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Home My WebLink About073-170-004D- VI.D DORN 73-17-4 0 Orr 3/4 off NIS Old Forbestown Rd, app 15(0713=170-,'. E Forbes wn Rd, Forbestown ADMINISTRATIVE'.USE �n bSE4ERMITP94L ADMINIST�ATIVE DENNIS j�. DORN 3 3 1 S 16 SQUAW Q W T 6 UA -FLAT 'RE Permit X2141-8. E(util, MH DORN A MH) ELE L �ORBES�`OWN GAS tI 0 ow 1 '20 -to allow 62h, '20 a 62 0 in U zone SUPPORT STRUCTURE EQ fW COMPACTION TES 'REQ I'vo X73-17-04 CZontr:-arific Modular Concepfs Perm- -2270-84NHI Is-ued DAVID DORN 73-17-04ICT;Pta� — Squaw Flat Rd, Forbestown Contr: P.M.0 A;2111r7 I PErmit#3326-87B,P,E(MH on foundation) 073-170-004 92-2504,BPEM DORN, DaVid V! Squaw Flat Rd, For/p,:f_o�� new Sf762/1200 i 073-7170-004.,PERMIT#94-2133 DORN, DAVID , *;,.�O 316 SQUAW FLAT RD'.'-, , FORBESTOWN MOBILEHOME-UTILITIES 62/1200 ELECTRIC gC>0 SC_pV. GAS LINE 2O L QC7 3A % COMPACTION TEST RE SUPPORT STRUCT RE) LQ_ 1> 073-170-004 PERMIT#94-1888 DORN, DAVID & DIANNA 316 SQUAW FLAT RD., FORBESTOWN VIIV751 CONT; MOBIU110ME-TENTER. MOBILEHOME INSTALLATION/62/1200 r I P s RESIDENTIAL *moo r. 'v*#1 I 073-170-004 PER11IT#94-2133 ,. DORN DAVID 315 SQUAW FLAT RD., FORBESTOWN MOBILEHOME UTILITIES 62/1200 JOB FINALED (04ta Signature OFFICE COPY j Address C GAS ; Meter By Dat ELECTRIC Meter By Date JOB FINALED (04ta Signature V=OK O=Not OK Not ' = Not Readyabte MOBILE HOMES 1 Date/Initials MOBIL E UTILITIES (Plans) OK except #'a - oning Requirements -Setbacks -Easements 2. SoU pecial MH Support Sketch • ewe • ocatlon-Teat-Fall-C/O Concrete • i star; Location -Teat -Easement Needed (Sketch) ect Ity; Location-Clearences-Grnd-/ /Amp -Concrete r� J es; L cation -Teat -Wrap: ///A 'L"ft. / / at. or/ /" L"ft./ /"LP_G ell Clearance & Disconnect Date/Initials MOBILE NOME INSTALLATION (Plans) OK except #'s Zoning Requirements -Setbacks, Easements ootings; Size -Spacing -Marriage Line i Gea; H Test-Demand-Valve—Connector 4-115factricity; MH Test -Crossovers -Breakers -Clearances ) amain.; MH Test -Fell -Flex Connector _Be -'Water; MH Test -Regulator -Connector ter and Sewer Connected -C/O to Grade -HD Approval Gas and Electricity Tagged ; Insp.-Sketch 0 Cert. of Occupancy MISCELLANEOUS Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs: Connectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 8. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftre-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date/Initials POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness ' Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI' 5. Elec.; Pool Lighting; 15 volts-GFI 8. Elec.;Enclosures; Conduit Entries -Terminals -Listed M 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater S. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Mein in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test V=OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date/Initials UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd. / /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fell -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Materiel -Support -Ina. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16, Insulation Date/Initials PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nall Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date/initials ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Meth. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels -Motors -Meth. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date/Initials MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date/Initials FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Wells over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing Date/Initials FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brec-Truss-Shthng.-Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Date/Initials FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Mach. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door, Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor -Mach. Protection 75. Pib., Elec. & Mach. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked In Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg -Appliance-Fireplace.-Clearance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Comments at Final: COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California T5965 - Telephone (916) 538-7541 ERMIT NO. APPLICATION AND PERMIT �` ASSESSOR PARCEL NUMBER 073-170-994 ZONING U BUILDING PERMIT OWNER DAVID DORN TELEPHONE SQ. FT. OCC. BUILDING V DATION OWNER'S MAILING ADDRESS PO BOX 263 FORBESTOWN 95941 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation Is Filing Fee $ 20,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER NONE h LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESSI S� S UAW FLAT RD PERMIT FEE $ FORBESTOWN 95941 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME P51 OMAP " ( Q Each gas water heater or vent 15.00 USEOF STRUCTURE - SF CIDuplex ❑ Mobilehome)D Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home )� gv 1 60.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities g[ Installation CIOther ❑ Describe Work: 69/1900 3 BEDROOM PERMIT FEE is 80.00 Contractor ELECTRICAL PERMIT Filing Fee 20.00 600V OR LESS Main Service ( 200AORLESS ) 23.00 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8. ACC. BLOS. ) so 3.50 FT. NEW CONST. MULTI -OUTLET NOW ESID. ( BRANCH CIRCUITS ) @7.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed under provisions of Chapter 9, Division 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 compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) ❑ 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 .00 BAL. @ 1.50 Ex. Occu FIXEDAPPS.OR p' (OWUTLETS (REBID.) EA. ) 5.00 . Temporary Service 23.00 Mobile Home Facilities 20.00 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 63.00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I als ree to save, inde nd keep harmless the County of Butte against all liabi ties, 'udgments, o dipenses whichmay in any way accrue against said Con i conserque t e gting of this permit. X Date -19V S at a of Ap licant Owner ❑ Contractor ❑ Agent f An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 166.00 HAZ. 0. FEES IMP Fl O C PAC This permit is hereby issued under the applicable of the Butte County Code and/r Resolutions ind' 4abeor s ave been By P MIT EXPIRES ON (Date) provisions to do work paid. to V / Receipt No. 167144 WHITE-D.D.S.-R.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I , E.H..HUSE Plot Plan Aft chad Floor Plan Atmched !1 % Seat to B.D. 1 TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance AuT D o4,d 140 L, 4 c6- OwnerLocation FCV—X—Spul.^ Plan Approved for: Sewage Disposaly Water Supply: 1 : Public " 72-17-114 Private Well Hold final for: 8/92 Health COUNTYOF BUTTE - DEPARTMENT OF D4��Y�. PMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 / ' P�ERMITAPPLICATION DATASHEET f OWNER ✓ l/1 { A. P. No. Proposed Building Use -Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: x F DATE RECENED BY 1. All items have been submitted. ............ ............................. 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wei signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ ............... 11. Impact fees as shown on attached schedule. .. jP 12. California Department of Forestry plan approval feesb I'forne..... 13. Flood elevation letter (100 year flo ) y C . 14. Sanitation and plot plan approval 0. V C Health Department . ............ 15. City of Chico plumbing permit . ......................................... Plot plan and business license approval from City of Biggs/Gridley. . 17. Planning approval for (A) Use: 4Aj1,Q0ej (B) Parking: ......... 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . L q9. Driveway permit (construction approval required prior to occupancy). . . Preanspedion requ� 20. Pre -inspection for required. .. to Building Inspector. (Date) 21.. Contractor's license information. (No., Name Style, Classification) .............. . -.22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner ........... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. . Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use. 28. Mobilehome utility clearance . ............................................ 29. Documentation of legal access . ...................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed - and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list. x' 33. , 34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. X Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation '-7_ Z7 Acreage Applican - Date // Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: .Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by - phone = mail Cou ter by _ Date Plans checked by Date Plans approved by� Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER .PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is coif pleted. Hyou have any questions pertaining to this matter, or need additional explanation, please contact.#ds office immediately. 1� Klzo D 6- J /D Date U Dl Inspector f REV 10W �9 Z-, 4,-; gf-� �. Date U Dl Inspector f REV 10W _ COUNrY OF BUTTE Department of Development Services Building Division Oroville: 7 County Center Dr., Oroville CA 95965 Chico: 1469 Humboldt Rd., Chico CA 95928 OWNER -BUILDER VERIFICATION Attention Property Owner: Ph: 916-538-7541 Ph: 916-891-2751 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 materials for construction of the proposed property improvement (yes or. no). 2. I (have/have not) q ut signed an application for a building permit for the proposed work. 3. I have c Name Address Phone the following person (firm) to provide the proposed construction: City Contractor's License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide thejo ork: me Na Address City Phone Contractor's License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. ,; .c :r ..:.. a<r r. _7 �; ^.:� rM:� >rsta..+ez�c; s'• .__ MOBILEHOME INSTALLATION ACCEPTANCE 1 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 j _ PERMIT N0. / '" 2Z Address or location of mobi lehome / 1 y SC,/ u 10 6j T/ /v 7 Owner's name jJD/4 U L Owner's address Insignia or hud number �•'Z i / 49 Manufacturer's name( Serial aumber of V.I.N. " b3 Year of manufacture 91U (Official Appro—ving Insolation) (Date) 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. 0 to 5138 White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive- Orovilii ;-Califp rnia 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND AND D ASSESSOR PARCEL NUMBER 073-170-004 ZONING J BUILDING PERMIT OWNER DAVID & D' ANNA DORN TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS PO BOY 263 FORBESTOWN, 95941 CONTRACTOR'S NAME MCTp ) p� t M758 O CONTRACTOR'S MAILING ADORE T740 RIVER BLVD ORO, 957 L T740 966 Fireplace P CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 23.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 2/ / J (p PERMIT FEE $ 43.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP' Each gas water heater or vent 15.00 .,. USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome IR Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G I W 20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other O Describe Work: MHI 3 BEDROOM PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Servicesoov oR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONIS. ( & ACC. BLDS. ) SO. 3.50 FT. NEW CONST. MULTI.OUTLET .NON-RESID. ( BRANCH CIRCUITS ) @7.50 CONTRACTORS LICENSE LAW( I declare under penalty of perjury (check one) 0 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and /effect. Professions Code and my license is in full force and License No.y� Classification C y % ❑ I, as the owner, or my employees with wages as their sole compensation, will To the work, and the structure is not intended or offered for sale. (Sec 7044) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason POWERAPPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) BAS @ 1'50 Ex. Occup.FIXED APKNS. OR (OUTLETS (RESID.) EA. ) S•OC Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ® I have placed on file with the County of Butte Dept. of Development Services, Building Division 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 Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20XV, Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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. 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 against said County in consequence of the granting of this permit. x _, o � /t' Date S20TKfure of Applicant - ❑ Owner ❑ Contractor 14 Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ 100.00 Energy Inspection Fee $ occ coNST. TYPE TOTAL FEE $ 143.00 HAZ. I D. FEES IMP F100D CDF p D I This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. DIREC ROOF PUBLIC WORKS By 8 D to 0�,. PERMIT EXPIRES ON tel ReceiptNo. 167066 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN RO D-APPLIC ANT � ^��Tevn.rat'�"`�74�. ,yrL�,�^�S•r+y�,+ifw-r YAr7r'�.'.,,,Q�Ri COUNTY OF BUTTE - DEPARTMEI It`T DF,, EU-OPMENTSERVICES -BUILDING DIVISION 7 COUNTYiCENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 ►; PERMIT APPLICATION DATA SHEET ji �jA6lfMY'M�"�h�i�"��P«f`�a,7�ray�P�r'Iii��f`�l"d"i'»�iK.'.�};t.:C�:.-.—.... k l� ' OWNER A. P No. 3"_1 70-66 ��•, Proposed Building UseN. Building Inspector At Date At time of permit applicatio'"n, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY A. All items have been submitted . ............. —J 2. Plot plans, 3/4 sets, signed by preparer of plans. �,..!�? kms .............. . 3. Complete plans, 3/4 sets, signed by preparer of plans. ...... ............... . 4. Engineered plans and talcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form. ............. ............................... 6. Energy Design Compliance and supporting documentation . .................. 7 A' emernU60't In e t for o�� h ea e,6 Mrd A/C Buildings . ...................... 8. Engineer edtruss details a"nd-lay, 6f In duplicate (required prior to plan check). .... 9. Mobileho a data and manufacturer's installation Ztr�ctio s ts. .. ...... .. Fees of $ .......... l l� %� ........ impact fees as shown on attached schedule. ct7t •%/�/ /F .. . 12. California Department of Forestry plan approval/fees. ....................... . P11Floodelevation letter (100 year flood) by California Engineer ................... )Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit" ............. . ........................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development.about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (constFucloon ap TwVequired prior to occupancy). . . s Inspector20. Pre -inspection for required. to Building re (Date) 21. Contractor's licensd information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _)............. 24. Recorded copy of Agricultural Acknowledgement Statement. ................... 25. Letter of signature authorization . ........................................ 'a Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . !'Letter of intent on building use . ........................................ ' Mobilehome utility clearance. .i ....................................... . Documentation of legal access .. x 30. Documentation of 50% subdivi ion developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. Wheg yo Issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at "(9/2- office. Deliver -with inspector. Other Parcel Creation Acreage Applicant � � �� Date ( 1-7 Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date - Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works t4 / /r7L(e5 3 ` S� SQ u •a -w �' ��T � REVISED & PRINTED: JANUARY 25, 19? ROAD NAMES TERMINI STAT. AP 3 RANGE OREGON CITY TRAIL OREGON GULCH RD TO END PVT 25-19 OREGON GULCH ROAD CHEROKEE RD -TO CHEROKEE RD PVT 41-30 OREGON STREET LITTLE AVE TO END GRID 21-10 ORIENT STREET HUMBOLDT AVE TO EAST IST ST CHICO 05-06 ORIOLE COURT SKYLARK DRIVE TO END CO 42-53 ORO AVENUE SPENCER AVE TO WASHINGTON AVE ORO 13-07 ORO FINO DRIVE VISPERA DRIVE TO END PVT 48-01 DRO VISTA DRIVE HARRISON SPRINGS RD TO END PVT 71-25 OROPOND LANE SKYLINE BLVD TO END PVT 69-43 OROVIEW DRIVE SECOND STREET TO GRAND AVE ORO ' 31-13 OROVILLE AVENUE PARK AVE TO WEST STH ST CHICO 05-10 OROVILLE BANGOR HWY LINCOLN BLVD TO LAS PLUMAS AVE CO 35-17 OROVILLE BANGOR HWY FOOTHILL BLVD TO LA PORTE RD CO 36-13 OROVILLE BANGOR HWY LOWER WYANDOTTE ROAD TO FOOTHILL BLVD CO 36-11 OROVILLE CHICO HWY DURHAM DAYTON HWY TO MIDWAY CO 40-13 OROVILLE COUNTRY CLUB ROAD GRUBBS ROAD TO END CO 27-11 OROVILLE DAM BLVD EAST HWY 70 TO CANYON DRIVE ORO,CO 35-03 OROVILLE DAM BLVD WEST HWY 99 TO HWY 70 ORO,STATE 30-25 OROVILLE GARDEN RANCH ROAD LOWER WYANDOTTE RD TO FOOTHILL BLVD CO 36-40 OROVILLE OUINCY HWY OROVILLE DAM BLVD EAST TO OLIVE HWY ORO,CO 68-25 OROVILLE OUINCY HWY OLIVE HWY TO PLUMAS CO LINE CO 63-15 ORPUT LANE END TO NORTH LIBBY ROAD PARA 53-16 ORRIN DRIVE ELLIOTT RD TO END PAPA 53-19 OSA6E AVENUE VEATCH ST TO PINE ST ORO 12-20 OSBORNE COURT HILLCREST AVE TO END CO 69-54 OTIS COURT END TO SHAW CIRCLE CO 66-07 OUR WAY HWY 99 TO END PVT 47-30 OUT OF THE WAY ROAD CLARK RD TO END PY ?films 55-51 OUTPOST ROAD OROVILLE QUINCY HWY TO END PVT 61-41 OVERHEAD DRIVE CYNTHIANN LANE TO END PVT 27-07 OVERLAND COURT IVY ST TO END CHICO 39-40 OWENS ROAD KEEFER RD TO END PVT 47-25 OXFORD WAY PARKHURST ST. TO END CHICO 02-25 Parc This set of pians and speoMeations MUST -be at a l t±mes and it is o.nia rM] to .n es or alterations or sax.ae wiihout6 '�•�'� •9''7 `-'ratericsd2sM10'r X111 �veCJ;? t r? a,nd 'r 9scribed for t; . BuileIng 1 �(r cv�4y.ev.ai the 4i REVIFWED BY �_ BUTTE CIO. FIRE DEFT.!,� Z w,Li�`0 CALIF.*DEI T . of FCRESTF�4 ❑ appl'o''--, las submitted �1►` 'ID [Xjl appri.,cied with conditions �,s� JQ �� SP �c_�-- per attach qd sheetS . ate /t .; old I 0),0 ALL STRUCTURES AND EQUIPMENT INCLUDING o . :N OVERHANGS SHALL BE CLEAR OF ALL EASEMENTS. A SET BACK OF _ �� FT. FROM THE SIDE AND �-O FT. FROM THE REAR PROPERTY LINES AND Ste( FT. FROM THE ROAD CENTERLINE SHALL BE CLEAR OF STRUCTURES AND EOUiPMENT EXCEPT FOR A 2 FT. SAVE OVERHANG. Y ev�� C°� EN�r :ING p�pARTM X iPA i )PROv C�VeA 4. � 4- COO(M IA Z) Itz lax 6,z G '7 3 -( -7 -b AP# CDF FIRE SAFE REQUIREMENTS q V'- zr 3 _� D&2 -V D1,-J,,O PERMIT # NAM Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail- ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provide for by the land owner. Driveway Standards 1273.02 Surface. All driveway surfaces and structures (bridges, 1273.07 culverts and other appirte7iant structures which supple- ment the roadway bed or shoulders) shall provide unob- structed access to conventional drive vehicles, includ- ing sedans and fire apparatus weighing up to 40,000 pounds. [)(l 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius [ 1. No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional sur- face width of 4 feet shall be added to curves of 50- 100 feet radius; 2 feet to _those from 100-200 feet. [ 2. The length of vert -i:: l .curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. [�1 1273.05 Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. 1270.10 Width. All driveways shall provide a minimum 10 foot traffic lane and unobstructed vertical clearance of 15 feet along its entire length. Page .1 a£ ? AP # PERMIT # NAME [ 1273.10 Turnouts. Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. 1273.10 Turnaround. A turnaround shall be provided at all building sites on driveways over 300 feet in length and shall be within 50 feet of the building. 1273.11 Gates ' [�(] 1. Gate entrances shall be at least two feet wider than the roadway it serves. [>(j 2. The gates must be located at least 30 feet from the roadway and shall open to allow a vehicle to stop without obstructing traffic on that roadway. [ ] 3. Where a one-way provides entrance, used. Fuel Modification road with a single traffic lane a 50 foot turning radius shall be 1276.01 Setback for Structure Defensible Space. [ 1. All parcels 1 acre aid larger shall provide a mini- mum 30 foot setback for buildings and accessory buildings from 411 property lines and/or the center of the road. [ ] 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See Other Requirements below. 1276.02 Disposal of Vegetation and Fuels. Disposal, including / chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification shall be completed -prior to completion of road construction Dr fi_ial inspection of a building permit. Page 2 of 3 % 3 -17 ' 9 �-- 2/ 3 3 AP # PERMIT # AME Other Requirements [ ] If Building Setback is 15 to 30 Feet: - Class A or B roof - Enclosed eaves [ ] If Building Setback is Less Than 15 Feet Choose any 3 of the following: - Metal or no doors on side toward property line with insuffi- cient setback - Class A or B roof with enclosed eaves . - Interior automatic sprinkler system per NFPA 13D - Glass area not to exceed 10$ of wall area toward property' line with insufficient setback - Siding from the following list: Stucco - 3 coat Hardi-Board or Plank Masonry Masonry veneer Metal Other Butte County Fire Department approved materials Date Signature Page 3 of 3 4`� ' BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1. Owner's Name: 1 /z M" •5- su�G � . 2. :.Installer's Name: L , 3. Is the site currently under permit? Yes No (If yes, furnish permit number Q fV-10;y(11;21 ) OR .,, ..._... _ .. Is the site an .existing. site? _." Yes U No t (If yes, furnish two plot plans.) 4. Will the-mobilehome be located at least 5 ft, away from septic tank and leach fields and clear of all setbacks and easements? Yes No (If no,clarify- 5. What is the mobilehome electrical rating? --------------- ��y Amps 6. What is the mobilehome site service rating? ------------- �� Amps 7. What is the mobilehome site circuit breaker rating? ----- ( 6 �J Amps 8. Is there any other electric load to be served by the --'------------------- service? -- Yes No mobilehome site ' (If yes, identify the load and size: &J0 wn (Load)' (Amps) 9. What is the mobilehome site gas pipe size? -------------- (in.) 10. What is the type of gas service?.------------------- Natural LPG 11. What is the gas pipe l'e'ngth• -'from' meter or' tank to the =-- ----- ------ (ft . ) inotiilehome2 --------------------------- * 12. What is the mobilehome gas demand? -------------- (BTU) *(This information not required if pipe length less than6 ft. on_ Y natural gas. or less. than •50 ft..on LPG.) u..� TE CDUt��l ... -DEPARTMENT Jey i BUILDING ,Apppp\/ED 1;:1BILLilOME SUPPOEU DATA If other than single wide, Mobilehome Mfr. /Il7�ir��(;U/�i furnish Setup Model No. �d Year i .Width j/0 (ft.) Box Length5(ft.) Tagalong or Expando Size�f 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 -pressure treated or foundation grade. 2. Other (specify) ( a_ SUPPORTS (check one) Concrete block. 11 2. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Line I • !'n—=� _ _ � Hain Beams _ . _ _ . . ,!—Line 2 Main Seams to no Line s.Lne Tag or Triple I ine 4 Line i Line I Piers: Line 1 Openings: Size -Min. ------------ ,x Size -Min. ------•---- Spacing -Max. Each Side of Openings From Ends -Max.------- " With Width Over ......... Line 2 Piers: Line 3 Piers: (Under Searing Wall Only) ^ Size -Min ------------- k3 0Size-Min------------------- ..x „ �� Spacing-May..Spacing-Max................ From Ends -Max. ----- / (� From Enda-Max.............. Line 3 Roof Wads: Size -Min .--•---------� .,x .,x ,k .k Location (From Front) Lt% -4 Piers Line S Piers: (Under Searing Wails Only) `Size -Min. ---------- k Size-Min-------------------- Spacing-Max ---------- ---------------•Spacing-Max.--------- Spacing -Max ---------------- From Ends -Max -------- From Ends -Max .•------------ " Line S Roof loads: Size -Min ------------- I.x „ ,x „ Kx lk 1, k „ Ox ,k „ Location (From Front) �_ '. " '_ " " '• TYPICAL BLOCKING DIAGRAM FOR DOUBLE -SECTION HOMES Support piers are required under porch posts and under fireplaces DOOR OR OPG. and wood -burning stoves located on floor overhangs. MAIN BEAM I' I . MAIN BEAM i I A BLL _ cc 0 cc 7_4� MAIN BEAM � MAIN BEAM DOOR OR OPG. 1I 40,-0" MARRIAGE WALL BLOCKING PIER FOOTINGS Based on a soil capacity of 1000 Ib. per square foot, a suggested footing size for all piers is 2'8" square. FRAME BLOCKING PIER FOCfTINGS Based on a.soil capacity of 1000 Ib. per square foot, a suggested footing size for all piers is 216" square. Alternate methods are acceptable if they meet with local soil bearing capacities. It is extremely important to check with local building officials as to the latest local codes in your area. MINIMUM PIER CAPACITIES (lbs.) NOTE: Blocking of perimeter rail Is required at each side of the large bow windows, recessed entries, exterior doors located in the SPACING ROOF LOAD ZONE sidewall, and any other opening in excess of 4'. For pier FOR BLOCKING 20# 30# 40# capacity, use 1/2 the value shown in marriage wall opening table, below. 24' wide 8'0" o.c. max. 3784 4248 4720 28' wide 8'0" o.c. max. 4296 4824 5360 32' wide 8'0" o.c. max. 4896 5504 aA MINIMUM PIER CAPACITIES FOR ' �:.; • MARRIAGE WALL OPENINGS (lbs.) CLEAR SPAN I DISTANCE IN 30# 40# MARRIAGE WALL 24' 28' 32' , 24' 28' 32' 24' 28' - �---------•----- 4'•t"••8'-0" 130a 1496 t720�1768 2024 232822a0 256 8'-1" ••12'0" 1956 2244 25802652 3036 34923360 384 1 12'•1"-16'-0" 2608 2992 3440 3536 4048 4656 4480 512 16'1"-20'-0" 360 3740 4300 4420 5060 5820 5600 640 \ NOTE: For 26' wide homes, use marriage wall pier capacities for 28' wide homes. The diagram above shows the minimum required placement of blocks under the frame of a typical length and width home. It is extremely important to check with local building officials prior to blocking your home as to the latest local codes in your area. FRAME BLOCKING Begin by placing piers at front and rear of home. Starting at front, place piers at a maximum of 8' o.c• along both main beams the entire length of home. Follow this procedure for any alength of Champion -built home. other blocking positions are also required under the center, marriage walls, depending on the model. These positions are determined by the locations of the openings in the marriage wall. Clear spans may occur on each section of the home or at the same location of both sections. There must be blocking at each end of the openings shown as A and B on diagram above and .vary depending on the model. For clear span openings l and, pier capacities see the chart shown above. /FOR 60# ROOF LOAD ZONE SEE PAGE 11 r 'Tr i J. -LI H 29 ' 94 9: 29 FROM CHAIV I CIII HONE TO HH CTR -O PAGE . 00 t V i ' iT IIP 1 �, FN !8 110 (m ''i IA LLIASU �. .. W 7u IM O • ,'� -; ou Tt � ��,(t�'tF *-.r s mak- Y %� t Y .a Y 'a ,.� t b ••! 1 -. K I� 1 '✓'t I ti, t - I. � � ��•♦ CU 0). i . Y°w '! >'1 f7 y:.Y t r t. .`n •..1� .t 7` � 4 a �C g +�' t•r. �. r t W �;�! I J�1 t' - ,9`�'ti{ yr k f k.; ,t�..�.c .. y;y tt<^. . � r r Gl1 � 9:03 r I A j i Z r ou `� o I' - 0 E7 r i' ` ( I �avt I i ' iT IIP 1 �, FN !8 110 (m ''i IA LLIASU �. .. W 7u IM O • ,'� -; ir, 140TE:---AI1 Materials & Workmanship Pra face B and 1 V\ Accordance with Recognized Go I of a quality prescribed &Mechanical Godes and t Uniform Buildined use in the g, Plumbing the National Electrical Code. i This set of plans and specificatiot s`!MUSI,be t kept on the job at all times p< d it is unlawful to L make any chcngos or c.�%rations on same without �vritton rmissi-., from the Department of Public W rk , Cminty of Butte. / A setback or 5 t om the t property l(nes and a se's z of Soft. from the road be of r i 01 cen#erline shall clear structures or equipment - for a 2 ft. eave overhang. for --- II i L r i Utility connections shall .be within 4 H. of the mobil:.#iome, either directly behind ortwithin the rear half of the roadside (left) of t mo ilehome. J t Syr i' i J n �i 1*1 A perm t will be required for the insialla on of the mobilek.me. s r • Y UUiTE CO NTY BUILDING DEPS, P" - APPROVED Y/ . ......... � tiro , � ' . �:..,f.,�,� y�r�:r-.. i -.. "1'q�' ��'�-Z . . ti -•-7 �.�:� =4r ^ti. � - ., .. • 1 1 . r •�1 � . i Marysville Joint Unified School District CERTIFICATION OF COMPLIANCE SCHOOL DISTRICT- DEVELOPMENT IMPACT FEES a To be completed by applicant and taken to: Marysville Joint Unified School District 1919 B Street, Marysville 4 Property Owner's Name: .Ur f: ,, r Ce, 1= H'/ Owner's Address: Project Address: /� �;_ �,r u� / /Ay T t 3 7 i, ParcelNo: � , 7 - r c - 6 0 `f Lot No: City or County: Building Depty Permit No: t " S F., 7.s TYPE OF CONSTRUCTION: Residential Construction Single Family Dwelling Residential Reconstruction Multiple Family Dwelling Commercial Construction No. of Units Commercial Reconstruction Mobile Home Total Number of Habitable Square Feet: //7- F r THIS CERTIFICATION COVERS ONLY THE AMOUNT OF SQUARE FOOTAGE INDICATED ABOVE. ANY ADDI- TIONS OR CORRECTIONS TO THE SQUARE FOOTAGE -FOR THE PROJECT WILL REQUIRE AN AMENDMENT . TO THE CERTIFICATION OF COMPLIANCE. FALSIFICATION OF SQUARE FOOTAGE AND/OR TYPE OF CON- STRUCTION IS CAUSE FOR REVOCATION OF CERTIFICATION OF COMPLIANCE r R / Applicant's Name: I�1D�1/t� yd .� /l��- Date: ck Applicant's Signature:. Part II TO BE COMPLETEDBY BUILDING DEPARTMENT Total'Number of Habitable Square Feet %�%Z City of Marysville County of Yuba Signature��.� . /1y r County of Butte Part III /i - TO BE COMPLETED"BY SCHOOL DISTRICT Certification of Compliance No. (Receipt No.): Fees Collected: No. of Square Feet x's $.27 for Commercial = $ No. of Square Feet 1 7 Z x's $1-65 for Residential = $ 2 0 Exempt from Fees: Reason: t. i Olk ha -IL, AS THE AUTHORIZED SCHOOL DISTRICT OFFICIAL, I HEREBY CERTIFY THAT THE REQUIREMENTS OF-� GOVERNMENT CODE SECTION 65996'HAVE BEEN COMPLIED WITH BY THE ABOVE SIGNED APPLICANT. i Signature QA_GOAI,�-Sandra Davini, Director of Business Services Date 11 1Li 0 White: - School District Yellow: - Applicant SD:co Pink - Building Dept 792 April 25, 1994 (ounfq 1) 01- HA I UKAI. W I-- AI I II IIIA ISI i, II I DIRECTOR'S OFFICE DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE. CALIFORNIA 95965-3397 TELENZONE: (91615313-7601 FAX: 19161 538-7785 Dennis Dorn 602 Ramar Road f Bullhead City, AZ 86442 IV E Sn { w ..l N 1 � rJ �_ .! - n Y,t . ti ' z ^•t�: Y fir. ' ..fit tntj*i t "' { Lr` "•`. >4z S � f A "'!'t' �- ti r: }K �` RE: Administrative Use' Permit Application,'AP#073=170-004. Dear Mr. Dorn: On February 22, 1994 the Butte County Board of Supervisors, by amendment, reduced certain fees charged under Butte County Ordinance No. 3070. The new fee schedule under this Ordinance is effective April 25, 1994. Concurrent with that amendment, the Board directed that refunds be made for the difference between the old fees, charged from July. 12, 1993 until April 24, 1994; and the new fees. You have been identified as an applicant for an Administrative Use Permit, for which you were charged $838.00. The new fee is $516.00, leaving you a refund of $322.00. Please sign the enclosed claim form and return it to the above -referenced address at your earliest convenience so that we may continue to process your refund. Thank you. r . _�....,USO ( tAT Sincerely, 316' �ilallJlJ �� • %`ci, Brian Larsen i Administrative Analyst p d! 3- [%Q -06� BL:jb Enclosure 1612- i�9.3 October 18, 1993 Dennis J. Dorn 602 Ramar Road Bullhead City, Arizona 86441 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (916) 538-7601 FAX: 19161 538-7785 Re: Administrative Permit, AP No. 073-170-004 Dear Mr. Dorn: CopyB eUlLOINpTT� G ©CT 19 1993 Enclosed is your validated Administrative Permit No. 94-04 to allow a senior -citizen dwelling no larger than 1200 square feet for 1 or 2 persons 62 years or older on property zoned "U", identified as AP No. 073-170-004 located at 316 Squaw Flat Road, Forbestown. Every Administrative Permit expires and is automatically null and void without further action by the County if the activity or use for which the Administrative Permit was granted has not been actively and substantially commenced within one year of the date of its final approval. To increase administrative efficiency, Statutes of 1990 AB 3158, Chapter 1706, delegated the collection of filing fees to the County Clerk and provided the County authority to collect a $25.00 documentary handling fee. The fee due for your project is $25.00. A check made payable to the Butte County Treasurer should be submitted to this department by October 22, 1993. Enclosed is the affidavit form you are required to complete, sign before a notary, record in the Office of the Butte County Recorder,* and return a copy of the recorded affidavit to the Planning Division, Department of Development Services. Should you have any questions regarding this matter, please contact this office. S' c4ee 14, i Liam Farrel D rector of Development Services WF:bd Enclosure cc: Land Development Division Building Division Environmental Health Department of Forestry ADMINISTRATIVE PERMIT BUTTE COUNTY PLANNING DEPARTMENT October 18, 1993 94-04 PERMIT NO. 073-170-004 ASSESSOR'S PARCEL NO. Pursuant to the provisions of the Zoning Ordinance of the County of Butte and the special conditions set forth below: Dennis J. Dorn is hereby granted an Administrative Permit in accordance with application filed July 16, 1992 to allow a detached Senior Citizen dwelling unit on property zoned "U”, identified as Assessors Parcel No. 073-170-004 located at 316 Squaw Flat Road, Forbestown. 