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072-270-044
N 72-21-44t John C. Egge a, S S pri.rd.,app.600'S.of Forbestown Rd`. ,'"p mi:E`:of"Hurlton Rd: 'Oro:"' Permit O3 9-76P,E(ut_ .,MH) ELEC. ` �b GAS 12 � S2PP RT CTURE REQ. COMPACTION TEST REQ. Aa �.- ♦-,� -. . contra Earle Towne, -Paradise` P Permit #23-77MHI C Issied 2'-27=44 J / J. Vaughan A, 0 % o% / O 0 f S/S pr.i.r'.;app.600 S.of Forbestown Rd., app;12 mi..E.of.Hurleton Rd., Oroville; contr:.Sandy Schlesinger'�Const., Oro. -- Permit #3401-81B(new- pr .garage) f 0 A e 0 I � c� cs� r► �C* 3401-81B PERMIT NO. PERMIT EXPIRES OWNER R. J. Vaughan. Sandy Schlesinger Const., Oroville CONTR. 72-27-44 ASSESSOR PARCEL LOCATION S/S,:pri.rd.,app.600'S.of Fobee ;^ town Rd.,app.lk mid of Hurle- ton Rd., Oroville i� Temp. Power Pole a Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Cal led PG&E JOB FINALED (Date) q Signature J = OK - O =_Not OK - = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except•q's 1, Zoning Requirements -Setbacks -Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch _ 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/. _ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date POOLS (Plans) OK except -N's 1 • Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval. 7, Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'-Circulating Equip. -Pool Lghtg. Boxes -Enc losures- Pane lboards- Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy "' 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date _ Card -BI Date Card -BI Date V = OK 0 = Not OK ' - = Not Applicable RESIDENTIAL Ain.gle and Duplex) * = Not Ready Date UNDERFLOOR (Plpf< OK exce t#'s Date FRAM Continued 1 ping requirements -Setbacks -Easements 48 r erty Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 4 xt. Doors -One 3' -Check Garage -3rd story, 2 exits Garage; Soils -Steel- /,/,V" Ftg. Depth Vii, th-Headroom-Rise-Run- Land ing-Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab b2,.Siding-Nailing-Veneer Ae"STernwalls, Garage; Steel-Blockouts-Wrapped-Slab 5, -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers-Firepl e t . -Steel a -Glass Protection -Skylights -Plastic 8. D.W.V.: F I -Fittings -Test -2 way C/O -Sewer Test 5b, -Shear Walls; Nailing -Bolts 9. Gas Pipk; Size -Anchors 10. Water Pip , Test-Anchors=Regulator-Service Test 11. Electric; UnsNrground 12. Plenums & D ts; Clearance -Material -Support -Ins. 13. Girders -Sill -Anchor Bolts -Joists -Vents -Cripples Card-BIDat Card BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL s) OK except N's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK expept k's xt. Steps -Door & Sidelight Protection -Landings 14. Water Ht.; Vent- Acc s -Combustion Air 58 Euawra• Us4ta-Clearance-Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & nchors-Nail Protection 16. D.W.V.; Test-Ftt gs & Anchors -Nail Protection 53--8edreea6.Exiting 17. Shower Pan; TeV, First Floor -Tub Access Fixtures & Tub Access 18. Test Tub & Sh911er, 2nd Floor -Tub Access & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Siz & Anchors -62.-4tairs'L-Rails Ga_EU&plase-arStove; Clearances -Hearth 64. Elec. 0u_tlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date e-=-K-.-F - «-AppIiance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66- F!Ie&,GoWatS& Receptacles at Kit. Counter ara a Fire Door; Swing -Landing -Closer Date ELECTRICAL P mit OK except N's 69v--A-6s Bvct-in Garage -Damper 20. Fixture & Tra former Clearance -Ins. Protection 4=�- W, -Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptac s Spacing -Lights & Switches at Doors Z!1 ai_ ti____ c- __ia & Mech. Equip. Listed for Location 22. Size Boxes & No. f Conductors -Stapled Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Clbke to Edge of Studs & C.J. �� I �„tattnn- �) InauL ` Foam -Looked in Attic ❑Yes 24. Equip. Ground made u /Mech. Fasteners -Bond Gas &Water & Deck Construction -Post Caps - 25. 2 Appliance Circuits in hen & Conductor Size U -Fdn-Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 26. Subfeed Wire Size / / ga.4 or AI-A.C. Wire Size / / ga. Cu or At 27. Range Circ. / / ga. Cu or AI Oven Circ. / / ga. Cu or Al, Insulated Neutral Dyes ❑N 75. Following instld.: , rive es []No; Walks es E] No; Planters es El No 28. Service -Riser Conductors & Gro+d-Main Disconnect 26_ -St We,&_8rown-Finish 29. Equip. Clearances; Panels -Moto s-Mech. Equip. µ-Oisconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Li ht-A•beve Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 78--Water-Well,;-Disconnect, Electrical, Plumbing U. --6x 4Gr_E,lec. Trim; G.F.I. Receptacle -Underground Card B -I Date Car BI Date 8kr-Vet�Hetion throughout House Card B -I Date C rd -BI Date a2_-G+&siT-Protection Date MECHANICAL (Permit) K except q's _ 89-- eerreetio is from Previous Inspections 84 __r..�.orecr_ Meters Tagged; Gas -Electric 31, A.C. Ducts; Insu tion & Support 85s-MsTgP-&-'Sewer Connected -C/O to Grade -HD Approval Certificate -Other Certificates 32. Vent Fan; Exh st above Insulation86---EnewyCompliance _ 33. Condensate Dr in & Overflow; Size & Grade 34. Furnace -Ven ; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic C BI D Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date F G P4-16) 0K except N's Comments at Final: Sills; Proper Material alls; Studs -Nailing, Spacing & Bracing -Plates -Sound _ Bearing Walls over Girders & Floor Nailing 3e"-f9ref�p in Walls (rat proof) re to Furred Ceilings -Stairs -Chases -Tub _ Header &Beam -Size &Bearing _ _ „y6 -Post Caps -Anchors -Connectors 4�ng. Joist-Rftr. Ties -Purl in -Roof Brac.-Truss-Shlhnp.-Rfng. A4--rTe%Lace Ties or Type A Flue -Fireplace Throat _ _ tti Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4eut fd(�rf. Windows or Exiting Doors -Sill Hgt. & Dimensions �iage Fire Protection Framing (NOTE: Anentrymust be made each time youvisit jobsite) COUNTY OF'BL(TTE - DEPARTMENT OF PUBLIC WORKS PE MIT NO. A 7 County Center L'�;WN - i5rovilie, California 95965 - Telephone 916/534-4541 12 APPLICATION AND PERMIT Ir I ASSESSOR PARCEL NUMBER ZONI -- y ? `-9if P BUILDING PERMIT OWNER TELEPHONE v � `M SO. FT. OCC. BUILDING VAL ION 0 OWNER'S MAILING ADD SS ,�qq CONTR�A/%TOR•S NA E t _Gi �J lilt �Q W I TE PZ rE "O/ / CONTjA TOR'S MAILING ADDR S 249 Lyo-E ^e, 2UNKNOWN �OGt1P Fire[_ _ace _CONSTRUCO� Total ValUatlOn $ V Filing Fee $ 10.00 LENDER'S MAILING ADDRESS `— Permit Fee $ 0.00 ARCHITECT OR ENGINEER ti d DD LICENSE NO. Plan Checking Fee $ ,GOFd0 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS – Permit fee $ 70,19c) BUILDING ADDRES f ��/► PLUMBING PERMIT Filing Fee 10.00 j / e S. 411 I Each Trap 2.00 Repair drainage or vent piping 5.00 0.. I., Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTUM SF ❑ Duplex ❑ Mobi lehoml Other__)_y`/ • FY f �P SPECIECI FY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Fl Addition Remodel Utilities❑ Installation❑ Other 0 Describe work:_T�`/r 2!Qta�_%P Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR101 OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.// DWELLING OCCUP.y OR ADDNS. \ ACC. BLDGS. 1 J 22 sq it CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No.�r��--��� Classification �j ❑ 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 NE Nr'-ONON.RESID R BRANCH UTLET CIRCUITS)2.50 ea NEw CONSTR. (POWER APPARATUS D1 NON.RESID. SINGLE OUTLET CIR. / EX. Occup OUTLETS OR FIXTURES BALM FIXED APPLNS. OR Ex. Occup. �OUT LETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor 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 Certifidate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation _+ permit Fee S Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby 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. C+This ;��—� Date, I Signatureo Applicant — Owner ❑ 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 Nome Installation Fee $ TOTAL PERMIT FEE $ occuP^G� uP TYPE OF CONST. N IPARCELI Nps Is5 permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF P ELIC BY PERMIT EXPFRES Date_ X the applicable provi- resolutions to do fees have been paid. WORKS D te'��1 Receipt No. �6 Z ;,-,4–r WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT L T- 7- r � —Tnisise pla I e I rV,•n -L F 7-T j 1; 1 If I I I I I. Ir L: 111101kill, CIFTy !IV�,; liq r I ra i nsiom* r. 15151,10 m T el I J I PAV itlerials iw e_ 9 1 -J LL Lln, 2 -A --:-'--7, .Ion9 L 40 r . . . ............. 4 r Jiez I L Perml -i '7 1,ji t -At V! 4 C Jnes -T I -�rA-j4-4 - ^11 UTIll icon eq -shah-t -5-, s- --- --- -T ;from Jocafed44hin-+k'but i.dW;f Wrear 61IFgr a e J .-side-�prop oft t1w h obiliv----------- dt' ftua-4-Aktik mannof�a: !-+--,edve ov6rhang-ln4- =7 6 4—, L ING D -'-"DEPA- -R-T-... f \: PERMIT NO. 53+9-76P,E. PERMIT EXPIRESj/ ;�OwNER John C. EQQe CONTR. owner; LOCATION (A.P. 72-27-44 � I S/S pri.rd.,app.600.'S.of Forbestown,Rd.,app. 1k mi. E.of Hurleton Rd., Oroville 0 Temp. -Power Pole Cp1led PG&E T e p. Elea Serv. Called PG&E - O � emp. Gas Serv. Called PG&E JOB ,1 A v FINALED ' (ADat 1 ( ignature) \ V a 1� 0 Temp. -Power Pole Cp1led PG&E T e p. Elea Serv. Called PG&E - O � emp. Gas Serv. Called PG&E JOB ,1 A v FINALED ' (ADat ( ignature) (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback 7.7 Firewall Soil Piping _. Forms ! Parapets irl 1st Floor Main Bldg. Restroom Finish` 2nd Floor Footings Windows 3rd Floor Stemwall A Siding To out Slab Roof Sheathing Water Piping -3- 2� Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI l ( Garage Vents Insulation Water Htr. Heaters Slab Carport Footings handicar pehddysic Ily Conformance of ex. structure Appliances Gas Piping & Test Gas Slab . Final 17 -Temp. Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rou h 1—.3 7 Reinf. Steel Final Fixtures Bond Beam 1=1AFrSPRlNK'LERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final J Final,' - DATE ! % REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE 'OROVILLS, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY °s This mobilehome has been installed in accordance with the requirements of the California dministrative Code, Title 25, Chapter 5, under permit number for the following location:,54 !Rni R 6 4,'7,b ',S ► ORSSTOwltl i2.D MY E OF �AIZ AU TO N j9p Owner 4-0141,1 C ad N Owner's Address2,204 7-54-71-165- r40-5 57'4.2. Zr eo)��77 Mobilehome Mfg. 1927'Al 1,11U LF Model = dOe e. Insignia No.('.,•t± Serial No. It is hereby c'e'rt'rfiA for occupancy at the above described location and may be occupied. . ,o-� - Director of Public Works Date 1�-�' B /!_ cIC4— _ Y, THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS . 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBIZEHOME INSTALLATION SHEET 1. owner's name: To N A/ �f 2. Installer's name: A (ZL �D lvN E 3. Is the site currently under permit? Yes 75F-7 No (If yes, furnish permit number ) OR ' r Is the site an existing site? Yes / / No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes % �% No ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- s P f' 6. What is the mobilehome site service rating? --------------------- Amps 7. What is the mobilehome site•circuit breaker rating? -------------- Amps, 8. Is there any other electric load to be served -by the mobilehome site service? --------------------------------------------------- Yes /% No (If yes, identify the load and size: (NFl•L (Load) ?C (Amps) ti 9. What is the mobilehome site gas pipe size? ---------------------- "" (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? -" (ft.) t_ 12. .What is the mobilehome gas demand? -------------------------=---- (BTU) Y (This information not required if pipe length less than.6 ft. on natural gas tor less than 50 ft-. on LPG.) MOBILEHOME SUPPORT DATA Zg GL Mobilehome Mfr. fA T { �4 (, e i/ Setup Model No. g Year ,4g)2 Width .y (ft.)"1 Z„ , Length g (ft.) Expando Size ft.x ft. �. (Draw support details below) On all mobilehomes manufactured after October 7; 1973, furnish manufacturer's installation manual and structural setup sheets (if not on .file with the County of Butte). Sin le ' ® Footings- (check. one) 1. Mood either Ij A 4S -.*' pre#ssure treated or Center Center Support fdn. grade. Support Footing Sizes Locations (in.) L;1 2. Concrete pad. 3. Other, specify 1 rn.din. "w — — -- — - S orts (check one) .. f Concrete block 2. Concrete piers r / / 3. Steel piers T-1 4. Other, specify __ - Typ ical $,upport -� x J Footing -,Size (in.)(in.) � r ---- Pier . (f Spacing in. 9 41 (in.)(in.) i Max. Overhang rain er piers �othrtharawn above, BUTTE COUNTY locations, spacing, and dimensions. BUILDING DEPARTMENT ' r APPROVED t t a COUNTY OF BUTTE — D-EPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 "'�� Telephone: i634-4541' sC>111<7— APPLICATION AND PERMIT c r--) L� above --mentioned property for inspection purposes. X zie, c LaDate —— 72k Signature of P/ermiitteee or Agent Receipt No. J� J/� White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions o1 the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date— .01 Bmi4ding permit expires Date / �9 BUILDING Owner j p /V SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Fireplace Contractor JFA 2L€ T4_9 ivA' Total Valuation Mai I i ng Address —5703S— C/ /2 C L f 1-10 Permit Fee Plan Checking Fee &/or Penalty ,AA R_A0 �S E. h Tele No. g _ one e Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 c S . . Each Trap 1.50 ` ` Repair drainage or vent piping 1.50 Water piping 1.50 �''O�j (/VO 0 p Each gas water heater or vent 1.50 A. P. N 72-2 7-� Zoning &Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F e Is n Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans ParcelLawn Declaration Parcel Map 60' R/W Improvements sprinkler system 2.00 ►► m .•iron C-11Parcel Ap oval Plan pproval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER [a ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 rp' V�&Main service 100 AMP ORV OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW LING O OR ADDNST ( ACC. BLDGS.CCUP. &\ 20sq tt / NEW CONSTR. MULTI -OUTLET NON.RESID. BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS &) NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: �' Ex. Occup(OUTLETS OR FIXTURES) 2@51004 Ex. Occup. (FIXED APLNS. OR 2.00OUTLETS () Temporaryservice 10.00 Mobile Home Facilities 15.00 License No. Ly���l j Classification e'— 6 � Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby d C� L=O TAL PERMIT FEE I above --mentioned property for inspection purposes. X zie, c LaDate —— 72k Signature of P/ermiitteee or Agent Receipt No. J� J/� White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions o1 the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date— .01 Bmi4ding permit expires Date / �9 COUNTY OF BUTTE - -,,DEPARTMENT OF PUBLIC WORKS 4111, .— 7 County Center Drive ("oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT 5 3�f 9-7G u — —representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1?e X g G Date `Z I ignature of Permit or Age Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR O PUBLIC WORKS BY JIII Date /-- / L ��_ ilding permit expires Date /b''fF - ?off BUILDING Owner A SQ. FT. OCC. BUILDING VALUATION Mailing Address S-00-6 < 0 f 3 Telephone No. Fireplace Contractor © Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Q Permit Fee $ Building Address •g �d. /LB � PLUMBING No. @ FEE PERMIT FILING FEE $3.00 .elD �^ J0 0 )4 49 FMbLS'b Each Trap 1.50 Z- � I �. 6F U / ;, 0" ZI Repair drainage or vent piping 1.50 Yevification only Water piping -4.11 Each gas water, heater or vent —.4.. s9 A. P. No. — _ l� S iW Gas piping system 1 - 5 outlets 1.50 Each additional outlet 30 Fees W.C. SqDkionl Fire Dept. FireZ.one Use Permit Building sewer 6-e& dO arkinEQA PPlansg Declarration arce ap 60' R/W Improv ents Lawn sprinkler system 2.00 C_�CL Plans Recd 1= Parcel Appr l PI Appl Permit Fee $.�g. NEWELECTRICAL ❑ ADDITION ❑ UTILITIES OTHER ❑ No. @ FEE PERMIT FILING FEE J$3.00 Main service 1000V OR 0 AMP ORLESS5.00 Main service EA. AOD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home [ Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD -L. 100 AMP 1.00 • .. r• FOR MOI NEW OR ADDNSCONST ( ACCLBLDGS.WELING CCUP. &) 2¢Sgft NEW CONSTR. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name of: Lao 9 25F Ex. Occup(OUTLETS OR FIXTURES)LL@1 BAL1 FIXED ALNS.style Ex. Occup. (OUT LETSP(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 O� License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 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. ❑ 1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No.1 @ I FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ u — —representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1?e X g G Date `Z I ignature of Permit or Age Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR O PUBLIC WORKS BY JIII Date /-- / L ��_ ilding permit expires Date /b''fF - ?off MOBTIJ'HOME INSTALLATION INSPECTION CHECK LIST 1. Is the. mobilehome located wii-], quired separation from lot lines and buildings and generally conform to plot plan? Yes o 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yed—" No 3.- Are footin,s and supports properly sized, spaced, and braced as p approved plans? (Note possible variation at spring shackles.) (Sec. 082 & 5083) Yes__ No 4. Is the mobilehome level? (Sec. 5088) Yes_ No 5. If morgan a single unit, are crossover connections properly installed? (Sec. 5088) Yes_v o 5. Water I A. Is 4q.ble connector of adequate size and properly installed (1/2" ID min,)? (Sec. 5566) Yes No B. Test - Does water piping withstand working pressure* or 50 lbs, air test? Yes No N,�'Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Y s_ No B. Does it have minimum per foot slope and is it properly supported? orted? Yes No C. Are any leaks detected in drainage system after running�lons of water through each fixture including washing machine standpipe? Yes_ No_ Oy�f coach is not State of California approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connect - Is mobilehome connected to the gas su ly with an approved 3/4" minimum ❑iobilehome,nnector not more than 6 ft, long? ote: All piping is to be at least as large as the m lehome gas line inlet witho reductions other than the mobilehome connector. Yes o B. Test OK as per following p cedure? Y s_ No 1. Open all appliance connec .val es. 2. Shut off appliance5burne� ,a pilo valves. 3. Air test with manometer o 10"-14" water co mn, or test with slope gauge (minimum 6oz.-maximum 8 oz.) c ibrated in tenth pound i ements. Test for 10 min, without drop. 4. Connect: gasmete to mobilehome with connector, turn. on gas, est connections with soapy water. C. Are all applianc vents properly installed? Yes No f 9. Electrical A. Is service Large en.oiigl. to provide .:Tdequar_e amperage to mobileliome. (must equal rating of Mobilehome (Ath i Jtlilil'?um of 100 amp) anal other facilitia-s on lot, i.e., water pumps, ,ara,,,e, caDayii1, e, c. "t Yes X No 13. Is then-,. proper clearances around panels? YesX No C. Is power supply cord or feeder assembly properly fused? Yes/, No_,,(('' T). I continuity tesL satisfactory as per the following procedure? Yes l�No__ De -energize electrical Wiring, syste:u of the mobilehome at the pedestal. 4'1?-�Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected, �Swi.tch all breakers and switches in the mobilehome to the "on" position. �nnect one lead of a test instrument to the mobilehome grounding conductor and apply the Gihet .i.c:au %U caCil niuu'L.�Ctturiit Sii�ipty CufiuuCtoL, iliCliiulitg f1e,lLrai. nor. -current, carrying metal parts of the mobi-lehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such egilipment and the grounding conductor. i6. U,�on co�pleticn of: the above proc..edure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity te_;C shall then be made between �.he grounding electrode and the chassis of the 1110bilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. it I,; job card si-nese by health Departmeat for water and sanitation? i �.;., If everything okay, sign off card and tag- services. iOBTLEilO!IL DATA Manufacturer and/or Namestyle Length &. Y Width L/ Vehicle Serial No. 6 State Identification leo. °.d(i i.tiona.l Infn)-nal—jon or Comm..ents: