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073-130-024
O-1 3-13-24 '3070-90P,E 07 *3- FSO -02# t r� G zq iZECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 30'-Hov-2005 2005-0072913 Has not been compared with original BUTTE COUNTY COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with Califomia Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. LILLIAN SHIRA 7 COUNTY CENTER DRIVE REAL PROPERTY OWNER/LESSOR MAILING ADDRESS 61 LONE OAK DRIVE OROVILLE BUTTE CA MAILING ADDRESS CITY COUNTY STATE OROVILLE BUTTE CA 95966 CITY COUNTY STATE ZIP SAME (I�IT-fi�� INSTALLATION MAILING ADDRESS, IF DIFFERENT DATE SAME CITY COUNTY STATE ZIP SAME UNIT OWNER (if also Property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 05-2371 (530) 538-7541 BUI ING PERMIT NO. TELEPHONE NUMBER �r�nft►1a 1 .�i146r mgr (I�IT-fi�� SIOWTORE OF LOCAL A Y OFFICIAL DATE NONE DEALER NAME (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO CHAMPION HM BUILDERS 1990 SC648C MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMEMUMBER 0916482318A/B 44 X 11'8" CAL366969/70 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSORS PARCEL NUMBER 073-130-024 SEE ATTACHED END OF DOCUMENT ^,cc,5pl 90-24 1 94 B Order No. 35730 PC DESCRIPTION All that certain real property situate In the County of Butte, State of California, described as follows:• Lots 3 and 4, as shown on that certain Parcel Map •of a portion of the Southwest quarter of the Southwest quarter of Section 17, Township 19 North, Range 6 East,'M.D.B. & M., which Map was filed In the Office of the Recorder of the County of Butte, State of Californla, on August 30,, 1971, In Book 40 of Parcel Maps, at page 9. TOGETHER WITH AND RESERVING'THEREFROM a right of way for road purposes, as shows, on said Parcel Map. END OF DOCUMENT • BUILDING PERMITS NUMBER: 05-2371 Address or location of unit: 61 LONE OAK DRIVE, OROVILLE 95966 Legal Description of Real Property: 073-130-024 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: LILLIAN SHIRA Owner's address: 61 LONE OAK DRIVE, OROVILLE 95966 INSIGNIA OR HUD NUMBER: CAL366969/70 SERIAL NUMBER OR V.I.N.: 0916482318A/B MANUFACTURER'S NAME:CHAMPION HM BUILDERS YEAR: 1990 OFFICIAL APPROVING INSTALLATION: (9�Q IYUi DATE: ( I - tg-05 PHONE: (530) 538-7541 H.C.D. 513C STATE OF CALIFORNIA -DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DFnTQTDATTnm PADn MnDTl cunMC — .. . -1 ... MANUFACTURER NAME/ID TRADE NAME MODEL DOM DOT DFS SPC EXPIRATION CHAMPION HM BUILDERS/90086 MEADOW CREEK SC648C 10/11/90 10/15/90 11/13/90 U SERIAL NUMBER I 0916482318A LABEL/INSIGNIA NUMBER CAL366969 WEIGHT 015720 LENGTH 000528 WIDTH 000140 ISSUED SCC 05/29/91 04 EXEMPT USE TYPE SFD LPT 2 09164823188 CAL366970 013500 000528 000140 a .�Q TOTAL FEES ` 5 ` PAID: 6 S.00 I A D D R E S S E R E G M I A S I T L E R E D oS wi N T E U R S L E G A L 6 w N E R J U F N I I R O S R T L I E N S H E OC L.O D N E D R SHIRA LILLIAN PO BX 268 FORESTOWN CA 95941-0000. SHIRA LILLIAN OF PO BX 268 FORESTOWN CA 95941-0000 61 IONE OAK DR .. OROVILLE " GREEN TREE ACPT 350 UNIVERSITYPIAVE S SACRAMENTO DATE 12L0 1 DUPLICATE COPY TO BE FILED WITH THE MOSILEHOME IV 9 PARK OPERATOR A9 REQUIRED BY LAW IMPORTANT 03-143-00182 THE OWNER INFORMATION SHOWN ABOVE MAY NOT REFLECT ALL LIENS RECORDED WITH THE DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT AGAINST THE DESCRIBED UNIT. .2 THE CURRENT TITLE STATUS OF THE UNIT MAY BE CONFIRMED THROUGH THE DEPARTMENT. 0300032 rau;lne x0mano PO Gcx 2345, Ovrile, CA 95965 539-b34- ^_^C -3-'u to Cr,. LDA fi DE -150 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name,:' gr number, and address): TELEPHONE AND FAX NOS.: FOR COURT USE ONLY 5, -589-4685 Barbara J. Maine 45 Lone Oak Drive Oroville,'CA 95966 Petitioner in pro per F Butte County F ATTORNEY FOR (Name): upenor Courl, SUPERIOR COURT OF CALIFORNIA, COUNTY OF BUTTE STREErADDRESs: 655 OLEANDER AVENUEAUG 0 A M5 L MAILINGADDRESS: 655 OLEANDER AVENUE D'S F i t i! a d lark D CITYANDZIPCODE: CHICO, CA 95926 BRANCH NAME: PROBATE By Deputy ESTATE OF (Name): LILLIAN ESTER CAMPBELL SHIRA, deceased DECEDENT TESTAMENTARY LETTERS =OF ADMINISTRATION IYR .3 7s/ 3 7 4 © OF ADMINISTRATION WITH WILL ANNEXED = SPECIAL ADMINISTRATION ' LETTERS x0 The last will of the decedent named above having been proved, the court appoints (name): Barbara J. Maine a. 0 executor. b. Fx administrator with will annexed. 2. 0 The court appoints (name): a. 0 administrator of the decedents estate. b. special administrator of decedents estate (1) 0 with the special powers specified in the Order for Probate. (2) 0 with the powers of a general administrator. (3) letters will expire on (date): The personal representative is authorized to administer the estate under the Independent Administration of Estates Act x0 with full authority = with limited authority (no authority, without court supervision, to (1) sell or exchange real property or (2) grant an option to purchase real property or (3) borrow money with the loan secured by an encumbrance upon real property). 4. 0 The personal representative is not authorized to take possession of money or any other property without a specific court order. WITNESS, clerk of the court, with seal of the court affixed AUG 0 4`2005 Date: f SHAROL STRICKLAN;D, Clerk, by Form Approved by the Judicial Council of California DE -150 [Rev. January 1, 19981 Mandatory Use [11120001 AFFIRMATION 1. = PUBLIC ADMINISTRATOR: No affirmation required (Prob. Code, § 7621(c)). 2.x0 INDIVIDUAL: I solemnly affirm that I will perform the duties of personal representative according to law. 3. = INSTITUTIONAL FIDUCIARY (name): I solemnly affirm that the institution will perform the duties -of personal representative according to law. I make this affirmation for myself as an individual and on behalf of the institution as an officer. (Name and title): 4. Executed on (date):/7i�/(� at (place): 0i2.� (�L California. (SIGNATURE) Barbara J. Main CERTIFICATION I certify that this document is a correct copy of the original on file in my office and the letters issued the personal representa- tive appointed above have not been revoked, annulled, or set aside, and are still in full force and effect. Date: AUG 0 4 2005 SHAROL STRICKLAND, Clerk, by LETTERS j,p�� Probate Code, §§ 1001, 8403, (PrProbate SO ut7-� Z1S 8405.8544,8545: obate) l_q� Code of Civil Procedure, § 2015.6 NOTES RESIDENTIAL + PERMIT '-073-130-02 - . 'OS -2371 MAINE, BARBARA, 61 LONE OAK DR, OROVILLE ' Cont: MARCUS JONES -MH PERM FND (EX), 1. j' i SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER LCTT--,Iv- PQ53c/4' j . r Gal -+ . � p� q gea CAL— AIS i JOB FINALED (Date) Signature J=oK o - Not OK = Nt ltle M.O B I L E HOMES . � Not Ready Ready Date MOBILE HOME UTILITIES (Plans) OK except #'s I Date 1. Zoning Requirements -Setbacks -Easements Date 2. Soils; Speci & ,MH Support Sketch Date 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location =Test -Wrap; / P L'fL . /' P Nat or / P' L 'ftJ /LPG 7. Well Clearance & Disconnect 8. Uti ty Clearance - 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/F-Circulating Equip. -Heater Date Card B-1 Date Card B-1 Date Cana B-1 :Date . Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector Date .j 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date 5. Drain; MH Test -Fall -Flex Connector 6. Water, -MH Test-Regulator-Connectoe 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert 10. Exits; Insp.-Sketch 11. Cert of Occupancy .t Date Cana B-1 - Date Cant B-1 k Date Card B,1 Date Card B-1 i Date PER ENT END SYSTEM (ONLY) i • 1 -A09iKg Requirements -Setbacks -Easements ' ngs; Size -Spacing -Marriage Line ; i'ttlockbig Gas; MH Test -Demand -Valve L5 -,Electricity; MH Test r 6 Water, MH Test Water and Sewer Connected { - r -Gas and Electricity Tagged -G.-Exits <fT71cense Decals ; • _ I _ Verify #'s with Offic . Date I It pt -Card B-1'Uw Date Card B-1 i Date Card B-1 Date Card B-1 t MISCELLANEOUS ' Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists-Decking-Bracing-Stairs-FWs 4. Wood Awn.; Posts-Searns-Rftrs-Connectors Shthg-Frg-Bracing S. Alum. Awn.; Columns-Connections-Splice-Decal-Enciosures 6. Carports; Windows -Doors 7. Electric r . 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext; Steps -Doors -Land_ ngs 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Stricture Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GA 5. Sec.; Pool Ughting;15 Volts -GF] 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/F-Circulating Equip. -Heater 8. Elea; Grounding; Equip. w/5' Circulating Equip; Pool Lghtg. Boxes'-Enclosures-Panetboards-Ins. to Main Conduit 9. Health Department Approval 10. _ Plumb.; Cir. Test -Water Supply Test 11. _Light Niche - 12. -Enclosure; Fencing -Alarms Date Cant B-1 Date Cant B-1 Date Card B-1 _ _ Date Card B-1 I - OK 1 - Nat OK = Not Applicable - f,ot Ready RESIDENTIAL (Singie & Duplex) date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Sols-Steel-Elec. Gmd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ P Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall-Frtting-Test-2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Showef Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral O Yes O No Date FRAMING (Continued) 47. Hangers -Post Caps-Anchors-Corinectors 48. Cling. Joist-Rftr. Ties-Purfin-Roll Brac: Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Naffing -Botts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit Fid. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at KA Counter 75. Garage Fire Door, Swing -landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. HV.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor -Meth. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.FI.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following InstldJDrive O Yes O No/Walks O Yes O No/Planters O Yes O No 84. Stucco Brown -Finish _ 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appriance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 95. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes.Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Cana B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Duds Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Retum Air Vent 115 Outlet 40. Attic Access & Platform it Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42, Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps-Anchors-Corinectors 48. Cling. Joist-Rftr. Ties-Purfin-Roll Brac: Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Naffing -Botts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit Fid. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at KA Counter 75. Garage Fire Door, Swing -landing -Closure 76. A.C. Dud in Garage -Damper 77. Wtr. HV.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor -Meth. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.FI.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following InstldJDrive O Yes O No/Walks O Yes O No/Planters O Yes O No 84. Stucco Brown -Finish _ 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appriance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 95. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #. (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and. effect. License Class : License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: 0 D Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Policy Iff I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 0 " Applicant: WARNING: Failure to secure orkers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. PERMIT NO, BP052371 Issued Date: 10/04/2005. APN: 073-130-024-000 Site Address: 61 LONE OAK DR ORO Map Index: Description: EX MH, EX SITE ON PERM FND (1050) Owner: SHIRA LILLIAN 61 LONE OAK DRIVE OROVILLE, CA 95966 Applicant: MAINE, BARBARA 45 LONE OAK DRIVE OROVILLE, CA 95966 (530) 589-4685 Contractor: License #: Architect: Engineer: Qa Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: ,7 V CONSTRUCTION LENDING AGENCY This permit is reby issue nde the�ableons of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutto o do work !itate' abve been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) / . a_ Name: By � Date: / PERMIT XPIRES ON: x© [_,/ � / �r Address: Mate) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, . handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. A Print Name: V,' 4-6" A t.) Signature:,�C1�/�(�� Dale: / 0 K— ❑ Owner ❑ Contractor /Agent for Owner for Contractor B. C. Building Permit 01-16-04 pg 1 I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A'FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY"-- OWNER LEARLY** APPLICANT NAME OWNER Name Last Name n� ,/� Address First Name Address Apz Fax /"V , City ,l uU / y L' Phone State �. Zip - L' Phone C` C � Fax E-mail APPLICANT NAME CONTRACTOR Name Address Zip l�',& City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Ora V! Address Zip l�',& City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address LCNI� r1lilL l�✓LI ►/1� . City Ora V! Stated Zip l�',& Phone 3�� , , fs� Fax E-mail APPLICANT SIGNATURE r For office use only: o Zoning I TM_ Flood Zone X I SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc roR+. PERMIT NO. BIN # LOCATION Property Address City Cron Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Wolk: kmq New 7 - AA -i-16 Al s Sq. Footage /1) 5—? O Structure Built without Permits Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: 6 Amount: V 2 l M C Bldg SRA Receipt #: —Sheriff SMIP Date: q -2 ob I Q (��` Other 1. 21 -I.11D Total REV 2-24-05 11 1 , Y SUBMITTAL & PERMIT REQUIREMENTS jY\ 61t_e,5-�) The following drawings and specifications must be submitted to the Building Division In order to apply for a mit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. r . 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie door fnd plans, all duplicate. 4 ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. 11 .4. Deed, uI.H. Title/Statement of Facts. 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538.7541. ti EXPIRATION OF APPLICATION e Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION' 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 i . PERMIT APPLICATION DATA SHEET ShirCl, - OWNER: % \ MQ Nt ,�c� ro►ba� ASSESSOR PARCEL NUMBER �Q Proposed Building Use: FX M N t FAt IJE PERM F� permit Technician: K-67. Date: q--9-05 Items required in order to apply fora permit. All boxes MUST be checked OR marked NA in order to apply. 91a 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 faxesl ` ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. 2 ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. 1 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down ondlans- II in duplicate. ❑ 9. 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. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intentlfo� non-residential` buildirigs ❑ 12. Hazardous Material Form ❑ 13. Acknowledgement of building permit application without required clearances. t�i❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 16. Fire Sprinklers............................................................................................ ❑ 17. Agricultural Buffer cir and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... V9 Erosion Control Plan Required........................................................................ 20 Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 26. NPDES Form..........'................................................................................... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits....................:..................................... ❑/ 34. Deed Restriction............. t4 .:.....................................::.............................. V� 35. i te�tal description, C 4 the title search, re istration or NICO ......................... �ZN 36. Other: 0611r4 as admini ra+o oL+__4A+p . ❑ 37. Other: When issued TelephoneS$`1' 4�n R "�RnIrne" and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: C/�'/ �G vl G Date: 2 6, 1. Index permit application for t vems numbered: Plan Check Letter" 2. Additional items re d / Contractor, designer, own vised of the above data by' ❑ phone, ❑ mail, ❑ counter, Ify Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above jata b ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: ,fir' Date: o Plans approved by: 7 r' Date: q 8 Q 5 Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Q 1 n 1�Website: www.buttecounty.net/dds OWNER V� I C� l_ ` (IlA 1 1 A.P. # PROPROSED BUILDING USE FX M F K 5_J_T FTP F &M ft DATE q-2-- OS RECEIPT # DATE REC. 1. BUILDING PERMIT FEES n . ('� J --- Balance Due ................... $ �`% --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.).. Sq.Ftg. X $0.03 = $ 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per. dwelling) Zoning 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 8. SMIP 9. OTHER 10. OTHER 11. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT<DATE 961d Pursuant to Government Code Section 66020, y u are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) 2"ii 2"x 3/16- STEEL /16"STEEL ANGLE DETAIL "A" CHASSIS FRAME 1/4" GRIPPER PLATE -(2) REQUIP,EO 1/4" GRIPPER BASE 1/2-ISUNC-A307 x 4 --,--- BOLT WJTH HUTS (4) REQUIR_0 fat 1/2" SCH 40 PIPE' RISER WITF. 01/2" ADJUSTER HOLES AV0 3/8" THICK TOP PLATE 02" SCH 40 PIPE STAND WITH TWC, 01/2" ADJUSTER HOLES ABESCO ABS PAD #503 SF£EL FPAME.L-, SEE DETAIL ."A" 3/8" CAU PLA -ED BOLT, NUT & WASHER COUNTER BORED FLUSH WITH 307014 AT B" D.C. (8) REQUIRED 1/4" STAND BASE ,,-- ASESCO ARS PAD #503 36" MAX TO BOTTOM OF PAD 01/2"x 3" C-R. LOCK PIN WITH 01/8" BRIDGE PIN J ! 37" 18 1/2" COAL -I "C" FRAME 2" CHANNEL 1/4"x1-1/4"- TEK S'S (2) REQUIRED 1/4" GRIFPER BASE 1/2" A307 BOLT (2) REQUIRED 3/8"x 6'x 6" STEEL PLATE 1/2" A307 BOLT (2) REQUIRED 10_00 o w- ;0.00 09/16 HOLE (TYP) STAND BASE TOP VIEW 17918 ��p`ORk Lp TUF-:-1 PERMANENT FOUNDATION SYSTEM AEESC0-GUS GUARD COMPANY - 5831 FLORIN - PERKINS ROAD SACRAMENTO, CA 95823 PH: (800) 382-8831 FAX: (916) 383-5207 COACH "J" FRAME 1/4- GRIPPER1 /4"> 1-1 /4" PLATE TEK STS ® (4) REQUIRED 1/4" GRIPPER 1 BASE 1/2" A-107 BOLT f (4) REQUIRED t .C—BEA M J—BEAW ATTACHMENT tATTACHMv NT i 71. $ /2'° DIA. HOLE (8) PLACES STEEL FRAME �.• TOF VIEW ' ST - ._ .. �BAL'IRAt� � sBC1t10E�ltfell s Jl�rl�!►'1►�>�tat��llt'aal�dt�u�R ,!�::` oearl�aasaai�esvu>�>>�1o�,�ra�e 0 - (f- WAYNE POLVAOO, PE—LISTING NO_ F94249 SHEET i or 3 GENERAL NOTES GUS GUARD TUF-1 DESdGN LOADS: LIVE LOAD - 30 L9. FLOOR LEVE LOAD - 40 PSF WIND LOAD - 80 MPH EXPOSURE "C" SEISMIC ZONE '4" *SNOW LOAD 100 PSF (SEE NOTE j15) 2. THIS FOUNDATION SYSTEM IS DESIGNED TO BE CCNSTRUCTED ON A FAIRLY LEVEL SITE WITH NO EXISTING SOIL PROBLEMS. 3.' CHASSIS BEAU SUPPOETS SHALL BE LO;ATED AND SIZED FOR THE LOADS AS SHOWN IN THE `MOBILE HOME INSTALLATION INSTRUCTIONS'. i, IN AREAS WHERE DIFFERENTIAL SETTLEMENT (D.S.) CAN OCCUR, MANUFACTURED HOME SHALL BE READJUSTED WHEN DS EXCEEE•S 1/4, OW WHEN IT WILL ADVERSELY AFFECT MOBILE HOME UNIT. 5. CARRY ALL FOOTINGS DOWN TO FIRM: UNDISTUR13EO SOIL FOOTINGS ARE DESIGNED FOR 1,000 PSF TOTAL LOAD SOIL PRESSURE, AND SHALL BE CO€[PATBLE WITH LOCAL SOIL CONDITIONS. COMPACTED SAND MAY RE USED TO FILL LOCAL VOFDS UNDER PADS, E. STRUCTURAL STEEL- FABRICATED ACCORDING TO A1SC SPECIFICATION. WELD ACCORDING TO ANS SPECIFICATIONS. ELECTRODES -370 PLATES -ASTM A36 EOLTS-SIZE GR 5=AST€! A449=AST1J A3725. 7. THE CUS GUARD ASSENBUES SHOWN ON THIS PAGE SHALL BE LISTED AND LABELED BY BSK AND ASSOCFATES FOR THE FOLLOWING LOADS: AILOWABLE LOADS• HORIZONTAL VERTICAL G'JS GUARD TUF-1 2200,E 60001 GUS GUARD MGP PAD 22430 j 6000# GUS GUARD E -Z TIE PAD 22,001 60001 S. DURING PRELIMINARY INSPECTION, THE ESTIMATOR SHALL ENSURE THAI. MOBILE HOME CHASSIS BEAMS ARE OF STANDARD SECTION. 9. EXISTING COACHES MAT BE RETROFITTED TO RESIST SEISMIC FORCES BY INSTALLING GUS GUARD TUF-1 LNITS AS SHOWN ON' THIS PAGE OF TYPICAL FOUNDATION DLANS. 10. THE CUS GUARD TUF-I SYSTEMS ARE SAFE FOR INSTALLATION IN FLOOD PLAIN AREAS WHERE DEPTH OF FLOODING DOES NOT EXCEED THE HEIGHT OF THREE FEET. t 1. MULTIPLE UNIT INSTALLATION IS ACCEPTABLE PROVIDED THE NUMBER OF TUE-1 UNITS UNDER EACH UNIT IS THE SAFE AS SHOWN REQUIRED PER EACH UNIT. 12- SINGLE -WIDE UNITS REQUIRE ADDITIONAL RESTRAINT. s (SEE SHEET /3) :• 13. ALL UETAL COMPONENTS ,WD ATTACHMENTS ITEIJS SliaL BI PI;OTfCT1YE COATED. 14, WHEN CONCRETE .SLAB 15 IN ECSTANCE, PAD IS NOT 16. FOUNDATION FLOCKS 16"x 16"xl2" POURED IN RACE AT GROUND LEVEL WAY BE USED AT INSTALLERS DISCRETION ALTEPPATIVE TO PADS, SIYGLE WIDE COACHES tOUBLE/MULTIPLE COACHES E= 2' WIN. / S' MAX. £= 2' WN_ 11' MAX. S= 6` MIH. /16' MAX. S= 6' WIN- / 22` MAX. VARIES 10'-70' (SEE TA31LE ON SHEET #3) U U [_J ❑ RIDGE BEAM SUPPORT AS REQUJJRED BY MANUFACTURER ❑ir❑ (TYPICAL) } ® 0 ❑ ❑ u - a ❑ El—T ❑ 0 ❑ ❑ 8' NOM. ❑ ❑ 2' NOM. PADS IN ANY PMR MAY BE STANDARD M.H. FOUNDATION ROTATED 90 DECREES OR PIERS AS RECOMMENDED BY PVC SERIES OFFSET TO OTHER SIDE TO THE MANUFACTURER OR THE SUPPORT -AVOID CLEARANCE PROBU=MS- ENGINEER. TYPICAL THROUGHOUT PAD (7YP) . 17918 Eup.� �lqr� 0F�CR REQUIRED. ANCHOR STAND TO CONCRETE SLAB WITH -:UF-1 PERMANENT FOUR (4) 1/2% 3 1/2" EXPANSION ANCHORS. FOUNDATION SYSTEM 15. GUS GUARD TUF-1 FOUNDATION SYSTEM PROVIDES ALLOWABLE SHOW LOAD TO IOC PSF WHEN JNSTALLED ABF -SCO -GUS GUARD C(%VANY WITH EXISTING STANDARDS REQUIRED BY COACH 5851 FLORIN - PEP.KWS ROAD MANUFACTURER OR REPLACE THEM ON A ONE TO SACRAMENTO, CA 95$23 ONE BASIS. _. _ _ _ _ i STATE APPROVAL MANLFACTUR130 ROl.1WOMA FOUNDATION SYSTEM 11,78AND SATFsT'Y CODE JI6CiM IgM APPROVED . SUBIFIXT >tD C OIRBCTIONB MOM APPROVAL DOES NOTAMORTZB OAAT'MMR AXr OMISSIONS OR DFVLAnoN rAOM R (W . APPLICABLE STATS LAWS AND RBGMATXM b`tata ofCxikmu of HoasiaR sad Com O DE& AND 8 ne BYL� 2 v SPA NO. 7 �. 6 F I l t T1 is Plan AvamvslF_s,.h.e I I % T77— -- WAYNE T. POLVADO, PE—LISTING NO. F94249 SHEET 2 of 3 m m W L7 0- U Z H O V W ca <L ti m N m Cn m m Lo CV m cov m M CV N m 3/4" DIA. x 18" LG. I/2"x 3 1/2" 1/2"x 8" LONG (4) REQUIRED EXPANSION ANCHOR ANCHOR BOLT 3/8" CAO PLATED BOLT, HUT & WASHER ;4) REQUIREO (4) RECUIRED COUNTER BORED FLUSH WITH BOTOM AT 8" O.C. \ (8) REQUIRED CONCRETE PAD INSTALLATION CHAS5IS FRAME 1/4" GRIPPER.. PLATE (2) REQUIRED t/4" GRIPPER BASE 1/2-13UNC—A307 x 4' BOLT WITH NUTS (4) REQUIRED 01 1/2" SCH 40 PIPE RISER WIT. 01/2" ADJISTER HOLES AND 3/P" THICK TOP PLATE 02" SCH 4A PIPE STAND . WITH TWO 01/2" ADJUSTER HOLES ABESCO ABS PAG #503 STEEL FRAME X- - G]i. LIGH- HEAVY—WEIGHT PLASTIC PAO • BOTTOM36* MAX MMM—WIDE UK= SINGM WIDE UbIrr* TO !� OF •.0 01/2"x 3" CR.j LOCK PIN WITH 01/8" BRIDGE PIN --- 37" TUF-1 PERMANENT FOUNDATION SYSTEM 18 1/2' ABFSCO-CM GUARD G?MPAA'Y 5851 FLORIN - PERKINS ROAD SACRAx4T;l +O, CA 95823 E - L TIE PAD PH: (800) 382-8831 FAX: (916) 383-5207 LENGTH OF HONE 24 WIDTH OF H04[E 2 2B 44 UP TO 44' B 8 1 8 12 44'-1, to Sww 1s 12 12 18 Bi'—/" to 8o 2r 20 20 24 LENGTH KOME 1D YTIRTH OF HOME 12 14 16 IIP TO 4S' 1 6 1 6 6 $ wl 8 I 8 8 8 mto I, to Sol 10 110 f 0 in NUMBER OF TUF-1 REQUIRED NUMBER OF TUF-1 REQUIMI) MOTE: —Z Tt= PADS. G SINGLE WIDE UNITS REQW E (4) EUS GUARD TUF-1 PIERS ARE TO BE PLACED AT APPROXBAATFLY EQUAL P(TERYAIS ALONG EACH FRAME RAIL STATE APPROVAL FCUNDA*a0N SYSrM ANC SAFETY CODE, =nON X5Jl APPRDVED Suw= TO OOitRwnON6 NOTED v' ' APPROVAL DOES NOT AUMORM OR APPR•DVE AM I OMISSIOMS OR DEVIATION FROM R€QUIREMENTS W APPL:CABLB.TATE LAWS AND REGULATIONS . - smte oTCnllfosclr . . _d IS AND STAIMAIlO$ -s.� BPAXO. ThIsFlsnA"mvnlExphfu / Oe t.r.-tei! WAYNE T. POLVADO, PE—JSTING NO. F94249 SHEET 3 of 3 NOTES r, • RESIDENTIAL PERMIT NO. +-073-130-024 2-1652 ' SHIRA'LILUk4 61 LONE OAK DR., OROVILLE I STORAGE SHED (12 X 12) i, 1,. ,1 f SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY - USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER i 4 a } r i JOB FINALED (Date) Signature Y� 'a r f , r SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY - USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER i 4 a } r i JOB FINALED (Date) Signature =OK' 0 = Not OK' - = Not Applicable '* = Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 7. 1. Zoning Requirements -Setbacks -Easements 8. 2. Soils; Special MH Support Sketch 9. 3. Sewer; Location -Test -Fall -C/O -Concrete 10. 4. Water; Location -Test -Easement Needed (Sketch) 11. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 12. 6. Gas; Location -Test -Wrap;-/ /" L'ft. / /'Nat. or/ /"L"ft./ /'LPG 7. Well Clearance & Disconnect 8. Utility Clearance Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Date Setbacks -Easements Card B-1 Date Card B-1 Date Soils; Compaction -Structure Stability Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. r 10. Exits; Insp.-Sketch ` Date 11. Cert. of Occupancy 1 Date 12. Permanent Foundation Only; License Decal i 1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, CQYRRS, CARPORTS GARAGES (Plans) OK except #'s 1 oning Requirements -Setbacks -Easements j . Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails /J 4. Wood Awn.; Posts- Bea ms- Rftrs.-Co nnectors LY 6. m. Awn.; Columns-Connections-Splice- Decal- Enctosures Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche r ` Date Card B-1 Date Card B-1 1 Date Card B-1 Date Card B-1 i 1 I J = OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (; Date 46. Underfloor (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 63. PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 70. Fireplace or Stove, Clearance -Hearth Date 71. Card B-1 Date Card B-1 Date 72. Card B-1 Date Card B-1 Date 73. ELECTRICAL (Permit) OK except #'s 23. Fixture & Transformer Clearance -Ins. Protection 24. Elec. Receptacles Spacing -Lights & Switches at Doors 25. Size Boxes & No. of Conductors Stapled 26. Romex Installed Close to Edge of Studs & C.J. 27. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI 30. Range Circle / / ga Cu or Al -Oven Circ. / / ga Cu or At Insulated Neutral ❑ Yes ❑ No 31. Service -Riser Conductors & Ground Main Disconnect 32. Equip. Clearances Panels-Motors-Mech. Equip. 33. Clothes Closet Light -Shower Light -Spa Light 34. Smoke Detector 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Date 86. Card B-1 Date Card B-1 Date 87. Card B-1 Date Card B-1 Date 88. MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Comments at Final: 40. Sits Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing single & Duplex) Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Ring. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 82. Following Instld./Drive J Yes Q No/Walks 0 Yes 0 No/Planters Yes J No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERT% &, ! (Rev. 12/96) APPLICATION AND PERMIT o3 "/d - ASSESSOR PARCELNUMBER 0-73-1-30-02.9 ZONING Tim -2 BUILDING PERMIT OWNERTELEPHONE Li 460' rt S{t�ra1-2-11-71 SO. FT. OCC. BUILDING VALUATION U 2592-00 OWNERS MAILING ADDRE44 SS Box 959Y/ CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 2592.00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 54.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $35-10 SUILDINGADDRESS 61 LONE OAR DR. OROVILLE Energy Plan Checking Fee $ $ PERMIT FEE $ 109.1 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY 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: 12 X 12 STORAGE SHED Gas piping system t - 5 outlets 15.00 Building sewer 15.00 Mobile Home IS I GI W @20.00 PERMIT FEE S ELECTRICALPERM T Filing Fee 20.00 LJEss Main Service 200AORLESS 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.POWER 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 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 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.) )4 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. 9Ck to l� - b 'pcf��� 16nature of Applicant - Owner ❑ Contractor Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in heig Main Service PDA TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( 8 ACC. S.3.5¢FT. "No�"Na°�,uT. MULTI.OUTLET 97.50 APPARATUS 8 SINGLE Oun, CIR. 0 OUTLET OR FOCTURES Q 1.00 Ex. Occup.g21A0 @ .00 Rj Ex. Occup. otnLEE°rsA R D.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ H ° 11QP o coF c uE This permit is hereby issued under of the Butte County Code and/or indi a for hich fees have B PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Da Olt Y Date Receipt No. //�% WHITE-D.D.S.-B.D. CANARY -A SOR PINK -INSPECTOR GOLDENROD -APPLICANT r. e COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET ` 1 OWNER: L ,I. , ASSESSOR PARCEL NUMBER Proposed Building Use: �� v '� Counter Technician: Date: ((J �l , Items required in order to app or a permit. All boxes MUST be checked OR marked NA in order to apply. .. Plot plans, 3 or 4 sets, signed by the preparer of the plans. 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 instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ T. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views 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. Date Received By 0.8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ 9. Plot plan and business license approval from the City of Biggs .................................... 10. Letter of intent for non-residential buildings......................................................... LAA; -Detached Accessory Building Form filled out by the owner ..................................... 12. Hazardous Material Form............................................................................... ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) I. IJW14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... 415 Statement of Intent for Non -heated and A/C Buildings ................................... anitation and plot plan approval from the Environmental Health Department in O,Aof Chico Plumbing permit ........................ W ......... California Department of Forestry plan approvalaid. Sent by:ti ....... ❑ 19. Planning approval for (A) Use: (B)Parking: (CCheck: -* ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for ' required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verificatiori (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits.......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner,❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone 7 and hold for pickup. I have been informed'of t bove items and requirements for obtaining a building permit. R oa G licant: C� D « 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required r Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the abo e d to by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: L Plans approved by: %l.�,i Date: jf2� Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division ..d 4:e4 E.H. USE ONLY jr.� f! • Plot Plan AtlecMd Fleas Plan Atas a San% to ®.D. 1 ! TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance 1 ,eel CAU_ 0�3 13o�zy Owner Location AP# Plan Approved for: Sewage Disposal Water Supp, ublic Private Well Clearance for dwelling. Other %� �L Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist 8/96 --7t)2- Date Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX DETACHED ACCESSORY BUILDING OWNER'S STATEMENT OF USE Plan review will not be started until this form is completed, signed by the property owner, and returned to the Butte County Building Division. Attached Accessory Buildings and Additions will be checked for residential use. Exception: Garages and Carports. Owner: Ldk,ac, 21-t r l"�— Phone: FS q -;111-7 Mailing Address Site Address: (_Q I � QO Q Q 9, - Assessor's Parcel Number: (� 7 3 - 13 O - O `L t Zone: Please answer questions 1-16, and explain any yes answers for questions 2-14 in the space provided on page 2 of this form. GENERAL INFORMATION: ' 1. Is there a primary dwelling on the property? Yes © No ❑ 2. Is the structure already built, under construction, or under notice of code violation? Yes ❑ No 3. Will items produced in this building be offered for sale? Yes ❑ No 4. Will the public have access to this building? Yes ❑ No B 5. Will any advertising, on or off site, be associated with the use of this building? Yes ❑ No [3, SITE CONDITIONS: 6. Is the structure foundation within 5' of septic tank or 10' of leach lines? Yes ❑ No 7. Is any portion of the structure located closer than 20"to your front property line? Yes ❑ No 8. Do you plan to add a driveway or modify existing access to a county maintained road? Yes ❑ No 9. Will the proposed structure encroach within any recorded easement? Yes ❑ No CONSTRUCTION FEATURES: 10. Will this building have insulated floor, walls, or ceiling? Yes ❑ No 11. Will this building be heated or cooled? Yes ❑ No 0 12. Will this building have a water closet/toilet? Yes ❑ No 13. Will this building have a sink? Yes ❑ No 14. Will this building have a water heater? Yes ❑ No 15. What type of floor covering will the building have? CQ.YNRV\jr 16. What type of wall covering will the building have? -n fty\Q OVER 1 of 2 PROPOSED USE: (check only one box) 1. [Y Residential Storage Shed — I will be storing WOO d in this building and it will not be used for any other purpose (no bathroom and no heating or cooling). 2. ❑ Private Garage — "A building or a portion of a building not more that 1,000 square feet (3,000 by exception) in area in which only motor vehicles used by tenants of the building or buildings on the premises are stored or kept." A garage door is required. 3. El Residential Carport — A covered structure intended for parking of vehicles. Two or more sides must be entirely oven. 4. ❑ Residential Occupancy — Structures meant to be occupied, as opposed to a storage shed, garage, or carport. If you checked #4, please check the uses below which best fit this building. ❑ GuestHouse ❑ Pool House ❑ Studio Apartment ❑ In-law quarters ❑ Recreation Room ❑ Game Room ❑ Study ❑ Library ❑ Bonus Room ❑ Playroom ❑ Den ❑ Studio ❑ Artist Studio ❑ Hobby Room ❑ Craft Room ❑ Sewing Room ❑ Canning Kitchen ❑ Music Room ❑ Family Room ❑ Sun Room ❑ Private Office ❑ Workshop' ❑ Home Occupancy Z © Other — Use Describe type of Wo&hop Z. Must be approved by the Butte Courty Planning Division Explanations: This area is for explanation of any "yes" answers on questions 2-14. Please indicate the question number before the explanation. Additional Information: Plan review will not be started until this form is completed and received. A Plans Examiner will contact the owner with specific requirements per the use indicated. I hearby affirm under penalty of perjury that the above information is true and correct. I understand that any changes to the use, or character of use, of this building will require permits from the permitting authority. I understand that Real Estate Disclosure laws require disclosure of this information if or when the property is offered for sale. O-wner's Name: Please Print k I LLt o -r Owner's Signature: r Date: t_p J 7-- Qe� 2 of 2 O`VNER-BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signft e. Please complete and return this information at your earliest opportunity to avoid ueeess mw May in processing and issuing your building permit. No building permit will be issued until this verification is received. C9I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES G' NO ❑ I HAVE ❑ HAVE NOT ❑ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PH0NE: 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 major work: N AINIE: 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: NAME ADDRESS PHONE TYPE OF WORK SIGNED: —_ PROPERTYOWNER: aex,hc SOCIAL SECURITY NUMBER: DATE: Cl�u►�� �S 4 NOTE: This Owner -Builder Verification is required by Section 198.31 and 198.32 oflbs California Health and Safety Code. This verification must be completed Md returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFOIL ATION Dear Property 0—..d 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 dieir own work. If your work is being performed by someone. other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work. with the exception of various trades that 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 worst (including materials and other costs) is $300 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 emplover, 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 for 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, if you wish. the U.S. Small Business Administration). For more specific information about your obligations under Sate Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contactor 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. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1030 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 returned. I rely, ivtic el C. Vi iia, C.B.O. bt ger, Building Inspection NOTE: Tins 0waer-8uilder Information is required by SeClio n 19830 of the Colifornla Health and Safety Cods OVER FE cru /k� llioln Shy a - CL . a. WED BY f} 4te�1 `Se i -i � i� & - REVIE --� ST _.._ DEPT• P BUTTE CO• FIRE Sy,+�r., of FORESTRY Mobs l CALIF. DEPT. as submitted Dome. /00' apprO �'F�r'oppoaed approved with conditi°ns exisfr��1j�j Shed skeet. shef] 1 rte, attache U, _ 167 Date I ower c{rive,�ay r r - <1 r c O v c ALL STRUCTURES AND EQUIPMENT INCLUDING m c OVERHANGS SHALL BE CLEAR OF ALL EASEMENTS. eN F A SET BACK OF ?o FT. FROM THE SIDE AND m 30 FT. FROM THE REAR PROPERTY LINES AND FT. FROM THE ROAD CENTERLINE SHALL BE CLEAR OF STRUCTURES AND EQUIPMENT EXCEPT N=OR A 2 FT. EAVE OVERHANG. OAK PLANI,M DIVISION- BUILDING z77 OVAL Use: �'� - .62 Parking: ' Landsmong: �=orb�5�-oL��_ n i O 1 FAk-G rob WR 7- ,• � hal WR 7- CDF FIRE SAFE REQUIREMENTS 73 0,1 9; ,e - AP# PERMIT # NAME Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made apart of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. (/] 1272.00 Maintenance of.Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail- ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provide for by the land owner. Driveway Standards 1273.02 Surface. All driveway surfaces and structures (bridges, 1273.07 culverts and other appurtenant structures which supple- ment the roadway bed or shoulders) shall provide unob- structed access to conventional drive vehicles, includ- ing sedans and fire apparatus weighing up to 40,000 pounds. fQ 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius .1. No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional sur- face width of 4 feet shall be added to curves of 50- 100 feet radius; 2 feet to those from 100-200 feet. ] 2. The length of vertical curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall'be not less than 100 feet. .1273.05 Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. �J] 1270.10 Width. All driveways shall provide a minimum 10 foot traf f is lane and unobstructed vertical clearance of 15 feet along its entire length. Page 1 of - 3--. J -7 � , / 3 . 0)_ - S;; C"/ L, q-, ZL i- L_mJ AP # PERMIT # NAME [A Y 1273.10 Turnouts. Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. 1273.10 Turnaround. A turnaround shall be provided at all / building sites on driveways over 300 feet in length and shall be within 50 feet of the building. 1273.11 Gates 1. Gate entrances shall be at least two feet wider than the roadway it serves. 2. The gates must be located at least 30 feet from the -roadway and shall open to allow a vehicle to stop without.obstructing traffic on that roadway. / 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. Fuel Modification 1276.01 Setback for Structure Defensible Space. A [� 1. All parcels 1 acre and larger shall provide a mini- mum 30 foot setback for buildings and accessory buildings from ull property lines and/or the center of the road. [ ] 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See Other Requirements below. [] 1276.02 Disposal of Vegetation and Fuels. Disposal, including chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification shall be completed prior to completion of road construction )r fi:ial inspection of a building permit. Page 2 of 3 AP # PERMIT # NAME ' Other Requirements i [ ] If Building Setback is 15 to 30 Feet: - Class A or B roof - Enclosed eaves [ ] If Buildincr Setback is Less Than 15 Feet Choose any 3 of the following: - Metal or no doors on side toward property line with insuffi- cient setback - Class A or B roof with enclosed eaves Interior automatic sprinkler system per NFPA 13D Glass area not to exceed 10% of wall area toward property line with insufficient setback Siding from the following list: Stucco - 3 coat Hardi-Board or Plank Masonry .Masonry veneer Metal Other -Butte County Fire Department approved materials �p _LE- -D 2. Date Signature Page 3 of 3 -� RESIDENTIAL'. 73-13-24 3070-90P, E SHIRA, Lillian ' 61 Lone Oak Dr, Forbestown ! (utilities/MH) . P(c- � s fa � ►^s � � ,� � , t f i JOB FINA Slgnatu OFFICE COP i Address GAS I Meter y ELECTRIC Dat Meter By 4 O O = Not OK Not Not Readyable MOBILE HOMES Date MgBILE HOME UTILITIES Plans OK exce t #'s Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/ Concrete Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grn - 6Amp-Concrete ation-Test-Wrap: / /" L" ft. /"Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance - r k MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg.-Br$cing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip, w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-PaneIboards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date to Date and B-1 Date Card B-1 Card B-1 Date Card B-1 Date MOBILE H INSTALLATION Plans OK except #'s onin equirements-Setbacks Easements ootin s' Size -Spacing -Marriage Line as; MHT -Demand-Valve—Connector 4. city; MH Test -Crossovers -Breakers -Clearances rai Test -Fall -Flex Connector I . ater; MH Test -Regulator -Connector P,wgre—rand Sew Connected -C/O to Grade -HD Approval i y Tagged ` it • P. -Sketch rt. of Occupancy Date/ jy — GSCard B-1 Date Card B-1 Dae —� Card B-1 Date Card B-1 k MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg.-Br$cing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip, w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-PaneIboards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 V=O.K.` O --'Not OK - = Not Applicable ' =Not Ready RESIDENTIAL (Single & Duplex) - Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. ties -Purl in -roof Brac-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 50. Garage Fire Protection Framing 6a. Hold Downs and Special Anchors 51. Property Line Firewall & Openings 7. Slab; Steel -Wrapped 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 8. Piers -Fireplace Ftg.-Steel 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. Gas Pipe; Size -Anchors 55. Siding -Nailing Veneer 11. Water Pipe; Test -Anchor -Regulator -Service Test 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric; Underground 57. Glazing Area -Glass Protection -Skylights -Plastic 13. Pienums & Ducts; Clearance -Material -Support -Ins. 58. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 59. Insulation -Walls -Ceilings 15. Insulation 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Date Card B-1 Date Card B-1 16. Water Htr.; Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchor -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa Date Card B-1 Date Card B-1 66. Elec. Trim & Subpanel; Breaker Sizes & Labels Date Card B-1 Date Card B-1 67. Stairs & Rails Date ELECTRICAL (Permit) OK except #'s 68. Fireplace or Stove; Clearances -Hearth 22. Fixture & Transformer Clearance -Ins. Protection 69. Elec. Outlets at Wood Panel; Int. _& Ext. 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 24. Size Boxes & No. of Conductors -Stapled 71. Elec. Outlets & Receptacles at Kit. Counter 25. Romex Installed Close to Edge of Studs & C.J. 72. Garage Fire Door; Swing -Landing -Closer 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 73. A.C. Duct in Garage -Damper 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 75. Plb., Elec. & Mech. Equip. Listed for Location 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral 0 Yes ❑ No 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 30. Service -Riser Conductors & Ground -Main Disconnect 78. Guard Rails & Deck Construction -Post Caps 31. Equip. Clearances Panels-Motors-Mech. Equip. 