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072-290-157
72-29-1,57 0A4WAWA* DONALD & SHARON SMITH S/S Black Bart Rd, 1.5 mi S Forbestown Permit/b9-85A(AQricultural Bldg Exemp hsg of animals, & feed stg etc' Permi .839$85E(ele for well & future home) Contr: MobileHomeCenter ermit#2274-85P,E(util, MH) - �LE.-./4� oe GAS LPA. O .90 SUPPORT STRUCTURE REO COMPACTION TEST RE "10 jdia� Contr: Mobil" _me Center ermit# 85MHI sse '072-610-019 I . ,. . i, 06-116.1; MCKINNON; CECELIA 280 BLACK BART.RD,OROVILLE _Cont:.OWNER. /} . ELEC(POLE & METER, 0 NOTES 072-610-019 06-1161 MCKINNON, CECELIA '. 280 BLACK BART RD, OROVILLE Cont: OWNER • °p" y EL.EC(POL.E & METER) APN: Owner: Site Address: ,_ Contractor: 1 e,. 41. �• SII Type of Permit: kE6iur-'V I iAL Permit No. 3 9 -- 7 p OFFICE COPY Address I { GAS a, Meter By Date ! ELECTRIC Meter ByDai��t, SPECIAL CONDITIONS y CHECKED BY Q SRA Q FLOOD CERTIFICATE EQUIRED Q FIRE SPRINKLERS REQUIRED 0 SPECIAL INSPECTION ITEMS Q VERIFY Q USE PERMIT CONDITIONS Q SUBSTANDARD HOUSING LETTER ❑ ENCROACHMENT PERMIT Q REINSPECTION FEE PAID s� a ENV HLTH CLEARANCE s w i u"::': § Y, 'k DATE JOB FINALED: �SIGNATURE: C�0�4 ( C7W ^17 �.., •wp ra 'i 3h`Y.a, ti^ -ti �.u._ r. ..ur.w..� ^M.. .wa, r... ....iu...s_..�Y^- +=OK 0 = Not OK MANUFACTURED, HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd 'Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LP[::] Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE DECKS -COVERS -CARPORTS •GARAGE S 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-DpthSpacing-DnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing . Stairs-Guard/Handralls ` 4 Wood Awn; Posts-Beams-Rftrs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls 41 DATE JPOOL.S 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI , 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-En6isrs-pnlboards4nsultn•to Main Conduit 9 Health Dept Apprvl . 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide 0 °,• �� � Asa yo- _ Pool Drawing +=OK 0 = Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR I DATE IPLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd Fig Dpth 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth 4 Ftg Porches/Decks; Soils -Steel Fig Dpth 5 Stemwalls Main; Steel-Blockouts-Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12, Elec Undrgrnd 1Plenums & Ducts; Clrnc-MaterialSupport4nsultn 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Acc & Vntltn 16 Insulation Ole o` DATE IFRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred CeilingsStairs-Chasers-Tubs 22 Headers & Beams -Si & Bearing 23 Hangers-PostCaps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 25 Frpic Ties or Type A Flue-Frpic Throat Clrnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc 35 Glazing Area -Glass PrtctnSkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration -Walls -W ndws DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cites In Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ea OCU or 0 A AC Wire Sz ea QCU or 0 A 48 Range Circ ea Q CU or F-1 AL Oven Circ ga [::ICU or ❑ AL Insulated Neutral Q Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 1 53 Wtr Htr; Vent Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr. Nail Prtctn 56 Shwr Pan; Test, First fir -Tub Acc . 57 Test Tub & Shwr, 2nd fir - Tub Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping DATE IMECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insulin 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn1Vent 115 Outlet 65 Attic Acc & Pitfrm if Furnace in attic oa �s} oa+ Asa. o'e 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clmc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handralls 74 Frpic or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑ Yes ❑No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frpic-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvi 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT BP061161 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/17/2006 APN: 072-610-019-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 280 BLACK BART RD ORO Date: Contractor: Map Index: Description: NEW POLE AND METER FOR EX MOBILE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MCKINNON CECELIA K to its issuance, also requires the applicant. for such permit to file a P O BOX 28 signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section CLIPPER MILLS, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95930 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the to a civil penalty of not more than five hundred dollars ($500).): applicant ItU I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an Applicant: MCKINNON CECELIA K owner of property who builds or improves thereon, and who does P O BOX 28 such work himself or herself or through his or her own employees, CLIPPER MILLS, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95930 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code Date :_�"/L44 Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy#: Valuation: $0.00 V I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith complywiththose provisions. Date: Applicant: �.