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072-340-021
} ,s-.- � �.r-.. 'sf7 ^•its', �& . - �o ��,. �� ' ly♦ _ �_�,,,,,_ -� - — •- y�� — - - ti /a -,544- a / A. P DONALD M. BLOODGOOD n/s Black Bart, Rd . -: mi:. east Fire Camp Rd . , Oroville Permit 266.-72P,E ! (utilities for mobile -home"••••-••'••••♦•--•---- A. DONALD M. BLOODGOOD n/s Black Bart Rd. ! mi. east of Fire Camp Rd ., Oroville ° _ -23 CONTR: North Valle wring, Yuba City Permit 815-73B W. covered deck.&-.,awning..for m,. home)--? 072-340-021 ,, 1103-3417 SMITH, WILLIAM & KAREN 491 BLACK BART F -D, ORO? fILLE . Cont: OWNER RE TAG ELEC'. E: 672-340-021'-'- • y 04-0091 GEORGE'STEVEN 491 BLACK BART RD, O,ROVI°LLE . `CONT: OWNER` MISC ELEC r B07A791 r-1� �I I��/2-340-021 RESIDENTIAL SFD-Mobile Home RET' EX MH EX SITE PERM'FNDN (800) 491 BLACK BART RD GEORGE; STEVEN & YVONNE i 107 { I, i 107 Ar � , r BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 2 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-0791 Issued: 04/13/2007 Address: 491 BLACK BART RD Area: OROVILLE Owner: GEORGE, STEVEN & YVAPN: 072-340-021 Applicant: SIERRA MOBILE SERVIMap Page: Permit Type: SFD-Mobile Home RET Description: EX MH EX SITE PERM FNDN (800) Flood Zone: None SRA Area: Yes SETBACKS Front Setback: Side Setback: Rear Setback: Other Setback:. Minimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 ShearwalUB.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 1 802 177A fi�� FirlaIs 7 Inspection Type I IVR I INSP I DATE Do Not Insulate Until Above Signed Wall Insulation I 117 Ceiling Insulation 1 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation _System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: SKYLINE CORP Date of Manufacture: 1973 Model Name/Number: Serial Numbers: S375478U/X Length x Width: 40 X 20 Insignia: 81529/30 Pubiltc Works Fina 538-7681 Fire Department/CDF 538-7111 Env. Health Final 538-7281 Sewer District Final **PROJECT FINAL 801 rrolect rural is a certificate of occupancy for (Residential Only) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 491 BLACK BART RD Owner: Permit No: B07-0791 APN: 072-340-021 GEORGE, STEVEN & YVONNE Issued Date: 04/13/2007 By KEJ Permit type: RESIDENTIAL 491 BLACK BART RD Subtype: , SFD-Mobile Home RET OROVILLE, CA 95966 Expiration Date: 04/12/2008 Description: EX MH EX SITE PERM FNDN (800) Occupancy: Zoning: MR Contractor Applicant: Square Footage: SIERRA MOBILE SERVICE & SUPPLY SIERRA MOBILE SERVICE & Building Garage Remdl/Addn 466 CIRCLE DRIVE 466 CIRCLE DRIVE OROVILLE, CA 95966 OROVILLE, CA 95966 (530)534-0599 (530)534-0599 Other Porch/Patio Total FEE INFORMATION DBF MH Plan Check $219.96 DBMSC Mobile Home $329.94 Total Charged: $549.90 Fees Paid: $549.90 Balance Due: $0.00 Receipt No: B2640 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License SIERRA MOBILE SERVICE & S 470386 / C47 B / 03/31/2007 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 04/13/2007 penalty [$500]; Please check one of the following: Contractors Signature Date ❑ 1, 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 Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND WILL MAINTAIN the work himself or herself or through his or her own employees, provided that such improvements ❑I A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I'HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by la u Section 3700 ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: State Fund policy Number: 046'002126LExp. Dale:01/01/2008 Contractor's License Law.). (This section nee not be completed if the permit is or one hundredollars ($100) or ass. ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 04/13/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date provisions. X04/13/2007 1 hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorizep to act on thiVroperty owner's behalf. - / D 04/13/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner ID -Contractor OR Agent for Owner Agent for Contractor FILE COPY Lenders Address City State Zip • RECORDING REQUESTED BY MID VALLEY TITLE & ESCROW CO. AND WHEN RECORDED MAIL TO: STEVEN GEORGE 1136 Bald !tack Rd Berry Creek, CA 95916 I 20103-92P9208221 I Recorded Official Records County Of BUTTE CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 09:00AM 21—NOY-2003 REC FEE 10.00 TAX 49.50 MONUMEN 10.80 Kathy Page 1 of 2 Above This Line for Recorder's Use Only A'.P.N.: 072-340-021 Order No.: 215336AiM-ORO-C Escrow No.: 215336AM GRANT DEED THE UNDERSIGNED GRANTOR(s) DECLARE(s) THAT DOCUMENTARY TRANSFER TAX IS: COUNTY 49.50 X ] computed on full value of property conveyed, or computed on full value less value of liens or encumbrances remaining at time of sale, ] unincorporated area; [ ] City of _, and FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged, WILLIAM RAY SMITH and KAREN ANNE SMITH, Husband andWife as Community Property With right of . survivorship hereby GRANT(S) to STEVEN GEORGE and YVONNE GEORGE, Husband and Wife as Joint Tenants the following described property in the City of UNINCORPORATED AREA, County of Butte State. of California; SEE ATTACHED ]LEGAL DESCRIPTION WILLIAM RAY SMITH ' KAREN ANNE SMITH Document Date: _November 16, 2003 STATE OF CALIFORNIA )SS COUNTY OF ) On I i 01 L -to