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072-590-019
7-D dWxeAl Q ;q1_,100jw ard Brow n - A p_Pg4'M i o f Stringtown Rdl,(on pri. rd),ap-p,,5 mi.N.of Hurleton Rd.-, Orot; contra A -Lume oroville Permit #51.85'-&O.B(2 new awnings/MH) Permit #5512-8'OB(new 0Ren'ec1k1764)'_ ermit #1450-78 Issued E u t i15,� mH) 7e—rm1_t7X!674�-a8Q!L'TQ0_p' E -Zoe GQA k SUPPORT 41 2�U-M-„ R E' REQ_.___ COMPACTION TEST -M- Contr: Mobile me Center nc. Tt 9R 7E Permit�� 30MHI I 'I psAdd 46 0 � ' � u� ori 1'. V' � _ `��� � � !' �_ N "�' PERMIT NO. 5512-80B i c PERMIT EXPIRES %•I / ��/ OWNER Howard Brown CONTR. owner ASSESSOR .PARCE L72-36-39 5 LOCATION App. 4 mi.E.ofStringtown Rd.,(on pri, rd.), app. 5 mi.N.of Hurleton Rd., Oroville a ' Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas SerGice r Cal led P_G&E JOB FINALED (Date)az Signature Z = OK = Not OK Not Applicable MOBILEHOMES Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning Requirements—Setbacks—Easements Date ®, D, KS, COVERS, CARPORTS, ETC. (Plans) OK except'It's Zoning Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch _ 2. Fo gs; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete ecks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors 7. Utility Clearance 7. Elec. Card -BI Date and -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements—Setbacks—Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except #'s 1, Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 4. Electricity; MH Test—Crossovers—Breakers—Clearances 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4, Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes— Enc losures— Pane [boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL` (Single and Duplex) Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requifements-Setbacks-Easements 48. w 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. Fig., 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. D.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-Seryice Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's Card -BI Date Card -BI Date Date _ PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 56. Ext. Steps -Door & Sidelight Protection -Landings 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth Card -BI Date Card -BI Date 64. 65. Elec. Outlets at Wood Panel; Int. & Ext. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. 70. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection Plb., Elec. & Mech. Equip. Listed for Location 21. Elec. Receptacles Spacing -Lights &Switches at Doors 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 E] Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size Guard Rails & Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes ❑No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters El Yes 0 N 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 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 Card B-1 Date Date Card BI Date Date Card -BI Date MECHANICAL (Permit) OK except N's 81. 82. Ventilation throughout House Glass Protection 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval - 32. Vent Fan; Exhaust above Insulation 86. 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 Date FRAMING(Plans) OK except q's Comments at Final: 36. Sills; Proper Material & Anchors _ 37. 38. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) _40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub Header & Beam -Size & Bearing ___41. 42. 43. 44. Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfnp. 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: An entry must be made each time you visit jobsite) COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Onovill6, Lalifornia 95965 - Telephone 916/534-4541 ' APPLICAT101tAND ..PERMIT PERMIT NO. O ASS 5 OR PARC L N Q.E(t ^ ZO ING BUILDING PER owTELEPHONE SQ. FT. OCC. BUILDING VALUATION O ER'S MAILING ADDRESS O A TO NAMETELEPHONE YJ le'r CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ l Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ 0 BU LDIN ADDRESS Yrs i i2)�ar 1 PLUMBING PERMIT FiIingFee 3.00 �V V, a Each Trap 2.00 Repair drainage or vent piping 2.00 p Water piping LOT NO. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 2.00 , TYPE OF WORK New ❑ Addition g Remodel ❑ tiliti [0 Instal lation❑ Other ❑ Describe work: V 1h Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service8000 AMP ORLESS5.00 Main service EA. ADO'L 100 AMP 2,50 NEW CONST. DWELLING OCCUP.&) OR ADDNS. ( ACC. BLDGS. / 2¢sgft 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. f License No. Classification -[� I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ i am exempt under Sec. , Business and Professions Code for this reason NEW NO R BRANCH CIRLE CTITS 2.50 ea NON -Roes o R. ( POWER SINGLE OUTLET US.&) Ex. Occup(OUTLETS OR FIXTURES 5 AL@1 BL@0C FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 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 3.00 Heating Cooling Hood 2.00 Ventilation Permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of 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 agai st said County in consequence of the granting of this permit. //--) -_P0 AZZ Date r lx-dql ignature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ TOTAL PERMIT FEE $ _ OCCUP, GROUPTYPEof �_ l CO T. V_O N PAR EL P v SUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR F PUBLIC By PE EXPIRES Date_ the applicable provi- resolutions to do fees have been paid. WORKS Datell— %= J/��'��- Receipt No. qq WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT NO. 5185-80B PERMIT EXPIRES- OWNER XPIRES OWNER Howard Brown ,i CONTR. Acro-Lume, Oroville ASSESSOR PARZiL26-39 LOCATION App.4 mi.E.of Stringtown Rd.,(on pri rd.), app. 5 mi.N.of Hurleton Rd., Oro. Temp. Power Pole f Called PG&E lTemp. Elec. Service Called PG&E Temp. Gas Servi%cee Cal led PG&"E JOB FINAED (Date) Signature = OK = Not OK _ = Not Applicable MOBILEHOMES MISCELLANEOUS Not -Ready Date MOBILEHOME UTILITIES (Plans) OK except #'s Date D5SKS, COVERS, CARPORTS, ETC f except #'s 1. Zoning Requirements -Setbacks -Easements & . Zoning Requirements -Setbacks -Easements • 2. Soils; Special MH Support -Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete 2. Footings; Size -Depth -Spacing -Connectors 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Woo n.; Posts -Beam Rftrs.