1. Failure to comply with the conditions specified herein as the basis for approval of application and issuance of Permit, constitutes cause for the revocation of said permit in accordance with the procedures set forth in the Butte County Zoning Ordinance, including Butte County Code Section 24-62. 2. Unless otherwise provided for in a condition to an Administrative Permit, all conditions must be completed by the permittee within 12 months of the delivery of the countersigned permit to the permittee. 3. If any use for which an Administrative Permit has been granted is not established within one year of the date of receipt of the countersigned permit by the permittee, the permit shall be come null and void and reapplication shall be required to establish the use. 4. The terms and conditions of this permit shall run with the land and shall be binding upon and be to the benefit of the heirs, legal representatives, successors, and assigns of the Permittee. SPECIAL CONDITIONS: 1. The "living area", meaning the interior habitable floor space area of a dwelling unit including habitable basements and attics, but not including a garage or any accessory structure, shall not exceed 1,200 square feet. 2. The senior citizen dwelling unit shall be for the sole occupancy of one (1) adult 62 years of age or over or two (2) adult persons, one of whom is 62 years of age or over. An affidavit of compliance with the age requirements of this section shall be recorded in the office of the Recorder prior to issuance of building permits. Said affidavit shall include the legal description of the lot or parcel and shall constitute a covenant running with the land, binding upon M the original owners and their heirs, successors and assigns, limiting the occupancy of the senior citizen dwelling unit to the conditions described in this section. 3. The senior citizen dwelling unit shall not be sold as a separate unit unless a parcel containing the unit is created in compliance with the existing zoning and subdivision ordinances and the resulting density is in conformance with the General Plan. 4. Two off-street parking spaces shall be provided for the senior citizen dwelling unit in addition to the parking spaces required for the primary dwelling unit. 5. Adequate sewer and water facilities shall be provided subject to the approval of the Environmental Health Department. 6. All site development standards as required by the zoning district in which the unit is located shall be met. 7. The Senior Citizen Dwelling unit shall be a conventionally constructed building or a mobile home that complies with the National Manufactured Housing Construction and Safety Standards Act of 1974, except that in the "A", "FR", and "TM" series of zones a mobile home, as defined in Section 24-21.28, may be used. Travel trailers and recreational vehicles shall not be allowed as a Senior Citizen Dwelling Unit. 8. New structure must meet the Fire Department Safe Regulations of Public Resources Code 4290. 9. The approval of this permit constitutes approval only to the extent that the project complies with the Butte County Code and all other applicable regulations. 10. The requirements of all concerned governmental agencies having jurisdiction by law, including, but not limited to the issuance of appropriate permits, shall be met. NOTE: Minor changes may be approved administratively by the Director of Development Services upon receipt of a substantiated written request by the applicant. Prior to such approval, verification shall be made by each Department or Division that the modification is consistent with the application, fees paid and environmental determination as conditionally approved. Changes deemed to be major or significant in nature shall require a formal application for amendment. NOTE: Issuance of this Administrative Permit does not waive requirement of obtaining Building and Health Depa tment permits before starting construction and their approval pri o use or occupancy, nor does it waive any other requirements.n CC: Land Development Divi on Building Division Health Department Department of Forestry Develdpment Services 0 Ifte. I A-1 pi 3 - 170 - oo q 31q rr 4-o 0- 1;10-j— vlo.rr ILAv�d LOW DEVELOPMENT PLAN E A �21-MIT VARIANCE 13Y 0—aale-) n LOW DEVELOPMENT PLAN E A �21-MIT VARIANCE 13Y 0—aale-) n tl t { + � o t e ' 1 [MAR 2 4 1992I LJ BUTTE CO. PLANNING DEPARTMENT OROVILLE, CALIFORNIA + � o ' t " ' s r > r • r, 7 r . [MAR 2 4 1992I LJ BUTTE CO. PLANNING DEPARTMENT OROVILLE, CALIFORNIA . N mac.. D MAR 24f992 i;BLME CO. PLMIRNIIING DEPARTMENT � OROVILLE, , CaUFRI IA 4 DuUe ouw* OROVILLE, CALIFORNIA GENERAL. CLAIM CLAIMANT: David Dorn ADDRESS: P.O. Box 263 CITY & STATE: Forbestown, CA 95941 IMPORTANT: DATE OF CLAIM: September 10, 1992 SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) ; AMOUNT Owner had decided not to do work. Permit #92-2504B,P,E,M, AP#073-170-004, Receipt #122308, dated 7/16/92. i I. Total Permit Fees Paid -------------------------------- $293.25 Retain Partial Plan Checking Fee ------------- $20.00 Retain Building Permit Filing Fee------------ 15.00 Retain Plumbing Permit Filing Fee------------ 15.00 Retain Electrical Permit Filing Fee---------= 15.00 Retain Mechanical Permit Filing Fee---------- 15.00 Total Permit Fees Retained---------------------------- 80.00 TOTAL REFUND DUE -------------------------------------- $213.25 i I I I TOTAL $213 25 I, the undersigned, .ieclare under penalty of perjury that the services or articles claimed ve en performed d ere end at this claim is true and correct as stated. Dated this ..... V..:.l.�. .......day of .�. .. .. 19./.,at..v..t..l.�.............. Calif...... ........... ,614.......... Signetur of Claimenv I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specifi above been performed or de- livered and that there is a Budget Appropriation 13 or Specific Board Approval E] (Check one) for thee/ Dated this 107th day of ,September 19 92 at Oroville Callf.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,_,......... ...... ............................ . apartment Head or Authorized Deputy Dept. Exp. SS Const. Permits Cade .4.4.0.-Q0�................ Code........4�.0,I.QR...................PAYABLE FROM ......................................................................................... FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. JOS e,�Ckte9 VA �o bu,1j hau6cel't-r*t �,� rtQ�� COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 RE: With reference to the above subject: A. P. # DATE �l Attached is: Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER LL We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. Complete plans in including plot plans. Plot plans in • Structural details in Complete plans and talcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of plans in accordance with the changes marked in red. Sanitation approval from Butte County Health Department at: 196 Memorial Way,' Chico 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise ! Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. L__L OTHER Should you have any questions concerning the above, please contact _ of this office. Yours very truly, William Cheff Director of Public Works .F. Glander I`JFG/aj Chief Building Inspector I,U �,u�rzsv��io r�caa�f� (6 to COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovlllg, California 95965 - Telephone: 916-'538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 03'70-d� - ! 0ZONING BUILDING PERMIT OWNER �f�Ue� TELEPHONE 675-z174(/ SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS Po �mX 2&3 or6e,5vow?3 g5�� CONTRACTOR'S NAME W[��(� TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace /I CONSTRUCTION LENDER UNKNOWN Total Valuation Filing Fee µ`. ? 15.00 LENDER'S MAILING ADDRESS Permit Fee Plan Checking Fee Energy Plan Checking Fee $7 XC �`�' $ � ��2, ZS $ -�0 ARCHITECT O ENGINEER LICENSE NO. ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Sgagc2 Art d i�rke o K T Permit fee $61711--7-5 PLUMBING PERMIT Filing Fee 15.00 I l Each Trap 5 5.002 C,.X> Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 2.(S�O Each qas water heater or vent 7.00 B� USE OF STRUCTURE SFU� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 $, 0,0 Building sewer 1 15.001/ 57 - 00 Mobile Home S G W 7 15.00 TYPE OF WORK New'l- Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: 2 DB2 Int--• Ili 20Q Permit Fee $ -7 -66 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600v OR LESS 200A OR LESS 18.50 gs� Main service 20(ATO1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of uone): P Y perjury Jr Y(check e ) ❑ 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 CONST. DWELLING OCCUPM OR ACDNS. ACC. BLDGS. I 3.64 sq.tt. Q/ 3Q(QS NEW CONSTF UQ*OUT LET NON.RESIO BRANCH CIRC ITS @ 5.00 POWER APPARATUS e\ SINGLE OUTLET CIR. / Ex. 000Up(OUTLETS OR FIXTURES20 76 d Ex. OCCup. OUTLETS PIRESID.)FIXED APLNS.REA.1 I . 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 72•/S Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject 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 1 15.00 Heating 4 4414 Cooling Hood 6.50 (� 15CP Ventilation permit Fee $ _60to I Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHAwork permit is required For excavations over 5'0" deep and demolitionor construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES HAz 1 DFEES I IMP I FLOOD I COF I PARC M HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date ZZ��D -' e —5129.3=— IReceipt No. PG l`r WNITC•D. P. W., YEL1OW-...ESS0R, PINK -INSPECTOR, GOLD ENROD-APPLICXNT �,,,7f ., r r. �1i*'dY Vk* r "YY'+('r i.", ff y )' r r d t • ^ . ,� , :t Y 1 S .F';Y `�1�'1 Ab ii ��F k "�A.." •��'Y h'f r tZ c. -� X� e COUNTY OF BUTTE: PARTMENT OF PUBLIC I BUILDING DIVISION 7 COUNTY CENTER DRIVE'- OROVILLE, CALIFORNIA 95965,- TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER CA lo/ -A / A A. P. No. 073` /*-)U - ooy Proposed Building UseBuilding Inspector 76D Date '% YZ At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items hAve been submitted. ..... 