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector 80. Following instld.; Drive 0 Yes ❑ No; Walks 0 Yes ❑ No; Planters ❑ Yes ❑ No Date Card B-1 Date Card B-1 81. Stucco; Brown -Finish Date Card B-1 Date Card B-1 82. A.C. Unit; Disconnect, Electrical, Plumbing Date MECHANICAL (Permit) OK except #'s 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 34. A.C. Ducts Insulation & Support 84. Water Well; Disconnect, Electrical, Plumbing 35. Vent Fan; Exhaust above insulation 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 36. Condensate Drain & Overflow; Size & Grade 86. Ventilation Throughout House 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Glass Protection 38. Attic Access & Platform if Furnance in Attic 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card B-1 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s Date Card B-1 Date Card B-1 39. Sils, Proper Material & Anchors Date Card B-1 Date Card B-1 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Date Card B-1 Date Card B-1 41. Bearing Walls over Girders & Floor Nailing Comments at Final: 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing each time you visit job site) (NOTE: An entry must be made MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT N0. ,—b7U 92) Address or location of mobilehome Owner's name 5 J 4 Owner's address Insignia or hud numberC-(4_/ Manufacturer's name Seri`ll number of V.I.N ,O C11- GUS 3/,:F- Year of manufacture E al App[dving Installation IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White - Owner, Yellow -Installer; Pink.-..D.P.W. „ r..1. •-<'^ - .... �:t. '- � _-.. -:.:s., �rrrt•.y;epi.�i.r:4'Rtsi."�T::yyw+,r�.r'.'�---.s'b:w���-:r-?+'=�'+^ti.� COUNTY OF 3UTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541' 747 Elliott Road, Paradise— phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please conta.t this office immediately. Date_ r `���5� Inspectorgozf _ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroyille, Carifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT 74 PERMIT NO. l ASSESSOR PARCEL NUMBER 73=13-24 ZONING TM -2 BUILDING PERMIT OWNER Lillian Shira TELEPHONE none SQ. FT. OCL`, BUILDING vA-i:lJATION OWNER'S MAILING ADDRESS 61 Lone Oak Dr. Forbestown CONTRACTOR' S NAME Mobile Home Center TELEPHONE 533-4403 CONTRACTOR'S MAILING ADDRESS 1838 Feather River Blvd. Oroville, CA 95965 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,t' 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 61 Lone Oak Dr. Forbestown Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap J 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDI VISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ut/ilities ❑ Installationl Other ❑ Describe work: �� 1 / 1��7� Q Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 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 Professiop�c�d� and my license is in full C fq{ce and effect. 216 UU �4( License No. Classification ❑ 1, 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 CONST. DWELLING OR ADDNS. ACC. SLOGS. / , OCCUP.a` �20sgft NEWCONSTR TNLET NON-RESID .BRA C CIRC ITS 2.50 ea POWER APPARATUS e SINGLE OUTLET CIR. EX. OCCup OUTLETS OR FIXTURES eA 090 FIXED LNS Ex. Occup. OUTLETS-((RESID )REA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Yirin 15.00 9 Permit Fee $ 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 provi.sions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee = 45.00 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte 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 said County i -c' asequence of the granting of this permit. > X �� Date , Signature pplicant — Owner ® Contractor ❑ Agent ❑ An OSH 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 70.00 Occup. CONST.TYPE SCHOOL FLOOD PARCEL I PD I ND 99 This permit is hereby issued under the applicable provi- sions of the .Butte County Code and/or resolutions to do work indicated abov for which fees have been paid. D C R F PUBLIC WORKS BY Dae 'U P MIT EXPIRES Date Go Receipt No. 74081 — $70.00 WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDEN ROD-AP►LI CANT COUNTY OF BUTTE - DEPARTME_NTeOF PUBLIC WORKS - BUILDING DIVISION -_ 7 COUNTY CENTER DRIVE - OROVILLE,.,,, LIFORNIA 95965 - TELEPHONE:'916/538-7541 PERMIT APPLICATION DATA SHEET r ,q 4 ,. Permit No. OWNER /�-J 15/114 A. P._.No. Proposed Building Use �y%rY�%- Building Inspector — Date 0-1�— 0 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED _0"1. All items -have been submitted . ........................ . ......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . *4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ... I........... 8.. Engineered truss details and layout in duplicate (required prior to plan check) 9� Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval fbr (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications .. 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement .......... 5. Letter of signatureauthon tion ............................ . �26. r 27. When you issue the permit, process as follows: Mail tQowner. Mail to contractor. _ Telephone X33 and hold for pickup at 1� office. De`liver.w./inspector. Other Appl ican�,� Date i X Fe Copy of Haz-Mat form sent Health Dept. Fire Dept. _Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items.No. 2. Additional items required: CContr or, designer, owner, was advised of above required data by phone�nail_counter by..datetracta, designer, owner, was advised of above required data bphone_mall_counter y date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 - APPLICATION ANO PFPL41T ASSESSOR PARCEL NUMBER 3 ' 23 _2 OWNER" ZONING 0.7 Q_ BUILDING PERMIT '- TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADORESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ • LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee Permit Fee Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5,00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home O.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[], Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service i°oo AMP ORSLE55 10.00 CONTRACTORS LICENSE LAW I declare under lt of penalty p y perjury y (check one): El am licensed under provisions Of Chapt. 9, Div. 3 of the Buslnes$ and Professions Code and my license is in full force and effect. License No. Classification 1, 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) El I, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADONS. ( ACC. BLDGS. ) , /20sgft NEW CONSTR. ULTI.OUTLET NON.RESID - BRANCH CIRCUITS) 2.50 ea /POWER APPARATUS e \SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20®30t -ALO 30 FIXED APP NS. OR Ex..Occup. OUTLET- IRLESID.1 EA.) 2.00 Temporary service 10.00 Mobile Home acilities F 15.00 Misc. Wiring 15.00 Permit Fee $ 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3,00 Ventilation Permit Fee $ _� O Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County Ot 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 said County in consequence of the granting of this permit. xTh;s Date Signature of Applicant - -•:' "Owner ❑ ',-Contractor ❑ Agent ❑ 1 An OSHA permit is required for.excavations over 5'0'.' deep and demolition or construct- ion of structures over stories in height. Mobile Home Installation Fee -$ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ �� HAZ CUA PARK SCHL FLO PAR Po Ho I ISSUE permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date /3 Receipt No. 1" ~/3 g�.- �7f�:"<O'Q:'_: -` WNITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR,. GOLDENROD -APPLICANT '1 BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS' _ 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: h l L & I AIJ rL 2. Installer's Name: /V `G L� %�GM E" Aj 3. Is the site currently under permit? Yes No -(If yes, furnish permit number n 70 — D ) OR Is the site an existing site? Yes No (If yes, furnish two 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 F (If no, clarify BUTTE COUNTY BUILDING :DEPARTMENT APPROVED 5. What is the mobilehome electrical rating? --------------- LG �. Amps Z_ C, G 6. What is the mobilehome site service rating? ------------- Amps G '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 E2SJ No (If yes, identify the load and size: f t/&C/_(Load) (Amps) 9, What is the mobilehome site gas pipe size? -------------- iq (in.) 10. is type ------------------- Natural LPG F] What the of gas service? 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.) BUTTE COUNTY BUILDING :DEPARTMENT APPROVED MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. U 41 furnish Setup Model No. Z' y Year Width / y �(ft.) Box Length_YY Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish man acturer's installation manual and structural setup sheets (if not on file with the County of Butte). FOOTINGS (check one)1. Wood -pressure treated or foundation grade. ❑ 2. Other (specify) SUPPORTS (check one) - 1. Concrete block.a 2. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Linp I Line 1 Line 2_ � : — _ — _ — Line 2 Main Beams Line T-� . — — — — _ — — — — — — — — Line 2 — — — — — Main Beams — — — — ]Ee:2 Tag or Triple ----------- Tin Line 1 Piers: Size-Min.