- ec.- g. -R .-BrAatng 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete lum. Awn.; Colu -Connections-Sp ce-Deca - s 6. Gas; Location -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 -B e` 3 Card -BI Date Card -BI Date Card -BI Date Card -BI Dal/Z and -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s Date POOLS (Plant) 0 except #'s 1. Zoning Requirements -Setbacks -Easements 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Elec.; Receptacles and Lighting; Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg, Boxes -Enclosures -Panel boards- Ins. -to Main in Conduit 9. Health Department Approval 9. Exits; Insp.-Sketch 10, Cert. of Occupancy 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable RESIDENTIAL j6ing�e and Duplex) = Not Ready 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, � 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 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 54. 55. Glazing Area -Glass Protection -Skylights -Plastic 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 q's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 57. Smoke Detector _ 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. 19. Test Tub & Shower, 2nd Floor -Tub Access Gas Pipe; Size & Anchors 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 62. Stairs & Rails _ 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except k's 67. Garage Fire Door; Swing -Landing -Closer 68. 69. A.C. Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 20. Fixture & Transformer Clearance -Ins. 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 At 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, Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. 30. Equip. Clearances; Panels-Motors-Mech. Equip. Clothes Closet Light -Shower Light 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 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. Ventilation throughout House Card B -I Date Card -BI Date 82. Glass Protection Date MECHANICAL (Permit) OK except p's 83. Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts: Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation 86. 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-_ _ateDate Card -BI Date Card -BI Date Card -BI Date Card-BI DCard-BI Date Card -BI Date Card -BI Date Date FRAMING Plans OK except N's Comments. at Final: 36. Sills; Proper Material & Anchors 37. Studs -Nailing, Spacing & Bracing -Plates -Sound _ 38. _Walls; Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) _ 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. 45. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfnp. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time you visit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS v. 7 County Center Drive - OroviIle,ftalitorn ia 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT I IF, 4411 F0 ASSESSOR PARCEL NUMBER 17 –ZJv-3 ZONING All_�, BUILDI PE /6,00 OWNER /��1 �dw r TELEPHONE e �Z FT. OCC. BUILDING VALUATION FASO. '7 OWNER'S MAILING ADDRESS a ?�VI G CONTRACTOR' NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS 1 -MOLE L R �l CONSTRNDER UNKNOWN Fireplace Total Valuation $ 37 90 LENDER'S MAILING ADDRESS Permit Fee $ aget. J ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ u Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS' Permit fee $ 6- y U BUILDING ADDRESS is PLUMBING PERMIT Filing Fee 3.00 /, St i /� �%TiE�i1� To Each Trap 2.00 Repair drainage or vent piping 2.00 /WzAj I o "Tb N O F /fit C i d A/ c. Ey•���u �L b — Water piping LOT NO. UBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY -1 Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ❑ Describe work:e/Z.0 9x GLJ iS///1/tfi• Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 100 AMP OROR LESS5.00 Main service EA. ADD'L_ 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 20sgft CONTRACTORS LICENSE LAW I declare u er 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. Z 7'¢B C _G ( '�� 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 ULTI-OUTLET 2.50 ea NO N.RESID BRANCH CIRC ITS NEW CONSTR. ( POWER APPARATUS 8) NON-RESID. SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 50@25C BAL@1W Ex. Occup.(OUTLETS FIXED P(RESID.)LNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6,25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. nFave placed on file with the County of Butte Building Department 11� Xa 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 3.00 Heating Cooling Hood 2.00 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 against aid `ty in consequence -the granting of this permit. X Date /0 r / c� Signature of Appl nt — Owner ❑ Contractor W Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Land Development Fee $ r TOTAL PERMIT FEE $ OCCUP, GROUP I TYPE OF CONST. PARCEL PD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE9.TPR OF PUBLIC P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date I Receipt No. '�.7 Z�;By WRITE•D. P. W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 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 i `, OC%/✓ , , e l �;- Mobilehome Mfg. Moder—L-A, - L' Year : i r K u Insignia No , s , /��r ,(✓ �,/ , »� �� %/ H i'G Serial No. off It is hereby certified for occupancy at the above described location and may be occupied. Di rec,"to^r of Public Works Date %� ` �� !;1 By -Z/ )1-16 THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED U ref s -a �28` PERMIT NO. 1449-78P,E Plot PERMIT EXPIRES ,OWNER J. S. Delahunt- CONTR. owner a LOCATION (A.P. 72-26-39 Appt� mi E.of Stringto�In Rd. (on ri.rd.), app. 5 miMot Forbestown Rd. , Orovill� t r. k ,f r c . f Temp. Power Pole Called PG&E Temp. Elec. Serv. *9,72 SEK C✓ty u- Called PG&E Temp. Gas Serv. — �— Iled L Y JIB 7INALED �f7 (Date) (Signature) , PF Footin s Fc Masonry Walls TF Reinf. Steel/ FI Bond Bea Framing Tc Stucco FI MECHANICAL Motors .Ulull Briwn COUNTY OF 9UTTE' — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD ser ce emp. Pole BUILDING BUILDING (Cont'd) PLUMBING Se ack Fi wall Sit Piping Fork Para is t Floor MaINPIdg. Restro Finish UN Floor Foo s Windows 3rdk loor Stemw I Siding To out Slab Roof Sheath*kg Water PAng Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwal l Insulation Heaters Slab Carport Footings Prov. for physically handicapped V Conformance of ex. A structure Appliances Gas Piping &Test Temp. Gas Slab Final Sanitation Patio /IREPLACE Final PF Footin s Fc Masonry Walls TF Reinf. Steel/ FI Bond Bea Framing Tc Stucco FI MECHANICAL Motors .Ulull Briwn neavng Co ing ser ce emp. Pole nishD 'cts Underground Interior Lath entilation Permanent oor Closer /Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal 4/_���% Water Piping ` '— Z� -"7 ;- ��/ Sewer �,��_ 7 8 �j Gas Piping W2116EUOME INSTALLATION - - - - - - - - - - - - - - Support - - Elec. Continuity .. Water Piping Drainage Gas Piping -- DATE % d ®� © 51 Zg N0047- ® ice.."'• �� VIW REMARKS OR CORRECTIONS FOn- -P00 .4 Oi�'1�/`I ��L�� - LL JVD 2 0.-1 (NOTE: An entry must be made on this form each time'you visit the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT aummize ruPreseniatlVes pt ine County of butte to enter upon the above-mentioned property for inspection purposes. - xDate 3 a ignature offPermitee or Ageennt Receipt No. / c' 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 fo hich fees have been paid. D ECTO PUB I WORKS • Da Building permit expires Date 3 BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address T laphone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address d Plan Checking Fee &/or Penalty Permit Fee s /A Zell e PLUMBING No. @ FEE / ` PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 FtW1 W -� FireDept. FireZone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel Declaration I Parcel Map 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 d Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ 7 �P �/ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Single Family ❑ Duplex ❑ Mobil Home ❑ OthersM Main service 100 AMP ORSIS.ESS 5.00 -� Main service EA. ADD•L too AMP 2.50 -, i 0 0 VER 600V AMP OR LESS 25.00 Main service 1 Mairi service/ EA. ADD'L 100 AMP 1.00 NEW CONSTDWELING OR ADDNS. \ ACCLBLDGS,CCUP. Y) 22 sq ft 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: NEW RESID. MULTI -OUTLET NON.RESI D. (BRANCH CIRCUITS) 2.50ea CII NEW CONSTR (POWER APPARATUS 8 NON.RESID. (POWER OUTLET CIR. Ex. Occup(OUTLETS OR FIXTIIRES 5 L� Ex. OCCU FIXED APLNS. OR P•(OUTLETSP(RESID.) EA� 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 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. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 2certify that in the performance of the work for which this peris issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No -1 @ FEE PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ ,(' aummize ruPreseniatlVes pt ine County of butte to enter upon the above-mentioned property for inspection purposes. - xDate 3 a ignature offPermitee or Ageennt Receipt No. / c' 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 fo hich fees have been paid. D ECTO PUB I WORKS • Da Building permit expires Date 3 V BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7_Co_unty Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION .SHEET 1. Owner's name: � ,h /1_ 42 2. Installer's name: — 3. Is the site currently under permit? Yes / / No (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No (If yes, furnish two (2) plot plans.)- 4.- Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- v Amps 6. What is the mobilehome site service rating? --------------------- 10 O fps 7: What is the mobilehome site circuit breaker rating? ------------- �� t 0 �% Amps 8. Is there any other electric load to be served by the mobilehome site service? ------------------------- Yes No P / A. � (If yes, identify the load and size. ."ry C . • oad� — (Amps) 9. What is the mobilehome site gas pipe size? --------------- /%{ (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG )<-/ 11. What M)the gas pipe length from meter or tank to the mobilehome?. (ft.) 12. What is the mobilehome gas demand? ------------------------------ (BTU) ,(This information not required if pipe length less than 6 ft. on natural gas ``or less)`than 50 ft. on.LPG.) � yam. - . • s � f MOBILEHOME SUPPORT DATA Mobilehome Mfr. U a Setup Model No: 717WN JYear Width 070 ` (ft.) Length .. %2� . (ft.) Ekpando Size ft.x ft. (Draw support details below) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual a d struc ural setup sheets (if not on .file with .the'County of Butte). Sin e �(,�;� ���� Footings (check one) 1. Wood..either . pressure treated or Center Center Support fdn. grade. Suppor Footin Sizes Locat ons (in. 2. Concrete pad. . r 3. Other,: specify in. in. b ftS�� ink in _ Supports (check one) 1. Concrete block 2. Concrete piers ( in )(in.) 3. Steel piers 4. Other, specify 0 ¢ �I, x�D Typical Support Footing Size x ] I 1 in. i.n. .(in )(in.) -� 4 J. \ in.) -IA-- si h Max. Pier Spacing ln•) *If center piers are other than drawn above, draw in locations, spacing, and dimensions. Max. Overhang IN pE G PARTM�N`1 A �UILD 9PROv �-_D fh4"Set of plans and specifications MUST—bF• �„ a'"-``� at e'l tunas and it is unlawful M�»a ny c ^ :ngG,s or alterations on safe „�iti�co g, `;k' �' +r%;"I' �! .