(;G a✓��!/"�'/%'�1� WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in' addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. -, j J C� z--, - CONSTRUCTION LENDING AGENCY - This permit ishereby' su under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions rk indic ted above for which fees have been paid. � >t �� Name: By: Date: `J Address: PERMIT EXPIRE 1 Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enterupon the above mentioned property for inspection purposes. Print Name: � G///�J�/�%✓dJy Signature: Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 .,, BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP061161 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/17/2006 APN: 072-610-019-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 280 BLACK BART RD ORO Date: Contractor: Map Index: Description: NEW POLE AND METER FOR EX MOBILE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MCKINNON CECELIA K to its issuance, also requires the applicant for such permit to file a P O BOX 28 signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section CLIPPER MILLS, CA 7000) of Division 3 of the Business and Professions Code) or that he or 95930 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: MCKINNON CECELIA K owner of property who builds or improves thereon, and who does P O BOX 28 such work himself or herself or through his or her own employees, CLIPPER MILLS, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95930 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and. Professions Code ✓'���� Date Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued, ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Policy u: Valuation: $0.00 I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwithcomplywith those provisions. Date: ����''� Applicant: �'(J��.Y G�✓ WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. l i� (� CONSTRUCTION LENDING AGENCY This permit is hereby ' su under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions rk indic ted above for which fees have been paid. /` ) 5 ; 1 V� Name: BY: ` �lDate: M Address: PERMIT EXPIREv Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: L/� l�/✓dA/Signature: Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #l: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.nettdds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name / / i 6 Name Address City State /�/I City Phone,, Fax E-mail . APPLICANT INFORMATION CONTRACTOR Name //1 City Z5 Stat/9- Address Phone�/S Fax City Type Const. State Zip Phone Lot # Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name //1 City Z5 Stat/9- Address Phone�/S Fax City Type Const. State Zip Phone Lot # Fax E-mail State License Number APPLICANT INFORMATION Name Address z � //1 City Z5 Stat/9- Zi 9 Phone�/S Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Flood Zone Troperty Address SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: vv t=r< rvrt OUDIYII I I AL KtWUIMEMENTS K TORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 PERMIT NO. Gtr°- ►lcp i BP BIN # / n PROJECT LOCATION P# r r'. Troperty Address City Cross Street _ ave 6--e, /GZvi✓ (lam WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Sq FT- Living Garage Open I Cly Cov auuc[ure bunt witnout Hermits ❑ Proposed Change of Occupancy ` (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Recei t #: Date r Amount: �� Bldg SRA Sheriff SMIP Other T..�..1 REV 8-12-05 r SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSMILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 OWNER -BUILDER VERIFICATION Attention Property Owner: Ari "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 material for construction of this proposed property improvement: YES [ /] NO [ ]. 2. I HAVE ['V ] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S 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: ``nnom DATE: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR (PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.net/dds OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers" compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. - o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner-builder"=Building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321-CSLB (2752) or by accessing their website at www.CSLB:ca.gov. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, A�' . , -t Scott Rutherford Vion Manager, Building Divi NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. M I 839-85 q7S — PERMIT NO. PERMIT EXPIRES— �-h OWNER — DON & SHARON SMITH Mobile Home Center CONTR. ASSESSOR PARCEL 72-29-36 LOCATION 9419 Black Bart Rd,, Oroville OFFICE COPY Address GAS Date Meter By I ELECTRIC Meter B 4 ij 4 Called PG&E M I 839-85 q7S — PERMIT NO. PERMIT EXPIRES— �-h OWNER — DON & SHARON SMITH Mobile Home Center CONTR. ASSESSOR PARCEL 72-29-36 LOCATION 9419 Black Bart Rd,, Oroville OFFICE COPY Address GAS Date Meter By I ELECTRIC Meter B 4 ij Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E — JOB FINALED (Date) _a,, Signature V,=OIL ` f 0 = Not OK — = Not Applicable MOBILEHOMES MISCELLANEOUS ` * = Not Ready /- Date MOBI OME UTILITIES (Plans) OK except k's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except p's . ZA i nWAequirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—.Easements So' ; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors er; Location—Test—Fall-C/0—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails ter; Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Posts— Beams— Rftrs.—Con nec.—Shthg.—Rfg.—Bracing ctricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures G ocatiort—Test—Wrap:/ /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors .7 tility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date I Card -BI Date Card -BI Date Card -BI Date Date MOB1106HOME INSTALLATION (Plans) OK except N's Date POOLS (Plans) OK except N's ning Requirements—Setbacks—Easements 1, Setbacks—Easements otings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3 as• MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining ectricity; MH Test—Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI ain• MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI W H Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7 and Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'—Circulating Equip.—Pool Lghig. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit xits; Insp.—Sketch le Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card -BI Date Card -BI Date Card B -Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK 0 = Not OK - = NotApp4pable RESIDENTIAL (Single and = J1ot'Ready ' Duplex) Date UNDERFLOOR Plans OK except H's Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. O.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 55. Shear Walls; Nailing -Bolts 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except N's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except s's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. 63. Stairs & Rails Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except N's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 72. Insulation -Foam -Looked in Attic E] Yes 25. 2 Appliance Circuits in Kitchen & Conductor Size Guard Rails &Deck Construction -Post Caps 26. Subteed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes ❑No 75. 76. Following instid.: Drive C] Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No Stucco; Brown -Finish 28. Service -Riser Conductors & Ground -Main Disconnect 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, 78. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 30. Clothes Closet Light -Shower Light 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B -I Card B -I Date Card -BI Date Date Card -BI Date 81. 82. 83. Ventilation throughout House Glass Protection Corrections from Previous Inspections Date MECHANICAL (Permit) OK except q's 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86. Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING(Plans) OK except q's 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound ` 38. Bearing Walls over Girders & Floor Nailing 7 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Sh_thng_.-_Rfn_p._ _ Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE:Anentrymust be made each time you visit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE -Iz 7.5- 85 OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. L� t,. Nil Inspector\ �. Date�� W MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE t.. r OROVILLE, CALIFORNIA — 534-4541 PERMIT N0. Address or location (off mobilehome ���% i1�., /,- Owner's name 1��.� S �u�0 ,, . 