l`Ic�hercunto sc-� my, h,D' d and 7.i.L - O i li:: f]1 `i. a 1 n �.?t'' I.O .+'li:y O l/.SLC J tiic` ay and y"� a.;_' in tl. is �1�':l %� irst abo` e :irittern_ . 000 /jam/j �/ 1 ' Li • _,ice i. f , - V I • I COUNTY OF BUTTE - Department of Public Works .7 County Center Driye,,.Oroville, California. PHO$lE : 534-4541 i� • 1 ru, ' �. 1 Utility r • .20' t� ty Min M w W rnt K P_ a w w o 0 91 cn rt K M M rt 0 K d K F'• C .M N u MOBILEHOME INSTALLATION INFORMATION Lot Facilities Mobilehome Data FyI 1. Plot plan dimensioned, location of mobile 1. Length 7'0 Width f' 0 z and utility connections? 1 Manufacturers44riG�1�?fi` Yes No Vehicle Serial No. 2. Electrical -service equipment ampacity 2O 0 Insignia Control No. 15e F-7 C H Circuit breaker ampacity /.00 2. Feeder assembly ampacity�/� O Permanent Wiring Connection %A S Conduit size Ampacity /go O Power supply cord (amps) Receptacle Ampacity r— 3. Gas inlet size 3� 3. Gas:. Natural LPG_ Mobiiehome connector. sizer Gas riser size Capacity. 4. Drain inlet siz�—' 4. Drain connector: describe. on reverse side 5. Water riser. size / 5. Water connector: describe on'reverse side 6. Are utility connections located outside 6. Designed loads: the rear 1/3 of the mobilehome within Roof live load O psf. 4 feet of the left wall? Yes No Wind load / .S� psf. . If not, show di.mensions. above. (only for robilehomes manufactured after 7. Is the mobilehome clear of septic tank, October 7, 1973) leach fields and located outside public 7. Manufacturer's installatiAn.instructs ns? utility easements? Yes No Yes No eLC_ 8. Do you propose to do other work on the 8. Will the mobile home be installed on a property other than the mobilehome separate support structure. installation \w}� ich will require a permits Yes No x Yes No If so, specify *For plans and specifications of support system, see other side. LOAD. BEARING SUPPORTS ADDITIONAL CO !.7'iTS Drain Connector, Describe Q Water Connector, Describe LOAD BEARING SUPPORT AND i' DOTING INFOP.IlATION Pier Spacing Used Maximum Pier Load \\ Maximum Column Load (multi -units only) -Soil Bearing Capacity. , A Footing Dimension Used `i- A X 3 p TYPE OF PIER. USED Steel Concrete Concrete Block L TYPE OF FOOTING MATERIAL USED Pressure Treated Wood Concrete Redwood (Grade) Other Approved Type BUTTE COUNTY BUILDING DEPARTMENT APPROVED COUNTY OF BUTTE — D MENT OF PUBLIC WORKS 7 County Center Dr ve-?-Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT QUUIVIILC la UIIL0LIVe21 UI lire I,umity ul Bull", to enter upon the above -men`' n property for ins ection purposes. X U Date igrature of Permite r Agent Receipt No. 6 �� White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTQR OF PUBLIC WORKS By Date EL g permit expires Date ,27 /i/7 7 BUILDING Owner �j '��f,pYt2I SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address /�] `•t �/% Telephone No. Fireplace Contractor Lj�� 1�/ Total Valuation Mailing Address6l4 �� 1ll�l, Permit Fee Plan Checking Fee &/or Penalty ` Telephone No. a ., Building AddressPLUMBING No. @ FEE PERMIT FILING FEE $3.00 11L4 AA Its, ep e--- Each Trap 1.50 ir siE! C ° Repair drainage or vent piping 1.50 WaterI P. P i n 9 1.50 IR'D/ .E ,1C�T' p /U %�/) T (� Each gas water heater or vent 1.50 h r A. P. No. ,,� v-oC Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F� We 6enRa+efl I FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma P 60' R/W Im provements Lawn sprinkler system 2.00 Bldg. Plfins Rec'd Parcel proval Plans Ap oval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 os Q��?.i� �xL'E'd1 �o• -� ' /) / r �� IJP• Main service EA. ADO'L 100 AMP 2.50 �na Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service O VR 600V OEAMP OR LESS 25.00 Main service/ EA. ADD'L 100 AMP 1.00 NEW CONST.DWELLING 1 OR ADDNS. ( ACC. BLDGS.CCUP. &\ ,Z¢Sgft / NEW CONSTR. MULTI -OUTLET NON-RESID. BRANCH CIRCUITS)2.50ea NEW CONSTPOWER APPARATUS & NON.RESIR. D. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Y z'J, ail /W Ex. Occup(OUTLETS OR FIXTURES)�� BALM FIXED APPLNS. OR Ex. Occup. ( OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 License No.�_ —o 33 9 Classification Mobile Home Facilities 15.00 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. UI I have placed on file with the County of Butte a certificate of AJ Workmen's Compensation Insurance. I certify that in the performance of the work for which this El permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby M ZZZ XAr.5 44 A Y 30, 00, TOTAL PERMIT FEE $ O O 1 QUUIVIILC la UIIL0LIVe21 UI lire I,umity ul Bull", to enter upon the above -men`' n property for ins ection purposes. X U Date igrature of Permite r Agent Receipt No. 6 �� White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTQR OF PUBLIC WORKS By Date EL g permit expires Date ,27 /i/7 7 13 This set of plans and specifications MUST be t.�h+ An' A,4 im6 at all times and it is unlawful to "nIf-r,+;ans on some without 11r±pmission from the Department of Public Works, County of Butte.. 06g Thee• Setback shall be 5 ft. from the side property line and 50 ft. fFOV" the centerline of the road, permitting a maximum of a 2 ft. eave overhang 9 Q a BUTTE COUNTY ALJI DING DEPARTMENT APPROVED BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,.CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owners name: 2. Installer's name: GZ 3. Is the site.currently under permit? Yes / / No (If yes, furnish permit number ) Is the'site an existing.site? Yes No (If yes, furnish two (2) plot plans.) OR 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? ------------------------ j(,2 G Amps 6. What is the mobilehome site service rating? --------------------- d ® Amps 7. What is the mobilehome site circuit breaker rating? _____________ d O Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes (If yes, identify the load and size: (Load) No —(Amps) 9. What is the mobilehome site gas.pipe size? _ ____________________ `3 (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG / / 11.. What is the gas pipe length from meter or tank to the mobilehome? 30 (ft.) 12. What is -the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) e ' . "i MOBILEHOME-SUPPOFT DATA Mobilehome Mfr. /,Wa^ it ZYo'a+.t Setup Model No. -.2 YX 61 "/Q Year 7,e/7 �C-K Width _(ft.) Length . (ft:)--Expando `Size ft.x ft.' (Draw.support details below) . On all mob ilehon ,manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets :(if. not .on file with the County of Butte) . Single Footings - (check . one; / / 1 Wood 'either °i pressure treated or Center Center Support : fdn.`grade.:: Support Footing Sizes Locations (in.) /ij 2.�:Concrete pad. S- 3 t j x j o 3. -Other, -specify ua. in. in. — Supports (check one; Concrete block x 3 O ' / / 2. Concrete piers c`f7�in� 3. Steel piers ;n:......... .... . Other, specify .� .... ......... Typical Support Footing Size (in.) (in.) ......... d. -Max. Pier:. .. Spacing in• . •) . . (in.) (pan.) ' Max. Overhang • �• *If center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COUNTY -?* EUlWING DEPARTMENT APPROVED MOBILEHOME• INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with require&'separation from lot lines and buildings -and generally' conform to.plot plan? Yes e/ 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 per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes,f/ No 4. Is the mobilehome level? (Sec. 5088) Yes �No 5. If more than a single unit, are crossover connections properly installed? (Sec. 5088) Yes �No 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) YesNc B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes --No C. Back-flow - 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 L"'No B. Does it have minimum 4" per foot slope and is it properly supported? Yes ,�— No C. Are .any leaks detected in drainage system after running 3 -gallons of water through each fixture.including washing machine standpipe? Yes No D.• If coach is not State of California approved,. does station have required trap and vent? Yes No P A14. 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehome gas line inlet without reductions other than the mobilehome connector. Yes 1--ao B. Test OK as per following procedure? YesNo 1. Open all appliance connector valves._ 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum. 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes a' No. s O-7 9. Electrical -g-/(_� 9.-t7_S r Z_Q/? � r.. _ A. Is service large enough to provide adequa`_e'amperage- to mobilehome (must equal rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes P_'No' B. Is there proper clearances around panels? Yes �'No C. Is power supply cord or feeder assembly properly fused? Yes " No— D. Is continuity test satisfactory as per the following procedure? Yes 4"'No 1.' De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test.instrument to the mobilehome grounding conductor and apply the.other lead to each m.obileiiome supply conductor, including neutral. 5. 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. 6. 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 the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? Zi 11'S I7�r� 5�1 w. 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle�rf_�I Lergth,Width Vehicle Serial No. A /2 s gU State Identification No.')_3,:1c31 a 33019 Additional.Informati.on or Comments: vG �/ Z - a --7 G