HomeMy WebLinkAbout073-170-003�y
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C;Nrence R. Riley � �a 1 � 1/77
W/S 1'.rd.,app.3/4 mi.N.of Oro -Forbes
town ^Rd. ,, app.3/4 mile E. of P.Q
Forbestown
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JOHN WINTERS 73-17-3
Squaw Hat Rd�t/+ -
Contr:. P Forbestovjn
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Issued g Slte)
073-170-003 06-2081
TUCKER, JOHN F
199 SWEDES FLAT RRD` IFF'ORBESTOWN .
Cont: OWNER
SHOP(METAL)- , -D
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
INSPECTION CARD
24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico)
Office: (530) 538-7541 Fax: (530)1538-2140 Website: www.buttecounty.net/dds
I i
Permit No: 06-2081 Issued: 09/25/2006
Address: 199 SQUAW FLAT RD
APN: 073-170-003 Permit Subtype: SHOP(METAL)
Owner: JOHN & MARCEIN TUCKER j
Applicant: JOHN & MARCEIN TUCKER t
Description:, SHOP(METAL) Cj&lr bl d
MUST BE ON JOB SITE
JOB SHALL BE READY PRIOR TO CALLING FOR
INSPECTION. THE INSPECTION CARD AND
APPROVED PLANS MUST BE AVAILABLE FOR EACH
INSPECTION OR THE INSPECTION WILL NOT BE
MADE AND A RE -INSPECTION FEE MAY BE
ASSESSED.
ALL PLAN REVISIONS MUST BE APPROVEI) BY THE COUNTY BEFORE PROCEEDING
i
Inspection Type IVR INSP DATE ► Inspection Type IVR INSP
Setbacks 132
Foundations / Footings 111 Q f
Pier/Column Footings 122
Grade Beams 114
Eufer Ground 216
t
Forms/Steel/Holdowns 122
Do Not Pour Concrete Until Above are Signed
est
Shear Transfer
136
Under Floor Plumbing
412
Under Slab Plumbing
411
Gas Piping
403
Do Not Install Floor Sheathing or Slab Until Above Signed
Rough Framing
128•ZS w
Rough Plumbing
406
Roueh Mechanical
316
I Do Not Insulate Until Above Siened I
W
Do Not Cover Until Above Signed
T -Bar Ceiling / RC 145
Gas Test 404
Stucco Lath 142
Stucco Scratch 143 '
Stucco Brown 144 p '
lbing Final 813 - I
ect Final I 801
ERMITS BECOME NULL AND FROM THE DATE OF ISSUANCE. IF WORK HAS
COMMENCED, YOU MAY PA FOR YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION
Inspector Copy
4
v
COUNTY OF BUTTE
BUILDING DIVISION
n=pAo,rRAcKi"r OF DEVELOPMENT ccoxiit%mc-
'7 County Center Drive * Oroville, CA * (530) 538-7541
CORRECTION NOTICE
A -
OWNER
PERMIT NO.
the above address and should be corrected. Please call for re -inspection when correction of
work is completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below.
'N
o
A/
Date Inspector!/
REV 4/05 Phone#
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
F
COUNTY OF BUTTE
r BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive - Oroville, CA - (530) 538-7541
CORRECTION NOTICE
r OWNER o P ERMIT NO.
�Ik
fi A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please call for re -inspection when correction of
work is completed. If you have any questions pertaining to this matter, or need additional
�X explanation, please contact the Building Inspector as indicated below.
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Date Zzsz Inspector/ -1,
REV 4/05 Phone #
fir...
" FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
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COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (530) 538-7541
;i
"CORRECTION NOTICE
Tu c— ie 0K) — 7061
A, {
rid''
—.—r
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
.: IgN,,
the above address and should be corrected. Please call for re -inspection when correction. of
work is completed. If you have any questions pertaining to this matter, or need additional
s
explanation, please contact the Building Inspector as indicated below.
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ri
�CZe 0-.o.a-e 1t"'�oc-e S t & L.o� C L..11_
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Date Inspector
REV 4/05 Phone #���� —36
R-RE=INSPECTION CALL: 538-7636 OR 891=2834" �'''
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 199 SQUAW FLAT RD
Q
APN: 073-170-003
Owner:
JOHN & MARCEIN TUCKER
Permit No: 06-2081
Issued Date: 09/25/2006 By KEJ
Permit type: MISCELLANEOUS
P.O. BOX 306
Subtype: SHOP(METAL)
FOR.BESTOWN,
CA 95941
Expiration Date: 09/20/2007
Description: SHOP(METAL)
(530) 675-0145
Occupancy: Zoning: U
Contractor
Applicant:
Square Footage:
OWNER
JOHN & MARCEIN TUCKER
Building Garage RemdVAddn
P.O. BOX 306
884
FORBESTOWN, CA 95941
Other Porch/Patio Total
(530)675-0145
884
FEE INFORMATION
Fund 10 BLDG $329.94
Garage - Wood Frame $329.94
SMIP - Residential $2.12
SRA Fees $95.00
Total Charged: $757.00 Fees Paid: $757.00
Balance Due: $0.00 Receipt No: B228
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractors License
OWNER / /
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractor's 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
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.
X 09/25/2006
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractor's Signature Date
rM 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
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
year of completion, the owner -builder will have the burden of proof that he or she did not build or
improve for the purpose of sale.).
❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
r� I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
The Contractors License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Carrier: Policy Number: Exp. Date:
(This section need not be completed if the permit is for one a i- und�llars ($100) or ess.
❑ IAM EXEMPT under Section B. & P.C. for this reason:
M: CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
/J
X 1�+�-"� 09/25/2006
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
provisions.
XYNLA��09/25/2006
Owner's Signature Date
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, and liability for personal
its officers, agents and employees from any and all claims ,or
injury, including death, and property damage caused by, arising out of, or in any way connected with
o
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. 1 hereby authorize representatives of Butte
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
property owner or am authorized to act on the property owner's behalf.
7ZLr-(Ce,.— 09/25/2006
CONSTRUCTION LENDING AGENCY
Name of Permittee [SIGN] Print Date
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Owner ❑ Contractor OR; Agent for Owner Agent for Contractor
INSPECTOR COPY
Lender's Address City State Zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 199 SQUAW FLAT RD
Q
Owner:
Permit No: 06-2081
APN: 073-170-003
JOHN & MARCEIN TUCKER
Issued Date: 09/25/2006 By KEJ
Permit type: MISCELLANEOUS
P.O. BOX 306
Subtype: SHOP(METAL)
FORBESTOWN,
CA 95941
Expiration Date: 09/20/2007
Description: SHOP(METAL)
(530) 675-0145
Occupancy: Zoning: U
Contractor
Applicant:
Square Footage:
OWNER
JOHN & MARCEIN TUCKER
Building Garage Remdl/Addn
P.O. BOX
306
884
FORBESTOWN,
CA 95941
Other Porch/Patio Total
(530)675-0145
884
FEE INFORMATION
Fund 10 BLDG $329.94
Garage - Wood Frame $329.94
SMTP - Residential $2.12
SRA Fees $95.00
Total Charged: $757.00 Fees Paid: $757.00
Balance Due: $0.00 Receipt No: B228
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
OWNER / /
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X 09/25/2006
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractors Signature Date
711, 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
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
ElHAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
ection 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The,Contractors License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Carrier: Policy Number: Exp. Date:
(This section need not be completed if the permit is for for once hundred dollars ($100) or less.
❑ I AM EXEMPT under Section B. & P.C. for this reason:
[� I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
v _ �(
A �,s_((io,� 09/25/2006
J ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
the
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 with those
Owner's Signature Date
provisions.
X _ e 09/25/2006
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
property owner or am authorized to act on the property owner's behalf.
09/25/2006
CONSTRUCTION LENDING AGENCY
Name of Permittee [SIGN] Print Date
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Owner ❑ Contractor OR; ElAgent for Owner Agent for Contractor
FILE COPY
Lender's Address City State Zip
rr
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 REO UIRED AT TIME OFAPPLIC4TION.
Website: www.buttecounty.netldds
cMTn, --10 tai
**PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Na e .
Name
usI Name
v a M fFr?5--6 kl
Address �� 66X 3Dty
Zp �(Si L( I
City FXbES-r0W A)
State e A
11PI 5111
Phone -
J 3U—Ce 7 5—o t (j
Fax S
E-mail
l��r�e, v. 5b�
5.l-rvo. r,e-i• .
APPLICANT INFORMATION
CONTRACTOR
Name
City -. .F0j� 57'6010 �
Address
Zp �(Si L( I
City .
Fax S30 -G ?S- D (t
State
Zip
Phone''
Subdivision Name
Fax
E-mail
Page
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City -. .F0j� 57'6010 �
Address
Zp �(Si L( I
C4
Fax S30 -G ?S- D (t
State
Zip
Phone
Subdivision Name
Fax -
E-mail
Page
State License Number
APPLICANT INFORMATION
Name -SQAJ d- M Aa4C-1Ai 1 Lt &KeA-
Address n. v RD 304
City -. .F0j� 57'6010 �
St�te
Zp �(Si L( I
Phone
5-30-1,r75- O(LYs
Fax S30 -G ?S- D (t
"E-mail
5bc 4.flod dt�-�
APPLICANT SIGNATURE
For office use only:
AP# 0`73.- f 70-003-6oO
Zoning
City
�a E�ICc
Flood Zone
SRA
as
No
Occ•
Type Const. V rJ
Subdivision Name
Name
,
Map Book
Page
Lot #
Planner
Date Approved:
PROJECT LOCATION
AP# 0`73.- f 70-003-6oO
Pro a Add s
LIA R pt 1 OZ.UA1
City
�a E�ICc
Cross Street
WORKER'S COMPENSATION——
Policy Number
Carrier
if hiring anyone other than license confractors, a certificate of worker's
compensation must be shown at the time ofpermit issuance.
LENDING -AGENCY
Name
,
Address
Description or Scope of Work:
P�jTuC A-1rko)E'L8-Li rs.
Amite 6AM STi�LSP40J
Sq FT- Living gg arage I Open Cov
❑ 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 prder. to renew action on an.
application after expiration, a new application, plans and fee will be
required.
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 depwttnent costs are not
refundable.
rl
Received by: K V .
Receipt 0
Dater -2q _0(�
Amount qG i Bldg
t2oq ,q� SRA
Sheriff
t� SMIP
���� f Other
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building -Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED., ALL PLANS MUST BE LEGIBLE AND IN INK .
❑ 1. Site plans, 3 oro 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 or4 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 faxesl
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for'Non-heated and A1C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 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. Building Permit Application Without Required Clearances Form
❑ 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). -
0
4.
NPDES Form.
❑
5.
-11nc' achment 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.
❑ Legal description from current recorded grant deed; ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
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.
EXPIRATION OF APPLICATION
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
TO: Building Division = Development Services
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location
Plan Approved for: Sewage Disposal?
Clearance for dwelling. Other
Water Supply: Public
Hold final for:
Final clearance O.K. for:
NOTE:
Environmenta Health Specialist Date
Building Clearance 9/2005
Plot Plan Attached
Floor Plan Attached
Sent to BDIDS I
07 3 -/ ?o -00.3.
AP#
Private Well
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 . bP0 Co 20D2
OWNER: ASSESSOR PARCEL NUMBER v oz - w -co2)
' S-2 q
�1 t�CD
Proposed Building Use: Nnr:04 G � Permit Technician: , 7 . Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
XN 1. Site plans, Dr 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.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans anccaign triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
Cl 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate.
V0 11. Hazardous Material Form
VN 12. Acknowledgement of building permit application without required clearances.
❑ 13. Other
ReydaiVg
ms needed to issue the permit. (May require additional plan review upon receipt of the following items.)
Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable-# 2Sk- �QnS A 2 F��r
❑Fire Sprinklers............................................................................................
❑ Aricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ . Soils Report and/or Engineered Foundation required ........................................... s
❑ V2City
Erosion Control Plan Required........................................................................
Fees as shown on the attached Schedule of Fees Due Sheet ..............................
❑ of Chico Plumbing permit.......................:.....'............................:...........
21. Site plan and business license approval from thVe Cii of Biggs ..............................
22. California Department of Forestry Ian approval`C�5 paid. Sent by:
23. Planning approval for (A) Uset� (B) Parking: (C) Parcel Check:....... i/
❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................
❑/ 25. Fire Marshall Review (commercial projects only). Sent by: ......................
. 26. NPDES Form.............................................................................................
❑ 27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Contractor's license information. (Number, Name Style, Classification)...................
V❑ 29. Worker's Compensation Carrier and Policy Number ..........................................
�J 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..........................................................................................
❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO .........................
❑ 36. Other:
❑ 37. Other:
When issued Telephone (5_0)6075 -01 qL5 nwws and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant: N Date:
1. Index permit application for the above items numbered: Plan CheckLe er
2, Additional items required
Contractor, designs advised of the above data b _ phone, ❑ mail, ❑ count Date;
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by - Date:
Contractor, designer, own r, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, y Date:
Plans reviewed by: Date: Plans approved by: Date: IAV L
Structural reviewed by: Date: Structural approved by: Date:
Note transfer by: Date: 0(i
Yellow: Building Division
K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05
BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965
www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140
RECEIPT OF FEES SCHEDULE - RESIDENTIAL
Owner TUCKER APN No: 073-170-003 Permit Type: I I " Subtype:
App Date: 8/29/2006 Permit No: BP 062081 Permit Desc: I I. New
1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION
Plan Check portion of Permit Fee
2 FEMA RYes Flood Elevation Review $109.98
3 SRA* Yes Fire Plan Check - Non -Refundable $95.00
(State Responsibility Area) Building Inspection $109.98
NON-REFUNDABLE portion of fees due at application
$549.90
$219.96 $329.94 Balance of Building Permit Fee
0
$95.00 $204.98
$109.98
1314.96 RECEIPT DATE Tech/Asst
FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $424.94
FFFA IRFI Owl ni IF PRIOR TA IRRI IONCF OF PFRMIT 4tzt9 na
10 (j 8/29/06 Kourtni
At the 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: Jl,� Date: U / �16'-G
Pursuant to Government code Section 66020, you are hereby notified those Items followed by an " " may have been imposed on your project. You have 90 days
from the date of approval of the porject or from the impostion of the above referenced items during which you may protest. The requirements for a protest are
specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 041506
- I OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return this information 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 material for construction of this proposed
properly improvement: YES.[ < 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: iJ W
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO:
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise, and -provide the major work:
NAME: %
ADDRESS:
PHONE: CONTRACTOR'S LICENSE NO:
S. 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
6 I LL' 5u -'J --r00 �'j(2 0LJnt5V ► 11��. Gr? 5-10.[3 GDnc,2E7—L– SL43
SIGNED:
PROPERTY OWNER-
DATE:
WNER
DATE: Kf a_-rI d(?
NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code.
This verification must be completed and returned to our office before we are permitted to issue the
Butte County .department of Development Services o O:-zz
1 T
ADMINISTRATION 'BUILDING* GIS ° PLANNING
o o
_ o
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2140 Facsimile
OWNER -BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a
permit Building permits are not required to be signed by property owners unless they are personally performing their own
work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if
that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business 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 your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal government 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.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the 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 contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractor 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 contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
Sincerely,
Scott Rutherford
Chief Building Inspector
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
Butte CountyDepartmentof'Developinel2LScivlCCS
°$vTr�° r
7 County Center Drive
Oroville, CA 95965
° "-.•;, :-ate. °
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES
I request and authorize the Building Division to process this building pen -nit application through the plans
examination process WITHOUT first obtaining all necessary, related permits and clearances from other
regulatory entities, including but not limited to, Planning, Environmental Health, Land Development,.
County Fire, and Agriculture.
I hereby acknowledge:
0 I need to submit applications for septic and/or well to Butte County Environmental Health
immediately.
I ant required to bring the approved Environmental Health site plan and approved sanitation
clearance to the Building Division as soon as clearance is obtained
a I am responsible for notifying Development Services, in writing, to stop processing of the
application and to arrange for disposition of plans.
,.
The Building Division will process the application through the plans examination process, as submitted,
without input from other regulatory entities that could prohibit issuance of the building permit or r uire
submission of amended building plans to the Building Division. Once the 'plans examination process
begins, there will be no refund of plans examination fees. Any changes requiring submission of amended
plans to the Building Division will incur additional fees. '
Within one year from the date of application for a building permit, all other required permits and clearances
from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances
will void the application.
Typically other required permits/clearances include, but are not limited to, verification the parcel was
legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well
as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture
buffer zones, and habitat/species).
Please print:
Applicant Name: MZC'e�/N —rZ(G4Yz— APN: 023- —bb3
Building site address: �l 5�{ Uf�W 2r� �L ST�Permit No.: 0(i oZ 4 9
I have read, understood and accept the terms and conditions as expressed herein as indicated by my
submission of the above -referenced building permit application and my signature below:
SIGNATURE OF APPLICANT DATE
o�QpST"'�vr
Y 06UTT�
\\ COUNT_
o&�, Department of Public Works
C o u n t y o f B u t t e
O
LAND DEVELOPMENT DIVISION
° J. Michael Crump,
- o �� Storm Water Management Program
/i Director 7 County Center Drive
Oroville, CA 95965
iOvQ�I�"�W �5 )530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase II
Construction Storm Water Permit and Storm Water Pollution. Prevention
Plan (SWPPP) Acknowledgement - [LESS THAN 1 ACRE]
Project Description:
Project Location and/or Parcel Number: %'qJ? SQA-{ A -LO -FLAT 62P F02a-E5T&->3 YA
GAx'5114) -1� 023-Do-oo3
By signing below, I, the project owner/owner's agent, certify that this. project WILL NOT DISTURB
1 acre or more of land and that .I, therefore, do not need to apply for a Construction Storm Water
Permit from the State of California Regional Water. Quality Control Board. Phased projects that .
contain multiple site build -outs of less than one acre but when combined with subsequent phases total
more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of
California Regional Water Quality Control Board.
I am aware that submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
Signed:
Title:
Less than I Acre NPDES & SWPPP Compliance Certification
-----------
OWNER:
LOCATI(
CONTRAk, i vr<.
FIRE DAMAGE REPORT
DATE: 6 -a %7-0 Q ,
A.P. # L) 93-170
QQ j
DATETO INSPECTOR: L� ",�S �� �` PERMIT HISTORY:( ? NONE ( LEAS FOLLOWS:
BUILDING INSPECTOR'S REPORT
Building Description:
CommerciaUUsage:
ResidentiaU# of Units:—�
Currently Occupied
AbandonedNacant
Electric:
Yes / No Electric currently On_Off
Condition of Electric
Gas:
Natural
Propane_ ZNone
Obvious Problems:
Currently On /off
Sanitation: /
Plumbing Working
Well Working / Potable Water
Obvious SewageProblems
Description of Damaged
15
Estimate Valuation of Damaged Area:
Condition of Foundation:
Mobile Home:
Inspector.
Sketch bu
on reverse and indicate area of damage.
Date J—(O—e
�Ct CSG 0
F A
DF/BUTTE COUNTY FIRE INCIDENT LO
70 -06,3
DATE 01/26120021
INCIDENT NUMBER 939. LOGGED B JMH
REPORT TIME 11:10
LOCAL FIRE NUMBEi AAr i M A� FiM RO
SHEM HAWK
STATE FIRE NUMBERAAr CrArp FIM nffi�u.A BI
14
J
CASE NUMBEREi AArrAAps MEDICS
LOCATION 199 SQUAW FLAT RD I PRA D6 ECC ❑
RP LIBBY
PHONE NUMBER
675-1154 I REPORT METHO 911
WILDLAND FIRES ❑ ESTIMATED ACRES 0
FIRE INFORMATION
STRUCTURE FIRE
FIRE INFO SENT HO
EMAIL BY JMH TO
RESIDENTIAL I
OTHER FIRE
7 -DAY LOGGED INITIALS IMM
MEDICAL AIDS
I
INCIDENT NAME ISQUAW
PSAlOTHER
START DATE 01/26/2002 START TIME 10:00
HAZ MAT
DIAMOND #
12.0
COMMENTS
CAUSE
MISC
LAND USEDOMESTIC
ACRES _ 0 TYPE OF ACRES
DIAMOND 5 ONLY $ DAMAGE TYPE
DOLLAR DAMAGE 10000.00] SAVE 50000.00
INJURIES/FATALITIES ❑
# CIVILIAN INJURIES OJ # CIVILIAN FATALITIES
EMD ❑ DES
❑
# FF INJURIE 0101 # FF FATALITIES
EEO
♦ dew Incident
!
FC-40 INFORMATION
FC -40 ❑ DATE OF FC -40 INC
AGENCY INC # INC P#
FC -40 COMP DATE j FC -40 COMP BY 1�
County Notifications ❑ EARS Hard Copy Recieved F./� EARS Checked Agenst EARS Computer ❑
P 73-17-
CNrence R. Riley Y'/
_ W/S` pV,� rd. ,app.3/4 mi.N.of Oro-Forbe
town Rd ;.,app.3/4 mile E.of
Forbestown
Permit 68 77P.,E(ut4l.,MH)
ELEC.
GAS
SUPPORT STRUCTURE REQ,-
COMI A CTION TEST EhTQ,;
73-17-3 f
Permit..4 869 7MHI
Isstied _ _ 7
s ,
JOHN WINTERS 73-17�
Squaw Hat Rd Forbesto n
Contr: PSC
ermi t #3614-87MHI Rs&
ISsued xisting site)
a
j
i
t
4 _
•
60_
+
V
i
PERMIT NO. —
PERMIT EXPIRES
OWNER 404N. WINTERS,
CONTR. $��dsee4�r
ASSESSOR PARCEL 73-1773
LOCATION 4 Swquaw Flat Rd, N/S WEst of
0
School St,z mi pri rd, Forbestown
I
t
OFFICE COpY
{
4� Address
Date -Z
'r Temp. Power 1 ete _BY
ELECTRIC Date (11 w
Called. PGA
Meter BY _ ry
w}
Temp. Elec. Se!vice
Called PG&E
Temp. One Service
Called PG&E
JOB FINALED (Date) (!
Signature ' '
=OK,
0 = Not OK
= Not Readyiable
MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
3. Sewer; Location -Test -Fall -C/O -Concrete
'4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Grnd.-/ . / Amp -Concrete
6. Gas; Location -Test -Wrap: / /"L"ft.
• / /"Nat. or/ /"L"ft./ /"LPG
7. Utility Clearance
Card -81 Date Card -81 Date
Card -81 Date Card -81 Date
Date MO_RfLEHOME INSTALLATION Plans OK except #'s
Z ing Requirements -Setbacks -Easements
Fo .Ings; Size -Spacing -Marriage Line
J (- S s; MH Test -Demand -Valve -Connector
ectricity; MH Test -Crossovers -Breakers -Clearances
•
Drai H Test -Fall -Flex Connector
er H Test -Regulator -Connector
er and Sewer. Connected -C/O to Grade -HD Appn
Z as and Electricity Tagged
E its; Insp.-Sketch
(`05 1 ert. of Occupancy
Card-B1j!j ` Date //,--� Card -B1 Date
Card -B1 Date 1 f-7_SR"ard-131 Date
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 -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures.
6. Carports; Windows -Doors
7. Elec.
8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Card -131 Date Card -131 Date
!Card -131 Date Card -81 Date
,Date POOLS (Plans) OK except #'s
I 1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness -
Dead Men -Lining
1 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
1 8. Elec.;Ground ing; Equip. w/5' -circulating Equip. -Pool Lghtg.
1 Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
I 10. Plumb.; Cir. Test -Water Supply Test
I. Card -B1 Date Card -61 Date
Card -131 Date Card -131 Date
= OK
0 = NotOK
RESIDENTIAL (Single and Duplex)
- =Not Applicable
--Not Rdedy
Date
UNDERFLOOR (Plans) OK except #'s
Date
FRAMING (Continued) _
1. Zoning requirements -Setbacks -Easements
44. Hangers -Post Caps -Anchors -Connectors
2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth
45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
3. Ftg., Garage; Soils -Steel-/ P' Ftg. Depth
46. Fireplace Ties or Type A Flue -Fireplace Throat
4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth
47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
5. Stemwalls, Main; Steel-Blockouts-Wrapped
48. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
49. Garage Fire Protection Framing
7. Slab; Steel -Wrapped
50. Property Line Firewall & Openings
8. Piers -Fireplace Ftg.-Steel
51. Ext. Doors -One T -Check Garage -3rd story, 2 exits
9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test
52. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
10. Gas Pipe; Size -Anchors
53. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
11. Water Pipe; Test -Anchors -Regulator -Service Test
54. Siding -Nailing Veneer
12. Electric; Underground
55. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
13. Plenums & Ducts; Clearance-Material-Supprt-Ins.
56. Glazing Area -Glass Protection -Skylights -Plastic
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
57. Shear Walls; Nailing -Bolts
15. Insulation
58. Insulation-Walls-Clg.
59. Infiltration -Wal Is-Wndws
Card -B1
Date Card -61 Date
Card -B1
Date Card -81 Date
Card -131
Date Card -131 Date
Card -B1
Date Card -B1 Date
Date
PLUMBING (Permit) OK except #'s
16. Water Ht. Vent -Access -Combustion Air
Date
FINAL (Plans) OK except #'s
17. Water Pipe; Test & Anchors -Nail Protection
60. Ext. Steps -Door & Sidelight Protection -Landings
18. D.W.V.; Test-Fttngs & Anchors -Nail Protection
61. Smoke Detector
19. Shower Pan; Test, First Floor -Tub Access
62. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Mach. Protection
20. Test Tub & Shower, 2nd Floor -Tub Access
21. Gas Pipe; Size & Anchors
63. Bedroom Exiting
64. G.F.I. & Bath Fixtures & Tub Access -Spa
65. Elec. Trim & Subpanel; Breaker Sizes -Labels
Card -B1
Date Card -B1 Date
66. Stairs & Rails
Card -B1
Date Card -131 Date
67. Fireplace or Stove; Clearances -Hearth
Date
ELECTRICAL (Permit) OK except #'s
68. Elec. Outlets at Wood Panel; Int. & Ext.
22. Fixture & Transformer Clearance -Ins. Protection
69. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance
70. Elec. Outlets & Receptacles at Kit. Counter
23. Elec. Receptacles Spacing -Lights & Switches at Doors
24. Size Boxes & No. of Conductors -Stapled
71. Garage Fire Door; Swing -Landing -Closer
25. Romex Installed Close to Edge of Studs & C.J.
72. A.C. Duct in Garage -Damper
26. Equip. Ground made up w/Mach. Fasteners -Bond Gas & Water
73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor -Mach. Protection
27. 2 Appliance Circuits in Kitchen &Conductor Size
74. Plb., Elec. & Mech. Equip. Listed for Location
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga.
Cu or Al
75. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
29. Range Circ. / / ga. Cu or Al -Oven Circ. / / ga. Cu or AI.
Insulated Neutral Yes No
76. Insulation -Foam -Looked in Attic O Yes
77. Guard Rails & Deck Construction -Post Caps
30. Service -Riser Conductors & Ground -Main Disconnect
78. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor 17 Yes
31. Equip. Clearances Panels-Motors-Mech. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
79. Following instld.; Drive ❑ Yes O No; Walks 0 Yes O No;
Planters o Yes 0 No
80. Stucco; Brown -Finish
Card -131
Date Card -B1 Date
81. A.C. Unit; Disconnect, Electrical, Plumbing
Card -81
Date Card -B1 Date
82. Vents Above Roof; PIbg.-Appliance-Firep I. -Clearance to
Openings.
Date
MECHANICAL (Permit) OK except #'s
83. Water Well; Disconnect, Electrical, Plumbing
33. A.C. Ducts Insulation & Support
84. Exterior Elec. Trim; G.F.I. Receptacle -Underground
34. Vent Fan; Exhaust above insulation
85. Ventilation throughout House
35. Condensate Drain & Overflow; Size & Grade
86. Glass Protection
36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet
87. Corrections from Previous Inpections
37. Attic Access & Platform if Furnace in Attic
88. Gas Test -Meters Tagged; Gas -Electric
89. Water & Sewer Connected -C/O to Grade -HD Approval
90. Energy Compliance Certificate -Other Certificates
Card -81
Date Card -131 Date
Card -B1
Date Card -131 Date
Card -B1
Date Card -B1 Date
Date
FRAMING (Plans) OK except #'s
Card -131
Date Card -131 Date
38. Sills, Proper Material & Anchors
Card -B1
Date Card -B1 Date
39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
Comments at Final:
40. Bearing Walls over Girders & Floor Nailing
41. Draft Stop in Walls (rat proof)
42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
43. Header & Beam -Size & Bearing
(NOTE: An entry must be made each time you visit job site)
A MOBILEHOME INSTALLATION., -ACCEPTANCE k
.,
COUNTY OF BUTTE ;. 3 `-:
�_ OEPARTMENT'OF PUBLIC WORKS —"' 7 COUNTY CENTER'DRIVE_;
OROVILLE,.CALIFORNIA'— 534-4541
PERMIT?N0.1�
y
Address or location of mobile
� r 4•
"name ' `
Owrier's tiL'�i i
kf-Owner's.address
�; Insignia or hud number
`Mariufacturer's name
�
:$S erial number of V.1 d ad •y " (k— Year of manufacture
as
(Official Approving Installation) U"flDate).
,
;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..
A513B,, White —Owner, Yellow. Installer,
.r. -.,x ...t_ __.r .... s>± ..,.,1...• _ti.0 ..._. tal
R
COUNTY OF BUTTE
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
--,?6/y-�
PERMIT I
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.
// a
up
Inspector _66 Date &-1,,2- — d
I
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS NO.7 County Center Drive - Oroville, California'95965 - Telephone: 916/538-7541f&eERMIT
�APPLICATION AND PERMIT
ASSESSOR PARCEL UMBER/ —
ZONI G
BUILDING PERMIT
OWNER
J iT
TE�EPf°E
f'7�
C�(O v
SO. FT. OCC. BUILDING VALUATION
OWN •S MAILING ADDR S
RACTO 'S NAME -
T LE PH,OJJ��/
`
O ACTO ILING ADDRES
4%
Fireplace
CONSTRUCTION YEj°
N ER
UNKNOWN
Total Valuation $
Filing Fee
$ 10,00
LENDER'S MAILING ADDRE
Permit Fee
$
ARCHITECT OR ENGINEE
LICENSE NO.
Plan Checking Fee
Energy Plan Checking Fee
A$.
$
ARCHITECT OR ENGIN ER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
oaw (
Permit fee
$
PLUMBING PERMIT
Filing Fee 10.00
//
�;��1 UU`
Each Trap
2.00
,:p_
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME VPARCEL
MAP
v .
Water piping,
5.00
Each gas water heater or vent
5.00
USE OF ST
SF ❑ Duplex❑ Mobilehome Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
r10-00ea
Building sewer
5.00
Mobile Home S G W
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑
Describe work: _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filin"]7gFee 10.00
Main service °00V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare der penalty of perjury (Check.one):
- I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Prof`7 C de a•do my license is in f force Ind ffect.
�` C
License 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 oCCUP.&)
OR A.D.S. ACC. BLDGS. _
y22sgft
NEW CONSTR.ULTI.OUTLET
NON•RESID BRANCH.CIRC ITS
2,SOea
POWER APPARATUS p�1
SINGLE OUTLET CIS• /
-
EX. Occup(RES
OUTLETS OR FIXTURES
20®300
15AL030
FIXED APPLNS. OR
EX. Occup. OUTLETS (RESID.) EA.1
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure. .
❑ I shall not employ any person in any manner so as to become 'subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
FiIingFee 10.00
Heating
Cooling
Hood
3.00
Ventilation
Penult 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.
o agree to save, in emnify and keep harmless the County of Butte against
all li lilies, judg ant costs, and expenses which may in any way accrue
against s unty n oaence o t e granting of this pe it.
- Date/ v
Signa re of pplicant — Owner Contractor ❑ Agent
n 0'S permit is required for excavations over 5'0" deep and demolition or construct-
ion of str ctures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
TOTAL PERMIT FEE $ b
Occup.
C0.ST.TYPEJ
PLOOD ARe
PD HD Iseu
This permit is hereby issued under
sions of the Butte County. Code and/or
work indicated above for which
DIRECTO F PUBLIC
By
PE T EXPIRES Date -
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date �t—
Receipt No.
WHITE-D.P.W.. YELLOW-AS°E390R, PINK -INSPECTOR, GOLDENROD -APPLICANT
TO Buildinq DepartmentZ;�� -
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner
Plan Approved for:
Hold final for:
Location AP#
Sewage Disposal ._,Z-- Water Supply
Final clearance O.K. for:
Clearance for ra bedroom obile home.
NOTE * * *
Sanitarian
Water Supply
/' Water Supply
A
Other 60 k
Dat
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS -BUILDING DIVISION %
7 COUNTY CENTER DRIVE - OROVILLE,`CALhFO iNIA 95965 - TELEPHONEi 9167534-4541 y
r
PERMITIAPPLICATION DATA SHEET.
Permit No.
OWNER �/1%-^--P/li l�11' f i✓ • pp'� A. P. No. " " 3
Proposed Building Use �'``• L ��J� —04=,g,g 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. Plans with Energy Design Compliance Statement. . . . . .
6. CUSD "Fees Paid'' Stamp on Floor Plan . . . . . . . . 8.
7 Statement of Intent for Non -Heated and AC Buildings.
F 8. Fees of $ . 4. . . . .
-_. 9. Letter of signature authorization. . . . . . . . . . . ,
10. Sanitation approval from Health Dept.
11, Planning approval for (A) Use: (B) Parking:
12. Certificate of Workmen's Compensation Insurance. . . . . .
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ),
Improvements may be required. . . . . . . . . . . .
16. Mobi lehome Installation Data. . . . . . . . . .
Pre-Inspec.request to (Date)
17. Pre -Inspection for Required.. Building.inspector
' 18. Recorded copy of Agricultural Acknowledgment Statement.
19. Driveway Permit.
20. Plot plan approval from city of
21.
Y 22.
When ,od issue the ermit, process as follows: Mail to owner, Mail to contractor.
7�Telephone V%%— and hold for pickup at � ice Deliver w/inspector.
Conv of plans sent
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: �•
Contractor, designer, owner, was advised of above required data by—phone--.Mai I counter by
Contractor, designer, owner, was advised of above required data by—phone —Mai l—counter *
Plans checked by
Copy—DPW
Date Plans approved by
Sets of plans on hold in File cabinet AP folder
date
date
Date_
— Hours: 10:00 a:m. - 3:00 p.m.
-and pqcjficafiani -MUST -be,
This set Of pldns- _5
L six it urjc&ful to,
kjpf
P, __' __
e��i eL Ions Ojf some -W
arry ck'mges
----Imen+of
i, -7-
A—e-De
Uri
Butte. ---
;14u
T
—7—
ZI wu o Aidomolold a-
n t
OCIM174liell
lutes
fut u gm
--------------
dd
Lit)
�wq
y CoMe siufft. zi`Oicui
Wort, ioll ne-
he M�
hilou Vil '4vt .........
itha
80 4
N. Or! Z) t
-1
PFOP�T'�,'ld ancl a --------
_57
1 11 IV[ 11 f
-.4 -- ---- JO.e. 06C
--a
rte
m!ent
IL
T a
—71 .
40; 7 7-1
—
—
�ffj
a
-- - ---------
J-1
1 171,
;v
BUTTE COURrY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA
PHONE: 534-4541
1. Owner's Name:
MOBILEHOME INSTALLATION SHEET
2. Installer's Name:
3. Is the site curre
(If yes, furnish permit number ) 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 seprll�o
nk and leach
Yesfields.and clear of all setbacks and easements?❑
(If no, clarify
5.
What is the
mobilehome electrical rating? ---------------
® a Amps
6.
What is the
mobilehome site service rating? -------------
�i O 0 Amps
7.
What is the
mobilehome site circuit breaker rating?
----- /00 Amps
8.
Is there any
other electric load to be served by the
site service ? --------------------------------
Yes � Leo
mobilehome
(If yes,
identify the load and size:
(Load) (Amps)
9.
What is the
mobilehome site gas pipe size? --------------
1V (in.)
10.
What -is the
type of service? --=----------------
Natural
LPG
gas
11.
What is the
gas pipe length from meter or tank to the
r
/ 1
mobilehome?
----------------------- -.----------- -
(ft.) .
* 12.
What is the
mobilehome gas demand? ------- ------
(gTU)
BUTTE COUNTY
*(This
information not required if pipe length
less than 6 ft. on.
natural gas or less than 50 ft. on LPG.)
BUILDING DEPARTMENT
AF �
V
2
3 .
�Xlfn41Y✓�n'rJ.enMY.Y(r•+fun9. Win^
:..4w_'s^�hY-
:Lt1'W'^+lRRw^."rv►•'�t...+•+fc!..'a•.+Y•.++s•P.%R".vwurw....WYwu'^'�^.�•..•^.wNNx•M—'v9�.N19!'N!uF
'Y'+AW,"Y+a�.6'TN1su>Y'SIQ. L 6R!I.T.Tiewew+4..'a:1.MC=Lmvvf'.1
-• r Hobileh�e Mf furnish Setup Madel No. (��'Pe 11� � _ year t JD
A
)4idth (-ft.) Box Length
6Tagalong or Expando Size ft• z ft
(SRO4T SUPPORT DETAILS BELOW)
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's inat►.all.atinm
' manual and 'structural setup sheets (if not on file with the County of Butte).
All center supports measured from front of
mobilehome unless otherwise specified \j1
Single �V lAILJD�
(ft.)(in.)
F Center support
locations*
(ft.)(in.)
(ft.)(in.)
(in.) (in.)
Center support
footing sizes
(in.)
(in.)I (in.) ,a;
*If center piers are other than c-: -a above,
draw in locations, spacing, and _ ensions.
Foat in,Zs (cher-k an
�1. Wood either
pressure tx e.a t ed
foundation grade
2. Other (specify)
Supports (check oa
WOO Concrete block.
El -2. Other (s;pecify)
Tagalong or Ep
show support details
L). x,201 -- Typical Support
;n. (in.) Footing Size
..-U I -- Max. Pier Spacing
(ft.)(in.)
vp -- Max. Overhang
(ft.)(in.)
BUTTE COUNTY
BUILDING DEPAR ; MIE NT
APPROV'
Return to DPW AGRICULTURAL 'STATEMENT OF ACKNOWLEDGEMENT
FOR RESIDE14TIAL DEVELOPMEElff
Section 26-8.1 of the Butte County Code requires this acknowledgement
be recorded prior to issuance of a building permit. -RECORDED BUTTE CO 'W"
87-41006 OFFICIAL RECORDS gY
The property described herein is adjacent to land or included (�
within an area zoned for agricultural purposes, and residents of this J'
property may be subject to inconveniences or discomfort arising from�Cti �,t �� SO
the use of agricultural chemicals, including, but not limited to herb ic „ e d s,
and fertilizers; and from the 'pursuit of agricultural operations includi� ted
�.1T "
to cultivation, plowing, spraying, pruning, and harvesting which occasions y genera e. 't,
smoke, noise, and odor. Butte County has established agricultural zone -(F
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.
A.P. # 073-17-0-003
All that real property situate in the County of Butte, State of California, described
as follows: PARCn- 3, AS SHOWN ON PARCEL MAP OF A PORTION OF TH?
KVYSTONF' CONSOLIDATIOM QUARTZ MINING CLAIM CONSISTING
OF THPP, KFYSONT? QUARTZ AND GOLD FINCH QUARTZ LODE' CLAWS,
D'RSIGNATFD BY . THT SURVAYOR GVNRRAL OF THS' UNITRD STATRS LOT NO.
3600 VFNBRACING A PORTION OF SECTION 3 IN TOWNSHOP 19 NORTH,
RANG'? 6 FAST, MOUNT DIABLO MRRIDIAN , AS DFSCRIBFD INTHF PAPT iT
FROM THr UNITED STATUS OF AMERICA TO LVWIS K. ROASONFR AND
DOUGLAS MCLAURIN, DATED SFPTVMBVR 16, 1899 AND RVFCORDRD
MAY 18, 1948 IN BOOK I OF PATTJTS, AT PAG7?S 320, RVCORDS OF
BUTTI? COUNTY, CALIFORNIA, WHICH PARCn MAP WAS FILM IN
THF OFFICR OFTH'T, RI?CORDVR OF THF. COUNTY OF BUTTT, STAT'? OF C
CALIFORNIA, JULY 269 1967 IN BOOK 36 OF PARCEL MAPS, AT
PAGE 10.
tool- COMPARED WITH
ORIGINAL DOCUMENT
Date: �� I
_._.Sta
PROPERTY OWNERS:
day of
( imess)
S76TE OF CALIFORNIA COMMONWEALTH LANDS
I
SSTTtt"t R&A ANCt COMPANY
COUNTY OF BUTTE
on 0ctQhPr 300 1987 ,bdomme, Tara J. Ho�hall
a Notary Public in and for said State, personally anneared�TOa n W n . r� 1 P—aay (known to me) `
iq3 !K to be the person whose name is subscribed to the within Instru-
ment, as }a� PWitness thereto, who being by me duly sworn, deposes and says;
That r S �1� r ifi s t e r s a `1 T s e, (` a l i f (� r n i a , and that �Qwas present and saw
����� , personally known to h e
to bethe same person—described in and whose name i s subscribed to the within and annered Instrument as
t h e Part i P thereto execute and deliver
the same, and he acknowledged to said af%antthat ®�®■�pS®®��cloi��®BO@B9®B®t$��
he —executed the same; and that said affiant sabscnbed ■
,her name theto as a Witness. a TAFiA J. F6oSHALL
reA
UtITNESS my nd and official seal.
Si nature
Foran 3214 (CA 124
JJd "� NOTA"PV'SLIC-CALIFORNIA
O euce covnry a
■ My Conxnwiorr, Expwes March 8, f W N
■
■■®1012 amisrstaJaa0a0affaaaQr0!®
(T Ar" for olriawawm rw .sJ)
19 , before
sis
to
seal.
1
PERMIT NO. 868-77P)E
PERMIT EXPIRES 17kl
OWNER Clarence R. Riley
CONTR. owner
LOCATION (A.P. 73-17-3
W -Forbestowri Rd., app,
3/4 mi7.E:.of�ro
P Forbes a
14 P m
At 6% eltz) P46s-/zLA-) b
APP)( - / All / E OF F.64 iDs Y--6 Lo &,p jeD
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.—
Called PG&E
Temp. Gas Serv.
eA
rJOB
ED
(DA
W-Lvf/c'
(Signature)
COUNTY OF BUTTE - DEPARTMENT OF, PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
(NOTE: An entry must be made on this form each time you visit the job site.)
F ewaII
So Piping
Pa ets
1 Floor
%MalBlidg.
Rest om Finish
2n loor
s
Windo
3rd oor
ll
Siding
To out
Slab
Roof SheaNing
Water PI i
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa l l
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
v
handicar pehysical
Conformance of ex.
structure v
A liances
Gas Piping & Test
Temp. Gas
Slab
A
Final A
Sanitation
Patio
FIREP.ACE
Final
Footin s
Footing
E ECTRIC L
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
IRE qPRINICLF!%Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanel
Mesh
MECHANICAL
Grd. F It Prot.
Scra h
HeatI1A
Servl
Bro n
Coo ng
T16p. Pole
F ish
D is
nder round
In rior Lath
ntilation
Permanent
rfoor Closer
Inal/Final
MOBILEHOME UTILITIES -----------------
Elec_ Service r (��
Elec. Pedestal -�--�
Water Piping
— A:P--
Sewer
Gas Piping
MRSILEUOME INSTALLATION - - - - - - - - - - - - - -
Support
Elec. Continuity
Water Piping
`_ �'�
Drainage �� ,`� �,
�v� Gas Piping
DATE` •`� �`t
s
Z® DACCD
REMARKS OR CORRECTIONS
LA) :)LO 11
To us&,f /-S-e ��a
�! '. �d Suri'
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY tSF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
C
ERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
V'of 'theur �a Administrative Code, Title 25, Chapter 5 under permit
number kl? '77 for the following location: LIDS ikl z814 S
Owner
Owner's Address r - ea 4 179 M k .?ES 7--0 U'N e' 4;
Mobilehome Mfg. Ft; CCIDModel 3 Year
Insignia No.1 Qk4 ln�.0` at Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Director of Public Works erf-
Date 114 /7 / B
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
of f" 1-1
- I .
9. Electrical -
A Is service Large enough to provide adequate amperage to mobilel-rome (must equal rating of
i
mobi_lehomie faith a. :::inu,:um o 6 amp) and other faciliti_as on lot, i.e., water pumps,
,arate, cabana, etc.7 Ycs No ,
B Is them prope..r. clearance -s around panels? Yeses <o_
C. Is power supply cord or feeder assembly properly fused? Ye N,
D. Is;.continullty, test satisfactory as per flie following procedure? Yes_ No ^
�/. De -energize electrical wiring, syste:a of the mobilehome at the pedestal.
T
?�. Make sure that tyre power supply cord or feeder assembly conductors, including neutral
conductor, havc� been disconnected, 1
'3. switch all breakers and switches in the mobilehome to the "on" position.
Connect one Inad of'a test instrument to, the mobilehome grounding conductor and
,. ,
Gppi
t• i0B111r.11101ME, L1 S`I'ALLATION INSPECTION CHECK DIST
1. Is the mobilehomt- located wi.i_li `quired separation from lot lines and buildings and generally
conform to plot plan? Yes I No
2• Doe: the mobilehome have requirud clearances above ground? (Se.c.5085) Yes 't- No
3. Are foot.Ln--,s and supports properly sized, spaced, and braced as per proved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes_ _ No
N
4. Is the mobilehome level.? (Sec. 5088) Yes!`� o+
re than a single unit, are crossover connections properly installed? (Sec. 5088)
U V lees_ No
5. [dater.
A. Is fle ;e connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566)
YesNo
B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes l_No
C� (i4tlflow - If coach is not State of California approved, does station have backflow device
and pressure -relief valve? Yes No
7. ida es and Drains
Is connection made with Schedule 40 DWV and have flex conn _
ectors at each end. Yes No_
a Does it have minimum i;" per foot slope and is it properly supported? Yes ✓o
C. Are any leaks detected in drainage system after running 33 ns of water through each
fixture including washing machine standpipe? Yes No
`coach is not State of California approved, does station have required trap and vent?
es 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
B. Test OK as per following procedure? Yes ✓ Pdo_
'11�Open all appliance connector valves.
but off appliance burner and pilot valves.
3. r test with manometer to 10"-14" water column, or test with slope gauge (minimum
607. -maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without
drop.
onnect: gas meter to mobilehome with connector, turn. onas test st connections with
soapy water.
C. Are all appliance vents properly installed? Yes No_
—COUNTY OF -BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — 'Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
autnonze representatives of the county of tsutte to enter upon the
above-mentioned property for inspection purposes.
X Date
Signature al Permittee or Agent
Receipt No. /60 R!Z2
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 OE PUBLIC WORKS
By �>' Date .S=-3
tiding permit expires Date S�3 `7
BUILDING
Owner 14 C '
SQ. FT. OCC. BUILDING VALUATION
Mailing Addres O
:Telephone No.
.. n
Fireplace
Contractor
LJ
Total Valuation
LIP
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address W
PLUMBING No.1 @ FEE
PERMIT FILING FEE J$3.00 ,()-o
3 r
Each Trap 1.50
' 3 `
Repair drainage or vent piping 1.50
Water piping 1.50 Q cy-O
'
r /
Each gas water heater or vent 1.50
Gas piping system 1 - 5 outlets 1. Q
A. P. No5U
3 �Za"
Each additional outlet .30
Fees W. C.
S tion
FireDept.
Fire Zone Use Permit
Building sewer 5.00 ,q{)
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60'.R/W
Im rovements
P
Lawn sprinkler system 2.00
Bld ec'drcel Approval
r Plan4lpproval
Permit Fee $ 3•
NEW ❑ ADDITION ❑ UTI LITIESO OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 3.070
0V OR
Main service 100 AMP ORSLESS 5.00 i6 -p
Main service EA. ADD•L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home E4 Others ❑
Main service OVER 600V 25.00
100 AMP OR LESS
Main service EA. ADD -L 100 AMP 1.00
NEW CONST. DWELING
OR ADDNS. ( ACCLBLDGSCCUP. &) 20sgft
NEWCONSTR. MULTI.OUTLET
NON .RESID. ( BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS &
NON.RESID. SINGLE OUTLET CIR.
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:
Ex. Occup(OUTLETS OR FIXTURES) @�1
BAL@
Ex. Occup. FIXED APPLNS. OR
P•(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
09 1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $ i{
G 5-(
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
M I certify that in the performance of the work for which this
lJ 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 herebyrg
.e._
TOTAL PERMIT FEE
$
L5
autnonze representatives of the county of tsutte to enter upon the
above-mentioned property for inspection purposes.
X Date
Signature al Permittee or Agent
Receipt No. /60 R!Z2
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 OE PUBLIC WORKS
By �>' Date .S=-3
tiding permit expires Date S�3 `7
_COUNT ' BUTTE — DEPARTMENT OF PUBLIC WORKS
* unty Center Drive Oroville, California 95965
w Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
z4 Xe V44�4� Date Zjz:e ' ./l e1
Signature of Permiitte/eor Agent
Receipt No. 1`� Z
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 Date
B ilding permit expires Date
BUILDING
Owner
SO. FT. OCC. BUILDING VALUATION
Mai I i ng Address
Telep�No.
Fireplace
Contractor 14, X4
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
Building Address S -Awl
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
0 —
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No 3rl ` -3
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
FeekT
W.t
on
FireDept.
FireZone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma p
60' R/W
Im rovements
p
Lawn sprinkler system 2.00
Bld . P ea d
Parcel Apr
Pla pproval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ®
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
,c�
hS _(o✓(
Main service 100 AMP OR00V OR SLESS 5.00
Main service EA. ADD'L 100 AMP 2.50
Main service OVER e 25.00
100 AMP O OR LESS
Single Family ❑ Duplex ❑ Mobil Home, Others ❑
Main service EA. ADD'L 100 AMP 1.00
NEW CONST. DWELING
OR ADONIS.( ACCLBLDGS.OCCUP. &) 20sgft
NEW CONSTR. MULTI -OUTLET
NON.RESID. ( BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS .&)
NON-RESID. SINGLE OUTLET CIR.
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:
50
Ex. Occup(OUTLETS OR FIXTURES) @�
BAL@1
FIXED APPLNS. OR
Ex. Occup. (OUTLETS (RESID.) EA) 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
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
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
10 7 104
1,70
TOTAL PERMIT FEE
$ d
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
z4 Xe V44�4� Date Zjz:e ' ./l e1
Signature of Permiitte/eor Agent
Receipt No. 1`� Z
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 Date
B ilding permit expires Date
i.
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.���'n"ie���''
3. Is the site currently under permit? Yes No ti
( If yes, furnish permit number OR
Is the site an existing -site? Yes / / No
(If yes, furnish two (2) plot plans.)
4. Will the mobilehome be located at least 5'ft, away from septic tank and leach fields and
(This information not required if pipe length less than 6 ft. on natural gas
or less than 50 ft. on LPG.)
clear
of
all setbacks and easements? Yes No
( If
no, clarify
)
5.
What
is
the mobilehome electrical rating? -------------------=---
Amps
6.
What
is
the mobilehome site service rating? ---------------------
al" Amps
7.
What
is
the mobilehome site circuit breaker rating? -------------—
Amps
8.
Is there
any other electric load to be served by the mobilehome
site
service? ---------------------------------------------------
Yes No
(If
yes, identify the load and size: (Load)
ty- ? _(Amps)
9.
What
is
the mobilehome site gas pipe size? ----------------------
10.
What
is
the type of gas service? ----------------------------- Natural / / LPG =--r
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.)
MOBILEHOME SUPPORT DATA
Mobilehome Mfr. % Setup Model No. Year
Width (ft.) Length ..J (ft.)-Expando Size t.
(Draw support details below) .
On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation
manual and structural setup sheets :(if. not .on file with the County of Butte) .
. Footings--(check.one)
/ 1. Wood:either .
pressure treated or
fdn.`grade.::
j,L 2. :Concrete pad.
`/ / 3. --Other, -specify
Supports (check one)
/ 1. Concrete block
2. Concrete piers
3. Steel piers
T_7 4. Other, specify 7.j
Support
Size
*If center piers are other than drawn above,
draw in locations, spacing, and dimensions.
BV77E COUNTY
BUILDING pFPn.Rrti�uT
APPROVED
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Assessor's Parcel Number 0 ®131 — 0 F-1201' — 0 E DI Scale: 1 -
Owner. Namet�h
Address/ Phone No.
Site Location ( I '� 5
$4
ri
Contact: , Nameo;� Phone
C r'-1-
b
S 6-
_ Oct- 23,2CO3
FOR OFFICE USE ONLY
Zoning:
General Plan Desig:
Size, Acres •
4.00 .
PROVIDE FOR ALL
ADJACENT PARCELS
SIZE (AC):
ZONING:
GEN PLAN:
USES:
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Assessor's Parcel N"mkar- -® F51 F---' — F� F -r --,l r -,-,l — - I I ai �-- - � I ........... ..... ...... 0
L--jj LL-'JL2JL-2J Scale: 1"= 0 *�&
Owner. Name* 3-0 k TLS, 4- K e- Y- cL 11\,c,, r- <, c%. r\ Tu 4- ice -
Address/ Phone No. (o- '7 57r 0 1 L( 0
Site Location 24 L-; 6-\ c i S5 Cl/
06
Contact: -Na'm*e - vx
TL-,- —c, 14�e-v- Phone
6c23,
FOR OFFICE USE ONLY
Zoning:
General Plan Dpesig'.-
Size, Acres
4.0(r
PROVIDE FOR ALL
ADJACENT PARCELS
— SIZE (AC):
— ZONING:
GEN- PLAN:
USES: