HomeMy WebLinkAbout072-330-02372=33-23 - r
ART LEINGANG'
Send Firecamp Rd."Off. S./$ Sandra Lane ,
Oroville
•72-33-23
Permi , 03-84P(gas piping/existing site
Permit#-qj3-84 I 7 33-23
(xisting site)
lool Lied
072-330-023 05-2977
LEINGANG, ARTHUR _ ).
690 FIRE CAMP - I E
Cont: OWNER
ELEC SERV
J
�, M
N
� Butte County Department of Development Services.
V euT2e,
AREA
1 ® T E S 7 County Center Drive, Oroville, CA 95965
(530) 538-7601 v{ww.buttecounty neudds •cOp"�{
RESIDENTIAL
APN: Permit No.
Owner- 072-330-023 _ 05-2977_
LEINGANG, ARTHUR i
Site Address: .690 FIRE CAMP, OROVILLE
1 Cont: OWNER
Contractor. ELEC SERV
Type of Permit'.,_
OFFICE COPY
Address
d
GAS
Meter By ate
ELECTRIC Date I
Meter By r
L
SRA
FLOOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUBSTANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
DATE JOB FINALED:
SIGNATURE:
�111
OK
Not OK
MANUFACTURED HOMES
MISCELLANEOUS
DATE PERMANENT FOUNDATION Lj 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 LPO
Inch Sz Ft Lngth
7 Blckng; Sz-Spacing-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 D E C K S -C O V E R S`C ARP O RTS `G A R A G E S
1 Zoning -Setbacks -Easements
! 2 Ftgs; Soils-Sz-Dpth-Spacing-CnnctrsSteel
3 Decks, Girders/Joists-Dcking-Brcing
i Stairs-Guard/Handrails
4 Wood Awn; Posts -Beams-Rftrs-Cnnctrs-Shthg
Frmg-Brcng
5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs
6 Carports; Wndws-Doors
7 Electric
8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof; Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wall pnls
DATE IPOOLS
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-GFl
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-Enclsrs-pniboards4nsultn to Main Conduit
9 Health Dept Apprvl
10 Plmb; Cir Test-Wtr Supply Test '
11 Lt Niche
12 Encisr; Fencing -Alarms
13 Bonding, Diving board or Slide
Pool Drawing
= OK
0 = Not OK
RESIDENTIAL (Single & Duplex)
DAIt JUNDERFLOOR
DATE IPLUMBING
1 Zoning -Setbacks -Easements -Flood -Slope
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
2 Ftg Main; Soils-Elec Grnd Ftg Dpth
54 Wtr Pipe; Test & Anchr-Nail Prtctn
3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth.
55 DWV; Test Fittings & Anchr Nail Prtctn
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth
56 Shwr Pan; Test, First flr-Tub Acc
5 Stemwalls Main; Steel-Blockouts-Wrapped
57 Test Tub & Shwr, 2nd fir - Tub.Acc
6 Stemwalls Garage; Steel -Blockouts-Wrapped•
58 Gas Pipe; Sz & Anchrs
69 Hold Downs and Special Anchrs
59 Fire Sprinkler; Test
7 Slab, Steel Wrapped
60 Yard Gas Piping
8 Piers-Frplc Ftg-Steel
9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
o9e 0\\C Oho \\C
o
1l Wtr Pipe; Test-Anchrs-RgltrService Test
12 Elec Undrgrnd
DATE IMECHANICAL
13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn
61 AC Ducts Insultn & Support
14 Girders-Sills-Anchr Botts-Joists-Vnts-Cripples
62 Vent Fan, Exhaust abv Insultn
15 Acc & Vntltn
63 Condensate Drain & Ovrflw, Sz & Grade
16. Insulation
64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
o+`' 0 0+`` 0•
DATE IFRAMING
17 Sills Proper Materials & Anchrs
DATE F I N A L
18 Walls Studs -Nailing Spacing & Braces -Plates -Sound
66 Ext Steps -Door & Side Lt Prtctn-Landings
19 Bearing Walls over Girders & fir Nailing
67 Smoke Detector
20 Draft Stop in Walls (rat proof)
68 Furnace Vnts-CImc-Comb, Air-Cnnctr
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
In Garage; abv-flr-Ducts-Mech Prtctn
22 Headers & Beams-Sz & Bearing
69 Bedroom Exiting
23 Hangers -Post Caps-Anchrs-Cnnctns
70 GFI & Bath Fxtrs & Tub Acc-Spa
24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg
71 GFI Arc Fault
25 Frplc Ties or Type A Flue-Frplc Throat Clmc
72 Elec Trim & Subpnl, Breaker S7s & Labels
26 Attic Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles
73 Stairs, Guard/Handrails
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
74 Frplc or Stove, Clmc-Hearth
28 Garage Fire Prtctn Framing -RC Cliannel
75 Elec Outlets at Wood Pnl, Int & Ext
