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Home My WebLink About073-150-008� ~ '- ! ^ ' ~ ' ` o i . ------ -- --,- ------ - -- ---' -- ------'-- -' ---� ---- -- -- --,� x�� W,-� r" ^ ' ) COUNTY OF BUTTE — DtPAR-TMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 ' APPLICATION AND PERMIT autnor)ze representatives or the t;ounty OT t3utte to enter upon the above-mentioned property for inspection purposes. F Signature of Permitee or Agent Date Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Building permit expires Date Date BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mai I i ng Address Telephone No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. Zoning &Planning Water piping 1.50 Each gas water heater or vent 1.50 Fees W.C. I Sanitation Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 Bldg. Plans Rec'd Parcel A roval I Plans Approval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ Lawn sprinkler system 2.00 Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 6001 OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 6001 25.00 100 AMP OR LESS Main service EA. AOD'L 100 AMP 1.00 NEW OR ADONST ( ACCLBL GS.LING CCUP. 4) 22sgft. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: NEW CONSTR I-OBRANCH C1R T NON.RESID, (MULT BRANCH CIRCUITS 2.50ea NEW CONSTR. POWER APPARATUS 6 . NON-RESID. (SINGLE OUTLET CIR, Ex. OccuD(OUTLETS OR FIXTIiRES) g L10l FIXED APLNS Ex. Occup.( OUTLETS P(RESID.)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ autnor)ze representatives or the t;ounty OT t3utte to enter upon the above-mentioned property for inspection purposes. F Signature of Permitee or Agent Date Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Building permit expires Date Date - COUNTY OF BUTTE — APAOMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATIQN AND PERMIT 707&___ _ BUILDING Owner s p� /, �7��_� _7 SQ.—FT.7 OCC. BUILDING VALUATION Mailing Address /� ` Telephone No. (% /IS Contractor Mailing Address Telephone No. Building Address i5&C.'o ma i A. P. No. Zoning & Planning F 9en4e+ion FireDept. Fire Zone Use Permit EQA Parking I Parcel Parcel Ma 60' R/W Im r Plans Declaration P p ovements Bldg. ans Parcel Approval 7 Plans Approval NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER I.� i liii+►�r Single Family Duplex ❑ Mobil Home ❑ Others ❑ CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: License No. Classification 0 1 am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. xko Date ign lure Permitee or Agent Receipt No. -:2lI- 7 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Fireplace 150eZX BAL@1 Total Valuation 2.00 Permit Fee No.1 @ Plan Checking Fee &/or Penalty PERMIT FILING FEE Permit Fee c0( PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each TraD 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Building sewer 5.00 Lawn sprinkler system 2.00 Permit Fee 150eZX BAL@1 $ 2.00 ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 c0( Main service 600V OR LESS 100 AMP OR LESS 5.00 ` Main service EA. ADD•L 100 AMP 2.50 Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. ( OR ADDNS. DWELING ACCLBLDGS.CCUP. 5i) Csgft NEW CONSTR. No N.RESID_ MULTI -OUTLET BRANCH CIRCUITS) 2.50ea Ex. OCCUD(OUTLETS OR FIXTURES 150eZX BAL@1 FIXED APPLNS. OR EX. OCCUP•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wirina 6.25 .. • Y.S Permit Fee $ MECHANICAL No. @ PERMIT FILING FEE $3.00 Heating Coo I i Ventilation Hood 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE $ s_ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIREC OR OF UBLIC WORKS BYL Date . [� "' Building permit expires Date li. Applica. Address Te lepho Name of Address "A-3;' AGaICULTURAL WORKER AFFIDAVIT 2. Assessor's Parcel No.. on whi.&h mobile hume is to be located: 3. When purchased_-- JG I ,,,.. / t% %8-., �VQ k? /v, ~.e 11—N..S_ r 4. Please read the following carefully before. signing: "A-3" (Agricultural) Regulations, Sectio 2.1-d allows: "d. Housing facilities (including mobile.homes) to accmwx} data o a:]:y agricultura.L employees and their farm,] i.es employed by thec-swiret3�' Qx- operator of the premise,9; and provided further, that such bous.ixg-, facility shill be considered accessory t c) the itiz .n btu 7 d-JLng &ucl shall: conform to the provision pertaining to required yard and open s-yac:n: for dwellings." Ordinar,.ce No. 1439 states: 2- "l. a. AGRICULTURAL EMPLOYEE: An i.ndiv .idua l who verifies, by p&rs-caval.. affidavit and by affidavit of his that. hn* is, or will be, employed at least: 32 hours per week for at:, least 1.6 weekv per yeas:, or that his primary source of. annual Income is, or is antic ipat c --d to be, derived from, any of the following -described occupations:., (1) The. preparation, care, and treatment of farm Zaxd, or'ditche:s, including leveling for agricultural pt1.rf)0s.ps;, plowing, discing, and fertilizing the sail; ('2) The sowing and planting of any agricultural or horticultural.. commodity; (3) The:. care of any agricultural or hort.ictatt:ura,l. comeLl adit:y . As . . used in this subdivision, "care" i.ncl,tacies, but: is not, l.i.AAL-0.& tee, cultivation, irrigation, weed control, thinning, heating, pruaiing, or tieing, fumigating, spraying, and, dusting; (4) The harvesting of any or hortIculztuxa,l_ ccammadi,t:yL including but, not li,ni ted to, pickknq, cutting, tloee,,i.h _►. y, maw -ii g',. knocking off, field chopping, kt'unching, haling, balling, fie.,.ld packing, and placing in field conta..ine.rs or in the vehicle. in which the commodity will be hauJ_ed on the farnL or to the place of first processing; (5) The assembly and storage of any agricultural or horticul- tural commodity, including but not limited to, loa.ding, roadsides ng-, banking, stacking, binning, and piling; (6) The raising, feeding and management of livestock, fur bear- ing animals,.fish, frogs and other aquatic animals, and bees, including but not limited to, heEdin.g, housing, hatching, milking, shearing, handling eggs-, and extracti.nt honey. (7) The operation, conservation, improvement or maintenance of such farm and its -tools and equipment." 5. I, L-� �C�/ti'L,t,� _, do declare, subject to.the penalty of perjury, that Z reside at and that the permit applied for under th-this application ,.for housing facilities on property identified in Section 2, does conform to Section 2.1-d as identified in Sectiod 4 of this application and Agridultural of this application and Agri6ultural Employee as'defined in Ordinance No. 1439. ; 6. Permit description and number—_— Date issued_ -_ox„ r -2-, r r ; li� Applicant_=� Address (Presen -' Telephone (All Name of Owner) Address . 0,904 M �,O 2. Assessor's Parcel No. on which mobile home is to be located: 3. +vrnen purchased J4 /y 2 1,978 /�4 VA /LABL� r z 4. Please read the following carefully before signing: "A-3" (Agricultural) Regulations, Section 2.1-d allows: "d. Housing facilities (including. mobile homes) to acccmmdate: oa-ly- agricultural employees and their families employed by the c,,mar or operator of the premises; and provided further that such housl=g- facility. shall be considered accessory to the main building ng and shall conform to the provision pertaining to required yard and open sgaaa for dwellings . " Ordinance No. 1439 states: "1. a. AGRICULTURAL EMPLOYEE: An individual who verifies, by persona1 affidavit and by affidavit of his employer, that he is, or will ba, employed at least 32 hours per week for at least 16 weeks per year, or tzat his primary source of annual income is, or is anticipated to be, derived from, any of the following described occupati.on.s: (1) T'no preparation, care, and treatment of farla esed, p ,i .!iRe., Or ditches, including leveling for agricultural purpo: es, plowing, discing,-and fertilizing the soil; (2) The sowing and planting of any agricultural or horticultural commodity; (3) The . care of any .agricultural or horticultural coum:adity. As used in this subdivision, "care" includes, but is not; limited to, cultivation, -irrigation, weed control, thinning, heating, pruning, or tieing, fumigating, spraying, and dusting; (4) The harvesting of any agr3c-altura.l or horticultural cemmadity., including but not limited to, picking, cutting, tlires'hin�r, mawai:ng, knocking off, field chopping, bunching, baling, balling, field packing, and placing in field containers or in the ve'hicle in which the commodity will be hauled on the farm or to the place of first processing; (5) The assembly and storage of any agricultural or horticul- tural commodity, including but not limited to, loading, roadsid_ing, banking, stacking, binning, and piling; (6) The raising, feeding and management of livestock, fur bear- ing animals, fish, frbgs and other aquatic *animals, and bees, including but not limited to, heading, housing, hatching, milking, shearing, handling eggs, and extracting honey. (7) The operation, conservation, improvement or maintenance of such farm and its tools and equipment." S. Iv Phomas !� M�Cle�n _, do declare, subject to the penalty tj 4 of perjury, that I reside at a9o79�� uG�/ C7 Venue,, . c A . 9#5/Q COl�CO/"�, 0 and that the permit applied for under th this application, for housing facilities on property identified in Section 2, does conform to Section 2.1-d as identified in Section 4 of this application and Agricultural of this application and Agricultural Employee as defined in Ordinanca No. 1439. 6. Permit description and number Date -issued By e PERMIT NO. .1565.-80P,E PERMIT EXPIRESe �• �/ OWNER Thomas McClean owner CONTR. - LOCATION (A.P. 73-15-8 E/S Robinson Mill Rd., across from Black Tail Rd., Forbestown ti Temp. Power Pole I Called PG&E 7 Temp. E,Iec. Serv.— CaMed PG&E Temp/Gas Serv. W!70' 0 Tempt'! PG&E JOB �jINALED 2, J If (Date) (Signatuo MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located wity required separation from'lot lines and buildings and generally conform to plot plan? Yes_ No 2. Does the mobilehome'have required clearances above ground? (Sec.5085) Yes�o 3. Are footings and supports properly sized, spaced, and braced as pe approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes 7N 4. Is the mobilehome level? (Sec. 5088) Yes ✓ No If more than a single unit, are crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is flexIble connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yeso_ B. Test —Does water piping withstand working pressure or 50 lbs..air test? Yes y No_ Backflow - If coach is not State of California approved, does station have backflow device and pressure -relief valve? Yes_ No_ 7. Wastes and Drains A. •Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes_ZNo B. Does it have minimum 4" per -foot slope and is it properly supported? Yes. Z! o C. Are any leaks detected in drainage system after running 3- allons of water through each fixture including washing machine standpipe? Yes_ No, If coach is not State of California approved, does station have required trap and vent? Yes No� 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobile me gas line inlet without reductions other than the mobilehome connector, Yes No i B.. Test OK as per following procedure? Yes_ ' 1. Open all appliance connector valves. 2. Shut off appliance'burner and pilot valves. 3. Air test with manometer to 10"--14" water column, or test with slope gauge (minimum 6oz,-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. , 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes_ 9. Electrical ` A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating�.P mobilehome with•a minimumof 00 amp)` and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes�No_ I— B. Is there proper clearances around panels? Yes y No_ C. Is power supply cord or feeder assembly properly fused? Yes V No D. Is continuity test satisfactory as per the following procedure? Yes-LI-_�9 1. De -energize electrical wiring system of the mobilehome at the pedestal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. I 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for energizing. 10,. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle Length__ Width Vehicle Serial No. /� ,! State Identification No, W_ Additional Information or Comments: io .t` . C®UNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING S back FI wall So Piping Fo s Par ets 1 Floor Ma Bldg. Rest om Finish 2nd loor F tins Windo 3rd or Ste wall Sidin To out Slab Roof She Ina Water PipiNg Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for physy ica handicaped Conformance of ex. structure Appliances 01 Gas Piping & Test Temp. Gas Slab Final Sanitation Patio IRE LACE Final Footings Footing Ut ECTRIC SPRIN Motors MECHANICAL Grd. Fdblt Prot. HeatlrA Servi CooAg T mp. Pole Dusis nder round ntllation Permanent anal --Nfinal ITIES ------------------ Elec_ Service j d Elec. Pedestal S11dlky Sewer z Gas Piping ALLAT N - - - - - - - - - - - - - - Support 47) Elec. Continuity �U Drainage Gas Piping !2:a Q REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) -•--� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5;- under permit number-? 7 0 77�i -' for the following location: A ��i' K1" r . �''.!%c.d :R../�' ec r sem,...✓ %i'tfCc-,�.,� .�r%r.-�' /COY' Owner Owner's Address, Mobilehome Mfg. Model 5~'`' Year Insignia No. 5 Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works, Date `� /'f r.� By XI THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. 'COUNTY OF BUTTE 3 "DEPARTMENT OF PUBLIC WORKS 695 Oleander Avenue, Chico — Phone 343-4211 , Ext. 70 •c 7 County Center Drive, Oroville — Phone 534-4541 G Skyway and Elliott Road, Paradise — Phone 877-3435 =. CORRECTION ;NOTICE BUILDING OR PROPERTY. ADDRESS A routine inspection indicates that the following :violations of County Ordinance exist at the above address -.and should be corrected. Please notify, this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately.,!� - ' - COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovilie, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMITN0. c22 2 o ASSESSOR PARCEL NUMBER i3 -/S-0$ ZO ING /�-5 BUILDING PERqV OWNER T'NOMAS M CLC—/-� TELEPHONE SO. FT. OCC. BUILDING VA ION OWNER'S MAILING ADDRESS 2g�9'IZ 97UI! U a ASE. CO/vloleD e* 84519 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS - - CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEERLICENSE NO. Plan Checking Fee $ Penalty • $ ARCHITECT OR ENGINEER'S MAIL G ADDRESS Permit fee $ BUILDIN ADDRESS C R0�31A)SOAl )WILL 'PD.. AGP_oSS PLUMBING PERMIT Filing Fee 3.00 /t&A,? 1-ACk T144i, Each Trap 2.00 Repair drainage or vent piping 2.00 ' / FO- tE8 �5 % QGtf/V Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF [J Duplex❑ Mobilehomeg-'Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK --/ New ❑ Addition ❑ `Remodel ❑ Utilities ❑ Installation L✓ r Describe work: JirodT)L P�,�1 iS(oS- 8� --"Main Permit Fee $ ontractor ELECTRICAL PERMIT Filing Fee 3.00 service 1000V OR 0 AMP ORLESS5.00 Main service EA. ADD'L too AMP 2.50 NEW CONST. DWELING OR ADONIS.( ACCLBLDGS.CCUP.9 20sgft CONTRACTORS LICENSE LAW .I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONSTR ULT' -OUTLET No N.RES'D BRANCH CIRC ITS 2.50 ea NEW CONSTR. ( POWER APPARATUS &) NON-RESID, SINGLE OUTLET CIR. Ex. Occu 50@� OR FIXTURES BAL@10C P(OIXED A EX. Occup. FIXED APPLES, OR P•(ouTLETs (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6,25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of,Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shat l not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 3.00 Heating Cooling Hood 2.00 Venti lation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue again Cou y i co sequence of the granting of this permit. � X Date Signature of Applicant — OwnerZ 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 $ .pp Land Development Fee $ '/v^, t70 TOTAL PERMIT FEE T OCcuP. GROUP 1, TYPE OF CONST. PARCEL PD HD esuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which "7OF PUBLIC By f M EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date/"—( L—'? c' b� tZ P/ Receipt No. �'��1 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. M_, furnish Setup Model No. < Year Widt (ft.) Box Length �Z_`a.(ft.) Tagalong or Expando Size ft. ft.' (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after -October' 7, 1973; furnish manufacturer's installation manual and structural 6etup, sheets (if not on file with the County of Butte). All center supports measured f tom front of mobilehome-unless otherwise specified. - Footings* (check one) Single VA I We%e%A ;04# -ha" (ft.) (in.) `(in.) We Center suppo Center su port locations* footing 3Ees pressure treated or foundation grade. 2. Other' (specify) Supports (check one) V.; Concrete block.' 2: Other (specify) *If center nter piers are other than drawn above, in locations, spacing, and dimensions. OUTTr= CoUtqyV IVILDING DEPARTMENT APAROVE-.D./�/ <----Tagalong or Expando,' show support details. (ft.)(in.) (in.) (in.) Typical Support in.) (in.) Footing Size x n.) (in.) Max.. Pier Spacing Max. Overhang (ft.)l (in.) *If center nter piers are other than drawn above, in locations, spacing, and dimensions. OUTTr= CoUtqyV IVILDING DEPARTMENT APAROVE-.D./�/ BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: 2. Installer's name: "\0 a K) 3. Is the site currently under permit? Yet No _� •. (If yes, furnish permit number /S"&S ) OR Is the site an existing site? Yes _� No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of'all setbacks and easements? Yes No ( If no, clarify ( ) 5. What is the mobilehome electrical rating? ----------------------- �% 6 -e:) Amps 6. What is the mobilehome site service rating? --------------------- z Amps 7.. What is the mobilehome site circuit breaker rating? ------- ---- n Amps 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- Yes No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- (in.) 10. What is the type of gas service? ----------------------------- Natural —7 LPG i7 11. What is the gas pipe length from meter or tank to the mobilehome? -/Id (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.) I COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Tel ephbnb: 534-4541 APPLICATION AND PERMIT V/ 549 QUUIUIILC ICJ/ICSCIIIQUVCS UI Ule wunly UI ouuU tU Unlet Upvn 1ne This permit is hereby issued under the applicable provisions of above-mentioned property for inspection purposes. the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. /-c 5� �� y�� _ DIRECTOR OF PUBLIC WORKS /l –� Dat Signature of Permitee or Agent -71/70/ e?,S 1�PQ �� 7 �y, BY - Date O G Receipt No. Dp White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant BA/ding permit expires Date BUILDING Owner �, J! SCG SQ. FT. OCC. BUILDING VALUATIO Mailing Address uGG.j L� els e on o Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee c r PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each.Trao 1.50 per+•• -a Repair drainage or vent piping 1.50 r .�' A. P. No./ `j OF Doing 8, Planning Water piping 1.50 Each gas water heater or vent 1.50 F s W — Sa I tion Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 , i� EQA Parking Parcel Plans Declaration Parcel ap 60' R/W Improvements Each additional outlet .30 B ilding sewer 5.00 Bldg.. Plans Recd )Parte royal Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ Permit Fee $ 7(56 $ �( ELECTRICAL No. @ FEE PERMIT FILING FEE $3,00 Main service 100V OR LESS 1 O� 100 AMP OR LESS 5•0� Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 a4:S70 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 OR ADDNSNEW // CONST. ACCDWELBLDGS.LING CCUP. S) 2¢Sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style le of: NEW RESID. BRANCH CIRCUITS) NON.CONST BRANCH CIRCUITS) 2.50ea NEWCONSTR./R,POWER APPARATUS & NON .RESID, (SINGLE OUTLET CIL4_ EX. OCCUD(OUTLETS OR FIXTIIRES) BAL@1 Ex. OCCU FIXED APPLNS. OR p• OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 ir cense No. Classification Mist. Wiring 6.25 we LL R,,60 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ , t;z:s $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. M have placed on file with the County of Butte a certificate of Korkmen'sCompensation Insurance. certify that in the performance of the work for which this rmit is issued I shall not employ any person in any manner to become subject to the Workmen's Compensation Laws of California. @ MECHANICAL No. FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ QUUIUIILC ICJ/ICSCIIIQUVCS UI Ule wunly UI ouuU tU Unlet Upvn 1ne This permit is hereby issued under the applicable provisions of above-mentioned property for inspection purposes. the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. /-c 5� �� y�� _ DIRECTOR OF PUBLIC WORKS /l –� Dat Signature of Permitee or Agent -71/70/ e?,S 1�PQ �� 7 �y, BY - Date O G Receipt No. Dp White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant BA/ding permit expires Date