44 i .Owner's address < `---e wt.n Insignia or hud number Cas --I U t. 9 t � CS• Manufacturer's name ff ..:r -'� n,.n A �5VI.."ack ^Serial number of V.I.N. A. Year of manufacture I G 'mak (Official Approving Installation) / (Date) -IF THE'MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCESHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME 1S,INSTALLED ON A FOUNDATION SYSTEM. 4 r - r 513B White - Owner" Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 V/-AkPLICATION-AND PERMIT PERMIT NO. �'7 s = 5 'l - ASSESSOR PARCEL NUMBER ©_ 3� Ort I ZO7-,5— -� BUILDING PERMIT OWN:TELE ow HON S SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING D RESS O T CT R•S NA TELEP ONE _ D CONTRACT R'S M R AILING A. DS 17 Fireplace CONSTRUCTION LENDr=R UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ f Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ (� BUILDING AD ESS �t PLUMBING PERMIT Filing Fee 10.00. Each Trap 2.00 Solar Water Heater 20.00 v`0v fr Water piping 5.00 LOT NO.SUBDI VISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE O UCTURE SF ❑ Duplex ❑ Mobi lehome Other SPECIFY Building sewer 5.00 Mobile Home JSJGJWJ 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti ities ❑ InstallationOther ❑ Describe work: �% 2• �(1� 2 2— Permit Fee $ Contractor ELECTRICAL PERMIT FifingFee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCC UP.& OR ADDNS. ( ACC. BLDGS. 1 2/2QSQft CONTRACTORS LICENSE LAW I declare der penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions o e and m license is in full f .Sce and effect. y y 7 License No. Classification �" ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTF; ULTI-OUTLET 2.50 ea NON.RESID - BRANCH CIRC ITS NEW CONSTR.POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. 20@50t Ex. Occup(OUTLETS OR FIXTURES BAL030 EX. OCCUp. OUTLETS FIXED P(RESID.)REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The ermit is for $100.00 (valuation) or less. have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. , Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating ' Cooling Hood 3.00 Ventilation permit Fee $ 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 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 li1lktr gments„¢ s s, a d expenses which may in any way accrue against o ty I o'nseque e�rerttiflg of this per It. 44 c���95' Signature of Appli ant — Owner ❑ Contractyr'E�l 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 $ / TOTAL PERMIT FEE $ 1 looButte Oc CuP. GROUP I TYPE OF CONST. PARCEL PD I HD I 199U This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By MIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date ZT 9 it A Receipt No. 'J)1 WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT BUTTE COUNTY. DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. e PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: /G` 3. Is the site currently under permit? Yet /41� No _1 (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No / y/ (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes F7 No , (If no, clarify \ ) ( ) 5. What is the mobilehome electrical rating? ----------------------- Amps 6. What is the mobilehome site service rating? --------------------- C -2e9 -C'2 Amps 7.. What is the mobilehome site circuit breaker rating? ------------- 0 Amps 8. Is there any other electric load to -be served by the mobilehome siteservice? ----------------- ----------------------------------, YesNo i (If yes, identify the load and size: (Load) (APs) 9. What is the mobilehome site gas pipe size? -------=------------ 10. What is the type of gas service? '---=---:---------------------� Natural %� LPG /Y 11. What is the gas pipe length from meter or tank to the mobilehome? .7-00 (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.) zz7s-es BUTTE COUNTY BUILDING DEPARTMENT APPROVED Al MOBILEHOME SUPPORT DATA �_ � If other than single wide, Mobilehogmel Mfr.Irp �' �� � furnish Setup Model No. Year ydidth U` / (ft.) Box Length (ft.) Tagalong or Expando Size C -,--ft. x (SHOW SUPPORT DETAILS BELOW) ft all mobilehames manufactured after October 7, 1973; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. otin s (check one) *If center piers are other than drawn above, draw in -locations. spacing, and dimensions. ` Single ' `! .' ' 1. Wood either pressure treated or foundation grade. , as x30 (ft.)