------------ Spacing-Max - ----------- Spacing-Max. --------- , From Ends -Max. ------- _ Line 2 Piers: Size-Min.------------ Spacing-Max ---------- From Ends -Max .------- _ O Line 3 Roof Loads: Size -Min. ------------ Location (From Front) Line 4 Piers: Size -Min .------------ k Spacing -Max.--------- , From Ends -Max .------- „ Line 1 Openings: Size -Min. ------------------� "x Each Side of Openings With Width Over --------- Line 3 Piers: (Under Bearing Wall Only) Size -Min .------------------ Spacing -Max.--------------- From Ends -Max -------------- d±--32- ------------- d„x32- "x30„ "x „x „ „x ,. "A Line 5 Piers: (Under Bearing Walls Only Size -Min .------------------ "x Spacing -Max.--------------- From Ends -Max .------------- Line 5 Roof Loads: Size -Nin.------------ „x k "x ,. "x k „x 1x N 1. Location (From Front), - 23 COUNTY OF BUTTE > DEPARTMENT OF PUBLIC WORKS PERMIT NO. j 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 0 APPLICATION AND PERMIT ASSIESSOR PARCEL NUMBER 73-13-24 ZONING TM -2 BUILDING PERMIT OWNER Lillian Shira TELEPHONE SQ. FT. OCC. BUILDING VALUTION OWNER'S MAILING ADDRESS P.O. Box 268 Forbestown 95941 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS - Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation Is Filing Fee g $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ 15.00 Energy g Fee Ener Plan Checking $ ' ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 15.00 PLUMBING PERMIT Filing Fee 10.00 61 Lone Oak Dr., Forbestown Each Trap 2.00 Solar or heat pump water heater 20.00 LOT N . SUBDIVISION NAME PARCEL MAP Yom- Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W I 1 2110-00e TYPE OF WORK New Addition❑ Remodel El Utilities [y Installation❑ Other ❑ Describe work: 3 BEdroom _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS 11 10.00 10.00 Main service EA. ADD'L 100 AMP 11 2.50 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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) ❑ ossa the owner, am exclusively contracting with licensed contract- 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.5i OR ACDNS. ( ACC. BLDGS. / /z¢sgft NEW MULTI -OUTLET NO N.RES ID BRANCH CIRC ITS 2,50 ea /POWER APPARATUS I SINGLE OUTLET CIR.e ) Ex. Occup(OUTLETS OR FIXTURES 2Oe5Oc BALO 30 FIXED APPLNS• OR Ex. OCCUp. OUTLETS IRESID.1 EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 15-00 Misc. Wiring 15.00 Permit Fee $ 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. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte 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 id County in consequence o6the granting of this ermitZ 1 -// / Date `� 1� ; O Signature of Applicant — Owner g pp 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 $ Energy Inspection Fee $ occ CONST TYPE AL FEE TOTAL _ F PAR PD 1 ISSUE Ll This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIR T OF PUBLIC BY PERMIT EXPIRES Dat the applicable provi- resolutions to do have been aid. p WORKS Date Receipt No. 73354 WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT oq � COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916;'538-7541 APPLviCATIAN AND PERMIT ASSE oR AR CE� �M�ER_ ZONIN BUILDING PERMIT OWN 9 - r G� t TELEP40NE SQ. FT. OCC. BUILDING VALUATION _. OW RU -.AI LIN ADDRESS o o In e fn w �S9 OR'S,NANAME COyf"ACT'Y /tel// ✓ ^l& TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CON UCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ LENDER'S AILING ADDRESS Permit Fee $ ARCHI ECT OR ENGINEER ICEN LSE NO. Plan Checking Fee $ / Energy Plan Checking Fee A CHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee ; PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 _ —©r e ou) l Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeOther SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home 6 S G4! 10.00e TYPE OF WORK New❑ Addition[] Remodel[] Utiliittiies Installation❑ Other ❑ Describe work: r� /�) _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 S AMP OR LESS 10.00 O Main service EA. ADD'L too AMP 2.50 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.SINGLE 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)Mobile ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.&) OR ADONS. ACC. BLDGS. / /2¢sgft NON•RESID R. BRANCH CIRCTITS) S 2.50 ea POWER APPARATUS a OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES Ex. Occup. OUTLETS FIXED PIRESIO IREA.� q2.O Temporary service Home Facilities Misc. Wiring 9 15.00 Permit Fee $ 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. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee ; Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte 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 said County in consequence of the granting of this permit. X Date Signature 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 $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ _ HAz I CLIA I PARK 17.1 FLo I PAR I PD HD I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR, P14 -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE,CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET �-�--�- Permit No. OWNER l 1, �C �i ) i� A. P. o. r �� Proposed Building Use 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, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans . 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions........................................................ 10. Fees of,$ ........................ 1 1. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... S of Distri fees paid .............. _ 00 14" Sanitation approval from (10 t) + �� Health Departm� � o 0. 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. jmprovements may be required. Contact Land Development Section DPW ifi. (Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec.request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23 Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 4. Recorded copy of Agricultural Acknowledgment Statement ... :... 25. Letter of signature authorization ..................................... 26. 27. When you issue the permit, process as follows:Mail to owner. Mail to contractor. Telephone and hold for pickup at office. - Deliver w./inspector. Other 'X) Applica t Date 11 Copy of Haz-Mat form sent Health Dept. Fire Dept. _Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior rmit issuance: (Circle new item not checked above), 1. Index permit for above items No. - 2. o. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---nall—counter y ..date Contractor, designer, owner, was advised of above required data by—phone —mal l—count by date Plans checked by Date ns approved by Date Sets of plans on hold in File cabinet V AP folder Copy—DPW .1 TO Buildinc Department FROM: Environmental Health SUBJECT: Sanitation Clearance �, �7�-�3`�� AP# Owner Location Pian Approved for: Hold final for: Sewaqe Disposal Final clearance O.K. for: Clearance for bedroo obile ome. Other Water Supply 0 'e tf Water Supply Water Supply NOTE *** /7 �d r ' Date Sanitarian COUNTY OF BUTTE Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for 4.n 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 or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address _ _ 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: 4 Property Owne Social Se urit N tuber _ — -' Date 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 per- mitted to issue the permit. BUTTE COUNTY SCHOOLS'UV'ELOPMENT FEE CERTIFICATION FORM ('One Form per Building) A.P. Number �p� Building Department•No.. School District ��Q�� City County r_V1 Jurisdiction Property Owner ► I C(Iri �,•1 I f� Project Location/Address Subdivision Lot Number Residential Development: I A J Sq. Footage 00 # of Living AH1 Addition (Group R) Units Commercial/Industrial:. New Sq�. Footage Addition (Including Exterior Roofed Areas) Date (Floor Plans reviewed by School District Personnel) PAID BY CHECK NO. BANK NO PAID BY CASH REMARKS: white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) District Id No. /09/ School District certifies that (Applicant (Phone Number) f Name) (Street Address)",- , - C� 9C9 6 6 (City) (State) (Zip Code) has complied with the requirements of Resolution No. 9 by yment of $ representing 04-(o square feet. =t School District Re esentative - Date PAID BY CHECK NO. BANK NO PAID BY CASH REMARKS: white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) Return to DPW AGRICULTURAL -STATEMENT OF ACKNOWLEDGEMENT 90-35294 FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County" Code, requires this acknowledgement be recorded prior to issuance of a building permit. �-` - - -- --- - --- All that real property situate in the County of Butte, State of California, described -as follows: Lots 3 and 441as shown on that certain Parcel Map of a portion of the Southwest quarter of the Southwest quarter of Section 17, - Township 19 North, Range 6 East, M.D.B. & M., which Map was filed in the Office of the Recorder of the County of Butte, State of California, on August 30, 1971, in Book 40 of Parcel Maps, at page 9. TOGETHER WITH AND RESERVING THEREFROM a right of way for road purposes, as shown on said Parcel Map. (AP NO. O-73-130-`0.2.3 and --07.3--1-30=0-24) Date: f — - 4Q PROPERTY OWNERS: State of O� On this the [(�t� day of 19� before me, �e_.)SS. the undersigned Notary Public, per nally appeared County of II alvlk a i f Ct-- Personally known to me. Proved to me on the basis _ a TARAJ.H $HALL© of satisfactory evidence. ® "rs NOTARYPUBLIC-CALIFORNIA a to be the person(s) whose name(s) S ® tiA But to ° subscribed to the within instrument and acknowledged that My Commimlon Expires March 8, 1991 ®ac�caQa®�csraar:©oc®©®Qa®o©©o v executed the same for the purposes therein contained. IN WITNESS ® WHEREOF, I hereunto set my hand and official seal. Present A.P. No. �3 3 'Z kol'a Qt,�& N ary Public ENS OF DOCUMENT The property described herein is adjacent 90-0352941 Rec Fee 5.00`, to land or included within an area zoned' Cash 5.00' .for agricultural purposes,. and residents Recorded ; of this property may be subject to incon- 5 Official Records ; veniences or discomfort arising from the County of use of agricultural chemicals, including, Butte ; but not limited to herbicides, pesticides, Candace J. Grubbs and fertilizers; and from the pursuit Recorder ; of agricultural operations including, 8:01am 17 -Aug -90 CD 1' but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described -as follows: Lots 3 and 441as shown on that certain Parcel Map of a portion of the Southwest quarter of the Southwest quarter of Section 17, - Township 19 North, Range 6 East, M.D.B. & M., which Map was filed in the Office of the Recorder of the County of Butte, State of California, on August 30, 1971, in Book 40 of Parcel Maps, at page 9. TOGETHER WITH AND RESERVING THEREFROM a right of way for road purposes, as shown on said Parcel Map. (AP NO. O-73-130-`0.2.3 and --07.3--1-30=0-24) Date: f — - 4Q PROPERTY OWNERS: State of O� On this the [(�t� day of 19� before me, �e_.)SS. the undersigned Notary Public, per nally appeared County of II alvlk a i f Ct-- Personally known to me. Proved to me on the basis _ a TARAJ.H $HALL© of satisfactory evidence. ® "rs NOTARYPUBLIC-CALIFORNIA a to be the person(s) whose name(s) S ® tiA But to ° subscribed to the within instrument and acknowledged that My Commimlon Expires March 8, 1991 ®ac�caQa®�csraar:©oc®©®Qa®o©©o v executed the same for the purposes therein contained. IN WITNESS ® WHEREOF, I hereunto set my hand and official seal. Present A.P. No. �3 3 'Z kol'a Qt,�& N ary Public ENS OF DOCUMENT u Z ,o DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT kion 26-8.1 of the Butte County Code requires this acknowledgement be recorded :prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned NOT COMPARED WITH ORIGINAL DOCUMEM [or agricultural purposes, and residents ACCEPTED FOR RECORDING of this property may be subject to incon- veniences or discomfort arising from the AT 3:J� A.M. use of agricultural chemicals, including, /., U but not limited to herbicides, pesticides, _. and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept ,such. inconvenience or disconform from normal, necessary farm operations. �rtv c; t iiaro i- rh- r__-- 4. Th -e land referred to in this policy is situated in the County of Butte, State of California, described as follows: Lots 3 and 4, as'shown on that certain Parcel Map of a portion of the Southwest quarter of the Southwest quarter of Section 17, Township 19 North, Range 6 East, M.D.B. & M., which Map was filed in the Office of the Recorder -of the County of Butte, State of California, on August 30, 1971, in Book 40 of Parcel Maps, at page 9. TOGETHER WITH AND RESERVING THEREFROM a right of way for road purposes, as shown on said Parcel MAp. (AP NO. 073-130-023 and 073-130-024) State of On this the l� day of 19� before me, SS, the undersigned Notary Public, per nally appeared County of ) P II �, ;�oc�nuo�2coomatic oaamum®E] Personally known to me. roved to me on the basis 1L ® of satisfactory evidence. << i:�;;...• i��a a to be the person(s) whose name(s) S i,:zrch 8, 1991 ° subscribed to the within instrument and acknowledged that a executed the same for the purposes therein contained. IN WITNESS ..a IYA .'L! U_)urJu.` "Ua6'"j L'W°� WHEREOF, I hereunto set my hand and official seal. Present A.P. No. Wary Public ELECTRIC GAS Support Struc. Compaction Test eq. Service Size- Other Load Type Pipe Size Length YES NO YESI �NNO• ?his set of plans andospedfications�.MUST . r . kept on the job at all times and it is unlawful* make any changes or alterations_on same wi*v. 1 iQ f om the De rtment of ' BUTTE COUNTY TITLE Co. outwritten perm ss n r Pa This is n:t a s::;•/=y of tf�o lard, but is frubtk WOfkS. County- Of Butte. C"';'4 t t1' -in J31:2 shown by th• public — �• • NOTA—AA Materials do Workmanship Shah Be b 0V/C• • Accordance with Recognized Good Practices aid _ a = 2O of`a�quality prescribed for the Specified we in f6T !8".2 6 8 08 RM' Ifil4i g, Plumbing & Mechanical' Codes'and e.0Ab hacgl Code. —130 v' N 87--35 42E 80 g 25 f 94 B / 33 :R' LINE • T )RBESTOWI 1 0 23.09 2 N I, ` I � >6 � lD 43[1 O "///���t' m1 • 1 35 42 E 278.53 . 46./3/� D 1 N g7 c1 60' R/W to be reserved in deeds — 134.01 a1 — -—_---_—_�-- p_R833000 48.336 00 • NI m r _ _ _ 0.00 21 ori CD l 02.15 AC. N .. YI Co Q I N m 1 0,in X N I I a: l I' • 0CD 1 ( N 89 38 59 W I �1 I I • I � m �1D•I I I I mo Z vl d l I w Iz CI I 1 A setback of 5 ft. from the I vl >1 i property lines and a setbacly OP la ,•' _ 50 ft. from the road . 1 Co centerline shall be clear oft o Ica >strw�ures-or equipment ex�� o for a 2 ft. eave overhang .g4 I o zo TO: 1 1°n 0:64v- aF A66 6AW1446VIS I 1 1 1' 1 30k I .. I 518.88 O 2.00 AC. N 89 38 59W 518.88 O 2.00 AC. m . 0 N Q ID panni#. wAl 6e mgtort►ea for f% 3 WoUafton of the mobilehorne. m m N 89 38 59W o o o Z e BUILt�1NG pEPAA��_ I F.D. 3/4" I.P. I R.C.E. 11,553 I I 518.88 801.50(R) V SOUTH LINE SEC. 17 N 89 38 59 W o z.00 ppa�NEv 518.91(R) _ N 69 12 15 W (R) NOTHING FD. s i1 E7 I 518.88 O 2.00 AC. N 89 38 59W 518.88 O 2.00 AC. m . 0 N Q ID panni#. wAl 6e mgtort►ea for f% 3 WoUafton of the mobilehorne. m m N 89 38 59W o o o Z e BUILt�1NG pEPAA��_ I F.D. 3/4" I.P. I R.C.E. 11,553 I I 518.88 801.50(R) V SOUTH LINE SEC. 17 N 89 38 59 W o z.00 ppa�NEv 518.91(R) _ N 69 12 15 W (R) NOTHING FD. SITE PLAN _............. -- ... .. - -- - i�' .. Oz` .. .. •• . .. .. . �!..... _ .. - . .... ..:. .:.. ... 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Assessor's Parcel Number: 0� 70 03 — ©3[� — 0 [[ Scale: 1" = 2 a a Owner Name V AIAR�-�1 MA 1 Nr� ° a Address/ Phone No. ¢5- (��nl��y 0A/e. t%LIdIL ,sfy-Wes Site Location I� �- Ol�fr o A X- bK- O Y.o 01WZ C,6 2 4 c' )' c Contact: Name f-3ft lai)+" Yy A /MlL Phone 5LE 9- va oCU,W23,Z0, FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres 4.00r PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: SITE PLAN .................. ------- •. - .. .. .................... .---...----..... _ :� G..........:.. . . . . . . . . . . . . . . . . . . . 00 y.. .............. .. . . . . . . . . . . . . ' .. :......:... .. ............. ...........Q : : . . ..... ....: C C10 6 . ........... ............... ..Q. .. .. .. . .. .. ................. .. .. . . _ .. :....... .. .. ............................................ ............ - - : : 1 .. .. .. .. .. .. _. :.....:.....:...... .......................... .. :..•--....................... .. .. ... .. ........................ .. - .. :.. . • -• . . -- • .. .. .. . •. .. ...... . • .. ... .. ............ . ... ................. •.......................... ... .. .. ... .. .. - ..... :....... ,......: --- i ............................................... ...-...-•••..... ........ ............................. . .......... :....................... .. .. .. ... .. .. .. .. ............. _._ .. .. .. .. .. .. .. _.. ............................ ._ .. ... .. ..... . •. . --..._. .. ... ............. .. .. .. ............. .. .. .. .. .............. .. .. .. .. .. .............................. 0 ............ •. •. • ................... .. ... --- -. .. ............................ _ ... S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. _. .... :s................ ��.. .. ................... E` .............. ..........: .......... .. . l :► x . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : _ a ..................... :.................... �. Assessor's Parcel Number: E 0 a — ©0 E — '= Scale: l" = 2 D Owner Name V ff kbft" M AI MrL Address/ Phone No. on t4l ale Shy— T6e5' Site Location (0 G-0/Kc, 0 AIC WL DY-00lYg CA y( � Contact: Name-iA-il-1 AI" 1M A IMiL Phone S -f 1- WE— — Octcboa zi, FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres 4.00r PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: