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HomeMy WebLinkAbout078-030-004Martin Owens 6366 Custer Lane, Oroville (f� Permit #3041-77P,E(util- 1 ELEC. ),011-2h7- 0 � �"�A4 Q � gas- 7' _. 0?4 ° " =� /D�l TRIOLO, 'Joseph - 1207-70B7 ' SUPPO S RUCTURE REQ, d� _ _-„1020-70P _t COMPACTION TEST REQ. 3 r66366 U7 %am- 7 63 Custer Lane (last house on w'sidePalermo 61-77 MHI I1(reframe roof & install partial foundation) : Holmes Mobile Home Serv.,Bango t # 2,02-78„,5(newbawnin deck/MH)PME MartinCuste t-ies%MH) Oroville GAS- COMPACTION_ TEST REQ.', SUPPORT STRUCT �_ RE •• - S Permit#468-91MHI (installamh) ' RESIDENTIAL 36-291-47 2662-90PME OWENS, Martin, � 6366 Custer Lane, Oroville (utilities/MH) Address GAS Meter By_ ELECTRIC Meter By_ JOB FINALED Signature — OFFICE COPY —7 Dat 7 `. J=OK O'= Not OK = Not Readyable MOBILE HOLES Date - ' MOBILE HOME UTILITIES (Plans) OK except #'s ' r/f. Zoning Requirements -Setbacks -Easements j/2. Soils; Special MH Support Sketch 3. wer; Location -Test -Fall -C/O Concrete Water; Location -Test -Easement Needed (Sketch) er52 Electricity; Location-Clearences-Grnd-/ /Amp -Concrete Maas; Location-Test-Wra : / /" L" ft. f /t / /"Nat. or/ 7. Utilitv Clearance Date — / Card B-1 Date Card B-1 Date /1 -Card B-1 / Date. Card B-1 1 Dater MOBILE HOME INSTALLATION (Plans) OK except #'s 1 1. Zoning Requirements -Setback's Easements 2. Footings; Size -Spacing -Marriage Line ' as H Test-Demand-Valve—Connector j lectdcity; MH Test -Crossovers -Breakers -Clearances rain; MH Test -Fall -Flex Connector v_e._Vva_ter; MH Test -Regulator -Connector ; k,_—T.—Water and Sewer Connected -C/O to Grade -HD Approval V/rGas and Electricity Tagged j Exi; Insp.-Sketch j Cert. of Occupancy f Date,j— 5 — Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 1 �r Z.1-5(-9-0 1 S w MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans).OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panel boa rds-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ✓=6K" MO =Not OK - = Not Applicable RESIDENTIAL (Single & Duplex) - KIM Read y Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ . /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 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 -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B71 Date Card B-1 Date Card B-1 Date Card B-1 Date 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/Mech. 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 O Yes O No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 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 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls 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 FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-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 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 61r Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. 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-Mech. Protection 75. Plb., 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 O Yes 80. Following instld.; Drive ❑ Yes O No; Walks O Yes 0 No; Planters 0 Yes IJ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; PIbg.-Appliance-Fireplace.-Clearan ce 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 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE y DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE ' & o" OWNER PERMTT N0. 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 nged additional explanation, please contact this office immediately. n 1 A It t r Date�l�� Inspector t MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541 PERMIT N0. cz(fg —g Address or location of mobi lehome �� 3 7 jv C C/ -151, T L 62 L W Owner's name 10/4 PT! W 0 W 15 IyS Owner's address !! ,, t �^ Insignia or hud number ITki M =? o — S Manufacturer's name T L,,00��6 1:: oo �/% Serial number of V.I.N V (0�� � + " Year of manufacture tial 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. S ' } 513B White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive `Orovilid, California 95965 - Telephone: 916/538-7541 r + e APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER _ _ ZONING M BUILDING PERMIT OWNER Martin Owens TELEPHONE 533-1159 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 6366 Custer Lane, v lle 95966 CONTRACTOR'S NAME Cpgar Mprrndn Mohilp Home Service TELEPHONE 533-1562 CONTRACTOR'S MAILING ADDRESS 1420 91st qt- Oroville 95965 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 15,00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 6376 Custer Lane Permit fee $ 25.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomeo Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel [I Util' ies ❑ Installation NX Ot er F] Describe work: �66� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service sooV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD-[- 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9Div. 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 r sale. (Sec. 7044) 1 v1 I, as the owner, am exclusively contracting with licensed contract ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ADONS. (ACC. BLDGS. , 2/zQsgft NEW CONSTR ULTI.OUTLET NON.R ESIO BRANCH CIRCUITS 2,50 ea POWER APPARATUS & (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES B AL®ao 30AL0 Ex. Occup. OUTLETS ((RESID )REA.FIXED APPLNS. ) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Virin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, dgments, s, and expenses which may in any way accrue a I id unt �inXence of the granting of this permit. or Date-_� �� ignature o. Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ 45.00 Energy Inspection Fee $ occ CONST TYPE TOTA A L FEE $ 70. 00 HAZ CUA PARK (/ FLD / PA PD HD This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees R CTD F PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been aid. p WORKS Date 7�7- q Z Receipt No. 83849 WNITE-D.P.W., YELLOW-A58fSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 1 , AP i t OWNER PERMIT MH UTIL.CLEARANCE DATE INSPECTOR GAS Support Struc. Compaction Test eq. _ELECTRIC" xvice .ze Other Load Type Pipe Size Length— YES NO YES NO COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO, 7 County Center Drlve - Oroville, Callfornla 95965 • Telephone: 916/558-7541 APPLICATION AND PERMIT ASDESD0H R-ARCXL NN '' —0­W`N`F—.Ir BUILDING PERMIT rrTICLILPHUNIS J. SO. FT. OCC. BUILDING VALUATION iLLI OWNER' IN AD RED v✓ CON T R'D NAME r �Jrs EP HON CON CrTQ *S MAI IN A ESS p ('j� oo��)) l Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 10 00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee , PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 55.00 Each qas water heater or vent 5.00 US 0 STRUCTURE SF ❑ Dupl Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New ❑ Additicn ❑. Remodel Utilities ❑ Installati9K Other ❑ Describe work: �_�/% 1 Penult Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 0V OR Main service 100 AMP ORSLESS 10.00 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 Main service EA. ADD'L too AMP 2.50 NEW CONST. DWELLING OCCUP.ei OR ADONS. ACC. BLDGS. , �2QSgft NEW CONST"ULT'-OUTLET NON.R ES-D,BRANCH CIRCITS 2.50 ea/POWER — - APPARATUS e (SINGLE OUTLET CIR. Ex. OccU OUTLETS OR FIXTURES p 2ALO 30 eL0 FIXED Ex. OCCup. OUTLETS P(RESID.)REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring. 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Penult Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judg,@nts, costs, and expenses which may in any way accrue against i ount in conse a of the granting of this permit. Date ! Signature of Applicant — Owner ❑. Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ • occ CONST TYPE TOTAL FEE $ HA2. CUA PARK scrlL FLD cgF P PD I r+D. ISSUE This permit is hereby issued under the applicable provi- signs of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. WNITE-D.P. W.. YELLOW-ASSE330R. PINK -INSPECTOR. COLD ENROD-APPL I CANT ,r-r.:.x•,..,,j,.�Y,�"'"�i'�n�n q�.m•••.n+e'"iMR"Ih'rrsgv?1�,11 �. �. � �'�.�t"''": i,'u �:'!-y.-�. ���,'�'pw.' BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building). A.P. Number 'j�j�-�pZ�%�'��� Building Department No. School District 04 1) C/�t/ f/< City U County _[� Jurisdiction Property Owner Project Location/Address Subdivision Lot Number Residential Development: USC Sq. Footage # of Living MHI Addition (Group R) Un1jtS �_ .. Commercial/Industrial:' Sq. Footage ? New Addition (Including Exterior Roofed Areas) building D arl5mekit Representative Date (Floor Plans reviewed by School,District Personnel) i rict ,Id No. 91016 8 o ids School District certifies that ry(A plicant Name (Phone Number) eet Addres ) '(City) (State) ( Zip Code) has complied with the requiremen S of Res,' tion No. lfi�, � Jl by the pa ment'of $ ting square feet. ,;School District Rep esentative Date t PAID BY CHECK NO. REMARKS: BANK NO PAID BY CASH white-a'-ppaht, yellow -building department, pink -school district SCHOOL.FEE (8/88) ,. 1. Owner's Name: 2. Installer's Nam BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville; CA PHONE: 538-7541. MOBILEHOME INSTALLATION SHEET 3. Is the site currently under permit? Yes No Lj (If yes, furnish permit number o2 6 OR Is the site an existing site? . Yes No (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes Pr No D (If no, clarify 5. What is the mobilehome electrical rating? --------------- j O 4 Amps 6. What is the mobilehome site service rating? ------------- C 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 1 (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? --'------------ 1 ! (in.) Natural LPG 10. What is the type of gas service? ---------- 11. What is the gas pipe length from meter or tank to the %5 Q l (ft.) mobilehome? -------------------------------------------- 1 3S� O�� (BTU) 12. What is the mobilehome gas demand? ---------------------- *(This information not required if pipe length less thani, t on natural gas or less than 50 ft. on LPG.) �'j . ANG MARV" 'IPPR^VED MOBILEHOME SUPPORT DATA' If other than single wide, Mobilehome Mfr. furnish Setup Model No. Year Width(ft.) Box Length�y (ft.) Tagalong or Expando 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) 0. S111 -,PORTS (check one) 191. LJne 1 P_Ie ra" Wood -pressure treated or foundation grade.0 2. Concrete block . . Other (specify) Pier Footing Sizes and Locations 3iNCI.E-WIDE MULTI -WIDE I.Jne 1 e 1 a — _ — Ma1n Beams Lin 2 Line — — — — — — — — — — — — — Line 2 Main Beams — — —' — —' — — — — — — — Line 2 Size -Min.------------ Spacing -Max. --------- Fran Ends-Max.------- Idoe 2 11i era: Si%e-MIn. ------------ Spacing -Max.--------- r_ " From Ends -Max .------- _ I_Jne-S (Lxii loads: SJze-Min.------------ Location (From Front) Lin -e4 Piece: 1 7 7 Line S Piers: (Under Bearing Walls Only) Size -Min.------------ Size -Min.------------------ „x Spa, J.18 -Max.--------- „ Spacing -Max .--------------- �_ n From Ends -Max.------- From Ends -Max .------------- line 5 Roof Loads: Tag or Triple V 7�n A6/ �Sua60o2-/ Line 1 Openings: Other (specify) Size -Min. ------------------ nx n Each Side of Openings With Width Over --------- " Line 3 Piers: (Under Bearing Wall Only) Size -Min. ----------------- I. - "x 'Spacing -Max.--------------- , From Ends -Max.------------- GcJ � `Ls Size-Milk.------------ IucaLion_(Frum Front) W_��Wm��M 1."x11"x Size-Milk.------------ IucaLion_(Frum Front) 1."x11"x COUNTY OF BUTTE - DEPARTMENT.OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER MA e:T:' % / .�i/ A. P o. C>7 Proposed Building Use ,2 Z Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................ .......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... -7. Statement of Intent for Non -Heated and AC Buildings .............. . Engineered truss details and layout in duplicate (required prior to plan check) Mobilehome installation data including manufacturer's installation Instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 3Park e, -,paid / .School District fees paid .............. a 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required . Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural AAcknowledgment Statement ......... �6.5. LetteX„of �i��atur� ,at i�`/S� ............................ . 27. When you issue the permit, proc s as follows: Mail to owner. to contractor. Telephone 1 3 and hold for pickup at -office./Deliver w./inspector. Other App 'ca 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_rnail—counter by ..date Contractor, designer, owner, was advised of above required data by_phone_mall_counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW 17 leo d c Alo 74 C�.c X�o�,4 e/ 9, c, k/C_ Aqd 0,16 0 a;Z4, lCe� I r-1 ? 7 s�and�s Mns,M b4�_'_� .set f PWR. - ELM - a U�lawfi A(3,)14;e\ �7 lzw on.jhc job-at-,ali t rg. nj on: same, it uta wrLntn,pei hfission :iro6t6e-De rlmeneof Pu t /0, ty.of:Ruia – E),'v c /it I f 7 tback of 511-1-F&M–Inti-I -4 -proper i�_lfni; and a setback7 of 50ftnfromAe Foid,_: ROO centerline 7sKa-Wbe;clear-of 0 4 � t�p) re C-01.5 46 , ie 7— Cstructul;8S,oi- eqy! .... ........ ................... .. pmenxce rV fora`21F:-_�aiie overfiianq. ice 7C, a. f xe Pe IZ I 4ocW7 3 to- S l__P Of 00 106 IV74 A, y, 9 C- 7v-7,v_1 47_100" _Pxall 17 S0 ?'0 �7 I:Bein �j�OTTE_COCJNTY� =-A — - i ;;-:P-z--'BP L NOT Mated.76 M a5' 'E niz ' 'Good:Pr'ctices and ? ActardWn 6 ad- a 68 n. it, ii ,,BUILDING b-EF.*ARTAdtNT of- a cfuality. proscribedlor the � Specin e c �? P_: . Uniform BLiiidip_g6_urWSing-, &-Machanic_Q-1,'C6d_6s IM A-LP R- 0 E—D the ifVational'Electdc.Al tsr, 3&6 P64 v -T, AVof COo, /eo,4o:q/ R""V- - .-- Rx 6?1 Rl 40 5-0 It Ttis set plans and 's MUS T be I& *"5WeV ck IC010 0 kept on job at all unla 611 Ck- ges :4.,, ftke any 14 alterat ;on samnleftur of uly, from e written per Nssion. the De rtin nt of. Works, Co inty of Butte. LtvC/P,F.- e A -i,XF1 r f� A setback of 5 ft. trom tnt; /k y 4 property lines and a setback el.7; -� of 50ft. from the road L f A10 ROO centerline shah be clear of tyx &6 structures or equipment excel; for a 2 ft. eave overhana. 76, 1 51 6 C // 0 5-0 ooqew, z� C.,7/ z/;v aelr-- A- ?-0 BUTTE COUNTY NOTE :—AJI Matewl, ViAaa0a, Be in aS 15 - Accordance with Recognized Good Practices and I BUILDING DE MRT4tNT of a quality: prescribed for the Specified use in the Uniform Building, Plumbing & Mechanical Codes and A ® P ® 0, L11 the National Electrical Code. 101 tsc. 3'&6 1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive- Orovi.,We; Gelifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. z660_ ASSESSOR PARCEL NUMBER 36-291-47 ZONING M-1 BUILDING PERMIT OWNER IW TELEPHONEMART 533-115 S0. FT. OCC.1 BUILDING VALU TION OWNER'S MAILING ADDRESS 6366 Custer Lane roville Ca 95966 CONTRACTOR'S NAME ownpr TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER Nonp UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ XXIXKOC Permit Fee $ A CHITECT OR ENGINEER Mone LICENSE NO. Plan Checking Fee $ 1 .00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILD G AD ES tuster Lane, Oroville Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT N SUBDIVISION NAMEARRCEL MAP 9;7— Water piping 5,00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑X Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Q Installation[] Other ❑ Describe work: 3 Bedroom _ (USE PERMIT) Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6101 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 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.N A � New , 2h¢sgft CONSTR.( MULTI -OUTLET NON-RESID BRANCH CIRC" IRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES SAL@AL0303O Ex. Occup. OUTLETS FIXED PRESID 1NS.REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 15.00 Misc. byirin g 15.00 Permit Fee $ 37.50 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation P Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all Iia ' ities, judgme ts, cost Shd expenses which may in any way accrue aga' st unty ' e nee of the granting of this permit. /` �r / ' ' Date Signature of Appicant — ner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ A.5 HAZ cuA PARK SCHL FLD PAR HD UE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DI R 0 ELIC BY3 PERMIT EXPIRES ate the applicable provi- resolutions to do have been paid. WORKS �j Receipt No. 70)497 WNITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT TO Building Department FROM: Environmental Health SUBJECT:. Sanitation Clearance Owner Location AP# Approved for: Sewaqe Disposal Water Supply ®� Plan App W /� . Hold final for: Water Supply Final clearance O.K. for: . Water Supply Clearance for 75 bedroom mobile ome. Other NOTE * * * - Sanitarian � -. w Tr s tV`i ' . x, x -• 3aTi+7 i`,y , ! I �.. 't� COUNTY OF BUTTE - DEI?ARTkPZNT OF PUBLIC WORKS - BUILDING DIVISION - 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET -�-- Permit No. p �.1 'OWNER 40 I`4! n l we K S A. P.. o. � / Proposed Building Use Building Inspector Date j At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED a 1. All items have been submitted . ................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ..................................... .. . 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ................ 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions.............................0......................... 10. Fees of $ — .........0........... 11. Chico Urban Area fees paid ....................................... 12. Park fees paid ....... ....o _..................................... 1,3. chool Qistyyict fees paid ......_........ 4. Sanitation approval from r© tJ ► [ e Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: . 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) T` 20. Pre -Inspection for required . Pre-Inspec.request to Building Inspector (Date) 21% Contractor's license information (No., Name Style, Classifications ... 22. 'Certificate of Workmans Compensation Insurance ................. . 23. Owner -Builder Verification (Given to owner 11, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... �=qlJ 5. Letter of signature hori tion . . 27.. When you issue the per it,process as follows: Mai to owner. Mail to contractor. Telephone – T� 3 and hold for pickup at CJ C0 office. Deliver w./inspector. Other 0n Appli Date C7 1 Pd Copy of Haz-Mat corm 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 —mal l—counter by date Plans checked by Copy—DPW Date Plans approved by Sets of plans on hold in File cabinet AP folder Date NOT '000� do—T N� 20 A/ -7 of.� I" I I I *% CA, s ZIP re 'eo"a lip _-__ / I i As ROO c'K /I P.R.O. V E D DEVELOPMENT PLAN RAI DAT __7 USE. PERMIT VARIANCE sy 'g c e-, =- - - t7 I�q^ 4 L 0'v r l t. S' '. / ep 10, or 00 1,50 4AV -09 75-74-1 3 3D' A, � s& --a '97 /— '7"7 '104) ?--too 514 sr' 6 ce� T� f 9 SO . c___ I I Im a:. USE PERMIT BUTTE COUNTY PLANNING COMMISSION August 15, 1990 DATE: (Certified Mail Rec.) 90-35 PERMIT NO. AP 036-291-047 ASSESSOR'S PARCEL NO. Pursuant to the provisions of the Zoning Ordinance of the County of Butte and the special conditions set forth below: Martin Owens is hereby. granted a Use Permit in accordance with application filed: 4/4/90 to allow a permanent second dwelling on property zoned M-1 located on the west side of Custer Lane, approximately 2300 ft., south of Kusel Road and Custer Lane intersection, Palermo. 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 Enabling Ordinance. 2. Unless otherwise provided for in a condition to a use 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 a use 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. SPECIAL CONDITIONS: 1. Any septic and leach field system must conform to the Butte County Environmental Health Department rules and regulations and be installed by a permit issued by the Environmental Health Department. 2. Meet the requirements of the Building Division of the Butte County Department of Public Works. 3. Connect to OWID for treated domestic water. 4. Applicant must also comply with all other applicable State and local statutes, ordinances, and regulations. I hereby declare under penalty of perjury that I have read the foregoing conditions, that they are in fact the conditions which were imposed upon the granting of this use permit, and that I agree to abide fully by said conditions. . , Dated: Applicant NOTE: Issuance of this Use Permit does not waive requirement of obtaining Building and Health Department permits before starting construction, nor does it waive any other requirements. _ Butte CouiW Planning Commission Chairman CC: Department of Public Works (2) Health Department - Department of Forestry COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION t . 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) (have/have not) !Z. -et, 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 r • r 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. REQUESTED BY: ' 0 �''"�—•�-� Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR -RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County. Code requires this acknowledgement be recorded prior to issuance of a building permit. 90-329fi0 The property described herein is adjacent to land or included within an area zoned'N 90-032960 , Rec Fee 5.00, for agricultural purposes, and residents r Cash 5.00 of this property may be subject to incon- 1" ,' Recorded, veniences or discomfort arising from the Official Records use of agricultural chemicals, including, Countyo.f but not limited to herbicides, pesticides, Butte f and fertilizers; and from the pursuit Candace J Grubbs 'f of agricultural operations including, Recorder I 1. but not limited to cultivation, plowing, 10:40am 2 -Aug -90,.: y CD. spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and. residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described, as follows: ` AO W-ieT.� 7/iCz� Date: PROPERTY OWNERS: State of ) On this the day of 19 before me, SS. the undersigned NotaryyPublic, perso ly appeared County of ersonally known to me. ❑ Proved to me on the basis of satisfactory evidence. OFFICIAL DKIVLER CHRISTINE to be the person(s) whose name(s)NOYARY PUBLIC• BUTTE COsubscribed to the within instrbment and ac nowledged thatM OW. EXP, Nov. executed the same for the purposes therein contained. IN WIT •'S WHEREOF, I hereunto set my hand and official seal. Present A.P. No. Mo—,n—LO Notary Public EN® OF DOCUMENT 0-H S C -0e P.) y In Suite Count _ LAND OF NATURAL WEALTH AND BEAUTY . PLANNING DEPARTMENT 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (916) 538-7601 Martin Owens 6366 Custer Lane Oroville, CA 95966 CERTIFIED MAIL Re: Use Permit, AP 036=291=047 Dear Mr. Owens: Enclosed is your validated Use Permit No. 90-35 to allow a permanent second dwelling on property zoned M-1 located on the west side of Custer Lane, Palermo. Should you have any questions regarding . this matter, please contact this office between 10:00 a.m. and 3:00 p.m. Sincerely, B. A. Kircher Director of Planning BAK:lr Enc. cc: Department of Public Works (2) Environmental .Health Department of Forestry �t r USE PERMIT BUTTE COUNTY PLANNING COMMISSION August 15, 1990 DATE: (Certified Mail Rec.) 90-35 PERMIT NO. AP 036-291-047 ASSESSOR'S PARCEL NO. Pursuant to the provisions of the Zoning Ordinance of the County of Butte and the special conditions set forth below: Martin Owens is hereby granted a Use Permit in accordance with application filed: 4/4/90 to allow a permanent second dwelling on property zoned M-1 located on the west side of Custer Lane, approximately 2300 ft., south of Kusel Road and Custer Lane intersection, Palermo. 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 Enabling Ordinance. 2. Unless otherwise provided for in a condition to a use 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 a use 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. SPECIAL CONDITIONS: 1. Any septic and leach field system must conform to the Butte County Environmental Health Department rules and regulations and be installed by a permit issued by the Environmental Health Department. 2. Meet the requirements of the Building Division of the Butte County Department of . Public Works. 3. Connect to OWID for treated domestic water. 4. Applicant must also comply with all other applicable State and local statutes, ordinances, and regulations. I hereby declare under penalty of perjury that I have read the foregoing conditions, that they are in fact the -conditions which were imposed upon the granting of this use permit, and that I agree to abide fully by said conditions. A i Dated: Applicant NOTE: Issuance of this Use Permit does not waive requirement of obtaining Building and Health Department permits before starting construction, nor does it waive any other requirements. Butte County Planning Commission Chairman CC: Department of Public Works (2) Health Department Department of Forestry lqa 1\ ,J/�0,2 /CoA<( M •Zp SO4 /� J `Z \ 0 '^ t r, '-''; ✓ i' � � �� it CJ Cji. /^, � � N� -� /%f /V� Pna ojo S' ; -, f t -'l IA., 64CCI p R .-0 1 / V �.(�' � •. .. Cct,.`./ , �c opt �G,� ^�FDA DEVELOPMEPfT PLAN ? �y-- w /y 90 a _..'_._��' 1 �y'• n'•/� oll 7G,c•c N..o,-) �A- USE PERMIT VARIANCE C tlY Re /�l �o&0 G,- 4Loti 1 "� LG f �Y7e-+, a /iQu •t.. ,� 3 � S '--� -. s�l.�l , � - t 3(0(------���':!"oo'':� / s o /4f'�. LFr�c�i L.��d�X�cb.►� Cu.r . x 9 Ll 4 ; G TTS ` ; '--- . ioo ' so AX 3( --a5as 0 -} . Q q • c PERMIT N0. 3041-77P,E �//PERMIT EXPIRES �; �'T / OWNER Martin Owens CONTR. owner LOCATION (A.P. 36-291-47 1 636.6 Custer Lane, Oroville 6 1 X `rY.. Temp. Power Pole Called PG&E Temp. Elec. Serv. M�OM Called PG&E Temp. Gas Serv. Called IDS JOB Z / 7 �j FINALED / (Date),a (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD X BUILDING A BUILDING (Cont'd) A PLUMBING Se ck ewall S I Piping ForAlp PAvets 1 t Floor Ma 5k,Bldg. Rest om Finish 2n FloorI Fo ins WindoN 3rd hoor Stem all Siding To out Slab Roof Sheaking Water Pi i Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport p Footings Prov. for physical handica ed Conformance of ex. structure V Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation Patio REP ACE Final Footin s Footin ECTRIC L Masonry Walls Throat Rough Relnf. Steel Final Fixtures Bond Bea FIRE SPRINKLEA Motors Framing Test Water Htr. ISuhDanell Stucco LFInal mesh MECHANICAL Grd. Fa&lt Prot. Scr ch Heati Servigg B n Coo ng T mp. Pole nish D is oder round erior Lath en IIlation Permanent oor Closer _Final inal MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal 0-4 oe Water Piping a3 SewerIVY--Z3 �' Gas Piping E ME INSTALLATI N - - - - - - - - - - - - - Support Elec. Continuity Water Piping M 7 Drainage �� �� fj� Gas Piping J / 7AOW DAT§ REMARK OR CORRECTIONS ��y�� j✓ism ��.3 �-- ,0o, s` v. &e c-/'- w, 7`4 a u, h e -r cn/ c- ,Ser -LAI ec. , CA" /d 6 �, r P+t.��-- • d e .LTC .;:z o l� (NOTE: An entry must be made on this form each time you visit the job site.) 'M0BTi,Eli0M-E INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome 1oc;itcd-xai.th required separation from lot lines and buildings and generall-, conform to plot plan? Yes No� 2, Duosthe mr)bilehome have required clearances above ground? (Sec.5085) YesA No 3. Are foot.in,;s and supports properly sized, spaced, and braced a� p r approved plans? (Note possible variation at spring -shackles.) (Sec. 5082 & 5083) Yes No 4. Is the mobilehome level.? (Sec. 5088) YesV7 No 5. If more` an`a single unit, are cross o s ro erly installed? (Sec. 5088) Yes No 5. Water A. Is fl xible connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes No B. Test- Does water piping withstand working pressure or 50 lbs, air test? Yes_�.No_ C. Backfl.ow - If coach is a e o nig appX_oLted,'does station have backflow device and pressure -re ief valve? Yes No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No B. Does it have minimum per foot slope and is it properly supported? YesX No C. Are any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes No J[;' D. If o a .D -d'oes station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the,gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft, long? Note: All piping is to be at least as large as the mo i ehome gas line inlet without reductions other than the mobilehome connector. Yes No B. Test OK as per following procedure? Yes No 1., Open all appliance connector valves., 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min, without drop. 4. Connect: gas meter to mobilehome with connector, turn. on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes No ` Is job card signed by health Departmeat for water and sanitation? 1.;.. If everything okay, sign off card and to services. MOBTLc,lOML DATA Manufacturer and/or Namestyl.e _ Length 4_ Width Vehicle Serial No. State Identification No. .de,,Ltional Information or Cormpients: 9: Electrical. A. Is service Large enouglt to provide adegUate amperage to mobilehome (must equal rating of mobilehome with a. ::;inv,:um of 00 amp) and other facilities on lot, i.e., water .pumps, gara-e, cabana, ctc.? Yes No_ B. Is ther,-� proper clearances around panels? Yes -4 No C. Is power supply cord.or feeder assembly properly fused? Yesk No_ b. Is continuity test satisfactory as per the following procedure? Yes No__ 1. De -energize electrical wiring, syste:a of the mobilehome at the pe estal. 2. Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Swi.r_ch all breakers and switches in the mobilehome to the "on". position. 4. Connect one lo.. -id of a test instrument to the mobilehome grounding conductor and , •, _1....._ ,_.. ,. , al,p,}j tine OiiA�l lead to eack rlIUU1.Lt::iLUlle Simply CUCtuuetUr, 1liUlii(11itg lieilLrdt, 5. All nor. -current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall. be connected to the site service equipment. A further continuity to;t shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of theelectrical tests, the lot or site service equipment may be approved for energizing. Is job card signed by health Departmeat for water and sanitation? 1.;.. If everything okay, sign off card and to services. MOBTLc,lOML DATA Manufacturer and/or Namestyl.e _ Length 4_ Width Vehicle Serial No. State Identification No. .de,,Ltional Information or Cormpients: COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLS, CALIF. 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the Cali�f9rnia Administrative Code, Title 25, Chapter 5, under permit number ?Vlo Z--77 for the following .location: /? Owner Owner's Addressy/�n'. Mobilehome Mfg. 1./.G%C,:/G�f Model Year/Z7__1/ Insignia No. %a Z�� Serial No. 9l%� It is hereby certified for occupancy at the above described location and may be occupied. Director sof Public Works Date -1,1111-1,1177 $ /1 Y r w THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED ' . COUNTY OF BUTTEI — DEPARTMENT OF PUBLIC WORKS • _ • 7 County Cenlar Drive — Uroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned pro erty for ins ection purposes. Date' -11 —77 Signature of Perm itee or Agent Receipt No. �- White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECT OF PUB IC WORKS By k p Date i!50;W permit expires Date � _7P , BUILDING Owner © ow Z f°A7 SQ. FT. OCC. BUILDIN_ ALUATION 01 Mailing Address Te ephone No. 0 114�%S Fireplace If Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 j/ A. P. No. ==26 _ y` Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 e W Sa6/ n Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Parcel Parcel Ma Plans Declaration p 60' R/W Improvements p Lawn sprinkler system 2.00 B y-Pl e d Parcel Approval Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600v OR LESS 5.00 100 AMP OR LESS Main service EA. ADD -L 100 AMP 2.50 Main service OVER e O 25.00 100 AMP OR LESS Single Family ElDuplex ❑ Mobil Home rL Others ❑ Main service EA. ADD'L loo AMP 1.00 NEW CONST. DWELLING OCCUP. & OR ADDNS. ( ACC. BLDGS. 22sgft NEW CONSTR. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS) 12,50ea NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name of: Ex. Occup(OUTLETS OR FIXTURES) @'10 4 FIXED ALNS.style Ex. Occup. (OUTLETSP(RESID)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 Ft I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. {� I certify that in the performance of the work for which this y� permit is issued_ I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned pro erty for ins ection purposes. Date' -11 —77 Signature of Perm itee or Agent Receipt No. �- White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECT OF PUB IC WORKS By k p Date i!50;W permit expires Date � _7P , BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive,'Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: Ll 'Vi ©� -�p LI,S 2. Installer's name: 3. Is the site currently under permit? Yes No /T / (If yes, furnish permit number �� f_ ) 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 tankand Peach fields and site service? ---------------------------------------------------- (If yes, identify the load..and size: (Load) 9. What is the mobilehome site gas pipe size? ---------------------- Yes / / No /(� ; % (Amps) (in.)' 10. What is the type of gas service? ------,----------------------- Natural / LPG,/ / 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.). 12:. .What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural-gas or., less 'than 50 ft.. on LPG. ) A clear of all setbacks and easements? Yes No (If no, clarify ) ( ) 5. What is the mobilehome electrical rating? ----------------------- v Amps 6. What is the mobilehome site service rating? --------------=------ Z. cz> cC__>Amps 7. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served by the mobilehome site service? ---------------------------------------------------- (If yes, identify the load..and size: (Load) 9. What is the mobilehome site gas pipe size? ---------------------- Yes / / No /(� ; % (Amps) (in.)' 10. What is the type of gas service? ------,----------------------- Natural / LPG,/ / 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.). 12:. .What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural-gas or., less 'than 50 ft.. on LPG. ) A MOBILEHOME SUPPORT DATA Mobilehome Mfr. r1(—�V' V `lj'�- d Setup Model No. Year Z Width .(ft.) Length.' .(.ft.) •Expando .Size ft.x ft. (Draw support details below).. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets. (.if not on .file with .the County of Butte) . Sin Ie '� Footings -(check one) 1. Wood. either —( pressure treated or Center Center Support fdn. grade. Support Footing Sizes - Locations (in.), [► 2..Concrete pad. -/ %� 3. Other,: specify rin. -- -- -- - - Supports (check one) 1. Concrete block (i ..� 2. Concrete piers f.�n1� (in.)(in.) 3. Steel piers Other, specify T -- �✓ E ( - Typical Support 3� x 3� x in, Footing Size ( in. !._._ .._--_� (in.) (in.) ;. . Max. Pier y Spacing in. in.)..O ; (in.) (in.) ��y ! ! a Max. Overhang .*If*If center piers are other than drawn above, draw in locations, spacing, and dimensions, BUTTE COUNTY BUILDING DF?ARTN47NT APPROVED r „ COUNTY OFBUTTE — DEPARTMENT OF PUBLIC WORKS y• -� 7 County Center Drive - OroviIle, California 95965 / Telephone: 534-4541 /4 S, '� l'-" 7� APPLICATION AND PERMIT C.) authorize representatives of the County of Butte to enter upon the above-mentioned pr erty for inspection purposes. Date .-fid^77 Signature of Permitee or Agent Receipt No. & &�, le- z-- White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF DUBLIC WORKS By Date? -59- 7 7 Bung permit expires Date7 Y BUILDING Owner 11kax �� ���+ SQ. FT. OCC. BUILDING VALUATION, Mailing Address T_elep one s Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address 31� PLUMBING No. @ FEE PERMIT FILING FEEO $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping -1-61& Zoning Verification Only Each gas water heater or vent 1.50 A. P. o. Zon Gas piping system 1 - 5 outlets ••#-9D Each additional outlet .30 VS C. S tion Fire Dept. Fire Zone Use Permit Building sewer EQA Parking Parcel Plans Declaration �rc Ma P 60' R/W, Im Improvements Lawn sprinkler system 2.00 AWfj�� �e���-., _4 orrs Rec'd T � %a el Approval Pla Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 z 100 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADO'L 100 AMP 2.50 Single Family ® Duplex ❑ Mobil Home Others ❑ Main service OOEAMP oR LESS 25.00 Main service .EA. ADD'L 100 AMP 1.00 1V{/ SQ. FT. MINIMUM NEW CONST. !DWELLING OCCUP. & OR ADDNS. ( ACC. BLDG ) 20sgft NEW CONSTR. ( MULTI.OUTLET NON-RESID, BRANCH CIRCUITS) 2.50ea FOR MOBILES NEW CONST. (POWER APPARATUS &) R NON RES,D. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) 50 BAL� Ex. Occu FIXED APPLNS• OR P• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 471 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. / I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby 0o, 1CF6 10�16_1 De TOTAL PERMIT FEE $ authorize representatives of the County of Butte to enter upon the above-mentioned pr erty for inspection purposes. Date .-fid^77 Signature of Permitee or Agent Receipt No. & &�, le- z-- White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF DUBLIC WORKS By Date? -59- 7 7 Bung permit expires Date7 Y M111 . 0! 1"-I—!LL 711 k j 1�1 F - . Imit , na 7T El 08.- IOV: ---- F -4C j_h+_r , I" ! '..1-I d' t ;� I _LI �i`L�_ / I ; -�-i-I i , ' '.:-- -;- !._ i---,-- • 1 � 1-�-�.J_.{__f I1 if - V Vol i ,': It I L if L m J_it T -F -71 It L. -L M111 I 77— ioz i_A h L 1"-I—!LL 711 k j 1�1 F - . Imit , na it e'road, r -4 _T 0-Y 9 j_h+_r , I" ! '..1-I d' t ;� I _LI �i`L�_ / I ; -�-i-I i , ' '.:-- -;- !._ i---,-- • 1 � 1-�-�.J_.{__f I1 if - V Vol ,': It I L if L m J_it T -F -71 It L. -L I Vi i_1--17! Jill T T I I J q ill 1 .1, j If -L-_j _j - T I if "FT 7 1 ; f —it if I tt it 'NUI/ I L Ft_ T I ti I 101 I I 4 i I FA I II_ I ill zill I I I I i I v I I It I I I I it I ! L 6 11 1.. U-1 I ii LA 1,4-1 if -1 1 101JIM, if P:4. J-11-1 0 1AY c 1 9 if I i if wi0- db) rri jaIrligi 1101 11 1 111, I A ­tA_ �l (r7k,44- vy ;.W. a Oh -11 All! it if it 177 F it I/L J I U r! irv-N v Op, 6 -w F7 .08 . . . . . . . . . . . -7-IFFT 1�.p 1. 1"1. MIA 1131tut: Ithe rear i I I 11 -I-, 'r-Fq, I %-P I WC611 A ION 111 AMINI I I I I IZI ZI Zl fWl A, id V I A 1 11 31 ! 1 I 1 I M111 r1w Jr. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 6366 CUSTER LN Owner: Permit No: B09-0007 APN: 078-030-004 WARNER, ELENA Issued Date: 1/2/2009 By GLB Permit type: MISCELLANEOUS 100 NIEMANN ST Subtype: Electric Panel WINTERS, CA 95694 Expiration Date: 1/2/2010 Description: REPLACE EX ELECTRICAL PANE (530) 795-1105 Occupancy: Zoning: AR 1 Contractor Applicant: Square Footage: WARNER, ELENA Building Garage RemdUAddn 100 NIEMANN ST WINTERS, CA 95694 Other Porch/Patio Total (530) 795-1105 FEE INFORMATION DBE Single Phase Service-Resid $59.00 Total Charged: $59.00 Fees Paid: $59.00 Balance Due: $0.00 Receipt No: B9460 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions is in full force and effect. of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the X1/2/2009 Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by for any applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 91 I, as owner of the property, or my employees with wages as their sole compensation, will do lull of or U portions of the work, and the structure is not intended or offered for Sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or Contractors -Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: improves the property, provided that the improvements are not intended or offered for sale. If, ❑ I have and will maintain a certificate of consent to self -insure for workers' however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or compensation, issued by the Director of Industrial Relations as provided for by Section improved for the purpose of sale.). 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. I, as owner of the property, am exclusively contracting with licensed Contractors to aEl I have and wig maintain workers' compensation insurance, as required by Section 3700 construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon, and who of the Labor Code, for the performance of the work for which this permit is issued. My workers' contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law.). Carrier: Policy Number: Exp. Date: I am exempt from licensure under the Contractors' State License Law for the following I certify that, in the performance of the work for which this permit is issued, I shallnot reason: employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' y X 1/2/2009 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with Owner's Signature Date �X PERMIT APPLICANT DECLARATION 1/2/2009 -Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS By my signature below, l certify to each of the f Ilowing: I am U a California licensed contractor or the property owner' or U authorized to UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES act on the property owner's behalf**. AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN I have read this construction permit application and the information I have provided is ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN correct. SECTION 3706.01F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. California Licensed Contractor, Property Owner' or Authorized CONSTRUCTION LENDING AGENCY DECLARATION 1 herebyunder penalty of perjury that there is a construction lending agency for the performancece of the work for which this permit is issued (Section 3097, Civil Code). 1 1/2/2009 i� Lender's Name and Address Name of Permittee [SIGN] Print Date FILE COPY Lender's Name & Address City State Zip �v BUTTE COUNTY o�vTTFo DEPARTMENT OF DEVELOPMENT SERVICES o \i o BUILDING PERMIT APPLICATION* OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 c _-'` , �y o A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY "When filed, this application and all supporting material becomes subject to the California Public Records Act. All related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name First Name NA Mailing Address 10 0 NIEMANN Sf• City W• N4 ER S stat A zip 9 5 .9 4 Phone_,., 0 fpr, Fax Email bA c cl 0 I d I$ c APPLICANT SIGNATURE X �,,4✓-a I PERMIT NO. BIN # PROJECT LOCATION CONTRACTOR Name D Address 4o-341 G A1.vE City ,( State Zip Phone O , –7Q 5 —1105 Fax E-mail Lic. # Class APPLICANT SIGNATURE X �,,4✓-a I PERMIT NO. BIN # PROJECT LOCATION ARCHITECT/ENGINEER Name L etvA WA2Ne2 Address 4o-341 G A1.vE City ,( State Zip Phone O , –7Q 5 —1105 Fax E-mail State License Number APPLICANT SIGNATURE X �,,4✓-a I PERMIT NO. BIN # PROJECT LOCATION APPLICANT INFORMATION Name L etvA WA2Ne2 Address 4o-341 G A1.vE City b ,( Statt A zip q s q to G Phones O , –7Q 5 —1105 Fax E-mail APPLICANT SIGNATURE X �,,4✓-a I PERMIT NO. BIN # PROJECT LOCATION AP# �- 1 � � c;� C50 SRA 1 Yes No Property Address (10344, C u L city O r o v', I I E WORKER'S COMPENSATION Policy Number Carrier' If hiring anyone other than license contractors, a certificate of worker's. . compensation inusi be shown at the time of permit issuance. DESCRIPTION OR SCOPE OF WORK: Replaceex 1 ' e)e G I CQ 1 Q O Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA 1 Yes No Occ. Type Const. Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at 6366 CUSTER LN. OROVILLE. We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. J" 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. i:Q 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. ,�AO 3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. �4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer' under state and federal law. IE,�tj_6. I understand if I am considered an "employer' under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 4J 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. Lr'0 8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. ::�,W 9. 1 understand I may obtain more information regarding my obligations as an "employer' from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. i-Nw10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: ,i'� 11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. 4. 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors'. State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Description: REPLACE EX ELECTRICAL PANEL Reference Number: B09-0007 Applicant Name: WARNER, ELENA Owner's Name: WARNER, ELENA ) AP # : 078-030-004 Signature of Property Owner: 4��.,,�-- (�JCu%.�a Date: /—C;? — D Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the, owners driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 3-2,02- 7&B `A -PERMIT NO. PERMIT EXPIRES Marty Owens OWNER CONTR. Holmes Mob:fle H me Serv., Bangor ;LOCATION (A.P. 36-291-47 6366 Custer Lane, Oroville Temp. Power Pole Called PG&E Temp. Elec. Serv.— ealled PG&E T/M'p. Gas Serv. Called PG VJ (0 B FINALED --77 (Date) I U (Sign re) COUNTY OF BUTTE — DEPARTMENT'OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets list Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding.To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings Garage Vents Water Htr. Stemwa I I Insulation Heaters Slab Carport Footings Prov. for physics y • handica ed Conformance of X. structure Appliances Gas Piping &Test Temp. Gas Slab anal Sanitation Patio FIREPLACE Final Footings IJ✓L+o Footing EL TRICAL Masonry Walls Throat Rough Relnf. Steel Final Fixtures Bond Beam FRE SPRINKLERS Motors rami 11 11 '2.- �i `t �j Test Water Htr. Mesh MECHANICAL Grd. Fault Prot. Scratch Heatina Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INS' TALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must -be made on this form each time you visit the job site.) COUNTY OF- BUTJE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orville, California 95965 Tel ephAe:'534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X 0,0Date Si ature of PPe7rmitee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF/PUkIC WORKS By / Date A—/ J- /¢ Building permit expires Date — �'� BUILDING Owner M aRTY nweoc-, SQ. FT. OCC. BUILDING VALUATION Mailing Address 3 O I LL 11'__ 6qsq5 � 00 .` Teleph6oiz Contractor I ESLknale I6 _J ✓• Mailing Address a ' Q Fireplace Total Valuation QT l J , Q le h e No. Permit Fee Building Address3 ��� Plan Checking Fee&/or Penalty Permit Fee Otft in PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No -- Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F s Sa n ,J Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 � � Bldg. P nns Rec'd Parcel Approval Plans Approval Lawn sprinkler system 2.00 NEW,M ADDITION ❑ UTILITIES ❑ OTHER ❑ permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 600V OR LE SS 100 AMP LEss 5.00 Single Family Duplex Mobil Home Others ❑ P ❑ ❑ -L Main service EA. ADD•L loo AMP 2.50 'A_. / x / l / I �/ GCk / I OVER Main service 1100 AMP oR LESS 25.00 Main service// EA. ADD•L 100 AMP 1,00 NEW CONS.LING 0 OR ADONST %ACCDWE`BLDGS.CCUP. 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style f: �rVi NEW RESID,CONSTBRANCH CIRCUITS) NON -REBID � BRANCH CIRCUITS) 2.50ea NEWCONSTR. POWER APPARATUS & NON -RESID, SINGLE OUTLET CIR. Ex. OCCUD{OUTLETS OR FIXTI]RES80@25c PAL@1 Ex. OCCUp ( FIXED APPLNS. OR • OUTLETS (RESID•) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 1 C- License No. ��7 / Classification r0 Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. Ill I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby. Land Development Fee $ TOTAL PERMIT FEE $ �® authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X 0,0Date Si ature of PPe7rmitee or Agent Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF/PUkIC WORKS By / Date A—/ J- /¢ Building permit expires Date — �'