2. Plot plans /4 sets, signed by preparer of plans . ......................... . 3. Complete plansO/4 sets, signed by preparer of plans. ............... . 4. Engineered plans and calcs, 3/4 sets, with wet signa � pdn plans . ............ . 5. Hazardous Material Form. . 5 ....................... . 6. Energy Design Compliance and supporting docum ntation. ................. . 7. Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data 2nd manufacturer's installation instructions, 2 sets. ........... 10. Fees of $.ami 1. . ................. 11. Impact fees as shown on attached schedule . ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer.: ................ . -/ 14. Sanitation and plot plan approval 0M(II4' Health Department. .....: . 15. City of Chico.plumbing permit . ......................................... 16. Plot plan and business license apgcoval from City of Biggs/Gridley. ............. >� 17. Planning approval for (A) Use: t/ (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. . 20. Pre -Inspection for to Building Ins actor required. . . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner_) . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . ................. . 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ........................................ 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ....................................... 32. Plan the k list. 33. ��iG�S...ssl��....................................... . 34. _When y u issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone _9 75�- Mand hold for pickup at 6&> office. liver with inspector. Other Parcel Creation Acreage Applica �Kp(Date 7 /g�`- Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior tormit i uance: (Circle new item not chc abe 1. Index permit for above items No. -. '10f, 2. Additional items required: t Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works 9640dads 6,��✓ ��'��i�-1-'1 . F COUN'T'Y OF BUTTE - DEPARTMENTS OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541 OWNERMIP P,0,11)A.P. N0. PROPOSED BUILDING USE ��-� 1(L- DATE 7�Zo Z / REC. # DATE REC V 1. School Distric Feesi (paid at District Office) ........................... 2. Sheriff Fees (paid at Building Department) Residential ..........X -360 =$ 3 unit amt. Commercial(per sq.ft.) R _$ sq.ft. amt. 3. Urban Area Fees (paid at Building Department Residential (per unit) X =$ # units amt. Commerical(per sq.ft.) X =$ sq.ft. amt. 4. Recreation District Fees (paid at District Office) 5. Drainage District Fees (Contact Land Development) 6. Other 7. Other At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. APPLICANT DATE -L— COUNTY OF BUTTE- Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 ' OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and .return this information at your eatliest'o.pportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1.. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) % signed an application for a building permit ' for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone - - -Contractors -Licens-e No. 4. I plan to -provide portions of this work, but I have hired the following person ' to coordinate, supervise, and provide the major work:... Name . Address City - PhoneContractors. License No. •. 5. I will provide some of the work but I have contracted (hired) the following - persons to provide.the.-work indicated: Name Address Phone Type of Work Signed: Property Owner p�(/ Social-Securit umber ' �® Date '- NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovilleq California 95965 - Telephone: 916/538-7541Jr- APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex[-] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S G W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ ' Utilities ❑ Installation] Other ❑ Describe work: _ Permit Fee $ Contractor ELECTRICAL PERMIT FiIingFee 15.00 Main service 600v OR LESS 200A OR LESS 18.50 Main service 200ATO1000A, 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the Buslnes$ and Professions Code and my license is in full force and effect. License No. Classification 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 CONST./ DWELLING OCCUP.8\ OR ACDNS. 1 ACC. BLDGS. 3.54 sq.ft. NEW CONSTRMULTI-OUTLET NON.RESID BRANCH CIRC ITS @ 5.00 POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.1 EA.� 3.00 Temporary service 15.00 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. ❑ 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. Ui I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Noce 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 15.00 Heating Cooling Hood 6.50 Ventilation permit Fee $ L Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also a to save, indemni eep harmless the County of Butte against all Ii Ilits, Jul s, s, a expenses which may in any way accrue aga' Sal' COLnty ' enc of the granting of this permit., X '' ��' Date _, � � of Applicant — Owner cDnrrocrDr [I Agent ❑ Si OSHA ion of strutures tover 3gstories oineheight ions over S'0" deep and demolition or construct- Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE HAz DFEES IMP FLOOD COF PARCEL PD HD ISSUE This permit is hereby issued under the sions sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT r PERMIT NO.. -1'176-87R,E,F PERMIT EXPIRES OWNER DAVID DARN CONTR.'F0 ASSESSOR PARCEL 73-7—p1� LOCATION Squaw Flat Rd, Forbestown 3/4 mi off N/S Old Forbes Rd, 150'E Forbes Rd F 1 OFFICE COPY Address G Meter BY t ELECTRIC Date iZ Temp. Powe, Meter By Date- # Called p Temp. Elec. Service Celled PG&E ! Temp. Gas Service Called PG&E .JOB FINALED (Date) Signature s = OK 0=Not OK ' = Not Read�yable MOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements-Setbacks-Easements 1. Zoning Requirements-Setbacks-Easements 2..Soils; Special MH Support-Sketch 2. Footings; Soils-Size-Depth=Spacing-Connectors-Steel 3. Sewer; Location-Test-Fall-C/0-Concrete 3. Decks; Girders and/or Joists-Decking-Bracing-Stairs-Rails 4. Water; Location-Test-Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp-Concrete 6. Gas; Location-Test-Wrap: / - /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enclosures. . 6. Carports; Windows-Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing-Veneer-Stucco-Mesh Card-131 Date Card-81 Date 10. Roof; Shthg-Roofing Card-131 Date Card-B1 Date 11. Ext.; Steps-Doors-Landings Date MO$KEHOME INSTALLATION (Plans) OK except #'s Z ing Requirements-Setbacks-Easements Card-B1 Date Card-B1 Date . F Ings; Size-Spacing-Marriage Line. Card-131 Date Card-131 Date . G , MH Test-Demand-Valve-Connector . E ectricity; MH Test-Crossovers-Breakers-Clearances Date POOLS (Plans) OK except #'s Dom; MH Test-Fall-Flex Connector 1. Setbacks-Easements r; MH Test-Regulator-Connector 2. Soils; Compaction-Structure Stability W r and Sewer Connected-C/0 to Grade-HD Approval 3. Pool Structure;. Steel-Connections-Thickness- Dead Men -Lining G and Ie ctricity.Tagged xi , nsp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI ert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries-Terminals-Listed 7. Elec.; Bonding; Metal w/5'-Circulating Equip.-Heater 8. Elec.;Grounding; Equip. w/5'-circulating Equip.-Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit Card-B1 Date and-B1 Date Card-131 Date Card-131 Date 9. Health Department Approval 10. Plumb.; Cir. Test-Water Supply Test Card-131 Date Card-61 Date Card-131 Date Card-131 Date = OK 0 = NotOK RESIDENTIAL (Single and Duplex) - =Not Applicable = N6t Readyl- Date UND FLOOR (Plans) OK except #'s Date FRAMING (Continued) . o ing requirements -Setbacks -Easements 44. Hangers -Post Caps -Anchors -Connectors Lg,Rfg., Main; Soils-Steel-Elec. Grnd.-/ ` /" Ftg. Depth 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 46. Fireplace Ties or Type A Flue -Fireplace Throat 4. 5W., Porches & Decks; Soils -Steel-/ /"Ftg. Depth 47. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 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. lab; Steel -Wrapped 50. Property Line Firewall & Openings 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-Underflr. 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-Walls-Wndws Card -8 Dat - - Card -B1 Date Card -131 4P -Date - and -B1 Date Card -81 Date Card -81 Date Card -131 Date Card -81 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 -Meth. 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 -61 Date Card -131 Date 67. Fireplace Stove; Clearances -Hearth or 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 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Elec. Outlets & Receptacles at Kit. Counter 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/Mech. Fasteners -Bond Gas & Water 73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. 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 AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 76. Insulation -Foam -Looked in Attic ❑ 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 ❑Yes 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 79. Following instld.; Drive ❑ Yes ❑ No; Walks O Yes ❑ No; Planters ❑ Yes ❑ No 80. Stucco; Brown -Finish Card -61 Date Card -131 Date 81. A.C. Unit; Disconnect, Electrical, Plumbing Card -61 Date Card -131 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 3 - 89. Water & Sewer Connected -C/O to Grad -e --HD Approval 90. Energy Compliance Certificate -Other Certificates Card -61 Date Card -131 Date Card -61 Date Card -81 Date Card -131 Date Card -81 Date Date FRAMING (Plans) OK except #'s Card -131 Date Card -B1 Date 38. Sills, Proper Material & Anchors Card -B1 Date Card -81 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) MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE r DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 .. t Address or location of mobilehome _.Owner's name Owner's address J PERMIT N0. yip :1-- t4� A ld Insignia or hud number le , /---:� V b 4!. L Cl 7— / t.2 _ Manufacturer's name Serial number of V.I.N. 7112 f) /7 f Year of manufacture r° (Official Approving Installation IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. :, 513B White - Owner COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWNER 3_3,2G r7 Rol 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. Inspector -/---2 /� ✓ �~ Date / r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. • 7 County Center Drive - Oroville, California'95965 - Telephone: 916/538-7541 APPLICATION ANI PERMIT ASSESSOR PARC L Npy1B R �U p,��j/ zONI BUILDING PERMI OWNER TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'SU AI LIADDRESS 'yy�/ CONTR CTO 'SN TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is ' Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS- Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFE] Duplex[] Mobilehome&a Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installatiop❑ Other [ Describe work: Ex/sj/N Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00' Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW ' I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and 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 CONST. / DWELLING OCCUP.ei\ '/a�sgft OR ADDNS. t ACC. BLDGS. / NEW CONSTR. MULTI -OUTLET 2,50 ea NON-RESID .BRANCH CIRC ITS /POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES 520 030 Ex. Occup. OUTLETS FIXED P(RESID )REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 L OD Permit Fee $ 00 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. j� I shall not employ any person in any manner so as to become subject `(— to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to en er upon the above-mentio property for inspection purposes. 1 also ree o save, in emnif d kee harmless the County of Butte against li ilitie , judgme s, c and xpenses which may in any way accrue/ agai s said County i con ce the granting of this permit. X Dated Signature of Applicant — Owns IQ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ OCCUP. CONST.TTPE JSCHOOLJFU)Zrj��J Poall " This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Q� innuheight. Receipt No ©GT 7� WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT TO Buildinq Department FROM: Environmental Health SUBJECT: Sanitation Clearance t F ^ ' 0(d Ot�tner Location AP# Plan Approved for: Sewage Disposal Water Supply Hold final for: Water Supply Final clearance O.K. for: Water Supply Clearance for c= -bedroom mobil home. Other NOTE * * * L Z - Sanitarian ate {• v til ifp hCyi��I-f11Lr r i : ��,f.Y . COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION • 7 COUNTY CENTER DRIVE ,OROVILLE,,.G—A'LIf,OR11A 95965'- TELEPHONE: 916/538-7541 KL• PERMIT APPLICATION DATA SHEET ./ Permit No. OWNER � C/ - A. P. o. 1 7- Proposed Building Use��l✓(�GG1�i�i'/a�ir Building Inspector T 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. . . . . . . . . . . . — ' . Plot plans i duplicate licate, signed by preparer of plans. . Com tete lans n u licat /triplicate, signed by preparer of .plans. P � P� P 4. Complete engil�ee.r-ed-plans and calcs, with wet signature on plans. _5ans with Energy Design Compliance Statement. . . . . . 6. School District ''Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . rf0. 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 ❑ ) -..._15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . Pre-Inspec. request to (Date.) 17. Pre -Inspection for __ —.. _-.__._. _Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. µ 19. Driveway Permit. — 20. Plot plan approval from city of— - —.- 21. — - — • r - 22. — — -- When, you issue the permit, process as follows: Mail to owner, Mail to contractor. c/ TeIephone�and hold for pickup at office, Deliver w/inspector. - Other Copy of plans sent Health Dept.; Fire Dept., Other Date The following data must be submitted prior to permit issua 1. Index permit for above items No. 2. Additional items required: ,_- (Circle new item not checked above). Cont.ar dlesigner, owner, was advised of above required data by phone_mail_counter byl�� date AP r;ontractor, designer, owner, was advised c? above required data by—phone —mail_counteltiy date rl Plans checked by Date Plans approved by ate 0 '0(0 -� Sets of plans on hold in File cabinet AP folder ' f Copy—DPW 0 _ , f• , "�� -� •r`,•' �lilAnl��;k zo, i Ali i��.!$+��'�Itki �r r� :f;l '��I}�,i ,, _��r_ t ^ r: ii l•i: , ., ib ., {.. . tit .i�•r r, 1 � iir '�i +i r; i i,t f` 1�� y, ., � t •t I n �1�•.'� ,h. •M 4 rl' ,i `r'.�..-.+*s"`.1:.r••vd'+"!" ! , ,'iidi- ° .�� t;l, .:',{•• . , • .�� .i;, �',�:1:'4,i1i'Yt. .. 0. 1 00 y ✓T�io !!i/ppGE© � 30KT7YO 01 Ir 3`v swam STi�,�/G�¢,e� C/fi.PP�T.• OIa7''/�if/i�... G°/fl.�'�.�T�J •.;... — 1 rt.�«�r�ili '�`w�Vf9)•, �CTiurY �x a -o �J�/n � _ . .iR. SU!' POR ! PIERS � �0 u� 110,1 0 GOLDEN WEST �i CAPACITY FOOTING SIZE CAPACITY FOOTING SIZE BE�Pa -S/z�Y <oP>" 3 . 'oo�s1) SQ. FT. HOMES L WAKEH AIA Sl yUup�! 12'x 24 BOOOv 40 lq 016t NG CARPET LAYOUT AND RIDGE Mood No SAN TA ANA, C PHONE, 11141 60 ziill 2�1" 10 00U GO x11! BEAM FIELD SUPPORT PIERS Olod/F,Q �G`Ir liii ,�._. grlorrN Br7,z w FOR FIELD SRT DETAILS. SFfc' ! Dwa S. 5-1 aB�d S -j OF IN5TALI.ATION MANUAL. pwlitUOr �w�_ 9 �� % 1 �Et•D(pOUC.Z �P 1,,. e'�,i"'a`F`��r?x'-�'1'FIR'r�r'1��"'�'''�'Y'� r+''"'?+'^a. .;�+;.a•.•?ngf;;-'..R,''`'1+a .. ., : 'ounty of Butte Dept. of Public Works 2. County Center Drtw mmillea California 95966 AND VKN RECORDED MAIL TO: Nff cuum of Butte Dept. of Public Works am 7,. County Center Drlv�- Tv, ; ville� Callfornle .AR, 959&5 4R? SPACE RECORDED BUTTE COUNTY OFFICIAL RRORDS BY X938 JAN, = Pik Of' CANDAC.E J. GRUSas URK - R.kOROFR FEE,,.::: TMS LIQ FOR RECORDER USE ONLY ��1GIN NOTICE OF MANUFACTURED HOME, (MOBILEHOME), OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the locai agency indicated is in accordance with California Heolth and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the Ifni t described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all per- sons thereafter dealing with the real property. David L. Dorn REAL PROPERTY OWNER/LESSOR P.O. Box 263 MAILING ADDRESS Forbestown, Butte, CA 95941 CITY COUNTY STATE ZIP Squaw Flat Rd. INSTALLATION MAILING ADDRESS, IF DIFFERENT Forbestown, Butte CA 95941 CITY COUNTY STATE ZIP SAME UNIT OWNER (If also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION County of Butte Dent_ of Puhlic Warks LOCAL AGENCY ISSUING PERMIf and CERTIFICATE OF OCCUPANCY 7 Cminty CPntar Dr_ MAILING ADDRESS Ornvi11P, Rntte rA 95065 CITY COUNTY STATE ZIP -87 (916)538-754 I ITN \ TELEPHONE NUMBER 12/7/87 SIGR r URE OF LOCAL AGENCY OFFICIAL DATE Pacific Modular Concepts DEALER NAME (If not a dealer sale, write "NONE") DEALER LICENSE NO. GQ1rlen West 10-19-87 Bardhitry/BD-601F-2 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER 702nA/7020B 60 X 27 CAT 348469/CAT .348470 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) 'REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER 073-17-0-004-0 SEE ATTA .H .D HCD FORM 433(A) 4/86 ENT OF ,OGS W� �c o lI, Q C044VNITY 00iEl of the Keystone Quartz and Gold Finch Quartz Lode Claims- ` ` csa u Wn4stxng eY designated by the Surveyor Genera of'- the United States as Lot No. 3600 embracing a portion of Section 3 in Township 19 North, Range 6 East, M. D. B. & M., as described in the Patent fran•the United States of America to Lewis K Reasoner and Douglas McLaurin, dated September 16, 1899 and recorded May 18, 1948 in Book I of Patents, page 320, Records of Butte County, California and more particularly described as follows Commencing at the Southeast corner of said Section 3, North 24" 46" 00" West, a distance of 2925.12 feet to corner No. 1 of Keystone Lode Claim; thence leaving oorner=No. 1 of said Keystone Lode -. Claim North 42' 15' 00" West, a distance of 595.80 feet along the Easterly line of said Keystone Lode Claim to corner No. 2 of said Keystone Lode Claim, said corner No. 2 of said Keystone Lode Claim being also corner No. 1 of Gold Finch Lode Claim; thence leaving the corner common to Keystone Lode Claim No. 2 and Gold Finch Lode Claim No. 1 and running South 47' 38' 54" West a distance of 749.76 feet along the line conBnon to Keystone Lode Claim and Gold Finch Lode Claim io the true point of beginning for the description; thence leaving the true point of beginning for this description and the line ccmmn to said Keystone Lode Claim and said Gold Finch Lode Claim and running South 42' 18' 32" East, a distance of 597.59 feet to a point on the Southerly line of said Keystone Lode Claim; thence North 47' 30' 41" East, a distance of .749.15 feet alona the Southernly line of said Keystone Lode Claim to corner No. 1 of said Keystone Lade Claim; thence leaving corner No. 1 of said Keystone Lode Claim and running North 42' 15' 00" West, a distance of598.80 feet along the Easterly line of said Keystone Lode Claim to corner No. 2 of said Keystone Lode Claim, said corner No. 2 of Keystone bode Claim also corner No.l of Gold Finch Lode Claim; thence leaving the corner common to Keystone Lode Claim No. 2 and Gold Finch Lode Claim No. 1 and running South 47' 38' 54' West, a distance of 749.76 feet along the line common to Keystone Lode Claim and Gold Finch Lode Claim to the true point of beginning for the description. TTCGETHER WITH a right of way for road purposes over a strip of land 60 feet in width crossing the Westerly one half of the Keystone Lode Claim. AP No. 073-17-0-004-0 !dd salt , IQf� 1/71 N' �I � 7+ i rn L+ END OF DOCUMENT i Addms or Lo Legal Descro Real Prop" A ®Mobilehome/Manufactured Home ®Commercial Coach has been affixed to -the real property described above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Ownees name: David L. Dorn Owner's address: P O. Box 263, Forbestown, CA 95941 I GMIA OR HUD NUMBER: CAL348469/CAL348470 SERIAL NUMBER OR V.I.M. 702OA/7020B A 7URIS G 1den We YEAR OF MANUFACTURE: 19 7 12/7/87 (916)538-7541 t= 613C r7ieoi Cw, osncrr-am"d"Ve, Ilkk of the Keystone Quartz and Gold Finch Quartz Lode Claims . "`"" " "'�' y ' ulau i c k)n-sting eY , designated by the Surveyor �ener - of the United States as Lot No. 3600 embraging apportion of Section 3 in Township 19 North, Range ;(-6 East, M. D. B. & M., as described in the Patent frcm•the United States of America to Lewis K Reasoner and Douglas McLaurin, dated September 16, 1899 and recorded May 18, 1948 in Book I of Patents, page 320, Records of Butte County, California and more particularly described as follows .Commencing at the Southeast corner of said Section 3, North 24'• 46" 00" West, a distance of 2925.12 feet to corner No. 1 of Keystone Lode Claim; thence leaving corner -No. 1 of said Keystone Lode -. Claim North 42' 15' 00" West, a distance of 595.80 feet along the Easterly line of said Keystone .lode Claim to corner No. 2 of said Keystone Lode Claim, said corner No. 2 of said Keystone Lode Claim being also corner No. 1 of Gold Finch Lode Claim; thence leaving the corner ccmnon to Keystone Inde Claim No. 2 and Gold Finch Lode Claim No. 1 and running South 47' 38' 54" West a distance of 749.76 feet along the line oomron to Keystone Lode Claim and Gold Finch Lode,Claim the true point of beginning for the description; thence leaving the true point of beginning for this description and the line common to said Keystone Lode Claim and said Gold Finch Lode Claim and running South 42' 18' 32" East, a distance of 597.59 feet to a point on the Southerly line of said Keystone Lode Claim; thence North 47' 30' 41" East, a distance of .749.15 feet along the Southernly line of said Keystone Lode Claim to corner No. 1 of said Keystone Lode Claim; thence leaving corner No. 1 of said Keystone Lode Claim and running North 42' 15' 00" West, a distance of598.80 feet along the Easterly line of said Keystone Lode Claim to corner No. 2 of said Keystone Lode Claim, said corner No. 2 of Keystone Lode Claim also corner No.l of Gold Finch Lode Claim; thence leaving the corner oommon to Keystone Lode Claim No. 2 and Gold Finch Lode Claim No. 1 and running South 47' 38' 54' West, a distance of 749.76 feet along the line oomwn to Keystone Lode Claim and Gold Finch Lode Claim to the true point of beginning for the description. TTOGETHER WITH a right of way for road purposes over a strip of land 60 feet in width crossing the Westerly one half of the Keystone Lode Claim. AP No. 073-17-0-004-0 � c~i jOrr rQ?v 'tt -'O. ✓0OJ��O U, END OF DOCUMENT V PERMIT RSO. 2,1.41 -(MH) -PERMIT EXPIRES Z&Z& OWNER DAVID DORN CONTR. owner ASSESSOR PARCEL 7317-4 LOCATION 3/4 mi off NS/,Old Forbes Rd, -150'E of Forbestown Rd, Forbestown 4 a� r. y; i Me C , , Meter B_:TR id >= .. ,:, Temp. Power Pole Called PG&E F Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E 1 JOB FINALED (Date) 1 Signatur Al r _ J OK 0 = Not OK = Not Applicable * = Not Ready 1 ! � MOBILEHOMES ; MISCELLANEOUS e Date MOBIL ME UTILITIES (P s) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1 o ing Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—.Easements 2 oils; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors ewer; Location est Fall-C/0—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails ater; Location .'est Easement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricit oc do Clearances—Grnd.— Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6: G do 7 —Wrap:/ /"L"ft./ /"Nat. or/,AX"L"ft./S "LPG `, 6. Carports; Windows—Doors . Utility Clearance ✓ 7. Elea _ I Card -BI Date and -BI Date Card -BI Date Card -BI Date Card -BI 4g Date Card -BI Date Card -BI Date Card -BI Date Date MOBILE . OMVI STA LATION (P OK except #'s oning Requirements—Setbacks—Easements Date ! POOLS (Plans) OK except #'s 1. Setbacks—Easements ootings; Size—Spacing—Marriage Line ! 2. Soils; Compaction—Structure Stability s• MH Test—Demand—Valve—Connector f 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining "1221- ricity; MH Test—Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI rain; MH Test =Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI ater; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed -�-Water and Sewer Connected—C/0 to Grade—HD Approval Gas and Electricity Tagged 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 6. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit . Exits; Insp.—Sketch ert. of Occupancy 9. Health Department Approval { 10. Plumb; Cir. Test—Water Supply Test i Card B -I Date and -BI Date Card -BI Date Card -BI Date C d B -I tlg— Card -BI Date Card -BI Date Card -BI Date a- 4 i r V = OK 0 = Not OK - = Not Applicable REVDENVI L (Single and Duplex) * = Not Ready Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 55. Shear Walls; Nailing -Bolts 11. 12. Electric; Underground Plenums & Ducts; Clearance -Material -Support -Ins. Card -BI 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Date Card -BI Date Card -BI Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except q's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's 14. Water Ht.; Vent -Access -Combustion Air 56. Ext. Steps -Door & Sidelight Protection -Landings 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. &Mech. Equip. Listed for Location 23. 24. Romex Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 72. Insulation -Foam -Looked in Attic ❑ Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails & Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Following instld.: Drive C] Yes ❑ No; Walks El Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B-1 Date Card -BI Date 81. 82. 83. Ventilation throughout House Glass Protection Corrections from Previous Inspections Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except q's 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. Vent Fan; Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING Plans OK except q's Comments at Final: 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. 40. Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. 44. 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Sh_thng_.-Rfn_g_.__ Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: An entry must be made each time youvisit jobsite) 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 Califor is Administrative Code, Title 25, Chapter 5, under permit number--!V-;V7- umber .� ZP%0 for the following location: Owner Owner's Address JM, 4'W., 96 /T Mobilehome Mfg. -*L-.e7 Model! s Year Insignia No. *21411/9 r% K `� Serial No.5— 4'7'5PV It is hereby certified for occupancy at the above described location and may be occupied. / . 1 Director of Public Works -. Date' i `h �- By_ -- THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ' V! 7 County Center Drive - Oroville, California-958fi51,Tel,phone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. 4. ASS OR PARCEL NUMBER ZONING BUILDING PERMIT R - a I 4 TELEPHONE SQ. FT. OCC. BUILDING VAL ATION (LING ADDRESS , R A C T R'S N. E T LEPHONE Yl O RAC OR*SMAILrNG ADDRESS Fireplace CONSTRUCTION NDE UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEEFPS MAILING ADDRESS Permit fee $ ING DRESS PLUMBING PERMIT Filing Fee 10.00 J ! Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USEOF ST SF ❑ Duplex❑ Mobilehome Other SPECIFY Building sewer 5.00 Mobile Home S G FW 10.00e TYPE OF WORK / New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑ Describe work: Y_ (00 D ®O Permit Fee $ Contractor ELECTRICAL PERMIT FilingFee 10.00 Main service s0ov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2/2 lt$q ft CONTRACTORS LICENSE LAW I declare u er penalty of perjury (Check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Profess' ns ode an my license is in f forc aqd effect. License N 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 LUTI.OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS NEW CONSTR (POWER APPARATUS & NON-RESID. C SINGLE OUTLET CIR. EX, DCCUp�OUTLETS OR FIXTURES BA 50 300 FIXED APPLNS. OR \ Ex. Occup. OUTLETS (RESID.) EA./ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ e permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making, this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot tteto enter upon the above-mentioned property for inspection purposes. I al agree to save, indemnify and keep harmless the County of Butte against all Iia ilities, 'udgm ts, costs, and expenses which may in any way accrue agains aid Coun y in consequen of the granting of this per it. �6/ X Date Signctu f Applicant - 0 ❑ Contractor 1-1 Agent ❑ ermit is required for excavations over 5'0" deep and demolition or construct- ion of stru ures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ of OCCUP. GROUP TYPE OF CONST. PARCEL PD' ND I ISSU This permit is hereby issued under sions of the Butte County Code and/or work indicated above for wi�Jch DECTV' (/ By PERMIT EXPIRES Date the applicable provi- resolutions to do f s have been paid. WORKS Date /— Receipt No. cD WHITE-D.P.W., YELLOW-ASSFSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phong: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE -2-:2 70 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. t t ` Ile A 12 I nspec Date ��`/ COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE a�2,2a--cs37,J- 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. � � h V .A YI%-II XA / Ate r Inspector � `T ' �- Date 91 ' r iL> 1 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone:'891-2751 7 County Center Drive, Oroville -- Phone: 534541 Skyway and Elliott Road, Paradise -- Phone: 872-2961, Ext. 57 CORRECTION NOTICE r'�'_ f* o ) __ - 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. Inspector_._._ Date COUNTY OF BUTTZ DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone': 891-2751, 7 County Center Drive, Oroville — Phone: 5344541 ay and Elliott Road, Paradise -- Phone: 872-2961, Ext. 57 CORRECTION NOTICE V+ AIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matt gr'or need additional explanation, please contact this office Immediately. r� // "000'.- Dat6' �-�%_ BUTTE CWM DEPAEtT MM OF PUBLIC WORKS 7 County Center Drive, Orovil,le. CA. PHONE: 534-4541 HOB II.E HOM INSTAII.AT ION SHEET 4. 1. Owners rimae. L POLMME MODULAR CONCEPTS, INC. 2. Installer's name: - AAC4c V PARADISE, CA. 5� 1. Is the site currently under ;t{t16) gy Ho -- (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 leaoh fields and clear of all setbacks and'easements? Yes 700 No (If no, clarify 5. What is the mobilehome electrical rating? ----------------------- Z O ° Amps 6. What is the mobilehome site service rating? --------------------- 7. What is the mobilehome site circuit breaker rating? ------------- .. 13. Is there any other electric load'to be served by the mobilehome Amps /v a Amps (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) BUTTE COUNTY a BUILDING DEPARTMEN APPROVED siteservice? --------------------------------------------------- Yes No (If yes, identify the load and size: (Load) _ (Amps) P. What is the mobilehome site gas pipe size? ---------------------- (�•) 1. What is the type of gas service. ----------------------------- Natural LPG L. What is the gas pipe length from meter or tank to the mobilehome? (ft.) Z. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) BUTTE COUNTY a BUILDING DEPARTMEN APPROVED (ft.) Box Length S (ft.) TagaYr�n or FX l. Site ft. s ft. (Si30Si SUPPORT DETAILS BELOW) - P-11 mobilehomes manufactured after October 7, 1973, furnish manufacturer�a installation .-._-ual and structural setup sheets (if not on file with the County of Butte). .? 1 center supports measured fro® front of ' ,z-Alehome unless otherwise specified. oot in s (check one) „p U7s� Single Pi 1; mood either S' D�' pressure treated o - A foundation grade. y: x (� 2. Other' (specify) -ft.)(in:) (in.) (in.) _er support Center support cations* footing sizes ® (in.) (ft.)(in.) � (in.) (in.) (in.) (in.) center piers are other than drawn above, sv in locations, spacing, and dimensions. Sup ort (check one) 6 `• Concrete block. D -2. Other. (specify) Tagalong or Expando,' show support details. L x,3 -- Typical Support . (in.) Footing Size S— (0 -- Max. Pier Spacing (ft.)(in.) L=_ -- Max. Overhang (ft.)(in.) JCOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS;' ' 7 County Center Drive - Oroville, Calitorniak!665 - Telephone 916/534=4541 APPLICATION ANp PERMIT PERMIT NO. i ASSESSOR PARCEL N MBER Jr (r ZONI G "' BUILDING PERMIT ow TE PHONE- - SQ. FT. OCC. BUILDING VALU TION i 0117,11-S. , W RS., ING ADDRESL CONTRACTOR'S AME TELEPHO E CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ S^ Penalty $. ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BTI G ADDRESS S PLUMBING PERMIT Filin Fee 10.00 9 . S r �' Each Trap 2.00 Solar Water Heater 20.00 IRA Fyb 9,4 Water piping 5.00 LOT O SUBDIVISION NAME PARCEL MAP Each qas water heater Or vent 5.00 -Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehomeOther SPECIFY Building sewer 5.00 Mobile Home 10-60ea D, TYPE OF WORK. � New ❑ Addition ❑ Remodel F1Utilities Ee/ Installation ❑ Other ❑ Describe work: — Permit Fee $ O Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600v OR LESS 100 AMP OR LESS 10,00 - ,on • Main service EA. ADD'L 100 AMP 2:50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 21/20sgIt CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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 CONNON•RESISTR MULTI -OUTLET 2,50 ea D BRANCH CIRCUITS) NEw CONSTR. 1 POWER APPARATUS &) NON•RESID, SINGLE OUTLET CIR. I EOccu RES AL BIsom x, p( FIXED APPLNSxORAL@30Q Ex. OCCUp. .OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 ^, Misc. Wiring 15.00' r Permit Fee $ 3 YXV Contractor r MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all Ii ties, judgments, cost penses which may in any way accrue agai t sa'd County. in onse en a of t e granting of this permit. X Date Signature of ApplicantT_/ Owner Contractor 1:1 Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over ren stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST, PARCEL PD YHD Iesu This permit,is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO OF PUBLIC (a By- PEi3 EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date �J/G — F� eceipt No.,� [:W. ITE-D.P.W., YELLOW-ASSE,SSO R, PINK -INSPECTOR, GOLDENROD -APPLICANT OFFICIAL•SE[,a: ARLINE J OVERSTREET NOTARY PUBLIC - CALIFORNIA BUTTE COUNTY I`My comm_ expires; NOV. 6,_1984 FOR.NOTARY SEAL OR STAMP' STATE OF CALIFORAIA �� SS. COUNTY OF __r[,�-«�C.• On 'l C j �Qbefore me, o the undersigned, otary lic in and for said County and State, per - CL sonally appeared z rfi personally. known -to me ( ed�-are-en44�as' tzar+sEaaary. � to be the per whose name is subscrib to the within a 3 Instrument (or proved to such by the oath of a credible witness who is personally known to me), as a subscribing Witness thereto, who v being byme, duly sworn, deposes and. W U Tharesides in 0 and that was present and saw _ ti �o �%rsonally known to to be the same person • a i described in and whose name -2 J subscribed to the within and annexed p Instruments as Part thereto, execute and deliver the sae, and � acknowledged to m v said affiant that executed the same; and that said CL affmt subscribed % name Hereto as a Witness. Signature Name (Typed or Printed) ' State Notary Public in and for said County and OFFICIAL•SE[,a: ARLINE J OVERSTREET NOTARY PUBLIC - CALIFORNIA BUTTE COUNTY I`My comm_ expires; NOV. 6,_1984 FOR.NOTARY SEAL OR STAMP' teturn to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT UFF101AL RECORD" FOR RESIDENFIALVEV>LOPMNT SUTTC. COUNTY -Obit,:.-. P,"_'OORDS RFQUESTE-, Section 26-8.1of the,Butte County Code requires this acknowledgement r be recorded prior to issuance of a building permit. MAY ZMC 9 428 a:- The property described herein is adjacent to land or included CLERK-RF'CUFt R within an area zoned for agricultural purposes, and residents of -F.,_ this property may be subject to inconveniences or discomfort arising 84-1 3 05 from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa- sionally generate dust, smoke; noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared •to..accept such inconvenience or discomfort from normal, 'necessary farm operations. pp No -_0_73-,1.7--07_0'04 rV " `'A'L:1. h.1� ►C icncal`-'propuity.� nituut�� l.ntl,l�o_ronnl.y ; titrate. ()f. Cal.i.fornia - •,., . tlescril)uri a follows: A portion of the Keystone.COns�lidated Quartz ing,�claim cons sting of the Keystone Quartz and Gold Finch Quartz Lode Claims:, designated by the Surveyor Genera of the United States as Lot No. 3600 embracing a portion of Section 3 in 'Township 19 North, Range 6 East,.M. D. B. & M., as described in the Patent from the United States of America to�Lewis K Reasoner and Douglas McLaurin, dated September 16, 1899 and recorded May 18, 1948 in Book I of Patents, page 320, Records of Butte County, California and more particularly described as follows Commencing at the Southeast corner of said Section 3, North 24" 46" 00" West, a distance of'2925.12 feet to corner No. 1 of Keystone Lode Claim; thence leaving corner -No. 1 of said Keystone -Lode r Claim North 42.'' 15'' GO" West, a distance of 595.80 feet along the Easterly lind'of .said Keystone Lode Claim to corner No,, 2 of said Keystone. Lode Claim,.said corner. No. -2 of said Keystone Lode Claim being also corner No, --1 of Gold Finch.Lode Claim; thence leaving the corner comtrion to Keystone Lode.Claim No. 2 and Gold Finch.Lode Claim No. 1 and running South.47.' 38'' 54 West a distance of 749.76 feet along the line common to Keystone Lode Claim and Gold Finch Lode Claim to the true point of beginning for the description; thence leaving the true point of beginning for this description and the line common to said Keystone Lode Claim and said Gold Finch.Lode Claim and running South 42' 181' 32 East, a distance.of 597.59 feet to a point on the Southerly line -of said Keystone Lode Claim; thence.North 47'' 30" 41"' East, a distance of 749.15'feet along the S �c� PRO "Y OWNS State of ) On this the day of , 19 SS. before me, the undersigned Notary Public, personally County of ) appeared known to me to be the person(s) whose name(s) subscribed to the within instrument and acknowledged . � a that executed the same for the purposes it therein contained. t IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public _ 'resent A.Y. N0.'T__..._.._. _ (I Southernly line of said Keystone Lode Claim to corner No. 1 of said Keystone Lode Claim; thence leaving corner No. 1 of said Keystone Lode Claim and running North -42' 15' 00" West, a distance of598.80 feet along the Easterly line of said Keystone Lode Claim to corner No. 2 of said Keystone Lode Claim, said corner No. 2 of Keystone Lode Claim also corner No.l of Gold Finch Lode Claim; thence leaving the corner common to Keystone Lode Claim No. 2 and Gold Finch Lode Claim No. 1 and running South. 47" 38' 54' West, a distance of 749.76 feet along the line common to Keystone Lode Claim and Gold Finch Lode Claim to the true point of beginning for the description. T OGETHER WITH a right of way for road purposes over a strip of land 60 feet in width crossing the Westerly one half of the Keystone Lode Claim. AP No. 073-17-0-004-0 Iyd A9 �44%, I t 211- r A I END OF DOCUMENT `_VIC �CZ L ,M ". ounty of Butte "D801. of Public Works 2 County Center Dr1w Qmvltl.ej California 05965 AND WHEN RECORDED IRAQ TO: X comy. of Butte an Int. of Public Works 7 County Center OrIvf- n covlale, California ATE. &15965 J& or, RECQR BUTTE COUNTY OFFICIAL RECORDS BY PUBLIC WORKS 198$ .JAN -s PI4 I: 01 CANDA.C..E J. GRUBBS Ci.ERI('RECORDER FEE FEE E ABOVE TICS LINE FOR RECI .88- 402 USE ONLY NOTICE OF MANUFACTURED HOME, (MOBILEHOME), OR COMMERCIAL COACH, ` INSTALLATION ON A FOUNDATION SYSTEM ET Recording of this document of the request of the locai agency indicated is in accordance with California Health and Safety Code SectiorP e6 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the uni t described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all per- sons thereafter dealing with the real property. David L. Dorn REAL PROPERTY OWNER/LESSOR P.O. Box 263 MAILING ADDRESS Forbestownr Butte, CA 95941 CITY COUNTY STATE ZIP Squaw Flat Rd. INSTALLATION MAILING ADDRESS, IF DIFFERENT Forbestown, Butte CA 95941 CITY COUNTY STATE ZIP SAME UNIT OWNER (If also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION County of Butte Dent_ of Public Work.-, LOCAL AGENCY ISSUING PERMIf and CERTIFICATE OF OCCUPANCY 7 Ccninty CPntar Dr- MAILING r_MAILING ADDRESS Orovi 11 P, R11ttP, C..A 95965 CITY COUNTY STATE ZIP -87 (916)538-7541 BUIL 1 IT N \ TELEPHONE NUMBER 12/7/87 SIGR r URE OF LOCAL AGENCY OFFICIAL DATE Pacific Modular Concepts DEALER NAME (If not a dealer sale, write "NONE") DEALER LICENSE NO. Golden West 10-19-87 Bardbiry/BD-601F-2 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER 702OA/7020B 60 X 27 CAT348469/CAT,348470 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER 073-17-0-004-0 SEE ATTACHED EN1 0: hOG HCD FORM 433(A) 4/86 0 � c �� 00, + ~UNITY OE'IE. f.ullOw.i: A portion of the Keystone Consolidated Quartz,m.ining, claim cons sting of the Keystone Quartz and Gold Finch Quartz Inde Claims, designated by the Surveyor Genera of,,the United States as Lot No. 3600 embracing a portion of Section 3 in Township 19 North, Range . 6 the M.-.D- B. & M., as described in the Patent from•the United States of America to Lewis K Reasoner and Douglas McLaurin, dated September 16, 1899 and recorded May 18, 1948 in Book I of Patents, page 320, Records of Butte County, California and more particularly described as follows Commencing at the Southeast corner of said Section 3, North 24" 46" 00" West, a distance of -2925.12 feet to corner No. 1 of Keystone Lode Claim; thence leaving corner -No. 1 of said Keystone Lode -, Claim North 42' 15' 00" West, a distance of 595.80 feet along the Easterly line of said Keystone lode Claim to corner No. 2 of said Keystone Lode Claim, said corner No. 2 of said Keystone Lode,: CO Claim being also corner No, 1 of Gold Finch. Lode Claim; thence leaving the corner common to co Keystone Lode Claim No. 2 and Gold Finch Lode Claim No. 1 and running South 47' 381 54" West a distance of 749.76 feet along the line common to Keystone Inde Claim and Gold Finch Lode Claim o n the true point of beginning for the description; thence leaving the true point of beginning for o this description and the line common to said Keystone Lode Claim and said Gold Finch Lode Claim .p - and running South 42' 18' 32" East, a distance of 597.59 feet to a point on the Southerly line o of said Keystone Lode Claim; thence North 47" 30" 41" East, a distance of 749.15 feet aloncr the ry Southernly line of said Keystone Lode Claim to corner No. 1 of said Keystone Lode Claim; thence leaving corner No. 1 of said Keystone Lode Claim and running North 42' 15' 00" West, a distance of598.80 feet along the Easterly lime of said Keystone Lode Claim to corner No. 2 of said Keystone Lode Claim, said corner No. 2 of Keystone Lode Claim also corner No.l of Gold Finch Lode Claim; thence leaving the corner common to Keystone Lode Claim No. 2 and Gold Finch Lode Claim No. 1 and running South 47' 38' 54•' West, a distance of 749.76 feet along the line common to Keystone Lode Claim and Gold Finch Lode Claim to the true point of beginning for the description. TTCGETHER IgITH a right of way for road purposes over a strip of land 60 feet in width crossing • - the Westerly one half of the Keystone Lode Claim. AP No. 073-17-0-004-0 END OF DOCUMENT Is CM Ij r...... ..... ma a 777771 7. 71. qvi r I�z T— 71 to t II r. in I ot'lvl. v w,lp p, Jw J;,:i. :,6 'ji mi i SIF.00" g"'Or O."t W'n f) 9el r, Wh'