���` 1D„ �n 't WV,41- vc,�v lltefla i` from the Depa fP,' t '+_.. s Works; County of Butte. ru L4� The. Setback shall be 5 ft, trtrtl the , side property line and- 50 ft. from Ad- centerline of the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely out of all easements. , All utility- connections shall be located within 4 ft. outside the rear third section of the mobile home on the left (road) side of the mobile home. o R�- �'S ANN NOTE: AI Materials & Workmanship Shall Be in Accordance with Recognized Good Practices and of a quality proscribed for the Specified use in the Uniform Bui Jing, Plumbing & Mechanical Codes and the Notionc . Electrical Code. Septic system and locations t to' be 'as per Butte County Health' Dept. quirerri,ents. . .. •err. 1'� %A permit will be required for the installation of the mobilehome. eldo BUTTE COUNTY 25� BUILDING DEPARTMEN APPROVED r:UTI.ELigUD-M;IZ_�\ ., �dgt| AFNO�__ | | � / go Support 2i;Gc, � Compa 'Lio> faG� f=R | � : ` | � ; || | | \ , 1 | | | � � | �• , � | | � � | | | | | | � | | | , | � . � | � | | | | Compa 'Lio> faG� f=R Owner J Mai I Ing Address Contractor Mai I i ng Address Building Address a COUNTY -OF -BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 7 0 Telephone: 534-4541 / APPLICATION AND PERMIT r_v BUILDING A n /j=76 1 SQ. FT. I OCC. BUILDING VALUATION ro � //v� d Telephone No. // %//%.v/1 A. P. No. — 4&-- ' Zoning & Planning FeWltl WAC./ Sa14a4ierr Fire Dept. Fire Zone Use Permit EQA I Parking I ParcelParcel Ma 60' R/W Im r Plans Declaration P p ovements Bldg. PI s Rec'd Parcel va Plans pprovol NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Single Family ❑ Duplex Mobil Home Others ❑ Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Mair service OVER e00v 100 AMP OR LESS Main service EA. ADD'L 100 AMP NEW CONST. / DWELLING OCCUP. 9 $3.00 1.50 1.50 1.50 1.50 1.50 30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 I2 so ft FEE FEE CONTRACTORS LICENSE LAW I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. ' ; AV is2:d,Date Signature of Permiteeee or Agent Receipt No. ` I -,- JCD White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant TOTAL PERMIT FEE $ -W This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above fo which fees have been paid. ECT OF PU WORKS B Y Date : �13 he Building permit expires Date � — NEW RE. MULTLO�T CO ID � BRANCH CIRCUITS) NW S'. 12.50eal I am licensed under the provisions of Chapter 9, Div. 3, of the NEW CONSTR POWER APPARATUS 8 NON-RESID, SINGLE OUTLET CIR, State of California Business & Professions Code under the name Ex. Occup{OUTLETS OR FIXTURES 5 Lg style of: Ex. Occu FIXED APPLNS. OR P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Lice se No. Classification �( "lam exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ FEE f WORKMEN'S COMPENSATION INSURANCE PERMIT FILING FEE $3.00 1 am aware of the provisions of Section3700 of the California Labor Heating Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Cooling ❑ W rkmen's Compensation Insurance. I certify that in the performance of the work for which this Ventilation It permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of Hood 2.00 California. Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. ' ; AV is2:d,Date Signature of Permiteeee or Agent Receipt No. ` I -,- JCD White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant TOTAL PERMIT FEE $ -W This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above fo which fees have been paid. ECT OF PU WORKS B Y Date : �13 he Building permit expires Date � - COUNTY OF:BUTTE — DEPARTMENT -OF PUBLIC WORKS ' 7 County Center Drive — Oroville, California 95965 %/Y� 7 • Telephone. 534-4541 •rte APPLICATION AND PERMIT Bldg. PIVns Recd Par roval Total Valuation Owner J NEW ❑ ❑ UTILITIES OTHER ❑ Mailing Address Permit Fee 2.50 Single Family ❑ Duplex ❑ Mobil Home Tele hone No. Contractor $3.00 (f 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: Mai I ing Address Repair drainage or vent piping License No. Classification Water piping am exempt from the Contractors License Laws of the State of California. Each gas water heater or vent Telephone No. Building Address 1.50 , Y % Oh r G Lawn sprinkler system 2.00 A. P. No. 77/ Oji / Zonin P n. F s WIR/ Sar ation I Fire Dept. Fire Zone Use Permit EQA IParking Plans I Parcel Declaration Parcel Ma P 60' R/W I Im yeti pro ents Bldg. PIVns Recd Par roval Total Valuation Plans Approval NEW ❑ ❑ UTILITIES OTHER ❑ IADDITION Permit Fee 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ PERMIT FILING FEE $3.00 (f 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: 1.50 Repair drainage or vent piping License No. Classification Water piping am exempt from the Contractors License Laws of the State of California. ( 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 �l ermit is issued I shall not employ any person in any manner X0 as to become subject to the Workmen's Compensation Laws of California. I certify that 1 have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Xate 2 Signature of Permiitteee or Agent Receipt No. / 1'7ry 3p;1 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant BUILDING SQ. FT.7 OCC. I BUILDING VALUATION Fireplace $ Total Valuation @ Permit Fee $3.00 Plan Checking Fee &/or Penalty Permit Fee 2.50 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 (f Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 ' Each gas water heater or vent 1.50 Gas piping system 1 - 5 outlets 1.50 , Each additional outlet .30 Building sewer 5.00 Lawn sprinkler system 2.00 Permit Fee $ ELECTRICAL No. @ PERMIT FILING FEE $3.00 Main service 1000V OR 0 AMP ORLESS5.00 Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. / DWELLING OCCUP, SA __ 1. EX. OCCUPCOUTLETS OR FIXTIIRES 1 1 50 V Z5t BAL@10 EX. OCCU FIXED APPLNS. OR (FIXED (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring _ 6.25 Permit Fee $ MECHANICAL No. @ PERMIT FILING FEE $3.00 Heating Coo I i Ventilation Hood 1 1 2.00 Permit Fee $ $ Land Dev Ree $ TOTAL PERMIT FEE $ 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. T R OF PUBLIC WORKS By4a Date 27 Building permit expires Date _CAX3 1-7 MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located wit equired'separation from lot lines and buildings and generally conform to plot plan? Yes_ No 2. Does the mobilehome have,required clearances above ground? (Sec.5085) Yes` No 3. Are footings and supports properly sized;,spaced, and braced as papproved plans? (Note possible variation at spring shackles.)'(Sec' 5082 & 5083) Yes_ No 4. Is the mobilehome level? (Sec. 5088) YeS_ No 5. If mor than .a single unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Isflexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yesl/ No_ �af� Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No_ 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes 4--doB.. Does it have minimum " per foot,slope and is it properly supported? YesL-No C. Are any leaks detected in drainage system after running 3- lons of water through each fixture including washing machine standpipe? Yes_ No &j If coach is not State of California approved, does station have required trap and vent? I0 " Yes_ No 4 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an `approved 3/4" Minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobiipllfome gas line iiilet without reductions other than the mobilehome connector. Yes No B. T st OK as per following procedure? Yes_ No— l11. ol1. Open all appliance connector valves. c2 -""'Shut off appliance burner and pilot valves. --3-'Air test with manometer to 10'-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min, without drop. _4�-Connect gas meter to mobilehome with connector, turn.on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes_ No 9. Electrical A. Is service large enough to provide adequate amperage -,to mobilehome (must equal rating of mobilehome with a minimum of X00 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes No B. Is there proper clearances around panels? Yes I- No_ C. Is power supply cord•or feeder assembly properly fused? Yes v No D. Is continuity test satisfactory as per the following procedure? Yes �No De -energize electrical wiring system of the mobilehome at the pedestal. Make sure that the power supply cord or -feeder assembly conductors, including neutral conductor, have been disconnected. 3Switch all breakers and switches in the mobilehome to the "on" position. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. �! All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6 Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. ob card signed by Health Department for water and sanitation? ..may 11. If everything okay, sign off�card and tag services. MOBILEHOME DATA Manufacturer and/or Namesty/le !`UQ Ur -4 Length_ Width Vehicle Serial No. State Identification No. M)4 /q'714, Additional Information or Comments: V U DECLARATION REGARDING LOTS OR PARCELS I certify that as owner of the property acquired by deed in de�.� Page Official Records of Butte County, (AP# 7 Z - 2-6 I am requesting permission to build or install an additional living unit on this property. I will not divide. the aforementioned property for 'sale, lease, rent, or financing unless all applicable land division laws and map requirements are com- plied with. I am conversant with the present zoning regulations affecting the aforementioned property, and declare that I shall not violate same. I represent that the proposed use, of. -the additional li.ving__unit.-_is_ �; �; ar4i �k) c'�p and._thav-fur th_er- i -ahal.l--not change chis- proposed _use= of the' additional= living -unit- ' unless and until I receive written approval therefor from the County of Butte. I fully -understand that pursuant to Chapter 20. of the Butte -County Code and §11535 et seq-of_the.Business and.Profess,ions--Code that if I, in the future, sell, lease or finance -the .area_on .or adjacent to. said improvement without- fully -complying with. - the applicable --laws and -ordinances, that -.1 shall be -guilty of a -misdemeanor -and therefore, subject --to the aforesaid --penalties and-imnrisonnent pursuant to law. Further, this statement shall be properly acknowledged and recorded at the request of- the County of -Butte: 7 OFFICIAL RECORCS BUTTE COUN?"-C�_ IFt.v MINA, LEY TITLE DEC ZI 1143 AN 1917 LOUlSE COUNTY RECnRCIR FEE a 2s4/ STATE_0f_.CALIF_ORNI-A ) « STATE OF 'IFORNIA 1 � C UNTY OF I ss. C EOnC �r 1— \�afore _me, the h� c>S;� m said State, personally appeare 1 r c a —LL known to me to be the person whose name V subscribed to the within instrument and acknowledged to me C that Yexecuted the same- WIT4myd and official seal. iE o Sign Name (Typed or Printed) byb -lL/b Owner Address ate 0MG- :AL DC -,*_ .1ENT a Notary Public in and for _. (This area for offc;al notarial seal) County of duly commis - known rument and seal in the .e first above [On--- MY COMbUSSION OFFICIAL SEAL 1 i.ME L. OMENS NOTARY PUBLIC - CALIFORNIA PRINCIPAL OFFICE LN BUTTE COUNTY EXPIRES JULY 19, 1981 (This area for offc;al notarial seal) County of duly commis - known rument and seal in the .e first above COUNTY OF BUTTE 1 ;1111111114, 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 y9Z"-- eO for the following location: 0/ me A- STi�':�c%7Dc.Ki i D S .yi / /V /44/91 f1 To+/ A6 0<0 4W C L r— Owner J0/4e' L--)oc tAl4i1^1 TT Owner's Address 13 W.5 Mobilehome Mfg.6-1-UX/brt1 /^/D Mode_► A// Year Insignia No.1iA14 Ll FL --i5 7 Serial No. L;1 ,2fL, Y 114 . 4 It is hereby certified for occupancy at the above described location and may be occupied. Director of PublicWorks f4 Date/0 �' �`� By } . r THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - O.P.W. PERMIT NO. 4647-80P,g PERMIT EXPIRES 9//sA�,L OWNER John Delahunt CONTR. owner P ASSESSOR PARCEL 72-26-39 LOCATION App.k mi.E.of Stringtown Rd.,app. 5 mi.N.of Hurleton Rd., Oroville i .t kik i1 { Temp. Power Pole (S Called PG&E Temp. Elec. Service 1 Called PG&E :t Temp. Gas Ser, Ze Yo `/a a Z0,44- Calle �t JOB FINALED (Date) v Signature J = OK 0 = Not OK - = Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready 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 Pr ection 4. Ftg., Porches Decks; Soils -Steel- / /'' Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Out ggers 5. Stemwalls, Mai ; Steel-Blockouts-Wrapped-Slab 52. Sidi -Nailing-Veneer 6. Stemwalls, Ga ge; Steel-Blockouts-Wrapped-Slab 53. Stucco esh-Drip Screed-Fdn. Vents-Underfir. 4ccess 7. Piers-Firepla a Ftg.-Steel 54. Glazing rea-Glass Protect ion-Skylights-Pla is 8. D.W.V.: Fall- ittings-Test-2 way C/O -Sew r Test 55. Shear Wa s; Nailing -Bolts 9. Gas Pipe; Size Anchors 10. Water Pipe; Tes -Anchors-Regulator-Servi a Test 11. Electric; Underg ound 12. Plenums & DuctA; Clearance -Material -Su ort -Ins. 13. Girders -Sills -A hor Bolts -Joists -Vent Cripples Card -BI Date Card -BI ate Card -BI Date Card -BI ate Card -BI Date Card -BI 40ate Card -BI Date Card -BI Date Date FINAL (Plans) OK a ept #'s Card -BI Date Card -BI Date Date PLUMBING (Permit) OK xcept q's 56. Ext. Steps -Door Sidelight Protech n- Land ings 57. Smoke Detector 14. Water Ht.; Vent -Ac ss-Combustion/Air 58. Furnace; Vents -C le rance-Comb. ir-Connector- Garage; Above FI r -Ducts -Me h. Protection 15. Water Pipe; Test & chors-Nail Pr actionIn r 16. D.W.V.; Test-Fttngs Anchors -Nall Protection 59. Bedroom Exiting 17. Shower Pan; Test, Fi t Floor-Tub/Access 60. G.F.I. & Bath Fixtures & Tub Ac ess 18. Test Tub & Shower, 24d Floor-Tub/Access 61. Elec. Trim & Subpanel; reaker izes-Labels 19. Gas Pipe; Size & Anctipirs 62. Stairs & Rails 63. Fireplace or Stove; Cleara ce Hearth 64. Elec. Outlets at Wood Pan ; nt. & Ext. Card -BI Date rd -BI Date 65. Kit. Fixt. & Appliance; Grn -Air Gap -Cooking Clearance Card -BI Date C rd -BI Date 66. Elec. Outlets & Receptacle t Kit. Counter Date ELECTRICAL Permit OK e e t 's 67. Garage Fire Door; Swing- an ing-Closer 68. A.C. Duct in Gara a -Da er 20. Fixture & Transformer CI ara a -Ins. Protection 69. Wtr. Htr.; Vents -Clearan a -Co M. Air-Connector-P.R.V.- In Garage; Above Floor ech. P otection 21. Elec. Receptacles Spacina-Ljghts & Switches at Doors 70. Plb., Elec. & Mech. Eq ip. Lista for Location 22. Size Boxes No. rs-Stapled 71. Elec. Receptacles in arage; (G. I.)-Romex Protec. 23. Romex Install led Cltoo sea tto o a of Studs & C.J. 24. Equip. Ground made up w/ ch. Fasteners -Bond Gas &Water 72. Insulation -Foam -Lo ed in Attic ❑Yes 73. Guard Rails &Deck onstruction-P st Caps 25. 2 Appliance Circuits in Ki en &Conductor Size 74. Fdn. Vents & Crawl ole Door -Drat ge & Wood -Earth Clearance Looked under Floor ❑ Yes It 26. Subfeed Wire Size / / g4. Au or AI-A.C. Wire Size / / ga. Cu or Al 27. Range Circ. / / ga. Cu r I -Oven Circ. / / ga. Cu or At, Insulated Neutral (__1 Y,No 75. Following instld.rive E)Yes E] No; Walks E] Yes E] No; Planters ❑ :Ye r_ No 28. Service -Riser Conducto & G and -Main Disconnect 76. Stucco; Brown -F nish 29. Equip. Clearances; Pan Is -Mo rs-Mech. Equip. 77, A.C. Unit; Disc nect-Clrnces-Brkr. & ond. Size -115V Outlet 30. Clothes Closet Light- hower L ht 78. Vents Above R of; Plbg.-Appliance-Fir pl.-Clearance to Opn s. - - - 79. Water Well; Di connect, Electrical, Pluming Card B -I - _Date Card -BI Date 80. Exterior Elec Trim; G.F.I. Receptacle -U derground 81. Ventilation t roughout House Card B-1 Date Card -BI Date 82. Glass Prote tion Date MECHANICAL (Permit) OK except q's 83. Correction from Previous Inspections 84. Gas Test eters Tagged; Gas -Electric - _ _ 31 _ 32. 33. A.C. Ducts; Insulclion & Support Vent Fan; Exhausl above Insuiatioi Condensate Drai & Overflow; Size S Grade 85. Water & wer Connected -C/0 to Grade -HD pproval 86, Energy ompliance Certificate -Other Certifi ates Card -BI Card -BI 34. 35. Furnace -Vent; cess -Comb. Air- eturn Air Vent -115V outlet Attic Access & tlatform if Furnace Attic Date Card -B II- Date Date Card -BI Date Card -BI to Card -BI Date Card -BI ate Card -BI Date Card -BI ate Card -BI Date Date FRAMING(Plans) OK except q's Com nts at Final: 36. 37. 38. 38. 39. 40. Sills; Properaterial & Anchors _ Walls: Studs Nailing,.Sp_acing &'Bracing Plates -Sound Bearing Wall over Girders & Floor Naili Draft Stop in Valls (rat proof) _ Fire Stops; F irred Ceilings -Stairs Chase Tub 41. 42. 43. 44. 45. 46. 47. Header & Be -Size & _Bearing Hangers-Pos Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shihnq.-Ring. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Rom_ex Protection -Draft Stop -Ins. Baffles Bdrm_Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) J.. x J OK 0 = Not OK — = Not Applicable ' {+ M-OBILEHOMES = Not Ready s I MISCELLANEOUS Date MOBILEHO UTILITIES (Plans) OK except N's Date DECKS, COVERS, rARPORTS, ETC. (PlaPA0K except a's og Requirements—Setbacks—Easements 1. Zoning Require nts—Setbacks—Ea mems of , Special MH Support—Sketch 2. Footings; Size—De h—Spacing— nnectors _ ewer; Location—Test—Fall-C/0—Concrete 3. Decks; Girders and/ Joists— ecking-jBracing—Stairs—Rails A, -Water; Location—Test— Bement Needed Sketch) 4. Wood Awn.; Posts—Be s— ftrs.—Connec.—Shthg.—Rfg.—Bracing le ricity; L ' n—Cle es— d.—/`00 Amp—Concrete _ 5. Alum. Awn.; Columns—C nections—Splice—Decal—Enclosures W'das: L io /"L"ft./ /"Nat. or/ 'L"ft./ "LPG 6. Carports; Windows—D rs Z_.AeriTity Clear"ance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BIDat d �0 Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME IN TALLATION (Plans) OK except N's Date POOLS (Plans) OK except N's Alf'—Zoning Requirements—Setbacks—Easements 1. Setbacks—Easements &9--r—goings; Siie—Spacing—Marriage Line 2. Soils; Compac n—Structure Sta lity 43-'GaXTest—Demand—Valve—Connector 3. Pool Structure; SNI—Connect/ns—Thickness—Dead ns—Thickness—Dead Men—Lining 4WIElectricity; MH Test—Crossovers—Breakers—Clearances 4• Elec.; Receptacles a Lig ing; Distances—GFI rain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 1 olts—GFI at H TestrRege#a+9,==Connector 6. Elec.; Enclosures; Co' uit tries—Terminals—Listed at nd Sewer Connected—C/O to Grade—HD Approval ` 7. Elec.; Bonding; Met w/5' -Ci ulating Equipment—Heater p. and Electricity Tagged 8. Elec.; Grounding; quip.w/5'—Ci lating Equip.—Pool Lghtg. Boxes—Enclos s—Panelboards—Ins. o Main in Conduit Ex' Insp.=Sketch go-t-ert. of Occupancy , 9. Health Depart ent Approval y - 10. Plumb; Cir. Test—Water Supply Test Card B- Date.•6-Y—O Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI DateCard-BI._y, r.. , Date Card -BI Date 0 .. i f i i f 0 r COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS .ti 695 Oleander Avenue, Chico — Phone 3.43-4211, Ext. 70 7 County Center Drive, Oroville — Phone 534-4541 Skyway and Elliott Road, Paradise — Phone 877-3435 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection Indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office .immediately. n/(- 5 7WI4& le(,F- Qu/f2./Zsb c d ( 1-/-f o, I/S Inspector ftll% Date /'0— "-F,— 'r-10 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 a' APPLICATION AND PERMIT PER IT NO. ASS ESs AR EL N B�2 /—�(p—�j ZONIN BUILDI RMI OW 111 J D EI-14,q SO. FT. OCC. BUILDING VALUATION 0 MAILI $ . A 36 CONTRACTOR'S N ©I/�%C� TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LEN R UNKNOWN Fireplace Total Valuation is LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINE LICENSE NO. Plan Checking Fee 44IT. OT7E $ IV. ©h Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING I RESS A -Pp. t /W/ 4E. ®F• 5 P_1AJ47VWAJ P—D, PLUMBING PERMIT Filing Fee /0.00 O J P� . PD' RP - 5 O , G , p, r `� w Each Trap 2.00 Repair drainage or vent piping 2.00 Q�(111—L Water piping . LOT NO. SUBDIVISION NAME PARCEL MAP Each gas water heater or vent 2,00 Gas piping system 1 - 5 outlets �pO USE OF STRUCTURE SF ❑ Duplex[]Mobilehome[P�ther SPECIFY Building sewer 100 Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities Installation ❑ Other ❑ Describe work: — Permit Fee $ . 00 Contractor ELECTRICAL PERMIT Filing Fee I Igloo Main service jp0 AMP OV OR RSLESS 5.00 6.00 Main service EA. ADD'L IOD AMP 2.50NEW CONST DWELING OR ADDNS. ( ACCLBLDGS.CCUP,&� 20 sq ft 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 CO ID FZ BRANCH CIRCTITS 2.50 ea NEWNONCONSD. R. (SPOWER INGLE OUTLET LIV ) SO @ 25C Ex. Occup(ourLETs OR FIXTURES BAL@Ioa FIXED APPLNS. OR Ex. Occup.(0UTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 X00 Misc. Wiring 6,25 160 %d /-#P O d Permit Fee $ e SQ 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. IV I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 3.00 Heating Cooling Hood 2.00 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. 1 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 a n t said County In onsequence the granting of this permit.. �Y�� / �Cy',� ��,� ®� ate` Date Signature of Applicant — OwnerJ& Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 s ries in hei ht. Mobile Home Installation Fee $ Land Development Fee $ 8 TOTAL PERMIT FEE .!50 OCCUP. GROUP I TYPE OF CONST. I PARC PD ND SSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIR OR OF BLIC a By ' PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS / Date � Receipt No. 2-0 1/4 WNIT E -D. P. W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS — BUILDING DIVISION w,..... 7 County Center Drive — Oroville, California 95965 —Telephone: 534-4541 PERMIT APPLICATION DATA SHEET OWNER JON/J Del -A9 IUti~ AP Permit NNNo. Proposed Building Use /L-/, H, (,17 -1,1 - Permit fee based upon: Complete Contract Price PW Valuation Other (explain) Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED PPROVED .nl,/ 1. All items have been submi ed......"..."'......'...'..'.'.....'........................... Plot plans in duplicat triplica . 3. Complete plans in duplica a triplicate ................................................... 4. Complete engineered plans and calcs..................................................... 5. Plans with Energy Design Compliance Statement ............................ 6. State Energy Forms No. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $.................................................. a 9' Letter of signature authorization............................................................. 10. Sanitation approval from Health Dept.... S 11. Planning approval for ............. 12. Cer;tific�aFte/offWorkme 's Compensation Insurance ........................ OIL - 13. Contractors�,LicensInformation (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. 15. Pre -inspection for required. Pre-inspec.request to (date) bldg. -inspector 16. Other When you issue the permit, process as follows: Mail to owner Mail to contractor. c/ �-- Telephone an:�old pickup at X20 office. Deliver w/inspection. Other 0 Applicant zr,`p Date Copy of plans sent Health Dept., Fire Dept., Other Date— During ateDuring the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. ZV 2. Additional items required: oe (Contractor, Designer,) was ad 'd of above required data by Telephone — /0-10 Other By ZDate Plans checked by Date Plans approved by /_ - Date / z OTHER: Copy/DPW n , COUNTY OF BUTTE - Department of Public Works 7 County`Center Drive, Oroville, CA. 95965 Phone: 916-534-4541 OWNER -BUILDER VERIF ICAT ION 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 in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your build- ing 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 or no) T� 3 2. I.(have/have not)�e?ue_ _ 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 City Phone Contractors License No. .4. I plan to provide portions of this work, but I have hired the -following person to coordinate, supervise, and provide the major work: Name ,• Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following:, persons to provide the work indicated: Name Address Phone Type of Work Signed: o • Property Owner Social Security number - Date D NOTE: This Owner -Builder Verification is sent to you as required by Sections 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. 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 z0NI - FIV A14 BUILDING PER /Q�M OW ER TELEPHONE SQ. FT. OCC. BUILDING VALUATION " OWNER'S MAILING ADDRESS CONTRACTOR'S NAME -- TELI�RHO.NE X33 -ate CONTRACTOR'S MAILING ADDRESS /111419 / CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRE,SS� Permit Fee $ ARCHITEC N.GA.N•EER•--- LICENSE NO. Plan Checking Fee M $ Q t Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDIN RPP / ADDRESS M/1 E. 0PS7- ,, (VA) AIR/. 12b PLUMBING PERMIT Filing Fee 3.00 /fid®%4,l / Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome�Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New❑ Addition❑ Remodel El Utilities❑1nstalla�Other❑ Describe work:%1771ELECTRICAL ��p'►" / — Permit Fee $ Contractor PERMIT Filing Fee 3.00 Main service 100 AMP V OR OLE 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 22 sq ft 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. a�i9A.i 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 NE C U 1 NON-RESID R BRANCH CIRCUITS 2.50 ea NEw CONSTR (POWER APPARATUS &� NON.RESID. SINGLE OUTLET CIR. Ex. Occup(OUTLETs OR FIXTURES 50@25Q BAL@10s EX. QCCU FIXED APPLNS. OR p•(OUTLETS (RESID.) EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6,25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. �I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 3.00 Heating Cooling Hood 2.00 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, judgment -s; costs, and expenses which may in any way accrue against_sat-d Eo�tyl onsequence of the granting of this permit.%� Date a� Signature of Applican Owner ❑ Contractor Agent F1work An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in he' hat. Mobile Home Installation Fee $ ,Qa Land Development Fee $ TOTAL PERMIT FEE �t/rUf� occuP. GROUP I TYPE OF CONST. PARCEL PD I ND SSU This permit is hereby issued under sions of the Butte County Code and/or indicated above for which ' DIRECTO F PUBLIC BY PER EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date—r?'o Receipt No. 4 (�J WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT I.$.;.Yj`-,J':_.'-�1 �!.�,� w�.`,,�''*,,,�,r,;,:+'- "v"'r�''�''o'yy.-'�^"'�,.%v�-� .f .ia..._Sw�:=�+v_�,.�-�--�-1+44��,r'.�,�"..i�.`•w r=.��1�4">�'�::��I,;,'�.,, `) COUNTY OF BUTTE = DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION ` 7 County Center, Dr,.Jv,e — 0roville, California 95965 — Telephone 534-4541 5 PERMIT APPLICATION DATA SHEET Permit No. _ OWNER/5,. I���/-► /�t�T —A. P. No. Proposed Building Use �t 1. =Z Permit fee based upon: Complete Contract Price DPW Valuation ��c 'er (explain) Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted................................................................... 2. Plot plans in duplicate/triplicate............................................................... 3. Complete plans in duplicate/triplicate................................................... 4. Complete engineered plans and calcs..................................................... 5. Plans with Energy Design Compliance Statement ............................ 6. State Energy Forms No. .................... 7. Statement of Intent for Non -Heated & AC Buildings ................... 8. Fees of $.................................................. 9. Letter of signature authorization.........:................................................... 10. Sanitation approval from Health Dept.... 11. Planning approval for 12. Certificate of Workmen's Compensation Insurance 13. Contractors License Information (no., name style, classification) ............................... 14. Improvements may be required. Contact Land Development Section of Dept. Public Works (see addressbelow)................................................................................................. 15. Pre -inspection for required. Pre-inspec. request to 16. Other bldg. inspector (date) When you issue the permit, process as follows: Mail to owner Mail to contractor. elephone E532 - 217- and,IxGld-3for pickup at 4-z office. Deliver w/inspection. Other �--� Applicant / __:/a V4 Date- �� Copy of plans sent Health Dept., Fire Dept, - Other Date— During ateDuring the plan checking process, the following data must be su , mitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required - (Contractor, Designer, Owner) was advised of above required data by Flans checked by. Plans approved by OTHER: Copy/DPW Telephone Mail Other Date Date Date • .. ,. BUTTE 'COUNTY DEPARTMENT.OF PUBLIC WORKS '. 7 County Center Drive, OroviIle, CA. - . •.r,; PHONE:. -;534-4541 ' MOBILEHOMEINSTALLATION'SHEET 1. owner's name: 2. - Installer's name: MO -Ar /4/ MC�I�F, P, .3.- o Is.; the site.currently under permit? Yet No (If yes,'furnish permit number (If ) OR Is the site an existingsite? Yes / / No / /� .. . (If yes, furnish two (2) plot plans.) . 4.,., Will.,the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes //-- % No _ .. ..... (If no', clarify ). 5. What is the mobilehome electrical rating? ----------------------- %'d�� Amps 6. What'is the mobilehome site service rating? --=------------------ Amps 7., What is the mobilehome site circuit breaker rating? ----=-------. Amps 8. Is there any other electric load,•to be• served by the mobilehome site service? --------------- ------------ --------------------- Yes 6A1 No .(If yes, identify the load and size: W n<< (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- (in.) 10. What is the type of.gas•service?----------------------------- Natural / / LPG /�'/✓ 11. What is the gas pipe length from meter or. tank to the mobilehome? `/ (ft.) 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.) ; MOB ILEHOME SUPPORT DATA m If other than single wide, Mobilehome Mfr. /'fA�l�/ -,,WAAY�S L/ furnish Setup Model No. Width (ft.) Box Length 01 (ft.) Tagalong or Expando Size "-=ft. x ft: (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,�pecif' d: � Footings (check one) g 1. Wood either, pressure treated or foundation grade. - � x (ft.)(in:) (in.) (in.) 2. Other (specify) Center support Center upport locations* foo ' g sizes Supports (check one) (in.) 1: Concrete block. El 2. Other (specify) (in.) (in.) 4--Tagalong or Expando,' show support details. (ft.)(in.) (in.) (in.) x cQ -- Typical Support (L (in.) Q(iin). ) Footing Size (ft.)(in.) (in.) (in.) Max. Pier Sp ac ing n. x Max. Overhang in.) (in.) (in.) (in.) f o0 BUTTE CGUN i t BUILDING DEPARTM.EN i APP.RQVP1 *if center piers are other than drawn above, draw immlocations, spacing, and dimensions. •�gaterIals & Workmanship Shall 0e in t4OTE. All ith !ze wd Good Practices and Accordance rescribed for the Specified use in the of a quality p plumbing & Machonical Codes and Uniform Building, the National Electrical Code. This set of plans and specifications MUST''° kept on the job at allalltimes t and o 'same with® t made any changelawful to s or written permission from the Department of P-ub oc Works, County of Butte. o(I 0 tk r A setback of 5 ft. from th6 property lines and a setback of 50ft. from the road centerline shall be clear of structures or equipment except for a 2 ft. eave overhang. I PaVPDSC D M, F/. IENT D Y,