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MIT#94-'2043
KNOX, JAMES Z3�9y r
19033 NEW YORK LhT RD., FORBESTOWN - 73-1$-��O b�
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073-180-066 PERMIT#94-2l044..x.
KNOX, JAMES:, -g-
19033
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19033 NEW YORK FLA RD., FORBESTOWN "
CONT: AL CARL
MOBILEHOME INSTALLATION
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COUNTY OF BUTTE -.DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICAT ON AND PERMIT
ASSESSOR PARCEL NUMBER-
073-180-066
ZONING
U K
BUILDING PERMIT
OWNER JAMES KNOX
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
EST
OWNER'S MAILING ADDRESS PO BOX 464 . BROWNSVILLE 95919
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
NONE
UNKNOWN
Total Valuation $
Filing Fee $
20.00
LENDER'S MAILING ADDRESS
Permit Fee $
15,00
ARCHITECT OR ENGINEER NONE
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
19033 NEW YORK FLAT RA
PERMIT FEE $
35.00
PLUMBING PERMIT
Filing Fee 20.00
FOREIRSWN o 95941
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
LOT NO.
SUBDIVISION'S NAMEPARCEL
MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF I Duplex ❑ Mobilehome D Other
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New O Addition D Remodel Q Utilities D Installation D Other Q
Describe Work: T)T!M
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( BOOV OR LESS ,
200A OR LESS
23.00
Main Service ( 200A TO IOOOA
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BLDS. I
SO.
3.50 FT.
NEW CONST. MULTI -OUTLET
-NON-RESID. ( BRANCH CIRCUITS 1
@7.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
1:11 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)
O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
O I am exempt under Sec. Business and Professions Code
forthis reason
( POWER APPARATUS 1
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES I
BL. @ 1.50
Ex. Occup.FIXED APPLNS. OR
( OUTLETS IRESID.1 EA. 1
5.00
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
4 Certificate of Consent to Self -insure.
t 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 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.
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
liabilitie , judgments, costs, and expenses which may in any way accrue against said
Countyconsequence of the granting of this permit.
X Date ��+ i(�
Signatu of Applicant - Owner D Contractor D Agent
OSH4 permit is required for excavations over 5"0" deep and demolition or
.construct on of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
ocC
CONST. TYPE I
TOTAL FEE $ 35.00
HAZ.
I D. FEES
I IMP
I FLOOD
XX
I CDF
PARCEL Po
HD
ISSU
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
11%An
indicated above for which fees have b en
By ,if,I ,�
.� e ►, �!/�' ,�
PERMIT EXPIRES ON
/Detel
provisions
to do work
paid.
Date
`
166
Receipt No. RSR
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION.AND PERMIT�a 6_1
ASSESSOR PARCEL NUMBER 073-180-066
U � ZONING
BUILDING PERMIT
OWNER
JAMES KNOX
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
EST
OWNER'S MAILING ADDRESS
PO BOX 464 BROWNSVILLE 95919
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 $
15.00
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS 19033 NEW YORK FLAT RD
PERMIT FEE $
35.00
PLUMBING PERMIT
Filing Fee 20.00
EnRRESTOWN, 95941
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15,00
LOT NO.
SUBDIVISION'S NAMEPARCEL
MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF LX Duplex ❑ Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Hoe S G W
m
@20'00
TYPE OF WORK
New O Addition ❑ Remodel 1:1Utilities O Installation ElOther f
Describe Work: n> Mn
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 800V OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & 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)
❑ 1 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
1, 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)
O 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
O 1 am exempt under Sec. Business and Professions Code
forthis reason
POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
BAL. @ 1.50
Ex. Occup.FIXED APPLNS. OR
( OF (RESID.) EA. )
5.00
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):
O This permit is for $100.00 (valuation) or less.
O 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 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certifythat I have read this application and state thatthe above informationis 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.
I also agree to save, indemnify and keep harmless the County of Butte against all
liabilitiejudgments, costs, and expenses which may in any way accrue against said
County consequence of the granting of this permit.
'�
X '• Date
Signatu of Applicant Owner O Contractor O Agent
An OS permit is required for excavations over 5"0" deep and demolition or
constru on of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 35.00
HAZ•
D. FEES
IMP
FLOOD
XX
CDF
PARCEL PO HD
IV
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated o for which f es hav b n paid.
By Date
PERMIT EXPIRES ON
/Date!
ReceiptNo. 166
WHITE-O.D.S.-B.O. C Y -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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 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) )VqW signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
.construction:
Name
.Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address . Phone Type of Work
Signed:
Property Owner
Social Securit
Date (' %/-fI
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.
f Demolition Permits
Asbestos Notification Statement
Date
AP# C % 3 -/&0
Pursuant to section 19827.5 of the California Health and Safety Code, all
demolition permit applicants are required to fill out this form.
"19827.5. A demolition permit shall not be issued by any city, county,
city and county, or state and local agency which is.authorized to issue
demolition permits'as to any building or structure except upon the receipt
from the permit applicant of a copy of each written asbestos notification -.
regarding the building that has been required to be submitted to the United
States Environmental Protection Agency or to a designated state agency, or
both, pursuant to Part 61 of Title 40 of the Code of Federal Regulations,
or the successor to that part. The permit may be issued without the applicant
submitting a copy of the written notification if the applicant declares that
the notification is not applicable to the scheduled demolition project. The
permitting agency may require the applicant to make the declaration in writing,
or it may incorporate the applicant's response on the demolition permit appli-
cation."
Attached is a copy of my written asbestos notification to the United States
Environmental Protection Agency for the demolition project located at
Signature of Applicant
OR
I hereby declare that a written asbestos notification to the United States
Environmental Protection Agency is not applicable to this demolition project.
760 ,
Signature of App 'cant
2/19/91 `
MAIL TO
ASBESTOS NOTIFICATION
EPA/NESHAPS Region IX
1235 Mission St. A-3-3
San Francisco, Ca. 94103
DATE:
PROJECT JOB #
(Please see reverse side)
Agancioa &= Notifi.ad:
❑ Zcoal
❑ Ca t i torsi a Air Aesourooa Board
❑ cwt OSEOL
❑ Bui1 i.aq Department
INSTRUCTIONS ON REVERSE
ASBESTOS DEMOLITION/RENOVATION
NOTIFICATION
IDE—PLEASE READ BEFORE USING THIS FORM
1.
EPA USE ONLY
Please check one:
DateRec
(Contractor)
Pstmrk
Renovation
ADDRESS
STREET ADDRESS
School
Demolition requiring
!
10 day notice
Del/ND
Demolition requiring
ADQUTE?
20 day notice
4. FACILITY DESCRIPTION
Code#:
Revision of Original
(Form on reverse side)
Doc#':
IDE—PLEASE READ BEFORE USING THIS FORM
1.
OPERATOR:
3. FACILITY NAME:
(Contractor)
ADDRESS
STREET ADDRESS
CITY STATE
CITY STATE
ZIP PHONE( )
COUNTY ZIP•
2.
OWNER
4. FACILITY DESCRIPTION
ADDRESS
CITY STATE
AGE _ SIZE
ZIP PHONE( )
PRIOR USE
5.
Project Start Date: Completion Date:
6.
Estimate of Friable Asbestos: ON PIPE: Linear Feet
SURFACE OF OTHER COMPONENTS: Square Feet
Nature of Materials:
7.
DESCRIBE METHODS OF REMOVAL:
S.
PROCEDURES USED TO COMPLY WITH 40 CFR 61.147 6 152:
9.
NAME i LOCATION OF DISPOSAL SITE:
ANY FURTHER PERTINENT INFO CAN BE INCLUDED BY ATTACHING ADDITIONAL SHEETS
QUESTIONS??? FOR FURTHER INFORMATION CALL (415) 556-6415 8am/4pm M -F
RENOVATION: means altering in any way, orle_or more facility components.
NOTICE MUST BE POSTMARKED AS EARLY AS POSSIBLESEFORE PROJECT
DEMOLITION: means the wrecking or taking out -of load -supporting structural
members of a facility together with any related handling' operations
10 Day notice for MORE than 160 sq.ft.or 260 linear ft. asbestos
20 Day notice for LESS than 160 sq.ft.or 260 linear ft. asbestos,
includes facilities which contain no asbestos.
FACILITY: means any institutional, commercial -or industrial structure,
installation,' or building. Renovations on single family residences
and apartment buildings with 4 units or fewer are exempt from
notification to EPA. -
PROJECT JOB #: Your OWN IN-H07SR I D for a specific jobsite. Optional,
but expedites communication -concerning notifications.
LOCAL AGENCY: Most areas in Region 9 -have local NESHAP delegated agencies.
In these areas notice must be provided to both EPA and the
local agency.
1. OPERATOR/CONTRACTOR: Full information concerning person doing the work.
2. PROPERTY OWNER: Complete in full.
3. FACILITY NAME: Must have complete address OR directions to the jobsite.
4. FACILITY DESCRIPTION: Current use of building. Project location in the
facility. Other descriptive information as necessary.
5. START AND COMPLETION DATE: Provide month, day and year. Must be revised
if dates change. (see revision form below)
6. Estimate of amount to be removed (must be in square or linear feet).
Revisions(see form below) must be made for additional amounts uncovered.
7. Examples of methods: glovebag, scrape, remove in sections, etc.
8. Examples: Adequate wetting prior to and during work, double bag, etc.
DRY REMOVAL MUST RECEIVE PRIOR WRITTEN APPROVAL FROM EPA
OR THE LOCAL DELEGATED AGENCY
IF MORE SPACE IS NEEDED THAN PROVIDED, ADDITIONAL SHEETS SHOULD BE ATTACHED
TO REVISE A NOTIFICATION ALREADY ON FILE WITH EPA, USE FORM PROVIDED BELOW
PROJECT NAME PROJECT JOB I
ORIGINAL NOTIFICATION DATE Revision Notice #1 2 3 4 5
please circle
This is to advise that the above referenced notification presently on file has
been revised. Please note the revised portion listed.
CHANGES FOR THIS REVISION: PROJECT ( )
CANCELLATION
1. NEW Location
2. NEW Scope of Work
3. ADDITIONAL Quantity of Asbestos
4..NEW Start Date
5. NEW Completion Date
6. NEW Disposal Site
V=OK
O= Not OK ;
-=dot Applicable
' =Not Ready MOBILE HOMES
Date/inititijs
MOBILE HOME UTILITIES Plans OK except #'a d
onin equirements-Setbacks-Easements
Special MH Support Sketch
ew ;Location -Test -Fall -C/0 Concrete
ater; L ation-Teat-Easement Needed (Sketch)
ricity; Location-Clearences-Grnd- p -Concrete
as; Location -Teat -Wrap: / /"L"ft.
/ /"L"ft./ /"LPG
e I Clearance & Disconnect
8. Utility Clearance
Date/Initials MOB HOME INSTALLATION (Plans) OK except #'s ?
Zoni g Requirements -Setbacks Easements
ootbgs; Size -Spacing -Marriage Line
,3-G • H Test-Demand-Valve—Connector
Elect city; MH Test -Crossovers -Breakers -Clearances
rein; MH Test -Fall -Flex Connector
ater; MH Test -Regulator -Connector
,jelFalgi,and Sewer Connected -C/0 to Grade -HD Approval
as and Electricity Tagged
VSs+-Ksp -Sketch
_41—Cert. of Occuoancm-7 //
MISCELLANEOUS
Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'a
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.-Rfd.-Bracing
5. Alum. Awn.; Columna -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date/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
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-Panel boards- Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
V=OK
O = 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. GrAd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel -Bloc kouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
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-Naii 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/Mach. 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 -Mach. 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. Wells Studs -Nailing, Spacing & Bracing -Plates -Sound
41. Bearing Walls 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-root Brac-Truss-Shthng.-Rfng.
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 3' -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-Skylighte-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. Plb., Elec. & Mech. Equip. Listed for Location
76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection
77. Insulation -Foam -Looked in Attic ❑ Yes
76. 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/0 to Grade -HD Approval
91. Energy Compliance Certificate -Other Certificates
Comments at Final:
�r MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE
'DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541
PERMIT NO. 20!2
Address or location of mobilehome 13 Nc W Xaa �S_ A - :'I- R
Owner's name
Owner's address J!"r/7C--
Insignia or hud number QA- L -? t ,-," Z -
Manufacturer's name V - FF/ -h Av, 4- '&zVIP
Serial numbex of V.I.N.^>C' /A:5A.) F61Zfzlq�
(Official Approving Inst'aflotion
3C
u
it of manufacture �W
Z -
(Date)
v
IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION'
ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE"
i�
MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. '
` 513B White - Owner, Yellow - Installer, Pink - D.P.W. t.
0
COUNTY OF BUTTE - DEPARTMENT OF'NVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, Caliib'mii 95965 - Telephone (916) 538-7541 PERMIT No.
APPLICATION AND PERMIT 94-2043
ASSESSOR PARCEL NUMBER
073-180-066
ZONING
U
BUILDING PERMIT
OWNER
JA,NES ,KNOX
TELEPHONE
SQ. FT, OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
PO BOX 464 BROWNSVILLE CA 95919
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
23.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESST
33 NEW YORK FLAT RD., FORBESTO�nIN
PERMIT FEE $
23 .00
PLUMBING PERMIT
Filing Fee 1 20.00
Each Trap
7.00
Solar or heat pump water heater
23.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Water piping
15.00
Each gas water heater or vent
15.00
USE OF STRUCTURE
SFO Duplex ❑ MobilehomeXa Other
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer }
15.00
Mobile Home S G W
@20.00 60.00
TYPE OF WORK
New O Addition O Remodel O Utilities;(_q Installation ❑ Other O
Describe Work: 2 BEDROW
PERMIT FEE $
80.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 'OVOR LESS )
200A OR LESS
23.00 23.00.
Main Service ( 200A TO I000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( 8 ACC. BLDS. )
S0r
3.5C FT-,
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)
❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
0 1 am exempt under Sec. Business and Professions Code
forthis reason
NEWCONST. MULTI -OUTLET
•NON.RESID. I BRANCH CIRCUITS )
@7.50 wj
( POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. Occup. ( OUTLET OR FIXTURES )
20 @ 1.00
BAL. @ .50
FIXED APPLNS. OR
Ex. Occup. ( OUTLETS IRESID.) EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00 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.
❑ 1 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 $
63,001
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.
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
Cou ty in consequence of the
/ggranting of this permit.
X b"' 1�� �/Y Date 7 i
Sign ure of Applicant - O Owner 0 Contractor ❑ Agent
An HA 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-
I D. FEES
I IMP
I FLOOD J
ODF PARC PD
M
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated abov for which fees have been paid.
By -� Dater ��
•�
PERMIT.EXPIRES ON % 9
torte)
Receipt 167230
WHITE-D.D.CANARY-ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
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 Bliat Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
PERMIT NO.
Anoa%e bulli ates that the following violations of Butte County Ordinances exist at '
the abo a'eJi4 andsahotdd be corrected. Please notify this office when correction of work '
iiscc�~ fymmbaveany questions pertaining to this matter, or need additional explanation,
yieave tllris office enmediately.
s
t�
B.H. USE ONLY/
Plot Pha Atbchad ✓
a. f Ploor Plm Amchad
• ' i:i Saat to B.D. /
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
73
F(- ------
Owner� Location � � AN
Plan Approved for: Sewage Disposal Water Supply: Public Private Well
Clearance for c9, bedroom Ga hem".0therL�Lo f3 go, y( a q CL2 le
Hold fuM for:
clearance 0. K. for:
Environmental
8/92
�" w^i'r��s �rs� �, y
r
.a
�" w^i'r��s �rs� �, y
r
{z' _ COUNTYOF BUTTE - DEPARTMENT0V :OPMA-T SERVICES - BUILDING DIVISION
7COUNTYCENTER DRIVE -OROVILLE, CALIFORNIA 95965 -TELEPHONE (916)538-7541
OWNER
Proposed Bu
Use
PERMITAPPLICARON DATA SHEET
T �A.•,P.-No. r
Building Inspector
Date 1 t A
At -time of permit application, I was advised"the following•aata must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY t
1. All items h been submitted. - "'. "�...........................
2. Plot plans sets, signed by pr`eparer of plans . ..................... ... .
3. Complete plans; 3/4 sets, signed by preparer of plans! ............... : ...:... .
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans......... ...... '
5. Hazardous Material Form......... '.......................................
sDesi h' Com liance and supporting documentation. . .
9Y 9 ' P� PPo 9 ..... ..........
7: Statement of Intent for Non -Heated and A/C Buildings . ................... . 01 /„
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. .. ... .
12. California Department of Forestry plan approva fees..'%��... -�'
13. Flood elevation letter (100 yefloo rby C lifforn rneer.
14. Sanitation and plot plan approval »; I�Health Department. ..............
j15. City of Chico plumbing'permit. ... r ..... ..... .............................
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), iainage....... .... .
Driveway permit (construction approval required prior to occupancy).. .
Pre -inspection for Preanspechon r6Gueg
required. . to Building Inspector �tl" r (Date) '
21. Contractor's license information. (No., Name Style, Classification) . ............ .
22. Certificate of Workmans Compensation Insurance. .. ..I,, ...:.........::.: { r.
23R'0 er_BuilderVerficatipn,(Give`n to owe Mail tis owner
s!24. e o'r ed>copy o A�r(culture#It/kokno edgem t>Statet t ' ' '
"'`5(Yettof�s.ignature,autfiorizai(ori��{✓�...z^�-�' 4�� -> '
26. Copy of recorded deed of parcel"creation an 6Q right of wa to a publcie�rgad
�,
9 x. I s, �. t -.
27. Lett. r"�f;�intent on,buildingt:use:.. * �,. i�)•.�.:� t � --�-: �... t .
1 28.t�k obileporr)e�tiiity-elea ante
29. Documentation of legal access. ..........:........... x'...... -4 ' n # r
30. Documentation of 50% subdivision de elope (A) Fkood.itrrprov�emen+ts,�compheted,-k
and (B) Parcel meets zoning area and ro agage' requirements . ...............
31. Existing violations/expired permits . ....................... , ............... .
32. Plan check list . .......................................................
33.
34.
Whey you issue the aermit process as follows: Mail to owner. Mail to contractor.
�_ Telephone �O `ls"�lD�_ % and hold for pickup at v' e office. Deliver with inspector.
Other wor K)
Parcel Creation
Acreage ^ ^�3a� Applicant Date
Date
Copyof Haz-Mat form sent Health Dept. Fire Dept. V_ Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other, Date By
The Olowing data must be submitted prior to permit issuance: (Circle new item not checked above). Y
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 1gf,;�-- Date /
Sets of plans on hold in
Copy - Department of Public Works
File cabinet AP folder
COUN f—OF BUTTE
Department of Development Services
. Building Division
Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541
Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751
OWNER -BUILDER VERIFICATION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and ,
issuing your building permit. No building permit will be issued until this verification is received.
1.. I personally plan to provide the major labor and materials for construction of the proposed property improvement
(yes or no)
2. I (have av 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 Contractor's License No.
4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and
provide the major work:
Name
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:.
Property Owner
Social Securityumber
Date rt
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.
94 -2986'9-
Rerun yQ: AGRICULTURAL STATEWNT 6F ACKNOWLEDGEMENT
�Iuilfding Division _ FOR RESIDENTIAL DEVELOPMENT _
t
Sectioa 26-8.1 of the Butte County Code requires this
acknowledgement -be recorded prior to issuance of a building �� ---- - - --- - — --- - - -
permit.
!94-029869'
I Rec Fee 9.00
The property described herein is adjacent to land or included I Check 9.00
within an area zoned for agricultural purposes, and residents Recorded I
of this property may be subject to inconveniences or Official Records I
discomfort arising from the use of agricultural chemicals, County of I
including, but not limited to herbicides, pesticides, and Butte I
fertilizers; and from the pursuit of agricultural operations Candace J. Grubbs I
including, but not limited to cultivation, plowing, spraying, Recorder -1
pruning, and harvesting which occasionally generate 12 : 41 p m 18 -Jul -94 I P U B L XX 2
dust,smoke, noise, and odor. Butte County has established
agricultural 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.
All that real property situate in the County of Butte, State of California, described as follows: 19 o
P&t&gy GUSH Spp;UJ.pGa.c,QLO,i cc,�Rw e �(jua�cl °(j LtQ I ; .
-r me) d e4c�-VJ_CAO
Lae, c�, Cgi�, o f / ►; / 43 IVO
s'-
ur�� ,
I cam, cC�-tcxnt,Cz 3iGt ,''J9 F�j 1 v ��"%
b yroy �
("� a
CW CLI �(,-b maw %l�1�ta�,cQ ; �+ u x, 4M)-,
AQU AAk pa� 0& 4,0-,V�
�L &� k�
►-. kZ Ccu/
Ccga\a� av, rur�-
Date: J U LA 4 M4 PROPERTY OWNERS:
6-, jtiroX
�JOnha C • lino x
State of California
personally appeared
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose names) -is/are
subscribed to the within instrument and acknowledged to me that heishetthey executed the same i l is/her/their authorized
capacity(ies), and that by+AsAwItheir signature(s) on the instrument, t e<. a .en s,or. e,ent{tv$u b of which the
person(s) acted, executed the instrument. GRACIE JEAN WHRELEY
WTTNESS my hand and official seal. a. COMM. & 997967 z
a .s
Z -� •. = Notary Public — California y
Z ' r,`;, a, YUBA COUNT/
My Comm. Expires JUN 20. 1997
Signature 2l Seal:
A.P. #
imono a
f� ha ( C -R7771;
U-12LPSV
y`fir
(1996, Lflo6
6.986Z-16
D
e�19
68t
�eot
011,
�t'J��G'S I tJ 111 1'� l.•�Z , .
I Le4�' a
v pmt$ !� Flre SOIR,
vai"'°t u nts MU21 tib f?RS
Ie4 andas C
er
by
A
17 REVIEWED BY
BUTTE CO. FIRE DEPT.
CALIF. DEPT. of FORESTRY
• ❑ approved as submitted
Kapproved vfitr conditions
per attached sheeTv
Signature Date
.Z (Ifl)r+.
yr Ff.
pq&e l # 0-73-190-066
All
�0
I 1 Z 1-=i-.
se
N
zr-
Sh 11 Es in
18�
t71fl T7£1liu7CY:1 E+iL `_ &EChaT]iCi31
des and the Ia atioildl L tact riC 4U Coda -
AND STRUCTU ,�� AND EQUIPMENT INCLUDINGr-
OVERHANGS SH '`'� E CLEAR OF ALL EASEMENTS. i 200 q
A SET SACK OFA'/� FROM THE SIDE AND J
3 O FT. FROM THE REAP PROPERTY LINES .AND
FT. FROM, THE. R+ AD? CENTERLINE SHALL BE
CLEAR OF STRUCTURES AND EQU€PtAENT EXCEPT
FOR A 2 FT. SAVE OVERHANG.
yt
�CDF'FIRE SAFE`REQUIREMENTS'�"?11
-7 4.3 kdox
AP# PERMIT # NAME
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.
IN 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
t�•j 1273.02 Surface. All driveway surfaces and structures (bridges,
1273.07 culverts and other appirtenzantt-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.
[�] 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 verti^wl curves in roadways exclusive
of gutters, ditches and drainage structures designed
to hold or divert water shall be not less than 100
feet.
] 1273.05 Turnarounds. If required, will have a minimum turning
radius of 40 feet from the center of the road.
[�] 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30
/r feet long with'a minimum 25 foot taper on each end.
Ilk] 1270.10 Width. All driveways shall provide a minimum 10 foot
traf f is lane and unobstructed vertical clearance of 15
feet along its entire length.
Page 1 of :2.-,
zv.
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.
[x] 1273.10 Turnaround. A turnaround shall be provided at all
building sites on driveways over 300 feet in length and
shall be within 50 feet of the building.
1273.11 Gates
[ 1. Gate entrances shall be at least two feet wider than
the roadway it serves.
[ 2. The gates must be located at least 30 feet from the
roadway and shall open to allow a vehicle to stop
without obstructing traffic on that roadway.
[ ] 3. Where a one-way road with a single traffic lane
provides entrance, a 50 foot turning radius shall be
used.
Fuel Modification
1276.01 Setback for Structure Defensible.Space.
[ ] 1. All parQels 1 acre and larger shall provide a mini-
mum 30 foot setback for buildings and accessory
buildings from ul] 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 or fi_ial inspection of a building
permit.
Page 2 of 3
r .�
3 - V- � G
AP #
PERMIT #
Other Requirements
tl_�2f Building Setback is 15 to 30 Feet:
- Class A or B roof ,
- Enclosed eaves
/ •�!� Jam/
AME
[ ] 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 110% 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
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 94-2044
ASSESSOR PARCEL NUMBER
073-180-066 N
ZONING
U
BUILDING PERMIT
OWNER
JAMES KNOX
TELEPHONE
S0, FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
P0 BOX 464, LE CA 95919
CONTRACTOR'S NAME
AL CA L
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
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
19011 NEW YORK FLAT -RD - 'tBESTOTdN
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.SU6DIVISION'S
NAME
PARCEL MAP
Each gas water heater or vent
15.00
USE OF STRUCTURE
SF ❑ Duplex ❑ Mobilehome CX Other
SPECIFY
Gas piping system 1 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
TYPE OF WORK
New ❑ Addition ElRemodel CIUtilities ❑ Installation CA Other ❑
Describe Work: 2 BEDROOM O)y/,a (' /
PERMIT FEE $
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00
Main Service ( 800v OR LESS )
200A OR LESS
23.00
Main Service ( 200A TO 1000A )
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BLDS. )
so.
3.50 FT.
NEW CONST. MULTI-OUTLETj
NON-RESID. ( BRANCH CIRCUITS )
@7.50
CONTRACTORS LICENSE LAW(
I declare under penalty of perjury (check one)
O 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)
Kl, as the owner, am exclusively contracting with licensed contractors. (Sec 7044)
❑ 1 am exempt under Sec. Business and Professions Code
forthis reason
POWER APPARATUS )
& SINGLE OUTLET CIR.
Ex. OCCU OUTLET OR FIXTURES
P• ( )
20 @ 1.00
BAL. .60
Ex. Occup.FIXED APPLNS. OR
(OUTLETS IRESID.I EA. )
5.00
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.
❑ 1 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 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.
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
liabili 'es, judgments, costs, and expenses which may in any way accrue against said
Coun in consequen a of the gra�/n%,ting of this permit.
X �\ �• Date 4
Signa re of Applicant - ❑ Owner Contractor ❑ Agent
An 0 HA permit is required for excavations over 5"0" deep and demolition or
const ction of structures over 3 stories in height.
Mobile Home Installation Fee $ 100.00
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 143.00
HAZ-
D. FEE
IMP
Floo
CDF
PARCEL PD
— —
HD
ISSu
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
By
PERMIT EXPIRES ON
(Da el
provisions
to do work
paid.
�f
ate
`/ ��✓
Receipt No. 167230
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
1&•wt
OWNER
"aMslr" �•'�F1h,+'R^+ y•{'+14iiVii}'iZ1f'.a-,.--'ifln7'iieTJSntitri�i q�v�"::lii'�'T'l'.IiliF Jl i'.'t.y"t
NTYOK,BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION
:N
7COI NTYCENTERDRIVE - OROVILLE, AUFORNIA95965 - TELEPHONE (916) 538-7541
Proposed Building Use
PERMIT APPLICATION DATA SHEET
A. P. No.
Build!ng Inspector Date
At time of permit application, I -was advised the following data must be submitted prior to permit processing and/or issuance:
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 wet signature on plans . .............
<+t 5.r Hazardous Material Form . ...........................:
6J Energy Design Compliance and supporting documentation.,.,., ........ _f.::'..... .
``\. 7. Statement of Intent for Non -Heated and A/C Buildings. .................
g, Engineered truss details and layout in duplicate (required prior to plan check). ....
V9 Mobilehome data and manufacturer's installation instructions, 2 sets.
....
. Fees f $ d s ...............
../
f - 11. Impacttfees as shown on attached schedule . ................... ........ ,
k 12. California Department of Forestry plan approval/fees.................. .
�13. >Flood elevation letter (100 year flood) by California Engineer ..................
14. 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. Planningapproval for (A) Use: '(B) Parking: :.... .
r' 18 Contact Land Development about (A) Improvements , (B) Drainage . . ............'
'19: Drivewaypermit (construction approval required prionto occupancy) ...... �.
PreansWc on 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 . ..................
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. .........................................
.......................................�-�l1�
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 . ...................................... : ............ .
33.
34.'
W en you issue the permit, proces as follows: Mail to owner. Mail to contractor.
Telephone and h I for pickup at vA office. Deliver with inspector.
Other Cwor
Parcel Creation :34 69
Acreage 1 �`� a Applicant 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 iss
1. Index -permit for above items No.
2. Additional items required:
not checked above).
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 oun r y _ 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 — DEPARTMENT OF DEVE[DMW SERVICES — BUILDING DIVISION
.7 COUNTY CENTER DRIVE, OROVILLE CA 95965 — TELEPHONE.(916) 538-7541
OWNER A. P. # 93
PROPOSED BUILDING USE 14)/V DATE �3
REC. # DATE REC
1 SCHOOL DISTRICT FEES X-4rus ✓ +Ile-
(paid at District Office). `�
2. SHERIFF FEES, x f 0 i(S e
(paid at Building Depart ent�
Residential...... x =$
unit amt.
Commercial (sgft). z _$
sq.ft. amt.
3. URBAN AREA FEES
(paid at Building Department)
Residential (per unit) x =$
# units amt. ,
Commercial (per sq.ft) x =$
sq.ft. amt.
4. RECREATION DISTRICT FEES
(paid at District Office) ..........................
5. DRAINAGE DISTRICT FEES
(Contact Land Development Division) ..............
6. SRA FIRE INSPECTION AND PLAN CHECK = $89.00......
(paid at Building Department)
7. OTHER
8. 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
vt
t
Marysville Joint Unified School District
CERTIFICATION OF COMPLIANCE
SCHOOL DISTRICT DEVELOPMENT IMPACT FEES
To be completed by applicant and taken to: • Marysville Joint Unified School District
1919 B Street. Marysville
Part I
Property Owner's Name:
Owner's Address:
Project Address: / CJ
Parcel No: 0 N
Building Dept: AIA WA
TYPE OF CONSTRUCTION:
Residential Construction
Residential Reconstruction
Lot No: City or County: 4) U it r
Permit No: "-
Single Family Dwelling
Multiple Family Dwelling
Commercial Construction No. of Units
A Commercial Reconstruction Mobile Home �j ) VILA
J Total Number of Habitable Square Feet: f � 485 iF�O (P e e 7t 6rJp4,5�ew.
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
Applicant's Name: ! l c� (U A) E� � f l Date:
�.
a
Applicant's Signature:iQ.n r'► r�
Part II TO BE COMPLETED BY BUILDING DEPARTMENT
Total Number of Habitable Square Feet (� � � City of Marysville
County of Yuba
Signature xe f County of Butte
Part III 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 x's $1.65 for Residential =.$
Exempt from Fees: i.` Reason: - ;� ` � IT, " I_
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.
Signature Sandra Davini, Director of Business Services Date
White:- School District
Yellow: - Applicant SD:co
Pink - Building Dept 792
A
tom• ::.i. %• „�' j ..
~ BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA y t
PHONE: 538-7541
MOBILEHOME INSTALLATION SHEET
1. Owner's Name:
2. Installer's Name:
3. Is the site currently under -permit? Yes F No
(If yes, furnish permit number ) OR
Is the site an existing site? Yes F// No F]
(If yes, furnish two plot plans:)
Will�the mobilehome be located at least 5 ft. away from septic tank and leach
fields and cleat -6f all setbacks and easements? Yes No
(If no, clarify
t
mobilehome?--------------------------------------------- (ft.) .
* 12. What is the mobilehome gas demand? -------;-------------- �,�� ��� B"
*(This information not required if pipe length less than 6 f on
a
natural gas or less than 50 ft. on LPG.)
- o
NEXT PAGE MUST BE COMPLETED TO PROCESS PERMIT APPLIQTION. rs
5.
What
is the
mobilehome electrical
rating? ---------------
Amps
6.
What
is the
mobilehome site
service rating? -------------
Amps
7.
What
is the
mobilehome site
circuit breaker rating?
-----
Amps
8.
Is there any other electric
load to be served by the
No
mobilehome
site service-? -------------
Yes
(If yes,
identify the
load and size:'
(Load) " --
(Amps)
9.
What
is the
mobilehome site
gas pipe size? --------------
_ -�
(in.) ,
---------
Natural'
LPG �.
10.
What
is the
type of gas service.
-
__
11.
What
is the
gas pipe length
from meter or tank to the
mobilehome?--------------------------------------------- (ft.) .
* 12. What is the mobilehome gas demand? -------;-------------- �,�� ��� B"
*(This information not required if pipe length less than 6 f on
a
natural gas or less than 50 ft. on LPG.)
- o
NEXT PAGE MUST BE COMPLETED TO PROCESS PERMIT APPLIQTION. rs
MOBILEHOME SUPPORT DATA
�r If other than single wide,
Mobilehome Mfr. /l. l/> furnish Setup Model No. ��� Year
Width 4-Z(ft.) Box Length_52,(ft.) Tagalong o.r.:E'xpando Size ft. x ft.
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)
SUPPORTS (check one)Concrete block. a 2. Other (specify)
Pier Footing Sizes and Locations
SINGLE -WIDE MULTI -WIDE
Lines Line 1
Line—2
Main Beams
ine2 ------ --------1
"Line 2
Main Beams
---- --- —
Line n 2
Line 1
Line
_-- -- _----- ..-Line
Tag or Triple "
Line 1
,Line 1 Piers: • Line 1 Openings:
t
Size -Min. ------------ „x „ Size -Min-
Spacing -Max. - '-"-- ,- Each Side, o ,Openings
From Ends -Max. ------- With Width Over ---------
Line 2 Piers: Line 3 Piers: (Under Bearing Wall Only)
Size -Min - ------------ „x D„ Size-Min-------------------
Spacing-Max.--------- 15--,_ c� „ Spacing -Max.--------------- .
From Ends -Max.------- Frdm Enda-Max--------------
Line 3 Roof Loads:
Size -Min. ------ ----- �Z„x 30, %2"x 7a" 2,q ,x30,'.2 /"x20" 1.2 "x30„ nx „ N „ „x „
/l
Location (From Front) Q '- Qi 3 3
Line 4 Piers.:. Jr Line..5 Piers:. (Under Bearing Walls Only
Size -Min.------------ Size -Min.---------- --------
-� „x n
Spacing -Max.--------- , „ Spacing -Max ----------------
From Ends -Max.------- ,_ „ From Ends -Max .-------------
Line 5 Roof Loads:
Size -Min.------------ ). :�
„x „x „ k „ k k
Location (From Front)
:7
;�AIiFAIAN & 6ROA0 HOME SYSTEMS:INC. INO.u/74� . ISIZE � �' I LO D� L8S. PL•F.�4.50'
SPAN 10' I' SPAN 9 I SPAN 8 SPAN^ ^7 i SPAN 6 • • SPAN 5 SPAN 4 SPAN 3 SPAN 2 -SPAN • 1" f I ! I . I.
K J ( H G F —x - • >1I -
GOY. 60%
. E• D C B
60% 140%
TYPICAL. --,'MULTI-WIDE MOBILE HOME'
SPAN 10
SPAN 9
SPAN 8
SPAN ''17
SPAN 6
SPANS
SPAN 'C
SPAN3
SPAN 2
SPAN 1
LENGTH
K&TI•%lOE
MOBILE HOMES
REOUIRE ; ADDITIONAL SUPPORTS AT
SEARING POLMTS ALONG THE • CENTERLINE.
^
�•/
FMWOM��
•�3_
THE SUPPOR�S
(JACKS) FIUST
MAVE.:A:: CAPACITY THAT WILE
SUPPORT THE RIDGE BEAM LOADS.
A
L®AO IN POUNDS:
HOUSING CtSTAN AROS1
� srJ�Tr s�Iwa�Ros
W
THE CHART.
AT BEARING
INDICATES THE
RIDGE.864 LbADS IN PCAINOS.
t THE LOCATIONS FOR FOOTINGS i SUPPORTS
POINTS ALONG
THE CENTERLINE. THE SIZE OF
FOOTINGS AAq SHOwN IN So INCHES FOR
'
MAR 141985
VARIOUS SON-
CONDITIONS.
821
-'.105...
C7Af TTY' 1500
•'i:
pC
A SUPPORT►TER
SNouLO
BE SEt'ECTE0' FOR .EACH LOCATION
INDICATED FOR YOUR MODEL THE '
Q
CAPACITY.'OF
T11E" &&PORT
PIER =SNIILLs BE EQUAL TO OR GREATER THAN THE POUNDS REOUTAEO IN
rh
. �
^n^om
THE _RIDGE
BEAN LOADS
COWMNi'ON .THE CHART _
4
i�r^: - °
2 Boo
.
FOR ADDITIONAL FOOTING
REOWREREHTS REFER -TO • THE
HONE WS''IALLATION MANUAL
1
1�
j
SPAN 10' I' SPAN 9 I SPAN 8 SPAN^ ^7 i SPAN 6 • • SPAN 5 SPAN 4 SPAN 3 SPAN 2 -SPAN • 1" f I ! I . I.
K J ( H G F —x - • >1I -
GOY. 60%
. E• D C B
60% 140%
TYPICAL. --,'MULTI-WIDE MOBILE HOME'
FROM
SPAN 10
SPAN 9
SPAN 8
SPAN ''17
SPAN 6
SPANS
SPAN 'C
SPAN3
SPAN 2
SPAN 1
LENGTH
3—
•�3_
1 -o
.4
FROM
Ut:AM LOADS,, WITH PIERS b 'FOOTING REQUIREMENTS
K
J
I
H
'_
F
E
p
C
8
A
L®AO IN POUNDS:
SOIL-. 1000
A
9 0:71
821
-'.105...
C7Af TTY' 1500
•'i:
(o'S4
FOOT0-3
ry
�
rh
. �
�z
��� ..
4
i�r^: - °
2 Boo
1
1�
AP # —/q 6 ,6
OWNER
PERMIT 4k 2
MH UTIL.CLEARA CE TES ®—
INSPECTOR
ELECTRIC
GAS
Support
Struc.
Compaction
Test Re ._
ervice
ize
Other
Load
Type
Pipe
Size
Len th
YESI NO
YES NO
' Z)