(in:) (in.) (in.) 2. Other: (specify) Center support locations* Center support footing sizes Su ort (check one) (in.) 01-1. Concrete block. �yX3� •2. Other. (specify) (in.) (in.) ` <--.Tagalong or Expando,' show support details. (in.) (in.) Typical Support (in.) (in.) Footing Size (in.) (in.) -7Z//] -- Max. Pier Spacing Max. Overhang (ft.) (in.) *If center piers are other than drawn above, draw in -locations. spacing, and dimensions. A setback of 5 ft. from the property lines and a setback of 50ft. from the road centerline shall be clear of structures or equipment except'' i' for a 2 ft..eave overhang. Y 0111 FOX ter' �- SQ. FT. MINI ►� i FOR MOBIta NOTE: All Materials & Wcr odh�paacesll Be in and Accordance with -Recognized Go of a quality prescribed for th /Specified use in the Uniform Building, Plumbing &Mechanical Codes and the National Electrical Code. I This set obe f plans and spe :(fic"tions MUST kept on the lob at or alters ns on some w'ithou make any changes Wry}}en permission from th Department of Public Works, County of Butte. C aC v 1 5d/ r.. y 9 / b 15t % Utility connections shill be within 11 4 ft, of the mobilehome, either directly behind or within the rear half of the roadside (left) of the mobilehome. %cel 19 �1)9 z BUTTE COUNTY 'BUILDING DEPARTMENT APPROVED. AP #. OWNER PERMTT �� mot �• %�� �� MH UTIL.CLEARAN DATE INSPECTOR ELECTRIC GAS Support Struc. Compaction Test eq. iervice Other Load Te Pipe Size YES NOUze' i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 ,APPLICATION AND PERMIT PERMIITf �NO. /. ASSESSOR PVL NUMBER -`/- O—z:93 _ ZONIN —,5 BUILDING PERMIT OWNERTEL .S/Y,11,1 iW _!5 7` PHONE .- SQ. FT. OCC. BUILDING VALUATION OWNER'S MA LING�DR ESS �� O T A �TjOR'S AME 4oc- TELEPHONE CONTRACT 'S MAILING APIPRESS l Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ ea— LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ !� 0 Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ /S BUILDIN ADDRESS PLUMBING PERMIT Filin g Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USEOF�TURE SF ❑ ❑ DuplexMobilehome Other SPECIFY Building sewer 5.00 Mobile Home 10-00e 50,(90 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation❑ Other ❑ Describe work: / l Permit Fee $ r Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP OR ADONS. .& ACC. BLDGS. I 220sgft d� CONTRACTORS LICENSE LAW I declare yn r penalty of perjury (check one): L --J,/ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and _my license is in II fore and effect. License No. �_r� �7QS Classification ti ❑ I, as the owner, or my employees with wages as their tole 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 CONSTR U TI.OUTLET NO N.RESID BRANCH CIRC ITS 2,50 ea NEW CONSTR. POWER APPARATUS &) NON.RESID. ( SINGLE OUTLET CIR. Ex. Occup(o XTs OR FIXTURES 2D®OOC SALO 30 FIXEEDDAPPLNS. OR EX. Occup. OUTLETS (RESID) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare un er penalty of perjury (check one): F-1/he permit is for $100.00 (valuation) or less. Ihave placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 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 tome on the above -me ned property for inspection purposes. I also agree to ave, indemnify and ep harmless the County of Butte against all, liabili ju me s, costs, d expenses which may in any ay a crue ag ' said C my ' copse ce of the granting of this permit. �—or)� Date Signature of Applicant — Owner El 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 $ TOTAL PERMIT FEE $ o OC CUP. GROUP TYPE of CONST. This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE R OF PUBLIC By PEIT EXPIRES Date PARCE PD Ho $$u; r the applicable provi- resolutions to do fees have been paid. WORKS r Date Receipt No. TADI WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT RE"•' -'RM 1lei4F'rl:; AL RECORDS - OF BUTTE COON i Y,CI LIFORNIA --tee AT THE REQUEST OF a4 1965 AUG 14 Alf 10: 28 ELEANOR Fl. BECKER CLERK( -RECORDER FEE 85-2446'7 Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT fla „ 1 - FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. f The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, 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 property situate in the County of Butte, State of California, described as follows: PROPERTY OWNERS: op State of Qn this the day of , 19 , before -- -I - , ,,,—..— n..t", ,.. ------a l 1 y appeared STATE OF CALIFORNIAttE Iss. COUNTY OF I` v August 9th 1985 ' C _, before me, the undersigned, a Notary Public in and for Q. E said State, personally appeared � LJJ�L�P/A1LLTj/, WL .L�-F/ASIS personalty 'known tome f be the person whose name is subscnbed to the within instrument, as a witness thereto, who being by me duty sworn, deposed and said: That he/sj% resides in_Butte raxi y - that he/4e ■ LOANNE GALLEGOS i U- was present and saw— Donald E. Smith and ■ N Sharon Smith NOTARY PUBLi4CALIFORNIA ■ c --- ,personally � Buttecounty i 3 known to him/or to be the same My Commission F-xpiresJuly 13, 1988 • tj� perwn(s) described in and who ■ executed the witttin instrument, as a party(ies) thereto, sign, seal ■ ■ ■ ■ ■ fa ■ ■ M ■ ■ i ■ ■ ■ ■ ■ ■ ■ ■ A ■ ■ N and deliver the same and that said party(ies) duly acknowledged in the presence of said atfiant, that tAANIthey executed the 0, 0 ' same, and that said affiant, thereupon at the partys(ies') request, 0 subscribed his/hir name as a witness thereto. 0 co WITNESS m h da al seal. _ Signatur (This area for official notarial seal) 7--y9—o-e�G to on the basis :tory evidence. _ subscribed to :ontained. nd official seal. ?ublic Beginning at a point in the East line of said S.M. 1/4 of the S.M. 1/4 of Section 24, said point being North 00' 02' 001 West, 330.00 feet from the Southeast corner of said S.W. 1/4 of the S.N. 1/4, of Section 24; thence North 00° 02' 00" West along skid East line. 458.44 feet; thence leaving said east line, North 67' 47' 00' West, 236.10 feet, thence North 68° 22' 00' West, 200.00 feet to the True Point of Beginningfor the herein described parcel of lands thence from said point beginning, continuing North 68' 22' 00' west, 163.46 feet to the center of Black Bart Road, (formerly known as Forbestown Rd.), thence along said road South 52' 19' 00' West, 24.33 feet; thence South 54° 40' 00' West, 81.35 feet; thence North 590 41' 00' West, 42.00 feet; thence South.12' 20' 00' West, 211.21 feet; thence leaving said road South 10' 57' 00' West 457.32 feet to the North line of the South 330.00 feet of said S.W. 1/4 of the S.W. 1/4 of Section 24; thence North 88' 59' 10' East along said line, 406.23 feet; thence leaving said line North 00" 02' 00' West, 628.60 feet.to the point of beginning and the end of .this •description. Containing 5.15 acres more or less. Together with and reserving therefrom a EO foot right -.,>f way for road and public utility purposes described as follows Beginning at the Northerly most point of the herein described parcel of land, said point being in the center of said Black Bart Roads .. thence leaving said road, South 68"722' 00' East, along theenn� line of the herein described parcel'of land, 163.46 feet; leaving said North line, South 000 02' 00' East, 64.57 feet; thence North 68° 22' 000 West, 225.13 feet to the center of said .Black Bart Road; thence North 54° 40' 00" West along the center of said road, 46.61 feet; thence North 520 19' 00' East, 24.33 feet to the point of 5eginning and the end of this description. Reserving therefrom a life estate for the grantor Zelma Sowell. .r �. -.. _�.,�„t�...Yy .r '�.:}r.y r... . f��.. ,`.J . --... ✓,' . .'y: .,� .. _, w � � t� r y �r `'. permit#839-85E Donald Smith Black Bart Rd .i n GG ,OFFICE COPY o a9 Address lee YG y: b Dates � ELECTRIC° r °Meier By 'n v Date, a COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS' 7 County Center Drive - Oroville,talifordia 95965 - Telephone 916/534=4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER , '7 a -.'q= ? f, ZONING /A S - BUILDING PERMIT OWNERn 4 F�rlO 14� TELEPHONE / SO. FT. OCC, BUILDING VALUATION MAILING ADDRESS WN C- I ^ lV �,)'s T-) CONTRACTOR'SNAME O\ � A Q' TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10•00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEERLICENSE FYY� Q NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESSll S � 5 '� /-� �k � � T �,� �ctivn PLUMBING PERMIT Filing Fee 10.00 -V/ 0 l/11 t o rbt fiN) ti Each Trap 2.00 Solar Water Heater 20.00 t` C\ Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G] W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel Q Utilities ❑ Installation❑Other ❑ Describe work: rl• Io.c'n Y l 11thtJl v fy ^ C nn ���� J Rh,, IA1\IYV`,C1 `' ��K/1tC1 U)10I \I �(1 -Q�� UQ:y Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service a°Dv OR LESS 100 AMP OR LESS 10.00 /� �/-� IV•W �( �\� p I J�� 1 �J Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADONS. ACC. BLDGS. I 2h2sgit 1 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification • Q I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) , ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. MULTI -OUTLET 2,50 ea No N•RESID BRANCH CIRC ITS NEW CONSTRL POWER APPARATUS & NON.RESID. SINGLE OUTLET CIR. Ex. Occu 20 @50C P�ourLETs OR FIXTURES eALeaosr FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Q J, Contractor MECHANICAL PERMIT FiIingFee 10.00 •:�';.-' •��. , ' 1" i WORKMEN S COMPENSATION.INSURANCE I declare under penalty of_perjuryr,(check one):.'`' ❑f"Thepermltls,for $100.00 (valuatlon)'or. less. ❑e I�"yetplaced'on flle;w th'the,,,County.of Butte Building Department .,a c- iflcate'of`Workmen s, Compensation Insurance or a Certificate 1—I" 'ofConsent,to Self-I6sftir it+,.t. t ' s� + � ' 1'.1 hall not employ any person�n any manner so as to become subject ,.,tothe W ;C"laws of;California. Not lce.to 'App licant.If'after;mak irig�this.statement, should you become subject to the.W. C: provisionsfoflthe;Labor.Code; you':must forthwith comply with such provisibns or. Y.this;permit+shall'be'deemed:revoked.;' . Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify`that`I�`have7read�this'applicat iori 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. 1 also agree"'6 save, indemnify and keep harmless the County of Butte against all liabilities, judgments, _costs, and expenses which may in any way accrue against,,66aid Couunnttyy�iri consequence•of the granting of this permit. X-2��j Date Signature of Applicant — Owner,O Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures ovelr73 stories in height. I Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE OF CONST. I PARCEL PD I ND 1 ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. r•1 DIRECTOR OF PUBLIC WORKS By � / Date PERMIT EXPIRES Date Receipt No. � / a 7 2 WHITE-D.P,W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Ctliforni195965,. Telephone 916/534-4541 APPLICATION AND PERMIT PEjaMLTN. ASSESSOR PARCEL N BER ZONI G —S' BUILDING PERMIT OWNER �� TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWN E . MAILIG ADDR SS (419 WS & 0M CONT ACTOR• NAME /q'�, `A \� V A V_ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING AD ESS PLUMBING PERMIT - Filing Fee 10.00 S III, J �� Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME- PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home S I G I W 10-00e TYPE OF WORK New ❑ Addition ❑ Remodel Utilities ❑ Insta,11ationEl Other ❑ Describe work: 4PA 1A bn,S Permit Fee $ Contractor ELECTRICAL PERMIT FiiingFee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 , • Main service EA. ADD'L 100 AMP 2.50 r NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 21h2sq ft CO RACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification i, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW NO R BRANCH CIRCTITS 2.50 ea NEW CONSTR POWER APPARATUS & NON.RESID. SINGLE OUTLET CIR. Ex - Occup OR FIXTURES Occu 20e50a BAL®so FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Q �r 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 Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agre o save, indemnify and keep harmless the County of Butte against all liabil' i s, judgments, costs, and expenses which may in any way accrue against d Cou y ' c n quencehof t e granting of this permit. /�C'� J Date (i 3 Signature of Applicant — Ownerg] Contractor ❑ Agent ❑ An OSHA permit is required for excavations over S'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP TYPE OF CONST. PARCEL PO HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DE AF PUBLIC I By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date �� Receipt No.. 2 WHITE-D.P.W., YELLOW-ASSeSSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS A 7 County Center Drive - Oroville, California J5965 - Telephone 916/534-4541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT N0. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall Jt be a place used by the public. ASSESSOR PARCEL NO ZONING J OWNER S S' PHONE NO. g" t OWNER'S ADDRESS S LOCATION OF UILDING s s"R dI.s USE OF BUILDING d '-' SIZE OF STRUCTtqE Ca 4 - ' X = SQ. FT. TYPE OF CONSTRUCTION: WOOD FRAME'IOSTEEL CONCRETE OTHER (Specify) TYPE OF SIDING ROOF VEJI G FLOW3 TYPE ESTIMATED COST OF CONSTRUCTION $ I S70 AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows•, ''-, I S S FRONT SIDES REAR - AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used'as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to -comply with the requirements in effect at that time and before occupa Date S KS^ Signature of Owner Permit Fee - $25.00 The above described AG Building is exempt from a building permit. Receipt No.Director of Public Works By '' Date White - DPW, Yellow - Assessor, Pink - B. I., Goldenrod - Applicant • J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Permit No. - OWNER nil );4A. P. No. r 9� Proposed Building Use Permit Fee Based Upon: Complete Contract Price DPW Valuation Other (Explain) Building Inspector. Date the following data must be submitted prior to permit processing At time of permit application, I w .A advised and:/or issuance: DATE'RECEIVED. APPROVED 1. All items have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate./triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . 4. Complete engineered plans and calcs... . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of .$ 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking:- 12. arking: 12. Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif.) X14. Owner -Builder Verification (Given to owner[], Mail to owner ) 15. Improvements may be required. . . . . . . . . . , , 16. Mobilehome Installation Data. . . . . . . . •Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector (Date) Recorded copy of Ag icultural Ac�owledgment Stateme t. Other �% � '0 \\ C I I S 1 When you issue the permit, process as follols: `Mall to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w./inspector. Other Appl icant :' , ,� , Date S �S— Copy of plans sent Health Dept., Fire Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone—Mail Other By Date Plans checked by Date Plans approved by Date Other: Copy—DPW i WHEN RECORDED MAIL T`, qy�9 wa MAIL TAX STATEMENTS TO: WWI D€�FtTy OWN I�F11 E EAkQ:t M. G5 • `•`F� �� HK - FBF . •iU�a SPACE ABOVE THIS LINE FOR 11ECO11OE11'S USE DOCUMENTARY TRANSFER TAX S 0 _ . Computed on the comWwatbn or vaius of peoperty conv.YW: OR Computed on the consideration or value )ea Ilrn or enoun wore e remaining of time of sale. Eleatwe a Uwiwert or Apnt dowminias w — Firm Name i GIFT DEED i IN -CCNSIDERATION of the lova and affection which the grantor bear S to the grantee S Zelr4Z.Howell a single woman, known to me to be the wha" name T,,,_> and to Don Smith and Sharon Smith �. dces..hehtiy fly. fl►a^t convey husband and wife .as..'Jo'int tenants, EW. DAMLMEIER sig•: • t1Ca y'vj�l "�S.�t,. `• -• NOTARY PUMJC-C"OFOAA 91 :`` �a11.a1iat'fpl aromw in ther+ttr-es- S.W. 1/4 of the S.W. 1/4 of Co Inty.of Butte E. Section 24, T -19N R -5E M.D)M.; , State of California, descnbed as WITNESS Inv and ottk:ier ted. --,Slipmewre *'?:JFollows j MO ►M.e. OIMIW CA EeeEa ,See Exhi'-)it A attached 'hereto and made apart hereof; (J, (Thio area for official noteriel o aN) 'JS,r%1i4,rn1 at .v Dated STATE OF CALIFORNIA 1 COUNTY AF On – before mer ow undwsired, a No Pubilc M for saw State, peniondly pp— gp?: - , ,l �E 1 known to me to be the wha" name T,,,_> sibecribed 10 t� �wdthin instrument end ackne.wledwd that i EW. DAMLMEIER ex ecu Nd the some, NOTARY PUMJC-C"OFOAA 91 WITNESS Inv and ottk:ier ted. --,Slipmewre MO ►M.e. OIMIW CA EeeEa (J, (Thio area for official noteriel o aN) A I t I 2elma Howell �E 1 W C EW. DAMLMEIER NOTARY PUMJC-C"OFOAA 91 of Wnateesiau Etat Date 17. 1906 MO ►M.e. OIMIW CA EeeEa (J, (Thio area for official noteriel o aN) 1 ORA 110/691 V Beginning at a point in the East line of said S.W. 1/4 of the S.N. 1/4 of Section 24, said point being North 000 02' 00" West, 330.00 feet from the Southeast corner of said S.W. 1/4 of the S.W. 1/4 of Section 24; thence North 000 02' 00" West along said East line, 458.44 feet; thence leaving said east line, North 67° 47' 00" West, 236.10 feet, thence North 68° 22' 00" West, 200.00 feet to the True Point of Beginning for the herein described parcel of land; thence from said point of beginning, continuing North 68° 22' 00" West, 163.46 feet to the center of Black Bart Road, (formerly known as Forbestown Rd.), thence along said road South 520 19' 00" West, 24.33 feet; thence South 540 40' 00" West, 81.35 feet; thence North 59° 41' 00" West, 42.00 feet; thence South 12° 20' 00" ,• West, 211.21 feet; thence leaving said road South 10° 57' 00" West 457.32 feet to the North line of the South 330.00 feet of said S.W. 1/4 of the S.W. 1/4 of Section 24; thence North 880 59' 10" East along said line, 406.23 feet; thence leaving said line North 000 02' 00" West, 628.60 feet to the point of beginning and the end of this description. Containing 5.15 acres more or less. I'. Together with and reserving therefrom a 60 foot right of way for road"and public utility purposes described as follows; Beginning at the Northerly most point of the herein described parcel _ of land, said point being in the center of said Black Bart Road; thence leaving said road, South 680 22' 00" East, along the North line of the herein described parcel of land, 163.46 feet; thence leaving said North line, South 00° 02' 00" East, 64.57 feet; thence North 68° 22' 00" West, 225.13 feet to the center of said Black Bart Road; thence North 54° 40' 00" West along the center of said road, 46.61 feet; thence North 520 19' 00" East, 24.33 feet to the point of beginning and the end of this description. Reserving therefrom a life estate for the grantor Zelma Howell. 4 t, � OF�p,1ME v 0 W vr'� 1 L '2;71c'�}4r l:. �.. Cf�• �e�1 l 1 �t�= ♦i CEJ -� u i �i'f - - k