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Home My WebLink About073-120-009'A. -P'. 73-12 9- DONALD KOMBRINK.. 6/10 mi. N.'off Forb'stown Rd., 7/10 ".mi':'-from"Fea=t Permit 1355-74P,E_(Util or MH) ELEC. GAS SUPPOR CTURB REQ. -"....0 0NP CT I0N `T EST,,, REQ _ AP 73-12-09 CONTR: English John's MH Sery Q Q, Para ") Penne_ d- �c _ • n I i i i i u . f i r �,� - L_ r --� PERMIT.NO. ( P E M ,MH UTIL. PERMIT NO. 1355-74P,F PERMIT EXPIRES OWNER Donald Kombrink CONT R. Owner ,LOCATION (A.P, 73-12-9 ) 4 6/10 mi. N. off-Forbestown Rd., 7/1( mi. E. from Feather Falls Rd. ' b a ) t Temp. Power Pole 3 �� Called PG&E Z a Temp. Elea Serv. Called PG&E Temp. Gas Serv. Called PG&E S JOB FINALED (Date) d (Signa �) A COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD f BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer ^ Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. StemwaII Slab Prov. for physically handicapped Heaters Appliances Carport Footings Conformance of ex. structure Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footing ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service — Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS on 7 � Z ACA"S low C- /�� • Septic systema ing drain stub outo, bet build — Ing quirements. Count y Health- Dept: Re - All utility connections. shall be 560 located -within 4 ft. outside the rear third section of the mobile home on the left (road) side of the mobile home. inns and specifications MUST be i his set of plans on the job at all, times and it same without unlawful 'to Cep tOUTTE.-COUNTY .make -any Changes or alterationsa Department of Public _ . written permissoo from the Dep BUILDING DEPARTMENT Works, County of .Butte. APPROVED LOAD BEARING SUPPORTS ADDITIONAL COKL!7,;TS Drain Connector, Describe ,� )q'9 S `L �c o 7� - �A-Vk-Jb � <-0o cult Water Connector, De�scr bei 09 tole so LORI)' --E ARING SUPPORT AND 1WTING IlNFOR ATION Pier Spacing Used-. S' Maxtmum Pier Load j n Maximum Column Load (multi -units onl)'�+..... its - S� Soil Bearing Capacity /o�� Footing Dimension Used__ el - SP 11 TYPE OF PIER USED Steel Concrete Coacrete Block (/ Other TYPE OF FOOTING MAT TRIAL USED Pressure Treated good Concrete // Redwood (Grade) b !/ Other Approved Type a17G - eAal BUTTE COUNTY BUILDING DEPARTMENT APPROVED* I F -- CL rt _r COUNTY OF BUTTE - Department of Public Works 7 County Center Drive,,Orovilre; California PHONE : " 534-4'541 Length = - _,•�, 11 MOBILEH024E INSTALLATION INFORMATION • Lot Facilities Mobilehome Data 1. Plot plan dimensioned, location of mobile 1. Lengthy a Width Cn and utility connections? Manufacturer ,cv Pri AS .82 Yes No Vehicle Serial No. 0j of -1c0- 2. Electrical. service equipment ampacityZ.o-V Insignia Control No. Circuit breaker ampacit.y �� P Feeder assembly ampacity ew-s-ep-o - Permanent Wiring Connection « Conduit size 45%c--- yc A,-upacity Power supply cord (amps) Receptacle Ampaei.ty 3: Gas inlet size Naw c�- 3. Gas:. Natural /��G Mobilehome connector siie Gas riser size Capacity. _ 4. Drain inlet size -3 '� 4. Drain connector: describe on reverse side 5. tater.riser size cr 5. Water connector: describe on'reverse side 6. Are utility connections located outside 6. Designed loads: the rear 1/3 of the mobilehome.within Roof live load psf. 4 feet of the left wall? Yes C --*--No Wind load -5- psf. If not,- show dimensions.abov_e. (only for mobilehomes manufactured after 7. Is the mobilehome clear of septic tank, October 7, 1973) leach fields and located outside public 7. Manufacturer's installation instructions? utility easements? Yes [/ No Yes No t- J FOS 8. Do you propose to do other work. on the 8. Will the mobile home be installed on"a property other than the mobilehome � installation ch will require a permit Y separate suppor structure. Yes No w iYes No If so, specify 5 ee li0l�� clovek� *For plans and specifications of support system, see other side. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WO 7 County Center Drive — Oroville, California 95965 - Telephone: 534-4541 APPLICATION AND PERMIT Owner Mai I i ng Address Telephone No. Contractor Mai I i ng Address Telephone No. Building AddressPd �� D e � ef"- Oyozzir A. P. No. ^-- — W . S ► iqp Fire Dept.if FireZone Use Pen -nit EOA Parking I Parcel Parcel Ma 60' R/W Improvements Plans Declaration P P Bldg.F� 11ns Recd Parc pprovalns Approval NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ Single Family ❑ Duplex ❑ Mobil Home Others ❑ 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: License No. Classification 20 am exempt from the Contractors License Laws of the State of California. 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. 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 abo mentioned property for inspection purposes. X Date Signature of Permitee or Agent Receipt No. //,w _ q White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant _ BUILDING V SO. FT. I OCC. I BUILDING VALUATION 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 incl. 1 meter Additional meters, each Sub -panel (12 or less) (more than 12) Range, Cook -top or Oven Water Heater or Space Heater Light fixtures Receps., switches & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. disp. or D.W. Air conditioner or heat pump Water pump Mobil Home Facilities Temp. Power Pole Misc. wiring Permit Fee MECHANICAL PERMIT FILING FEE Heating Cool i Ventilation Hood Permit Fee FEE $2.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 2.00 FEE 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. DIRECTOR OF P LIC WORKS By Dated 3 0'7, Bui ding permit expires Date..................r�°-73— COUNTY OF BUTTE — DEP4RTMI=NT OF -PUBLICS 7 County Center Drive ' — Oroville, California 95965 �•J Telephone: 534-4541 0 APPLICATION AND PERMIT BUILDING Owner SQ. FT. OCC. BUILDING VALUATION IV Mai I ing Address Telephone No. Fireplace Contractor . Total Valuation .01 Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No.Permit Fee Building Address ' PLUMBING No. @ FEE PERMIT FILING FEE $3.00 tlel 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. Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s ft tati•ort- FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 P a d Parcel lk,proval Pla Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No.1 @ FEE PERMIT. FILING FEE J$3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel 02 or less) (more than 12) — Single Family ❑ Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures •b A25 Receps., switches & fix outlets 20 025 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 Mobil Home Facilities 5.00 Temp. Power Pole 5.00 " License No. 21.41 Classification la % Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ MECHANICAL No. @ I 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. 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.Permit PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 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. Date Re AV'nature of Permitee or Agent pt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant OQ TOTAL PERMIT FEE I 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 1;�-— Date �4�A�li1 g permit expires Date �/ 9. Electrical ._._-_.._.. A. Is service large enough to provide adequate amperage -to mobilehome (must equa1 rating of mobilehome with a minimum of 100 amp) and other facilities on lot, i.e.,.water-.pumps, garage, cabana, -etc.? Yes *-'-N-o B. Is there proper clearances around panels? Yes `'Io C. Is power supply cord or feeder assembly properly fused? Yes 4 -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. Switch 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. L5. All non-current, carrying metal part13 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. L16'. 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 r;rounding 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. 10. Isob card signed Y Health De ned b artment for.water and sanitation? r L' J g P �%� 11. If everything okay, sign off card and.tag services. MOBILEHOME DATA' Manufacturer and/or Namestyle %�ilf /1' �/// are - Length Width Vehicle Serial State Identification No. 2.OR6 86-7-O&SR ) Additional Information or Comments: MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. 'Is the mobilehome located with required -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 per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) YesX_ No 4. Is the mobilehome level? (Sec. 5088) Yesi No 5. If moye than a single unit, are crossover connections properly installed? (Sec. 5088) YesNo_ 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes_,,<_No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes K -No C. 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— No B. Does it have minimum 34' per foot slope and is it properly supported? Yes o!No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes No a D. If coach is not State of California approved, does station have required trap and vent? Yes No__P fY A 8. Gas Piping nd Gas Vents A. Connector Is mobilehome connected to the gas supply with an a oved 3/4" minimum mobilehome co ector not more than 6 ft. long? Note: All p' ng is to be at least as large as the mob home gas line -iAl-et without reductions her than the mobilehome connector. Yes B. Test OK as per following p edure? Yes, No 1. Open all appliance connect valves. 2. Shut off appliance burner and pil-o�alves. 3. Air test with manometer to 10"7 " wate olumri, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrat in tenth you increments.. Test for 10 min. without drop. 4. Connect gas met/tobilehome with connector, tur on gas, test connections with soapy water. C. Are all applianceperly installed? Yes No - I