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078-040-029
r Louie Baker 6337 Custer Lane,, Oroyille Permit #6.166 77P E( 1 ) G' ELEC ho GAS - 4L A' /�S SUPPO T S RU RE -RVQ.. • A7Jd� ` COMPACTION TEST REQ. o�n�tlr / Oro3. lle Trailer Sales, Or Permit$#661'5=77MHI ssued k Permzt$#2,.555-81P (install nat, gas for existing MH) replace 1pg 0 05-2883 SNYDER,TRACY 6337 CUSTER LANE, OROVILLE Cont: OWNER M/H PERM FND (NEW) 1-113 'fib I E)i8- D4-0-O�q O U-0 r RECORDING REQUESTED BY: J --Z, AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER -DRIVE OROVILLE CA 95965 2007-0002254 Recorded I Official Records I County of I Butte I CfkVUALE J. GWBBS I County Clerk-Recorderl I I 03:45M 12 -Jan -M7 I REC FEE 10.00 MOfd4ED CAGY 1.00 CP Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER USE ONLY 'NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California. Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. TRACY L. AND SCOTT K. SNYDER REAL PROPERTY OWNEWLESSOR 6337 CUSTER LN. MAILING ADDRESS OROVILLE BUTTE CA 95966 CITY COUNTY STATE ZIP SAME r INSTALLATION MAILING ADDRESS, IF DIFFERENT SAME CITY � COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY ` COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 + CITY COUNTY STATE ZIP 05-2883 530 538-7541 B P T NO, TELEPHONE NUMBER SIGN 0 LO L AGENCY OFFICIAL DATE NONE DEALER NAME (ifma dealer sale, write "NONE") NONE DEALER LICENSE NO. UNKNOWN 1979 0000 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMENUMBER CAFL2A/B913091709 60'X 24' CAL145131/2 SERIAL NUMBERS) ; LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION ASSESSOR'S PARCEL NUMBER 078-040-029 SEE ATTACHED HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD - Building Dept. Real properly in the City of Oroville, County of Butte, State of California , described as follows: COMMENCING AT THE NORTHWEST CORNER OF THE SOUTH HALF OF THE NORTH HALF OF THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER OF SECTION 32, TOWNSHIP 19 NORTH, RANGE 4 EAST, M.D.B. & M.; THENCE SOUTH 0 DEG. 07' WEST ALONG THE NORTH AND SOUTH CENTERLINE OF SAID SOUTHWEST QUARTER, A DISTANCE OF 82.81 FEET TO THE TRUE POINT OF BEGINNING; THENCE FROM SAID TRUE POINT OF BEGINNING NORTH 88 DEG. 4430" EAST, A DISTANCE OF 542.56 FEET TO A POINT WHICH BEARS WEST, A DISTANCE OF 791.939 FEET FROM THE EAST LINE OF THE SOUTHWEST QUARTER OF SAID SECTION 32; THENCE SOUTH 0 DEG. 07' WEST AND PARALLEL WITH THE EAST LINE OF THE SAID SOUTHWEST QUARTER, A DISTANCE OF 165.46 FEET, MORE OR LESS, TO THE NORTHEAST CORNER OF A PARCEL OF LAND DESCRIBED IN A DEED FROM WALTER L BRAY, ET UX—TO-FRED HERZBERG; ,ET -l -1-X, -RECORDED APRIL -27, -1962—IN-BO01-117-7, PAGE- 331, -.OFFICIAL RECORDS; THENCE WESTERLY ALONG THE NORTH LINE OF SAID HERZBERG PARCEL TO THE NORTHWEST CORNER THEREOF, SAID POINT BEING IN THE WEST LINE OF THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER OF SAID SECTION 32; THENCE ALONG SAID WEST LINE, NORTH 0 DEG. 07' EAST, A DISTANCE OF 165.62 FEET TO THE. TRUE POINT OF BEGINNING. EXCEPTING THEREFROM THE WEST 40 FEET THEREOF. APN: 036-291-045-000 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION **PLEASE PRINT CLEARLY* * OWNER Last Name Name First Name Address S ) City �. 1 State Zip 1530_53tt _ Z Fax E-mail _ 2 ARCHITECT/ENGINEER Name Address City State Zip Phone Fax E-mail State License.Number CONTRACTOR Name SRA Address City Type Const. State Zip Phone _ 2 Fax E-mail Lic. # Class ARCHITECT/ENGINEER Name Address City State Zip Phone Fax E-mail State License.Number g Zoni g APPLICANT NAME Name SRA Address6',3_37 3 City Type Const. State aw Zp �G / l� Phone � _ 2 Fax E-mail g Zoni g Flood Zone SRA Yes No Occ, Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: rl\100 C/nD CI 1011111T -TAI W6 -(ll 11111 -MF -N 11 PERMIT NO. BIN # WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Mq w;+i / 17-1) A / Q Sq. Fdotage ' ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees -for work plan checked and other department costs are not refundable. Received by: K .G o I Receipt#: I A 0 L IDate: 10- 1q— 05 Amount 4 2 1'1 aq G Bldg SRA Sheriff SMIP Other Total SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed ❑ 3. calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to ❑ 7. mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in ❑ 11. triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. , 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ .-2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ . 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed. by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION ...�.................... r�nuc+01J-nJ-- D...... o ..cam RFV P-1ri U AREA i Butte County Department of Development Services. p' e�rrf, F V 0 T E S 7 County Center Drive, Oroville, CA 95965 s I (530) 538-7601 www.buttecounty neUdds .aceUN�y. c RESIDENTIAL APN: 05-2883 p 840-029 Owner. SNYDER, TRACY Site Address:, 6337 CUSTER LANE, OROVILLE Cont: OWNER contractor. , M/H PERM FND (NEW) Type of Permit: C,/I Cot it C'l SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE 4D: - O DATE JOB FINALSIGNATURE:ax CHECKED BY = OK u = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE I L..LPERMANENT FOUNDATION SOFT -SET oning-Setbacks-Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr, Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LPO Inch Sz Ft Lngth Ickng; 5z -Spacing -Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Ce Occupancy UD Label/Insignia Numbers Serial Numbers T-" DATE ID E C K S'C O V E R S'C A R P O R T S •G A R A G E S 1 Zoning -Setbacks -Easements t 2 Ftgs; Soils -Sz-Dpth-Spacing-CnnctrsSteeI 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts -Beams -Rftrs-C nn ctrs-S hth g Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors ' 7 Electric ( 8 Frmg; Sills-Anchrs-Studs -Rftrs-Trusses { 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing ; 11 Ext; Steps -Doors -Landings i 12 Braced Wall pnls ff! i DATE IPOOLS 1 Setbacks -Easements r 2 Soils; CompactionStructure Stability 2 3 Pool Structure; Steel -Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr f 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg 1 Bozes-Enclsrs-pnlboards-Insults to Main Conduit 9 Health Dept Apprvl i 10 Plmb; Cir Test-Wtr Supply Test i 11 Lt Niche ! 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide ° Pool Drawing e: = OK 0 = Not OK RESIDENTIAL (Single & Duplex) DATE IUNDERFLOOR I DATE IPLUMBING ' 1 ZoningSetbacks-Easements-Flood-Slope 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 3 Ftg Garage; Soils-Steel-Elec Grnd Fig Dpth. 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth ` 5 Stemwalls Main; Steel -Blockouts-Wrapped 6 Stemwalls Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 1.4 Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd 13 Plenums & Ducts; Clrnc-MaterialSupport4nsultn _ 14 Girders-Sills-Anchr BoltsJoists-Vnts-Cripples 15 Acc & Vntltn 16 Insulation s o'er m` opo m� DATE IFRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 22 Headers & Beams-Sz & Bearing 23 Hangers -Post Caps-Anchrs-Cnnctns 24 Ceiling Joist-Rftr Ties -Purl in -Roof Brac-TrussShthg 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtri Vnts-Undrflr Acc 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnis 38 Insultn-Walls-Ceilings 39 Infiltration -Walls -W ndws DATE JELECTRICAL 40 Fxtr & Trnsfrmr Cirnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or ❑AL AC Wire Sz ga ❑ CU or ❑AL 48 Range Circ ga ❑CU or ❑AL Oven Circ ea ❑ CU or ❑ AL Insulated Neutral ❑ Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV, Test Fittings & Anchr Nail Prtctn 56 Shwr Pan; Test, First flr-Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub-Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping o mac` o mac`. DATE IMECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door; Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-CImc to Opngs 90 Wtr Well, Dscnnct, Elec, Plmb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn 94 Corrections from previous Inspctns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #. (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO52883 078 - jq6 _Q 29 . B. G. Building Permit u1 -1b -u4 pg I LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 10/25/2005 AP&101-294449--000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 6337 CUSTER LN ORO Map Index: Date: Contractor: Description: MH REPLACEMENT ON PERM FND, EX SITE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the (1440 ) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: SNYDER, TRACY L.& SCOTT K signed statement that he or she is licensed pursuant to the provisions of 6337 CUSTER LANE the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966 violation of Section 7031.5 by any applicant for a permit subjects the (530 ) 534-8862 applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the .'property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: SNYDER, TRACY L. & SCOTT K. owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 6337 CUSTER LANE provided that such improvements are not intended or offered for OROVILLE, CA sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 95966 proving that he or she did not build or improve for the purpose of (530) 534-8862 sale.). Cl I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: pursuant to the Contractors' Stat icense Law.). ❑ I am Exempt under Article 3 t e BusinesTanProfessions Code Owner: Date: WORKERS' CO ENSAT DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.Architect: ElI have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: ' Total Square Ft: 1440 S.F. Policy #: Valuation: $93,600.00 1 I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall y� C17T f forthwith comply with those provisions. Date: — — 0q� Applicant: fl � WARNING: Failur to sec a workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one ,thousand dollars ($100,000), in addition to the cost of _50hundred compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the This permit is hereby issued under the applicable provisions of the Butte County C de and/or Resolu ' ns to do work indi ted ab ve f which fees have been paid. performance of the work for which this permit is.issued (Sec 3097 Civ.) B ' Date: v �� Name: _ Q PERMIT EXPIRES ON: Address: (Crate) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. 17 1 hereby certify that I have read this application, that the above information is correct, and that I am the owner or the d y/a thorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any ieial form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: % U 10 yi { ' Signature: Date: _% O ' S— D 15 7 �jOwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. G. Building Permit u1 -1b -u4 pg I E.H. USE ONLY Plot Plan AttacMd Flow Man Atuc"d Sent to B.O. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance S c'e>-4 9A S4? yl— Owner Location AP# Plan Approved for: Sewage Disposal— Water SuppI Pu licePrivate Well Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: c nvironmental Health Specialist 8/96 Date COUNTY OF,BUTTE-DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA :95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER:h _ p ASSESSOR PARCEL NUMBER D ) CD - S j n • 0 �q Proposed Building Use: An'Um m f NO. G ' SITF Permit Technician: , Date: WO/o5 Items required in ordeL o apply for a permit. All boxes MUST be checked OR marked NA in order to apply. V 1. Site plan 3 r 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non-ResidenVae uildings. XN 8. Manufactured homes: (A) Installation manual, inc di ar 'ine info(C) FJoor�lan,, (D) Tie down or fndpla� ns,a_II in duplicate. On si"n s ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other e arcing items ;needed to issue the permit. (May require additional plan review upon receipt of the following items.) 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico NrOroville, as applicable ❑ 15. Fire "Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... 11E ion Control Plan Required........................................................................ 19 ees as shown on the attached Schedule of Fees Due Sheet .............................. / ?$$ _ OOL 20. City;of Chico Plumbing permit........................................................................ ❑ 21. Site,plan and business license approval from the City of Biggs .............................. o- 22. California Department of Forestry plan approval ❑ paid. Sent by: ............. 23. Planning approval for (A) Use:OLL-_(B) Parking: - (C) Parcel Check: ............ I C3 _ ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ V25. Fire Marshall Review (commercial projects only). Sent by: ...................... m. 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... 0.29. Worker's Compensation Carrier and Policy Number .......................................... _ Given to owner, _Mailed to owner ..................... NXV 30. Owner -Builder Verification () ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... 3 e Restriction........... ............... 3 Legal description, M.H. Title, title search re istration or MCO ........................ �� 36. Other: l@+14r nV i n+cn+ 0 37. Other: When issued Telephone �A u - (V flf`f` and hold for pickup. I have been infory i9d of the above items and requirements for obtaining a building permit. Applicant: / .' �i \ i, Date: 1. Index permitapplication f r he above i emsriumbered: Plan Check Letter 4KaO 2. Additional items r 7 Contractor, design&-o-viiW, was advised of the above data by Yphone, ❑ mail, counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, b Date: Plans reviewed by: ; Date: Pla s approved by: Date: Structural reviewed by- Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division IVBuilding/Plan Check/Data Sheets/data sheet page 2 9.27.05 �P052��3 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DMSION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER smi d PROPROSED BUILDING USE Mfl Rpi ff JUnQ 0a pff(p �'NpFND FX S - z. BUILDING PERMIT FEES 11 --- Balance Due ..................... $ --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ -\,&2. A.P. # Q 2G:2J 0' n29 DATE lo" lq-n:) RECEIPT # DATE RE . SCHOOL DISTRICT FEES V' 1 . - 61 Ven Ta Id IN21 /OS (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Commercial (sq. ftg.)... .. X $0.03 = $ Sq.Ftg. C-{'�' 1� � 4. RECREATION DISTRICT FEES T eQtr k1gr -C) J\J i 10 9A105 (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) / ` 0-8. SMIP 9. DRAINAGE FEE 10.OTHER 11.OTHER At time of permit applit may be changed during APPLICANT /// I was advised the above fees are required to be paid prior to issuance of the permit. These fees DATE / (D—I � Y� Pursuant to Govemm�t Code Se966020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from th date of ap val of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 7/05) BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORINT )9:JEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE_ RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) . Assessor Parcel Number (s) _Mr/) - 6q0 ().q Building Permit Number 059M 3 Property Owner (s) A A 't N A h r Project Location /Address Subdivision Name Assessable Sq. Ftge 1440 Type of Residential Development (check one) New Development Single Family -Detached Alteration/Addition(s) Non -Residential to Residential Mobile home Mobile home replacement Dern,o Permit (date issued ) Comments: De-)artment 4. VFRRPEj ❑ CARD ❑ PRPD ❑ DRPD certifies that: Applicant Name Mailing Address Date Phone Number City Single Family -Attached Multi -Family Dwelling verified by Assessor Department verified by Building Department State Has comalied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ per unit for a total of Square Feet @ $ . per sq foot for a total of $ Zip Remarks: l�/LII/[��//LI/../I�L��1►>fr��;�/Jl�r(��[�rvi�.����w��.,�. -- — ---- va;,-t 1,-,, Check No: Paid by Cash: Receipt No: TRA 'Oq2- OCP BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District ��OV� lie1 Q �0� Building Department No. A.P. Number ��$y(} Q�� Jurisdiction: City County Property Owner Sny d-tr Property Location/Address ill 19 *r lJ V. Subdivision Lot No. Residential Development ID Ef Sq. Footage No of Living Mobile Home Addition/ _1440 'Supplemental to (Group. R) C Units S t'• �- Installation ,........................................................................................ Conversion Pefmit # '(No foundation inspection) Commercial/Industrial 0 New Buildin Department Repi4sentative strict Identification No.1L � b, r" jl� 0 Addition Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document). Sq. Footage (Including Exterior Roofed Areas) 10A9105 Date 0600.90 School District certifies that (Applicant) (City) (State) has complied with the requirements of Resolution No. representing `T 7 _ square feet. School District Representative Paid by Check # Remarks: (Phone Number) (Zip Code) by payment of $ A) 1 1,4 B 2926 $ ULL MITIGATION $ 16 i 9 Z6, Date / VL1U P, Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with Government Code Section 66020(a), within 90 days from the date fees aro paid. Failure to submit a timely written protest will prohibit you from challenging the ImposMion of the fees In any cotirt action. If, subsequent to the School District Representative signing this Buts County Schools Impact Fee Certification Form, the School District Is notified by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school ties to fully mitigate Its Impect on the school district's schools. White (school district), Yellow (building department), Pink (applicant) feeform.xla (3MS A I 1 T��►z�j...rSv� y�e.� �.rn____a'e-pJ ����, ,�„rrn ,._,.5;✓�, ,lL w� 1-f e�S`, U pDo��brrn pCc.�r�� c red l� e�rre�-Fo �'� 4 � •ry � r r` r l +"� f i. * � r � � t 1 1 "' t t a l • � ' v ' r �4 1. t OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner'builder building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed ' property improvement: YES K] NO [ J. 2. I HAVE [�G] HAVE NOT [ ] signed an application for a�building permit for the proposed work. 3. I have contracted with the following person (firm) to provide.the proposed construction: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 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: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION `BUILDING `GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a pennit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not cant' out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, AkyM:aeg� Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. q1 department of Public V s No C o u n t y o f B u t t e 0 LAND DEVELOPMENT DIVISION J. Michael Crump, DIl2Cto! Storm Water Management Program ! 01 /'7 County Center Drive Oroville, CA 95965 8 26b p g AU�C wolc (FAX) 538-7171 National Pollutant Discharge Elimination Systern (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 AMJ Project Description: )act On to/ +r►►� , �uN�G1—'� Project Location andlor Parcel Number: By signing below, L the project ownerlowner's agent, certify that this project WILL NOT DISTURB . 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board.. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project.' that disturbs one acre or more land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: Butte County Department of-Developr7ici2t Sel-wces o�`'�` , 0 7 County Center Drive Oroville, CA 95965 " m (530) 538-7601 Telephone �C'r,.. c-t� (530) 538-7785 Facsimile BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES' I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: ® 1 need to submit applications for septic and/or well to Butte County Environmental Health immediately. 6 1 am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained a 1 am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for* disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: <r) tlt�r APN: C3&-- Building site address: PenmitNo.: Q523 I have read, Wderstood and accept the terms and conditions as expressed herein as indicated by my submission QMe above -referenced building permit application and my signature below: SIGN'ATUREMF APPLI 10- i1 06 DATE •'6zording Requested By: Scott Kenneth Snyder WHEN RECORDED MAIL TO: Scott Kenneth Snyder Tracy Lyn Snyder 6337 Custer Lane Oroville, CA 95966 2005-0056752 Recorded I .REC FE. 1 .a� Official Records i'TAX v1. rad County of i .NONUNENT PRE ER i@.9@ Butte i i:44DACE J. 'GRUB63 i County Clerk-Recor'der i i I �A 05-.06Fllrl 20 -Sep -M i mane .1 of �Illfl! Ili � �illlil f��lfllll II alC�l : . A_P NO -o'036-291-045-000 DOCUMENTARY TRANSFER TAX $ ........... S..l..1.Q............................ YSPA/CBOVE THIS LINE FOR RECORDER'S USE ,X... Computed on the consideration or value of property conveyed; OR. ...... Computed on the consideration or value less liens or encumbrances --'remainmg-at'time of sale.-- signature recfarant o Aa� t &terrnining tax — Firm Name GRANT ED FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Herbert L. Lightle and Ruth A. Lightle.; Husband and Wife hereby GRANT(S) to Scott Kenneth Snyder and Tracy Lyn Snyder, Husband and Wife, as Joint Tenants the real property. in .the City of Orov i l l e County_of Butte ,State of California, described as See Attached Legal Description 94 ✓�, Dated . Sapt ember 1.5, 2 n 0 J } Herbert L. Lightle STATE OF CALIFORNIA }ss. COUNTY OF Buttp} On RepternhAr 1S, 2 0 0 5 before me, Penn r Rngl and , Nnf-ar3j Ptihl i C Ruth A. Lightle personally appeared _Herh mrt T, _ T.i gh 1 e and Rti#-h A•_ Tj ght-1 e personally known to me (or proved to me on the basis of satisfactory evidence) to be the persons) whose name(s) is/are subscribed to the within instrument and acknowledged tome that he/she/they executed the same. PENNY C. ENGLAND in his/her/their authorized capacity(es), and that by his/her/their signa-. Commission #14135804 A tures) on the Instrument the person(s) or the entity upon behalf of which o_ a Notary Public - Califomia r» the person(s) acted, executed the instrument. U Butte County WITNESS my nd nd official seal. My Comm. Exp. JAt�f 27, 2008 Signature MAIL TAX STATEMENTS TO: (chis area for official notarial seal) Real property in the City of Oroville, County of Butbe, State of California , described as follows: COMMENCING AT THE NORTHWEST CORNER OF THE SOUTH HALF OF THE NORTH HALF OF THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER OF SECTION 32, TOWNSHIP 19 NORTH, RANGE 4 EAST,' M.D.B. & M.; THENCE SOUTH 0 DEG. OT WEST ALONG THE NORTH AND SOUTH CENTERLINE OF SAID SOUTHWEST QUARTER, A DISTANCE OF 82.81 FEET TO THE TRUE POINT OF BEGINNING; THENCE FROM SAID TRUE POINT OF BEGINNING NORTH 88 DEG. W 30" EAST, A DISTANCE OF 542.56 FEET TO A POINT WHICH BEARS WEST, A DISTANCE OF 791.939 FEET FROM THE EAST LINE OF THE SOUTHWEST QUARTER OF SAID SECTION 32; THENCE SOUTH 0 DEG. OT WEST AND PARALLEL WITH THE EAST LINE OF THE SAID SOUTHWEST QUARTER, A DISTANCE OF 165.46 FEET, MORE OR LESS, TO THE NORTHEAST CORNER OF A PARCEL OF LAND DESCRIBED IN A DEED FROM WALTER L BRAY, ET — UX—TO-FRED HERZBERG,-ET-UXT-RECORDED-APRIL-27, -1962,—IN-BOOK-117-7, PAGE.331,..Ot-FICIAL RECORDS; THENCE WESTERLY ALONG THE NORTH LINE OF SAID HERZBERG PARCEL TO THE NORTHWEST CORNER THEREOF, SAID POINT BEING IN THE WEST LINE OF THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER OF SAID SECTION 32; THENCE ALONG SAID WEST LINE; NORTH 0 DEG. OT EAST, A DISTANCE OF 165.62 FEET TO THE TRUE POINT OF BEGINNING. EXCEPTING THEREFROM THE WEST 40 FEET THEREOF 4 APN: 036-291-045-000 14 0 DEPARTMEN-USEONLY STATE OF CALIFORNIA ,¢�0b DEPARTMENT USE ONLY BUSINESS. TRANSPORTATION AND HOUSING AGENCY B NEW DECAL S TRANS CODE DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DMSION OF CODES AND STANDARDS $� REGISTRATION AND TIT ING PROGRAM STICKER S APPLICATION FOR DUPLICATE �'I'S� CERTIFICATE OF TITLE oLDDECALa Name of Manufaclunar MFG ID S T defame Model Name or S Date of Mar ftetwo. CaW. Dealer License S Date of Transfer to Dealer from ILT Exemption MFG Dale First Sold New �� �` .�: ; �.{% . v` LENGTH WIDTH WEIGHT DATE FIRST SOLD DECALILICENSE S MANUFACTURER SERIAL NUMBER(S) HUD LABEL OR HCD INSIGNIAS (Inches) (Inches) (pounds) (H different limn above) l` L/ ADD UNITS USE CODE EXPIRATION DATE TAX TYPE ORIG COST PRICE CODE YR SALE PRICE PPF ILT EXT LPT PPT RF ❑ DEPARTMENT RECEIPT NUMBERS) RECEIPT DATES) CLERK'S MmALS SALE DATE ILT USE ONLY REGISTERED Last First Middle MRF PENI OWNER(S) [Print , �` ) d True Name(s)) PF_N2 MAILING ADDRESS Gty, Street . (. `) l .. 1 t r . t I . • Stam ` \ E J TRF 1 � � ' ! � ap 4 � LOCATION UNIT ADDRESS TOD LEGAL OWNER 7 _ r (P*dtmname) OUPT - kWLWNGADDRESS DUPR APPLICATION POR TRANSFER BY NEW OWNERS SUBD CONF Ime request that the new Certificate of Title and Registration Card to be hiSued as follows: REGISTERED Lam ` First MiddleIPO OWNER(S) [Print c. - !! EG true name(S)] a. ❑ JTRS ❑ TENCOM AND ❑ COMPRO T if check one of the following: TENCOM OR CillyMAUJNG Street C: T ADDRESS I LV7 FUTURE MARJNG RESS Streetcountyf�TP ZIP RT LOCATION ADDRESS Street j _ C V7 %� 'ii te �� • ( • ASF OFUNIT i i-f • CCP LEGAL OWNER (P*d true nRam) ❑ TENCOM OR ❑ JTRS ❑ TENCOM AND ❑ COMPRO TOTAL If check orae of the following: city Stam ZIP MAILING ADDRESS Street FIRST JUNIOR LIENHOLDER (Prkd true Aare) ❑ TENCOMOR ❑ JTRS ❑ TENCOM AND ❑ Comm B appfl cheek are of the foII : Gly Stam ZIP MAILING ADDRESS I street HCD 480A - Side 1 (:197) RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DMSION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 12 -Jan -2007 2007-0002254 Has not been compared With original BUTTE COUNTY COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. TRACY L. AND SCOTT K. SNYDER REAL PROPERTY OWNERILESSOR 6337 CUSTER LN. OROVII,LE BUTTE CA 95966 CITY COUNTY STATE ZIP SAME INSTALLATION MAILING ADDRESS, IF DIFFERENT SAME CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CrrY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 05-2883 530 538-7541 B G P N0. TELEPHONE NUMBER SIGNATURE OF' CAL AGENCY OFFICIAL DATE NONE �I DEALER NAME (if not a dealer sale, write "NONE") NONE _- DEALER LICENSE NO UNXN0WN 1979 0000 MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER C ' �' 2AB913091709 60' X 24' CAL145131/2 SERIAL. NUMBERS) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION CFF. ATTAC..HF.17 ASSESSORS PARCEL NUMBER 078-040-029 t HCD FORM 433(A) REV. 8/91 WHITE - County Recorder CANARY - HCD PINK -Applicant GOLDENROD -Building Dept. Real property in the City of Oroville, County of Butte, State of California , described as follows: COMMENCING AT THE NORTHWEST CORNER OF THE SOUTH HALF OF THE NORTH HALF OF THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER OF SECTION 32, TOWNSHIP 19 NORTH, RANGE 4 EAST, M.D.B. & M:; THENCE SOUTH 0 DEG. 07WEST ALONG THE NORTH AND SOUTH CENTERLINE OF SAID SOUTHWEST QUARTER, A DISTANCE OF 82.81 FEET TO THE TRUE POINT OF BEGINNING; THENCE FROM SAID TRUE POINT OF BEGINNING NORTH 88 DEG. 44' 30" EAST, A DISTANCE OF 542.56 FEET TO A POINT WHICH BEARS WEST, A DISTANCE OF 791.939 FEET FROM THE EAST LINE OF THE SOUTHWEST QUARTER OF SAID SECTION 32; THENCE SOUTH 0 DEG. OT WEST AND PARALLEL WITH THE EAST LINE OF THE SAID SOUTHWEST QUARTER, A DISTANCE OF 165.46 FEET, MORE OR LESS, TO THE NORTHEAST CORNER OF A PARCEL OF LAND DESCRIBED IN A DEED FROM WALTER L BRAY, ET UX, -T -A -FRED HER2 BERG,-EFU�-RECORD® L-2-1, -1-962--I"OOt-44-77, P-AGE.331,..OMCIAL - RECORDS; THENCE WESTERLY ALONG THE NORTH LINE OF SAID HERZBERG PARCEL TO THE NORTHWEST CORNER THEREOF, SAID POINT BEING IN THE WEST LINE OF THE SOUTHEAST QUARTER OF THE SOUTHWEST QUARTER OF SAID SECTION 32; THENCE ALONG SAID WEST LINE, NORTH 0 DEG: OT EAST, A DISTANCE OF 165.62 FEET TO THE TRUE POINT OF BEGINNING. EXCEPTING THEREFROM THE WEST 40 FEET THEREOF. APN: 036-291-045-000 � > BUILDING PERMITS NUMBER: 05-2883 Address or location of unit: 6337 CUSTER LN., OROVILLE CA 95966 Legal Description of Real Property: 078-040-029 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: TRACY L. AND SCOTT K. SNYDER Owner's address: 6337 CUSTER LN., OROVILLE CA 95966 INSIGNIA OR HUD NUMBER: CAL145131/2 SERIAL NUMBER OR V.I.N.: CAFL2A/B913091709 MANUFACTURER'S NAME: UNKNOWN YEAR 1979 OFFICIAL APPROVING INSTALLATION: DATE: % ' I O PHONE: (530) 538-7541 H.C.D. 513C Q Z3 31 y� parcel number site location . 036-291-045-000 6337 Custer lane owner name address Oroville, CA. 95966. ,phone# contact name&phone # Scott&Tracy Snyder Scott&Tracy Snyder 6337 Custer lane 6337 Custer lane Oroville, CA. 95966 Oroville, CA. 95966 530 534-8862 530 534-8862 SLOPE OF PROPER EWROP&ItNk HEALTH Cf: } ? 2 7C=TyCENTERDRN LN PROPOSEQ) DRY WELL DRIVE WAY - b h' i �9P��9P-9P—BP��6P�F9P—ik—BP—A l EXISTING RY WEAL EXISTING MARRIAGE LINE 8= = SEPTIC EXISTING STARTING FROM NORTH TANK DRY WELL -s9 O SOUTH ON CENTER it io z- 12" -11'-18-Z6'-39'-51'6"-59' ' OPOWER POLE " PROPOSED DOUBLE WIDE 24'X60' 1440 SF ON CONCRETE EXISTINGMOBILE BLOCK & 24"X24" 12'X 56'672 SF PLASTIC PADS TO BE REMOVED APPROVED DRIVE WAY 60' 0" i 60' 0" BEDROOM . 41 i 60' 0" MASTER BEDROOM 0 0 MASTER BATH m 0 W.H. o BEDROOM LIVING ROOM Oven 5 no 000 BEDROOM DINING ROOM KITCHEN C o ' r D olo o adz O� z MASTER BEDROOM 0 0 MASTER BATH m 0 W.H. o 27x 2"x 3/16" N STEEL ANGLE WW® C7 d m N u') m ao m w 1-4 cp DETAIL "A" CHASF4S FRAME 1/4" GRIPPER PLATE (2) REQUIRED 1/4" GRIPPER BASE t/2-i3UNC-A307 x 4" BOLT WITH NUTS (4) REQUIREO 01 1/2'° SCH 40 PIPE RISER WITH 81/2" ADJUSTER HOLES AND 3/b" THICK TOP PLATE 02" SC14 40 PIPE STAND WITH TWD 81/2" ADJUSTER HOLES Q ABESCO ABS PAD #503 -� STEEL FRAME SEE DETAIL "A"--!! 3/8" C40 PLATED BOLT, NUT & WASHER COUNTER BORED FLUSH WITH 90TTOM AT 8" O.C. (6) REQUIRED 1/4- STAND BASE Z- AIESCO ABS PAD #503 / 36" MAX TO BOTTOM OF PAD LOCK PIN WITH 81/6" BRIDGE PIN 37" COACH "C" FRAME 2" CHA14NEL 1 /4"x 1-1 /4r' T£K STS (2) REQUIRED 1/4- GRIPPER SASE 1/2" A307 BOLT (2) REQUIRED 3/8"x 6"x 6" STEEL PLATE 1/r A307 BOLT (2) REQUIRED —10.00 ---{ I 10.00 L,..A%, 89/16 HOLE (TYP) STi4ND BASE TOP VIEW TUF-1 PERMANENT FOUNDATION SYSTEM ABESCO-GUS GUARD COMPANY 5851 FLORIN - PF KiNS ROAD SACRAMEtdM, CA 95823 PH: (8.00) 382-8831 FAX: (916) 383-5207 1/4- GRIPPER PLATE C—BEAM ATTACHMENT - COACH "J" FRAME 1 /4"xl -1/4' TIT: STS (4) REQUIRED Tn J-BFA�I ATTACHMENT 1/4" GRIPPER BASE 1/2` A?07 BOLT (4) REQUIRED 4' �. g" 1/2" DIA. HOLE (8) PLACES — s0" STEEL FRAME TOP VIEW — (OF*Wgm* WAYNE T. POLVADO, PE—LISTING NO. F94249 SHEET I of 3 m m W (L 0 2 H 8 U) m Q ti m N U7 m CD m �o of u') m m u� m M N N am "Si t L GENERAL NO'S'ES GUS GUARD TUF-1 1. DESIGN LOADS: LIVE LOAD - 30 LB. FLOOR LIVE LOAD - 4G PSF HIND LCAD - BO MPH EXPOSURE "C" SEISMIC ZONE "4" * SNOW LOAD 100 PSF (SEE NOTE #15) 2. THIS FOUNDATION STEM IS DESIGNED TO BE COPISTRUCT'£D ON A FAIRLY LEVEL SITE WITH NO EXISTING SOIL PROBLEMS. 3. CHASSIS BEAN SUPPORTS SHALL BE LOCATED AMD SIZED FOR THE LOADS AS SHOWN IN THE "MOBILE HOME INSTALLATION INSTRUCTIONS'. S. IN AREAS WHERE DIFFERENTIAL SETTLEMENT (O.S.) CAN OCCUR, MANt;FACTURED HOME SHALL BE READJUSTED WHEN OS EXCEEDS 1/4", OR WHEN IT WILL ADVERSELY AFFECT MOBILE HOME UNIT. 5. CARRY ALL FOOTINGS DOWN TO FIRM, UNDISTURBED SOIL FOOTINGS ARE DESIGNED FOR 1,000 PSF TOTAL LOAD SOIL PRESSURE, AND SHALT. BE COJPATIBLE WITH LOCAL SOL. CONDITIONS. COMPACTED SAND MAY BE USEE, TO FILL LOCAL VOIDS UNDER MAS. 6. STRUCTURAL STEEL FABRICATED ACCORDING TO RISC SPECIFICATION. WELD ACCORDING TO ANS SPECIFICATIONS. ELECTRODa-370 PLATES -ASTM A36 BOLTS -SAE GR 5,ASTM A449=ASTM A3725. 7. THE GUS GUARD ASSEMBLIES SHOWN ON THIS PAGE SHALL. BE USTED AND LABELED BY 83K AND ISSOMATES FOR THE FOLLBMG LOADS: ALLOWABLE !&MS: HORIZONTAL VERTICAL GUS GUARD TUF-1 22005 6DOO# GUS GUARD MGP PAD 22005 6000# GUS GUARD E -Z TIE PAD 2200,8 60005 S. DURING PREUMINARY INSPECTION, THE ESTIMATOR SHALL ENSURE THkf'S MOBILE HOME CHASSIS BEAUS ARE OF STANDARD SECTION. 9. EXISTING COACHES MAY BE RETROFITTED TO RESIST SESMIC FORCES BY INSTALLING GUS GUARD TUF-1 UNITS A`.• SHOWN ON THIS PAGE Of TYPICAL FOUNDATION PLANS. 10. THE GUS GUARD TUF-i SYSTEMS ARE SAFE FOR INSTALLATION IN FLOOD PLAN AREAS WHERE DEPTH 0= FLOODING DOES NOT EXCEED THE HEIGHT OF THREE FEET. it. MULTIPLE UNIT INSTALLATION IS ACCEPTABLE PROVIDED THE NUMBER Of TUF—I UNITS UNDER EACH UNIT IS THE SAME AS SHOWN REQUIRED PER EACH UNIT. 12. SINGLE -IMIDE UNITS REQUIRE ADDITIONA'_ RESTRAINT. • (SEE SHEET #3).' 13. ALL IIETAL COMPONENTS AND A"ACHMENRI ITEMS SJALL BE P$OTECME CDATEC. 14. WHEN CONCRETE SLAB IS IN EXISTANCE, PAD IS NOT 16. FOUNDATION BLOCKS I Vx 16'x12' POURED IN PLACE AT GROUND LEVEL MAY BE USED AT INSTALLERS DISCRETION ALTER.gkIWE TC PADS. SINGLE WIDE COACHES DOUBLE/MULTIPLE COACHES E= 2' MIN. / 8' MAX. E= 2' MIN. / 11' MAX. S= 6' MIN. /16' MAX_ S= 6' MIN. / 22 MAX, �-- VARIES 10'-70' (SEE TABLE ON SHEET 93) -- --"� !+ E S. S u � u ❑ ❑ u RIDGE IF -AM SUPPORT AS REQUIRED BY MANUFACTURER El (TYPICAL) ❑ ❑ ❑ ❑❑❑a a' NOM. 2' TION_ ❑ PADS IN ANY PAIR MAY BE STANDARD M.H. FOUNDATION ROTATED 90 DEGREE'S OR PIERS AS RECOMMENDED BY PVC SERIES OFFSET TO OTHER SIDE TO THE MANUFACTURER OR THE SUPPORT AVOID CLEARANCE PROBLEMS. ENGINEER. TYPICAL THROUGHOUT PAD (TYP) 44 k Exp,. 400 ��91F OFf� "o;Ft�� REQUIRED. ANCHOR STAND 10 CONCRETE SLAB WITH TUF- 1 PERMANENT FOUR (4)• 1/27x 3 1/2" EXPANSION ANCHORS. FOUNOATiON SYSTEM 15. GUS GUARD TUF-1 FOUNDATION SYSTM PROVIDES ALLOWABLE SNOW LOAD TO SDO PSF WHEN INSTALLED ABISCO CjUS GUARD COWANY WITH EXISTING STANDARDS REQUIRED} BY COACH 5251 FLORIN - PERMS ROAD MANUFACTURER OR REPLACE THEM ON A ONE TO SACRANIEM-0, CA 95823 ON-- BASIS. PH: (800) 382-8831 FAX: (916) 363-5207 STATE APPROVAL IrQ WFALI'DRED fMMWMOMX 6=" FOUNIK'nON SYSTHIt 1TEALTH AND SAPBTY CODE, 88CffD03 JSW APP3t vw 811BT= TO C0RR6C'ilOEltbNM= ATT'ROVAL DOES NOT AUTBORM OXAFliRO'YM MW OATSSIONS OR 11BYIATION FMN RSQM=MB QF APPLICABLE STATE jAW9 AM LLAT gXW bhse oT C'.Ii6aQldi aT>3u�vat BY J :1-U,�� (dwalwo SPA N6, This Plan ApprovalExujm— WAYNE T. POLVADO, PE—LISTING NO. F94249 SHEET 2 o1 3 .. W Q d ti m 04 M m m m Lo of m CS) N N on CD l t s 1/2'x 3 1/2- - EXPAHSION ANC44OR (4) REQUIRED I i CONCRETE PAD INSTALLATION 1/4- GRIPPER PLATE (2) REQUIRED 1/4- GRIPPER BASE 1/2-13UNC-A337 x 4' BOLT WITH HUTS (4) REQUIRED 01 1/2" SCH 40 PIPE RISER WITH !o 01j2- ADJUSTER HOLES AND THI..K TOP PLATE o 02- SCH 4C PIPE STAND WITH TWA *1/2" ADJUSTER }IDLES �L ABESCQ ABS PAD X503 -� o 3/4' D'A. x 78- LG. 1/2"x 8- LONG (4) REQUIRED AdCHOR BOLT 3/.8- CAD PLAT£0 BOLT, NUT & WASHER (4) REQUIRED COURIER BORED FLUSH WITH BOTTOM AT 8" O.C. 1 (8) REQUREO POURED IN PLACE 16xlf-x12 CONCRETE 1 FOUNDATION INSTALLATION I I _ 36" MAX TO BOTTOU 407 PAD 01/2% 3" C.R. i LACK PIN WITH •'. O1/8- BRIDGE PIN E - Z TIE PAD I LIGHT HEAVY—WEIGHT PLASTIC PAD INSTALLATIDN KU=_w= U[TAQ'8 swGis vm mm lF1RGTHw HOME 24 WIDTH' 26 44 UP TO 44' 8 8 1 8 1.12 44 -1' to GWV 12 12 1 12 11 18 8b'-1' Ro ZR] 2t! 20 24 NUMBER OF TUF-1 REQUIRED NUMKR OF TUF-1 REQUIRED SINGLE WIDE LMIT4 REQUIK (4) E -Z TtE PADS. OJS GUARD 7UF-1 PIERS AF To BE PLACED AT APPTROXYMTEI-Y COUAL WnMYALS ALONG EKH FRA11E RAIL TUF-1 PERMANENT FOUNDATION SYSTEM ABESCR?GUS GUARD COMPANY 5951 FIARM - PFRY-NS ROAD SACRA2d.EN rO, CA 95923 PH: (800) 382-8831 FAX-. (916) 383-5207 STATE APPROVAL FOUNDAnON SYSnM ANG SAFMTCODB, SWnW 1!< l jenaVFD sUBu= TO c oRmcrtws pxm AL"ROVAL DOESS'NOT A". ORM OR A"ROVB A23Y P OMISSIONS OR DBVIA71ON FROM ]tFJQUIflE# ENTS Oi APPLICA LE STATS LAWS AND RWULA7lY I Surto of Cnlubralt to3 Camm =by DeFe m=l I1BB ATFIi $TAP}D '!� a NY I r`/ --DeA JF P !A 1 BPA IPO. ���oYYYf 5-44 Q4 i7iiaPlta Apyravtlli+�ira WAYNE T_ POLVADO, PE -LISTING NO. F94249 SHEET 3 of 3 LEt1= OF WM 'OF HOME WDAE 1 T2 - 14 18 UP TO 44 E 1 6 6 B 1%1' to 8 8 S S *6111 16 I i0 10 i0 NUMBER OF TUF-1 REQUIRED NUMKR OF TUF-1 REQUIRED SINGLE WIDE LMIT4 REQUIK (4) E -Z TtE PADS. OJS GUARD 7UF-1 PIERS AF To BE PLACED AT APPTROXYMTEI-Y COUAL WnMYALS ALONG EKH FRA11E RAIL TUF-1 PERMANENT FOUNDATION SYSTEM ABESCR?GUS GUARD COMPANY 5951 FIARM - PFRY-NS ROAD SACRA2d.EN rO, CA 95923 PH: (800) 382-8831 FAX-. (916) 383-5207 STATE APPROVAL FOUNDAnON SYSnM ANG SAFMTCODB, SWnW 1!< l jenaVFD sUBu= TO c oRmcrtws pxm AL"ROVAL DOESS'NOT A". ORM OR A"ROVB A23Y P OMISSIONS OR DBVIA71ON FROM ]tFJQUIflE# ENTS Oi APPLICA LE STATS LAWS AND RWULA7lY I Surto of Cnlubralt to3 Camm =by DeFe m=l I1BB ATFIi $TAP}D '!� a NY I r`/ --DeA JF P !A 1 BPA IPO. ���oYYYf 5-44 Q4 i7iiaPlta Apyravtlli+�ira WAYNE T_ POLVADO, PE -LISTING NO. F94249 SHEET 3 of 3 <- . DEPARTMENTUSE ONLY STATE OF CALUIORNIA DEPARTMENT USE ONLY TRANS CODE BUSINESS, TRANSPORTATION AND HOUSING AGEINCY NEW DECALS DEPARTMENT OF HOUSING AND C06OIUNRY DIVISION OF CODES AND STANDARDS REGISTRATION AND TIILMG PROGRAM STS= APPLICATION FOR DUPLICATE SOC CERTIFICATE OF TITLE O1D°L' Name of M nufRCWtar memo FlULT—EQwwom Date of Mauch m CaBf. DeaIwLIcwmai DateofTmNowtooeawft e Date Fine! Sold Naw 1_ i --r -, ., MFG �.-t.:, c7�ii��%-7 DECALA ICENSE 0 MANUFACTURER SERIAL NU 03ERIS) HUD LABEL OR HCD IfSIGIM S LENGTH (Lath-) vnm (Incite-) WEIGHT (pounds) DATE FIRST (r cI t rwA than ahow) F 1 Lc -I c li r fit . : . ELI Z z r_ i L . ';-r C IS I fit GfLf� ADD UNITS DEPARTMENT USE ONLY BECODE ELATION DATE --TAX TYPE - -ORIG COST PRICE CODE YR SALE PRICE PPF ILT EXT LPT PPP RIF RECEIPT NUMBERS) RECEIPT DATES) CLERK'S SALE DATE IL.T REGISTERED OWNER(S) [Print True Name(s)] Last ! Feat "'� Mldc fa PENT PE N2 MAKMG ADDRESS LOCATION ADDRESS OF UNIT Sheet . ` stab StmatC� State f1, 3 TRF LEGAL OWNERTOO 44P(p�tdtraenanh) C�'A " r' DUPT MARAGADDRESS Sheet . 7 ' :e Ia �i ( DUPR APPLICATION FOR TRANSFER BY NEW OWNERS We request that the new CeWficate of 71tde and RegLstradon Card to be issued as follows: sued t oNF REGISTERED OWNERS){Print true name(sq Last Fag Srddb RREG RSF r thdt o'ae otUh t . ❑ TE NCM OR mim ❑ TE NCOM MLD ❑ comma PLT MAD.MGADORESS MNUNG ADDRESS LOCATION ADDRESS Stnsat i -� _ Cft State •: , t2IQ CIS- SITFUTURE State all Shan! ' . " , j C , r �r - \ �— r7 (� ; i ). . 1 ( ttlP Na Strut'' q(y Camly Sfata r Z<➢ 9 ' f • UL�i % Int ASPOFUWT LEGAL OWNER ��; % CCP r ah koxmm tthe : U TE NCOMOR U im L.! 7EINCOMAND u COSIPRo TtnAL NALLMG ADDRESS Shad aly Stats ZIP FIRST JUNIOR v' LIENHOLDER (ptidtnhchme) - r --Oro orals u tnawr uec u . uco MAWNGADDRESS I Sheet COY State 2>)f HCI) 480A - Stria 10197) PERMIT NO. 6166-77P,E PERMIT EXPIRES OQ OWNER Louie Baker CONTR. owner LOCATION (A.P. ZXKM .36-291-45 6337 Custer Lane, OroviEe Temp. Power Pole Called PG&E Temp. Elec. Serv. , Called PG&E Tmle. Gas Serv. alled PG&E - JO B FINALED (Date) r (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS N �. BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING SeNpack I Afewall S I Plelna rvr PafQpets At Floor Mai Bidg. Rest om Finish 2n Floor Fo tins Windo 3rd Noor Stem all SidingTo out Slab Root Shea in Water PI I Piers Rooting Sewer GarageFdn. Vents Fixtures Footincis StemwaII Garage Vents Insulation Water Htr. Heaters Slab Carport Footings V Prov. for ph sical handica ed Conformance of ex. structure V Appliances Gas Pi in JL T..* Temp. Gas Slab A Final Sanitation Patio RE ACE Final Footin s Footing E ECTRIC L Masonry Walls Throat Rou h Reint. Steel Final 4 Fixtures Bond Bea FIRE SPRINKLE& Motors Mesh MECHANICAL Grd. F941t Prot. Scra h I HeatII6 Servl 56 Brq4n I Coo ng T mp. Pole Finish DiAts ifiderground In rior Lath entilation Permanent oor Closer Final inal MOBILEHOMEUTILITIES -------- Elec. Service c2 Elec. Pedestal Water ng a Sewer Gas Piping QNILEHOME INS TALLAT� - - - - - - - - - - - - - - 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.) MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobi'lehome located* h required separation from lot lines and buildings and generally conform to plot plan? Yes ,' No 2. Does the mobilehome have.required clearances above ground? (Sec.5085) Yes -k No i 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) YesNo 4. Is the mobilehome level? (Sec. 5088) Yes`�o No 5. If -.man than a single unit,_.axee crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID mJin.)? (Sec. 5566) Yes�No F B. Test - Does water piping withstand working pressure or 50 lbs. air test? YesATIo C. Ba is not State of—Cal.iffoo nia approved, does station have backflow device and pressure -relief valve? Yes_ No 7.. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes[ No B. Does it have minimum k" per foot slope and is it properly supported? Yes X No 7� C. Are'any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes_ NOX D. If\�is n t—Ste—of--Ga-l-if-ornia.a-pproved, _does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mob'le'home 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? Ye� No W'f' �' MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobi'lehome located* h required separation from lot lines and buildings and generally conform to plot plan? Yes ,' No 2. Does the mobilehome have.required clearances above ground? (Sec.5085) Yes -k No i 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) YesNo 4. Is the mobilehome level? (Sec. 5088) Yes`�o No 5. If -.man than a single unit,_.axee crossover connections properly installed? (Sec. 5088) Yes No 6. Water A. Is flexible connector of adequate size and properly installed (1/2" ID mJin.)? (Sec. 5566) Yes�No F B. Test - Does water piping withstand working pressure or 50 lbs. air test? YesATIo C. Ba is not State of—Cal.iffoo nia approved, does station have backflow device and pressure -relief valve? Yes_ No 7.. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes[ No B. Does it have minimum k" per foot slope and is it properly supported? Yes X No 7� C. Are'any leaks detected in drainage system after running 3 -gallons of water through each fixture including washing machine standpipe? Yes_ NOX D. If\�is n t—Ste—of--Ga-l-if-ornia.a-pproved, _does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mob'le'home 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? Ye� No • s'i?. 9. Electrical A. Is service large enough to provide adequate amperage-to mobilehome (must equal rating of mobilehome with a minimum o4,,,1.00 amp) and other facilities on lot, i.e., water pumps, garage, cabana, etc.? Yes ANo i B. Is there proper clearances around panels? Yes No� C. Is power supply cord,or feeder assembly properly fused? Yes No D. Is continuity test satisfactory as per the following procedure? Yes No 1. De-energize electrical wiring system 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. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle 7 Length 402 Width 2,7-�- Vehicle Serial No. State Identification No. Additional Information or Comments: -f� COUNTY OF BUTTE* DbOARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This .mobilehome has been installed in accordance withtherequirements of the California Administrative Code, Title 25, Chapter 5, under permit number for the following location: Owner Owner's Address Mobilehome Mfg. 1 Model Year L77 Insignia No. �ll� 07Sya 6Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director f Public Works Date THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS �. 7 County Center Drive. — Urovilie, California 95965 r ~ja Telephone: 534-4541 APPLICATION AND PERMIT ,".� .7 , / Date " T Sij(nature off PergK444- agent Receipt No. p0t7-J/`7 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. tQIRE T OF PU LIC WORKS B Date v 8permit expires Date Z—'Z-62 BUILDING Owner OLD V le SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. Contractor al Valuation Mai I Ing Address �U replace mit Fee n Checking Fee &/or Penalty phoneN .mit Fee Building Address PLUMBING No.1 @ I FEE PERMIT FILING FEE J$3.001 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 vi.,Each gas water heater or vent 1.50 A. P. No. -�' Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s 4aai4a4ef1 FireDept. FireZone Use Permit Building sewer 5.00 EQA ParkingParcel Plans Declaration Parcel Ma P 60' R/W Im provements Lawn sprinkler system 2.00 Bldg. Plah Rev'd P a r c e rovoI PI pprovaI Permit Fee $ NEW❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 — Main service aoov OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD•L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home 01101, Others ❑ OVER 600V Main service 00 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NE W OR ADONS. ( ACCLBLOGS.CONST. DWELING CCUP. &) 22sgft NEWCONSTR. MULTI -OUTLET NON •RESID, BRANCH CIRCUITS) 12.50ea NEW CONSTR /POWER APPARATUS & NON.RESI.D. \SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am elicense under the provisions of Chapter Div. 3, of the State ornia Business & ofessions C der a name St Ie Y C1 Ex. Occup(OUTLETS OR FIXTURES) BAL FIXED APPLNS. OR Ex. Occu p.(ou T L E TS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 / �-^— License No. [B /- 3 Classificatio 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 Wor en'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.1 @ FEEPERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Pe mit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize represe fives of the C ty of Butte to enter upon the ,,,,- — — "_ __,•,k_- , ��� __.______ �r V8 TOTAL PERMIT FEE Is This permit is hereby issued under the applicable provisions of ,".� .7 , / Date " T Sij(nature off PergK444- agent Receipt No. p0t7-J/`7 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. tQIRE T OF PU LIC WORKS B Date v 8permit expires Date Z—'Z-62 MOBILE EO�90,SI.LPPORT DATA: Mobilehome Mf Setup Model No. Year Width w� (ft.) Length (ft.) Expando `Size ft. (Draw support details below) . On all mobilehomej"'manufactured after October 7, 1973, furnish manufacturer's installation r manual and structural setup sheets :(if. not .on .file with the .County of Butte) . `Tf center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COON 1 r 8UILDING DEPARTMW APPROV A/ Slm le. Footing6--(check.one; 1. Wood 'either pressure treated or. a� Center Center Support fdn; ':grade.:: SaUppo* Footing Sizes Locati s (in.) .. :. /,d(,.2.::Concrete pad. x 3. :Other, :specify in. an. in. --�. — — Supports (check one) /'Concrete block 2. Concrete piers - / / 3. Steel piers Other, specify -j ................ ,. _.� ......... Typical Support g . Footing Size (in.)`(in.) 0 -... ..... �. Pier'..... .. _ , . Spacing ���• - in. J l ft. in.) (in. in.Max ) ( Overhang `Tf center piers are other than drawn above, draw in locations, spacing, and dimensions. BUTTE COON 1 r 8UILDING DEPARTMW APPROV 1. Owner's name: 2. Installer's na M BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville,.CA. PHONE: 534-4541 � MOBILEHOME INSTALLATION SHEET 3. Is the site currently under permit? Yes /y/ No (If yes, furnish permit number ) OR Is the site an existing.site? Yes / / No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes /.// No ( If no, clarify ) 5. What is the mobilehome electrical rating? ----------------------- �Amps 6. What is the mobilehome site service rating? --------------------- Zim Amps /� �� 7. What is the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes /"-/ (If yes, identify the load and size: (Load) No (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- 10. What is the type of gas service? ----------------------------- Natural / / LPG / 11. What is the gas pipe length from meter or tank to the mobilehome? /D (ft.) 12. :What is the mobilehome gas demand? ------------------------------ (BTU) (This,information not° required if pipe length less than 6 ft. on natural gas or less�'than,50 ft: on LPG,) I _ COUNTY.OF BUTTE — DEPARTMENT OF PUBLIC WORKS �f 7 County Center Dcive -1 Orovi Ile, California 95965 /,�,7 '�17/ Telephone: 534-4541 EL/ APPLICATION AND PERMIT , aU UIUI I Le IeflfeSUIIidIIVeS or the county or Butte to enter upon the above-mentioned property for inspection purposes. Jf -l—oa Date Signature of Permiitee 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 paid. DIRECTOR OF UBLIC WORKS BY —Date-/ 77 vuiicding permit expires Date I a" - 37-7? BUILDING OwnerLowe S0. FT. OCC. BUILDING VALUATION Mailing Address 6,1531 V S fJ t' \ Telephone No0 61 Fireplace Contractor v� Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 10 C) Each Trap 1.50 Repair drainage or vent piping 1.50 _ dV l I 5@9 V'erIRcafion Onl Water piping 1.50 . 0 Each gas water heater or vent 1.50 P. No. `T ,02& j Zonin Gas piping system 1 - 5 outlets 1.50 , 0(.)A. Each additional outlet .30 F Sa FireDept. Fire Zone Use Permit Building sewer 5.00 j)© EQA Parking Declarration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Bldg. Pla s Recd Parce Approval / Plans Approval Permit Fee ,$ ©0 $ 3 1 NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE J$3.00 Main service 1000 AMP ORV OR LESS5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 00 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 SQ. Ft. MINIMUM NEW CONS.SOU OR ADDNST ( LINGDWEACCLBLDGS.CCUP. &) 22sgft NON-RESID R ( BRANCH CIRCUITS) 2.50ea EQR_ MOBILES NEW CONSTR. POWER APPARATUS & NON-RESID. (SINGLE OUTET 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) BAL@1 Oq 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 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. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 1 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.1 @ I FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT F E L aU UIUI I Le IeflfeSUIIidIIVeS or the county or Butte to enter upon the above-mentioned property for inspection purposes. Jf -l—oa Date Signature of Permiitee 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 paid. DIRECTOR OF UBLIC WORKS BY —Date-/ 77 vuiicding permit expires Date I a" - 37-7? OTE: --;ill Materials & Workmanship Shall Be in ccordcnce �ii'i:, ltecognizeJ Good Practices and I a qualry ;%rescribed f'or the Specified use in the niform l uiong, Plumbing & Mechanical Codes and, 9e National Electrical Code. This set of plans and specifications !UST kept on, the iob 4t a'J ti—cs c.n : 11 is unlaw'l: mal;n any ch:::nr -� 0� r1i; rations on s3 ne without wri*en porr.-;is:ion from the Department'of Pub lic Works, County, of Butte. M 4A4 /C. 134ke-o- 1 P .bE- 36- a9/ •- 4 S 5 0.' A perm t will be requir Dd for the WCHat on of the mo ilehome. �Jerk7= ohb&?7 ' . All utility connections `shall 6e p Y - St �* located within 4 ft. outside the rear e icss-tem-p d s third section of the mobile home f i" taW to be as per ' on the left (road) side of the mobile Butte County Health Dept, Re- i home. quirements. ''' i� I The ft. Setback sha0 6e S' ft. frorn th6 4 -side property lire and 50 ft, from the centerline of the road, permitting a' maxi- mum of a 2 ft.*eave overhang but entirely' o out of all easements. d � BUTTE COUNTY BUILDING DEPARTMENT APPROVED COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER - 2457/-1�, ZONING ,�'%e/�%�'�� BUILDING PERMIT OWNER r n ��r/ TELEPHONE 60 r f1 S `7 f�J/bt SO. FT. OCC. BUILDING VALUATION /4/\�t//' r' OC ,1-.,J 7S MAILING AD-DR;frESS CONTRACTOR'S NAME 1./1}/ 10/ j-'' �j'. )t TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER (lIt4 y UNKNOWN Q Total Valuation $ FilingFee $ 10.0 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER VIII LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS 7 A( E PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 VILt ie Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets X USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑(s1"'Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New❑ Addition❑ Remodel❑ Utilitiesg- Installation❑ Other❑ Describe work: 1XJ571)1 L AIA T_ CA(/5 /�`G%� y)f 1 C.LESS K1,S17A, "� 44 / - l �+�JG. � �/"Lt ,/ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 600V OR Main service 100 AMP ORS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.( DWELLING OCCUP,aJ) OR ADDNS. ACC. BLDGS. I 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business50 and Professions Code and my license is in full force and effect. License No. Classification [� I, as the cwner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. TI -OUTLET NON-RESID BRANCH CIRCUITS) 2,50 ea NEW CONSTPOWER APPARATUS &) NON- RRESID. (SINGLE OUTLET CIR. Ex. Occup(Ts OR FIXTURES @ 25¢ BAL@10¢ FIXED Ex. Occup.(ouTLETS PR (RESID.)EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 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 shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the 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, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. �--�{ �� -%� X �rr-� Date Signature of Applicant - Owner Contractor ❑ Agent ❑ ion of structures over 3 stories in height. An OSHA permit is required for excavations over 5'0" deep and demolition or construct-*_�t= Mobile Home Installation Fee $ TOTAL PERMIT FEE $ 20. 0-0 OCCUP. GROUP I TYPE of CONST. PARCEL Po HD 99UE This permit is hereby issued under the applicable provi- sions,of the Butte County Code and/or resolutions to do work' indicated above for which fees have been paid. OF PUBLIC WORKS B _ Date y PERMIT EXPIRES Date /' Receipt No. 53 991 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT LOUIE BAKER 6337 Custer Lane, Oroville Permit#2555-81P(gas line) 9 I' ` C J; COUNTY OF BUTTE - DEPARTMENT OF PUBLIC /4-4541 PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 91[�� (�L�tt�.—Q / APPLICATION AND PERMIT ASS ESS9LR. PARCEVy MBE —Z /— ZO G 7�/VI� BUILDING PERMIT OW ER aff 8 /-?KC T LE Ho ✓3 8g SQ. FT. OCC. BUILDING VALUATION O 6 315 MAILING AES; CONTRACTOR'S NAM .. TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION L I ER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR E INEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BU e 3 DDRESS ^ t /� !/!i_K/� /V PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex[-] Mobilehomeg?"11"Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ / Remodel ❑ Utilities 0' Installation❑ Other ❑ Describe work: �.//JS/� z_(_ xlm— !:,qs n�r-,o .- / C/l/�/ �/) �� A/ - �: (/c-.G/—Ci4 Permit Fee $ od Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 ° NEW CONST. ( DWELLING OCCUP.DI\ OR ADDNS. ACC. BLOGS. I 2� sq ft 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 m license is in full force and effect. y License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEw CONSTR TI -OUTLET 2.50 ea NON.RESI.. BRANCH CIRC TS NEW CONSTR POWER APPARATUS S NON.RESID. SINGLE OUTLET CIR. 1 @ 25¢ Ex. EX. OCCup�OUTLETS OR FIXTURES BAL@100 IXED APPLNS. OR EX. OCCUp.�OUTLETS (RESID,) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIirig Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating . Cooling Hood 3.00 Ventilation permit Fee $ Contractor 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, judgments, costs, and expenses which may in any way accrue against s id County in consequence offttpe granting of this permit. r �/� Date 7— X.i2y' of Applicant - Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct-MCTOR ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ 2Q. o d OCCUP. GROUP I TYPE OF CONST. [___]PARCELJ PD 1 HF SSUE This permit is hereby issued under si*ftheButte County Code and/or wod above for which OF PUBLIC By. PERMIT EXPIRES Date ----7- the applicable provi- resolutions to doSignature fees have been paid. WORKS Date Receipt NO. �91 p WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT