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079-200-019
Bed I IU V -1511 i6w ,contr: Lloyd's Elec. , Orov:ille Permit #I1f 7-79E(elec. & yard light/ i_1 3 o I t' W OW1�ER JO� SCHURR /•}�%� 19 Phaeton Way, lot 19, Oroville Contr\ Oroville TrailerSales Permit#360-80MHI issued y contr: Sierra Mobile Serv.ice,._.Paradi Permit #741-80B(n w carport & covered deck/MH) %�a_/�,2 01-0360 SCRO INS, CHARLES 2663 PHA N DR., OROVILLE�i CONTR:OWN NEW STORAGE BLD r 0`79 -2.00-- 019 i9. P onWa 9 Orov i e Warre -1-4 T. Ambrose 2663 S_ Permit #513-79P(util.,MH ELEC. / - (- ffo 097 GABS -� -- D S`TPPO�: f- STRUCTUIE REQ. 4. COMPAM.TON TEST REO, '7J'd r IU V -1511 i6w ,contr: Lloyd's Elec. , Orov:ille Permit #I1f 7-79E(elec. & yard light/ i_1 3 o I t' W OW1�ER JO� SCHURR /•}�%� 19 Phaeton Way, lot 19, Oroville Contr\ Oroville TrailerSales Permit#360-80MHI issued y contr: Sierra Mobile Serv.ice,._.Paradi Permit #741-80B(n w carport & covered deck/MH) %�a_/�,2 01-0360 SCRO INS, CHARLES 2663 PHA N DR., OROVILLE�i CONTR:OWN NEW STORAGE BLD r 0`79 -2.00-- 019 i9. P onWa 9 Orov i e IU V -1511 i6w ,contr: Lloyd's Elec. , Orov:ille Permit #I1f 7-79E(elec. & yard light/ i_1 3 o I t' W OW1�ER JO� SCHURR /•}�%� 19 Phaeton Way, lot 19, Oroville Contr\ Oroville TrailerSales Permit#360-80MHI issued y contr: Sierra Mobile Serv.ice,._.Paradi Permit #741-80B(n w carport & covered deck/MH) %�a_/�,2 01-0360 SCRO INS, CHARLES 2663 PHA N DR., OROVILLE�i CONTR:OWN NEW STORAGE BLD r 0`79 -2.00-- 019 i9. r 1 NOTES r� Y r� t r, i RESIDENTIAL 036-780-019 01-0360 SCROGGINS, CHARLES 26631PHAETON DR., OROVILLE CONTR: OWNER NEW STORAGE BLDG SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) 2 �� Signature ,/ = OK , 0 = Not OK ' - = Not Applicable MOBILE HOMES . = Not Ready Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete MISCELLANEOUS f Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s 4. Water; Location -Test -Easement Needed (Sketch) 2. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /'L',ft./ PLPG 5. 7. Well Clearance & Disconnect Carports; Windows -Doors 8. Utility Clearance 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing Date Ext.; Steps -Doors -Landings Card B-1 Date Card B-1 Date 6. Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 1. Zoning Requirements -Setbacks -Easements Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit 2. Footings; Size -Spacing -Marriage Line Health Department Approval 3. Gas; MH Test -Demand -Valve -Connector Plumb.; Cir. Test -Water Supply Test 4. Electricity; MH Test -Crossovers -Breakers -Clearances Light Niche 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval Card B-1 Date Card B-1 8. Gas and Electricity Tagged Card B-1 Date Card B-1 9. Tie Downs -Type -Installation Can. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 12. Permanent Foundation Only; License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS f Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s l 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining , 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ✓ = OK 0 = Not OK - = Not Applicable = Not Ready FRAMING (Permit) OK except #'s RESIDENTIAL (; Date 41. Underfloor (Plans) OK except #'s 42. 1. Zoning -Setbacks -Easements -Flood -Slope Draft Stop in Walls (rat proof) 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 45. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4. Fig., Porches & Decks; Soils -Steel-/ P' Ftg. Depth Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 5. Stemwalls, Main; Steel-Blockouts-Wrapped Garage Fire Protection Framing 6. Stemwalls, Garage; Steel-Blockouts-Wrapped Property Line Firewall & Openings 6a. Hold Downs and Special Anchors Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 7. Slab, Steel -Wrapped Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 8. Piers -Fireplace Ftg.-Steel Plywood on Rocf Overhang -Attic Vents -Rafter Outriggers 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test Siding -Nailing Veneer 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 11. Water Pipe; Test -Anchors -Regulator -Service Test Glazing Area -Glass Protection -Skylights -Plastic 12. Electric Underground Shear Walls; Nailing -Bolts 13. Plenums & Ducts; Clearance -Material -Support -Ins. Brace Interior/Exterior Wall Panels 14. Girders -Sills -Anchor Bolts -Joists- Vent s-Crippies Insulation -Walls -Ceilings 15. Access & Ventilation Infiltration -Walls -Windows 16. Insulation Date Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings 17. Water Htr.; Vent -Access -Combustion Air Baffle Smoke Detector 18. Water Pipe; Test & Anchor -Nail Protection Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection Bedroom Exiting 20. Shower Pan; Test, First Floor -Tub Access G.F.I. & Bath Fixtures & Tub Access -Spa 21. Test Tub & Shower, Second Floor -Tub Access Elec. Trim & Subpanel, Breaker Sizes & Labels - 22. Gas Pipe; Sixe & Anchors Stairs & Rails 70. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Elec. Outlets & Receptacles at Kit. Counter 23. Fixture & Transformer Clearance -Ins. Protection Garage Fire Door; Swing -Landing -Closure 24. Elec. Receptacles Spacing -Lights & Switches at Doors A.C. Duct in Garage -Damper 25. Size Boxes & No. of Conductors Stapled Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Romex Installed Close to Edge of Studs & C.J. Plb., Elec. & Mech. Equip. Listed for Location 27. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Elec. Receptacles in Garage (F.F.I.)-Romex Protection 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI Insulation -Foam -Looked in Attic 29. Subieed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or At Guard Rails & Deck Construction -Post Caps 30. Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or At Insulated Neutral ❑ Yes O No Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Service -Riser Conductors & Ground Main Disconnect Clearance Looked under Floor ❑ Yes 32. Equip. Clearances Panels-Motors-Mech. Equip. Following Instld./Drive D Yes J No/Walks J Yes J No/Planters J Yes J No 33. Clothes Closet Light -Shower Light -Spa Light Stucco Brown -Finish 34. Smoke Detector A.C. Unit Disconnect, Electrical -Plumbing 85. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Ventilation Throughout House 35. A.C. Ducts Insulation & Support Glass Protection 36. Vent Fan, Exhaust above insulation Corrections from Previous Inspections 37. Condensate Drain & Overflow, Size & Grade Gas Test -Meters Tagged, Gas -Electric 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet Water & Sewer Connected -C/O to Grade -HD Approval 39. Attic Access & Platform if Furnace in Attic Energy Compliance Certificate -Other Certificates 94. Address Posted Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 40. Sills Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing :e tin jle & Duplex)-"' Date FRAMING (Continued)41 46. Hangers -Post Caps -Anchors -'Connectors 47. Cling. Joist-- Rftr.�Ties- Purliri-Roll Brac.-Truss-Shting.-Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Rocf Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels - 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixi. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 82. Following Instld./Drive D Yes J No/Walks J Yes J No/Planters J Yes J No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Goof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: COUNTY OF BJJTTE --DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-7541 PER T NO. (Rev. 12/96) APPLICATION ANDOERMIT %® ASSESSOR PARCEL NUMBER 036-780-019 =opub BUILDING PERMIT OWNER SCROGGINS CHARLES TELEPHONE 533-4355 SO. FT. OCC. BUILDING VALUATION 190 11 3,420-00 . OWNERS MAIUNO ADDRESS 2663 PHAErON DR., OROVILLE CA 95966 CONTRACTORSNAME 0 W LV1:J.\ TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Pian CheckingFee $ BUILDING ADDRESS 2663 PHAETON DR.. OROVILLE CA 95966 Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehom Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Oth Describe Work: STORAGE 10 X 10 + 12 X 7 1 1/2= 190 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 41n PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o.A OR LESS 23.00 LICENSED CONTRACTOR'S 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 the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: /tI, 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. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑' 1 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. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed If the permit Is for work of a valuation of one hundred dollars ($100) or less.) 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 workers' compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall orthwith comply with those provisions. n X G✓ Date � ` Z',Z- _yt Signature of Applicant - Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction®, of structures over 3 stories in height. Main Service Tow TO 46.00so CCU000A NEW CONST. DWELLING OCCUP. OR ADDNS. ( DT ACC. S. SO 3.50FT. NNONN-REBIIDD T. MU LT0.OIJTLET @7.50 POWE. APPARATUS 8 SINGLE OUTLET CR ZO @ L'50 Ex. Occup. OUTLET OR FORURES eAL @ ,50 Ex. Occup. 0 (RRM .ok 5.00 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE = 25.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FE I: $ Mobile Home Installation Fee $ Energy Inspection Fee $ oc T. TOTAL FEE $ 148.95 MAZ. D. FEES I FLOOD C ' P EL r pp D This permit is hereby Issued under the of the Butte County Code and/or indicated e o whi h fees have By PERMIT EXPIRES ON applicable provisions Resolutions to do work been paid. Date a Receipt No. 314679 / $ 148.95 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT iA:. 4 le:�J 'ay i'''A• �+e:. ,ti,. ti: .9 iii". Wyk:+; 't' LY COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER:5MirJ _ S ASSESSOR PAR ER: Proposed Building Use: Q Building Inspector: Date- j At time of permit application, was a ' ed the following data mutt b9 submitted prior to permit processing and/or issuance: Date Received By ❑ . All items have been submitted .-------------------------------------------------------------------------------=- Plot plans, 3/4 sets, signed by the preparer of plans. ----------------- ------------------------------------------- Complete plans, 3/4 sets, signed by the preparer of plans. --------------------------------- - ❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans - -------- "05. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! 06. Energy Design Compliance and supporting documentation. 117. Statement of Intent for Non -Heated and A/C Buildings. ---- ❑ 8. Hazardous Material Form, ------------------------------------------------------------------------ jOrImpactufactured H d t and installation instructions including Tie Down Specifications. of$----------------------------------------------- fees as shown on the attached schedule. ----------------------------------------------- ❑ 12. California Department of Forestry plan approval/fees. ❑ 13. Flood elevation certificate. ------------------------------• ❑ 14. Sanitation and plot plan approval Health Department. ❑ 15. City of Chico plumbing permit- ------------------------------ -------- 1116. ------ ❑16. Plot plan and business license approval from the City of Biggs. --- ❑ 17. Planning`approval for (A) Use: (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel.----------------- 1119. ---------------- ❑19. Encroachment Permit for driveway (construction approval prior to occupancy). --------; ------------ ❑20. Pre -inspection for required. Request to Building Inspector on E12 1. Contractor's license information. (Number, Name Style, Classification).------------------=---------- orkers' Compensation carrier and policy number: --------------------- ------------------------------------- er-Builder Verification (Given to owner ❑, Mailed to owner ❑),-------`_�t------- 1254Letter �----------- of signature authorization.------------------------------------------------------- _____-________------ ❑ 25. Recorded copy of Agricultural Acknowledgment Statement- ------------------- =-------------- 026. Letter of intent on building use.------------------------------------------------------------------------- 0 - -• ❑27. Manufactured Home utility clearance.----------------------------------------'----------------____-------____-- ❑28. Existing violations and/or expired permits--------- --=------------------------------------------------------------ 029. E1433 A, ❑Grant Deed, E M.H. Title, O Check to H.C.D $--------------- -� 030. Other: , r • When you issuethe -.J t, p zs as o ow ail to owner, ❑ a l/t�j c� j �t t r. elephone v and hold for pickup at /�VV V v ,ice. ❑ Deliver with inspector. (Date) Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Departmen , ❑ Air Pollution Date: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index pen -nit application for the above a items numbered: ❑ Plan Check List 2. Additional items required: ! Contractor, designer, owner, was advised -of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buil ivision counter, by Da Plans reviewed by: Date: Plans approved by: Date: 6 Sets of plans on holdin ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: VAInw r-1 — n.-.,4--+ 0—.:--- T]--_1 J__ — T'_-' -' •---------' ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel.----------------- 1119. ---------------- ❑19. Encroachment Permit for driveway (construction approval prior to occupancy). --------; ------------ ❑20. Pre -inspection for required. Request to Building Inspector on E12 1. Contractor's license information. (Number, Name Style, Classification).------------------=---------- orkers' Compensation carrier and policy number: --------------------- ------------------------------------- er-Builder Verification (Given to owner ❑, Mailed to owner ❑),-------`_�t------- 1254Letter �----------- of signature authorization.------------------------------------------------------- _____-________------ ❑ 25. Recorded copy of Agricultural Acknowledgment Statement- ------------------- =-------------- 026. Letter of intent on building use.------------------------------------------------------------------------- 0 - -• ❑27. Manufactured Home utility clearance.----------------------------------------'----------------____-------____-- ❑28. Existing violations and/or expired permits--------- --=------------------------------------------------------------ 029. E1433 A, ❑Grant Deed, E M.H. Title, O Check to H.C.D $--------------- -� 030. Other: , r • When you issuethe -.J t, p zs as o ow ail to owner, ❑ a l/t�j c� j �t t r. elephone v and hold for pickup at /�VV V v ,ice. ❑ Deliver with inspector. (Date) Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Departmen , ❑ Air Pollution Date: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index pen -nit application for the above a items numbered: ❑ Plan Check List 2. Additional items required: ! Contractor, designer, owner, was advised -of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Buil ivision counter, by Da Plans reviewed by: Date: Plans approved by: Date: 6 Sets of plans on holdin ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: VAInw r-1 — n.-.,4--+ 0—.:--- T]--_1 J__ — T'_-' -' Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major lad dr and materials for construction of the proposed property improvement: YES[ (,f NO[ ]. 2. I HAVE[ V1 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: 11�x ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. ` 4. I plan to provide portions of this work, but I have hired the following person` to coordinate, supervise, and provide the major, work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the follo*i ,persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: Ul�t r�PROPERTY OWNER: ' SO OBER: DAM-2- NOTE: ATE:2- 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. Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. f For your protection, you should be aware that as "owner -builder" you are the re! sponsible party of record on such a permit. Building permits are not required to be signed by property owners unless they ae personally performing their own work.. If your `work is being performed by 'someone other than yourself, you 'niay�_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 yoii plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family! and the work (including materials and other costs) is $300 or more for the entire project, and such peisons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments I 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. 0 There may be financial risks for'you if you do not carry out these obligations,'and :these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract 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 Ithe 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 contractors is to secure an "ownerbuilder" 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm. that you are aware of these matters. The building permit will not be issued until. the verification is returned. C. Vi f ira, C.B.O. . , Building Inspection NOTE: This Owner -Builder Information is required by Section -19830 of the California Health and SafetyCode. i ?. , " .- .r - I rf — .-.4s — — 0 — , . -- v 7Z L 0 C.<5 YJ N 12 2 COUNTY IvIsit"JA C 0 14 C R LZ- T- L-- 9; LA) (--' 1/z zc�lc i � COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE �-- -* r cn a -// -, OWNER PERf;4;RN6. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please ntact this office immediately. Date �— �- Inspector REV 10/92 2663 Phaeton view: 3/20/01 Page 3 2663 Phaeton view: view: view: 3/20/01 Page 2 e\ 4 k 4 1::�Ljc 2663 Phaeton 3/20/01 Page 1 �. __ 26 view: view: T./���, <� ®AV0/ ,tr n tt view: view: 3/20/01 Page 1 PERMIT NO 741-80,B PERMIT EXPIRES MY OWNER John Schurr Sierra Mobile Sev; Paradise CONTR. 'LOCATION (A.P. 8-12-19 2663 Phaeton Day, Oroville Temp. ower Pole Ca PG&E Temp. Elec. Serv. --alled PG&E Te p. Gas Serv. Called PG&E LQ o J B INALED- (Date)..9 (Signature*W COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) Setback Firewall Forms Parapets Main Bldg. Restroom Finish Footings Windows StemwaI l Sidin Slab Roof Sheathing Piers Roofing Garage Fdn. Vents ZQ Footings. Garage Vents' Stemwa l l Insulation Slab Carport F o o t i n g s Prov. for ph sically handica ed Conformance of ex. CIA-' ZZ6 YO s .Slab Ina Patio FIREPLACE Footings Footing Masonry Walls Throat Reinf. Steel Final Soil Piping 1st Floor 2nd Floor 3rd Floor Topout Water Pipim Sewer Fixtures PLUMBING n Appliances / Gas Piping & Test Temp. Gas Sanitation Final ELECTRICAL ..v Framinct rrnr_ Or-mmr%%-cr%Q Test muwis Water Htr. Stucco Final Subpanels Mesh MECHA ICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under rou Interior Lath Ventilation Pennane Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - • - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE !) REMARKS OR CORRECTIONS Ile (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE - DEPIARTMENT OF PUBLIC WORKS 7 County Center Drive Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or &gent Receipt No. 3/`�' 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. DIRECTO"F PUBLIC WORKS gy % _ Date2_7-0 - if—0 B tllding permit expires Date ?__ 1-0 - 1P I BUILDING ` Owner _1_- h kv Se- A& SO. FT. OCC. BUILDING VALUATION O Oot7.00 Mailing Address / Telephone No. 3 SO• Contractors e�y-Q �e Serd� 9GS� Mailing Address Fireplace .Oa Total Valuation "rte --a0 �3S • Q �4 d G Telephone No. X77=6 O Permit Fee 8. Oa Building Address ptamU ec I &/or Penalty Permit Fee p� el -1-0,t/ /; PLUMBING No.1 @ FEE // PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. �� /� - / 9 Zoning a Planning Water piping 0 Each gas water heater or vent 1.50 FWsJ Vitt I -9aTAt'dtloR I FireDept. FireZone Use Permit Gas piping system 1 -5 out s 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 wilding sewer 5.00 ���� Bldg. PlanYRec'd Parcel Approval T Plans Approval Lawn sprin r system 2.00 NEW 0/ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ Z49' O mar cry ELECTRICAL No, @ FEE 7x so PERMIT FILING FEE $3.00 Main service 100v DR LESS 100 AMP OR LESS 5•00 Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. AOD•L 100 AMP 2.50 Main service OVER e O 25.00 100 AMP OR LESS EA. ADD'L 100 AMP 1 Main serviceNEW CONST/ OR ADDNS. C ACCDWELBLDGS.LING CCUP. B) ¢sq ft 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 st le of: Y NEW CONSTR BRANCH CIR T NON.CONST BRANCH CIRCUIT 2.50ea NEW CONSTR. (POWER APPA RAT a NON-RESID. SINGLE OUTLET IR, Ex. Occuo(OUTLETS OR XTIIRES) B L@; Ex. OCCU / FIXED AP NS. OR P•COUTLET (RESID.) EA) 2.00 Temporary servig2l 10.00 Mobile Home acilities 15.00 License No��P/�d� Classification I/./ Misc. Wi • g 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 !t for Workmen's Compensation. ' u. have placed on file with the County of Butte a certificy,.ate 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. _ E @ PERMIT FILING FEE $3 Heating . Cooling t Ventilation Hood 2.00 Permi ee $ $ 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 Land Development Fee $ TOTAL PERMIT FEE $ OG authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or &gent Receipt No. 3/`�' 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. DIRECTO"F PUBLIC WORKS gy % _ Date2_7-0 - if—0 B tllding permit expires Date ?__ 1-0 - 1P I COUNTY OF BUTTE 05PT, OF PUBLIO WORK$ FEB 14 1980 AM PM 71819110111112111213141516 r- yXy �ou9 �:r a ._ b,o��yx%G;rder For s\cV \ucas anc\os.,d par nolo It .ad acous oe lIc \O S -\.A. scrawc :tico na.c 1_Sc\O.. a \O S.M. accnws :\\cu poc\e\ lninr\o k ' ap p<ea.. 7", 5" FpaClp -1 ` C%2" Inin. for I%1"-- postiaj'4 min. I for 3° poet, CONN. DE G' 14 .boI 1 I. j • 'Mefcri.ls .olD", or .oar Tens. Y.P. 28ks:, L �° 11gwre .lum. pont P..t. \ . IV t �- post) __L= Esisting wall pans\ a\!a<.wie e.bs \2'a.e_ Cau\\t r appr.A. - 103 p¢ c 6k rVclur¢ LOrr 1l CCec R.F_...nmbars\. Nola: T\\a 5• Pacu. m.y No. dead a. iba pr—A Cont. bnam ond/oc as an a\NC-1fra, akkoc\+\ng Awry\ng b¢om ON Il"n wa\\ conn • . Sna conn, ar,d Rail ok•toc\�. 6.V,\s Qor (6s}anars alta., I 2.30' I so\'\d wood mambo to panVr. so\\d ss109'.M. sc.elu. wood mamba. ®G'o.c• �Iti'min., ac skrevsr A\loc\•irng or'\\vV w b oQ R.F. .bmmR.F. n\nrr\b4cc - Fer q' post use ,'A �.. a\c:p,s•er 1"Snccla. 2 OP /bolt• X1"10 S.M,acrawsC� 4•' ac With alsi g\\ewn oc :n+ac\adc. woaher.d erhands• For I'/a"p.0 Ula /4" bolts d wa.hers• —Bao chat, as P., post ,3" Post o. I.e°orn•menrel pas+. ti" bolt for I%" post; 11/6' bolt. er 4 of •n to SN SEnows for 3" post. 5 ATTACH. DETAILS Y soi. pOsl or \11-C, %" WIf or 4 Of wB SN o<namanlo.\ co\. Screws per tube Ptar 1,12;r %2 at; s/ea bolt or 4 e1"-lO BM 9erawa Post M.chet for S. post• bar J. N. o r ,O a o 22"di• 14 R °o, o Typ. N Mesta r: a1:.040"., 3004$43(c, Mln.Tana. •C.P.: 26 %Isl Ult. - 35 Nsi. 11a¢ S R x.29" •e•4 •A' •'a .o: e! a'p4 2 0�\ 4q"a\afly Hp\\. 6lud amctiocs par ICBO RFt-26"\(. o<ayu \approved Qer sopa ni A\'\d<oww\ oQ "0. adga Srsianca 2". Usa ciaal w\ was"'ar a4 top - Eaisling Slab m.y used IP in good condition and apple—ed by the SuiWinq Ots Pieiol. Saa noke 4 - F)CISTING SLAB f .e.< spr�. GENERAL NOTES :90• o 1• Live Lood 10,1111", Floric.Wind IOpeP, wind Uplift lopsP on -\t nolo akk--W'n-3 2. HO<;s•..i„+d oPpUad {e �wlcn i\.¢ p.o�acind ocna oQ a\\ 1\.¢ no+n o\ 10— ttk_a la oQ end !zaCa. oQ \\\now 1ay.3 :Q eP—I or !o ik\4 „ g 1 R•.14” wo\\ conn.- SMMgrace arm CQ ¢nc\esti wsi\•. span mos\. lncad Typ. can 4 alkad4\, ecrean and/er ramov a, krone\Ve¢ni oc lrancp.ran>< N dales\\5 Qoc p\¢Aib\¢ P\eeF\e ne\ eeeemm++nnsl�6�666000000 iF\on�QO,rni\e i\i,ei a< Ca\;S,' Qadanacsapppp<wad soRa ancbsu� Encbs�<a m.\a�\a\ s\\a\\ not ba suppor ad b.}_�S\u<s.Ks - S. •ba 11024-T 4. 411 8 70' o.in 1. shell �p�77.�. q:�' o plated or tT.iholl b. claal. Ei. N 8la in lase S1a $. dlslanshwN 11 Cenera+e mid: •. �gr., sky d., 1.5 q.l./11 k., ZO f�.aiand d. r. In sle\TQO rel Jc< d, Splice, see ect y ba npa1 s I r medium to r• Note 10 O 1-15' compocl Pill ¢reap} loserclonic lyp¢s Mai¢ria\'• Be., ing SOON. O 3004N94 er 1, A\um. design 0 ;i L 30oSN29 a\,srn. B. q\iamaia\o s bEasad \dad \\tea ora. Material:.9004H96 Alum. M1^•vT'`2Tks\ req\•\aced w\\!\ A\v��qAsw6rid•as¢gVa\o<gr¢a,\n< • •040` C\\\ek 9\'a<antnad e.:\n. t ks+yla\d s nyk\\s. Mab\ UIt= 35 kcl, Mi"See Tem, Y•1"• . ks1 k\\;cknass spat\ \a ls�aira \ a- .040 nao�o,l;va "+hicknass, sae nate R. R F I\tZprt�. io\aroncn ;s -STs. '1" R.F- FASC\P t P 9. Each in.+.nation sh.oe.r_on idanti Py:nq t.q ., giving the nem. and �I ee o1" mono Pee Yv. n., Ir••''� e1 —cf.?n bar and �F'Aanumc, �das\g I r wand PV Q t bad ' .osnawxs .r,-rs'co•xo a mlKrtaL \oad �. u cum •.� sn:m cess, oms:ox u, nrt x t0. VOW,& Sp\% a .060", 60l13T5, 12' 1a 0I , i'acf¢n 1. Accra A v F P.O y t D wik4\ 2 OR r/q"be\4e or a t4 S• M, seraws o \ • s/q'; s Yq';.(r q" .. 111x.:••, M cosanrows xorm and I IYq";\ram ono and eQ e1"\res .Tejo\ B Pas 'No, . par t w. 4n•+I a., ..I ..•ca:....,,,... w •+.•• . sv.\lea • L ... It. a\ ar uirlh;n 2' Ct" oc on -N. pw% ;j < .0 n"" .•w -.•x .I ws w s d or sopped} Mac\r Lune a, cagman; -AN, .`N \each e po3Z3. ^ '1. Faec\a \\ower e<.d s\w\\ba wa\\d<ninad wi1\�ona oQ w+,H.l: aoo ST& A17 ;.ode ilck r..up1 as rx•f.1(0 erh Ise1aono ef+aen. Dem•) t. ,a ksf, Min.<. p126 lest „=.~- 3/40 lnin frent - el TO" N F•sien m steal It Oj tth en. Ye•Wtu 2 o9p" be na each O 1'Oa Y and o ec Tap •c e\'\. 4k•S N Spti ca, Sea I -� al0 � { N� Nota � w� g•25"ascap! �., ' 1 . oc s Materuls eoo4H9G,•ORO" N'\ N` P4l .Y•F.*25 ksl,Ult Is EOksl. Min.Tens. YP.=2a Ksi,Ult- Mansura mcki\ass a.doslvn oQ pnint4d pattern. S.M. nota 0• Al h., AWLI, Adrons, Masan hlibmb, Connediat. Dbbid et C.I..bb. 5" FASCIA (R.F) u -_4 Material 16069T0 a •e•4 •A' •'a .o: e! a'p4 2 0�\ 4q"a\afly Hp\\. 6lud amctiocs par ICBO RFt-26"\(. o<ayu \approved Qer sopa ni A\'\d<oww\ oQ "0. adga Srsianca 2". Usa ciaal w\ was"'ar a4 top - Eaisling Slab m.y used IP in good condition and apple—ed by the SuiWinq Ots Pieiol. Saa noke 4 - F)CISTING SLAB f .e.< spr�. GENERAL NOTES :90• o 1• Live Lood 10,1111", Floric.Wind IOpeP, wind Uplift lopsP on -\t nolo akk--W'n-3 2. HO<;s•..i„+d oPpUad {e �wlcn i\.¢ p.o�acind ocna oQ a\\ 1\.¢ no+n o\ 10— ttk_a la oQ end !zaCa. oQ \\\now 1ay.3 :Q eP—I or !o ik\4 „ g 1 R•.14” wo\\ conn.- SMMgrace arm CQ ¢nc\esti wsi\•. span mos\. lncad Typ. can 4 alkad4\, ecrean and/er ramov a, krone\Ve¢ni oc lrancp.ran>< N dales\\5 Qoc p\¢Aib\¢ P\eeF\e ne\ eeeemm++nnsl�6�666000000 iF\on�QO,rni\e i\i,ei a< Ca\;S,' Qadanacsapppp<wad soRa ancbsu� Encbs�<a m.\a�\a\ s\\a\\ not ba suppor ad b.}_�S\u<s.Ks - S. •ba 11024-T 4. 411 8 70' o.in 1. shell �p�77.�. q:�' o plated or tT.iholl b. claal. Ei. N 8la in lase S1a $. dlslanshwN 11 Cenera+e mid: •. �gr., sky d., 1.5 q.l./11 k., ZO f�.aiand d. r. In sle\TQO rel Jc< d, Splice, see ect y ba npa1 s I r medium to r• Note 10 O 1-15' compocl Pill ¢reap} loserclonic lyp¢s Mai¢ria\'• Be., ing SOON. O 3004N94 er 1, A\um. design 0 ;i L 30oSN29 a\,srn. B. q\iamaia\o s bEasad \dad \\tea ora. Material:.9004H96 Alum. M1^•vT'`2Tks\ req\•\aced w\\!\ A\v��qAsw6rid•as¢gVa\o<gr¢a,\n< • •040` C\\\ek 9\'a<antnad e.:\n. t ks+yla\d s nyk\\s. Mab\ UIt= 35 kcl, Mi"See Tem, Y•1"• . ks1 k\\;cknass spat\ \a ls�aira \ a- .040 nao�o,l;va "+hicknass, sae nate R. R F I\tZprt�. io\aroncn ;s -STs. '1" R.F- FASC\P t P 9. Each in.+.nation sh.oe.r_on idanti Py:nq t.q ., giving the nem. and �I ee o1" mono Pee Yv. n., Ir••''� e1 —cf.?n bar and �F'Aanumc, �das\g I r wand PV Q t bad ' .osnawxs .r,-rs'co•xo a mlKrtaL \oad �. u cum •.� sn:m cess, oms:ox u, nrt x t0. VOW,& Sp\% a .060", 60l13T5, 12' 1a 0I , i'acf¢n 1. Accra A v F P.O y t D wik4\ 2 OR r/q"be\4e or a t4 S• M, seraws o \ • s/q'; s Yq';.(r q" .. 111x.:••, M cosanrows xorm and I IYq";\ram ono and eQ e1"\res .Tejo\ B Pas 'No, . par t w. 4n•+I a., ..I ..•ca:....,,,... w •+.•• . sv.\lea • L ... It. a\ ar uirlh;n 2' Ct" oc on -N. pw% ;j < .0 n"" .•w -.•x .I ws w s d or sopped} Mac\r Lune a, cagman; -AN, .`N \each e po3Z3. ^ '1. Faec\a \\ower e<.d s\w\\ba wa\\d<ninad wi1\�ona oQ w+,H.l: aoo ST& A17 ;.ode ilck r..up1 as rx•f.1(0 erh Ise1aono ef+aen. Dem•) t. ,a ksf, Min.<. p126 lest „=.~- 3/40 lnin frent Poat br.cl{er. cent., of ya" F•sien m steal It boltor yla•min. tth en. Ye•Wtu 2 o9p" be na each Po, Iw K to 1'Oa Y and o ec Tap •c e\'\. 4k•S 111Ic t (111a• bel Y ba aapo..a L aa;,. { •rap wa\ aro\nae. ibis for 3/e' bolt. a.ss" .100 1 �dr+4n --al coo. ulo 11 <26 19 sy t -1• Dm II (� SPA NO. �' j for t/4" to boli to a ask PVK261980) This Pbn�Aonrovd train,: -1�•-0 235W.14OthsT,LOS A CALIF 9n061 013132 I 0S 111Ic t (111a• bel Y EE � w� n ' 1 . Materials 00413T4 Alum. (2sS"wide) Me1¢ri.l:.040'thi.1 S004H 36 Alum,, P4l .Y•F.*25 ksl,Ult Is EOksl. Mln.Tarie.'(.P,e REGISTERED STRUCTURAL ENGINEER 26ksi., Ulf.- 35ksi. Al h., AWLI, Adrons, Masan hlibmb, Connediat. Dbbid et C.I..bb. L5 POST FOR am Pm M lnll.n4 \V •` nwa+•r r x•:a,a "r crrq' o.•.....0 --al coo. ulo 11 <26 19 sy t -1• Dm P oj¢ek:on (� SPA NO. �' j for t/4" to boli to a ask PVK261980) This Pbn�Aonrovd train,: -1�•-0 W -in from S\o a: _ bl+center er'h'rsin. STRUCTURAL PANELS j for t/4" to boli to a ask (sae total.) ,ATTACHED), 235W.14OthsT,LOS A CALIF 9n061 013132 06 Hale for %4' bolt iC � w� n 1 . From the office of: g, 110,1 " o 2'q".'es�/ib/ L Steal• 10' i•'i. 9''141" Fo.c:e ASTM A3(o '16" tact P1* 11,4 gSTM A9G end ave Gptvo.in¢d Or painted with alPreved rve 35!"11" inFyibitinq pn mar @ ploatiIt poink 4:n\ch sp—Ino a \e1 Foraniis Iffprhed diel a.64 Pyrra is -:tcnyth of attach men pro}..+ion ""Pt'ha' achMan+ shall 1 fz� I'A'sq. Orn. sing4 a's Sa¢ noln STEEL FOOTING PQ�- Pat law wa'nq STRUCTURAL PANELS 0 psf (sae total.) ,ATTACHED), 235W.14OthsT,LOS A CALIF 9n061 013132 06 Hale for %4' bolt O 1 . From the office of: g, 110,1 ROBERT W. HAUSSLER REGISTERED STRUCTURAL ENGINEER Ali�oo avot\nb\e 4" \en9 Al h., AWLI, Adrons, Masan hlibmb, Connediat. Dbbid et C.I..bb. wst\\ ¢ore r MOYQA Florida.Ibnq 111W h. Wis.. Maine, Yutknd, M+a+N-fts, Mirhipa Mi . Material 16069T0 soon ffma. Nn k.aNdro. flee h toy, Ned Moi., R. York Oeio, OMs• hoon, Oram Tan, Yanost Potbb, WWigtoe. Y4aoosb sod W/oai4 Min.Y•et P =1SAfi Un -30•O Ms Drpck:, IAO"'r%ids. Maul gaetl a.y� ca film "I m1 1.5" POST BRACKET This plan sheet is the property o1 the engineer and may not be copied or reused entirely or in pen, arcept by company named In this title black. Plan expires 3 yuan Mar mbbn_ Faad;a J S.M. nolo -(y ono edje+h. ell be equal +o t\\a r enclosed per note Q +he last+ i.%k +I -es +1 e p m j. \ At+echinq b•vm,5" or � losdu Ealst inq Mobi Ie he Fascia or side Fascia MOBILEHOME PQ�- Pat AWNING STRUCTURAL PANELS 0 psf VEE PANEL ,ATTACHED), 235W.14OthsT,LOS A CALIF 9n061 013132 w14-2854-10� CAJF. SE690 I I 513-79P PERMIT NO. PERMIT EXPIRES % 'OWNER Warren T. Ambrose (� owner tCONTR. 't)LOCATION (A.P. 8-12-19 ) �t t 2646 Monte Vista Ave., Sp/19, Oroville b . r l !r ' 1 - k . t t i - r i Temp. Power Pole i Called PG&E Temp. Ele/Serv. © � ± Calle PG&Elco�4 Temp. as Serv. CZed PG&E F ALED (Date) gnatueddl ! t r 1 - 1. FdQtings Ste all Slab Piers Garage Footings Stemwa I I Slab Carport Footings Slab Patio Footings sonry Wall; COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS _ BUILDING INSPECTION RECORD BUILDING ff-BUILDING (Cont'd) PLUMBING rewall Soil Piping Phapets 1st Floor Res oom Finish 2nd Floor Windo s 3rd Floor Siding To out Roof She hing Water Piping Roofing Sewer Fdn. Vents Fixtures Garage Vents _ Insulation Water Htr. Heaters Prov. for physica handicapped Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Final Sanitation FIRE ACE Final Footing ELECTRICAL Stucco Mesh Scratch Brown Finish Interior Lath Door Closer MOBILEHOME UTI Water Piping BI E M S Water Piping DATE t r W y KLE REMARKS OR CORRECTIONS Rough Fixtures Motors Water Htr. Subpanels Grd. Fault Prot. Service Temp. Pole Underground Permanent Final Elec. Pedestal Gas Piping Elec. Continuity Gas Piping 1 (NOTE: An entry must be made on this form each time you visit the job site.) 1 2- z -V, Final MECHANICAL Heating Cooling Ducts Ventilation Final ES ------------------ Elec- Service 71-5' Sewer ? G% LATION--------------Support ?—V —ar a Drainage. i REMARKS OR CORRECTIONS Rough Fixtures Motors Water Htr. Subpanels Grd. Fault Prot. Service Temp. Pole Underground Permanent Final Elec. Pedestal Gas Piping Elec. Continuity Gas Piping 1 (NOTE: An entry must be made on this form each time you visit the job site.) 1 2- z -V, COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE x 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 6'0''0 for the following location: 1 1j -26, 6 3 { Owner IV Owner's Address Mobilehome Mfg. ��—/- - Model y `' 7J Year -2f Insignia No. 73 �' f� ' 12- Serial No. �� /2 14 �7 It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date J � L' _ `%� By C, THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W 7). COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT 360 -BD . —• BUILDING Owner JOHN SCHURR SQ. FT. OCC. BUILDING VAL ON Mailing Address 19 PHALT04 WAY R AiGE A Telephone No. Contractor L 79AILER SALLS Mailing Address 17q r ��ER LLP Fireplace Total Valuation 0 Telephone No. 3 - Permit Fee Building Address Plan Checking Fee&/or Penalty Permit Fee PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. / S_��r/ / z Hing &Planning Water piping 1.50 Each gas water heater or vent .1.50 F�,es� WA -4. o Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking arcel Plans Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. Pla�Rec'd Parcel Ap Plane roval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER'® Permit Fee $ Ls Ni 141 a" g n 1,- 12,-7 'ELECTRICAL No. FEE PERMIT FILING FEE $3.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Single Family ❑ Duplex Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADO'L 100 AMP 1.00 NEW CONST, ( OR ADDNS. ACCLBL GS.LING CCUP. Ei) 2P Sq ft 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: 7ri�AlL6/1C �5AI�6S• %NC - NEW CONSTRESID, -OUTLET NON-RESID BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS 9 NON-RESID. SINGLE OUTLET CIR. EX. OCcuD(OUTLETS OR FIXTIIRES BAL21 FIXED APPLNS. OR Ex. Occup. (OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 l `� f License No. �� 6/9�Classification l:. Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby L Fee t $ TOTAL PERMIT FEE $ autnonze repres niauves or the Vounty or tsutte to enter upon the above -men•' perty for inspecti n purposes. X Date ignature ermitee or Agent 14V Receipt No. 7 "S4�� -u— White-D.P.W. u White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the But County Code and/or resolutions to do work indicated a or which fees have been paid. OBLOF PUBLIC WORKS f� B Building permit expires Date MOBILEHOME SUPPORT DATA If other than'single wide, Mobilehome Mfr. J19kV,.D1X 16AY5K6RC furnish Setup,Mgdel .No. ✓a10 SCS Year Sb Width�{ y (ft.) Box Length �6 (ft,) :••,Tagalong or`Expando Size ft. x -- ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets.(if,hot.on file with the -County of Butte). All center supports measured from front of mobilehome unless otherwise specified, (ft.)(in;) Center,support locations* /3 (ft.)(in.) .27 S (ft.)(in.) yU v (ft.)(in.) ® 12gX21 t (in.) (in.) Center support footing sizes (in.) V / x•2/3 (in.) (in.) (in.) (in.) d . (in.) (in.) 21 (in.)I (in.) Single ' All, IM 62-q) 733) *If center piers are other than drawn above, A-r,MT.t A4--4- Footings (check one) E] 1. Wood either pressure treated or foundation grade. �! 2. Other (specify) GAWSMIE.. Supports (check one) 1: Concrete block. L Other (specify) �<--Tagalong or Expando,' show support details. /:Cj�o(// -- Typical Support (in-.) (in.) Footing Size Max. Pier Spacing (ft.)(in.) /' Ori I -- Max. Overhang (ft.)(in-.) BUTTE COUNTY BUILDING DEPARTMEN APPROVED � 36o -fib ;a i BUTTt' 6U` HT' Y' DEPARTMENT OF +PUBLIC WORKS _ 7'County Center Drive, Oroville, CA.' PHONE: 534-4541 ' MOBILEHOME INSTALLATION SHEET 1. Owner's name: ,`M fl N Sc N V K A 2. Installer's name: 01NI/LLE SALfS .3. Is the site currently under permit? Yes / / No (If yes, furnish permit number s the site an existing site? Yes / / No 7 1 f (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 J (If no, clarify ) ( t ) 5. What is the mobilehome electrical rating? ----------------------- Amps 6.• What is the mobilehome site service rating? ;----1--------------- _ Zoo Amps 1. What is the mobilehome site circuit breaker rating? ------------- - lnd Amps 8. Is there any other electric load to be served by the mobilehome C . siteservice? --------------------.---------------------------- Yes No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? -------------------- 4i� (in.) i 10. What is the type of gas service? ----------------------------- 'Natural J>e4 LPG ' f / 11. What is the gas pipe length from meter or tank to the mobilehome? (ft.) 12. What is the mobilehome gas demand? --------------- ------------ - (BTU) (This information not required -if pipe length less than 61f't. on natural gas or less than 50 ft. on•LPG:) f 'k • MOBILEHOME INSTALLATION,INSPECTION CHECK LIST 1.- Is the mobilehome located withAequired 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-1kNo 3. Are footings and supports properly sized-, spaced, and braced as per approved plans? '(Note possible variation at spring shackles,) (Sec. 5082 & 5083) Yes. t,-Ao_ 4. Is the mobilehome level? (Sec. 5088) Yes,/_ No= 5'. If more.than a single unit, are crossover connections properly installed? (Sec. 5088) . Yes INo_ 6. Water A. Is flexible 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 o 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 each end? Yes -No B. Does it have minimum 4" per foot slope and is it properly supported? Yes_ZNo C. Are any leaks detected in drainage system after running 3;gallons of water through each fixture including washing machine standpipe? .Yes_ No_.A/ 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 large as the mobilehome gas line inlet without reductions,other than the mobilehome connector. Yes V"'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. j C. Are all appliance vents properly installed? Yes. No_ 9. Electrical A. Is service large enough to provide adequate—amperage-to mobile�iome (must equal rating of mobilehome with a minimum of 1 amp) and-other=facilities on lot, i.e., watgr.purnps, garage,.cabana, etc.?. Yes V No_ B. Is there proper clearances around panels? Yes ►1 C. "Is power supply cord or feeder.assembly properly fused?. Yes r/ No D. Is continuity test satisfactory as per the following procedure? Yes X10 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. S. All non-current, carrying metal parts of th &obilehome (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 �. F , j Length. �� Width 'Vehicle Serial No. 1?49 , State Identification No. Additional Information or Comments: _ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT Owner Mailing Address -3;X_ Contractor Mai I i ng Address Building Address 2G Telephone No. --f J-ZP3— Telephone No. A. P. N0. ® 1 Zdninfi Ing -It. --as Sj i Fire Dept. Fire Zone Use Permit EQA Parking I Plans Parcel Declaration Parcel Ma P 60' R/W Improvements p ovements Bldg. kans Rec'd Parcel roval PIC ipprovol NEW ❑ ADDITION ❑ UTILITIESg OTHER ❑ Single Family ❑ Duplex ❑ Mobil HoNm6,U Others ❑ 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: License No. Classification i( I am exempt from the Contractors License Laws of the State of California. 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. 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. 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. Date 3/ — Signature of Permitee or Agent Receipt No. 1 126 2-7 `e White-D.P.W. – Yellow -Assessor – Pink -Inspector – Goldenrod -Applicant _ BUILDING V SQ. FT. I OCC. I BUILDING VALUATION Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each TraD Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee ELECTRICAL PERMIT FILING FEE Main service 600V OR LESS 100 AMP OR LESS Main service EA. ADD'L 100 AMP Main service OVER 600V 100 AMP OR LESS Main service EA. ADD'L 100 AMP NEW CONST. / DWELLING OCCUP. & @ FEE $3.00 .00 1.50 1.50 1.50 10�0a 1.50 1.50 .30 5.00 /,4.00 2.00 $3.00 5.00 2.50 25.00 1.00 NEW CON5TR. MUL I I.UU I � I .0 .R ESI D BRANCH CIRCUITS 12.50eal NEW CONSTR. (POWER APPARATUS 6 NON.RESID. SINGLE OUTLET CIR. r Ex. OCcuo(OUTLETS OR FIXTIIRES IFIXED BAL@1 APLNS.@ Ex. Occup.(OUTLETSP(RESID.)REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ MECHANICAL No. @ PERMIT FILING FEE $3.00 Heating Cooling 53 1 — FEE Ventilation Hood 1 1 2.00 Permit Fee $ $ Land Development Fee $ 5Z5— — TOTAL PERMIT FEE $ 58' o0 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. D ECJqp OF P BLIC WORKS Date Building permit expires Date �'� • - BOUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive,. - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT �/ C---2 BUILDING Owner IN1"'v N SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address Telephone No. .)3 Contractor 1 Mailing Ad ss ZaC Fireplace Total Valuation • Telephone No. Permit Fee Building Address Plan Checking Fee &/or Penalty permit Fee PLUMBING No.1 @ FEE i' PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. j Z �— f—y n .W &� 4enning Water piping 1.50 Each gas water heater or vent 1.50 FW I VPd_ Sem Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans I ParcelEach I Declaration I Parcel Map 1 60' R/W I Improvements additional outlet .30 Building sewer 5.00. Bl.dgsP21l,�W Parcel Approval I Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER a Permit Fee $ - a ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 �- Main service 100V DR LESS 100 AMP OR LESS 5•QO Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service EA. ADD'L 100 AMP 2.50 , C __?_ .Y -712 �•.�G OVER 600V Main service 100 AMP OR LESS 25.00 Main service/ EA. ADD'L 100 AMP 1.00 NEW CONST.OR A.D.S. \ ACCOWELBL GS.LING CCUP. !) 22sgft 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: �r/�� NEW CONSTR MULTI.OUTL T NON.RESI D, BRANCH CIRCUITS) 12.50ea NEW CONSTR (POWER APPARATUS 8 NON.RESID. ,SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXTIIRES g L2; 24 Ex. OCCU FIXED APPLNS. OR P OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 i Mobile Home Facilities 15.00 ,..- License No. `�c�'� /� �ioZ,Misc. Classification G�-tC� Wiring 6.25 D I am exempt from the Contractors License Laws of the State of California. 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. 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. 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. X 8A 61a P, AA&r.,, Date .93 -'7—_Z -Ci ignature of Permmiiteeee or Agent Receipt No. O a 7,)-1 White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant Permit Fee $ MECHANICAL No. @ PERMIT FILING FEE $3.00 Heating Coo I i �9 Ventilation Hood 1 1 2.00 Permit Fee $ $ Land Development Fee $ TOTAL PERMIT FEE I $=-L, 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. IRE T R OF UBLIC WORKS B RE -17- Y Building ,? - Building permit expires Date 3" a7-- 5>6 NO M,4-AcWr91s rkmanship Shall Be in Accordance- with Rerorinized .Gadd Practices .and i/2' k/ j of a quality orescr ham- for +he` Snecified use i e' • i/Z w Unifo�r�ml Building, Plumbing . & Machanical Code. £mss 55,0 I 2-I TY� - - - --- t=- -= -- - -,L-- AII' u E14 nnections. shall L s` y located withi Telephone 533-2000 North Burbank Public Utility District 1080 1960 Elgin Street OROVILLE, CALIFORNIA 95965 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works - Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North. Burbank Public Utility District, must be submitted to Butte County. Applicant: JOHN R.SCHURR . Applicant Address: 2663 Phaeton Drive, Oroville, CA 95965 Applicant Phone No.: N/A Property Location (s): Same A. P. No. (s): 008-12-0-019-0 r Fees Paid: SCOR Facility Charge $700.00 Connection Fee y Application for service approved: North Burba Public Utility District Inspection(s) made and successful test(s) observed: Location: Date: 0 North Burbank Public Utility District release to close permit: Date: By: ' A p $ APPLICATION FOR SEWER CONNECTION AND SERVICE FROM NORTH BURBANK PUBLIC UTILITY DISTRICT' hereinafter referred to as "Applicant", being the property owner for which sewer service is desired, hereby requests the North Burbank Public Utility District, hereinafter re- ferred to as "District" to connect Applicant's sewerage disposal line to the North Burbank Public Utility District's Sanitary Sewer System anc rov' ewerag service. Location' of property. - --- er of dwellings g located on property ':in vision • Lot Block Number of hookups _ this application trict to cover ` ❑ Out of District Number of. outlets Kindof Service per hookup, ❑ Residential Hookup fee ❑ Rental ❑ Residence .New Service ❑ Duplex ❑ Apartment Total amount ,,O—Industrial payable R rks —� - Service to be in acco Tice wit e conditions hereinafter set forth and the ordinances and rules and regulations adopted, or to be adopted, by the Board of Directors of District, all of which applicant agrees to abide by and fully perform. Applicant agrees to pay for such service at rate, of Its and charges a ab ished by the District from ti a to time. Date Si nature of Applicant and Owner 3 Mailing Address CONDITIONS OF ACCEPTANCE OF SEWERAGE SERVICE 1. Th( casioned t f., 2. In Y_ North Burbank.Public.uti1wt. _ _ . _..., _ form an '� `196U ELGIN STREET ` •" -- W` Y (916) 533.2000• be caused a OROVILLE, CALIFORNIA 95965 '� ' N o U801 disposal p 1 DATE i` � 19 � trict. RECEIVED FRO 3. Dig S®C) suiting fr 1 persons o FOi DOLLAARR S AMOUNT OF ACCOUNT —_ d- (T s material D CASH nfs QOu shall be 1 THIS PAYMENT n CHECK App.licanl BALANCE DUE CH ❑ CH By._ 5. Al i -- — ing with 6. No storm drain's or`Stormwate, ,au uc U, This application accepted thisW day of y Payment on above' application received by cash ❑ gJwek- $— NORTH BURBANK PUBLIC UTILITY DISTRICT / 11 By SERVICE LOCATION ACCT. NO. PH. 533- 4578 2310 OLD OUINCY ROAD OROVILLE WYANDOTTE IRRIGATION DISTRICT OROVILLE. CALIFORNIA 95965 L J FROM SERVICE TO PRIOR METER READING PRESENT- 'USAGE I CHARGES 40. 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