HomeMy WebLinkAbout078-050-024i
AP 3 07 V 05-6-1naY
RI RD GRAEFF
6317 coin Blvd., Oroville
Perm it ?.-75P,E(util., MH)
ELEC .
GAS - V7
SUPPORT STRU RE REQ. &0
A Vi � - -a
4
CONTR: Leonard's Service ara, i #
Permit# 656-75MHI t-�NAL �-
Issued
r
P -
Dave Rad or
6317 Lincoln Blv roville
ontr: Acro-Lume, Orovi
Per it #6494-76 ( esu awning/
N
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62GvarvtJ .
ab die r_ s
631'ncoln Blvd., Oroville 1�
`contr:_vis Const., Oroville
Permit #52`0*-80P,E(qitil. ,MH)
ELEC./O--7/-$ 2ooh
GAS
SUPPORT STRUCTUE REQ.
COMPACTION TEST REQ.
Contr : Linco4tvilbge Mobile HomE
Pssmit# x'33-80MHI
I �1,� A9 c2
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PERMIT NO. 5205-80P,E
PERMIT EXPIRES 642 101x1
OWNER Bob J. Myers
CONTR. Davis -Construction Co., Oroville
ASSESSOR PARCEL 36-292-34
LOCATION 6317 Lincoln Blvd., Oroville
Temp. Power Pole_
Called PG&E _
Temp. Elec. Service
Called PG&E-2Temp. Gas ServI_
Called /G&E
/a / z -7/k'r)
JOBJFIA(Date) !/ "o, ILILED�6)
Signature
= OK
Not OK
= Not Applicable" MOBILEHOMES
= Not Ready
MISCELLANEOUS
Date
MOBILE OME UTILITIES (Plans) OK except q's
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
4—'Zoning Requirements—Setbacks—Easements -
1. Zoning Requirements—Setbacks—Easements
q-150-ils; Special MH Support—Sketch
2, Footings; Size—Depth—Spacing—Connectors
ewer; Location—Test—Fall-C/0—Concrete
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
Water; Location—Test—Easement Needed (Sketch)
4. Wood Awn.; Posts—Beams—Rfirs.—Connec.—Shthg.—Rfg.—Bracing
lectricity; Location—Clearances—Grnd.—/2ff-/ Amp—Concrete
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
Gas'.Locatiort—Test—Wrap:/ /"L"ft./ /"Nat. /"L" ft./ LPG
6. Carports; Windows—Doors
7 tility Clearance
7. Elec.
44
Card -BI
Date Card -BI Date
Card- Date d Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILE OME INSTALLATION (Plans) OK except H's
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except H's
oning Requirements—Setbacks—Easements
1. Setbacks—Easements
9---F-66tings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
as; MH Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
Electricity; MH Test—Crossovers—Breakers—Clearances
rain MH Test—Fall—Flex Connector
4. Elec.; Receptacles and Lighting; Distances—GFI
5. Elec.; Pool Lighting; 15 volts—GFI
fir; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
Wa!6r and Sewer Connected—C/0 to Grade—HD Approval
7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
'@'�Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes— Enc losures—PaneIboards— Ins. to Main in Conduit
Exits; Insp.—Sketch s tog Z
1 ert. of Occupancy G
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
Card B -I
Datee� Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
J = OK
0 = Not OK
- = Not Applicable
= Not Ready
w/
RESIDENTIAL, (Single and Duplex)
Date
UNDERFLOOR Plans OK except #'s
Date
FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
48.
49.
Property Line Firewall & Openings
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
51.
52.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Siding -Nailing -Veneer
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7.
Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
8. D.W.V.: Fall -Fittings -Test -2 way C/0 -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
FINAL (Plans) OK except q's
56. Ext. Steps -Door & Sidelight Protection -Landings
Card -BI
Date
Date Card -BI Date
PLUMBING (Permit) OK except H's
14. Water Ht.; Vent -Access -Combustion Air
57.
Smoke Detector
58.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
_
15. Water Pipe; Test & Anchors -Nail Protection
16.
D.W.V.; Test-Fttngs & Anchors -Nail Protection
59.
Bedroom Exiting
17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except H's
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
20. Fixture &Transformer Clearance -Ins. Protection
21.
Elec. Receptacles Spacing -Lights & Switches at Doors
70.
Plb., Elec. & Mech. Equip. Listed for Location
22.
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23.
Romex Installed Close to Edge of Studs & C.J.
72.
Insulation -Foam -Looked in Attic ❑Yes
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
73.
Guard Rails & Deck Construction -Post Caps
25.
2 Appliance Circuits in Kitchen & Conductor Size
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI,
Insulated Neutral ❑Yes ❑No
75.
Following instid.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters El Yes 0 N
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
77.
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -BI Date
81.
82.
83.
84.
85.
Ventilation throughout House
Glass Protection
Corrections from Previous Inspections
Gas Test -Meters Tagged; Gas -Electric
Water & Sewer Connected -C/O to Grade -HD Approval
Card B -I Date Card -BI Date
Date MECHANICAL (Permit) OK except N's
31. A.C. Ducts; Insulation & Support
32.
Vent Fan; Exhaust above Insulation
86.
Energy Compliance Certificate -Other Certificates
33.
Condensate Drain & Overflow; Size & Grade
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35. Attic Access & Platform if Furnace in Attic
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
FRAMING(Plans) OK except q's
Card -BI
Comments
Date Card -BI Date
at Final:
36. Sills; Proper Material & Anchors
37.
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing Walls over Girders & Floor Nailing
Y
-38.
39.
Draft Stop in Walls (rat proof)
40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
_
41.
Header & Beam -Size & Bearing
_
42.
43.
44.
Hangers -Post Caps -Anchors -Connectors
Cing. Joist-Rftr Ties - Purl in - Roof Brac.-Truss-Shthng.-Rfng. _
Fireplace Ties or Type A Flue -Fireplace Throat
45,
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
46.
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
47.
Garage Fire Protection Framing E]�]
(NOTE:Anentrymust be made each time youvisit jobsite)
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the California Administrative Code, Title 25, Chapter 5, under permit
number for the following location:
Owner-
Owner's
wner Owner's Address f 7-2 f -4i
Mobilehome Mfg. r' Model !' �-a Year�yovy
Insignia No.—/ * r �� Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Director of Public Works
Date �a! 2 7l By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - Owner, Yellow - Installer, Pink - D.P.W.
Y
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1. Is the mobilehome located with equired separation from lot lines and buildings and generally
conform to plot plan? Yes o
2. Does the mobilehome have requited clearances above ground? (Sec. 5085) Yes�/1Go
3. Are footings and supports.properly sized, spaced, and braced as peapproved plans? (Note
possible variation at spring shackles.) (Sec. 5082 & 5083) Yes_ No
4. Is the mobilehome level? (Sec. 5088) Yeso_
5. If mor than a single unit, are crossover connections properly installed? (Sec. 5088)
Yes_
6. Water
A. Is fle le 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 v No
C. Backflow - If coach is not State of Ca ' ornia 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 '" per foot slope and is it properly supported? Yes_ No
C. Are any leaks detected in drainage system after running,3 allons of water through each
fixture including washing machine standpipe?.Yes No
If coach is not State of California approved, 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 n more than 6 ft. long? Note: All piping�is to be at least as
large as the mobile a gas line inlet without reductions other than the mobilehome
connector. Yes o
B. Test OK aser following procedure? YesZ�
P g P _
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? YesZ IN
9.
Electrical
A. Is service large enough to provide adequate amperage -to mobilehome (must equal rating of
mobilehome with a minimum of 140 amp) and other facilities on lot, i.e., water pumps,
garage, cabana, etc.? Yes' No_
B. Is there proper clearances around panels? Yes W/ No_
C. Is power supply cord or feeder assembly properly fused? Yes ✓No
IZ
D. Is continuity test satisfactory as per the following procedure? Yes_,,= -No
1. De -energize electrical wiring system of the mobilehome at the pedestal.
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 theelectrical 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 O
Manufacturer and/or Namestyle
Length 116 Width_
Vehicle Serial No. 0 � X 3 -,V-,g
State Identification No.
Additional Information or Comments:
►'
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKY PERMIT NO.
• r 7 County Centej.Drive - Oroville, California 95965 - Telephone 916/53 -4541 _
APPLICATION AND PERMIT r_ h
ASSESSOR PARCEL N M'BER
o L- -a o
ZO JJG
BUILDING PE
--
OWNER
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S M6LI �A KESS
()vIL31 o ��
D vL
C NTRA �TO 'S NAME/
LC CL L
TELEP ONE
CONTRACTOR'S M (LING ADDRESS
Ala,, 01co u 0c; 0.0, 9.s9 6
CONSTRUCTION LEN
UNKNOWN
Fireplace
Total Valuation $
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
�—
LICENSE NO.
Plan Checking Fee `+
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDI G ADDRESSL
, v a9 L N J2 COQ , __i�'rL
PLUMBING PERMIT
Filing Fee 3.00
��
t^ ) N )) ,.� )UC—
Each Trap
2.00
Repair drainage or vent piping
2.00
_
1— �C
Water piping
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehompk' Other
SPECIFY
Building sewer
Lawn sprinkler system
2.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑
Describe work: —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 3.00
Main service jp0 AMP ORV OR LESS5.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ACG. BLOGS.
20 sq ft
CONTRACTORS LICENSE LAW
declare under penalty of perjury .(Check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professiorls� ode/ my license is in fulJ�f orae end effect.
�� / [!1 (n /
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. MULTI -OUTLET 2.SOea
NON -RES,., BRANCH CIRCUITS)
NEW CON ST R.POWER APPARATUS 6
NON-RESID. (SINGLE OUTLET CIR.
EX. OCCUp(OUTLETS OR FIXTURES 50 25C
BALNIOQ
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID.I EA. 2.00
)
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 6.25
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 3.00
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
yy� 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
2.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to 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
st aid County in conse e e of the granting of this permit.
X ate p�oZ
ignature of Appli ant — Owner ❑ Contract -A Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
of structures over 3 stories in height.
Mobile Home Installation Fee $
Land Development Fee $
TOTAL PERMIT FEE $
OCCUR. GROUP
I TYPE OF CONST.
PARCEL
PD HD
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTO OF PUBLIC
BY
PEdMKT EXPIRES Date�OrTi��Y
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Datef��z7��o
l
LHion
ceipt No. 440 �Z
TE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS :.
7 County Center Drive, Oroville, CA.
PHONE: 534-4541
MOBILEHOME INSTALLATION SHEET
1. Owner's name: 13 ® ?n C V
2. Installer's name: 4gLn1 V/ U�p 19 1.
3. Is the site currently under permit? Yet ice/ No
(If yes, furnish permit number ) •'OR
Is the site an existing site? Yes _1 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? --------------------- Amps
7.. What is the mobilehome site circuit breaker rating? ---------------
_0 Q Amps
8. Is there any other electric load.to be served by the mobilehome
siteservice? ---------------------------------------=----------- Yes No
(If yes, identify the load and size: (Load) —&—_(Amps)
9. What is the mobilehome site gas pipe size? ------------------=
10. What is the type of gas service? ----------------------------- LPG,/
11. What is the gas.pipe length from meter or tank to the mobilehome? (f t.)
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.)
All center supports measured from front of
MOBILEHOME SUPPORT DATA
mobilehome unless otherwise specified.
If "other, than single wide,
ro
Mobilehome Mfr. L;/ /"I C9�)
,J�,
furnish Setup Model No. �
Year
Width•(ft.) Box Length
1410
(ft.) Tagalong or Expando Size_ft.
t.
(SHOW SUPPORT DETAILS
BELOW)
pressure treated or
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).
All center supports measured from front of
mobilehome unless otherwise specified.
Footings (check one)
Single
1. Wood either
pressure treated or
foundation grade.
(ft.)(in.)
• n
(in.) (1 •)
2. Other' (specify)❑
Center support
locations*
Center support
footing sizes
Supports (check one)
IOL 7
(in.)
1: Concrete block.
(�� �
�
❑ 2. Other (specify)
(ft.)(in.)
(in.) (in.)
M•v`
<---Tagalong or Expando,:
show support details.
(ft.)(in.)
(in.) (in.)
/c2 Q --
Typical Support
(in.) (in.)
Footing Size
/ vex
(in.) (in.)
Max.. Pier Spacing
(ft.)(in.)
*If center piers are other than drawn above,
draw in -locations, spacing, and dimensions.
Max. Overhang
(ft.)(in.)
53-3 3 �D
BUTTE COUNTY
BUILDING DEPARTMENT
.APPROVED
Z�Z
COUNTY OF BUTTE - DEPARTIEI`T OF PUBLIC WORKS PERMIT NO. n
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4 1
APPLICATION -AND PERMIT VVV
AS$OR L yU�@E
((!![[JJ Z _LJ
ZONIpf$/
(/�I
BUILDING PERMI
D"' b /W 1
HONE
SQ. FT. OCC. BUILDING
VALUATION
OWNER'S MAILING ADDRESS
D7/O�0A1 U,
SR'S NAM
TEL P
D(�Nyy/L
R/
CONTRACTOR'S MAILING
(03fEC/_1/
leo
CONSTRUCTION LENDER I�
UNKNOWN
Fireplace
Total Valuation Is
LENDER'S MAILING ADDRESS''
Permit Fee
$
ARCHITECT OR EN7j��,r /��
1/
LICENSE NO.
Plan Checking Fee
$ e
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUIL INA ESS / /®�
(/_ �L p,
PLUMBING PERMIT
Filing Fee j,000
Each Trap
2.00
Repair drainage or vent piping
2.00
40 i4(Jo
Water piping
A 've)
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
2.00
Gas piping system 1 - 5 outlets
V -QQ
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome Other
SPECIFY
Building sewer
IQ e00
Lawn sprinkler system
2.00
TYPE OF WORK
New❑ Addition❑ Remodel[] Utilities ff S Installation❑ Other ❑
Describe work: —
Permit Fee
$ �Q
Contractor
ELECTRICAL PERMIT
Filing Fee Z)OO
Main service 100 AMP OR01V OR LESS___5.00
S—off
Main service EA. ADD'L 100 AMP
2.50 Z_&-7
NEW CONST. DWELING
OR ADDNS. ( ACCL SLOGS.CCUP.&)
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check one):
fA 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
�,SLicense No. 314 Z.[9 Classification N .
❑ 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 U TI -OUTLET
NO 2,50 ea
N.RESID BRANCH CIRC ITS
NEW CONSTR ( POWER APPARATUS &)
NON.RESID. SINGLE OUTLET CIR. /
so@zsa
Ex. Occup(OUTLETS OR FIXTURES BAL�10Q
APP LNS. OR
Ex. Occup.(FIXEEDDOUTLETS (RESID.) EA,) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00 ,00
Misc. Wiring 6.25
Permit Fee $ , �Q
Contractor
MECHANICAL PERMIT
FiIingFee 3.00
WORKMEN'S COMPENSATION INSURANCE
1 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
2.00
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
1 also agree to save, indemnify and keep harmless the County of Butte against
all Iiabilitie , judgments, osts, and expenses which may in any way accrue
against sal oun in co equence of the granting of this permit.
Signature of Applicant - Owner El Contractor i& 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 $
Land Development Fee $
r
TOTAL PERMIT FEE $ 8 , 70
OCCUP. GROUP
I TYPE OF CONST,
JPARCE
✓/
1,,PJ
HD
o/
ISsuE
y/
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIREC OR OF PUBLIC
By
P T EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
J
Receipt No.
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
PI4T ;?dIpWfsrinls S, Workma
• �AccQrdance' writh ^, a.. „ ►-r Workmanship. Shall Be in
This set •of plans dnd specifications MUST 66 !n n �d Good Practices and, -
of on the job at all rimes and if il tlalgwful t o_ Qf a vic,1 v preser►++00.1 -r,- &L
any c on9-es or.c torr+: �` '- nt .ortrt'' ui. in • Plurn6ing & Machanical Codes a d
on$ on some without 9.
tteapermissia rom the-}men��f �ak�lic� /�cG�;�(: a�? Vional Electrical Co"J.
orks, County of Butte, ,
\
A set ack of 5 ft. fromt e
pr �� ty ines and setba
of � . f rim the roe d
center ;ne s`,all be cIQ of
structes or equipment except-----
for a 2 ft. ave overhang.
rV
I
!'
,
r--�i
--~rfity connections shall be wW;-,,
4'ft: of the mcb;lchome, eii
directly b,:;iind o: within tl— . :.r
half oC t6 roadside (left) of the
mobilehome.
go
? - BUTTE COUNTY
B�} tDIZ!G DcPARTMENI
APPROVE
►,�`/" �3•R h � � . 2 +r • � <,i' •. r"' M* f . 7. * - +� t stet a
¢ A.�Illn'�f' X?�`;, �� �`'� _ '"'�'� �'�����'t. ew��.�' Jr�..r• .z, i��e' 1� +ri'.+4;1.'ss i .
PERMIT NO. 6494-76B
PERMIT EXPIRES
OWNER Dave Radford
CONTR. Acro -Lune, Oroville
LOCATION (A.P. 36-292-34
6317 Lincoln Blvd., Oroville
0
C
w
4
2�
o
Temp. Power Pole_
Called PG&E _
Temp. Elec. Serv._
Called PG&E _
Temp. Gas Serv. _
Called PG&E
JOB
FINALED
(Date)
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
StemwaII
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwal I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Prov. for physically
handica ped
Conformance of ex.
structure.
Appliances
Gas Piping& Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rou h
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE REMARKS OR CORRECTIONS
%1/317-7
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE — 'DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Telephone: .534-4541
APPLICATION AND PERMIT
�9y
icN cacn�auves UI Me wun(y UI Butte to enter upon the
above-mentioned pro ,erty fo inspection purposes.
XDate//—aG-76
Signature ermitee or Agent
Receipt No. �5 - 7/1
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/oR OF PUBLIC WORKS
BYDate
wilding perLtexp�iresate ��� "
BUILDING
OwnerSQ.
ve zi-4 D 2 "
FT. OCC. BUILDING VALUATION
41 wU
1
Mailing Address
B 9 C, /L. C. C
Telephone No.
Fireplace
Contractor 2
Total Valuation
Mai I i ng Address 7i `'�
Permit Fee �^ u
PI anCheckingFee &/orPenal ty
C�QD IJiLCr� (p Lim .
Telephone No.
-C,yi
Permit Fee ea-._�
!fie
/
Building Address /
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Cd pts/LLt r
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No.Gas
Zoning &Planning
piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
W Sa& n Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma p
60' R/W
Im r
p ovements
Lawn sprinkler system 2.00
0d . �vf3"`Rec'd Parcel Approval
Plans �pproval
Permit Fee $
$
NEW ® ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service io°°V OR L o AMP ORLESS5.00
Main service EA. ADD'L too AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home ® Others ❑
R 60
Main service 1OOOEAMP OR LESS 25.00
Main service EA. ADD'L too AMP 1.00
/j� �, N l'v/
�J (/
NEW CONST. DWELLING OCCUP. &
OR ADDNS. ACC. BLDGS. ) 22sq ft
NEW CONSTR MULTI -OUTLET
NON-RESID. BRANCH CIRCUITS) 2.50ea
NEW CONSTR. POWER APPARATUS &)
NON•RESI D. (SINGLE OUTLET CIR.
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of Cali ornia Business & Professions Code under the name
style of: /
Ex. Occup(OUTLETS OR FIXTURES) @ 250
Occu FIXED APPLNS. OR
Ex. Occup. (RESID.) EA) 2.00
Temporary service 10.00
•
Mobile Home Facilities 15.00
License No.077y 5 / Classification
Misc. Wiring 6.25
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
I 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.
4V1 I have placed on file with the County of Butte a certificate of
y-tJ Workmen's Compensation Insurance.
{� In I certify that in the performance of the work for which this
ermit 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 $
$
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 FEE
$ 7 00
icN cacn�auves UI Me wun(y UI Butte to enter upon the
above-mentioned pro ,erty fo inspection purposes.
XDate//—aG-76
Signature ermitee or Agent
Receipt No. �5 - 7/1
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/oR OF PUBLIC WORKS
BYDate
wilding perLtexp�iresate ��� "
., PERMIT NO' 142-75P,E
P
E
M
MH UTIL.
PERMIT NO.
k
PERMIT EXPIRES 17f— -76
OWNER Richard Graeff r,
CONTR.
LOCATION (A.P. 36-2.92-34 )
63t;rLincoln Blvd., Oroville
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E
JOB �J
FINALED_ �'�S °� (�V*0
(Date)
(Signature)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback Firewall Soil Piping
Forms Parapets 1st Floor
Main Bldg. Restroom Finish 2nd Floor
Footings Windows 3rd Floor
Stemwall Siding To out
{ Slab Roof Sheathing Water PipingcS
Piers Roofing Sewer pZ 5
Garage Fdn. Vents Fixtures
Footings Garage Vents Water Htr.
Stemwall Prov. for physically Heaters
Slab handicapped Appliances
Carport Conformance of ex. Gas Piping & Test
Footings structure Temp. Gas
Slab Final Sanitation
Patio FIREPLACE Final 5�
Footings Footing ELECTRICAL
Masonry Walls Throat Rough
Reinf. Steel Final Fixtures
Bond Beam FIRE SPRINKLERS Motors
Framing Test Water Htr.
Stucco Final Subpanels
Mesh MECHANICAL Grd. Fault Prot.
Scratch Heating Service
Brown Cooling Temp. Pole
Finish Ducts Underground
Interior Lath Ventilation Permanent
Door Closer Final Final --�
DATE REMARKS OR CORRECTIONS
4
J
MOBILEHOME INSTALLATION INSPECTION CHECK LIST
1. Is the mobilehome located wit '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 L --'No
3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note
possible variation at spring shackles.) (Sec'. 5082 &.5083) Yes_ 4o
4. Is the mobilehome level? (Sec. 5088) Yes',j,No
5. If mor a single unit, are crossover connections properly installed? (Sec. 5088)
Yes !/ No
6. Water
A. Is fle ible 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? YeS4--11N0
C. Backflow - If coach is not State of California 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.e'ach end? Yes/",.- No
B. Does it have minimum 4" per foot slope and is it properly supported? Yes No
C. Are any leaks detected in drainage system after runnjng 3 -gallons of water through each
fixture including washing machine standpipe7, .Yes I- No
D. If coach is not State of California approved, 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
Targe as the mobil 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? Yesjo_
9. --Electrical - _ .. _..-._ _ . ._ .. . - ._--• .--,__-_ __._ . __-.__ _ ._._.._..._� __
A. Is service'.large enough to provide adequate amperage to mobilehome (must equal rating of
mobilehome with a minimum of �00 amp) and other facilities on lot, i.e., water pumps,
garage, cabana, etc.? Yes �/ No
B. Is there proper clearances around panels? Yes_l,.,/No
C., Is power supply cord or feeder assembly properly fused? Yes VINO_
D.' Is continuity test satisfactory as per the following procedure? Yes P No_
1. De -energize electrical wiring system of the mobilehome at the pedestal.
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
Length Width'.
Vehicle Serial No.
State Identification No.
Additional Information or Comments:
y
im
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC W
7 County Center Drive — Oroville, California 95965 1Q
Telephone: 534T4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date Z-27-75'
Sign re of Permiiltee or Agent
Receipt No. - �-�_�_7�^--�p2 \
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 PUBLIC WORKS
By - Date _,3 .r -2s
wilding permit expires Date ..................��-3
BUILDING
Owner
Mailing Address
SQ. FT. OCC. BUILDING VALUATION
Telephone No.
Fireplace
Contractor C,
Total Valuation
Mailing Address a
Permit Fee
Plan Checking Fee&/or Penalty
elep;on; No.
Permit Fee
$
$
Building AddressPLUMBING
No.
@ FEE
PERMIT FILING FEE $2.00
Each Trap 1.50
Repair drainage or vent piping
1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No._.
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
F s
ire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
IParking
Plans
Parcel
Declaration
Parcel Mah
60' R/W
Im rovements
P
Lawn sprinkler system 2.00
Bldg. PI ec'd
Parcel 4pproval
Planproval
Permit Fee
$
$
NEW ADDITION ❑ UT LITIE ❑ OTHER
ELECTRICAL
No.1
@ FEE
PERMIT FILING FEE $3.00
,JdX1 'Zk 'a
Main service incl. 1 meter
A01 C
Additional meters, each
1.00
Sub -panel (12 or less) (more than 12)
Single F ily ❑ Duplex ❑ Mobil Home Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures 20025
Receps., switches & fix outlets
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:
f, Ep�✓�9�D C446"Q U/SS
Hood, Ex. Fan or F.A. Furn. Motor
1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No.2?098'/Misc.
Classification
wiring
❑ 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.
lecertify 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 OrdinancesTOTAL
and State Laws relating to building construction, and hereby
14
—31--9a
PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date Z-27-75'
Sign re of Permiiltee or Agent
Receipt No. - �-�_�_7�^--�p2 \
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 PUBLIC WORKS
By - Date _,3 .r -2s
wilding permit expires Date ..................��-3
Ir r COUNTY OF BUTTE - Department of Public Works
r � 7 County Center Drive, Oroville, California
�.`
r- • PHONE: 534-4541
?I 7
1.
2.
3.
4.
5.
6.
7,
Lffl
MOBILEIiOME INSTALLATION INFORMATION
Lot Facilities
Plot plan dimensioned, location of mobile
and utility connections?
Yes No
Electrical. service equipment ampacity-A0
Circuit breaker ampacity /C 0
Permanent Wiring Connection 0
Ampacity
Receptacle -rapacity
Gas: Natural LPG
Gas -riser size
Drain inlet size '
t•7ater riser size
Are utility connections located outside
the rear 1/3 of the mobilehome within
4 feet of the left wall? Yes_ No
If not, show dimensions. above.
Is the mobilehome clear of septic tank,
leach fields and located outside public
utility easements? Yes_ No
Do you propose to do other work on the
property other than the mobilehome
installation which will require a permit`s
Yes No X
If so, specify
Mobilehome Data
1. Length yQ , Width
Manufacturer
Vehicle Serial No.
Insignia Control No. J. Srj,/114 0 d�
2. Feeder assembly ampaci'ty /42D A/Ve
-Conduit size
Power supply cord (amps) `
3. Gas inlet size�'�
Mobilehome connecto4 size
Capacity --
4. Drain connector: describe on reverse side
5. Water connector: describe on'reverse side
6. Designed loads: A4 °ccVG4 7996
Roof live load a o sf. .
Wind load X_psf. .
(only for mo i ehomes manufactured after
October 7, 1973)
7. Manufacturer's installation instructions?
Yes No
8. Will the mobile home be installed on a.
separate support structure?
Yes No ✓
-For plans and specifications of support system, see other side.
x
r -y
Aosua _/d //
••..tea ��� a�`d��. �.
LOAD BEARING
SUPPORTS.
ADDITIONAL CO1�D!.'7,;TS
Drain Connector, Describe
t
Water Connector, Describe �� 0a
LO,0 BEt2,.ING SUPPORT AND -?0 TING IK 0:A1ATION
Pier Spacing.Used //- 5
Maximum Pier Loader p n
Maximum Column Load (multi -units only)
Soil Bearing Capacity.
Footing Din:'ensi on Used
TYPE OF PIER. USED
Steel Concrete Concrete Block
Other
TYPE OF FOOTING MATERIA
Pressure Treated Wood
Concrete
Redwood (Grade)
Other Approved Type
toy a,
BUTTE COUNTY
OUILMNtG DERE• F-7w.4'IT
APPROVED
edd
el
COUNTY,OF BUTTE — DEPARTMENT OF PUBLIC WORKS
j 7 County Center Drive — Oroville, California 95965
Tel ephpns: 5344541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above -me "oned property for inspection purposes.
X ZiLdDate
Signature of Permitee-- 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 PUBLIC WORKS
B Date f`�� 7
Building permit expires Date .............../:.: ......� .
BUILDING
Owner EFF
SQ. FT. OCC. BUILDING VALUATION
Mailing Address MOA/TE 1,11$7_)1 /%/,E
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$
$
Building Address�� �V�
PLUMBING
No.
@
FEE
PERMIT FILING FEE $2.00
.00
Each Trap 1.50
Repair drainage or vent piping
1.50
Water piping 1.50
/,;570
Each gas water heater or vent 1.50
3_
A. P. No. oZ iv(
Zani P n
Gas piping system 1 - 5 outlets
1.50
/,5 0
Each additional outlet .30
F' sSa i tion Fire Dept. Fire Zone Use Permit
EQA IParking Parcel Parcel Ma 60' R/W Improvements
Plans Declaration p provements
Building sewer 5.00
10
Lawn sprinkler system 2.00
��Permit
P s Recd
Parcel Approval
Plans Approval
Fee
$
.00
$
NEW ❑ ADDITION ❑ UTILITIES 2S OTHER ❑
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00®O
Main service incl. 1 meter
< <n O
Additional meters, each
1.00
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Sub -panel (12 or less) (more than 12)
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures 10to
Receps., switches & fix outlets
A
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:
Hood, Ex. Fan or F.A. Furn. Motor
1.00
Evap. cooler, gar. di sp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
5.0
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
-oc 14 1 am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I 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.
.4 1�l R( 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.
@
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
TOTAL PERMIT FEE
Is
<Q1 0�
authorize representatives of the County of Butte to enter upon the
above -me "oned property for inspection purposes.
X ZiLdDate
Signature of Permitee-- 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 PUBLIC WORKS
B Date f`�� 7
Building permit expires Date .............../:.: ......� .
This set of plans an MUST be
kept on the job at all times and it is unlawful to BUTTF_ COUNTY
awake any changes or alterations on sarae without BUILDING DEPARTMENT
written permisson from the Department of Public '
. Works, County -of Butte. APPROVED
•