29 Prprty Line Firewall & Opngs
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clmc
30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits
77 Elec Outlets & Rcptcls at Ktchn Counter
31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn
78 Garage Fire Door; Swing -Landing -Closure
32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs
79 AC Duct in Garage -Damper
33 Siding -Nailing Veneer
80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV, abv fir
34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc
Mech Prtctn; LPG Appince Undr House 3" drain
35 Glazing Area -Glass Prtctn-SkyLts-Plastic
81 Plmb; Elec & Mech Eqp Listed for Loctn
36 Shear Walls; Nailing -Bolts
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
37 Brace Int/Ext Wall pnls
83 Insultn-Foam-Looked in Attic
38 Insultn-Walls-Ceilings
84 Guard Rails & Deck Cnstrctn-Post Caps
39 Infiltration-Walls-Wndws
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 CImc Drnge Planters ❑Yes F-1 No
87 Stucco Brown -Finish
o' o o'er vT
88 AC Unit Dscnnct, Elec-Plmb
89 Vnts abv Roof, Plmb-Appinc-Frplc-CImc to Opngs
90 Wtr Well, Dscnnc% Elec, Plmb
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
DATE JELECTRICAL
40 Fxtr & Trnsfrmr Clmc4ns Prtctn
41 Elec Rcptcls Spacing-Lts & Switches at Doors
92 Vntltn thru House
42 Sz Boxes & No Of Cndctrs Stapled
93 Glass Prtctn
43 Romex Installed Close to Edge of Studs & CJ
94 Corrections from previous Inspctns
44 Eqp Grnd made up w/Mech Fstnrs
95 Gas Test -Meters Tagged, Gas-Elec
45 Grndng Electrode Bond Gas & Wtr
96 Wtr & Sewer Cnnctd-C/0 to grade -HD Apprvl
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
97 Energy Cmpinc Cert -Other Certs
47 Subfeed Wire Sz c= ❑ CU or [I AL
98 Address Posted
AC Wire Sz 9 ❑Cu or ❑AL
99 Fire Sprinkler
48 Range Circ ga ❑ CU or El AL
Oven Circ ga ❑ CU or ❑ AL
Insulated Neutral ❑ 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
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.
BPO52977
B. C. Building Permit 01-16-04 pg 1
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 10/31/2005 APN: 072-330-023-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number:
Site Address: 690 FIRE CAMP RD ORO
Date: Contractor:
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: ELECTRICAL SERVICE
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: LEINGANG ARTHUR A & PATRICIA A
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commericing with Section
690 FIRE CAMP ROAD
7000) of Division 3 of the Business and Professions Code) or that he or
OROVILLE, CA
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
9.5966
applicant to a civil penalty of not more than five hundred dollars ($500).):
Ijd' 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
owner of property who builds or improves thereon, and who does
Applicant: LEINGANG ARTHUR A & PATRICIA A
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or Improvements are sold within one
690 FIRE CAMP ROAD
year of completion, the owner -builder will. have the burden of
OROVILLE CA
proving that he or she did not build or improve for the purpose of
,
sale.).
95966
❑ 1, as owner of the property, am exclusively' contracting with
(530) 589-5425
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,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor:
❑ 1 am Exempt under Article 3,4 the Business and Pr fe io s Code
0atwp��l—� Owner:
WORKERS' COMPENSATION DECLARA 0
I hereby affirm under penalty of perjury one of the follovting declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
License #:
Labor Code, for the performance of the work for which this permit
is issued.
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
insurance carrier and
Engineer:
policy number are:
Carrier:
Policy #:
Total Square Ft: 0 S. F.
❑ 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
Valuation: $0.00
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith
M
comply with those provisions.
��.
Date:
},
110103
Applicant:
-05
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.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutio s to do work Indic ed above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
' ^- 1` O r
By� Date: _ (J 1 `J
Address:
s i
PERMIT EXPIRES ON: FO -3 1. 0cn
(Date)
C 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.
C 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 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 d cume of Butte County. I hereby
authorize representatives of Butte County to enter upgn the above mentioned property for inspection purpos .
Print fQ-
Name: c��Signature:
Date:A-15
wner ❑ 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 INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
"PLEASE PRINT CLEARLY*
OWNER
Last Name .e
irst N e
Address 0 4/
City
Sten
C�jt
Zi
Phone s�- ��
Fax 1
E-mail
APPLICANT NAME
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Page
Fax
E-mail
Date Approved:
Lic. # Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
StateZip
Subdivision Name Map
Phone
Page
Fax
E-mail
Date Approved:
State License Number
APPLICANT NAME
Name
77[ -77 •�
_
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT S�_ ' �'1i
For office use only:
Zoning
PropertyAddress
,6�0
Flood Zone
SRA
Yes
No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO.
a 52477
BIN #
LOCATION
AP#0'72^ 330023
PropertyAddress
,6�0
City
o�✓/f
Cross Street
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
-Mdres.
_Dzscription or Sco a of Work:
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
OVER FOR SUBMITTAL REQUIREMENTS L,
K:TORMSMILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
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
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.
Received by: 0 ,
Receipt #:�' ll,�
Dateloo 31- t'
co
Amount: 7), Bldg
SRA
Sheriff
SMIP
Other
Total
REV 6-16-04
SUBMITTAL 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.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER!
OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4. Letter from Engineer or Architect for truss design review.
❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to
mobile or modular homes.)
❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 8. Sanitation and site plan approval from the Environmental Health Department.
❑ 9. Metal Buildings: (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.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑
1..
4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑
2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑
3..
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑
4.
Letter from Engineer or Architect for truss design review.
❑
5.
2 Energy compliance design and supporting documentation (if required).
❑
6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑
7.
Statement of Intent for Non -heated and A/C (if required).
❑
8.
Metal Buildings: (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.
❑
9.
Letter of intent.
❑
10.
Hazardous Material Form.
❑ 11. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSMILDING F0RMSkBIdgApp1SubRgmts.doc Page 2 of 2 . REV 6-16-04
Butte County Department of Development Services
ADMINISTRATION * BUILDING * GIS * PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2140 Facsimile
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 $200 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 coniributions.
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 perforin their
work personally or through their own employees, without a licensed contractor or subcontractor, only under lirnited
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 in your
community or at 1020 N Street, Sacramento, California 95814.
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,
Scott Rutherford
Chief Building Inspector
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary
delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and material for construction of this proposed
property impr vement: YES NO [ ].
2. I HAVE [ ] HAVE NOT [ ] signed an application for a building permit for the proposed
work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME:
ADDRESS:
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:
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:
DATE: /� -- 3 l _.
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
Complainant:
Address:
Phone Number.
Other Comments:
BUTTE COUNTY DEVELOPMENT SERVICES
'`othe lc
b
ola D
t`�ii�
�.n��Ys o aile
mat
o
Inspector must draw a plot plan with all building locations:
Additional Comments from Inspector.
fX� '
,:^i:a,,•, ,.:. `L _.'le. ..h6r:1-...J �...'_���..rn i'siis/. :r:�.
72-33-23
ART LEINGANG
Vend Firecamp Rd,off SIS Sandra Lane
Oroville
72-33-23
84P(gas piping/existing site
7.3ke33-23 Ad l
Permi 633-84 I ;Vsting sit)Is
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1
1633-84MHI
y PERMIT NO. 1903-84P1
PERMIT EXPIRES 6/19/85
OWNER ART LEINGANG
CONTR. owner
ASSESSOR PARCEL 72-33-23
LOCATION S/end Firecamp Rd,/end Wayman Ln, SW
S Black Bart Rd, Oroville
1
f
Temp. Power Pole
Called PG&E
Temp. Elec. Servh
Called PG&E
4
Temp. Gas Service
t
r
Called PG&E.
JOB FINALEI
Signature
1
V = OK
0 = Not OK
= Not Applicable MOBILEHOMES MISCELLANEOUS .;
* = Not Ready '`°•:+
Date
MOBILEHOME/UTILITIES (Plans) OK except #'s
1. Zoning equirements–Setbacks Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except H's
1. Zoning Requirements–Setbacks–.Easements
2. Soils; ecial MH+S –Sketc
2. Footings; Size–Depth–Spacing–Connectors
3. Se r; Loc tion' est 0 Concrete
3. Decks; Girders and/or Joists–Decking–Bracing–Stairs–Rails
4'_ ter; L cati a Easem nt heeded (Sketch)
4. Wood Awn.; Posts–Beams–Rftrs.–Connec.–Shthg.–Rig.–Bracing
le city ation–Clearances–Grnd.–/ / Amp–Concrete
5. Alum. Awn.; Columns–Connections–Splice–Decal–Enclosures
I Gas k6o6tAh–Test–Wrap: / /"L"ft./ /"Nat.or/ /"L"ft./ /"LPG
6. Carports; Windows–Doors
7, Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date,. -'Card -BI Date
MOBI INSTALLATION (Plans) OK except #'s
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except Ws
1, 7wnin equirements–Setbacks–Easements
1. Setbacks–Easements
2. F ting , 6ize–Spacing–Marriage Line
2. Soils; Compaction–Structure Stability
3. '6a,"_H H Test–Demand–Valve–Connector
3. Pool Structure; Steel–Connections–Thickness–Dead Men–Lining
4. E ctric,ity; MH Test–Crossovers–Breakers–Clearances
4. Elec.; Receptacles and Lighting; Distances–GFI
5 Dr ' MH Test–Fall–Flex Connector
5. Elec.; Pool Lighting; 15 volts–GFI
6 MH Test–Regulator–Connector
6. Elec.; Enclosures; Conduit Entries–Terminals–Listed
7411Wpefoind Sewer Connected–C/0 to Grade–HD Approval
7• Elec.; Bonding; Metal w/5'–Circulating Equipment–Heater
6-'_gia.land,erectricity Tagged
8. Elec.; Grounding; Equip. w/5'–Circulating Equip.–Pool Lghtg.
Boxes– Enc losures– Pane lboards– Ins. to Main in Conduit
00, s; Insp.–Sketch
Cert. f Occupancy 17
9. Health Department Approval
10. Plumb; Cir. Test–Water Supply Test
Card B-1
Date > C -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date and -BI Date
Card -BI
Date Card -BI Date
Of
J = OK
0 = Not OK -
- = Not Applicable
�E = Not Ready
RESIDENTIAL (Single and Duplex)
Date
UNDERFLOOR Plans OK exce t#'s
Date
FRAMING (Continued)
1.
Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings
2.
Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4.
Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
51.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
52.
Siding -Nailing -Veneer
6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7. Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
8. O.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Date
FINAL (Plans) OK except N's
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI
Date
Date Card -BI Date
PLUMBING (Permit) OK except q's
14. Water Ht.; Vent -Access -Combustion Air
15. Water Pipe; Test & Anchors -Nail Protection
57.
58.
Smoke Detector
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.Test
Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
Card -BI
Date Card -BI Date
64.
Elec. Outlets at Wood Panel; Int. & Ext.
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date
Date Card -BI Date
ELECTRICAL Permit OK except q's
66.
Elec. Outlets & Receptacles at Kit. Counter '
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
20.
Fixture & Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
21.
Elec. Receptacles Spacing -Lights &Switches at Doors
70.
Plb., Elec. & Mech. Equip. Listed for Location
22.
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23. Romex Installed Close to Edge of Studs & C.J.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72•
Insulation -Foam -Looked in Attic ❑ Yes
73.
Guard Rails & Deck Construction -Post Caps
25. 2 Appliance Circuits in Kitchen & Conductor Size
26.
Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes ❑No
75.
76.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters E-) Yes E) No
Stucco; Brown -Finish J
28. Service -Riser Conductors & Ground -Main Disconnect
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
77,
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size-115V.Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -BI Date
81.
82,
Ventilation throughout House ,
Glass Protection
Card B -I
Date
Date Card -BI Date
MECHANICAL (Permit) OK except q's
31. A.C. Ducts; Insulation & Support
32. Vent Fan; Exhaust above Insulation
83.
Corrections from Previous Inspections
84.
Gas Test -Meters Tagged; Gas -Electric
85.
86.
Water & Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates
33.
Condensate Drain & Overflow; Size & Grade
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date 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
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.
Cing. Joist-Rftr. Ties-Purlin- Roof
_Brac.-Truss_-Shthnp_.-Rfn_g_._
44. Fireplace Ties or Type A Flue -Fireplace Throat
45.Attic
Access; Size & Romex Protection -Draft Stop -Ins. Baffles
46.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
Garage Fire Protection Framing
(NOTE: Anentry must be made each time youvisit jobsite)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the California Administrative Code, Title 25, Chapter 5, under permit
number for the following location:
Owner .
Owner's Address
Mobilehome Mfg. Model Year
Insignia No. Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Director of Public Works,
Date By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
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
- APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
72 — 33—Z3
ZONING
"1 5
BUILDING PERMIT
OWNER
O'r1^A' �/
T Of_J/�2
SO. FT. OCC. BUILDING VALUATION
OWNE 'S MAILI� ,QDDR S �
CX
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is '
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT ORgE�NpGINEER
ENGINEER'S.MAILING
LICENSE NO.
Plan Checking Fee
$ S
Penalty
$
ARCHITECT OR ADDRESS
Permit fee
$
r
PLUMBING PERMIT
FiIingFee 10.00
L '.�,
Each Trap
2.00
Solar Water Heater
20.00
t,GADDRESS
ou
M6,I b� �j7�
Water piping
5.00
tUBDIVISIONIPAME
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USED STRUCTURE
SF ❑ ❑ DuplexMobilehome Other
SPECIFY
Building sewer
5.00
Mobile Home I S I G W
10.00e
TYPE OF WORK
New❑ Addition Remodel❑ Utiliti s❑ Installation M/Other❑
Describe work: — —
Permit Fee
$
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 OCCUR.&
OR ADDNS. ACC. BLOGS.
2/20sgit
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
LA�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. (Seca 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEWi.ROEs .. R BRANCH C.IRCTITS 2.50 ea
NEW CONSTR. POWER APPARATUS &1
NON-RESID, SINGLE OUTLET CIR. /
Ex. Occu 20®50e
P�o OR FIXTURES 13 L@300
FIXED A
FIXED APP LNS, 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 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.
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
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
again said Coul ¢ 1 consequence of the granting of this permit.
X Date 'n, a
Signature of App ant —ner antroctor ElAgent❑
An OSHA permit is required or excovotions over 5'0" deep and demolition or construct-
ion of structures over 3 stories i I height.
Mobile Home Installation Fee $ (�
60
TOTAL PERMIT EE
OCCUP. GROUP
I TYPE OF CONST.
F
PARCEL
PD
HD
550
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PU
10
By L
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
IC WORKS
Date 6/0
l
Receipt No. IIov's Z
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
• PERMIT N0.''
ASSESSOR PARCEL NUMBS
p0��
ZONI Ct
- --
BUILDING PERMIT
OWNER
TEL PHQNE
fQ, FT. DCC. BUILDING VALUATION
OW'S ING DDRES
T1,
CONTRACTOR'SNAME
N C/r
T L HONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$
Penalty
$
ARCHITECT ORENGINEER'S MAILING A DRESS
Permit fee
$
BUILDING ADDR
-
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
Water piping
5.00
LOT NO.
SUBDIVISION NAMEPARCEL
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 W
0.00 a 6, 610
TYPE OF WORK
New ❑ Addition Remodel ❑ Utilities Installation Other ❑
Describe work:
lO
Permit Fee
$ d
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 ADDNS. ACC. BLDGS.
/ 2/20sgft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check One):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR U TI.OUTLET 2,50 ea
NON.RESID BRANCH CIRC ITS
NON NEW -CONSTR RESID. SINGLE OUTLET CIRPOWER APPARATUS . &
Ex. Occu / 20®50a
P\OUTLETS OR FIXTURES BAL®ao
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 $
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
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 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 againstOCCUP,
all liabilities, judg nts, costs, and expenses which may in any way accrue
agains said C un ognsequence of the granting of this permit.
.P- ,,�r'
%� Date
Signature of Appl'cant _f Own r Contractor ❑ Agent ❑
An OSHA Perm' is required for excavations over 5'0" deep and demolition or construct-
ion of structures over ren
stories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE
GROUP
TYPE OF CONST.
PARCEL
PD
ND
S uE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DVRECOR F PUBLIC
BY 0
PERMIT EXPIRES Dat
the applicable provi-
resolutions to do
fees have been paid.
WORKS
—Date
/
Receipt No.i (j
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
11Y7 4 --vl/
Opo Vl�/e 4,
Ass— N••R4 •ggex
;13
chis set of plans and specifications MUST be
cept on the job at all times and it is unlawful to
make any changes or alterations on same without
written permisson 'from the Department of Public
Works, County of Butte.
NOTE:—All Mcaferials ' Workrnanshi Shall Be in
Accordance with R`.cc,-,,ni e ; t:y, -f Procfices and
of a quai'fy Prgr-
o•� t':':�c ,ir, CI�tC':� I -e in
Uniform Guidi,,g, d,ju;;;b; �c• wr ' fhe
fhe National Elecfrical Code, r. ec ,ai;iccl Codes and
A setback of '5 ft.
propert a rom the
Y lines and a setback
Of 50ft. from the r
oad
centerline shall be clear
`structures or e ar of
for a 2 ft. eavquipment eXt'��fi
e overhang,
m A4f
aS 43oIA. A*
z �
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED �j
MOBILEHOME SUPPORT DATA
�. If other than single wide, 9
Mobilehome Mfr. 4.0 furnish Setup Model No. Year
Width /� (ft.) Box Length 20 (ft.) Tagalong or Expando Size /A_'ft. x ft.
T
(SHOW 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).
All center supports measured from front of
mobilehome unless otherwise specified.
I \c\Foot inns (check one)
Single W. 1111,. Wood either
pre, ssure treated or
foundation grade.
Center\
locat
*If center piers are other than drawn above,
.-draw im•locations, spacing, and dimensions.
2. Other: (specify)
Supports (check one)
[g/1: Concrete block.
•2: Other, (specify)
Tagalong or Expando,'
show support -details.
I -- Typical Support
in.) Footing Size
-- Max. Pier Spacing
-- Max. Overhang
.BUTTE COUNTY
BUILDING DEPARTMENT
-APPROVED
BUTTE COUNTY DEPARTMENT OF.PUBLIC.WORKS
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's name:
2. Installer's name: -
3. Is the
ame:
1
3.Isthe site currently under permit? Yes / / No /,K / , •
s
(If yes, furnish permit number ) OR
Is the site an existing site? Yes / / No
(If yes, furnish two (2) plot plans.)
1
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
-7-
(If no, clarify , )
S. What is the mobilehome electrical rating? --- -� ------ Amps
---- ---- s
10
6. What is the mobilehome site service rating? � Amp
7.. What is the 'mobilehome'site circuit ,breaker ratingF� �- APs
8. Is there any other electric load to be served by the mobilehome
siteservice? --------------------------------- Xi ------------- Yes No %
Xi
(If yes, identify the load and size: (Load) (Amps)
--� _��
9. What is the mobilehome site gas pipe size. - - y (in.)
+ ----------- Natural
LPG /
10. What is the type of gas service?----
11. What is the gas pipe length from meter or tank to the mobilehome? �� (ft.)
` C
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.) �.t��,�.�
� r
I
Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT OFFICIAL RECOFO�
FOR RESIDENTIAL, bEVELOPMENT ou-7,E COUNTY-0
yl•1"
is2E0t3E'::TE
Section 26-8.1 of the Butte County Code requires• this acknowledgement PARTY SHOWN,
be recorded prior to issuance of a building permit: 49
The property described herein is adjacent to land or included fLEAN01• 1344•
within an area zoned for agricultural purposes, and residents of thip.Eft*K-RFCUKDER
property. may be subject to inconveniences or discomfort arising from 34-19876 Ff_
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:
Date: May 30, 1984 PR ERTY OWNERS:
State of California ) On this the 30th. day of May 19 84 , before
SS. me, the undersigned Notary Public, personally appeared
County of Butte. )
Patricia A. Leingang
Personally known to me. LX/ Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose iiame(s) ;., subscribed to
the within instrument and acknowledged that h,,
executed
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
A,7J&
CLQ
tary bl
— Z OFFICIAL SEAL
Present A.P. No . '72-- .� 3 Q� , DORTHY M BURNS C
NOTARY PUBLIC • CALIFORNIA'
K2.
BUTTE COUNTY Cr%�
My comm. expires MAY 25, 1981
END OF DOCUMENT
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