before me, personally appeared -,)b ASW personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s) on the instrument the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS m and and official e Signature This area for official notarial seal. LoJASON VANDENBERGComrrtls M `]402657NoforyTublic--CdlKt mloButte Cotuit +ny. eta M. Feb2�, Mail Tax Statements to: SAME AS ABOVE or Address Noted Below ��C Order No. BU -215336-3 AM Description' The land referred to herein is situated in the State of California, County of Butte, and is described as follows: COMMENCING AT THE INTERSECTION OF THE CENTERLINE OF THE BLACK BART ROAD WITH THE NORTH -SOUTH CENTERLINE OF SECTION 24, TOWNSHIP 19 NORTH, RANGE 5 EAST, M.D.B. & M.; THENCE NORTH 0° 30' 08" WEST, ALONG THE SAID NORTH -SOUTH CENTERLINE, 526.612 FEET; THENCE EAST, 170.678 FEET; THENCE SOUTH 01° 41' 56" EAST, 236.104 FEET; THENCE SOUTH 19° 39' 57" WEST, 295.623 FEET TO A POINT IN THE CENTERLINE OF THE BLACK BART ROAD AND THE TRUE POINT OF BEGINNING FOR THE PARCEL OF LAND HEREIN DESCRIBED; THENCE FROM SAID TRUE POINT OF BEGINNING, NORTH 190,39' 57" EAST, 295.623 FEET; THENCE NORTH 010 41' 56" WEST, 136,104 FEET; THENCE SOUTH 850 58' 55" EAST, 226.172 FEET; THENCE SOUTH 070 36' 04" WEST, 185.829 FEET; THENCE SOUTH 49° 50' 33" WEST, 230.671 FEET; THENCE SOUTH 019 08'06" EAST, 30 FEET TO A POINT IN THE CENTERLINE OF BLACK BART ROAD; THENCE SOUTHWESTERLY ALONG THE CENTERLINE OF SAID ROAD TO THE TRUE POINT OF BEGINNING. APN 072-340-021-000 Xi2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering Xi2 Concrete System Engineer Approval State Approval MANUFACTURED HOMEIMOBILE HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE, SECTION 18331 APPROVED SUBJECT TO CORRECTIONS NOTED APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS ANQ REGULATIONS Stft of California Dvw mw *(Homing nod Commu dw De'dopa OF C"ES AND S ANDARDS ti..: %) AIiQ 1. - - BUTTE COUNTY c, BUILDING DIV14SION PPROVED (31 ` Page 1 of 8 0 Li 0 0 0 Xi2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering REQUIREMENTS • These plans and specifications meet the requirements of Title 25 Section 1336.3 Sub Section A and 97 UBC Seismic Requirements, CBC 2001 addition. • Maximum vertical projection at sidewall is 9'. Higher walls may be used when the design loads are adjusted accordingly and approved by HUD. • Main rail spacing must be 75.5" - 99.5" * Except single sections 95" minimum • Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, and rim plates. The longitudinal component of the Xi2 system replaces end frame ties. Check manufacturers set-up requirements. • Maximum pier height is 48" pier. *Except for single sections 36". • Steel piers must be fastened to the I-beam with clamps provided with steel pier. • Systems must be placed as evenly as possible, no more than 10' from end of home. • Designed for 7:12 roof slope. *Except single sections, (20° - 4.37 in. 12" pitch). Additional Requirements for Concrete Systems • Poured concrete must be 2,500 PSI minimum at 28 days. • Square concrete pads minimum is 18" wide by 12" deep. Round concrete pads minimum is 18" wide by 14" deep. Strip footings minimum is 18" wide by 14' long by 6" deep. ®> * Xi2 components exceed HUD code 3280.306g "Anchoring equipment exposed to wea hgring shall ha�a�L;� resistance to weather deterioration at least equivalent to that provided by a coating of zinc on steel of not less than 0.30 ounces per square foot of surface coating...." Page 2 of 8 0 .. o Installation of Xi2 Ground Systems 1. Identify the number of systems to be used on the home using the chart provided. 2. Identify the location where the systems will be installed. 3. Clear all organic matter and debris from the pad site. 4. Place U -bolts through holes in pan provided. 5. Place pad centered under beam with the lateral strut bracket towards the inside of the home. 6. Press or drive pan into ground until level and flush with prepared surface. 7. Build pier according to State, Local or Home Manufacturers guidelines.(Figure 1) 8. Attach the end of the smaller tube to the inside of pan using U -bolt & nuts provided 9. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 2) 10. Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together. (Figure 1) 1-314" Tube J -Bolt Nut Washer � I � Lateral Struts Strut 72(flag end) ao ... 1-1/2" Tube 4-#12x1" Tek 5crewa 1-15eam Figure 2 Ul U -Bolt & mounting Figure 1 Bracket Install frame bracket clamps to I-beam on in side of block/pier. Do not tighten nuts at this time. Attach longitudinal strut to U -bolt in pan using nuts provided. Insert strut in the frame bracket clamp, attach with nut and bolt. Do not tighten at this time. Pull the frame bracket clamp with the fastened strut outward to remove any slack. Tighten all nuts and bolts on the struts and beam clamps. E7,1 7S I I Y-- 2.. TIE DOWN ENGINEERING 0 0 0 0 O -Xi2 Ground Parts Detail Xi2 Ground Lateral System Part Number 59306 Includes: 5' Strut, pad & hardware kit (#59329-1 includes all nuts and bolts) Longitudinal Hardware Kit Part Number 59331 Includes: 2 I-beam brackets & 2 U -bolts with all nuts and bolts. Lateral and Longitudinal Combination Part Number 59333 Includes: 5' Strut, Pad, Longitudinal Strut (#59329), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Struts for Longitudinal Systems Part Strut Pier Height No. Length Up To: 59330-44 44" 4 Blocks or 32" 59330-65 65" 6 Blocks or 48" ........ _...... _..._, Ground Longitudinal Hardware Kit Xi2 Ground system Longitudinal Strut & Hardware Kit o: Ground Longitudinal Strut Xi2 Stabilization Pier Placement for Ground or Concrete Single Section Home 0 -80' (76' Box) 4 Xi2 Systems Xi2 Pier Placement Double Section Home 0 -62' 3 Xi2 Systems* 63'- 80' 4 Xi2 Systems *2 Xi2 systems can be placed at either end of the home. Triple Section Home 0 -62' 4 Xi2 Systems 63' - 80' 5 Xi2 Systems Page 4 of 8 0 o R O Installation of Xi2 Concrete Systems 1.. Identify the number of systems to be used on the home using the chart provided. 2. Identify the location where the systems will be installed. 3. Build pier according to State, Local or Home Manufacturers guidelines. 4. Drill two 3/8"x 3" deep holes in the concrete using holes in galvanized bracket as a guide. Attach bracket to concrete pad using 3/8"x3-1/2" wedge anchors provided. Place nut & washer on anchor, leave enough room for 1 to 2 threads showing on top of bolt. Using a hammer, tap the wedge bolts into hole through bracket, leaving nut & washer flush with bracket. Using a 9/16" socket wrench, tighten wedge/anchor bolt, securing bracket to the concrete. 5: Attach the end of the smaller tube to the bracket mounted on the pad, using then grade 5,1/2" x 2-1/2" bolt/nut provided. 6. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over° ti the top of the I-beam with the nut & washer provided. (Figure 1 next page) 7. Install a minimum of four (#12 x 1" tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together 8. Install frame bracket clamps on I-beam on the inside of block/pier. 9. Insert strut in frame bracket clamp and attach with nut & bolt. Attach opposite en ete brack t. 10. Pull the frame bracket clamp with fastened strut outward to remove any slag-�� f 11. Tighten all nuts and bolts on system. <.-fi 1 LI Page 5 of 8 f T/E DOWN ENGINEERING X12 Lateral Concrete Systems Part#59307 Includes: 5' Strut, Bracket, & Hardware Kit #59315-1 with all nuts and bolt. Longitudinal Struts for "Concrete Systems" Part No. Length Pier Height #59013 44" up to 4 Blocks #59015 65" up to 6 Blocks Longitudinal Hardware Kit Part#59263 (Includes 2 sets per kit: I-beam bracket, nuts, bolts and washers) Lateral and Longitudinal Combination Part#59332 Includes: 5' Strut, Longitudinal Strut (#59364), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Figure 1 Nut & Washer amBeam Clamp Bracket Lateral Longitudinal — L I — — — — — I — ._ LI -Beam Lj Xi2 Installation Placement Longitudinal Strut Xi2 Concrete System Of 14otne En Concrete Longitudinal Hardware Kit Page 6 of 8 I OL Concrete Longitudinal Hardware Kit Page 6 of 8 Offset Placement Diagrams represent examples of double and triple section offsets. Total size is determined by the length of unit plus offset. Xi2 Stabilization Pier Placement for Ground or Concrete Xi2 Pier Placement k 1 S s Single Section Home _ 0 -80' (76' Box) 4 Xi2 Systems Double Section Home 0 -62' 3 Xi2 Systems* 63' - 80' 4 Xi2 Systems •2 Xi2 systems can be placed at either end of the home. Triple Section Home I I I I I I I I I I I I I I a I I I I I I T I I I I I I 1 I I 1 Triple Section Home 0 -62' 4 Xi2 Systems 63'- 80' 5 Xi2 Systems LEE@'> .................. Page 7 of 8 m - 0 Li 349-04010 o 0 Hardware Breakdown #59329-1 Hardware for 59306 Lateral System 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread Beam Clamp Base 1-3/4 zinc 4 10556 Tek Screw #12 x 1 " 1 10631Z J Bolt 1/2 x 5-1/2 grade 5 zinc 2 10640 Push Nut 1/2 1 12107 Flat Washer 1 x2" SS 1 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10519 Hex Nut 1/2" w/ Serr flange #59331 Longitudinal Hardware for 59306 2. 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-12 x 1-1/4 Carriage Bolt 1/2-12 x 1-1/4 4 10801 Full Thread 10 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10801 Carriage Bolt 1/2-12 x 2-1/2 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread Grade 5 2 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread 2 10519 Hex Nut 1/2" w/Serr Flange 1-3/4 zinc 4 10640 Push Nut 1/2 4 .10519 Hex Nut 1/2" w/ Serr flange # 59329 Hardware for 59333 Lateral and Longitudinal combination 1 59329-1 Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-12 x 1-1/4 4 10801 full thread 5 10646Y Hex Nut 1/2-13 Grade 5 zinc 1 10801 Carriage Bolt 1/2-12 x 2-1/2 2 10801 Grade 5 zinc 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread 6 10646Y 1-3/4 zinc 2 10640 Push Nut 1/2 2 10519 Hex Nut 1/2" w/Serr Flange #59315-1 Hardware for Lateral System 1 10631Z J Bolt 1/2 x 5-1/2 Grade 5 zinc 1 12107 Flat Washer 1/2" SS 4 10556 Tek Screw #12 x 1 " 2 10646Y Hex Nut 1/203 Grade 5 zinc 1 10826 Carriage Bolt 1/2-12 x 3 4 10801 Grade 5 zinc #59027 Hardware Kit for 59307 Lateral System 2 59264 3 Way Concrete Bracket 4 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Hardware Kit #59263 Longitudinal Hardware for 59307 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-13 x 1-1/4 1 59315-1 Full Thread zinc 12 10646Y Hex Nut 1/2-13 Grade 5 zinc 4 10801 Carriage Bolt 1/2-13 x 2-1/2 4 10926 Grade 5 zinc #59364 Hardware for 59332 Lateral and Longitudinal combination 1 59264 3 Way Concrete Bracket 2 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Lateral Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-13 x 1-1/4 Full Thread zinc 2 10801 Carriage Bolt 1/2-13 x 2-1/2 Grade 5 zinc 6 10646Y Hex Nut 1/2-13 Grade 5 zinc Page 8 of 8 2_ riE 'DOWN ENGINEERING 186f 1 �o Ak 00' Mut_ilE STEVe yVoN11f rrE.o�L(r� por�� �IqI $lAcli. �A�T 1�D eA Qta6� B t 01 2. 340 o J-1 BUTTE y I LD I N a D' N I L APPROVED STATE OF CALIFORNIA • BUSINESS, TRANSPORTATION AND HOUSING AGENCY ARNOLD SCHWARZENEGGER, Governor DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT v5tNG Division of Codes and Standards' .0 9NQ 0 © u Z 3 'gym 1i n w Title Search ���oa� Date Printed : 04/10/2007 Decal #: LAS7369 Use Code: SFD Manufacturer: SKYLINE CORP Original Price Code: ABV Tr'adename: HOMTTE - Rating Year: Model: Tax Type: LPT Manufactured Date: 00/00/1973 Last ILT Amount: Registration Exp: Date ILT Fee Paid: First Sold On: 02/14/1973 ILT Exemption: NONE Serial Number S375478U S375478X Record Conditions _Regi HUD Label / Insignia 81529 81530 PPF Exempt ion to LPT Length 40' 40' t CHARLES H HOSTETTER II N v SHERI LYNN HOSTETTER (Joi 491 BLACKBART RD OROVILLE, CA 95966 Last a Date: 11/24/1993 Last Reg 11/24/1993 Sale/Transfer Info: Price $28,000.00 Situs Address: 491 BLACKBART RD OROVILLE, CA 95966 Situs County: BUTTE Legal Owner: BENEFICIAL CALIFORNIA INC 121W 5TH ST P 0 BOX 3238 CHICO, CA 95927 Last Title Date: 11/24/1993 Lien Perfected On: 09/23/1993 12:00:00 a Jr. Lienholder: a Width 10' 10' with Right of urvi orship) n r d on 07/20/1993 WALTER WEISENBURGER HELEN WEISENBURGER (Joint Tenants with Right of Survivorship) 310 MELODY LN OROVILLE, CA 95966 ' Last Title Date: 11/24/1993 Reg Card: 11/24/1993 Lien Perfected -On: 09/23/1993 12:00:01 Inactive Decal/DMV: DECAL AAP3654, DMV JR9754, DMV JR9755 FOUNDATION SYSTEM CERTIFICATE OF OCCUPANCY - BUILDING PERMIT NUMBER: B07-0791 Address or location of unit: 491 BLACK BART RD OROVILLE CA Legal Description of Real Property: 072-340-021 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: GEORGE, STEVEN & YVONNE Owner's address:491 BLACK BART RD OROVILLE CA 95966 INSIGNIA OR HUD NUMBER:81529/30 SERIAL NUMBER OR V.I.N.: S375478U/X MANUFACTURER'S NAME: SKYLINE CORP YEAR: 1973 s OFFICIAL APPROVING INSTALLATION: i DATE: �. I'2 -O I 07 PHONE: (530) 538-7541 H.C.D. 513 EXPLANATION AMOUNT SIERRA MOBILE SERVICE SIERRA FOUNDATION LIC NO 470386 466 CIRCLE DR 530-534-0599 OROVILLE, CA 95966 PAY AMOUNT OF (,t-eA -- ` /C D --- — 90-2267/1211 3827 19886 H168 DOLLARS j U"�a'0"eo: Demeue m nea. DATE TO THE ORDER OF GROSSINC. TAX SOC. SEC. ST. TAX MEDICARE NUMeEa '1 nPAMA rZ) Q-/ AA r iC I I I I US BANK DESCRIPTION IVP _,- AUTHORIZED SIGNATURE ill OL9886110 1:L2LL226?D: L5340L4(7392Sill -:. Z COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION I •7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 014proq (Rev.12/96) APPLICATION AND PERMIT ASSESSORPARCFINUMB17t /1 BUILDING PERMIT OWNER i7r\ 1. O / 04__� /i /i'�Q� SO. FT. OCC. BUILDING VALUATION CONTRACTORS MAILING ADDRESS PERMIT FEE S ELECTRICAL PERMIT CONSTRUCTION LENDER Main Service "O.V on LM 23.00 Main Service Fireplace 46.00 NEW CONST. LENDERS MAILING ADDRESS Total Valuation $ OR ADONS. 8 ACC. IA.DS. ARCHITECT OR ENGINEER LICENSE NO. Erin Fee $ 20.00 Permit Fee $ ARCKMECT OR L-MIUM45 MAILING ADDRESS Plan CheckingFee $ sua.DING ADDR= Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SusDNISIDNSUWE PARCEL MAP PERMIT Fling Fee 20.00 Filing Each Tr 7.00 USEOFSTRUCTURE Soler or heat pump water heater 23.00 SF ❑ Duplex ❑ Mobilehome ❑ Other Water piping 15.00 SPEC" Each gas water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.00 INew ❑ Addition ❑ em Utilities in Building sewer Mobile Home S G W 15.00 @20.00 Describe Work: PERMIT EEE PAID V3 SHERIFF OTHER S E I AMOUNT RECEIVED $ D E RECE�,IVED Iq� ��,' l� I E. Opp. ( OUTLET OR MURES ) I I BALI. 4 .50 I I rutcu wrruYa. u 5 00 EX. Deeu p.DunETs FSiD. E& Temporary Service 23.00 Mobile Home Facilities 20.00 AIBcr Nrrinm 23.00 A7S I PERMIT FEE 1 S 19 MECHANICAL PERMIT I Firing Fee I 20.00 6.50 PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ =C -N"- TYPE TOTAL FEE $ HAZ I q FES I IMP I FLOOD I CDF I PARCH I PD I Fm I 65UE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which iees have been paid. By Date PERMIT FEE S ELECTRICAL PERMIT Fling Fee 1 20.00 Main Service "O.V on LM 23.00 Main Service 2004 TO IMA 46.00 NEW CONST. DwauNG Otxt1P. 3.505 - OR ADONS. 8 ACC. IA.DS. KEW cons I. M_ ( unun - Nluui otmt ) @7.50 I E. Opp. ( OUTLET OR MURES ) I I BALI. 4 .50 I I rutcu wrruYa. u 5 00 EX. Deeu p.DunETs FSiD. E& Temporary Service 23.00 Mobile Home Facilities 20.00 AIBcr Nrrinm 23.00 A7S I PERMIT FEE 1 S 19 MECHANICAL PERMIT I Firing Fee I 20.00 6.50 PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ =C -N"- TYPE TOTAL FEE $ HAZ I q FES I IMP I FLOOD I CDF I PARCH I PD I Fm I 65UE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which iees have been paid. By Date COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center DriveOroville, California 95965 • Telephone (530) 538-7541 PE Iy1y+G�.l (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER �)72-140-021 ZONING BUILDING PERMIT OWNER TELEPHONE S SO, FT, OCC. BUILDING VALUATION _ .OWNERS MAIUNd ADDRESS R 6 CONTRACTOR'S NAME ELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS TBAPT FQ. OROVILIE Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: MTSC. ELEC'TRTC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Feel 20.00 600VOR UE Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S 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 the Business and Professions Code, ( g ) and my license is in full force and effect.PSINGLE License Class LIC. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. B1ns. so 3.5¢FT: NEW CONSf__ MULTI.OUTLET NON•RESID. @7.50 a OUTLET COWER APPARATUS IR. Ex, Occup. OUTLET OR FDMRES 20 @ 1'00 eAL @ .50 Ex. Occup. oFlxLIT>trs R� ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 4 Misc. Wiring 23.00 PERMIT FEE = 6.3,0 WORKERS' COMPENSATION DECLARATION 1 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 is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEIE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) C�( 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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 comply with those provisions. X Date �U l Signature of Applicant - Owner ❑ Contractor ❑ Agen An OSHA permit is required for excavati over 60" deep and demolition or construction of structures t e t. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. rrvE TOTAL FEE $ HAZ. I D FEES IMP FLOOD CDP PARC HD ISS This permit is hereby issued under the applicable provisions o e Butt County Code and/or Resolutions to do work indica d v f r w ch fees have been pail. By ate PERMIT EXPIRES ON ( D Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-74 L PER NO. Rev. 12/96) APPLICATION AND•PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT - OWNER C .OWNERS MAID ADDRESS p v 999 cONTRACTOR'S NAME i TELEPHONE p y ELEPHONE SO. FT. OCC. BUILDING VALUATION CONTRAC OR MAIUNO ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $ Plan Checking Fee $ BUILDINGADDRESS - .. . 4401 r T OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDNIS IONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: _?2F._T�!, FT ECT -RIC Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 600V OR LESS 2o.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: XI, 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. ❑ j I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. <❑lram exempt under Sec. Business and Professions Code for this -,reason WORKERS' COMPENSATION DECLARATION Lhereby 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 is issued. f❑ 1 have and will maintain workers' compensation insurance, as required by Section f 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I'shall .� not employ any person in any manner so as to become subject to 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 comply with those provisions. ' X .. _ ate Main Service 200A TO I000A 46.00 v NEW CONST. DWELLING OCCUR SO OR ADDNS. ( a ACC. BLDS. 3.5¢FT; (commencing 6R61DT MULTI.OUTLET @7.50 PowER APPARArus d SINGLE OUTLET S Ex. Occup. OUTLET OR FDCTURES BAL Q 1.50 AXED Ex. Occup. OUTLETS RESID. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT (ling ee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ no HAD. FEES IMP FLOOD COF PARCEL Po HD ISS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. B Dte PERMIT EXPIRES ON De _ S' ture of Applicant - ❑ Owner ❑ Contractor nt An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �j `'I"�eSP`- �+.,,"•. 1c._.,rA^'Nk-hY�;."'j�"'y'r'lt"L�r`.+F {i.:�7''T.�3"t'�fts--vy,, ti„*"Pr+'`"^`^r.,,,.y_ePiY+_"�'.`�.;rw a.�, •�.`.r4t2""r 4"���°-`-rte-•. ••.n rti�/7 L"� e:...rL.. COUNT OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION f 7 County Center Drive, Oroville,.CA 95965 Phone (530)538-7541 Fax (530)538-2140 r PERMIT APPLICATION DATA SHEET w OWNER: / ASSESSOR PARCEL NUMBER /� / Proposed Building Use: _ Counter Technician: lTrcDate: Items required in order to apply for a permit. All, boxes MUST be e � cked OR marked NA in rder to apply. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans: ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans `�3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ? ❑ 6., Manufactured homes: (A) Data sheets and installation inst, (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. - - Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received.. - r:. DateReceived ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ • ❑ 9. Site plan,and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................... ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Fire Sprinklers............................................................................................ Ti. 14. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by �O 15. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items. ❑ 16. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ❑ 17. Statement of Intent for Non -heated and A/C Buildings ............................................. ❑ 18. Sanitation and site plan approval from the Environmental Health Department in ❑ 19. City of Chico Plumbing permit........................................................................ ❑ 20. California Department of Forestry plan approval ❑ paid. Sent by: ...................... ❑ 21. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: . ❑ 22.. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... ❑ 23-,NPDES Form.............................................................................I.............. 24. Encroachment Perm' fo drive y from the Pu • lic or •s .e h; ........................ 25. Pre -Inspection -f required ................ ❑ 26. Contractor's license information. (Number, Name Style, Class" ation)...................... ❑ 27. Workers Compensation Carrier and PolicyNumber.... # } ❑ Owner -Builder Verification ❑ Given.to owner, .0 Mailed to owner).:.......-........... 1 ❑ 29. Letter of Slgna ure authonzatlon ...............................................I.................. ❑ 30. Recorded copy of Agricultural Acknowledgment Statement.........` ........................... ❑ 31. Manufactured home utility clearance .................................................. ............... ❑ 32. Existing violations and/or expired permits.....:':.................................................. ❑ 33. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts; ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 34. Other: " When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: for the above items numbered: �--- Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: 'Structural approved by: Dale: Note transfer by: Date: - Yellow: Building Division i O.B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner:- An "owner -builder" building pemmit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit' will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed _ property improvement: YES O NO,$ . 2: I HAVF, HAVE NOT 11 signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: 'CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise,'and provide the manor work: NAME: ADDRESS: CITY: 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.: I NAME ADDRESS PHONE TYPE OF WORK SIGNE ROPERTYOWNER: NOTE: This Owner Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Coda This verification must be completed and returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION Dear Property Owner. An application for a building permit has been submitted in your name listing yourself as the builder of 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 ^ 1 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 you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (Including materials and other costs) is'S300 or more for the entire project, and such persons are not licensed as contractors or subcontractors; then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments 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. ♦ There may be financial risks far you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, ifyou 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 shvcture 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 contractors 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. Infomnation about licensed conftwtors may be obtained by contacting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is retained. Mic 1 C. Vi ira, C B.O. er, Building Inspection - NOTE: Ykis Owner-BuilderIrcformadon is required by Section 19830 of the California Health and Sa, my Code -PRE-INSPECZ OWNER: _ LOCATION: CONTRACTOR: PRE-INSPETION FOR _ c,y)-)n-Q�T -e •) <2—, DATE TO INSPECTOR PERMIT HLSTORY:( ) NONE YAS WELDING INSPECTOR'S REPORT Building Description: Commercial/Usage: Residential/# of Units: Currently Occupied Abandoned/Vaoant ` DATE:_ A.P. #tea' �• ��- 1 ZONING: Electric: / Yes No Electric currently On Off Condition of Electric Gas: Natural Propane None Currently On-rzOff Obvious Problems: Sanitation: Plumbing Working Well Working Potable Water / Obvious SewageProblems C1 ACTION RECOMMENDED: ISSUE: HOLD FOR ,i Ing r. 'Date Z� V �� s Sketch buildings on reverse and indicate location on property. 1!W COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING ._ BUILDING PERMIT OWNER .OWNERS MAIU ADDRESS pn COMRACTOR'S NAME GA 9692 TELEPHONE ELEPHONE SO, FT. OCC. BUILDING VALUATION C.ONTRAC O MAIUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flin Fee $ 20.00 ARCHITECT OR ENGINEERS MAIUNG ADDRESS Permit Fee $ Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE $ IDT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat Pump water heater 23.00 Water piping 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: RR–TAT ELECTRIC Each as water heater or vent 15.00 Gas piping sVstern 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Feel 20.00 Main Service z�o.A OR ESS 23.00 LICENSED CONTRACTOR'S 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 the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I herebyaffirm under penalty of perjury that I am exempt from the Contractors License P ny P 1 rY p Law for the following reason: ❑ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Seca Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 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'—Cooling compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier, Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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 comply with those provisions. X ate Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO ( 3.5¢Fr: N co" MUAcco NON R61D. @7.50 POWER APPARATUS & SINGLE OUTLET CIR, Ex. Occup. OUTLET OR FIXTURES eAL 20@'.00 Ex. Occup. FD(ED APPWS. OR ouTRErs RESID. Ea 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 = - PERMIT FEE S MECHANICAL PERMIT Vilind V4 20.00 Heating Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HAz D. FEESIMP FLOOD CDF PARCEL Pp HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON ate _ S` ture of Applicant - ❑ Owner ❑ Contractor nt [An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I ' 'te - DONALD M. BLOODGOOD n/s Black Bart Rd.. -21 mi.. east Fire Camp Rd . , Oroville Permit 2664-72P,E (utilities for mobile home A. P . --3Y-89-,85 D014ALD M. BL00DG00D n/s Black Bart Rd.-! mi. east of Fire Camp Rd., Oroville -73 COITR: North Vallewnz ng, Yuba City Permit 815-73B &Z (covered deck & awning for m—. - home) A - y4 Ni o i 7L'(v5 I COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive a Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT — ;ASSESSOR PARCEL NUMBER BUILDINGPERMIT SQ. FT. OCC. BUILDING VALUATION CONTRACTOR'S NAME CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER LENDER'S MAJUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. PERMIT Filing Fee $ 20'00 2ooA To imA Permit Fee $ OCeuP. ARCHITECT OR ENGINEERS MAILING ADDRESS Plan CheckingFee $ . OR SULDINGADOREss Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO.SUBOMSIONS NAME "R.°E1 PLUMBING PERMIT Fling Fee 20.00 Each Trap 1 7.00 USEOFSTRUCTURE Solar or heat pump water heater 1 23.00 SF ❑ Duplex ❑ Mobilehome ❑ Other Waterpiping 15.00 SPECIFY Each gas water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.00 New ❑ Addition ❑ R odel ❑ es ❑ Installation ❑ er Building sewer 15.00 Describe Work: Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 eoov oR LEss o300-177.— 300 .PERMIT, FEE PAID SRA SHERIFF OTHER AMOUNT RECEIVED $ DATE RECEIVED RECEIPT # Main Service SCoA oR LEss Main Service 2ooA To imA 46.00 NEW CONST.DWBIBJG OCeuP. 3.5QF7 ADONS. a ACC. &.Ds. . OR SEW CONST. - MULTI -CUTLET @7.50 I Ex. Occup. ( OUTLET OR F=URES ) I I B4L ® :so I Temporary Service 23.00 Mobile Home Fa ' ities 20.00 Kisc.Wifing 23.00 ` PER IT FEE $ �' IUIFCMANICOL PFRMIT Fling ee 1 20.00 Cooling Hood 6.50 PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ CCC cONsT. TYPE TOTAL FEE $ HAZ 10. FEES I IMP I FLOOD I COF I pRcEFf PD I HD I ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON Intl OWNER: LOCATION: CONTRACTOR: PRE-INSPETION FOR: PRE-INSPECTION. DATE: A -P. # ZONING: DATE TO INSPECTOR: PERMIT HISTORY:( ) NONE ( ) AS FOLLOWS: BUQ.DING INSPECTOR'S REPORT Building Description: CommerciaUUsage:_ Residential/# of Units: Electric: Gas: Currently Occupied Abandoned/Vacant Yes No Electric currently On Off Condition of Electric Natural Propane None Currently On Off Obvious Problems: Sanitation: Plumbing Working Well Working Potable Water Obvious SewageProblems Comments: ACTION RECOMMENDED: ISSUE: HOLD FOR Inspector. Date Sketch buildings on reverse and indicate location on property. k d` PERMIT NUMBER _ B 815-73B P E PERMIT EXPIRES dT— OWNER Donald M. Bloodgood CONTR: North Valley Awning, Yuba City LOCATION (A.P. 37-89-05 n/s Black Bart Rd.--! mi. east of Fire Camp Rd., Oroville I t COUNTY OF BUTTE t Department of Pubtic Works BUILDING INSPECTION RECORD Zoning. Setback Forms Foundation Piers & 644ers'_ �ilL `�' � —'� Fireplace Rgh. Plumbing Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. Vents Framing ^/— Pimg. Topout Rough Elee. Wtr. Htr. Furnace Kitchen Vent Firewall Garage Vents Sanitation & Water ELECTRIC GAS BUILDING Temporary Temporary Cert. of Occup. Final Final Final DATE REMARKS OR CORRECTIONS i i r COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORK ' 7 County Center Drive = droville, California 95965 t19 Telephone: 534-4541 tz APPLICATION AND PERMIT allLnUFi Lti reNresenidiiv's of the County of Butte to enter upon the above-mentioned property for inspection purposes. ate `Y —PI -73 Signature of Permiteeor A nt Receipt No. White-D.P.W. - Yellow -Assessor -Pink-Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECT -GR OF PUBLIC WORKS By.. Date O"�7 Building permit expires Date ,C BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. - Fireplace Contractor '' Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty - Telephone No. d Permit Fee $ $ i+ B ding Address PLUMBING No. @ FEE PERMIT FILING FEE $2.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. r p Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fes Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Parcel Plans Declaration Parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. Plans Recd Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Sub -panel (12 or less) .(more than 12) Range, Cook -top or Oven 1.00 ater Heater or Space Heater 1.00 Light fixtures pal aio Receps., switches & fix outlets zo M C ACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of `e1 Hood, Ex. Fan or F. A. Furn. Motor 1.00 Evap. cooler, gar. di sp. or D.W. 1.00 Air conditioner or heat pump Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 �l/ License Noo2 7��"�."7' Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. IQ I have placed on file with the County of Butte a certificate of y� Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE_ $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building .construction, and hereby TOTAL PERMIT FEE $ allLnUFi Lti reNresenidiiv's of the County of Butte to enter upon the above-mentioned property for inspection purposes. ate `Y —PI -73 Signature of Permiteeor A nt Receipt No. White-D.P.W. - Yellow -Assessor -Pink-Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECT -GR OF PUBLIC WORKS By.. Date O"�7 Building permit expires Date ,C COUNTY OF BUTTE - UEPAIITMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT iaNicociiiaLVES 01 me vuunte ty or t5uito enter upon the above-mentioned property for inspection purposes. �i X As aDate t 0 a - Signature �off Permiittteee/or/Agent Receipt No. _/ / "T v _ White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR;,OF PUBLIC WORKS Building Permit Expires Date BUILDING Owner" G SO, FT. OCC. BUILDING VALUATION Mailing Address !G ireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Permit Fee Building Address S'&c/L/- PLUMBING No. @ FEE PERMIT FILING FEE $2.00 &Q G Each Trap 1.50 _ Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 1 A. P. No.'— _ A-Gz, / Q Zor�ing Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Fire Zone Fire Dept. Sanitation Fla Hing Building sewer 5.00� r,— Plans Fees �� W. C. C— R/W Encroachment L awn sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER ❑ Permit Fee /QflG l e EU ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter O Additional meters, each 1.00 USE OF STRUCTURE Single Family Q Duplex ❑ Others ❑ Sub -panel (12 or less) (morethan12) Range, dryer or water heater 1.00 Oven, Cook -top or space heater 1.00 Light fixtures Receps., switches & fix outlets y CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap, cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump g Oo Misc. wiring License No. Classification y ❑ i am exempt from the Contractors License Laws of the State of California. Permit Fee 04 Ob WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Permit Fee I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby tate Fee for Str ng Motion Hsi rumentation fQrogram $0.07/$1000 Evaluation Is TOTAL PERMIT FEE iaNicociiiaLVES 01 me vuunte ty or t5uito enter upon the above-mentioned property for inspection purposes. �i X As aDate t 0 a - Signature �off Permiittteee/or/Agent Receipt No. _/ / "T v _ White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR;,OF PUBLIC WORKS Building Permit Expires Date 77 'loll .r.. ^�—+, ��-+..--+•.�I Jr".<.,/. ..-:r►•►s1,.•.n��-'�, .f.ti,-.,t_:{,.�.Y •ti. h..-,.. mss_ .,.�"r �, '- ..moi"•u �+.r.-... '`. G'.J�`^�`�w,�..`-'1'--�'Mr'S-v-.-.�•'�ti.r'.'(--•�^y'�-�Y'--•T�y,'v moi,, COUNTY OF BUTTE QEPARTMENT OF PUBLIC WORKS 7 County Center Drive Oroville; California 95965 -Telephone: 533-1230, Ext. 259 APPLICATION AND PERMIT >/ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X&_, _1 Date 0/ oZ/% Signature of Permitee/orAg,ent f f Receipt No. q� ee/ IF "T `� — White-D.P.W. - Pink -Inspector - Goldenrod -Assessor - Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. /DIRECTOR OF PUBLIC WORKS By —7,.� e� Date/6z v Building Permit Expires Date�-,/;, � I BUILDING OwnerY/2�� /6D fV ��Ge-X SO. FT. OCC. BUILDING VALUATION Mai I i ng Address / /.? C_/ Jam'':' }� `t �i /� Fireplace ` r - Contractor i Total Valuation Mailing Address J� Permit Fee Plan Checking Fee &/or Penalty Permit Fee $ $ Building Address,///,5_ �GtG�C. �� • / eal,W PLUMBING No.1 @ FEE FILING FEE $2.00 -200 /� iPERMIT z-/ %1j,,.. /., ,%J/,tifc Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 �Y1 - AL, t.pa_V lrL �.t1/:/ Each gas water heater or vent 1.50 A. P. No. F2— 09— 64re 6 G-, / to 14- Zoningy - Z. - Gas piping system 1 - 5 outlets 1.50 Each additional outlet .50 Building sewer 5.00 0/) Fire Zone Fire Dept. Sanitationv / Planning Plans « Feesf W. 0--R/W Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER ❑ Permit Fee $'(/UU— $/ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 : Uco -° •G Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) USE OF STRUCTURE Single Family -E] Duplex ❑ Others ❑ • Range, dryer or water heater 1.00 < i / �/ Oven, Cook -top or space heater 1.00 Light fixtures bal 010 Receps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar, disp. or D.W. 1.00 Air conditioner or heat pump Water pump f -/s / GG Misc. wiring License No. Classification r �❑ i am exempt from the Contractors License Laws of the State of California. Permit Fee a WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑ I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby $tate Fee for Strpng Motion $0.07/$1000 Evaluation Iln st rumen t atio n Program $ TOTAL PERMIT FEE $ Uv >/ authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X&_, _1 Date 0/ oZ/% Signature of Permitee/orAg,ent f f Receipt No. q� ee/ IF "T `� — White-D.P.W. - Pink -Inspector - Goldenrod -Assessor - Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. /DIRECTOR OF PUBLIC WORKS By —7,.� e� Date/6z v Building Permit Expires Date�-,/;, � I