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069-170-039
Lxr v. { ONALD W. HENRY Ka 75 Montros Dr, 1 t 39 KR#4A, Orov lle Permit_ Jk 099-79P,E('iitil, ) — ELEC GAS S- A ACTION . TEST REQ SUP �ORT STRUCTURE RE i - - — --- i Contr .i Cameros' Mobile Trans ort P rmit `#585 -79MHI } Issued o1` ✓!G 69-17-3? contr: Holmes Mobile Home Serv., Oro. PermitJ28-7 (de k &awnings/MH) 'U4 ;377, 069=C70-039 r 1 i MCCAld�1;'� ha �..�* t.a. kM rr �'•' P r •. t 75 MONTROSE- R OROVILLE r Cont MYRON LIND LIS CONT � '' W NED �`?R ✓,�t 1 p'�s+• �, F. I i 0 a COPY Butte County Department of Development. Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Facsimile www-buttecounty.net/dds www.buttegeneralplan.net ADMINISTRATION * BUILDING * PLANNING REQUEST FOR COPIES Please furnish me with copies of the building file documents I have indicated for the assessor's parcel number(s) and address(s) I have listed below. I understand there will be a copy fee of $.25 for the first page and $.06 for each additional page thereafter payable at the time the copies are picked up. I further understand that Butte County has up to 10 days to respond to this request based on the Public Records Act. Assessor's Parcel Number _ 04`1 • r To • 03 1 Address IS MpNrjeosr- DiQ, QL4aco Name of document(s) requested `713 u n -o s N c, Assessor's Parcel Number Name of document(s) requested Assessor's Parcel Number Name of document(s) requested Assessor's Parcel Number Name of documents) requested _Assessor's Parcel Number Name of document(s) requested Address Address Address Address Please Note: Conies of building plans are not covered by the Public Records Act but instead are under California Health and Safety Code Section 19851-19853 and require written authorization from the property owner and the Registered Design Professional before being duplicated and a separate fee of $127.00 is required r"IIKE�cKiE- M.t/T7/43 2plp. 1.2,, Printed Name Signalrj Date Contact Phone Number/Email Address *When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. 3-1-10J:\2010 Handouts and Policies for approval\Approved Handouts and Website forms\Request For Copies 3 3 l0.doc f NOTES RESIDENTIAL. 069-170-039 04/377 PERMIT NO. — MCCANN, I-krolc( 75 MONTROSE DR, OROVILL' Cont: MYRON L[NDQUIST CONT NEW DECK 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) `' L Signature' J=OK 0 = Not OK . = NotReadyabie MOBILE HOMES 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 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DE2n, COVERS, CARPORTS, GARAGES (Plans) OK except #'s Toning Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3e -'becks, Girders and/or Joists -Decking -Bracing -St ' -R s 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. goof; Shthg-Roofing 10'.' 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 POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, 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 Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 BUTTE COUNTY ` DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION **PLEASE PRINT CLEARLY** OWNER. Last Nam Qy\�D=\ q` ` l •�� t9 -R+9 Name [First Name Address__. Ci R Cityke d,\ .�-�� � a �'Pa,S�cE.Sa State. Zip Phone Address Fax E-mail Lic. # CONTRACTOR Name rl1 Name Address Address Ci R State(` A �'Pa,S�cE.Sa State zip Phone Address Fax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name Addres .... , . Ca t� Fir P Address Book city, zipz��CtPh . State zip Phone Address Fax E-mail State License Number APPLICANT NAME Name �n Occ. Addres .... , . Ca t� Fir P 4 Book State— zipz��CtPh . n 3 Fax E-mail Address APPLICANT SIGNATURE X — \1 1146 1 ; For office use only: Zoning Flood Zone X SRA es No Occ. Type Const . Subdivision Name Map Book Page Lot# Planner Date Approved: PERMIT NO. 33 t19 BIN # LOCATION [ ` (� Property ddress�, City Cr s Street \ r WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY —Name. Address K:IFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Description or Scope of Work: S.q. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION - Applications for which a permit has not been issued will expire one year.after the date of application. In order to. renew action on an application after expiration, a new application, plans and fee will be required REQUEST FOR REFUNDS Refunds. can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other. department costs are not refundable. Received by. Amount: ,jc�_J�� Bldg SRA Receipt # %� Sheriff —SMTP Date: , �J / Other ' lt�6 le Total OVER FOR SUBMITTAL REQUIREMENTS L REV 7-27-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING. DIVISION. 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET , OWNER: (�,lj�_ ASSESSOR PARCEL NUMBER 0& l� � r�� J L Proposed Building Use: 11 1 co! i ��:a Counter Technician: '. � Date: Items required in order fo Apply fora permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form P( 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................:............... ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ .22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of For stry plan approval ❑ paid. Sent by: ...;......... ' 24: Planning approval (A) Use:(B)Parking:(C) Parcel Check: _-�61- _ -❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... Ve� 26. NPDES Form ............................ . - ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization ....................................... :............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance .............................. ❑ '35. Existing violations and/or expired permits.............................................:........... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone c 6C=6)62-�J���i7 �o and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. (� Applicant: i ^ �Ll , Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items re cL Contractor, designer owner was advised of the above data by phone, ❑ mail, ❑ counter, by Date: Contractor, designer, er, was advised of the above data by ❑ phone, ❑ mail, ❑4w���Date: Date: Plans reviewed by: Date: Plansapprovedby: Structural reviewed Date: Structural approved by: Date: Note transfer b Date: Yellow: Building Division OPV PSVAENT 0& / 0 %JTr`0 Department of Public Works a o C o u n t y o f B u t t e C C 1.. Michael Crump, Director LAND DEVELOPMENT DIVISION \� C Storm Water Management Program CO Ll t4ly 7 County Center Drive tro Oroville. CA 95965 wo�''� (530) 538-7266 (FAX) 538-7171 National Pollutant, Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement .[LESS THAN 1 ACRE1 Project Description:,.�v,,. c Project Location -and/or Parcel Number: �g C( J-70 Q Cj By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB - 1 acre or more of land and that I, therefore, do not need to apply for A.Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when 'combined with subsequent phases total more than one. acre of disturbed_ soil will require a Construction .Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: ( Q Q AI A ` T`T- U A AAL Title: -04\ Date:. Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP043377 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 12/09/2004 APN- 069-170-039-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 75 MONTROSE DR ORO Date: Contractor. Map Index: Description: NEW OPEN DECK(96) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: MCCANN HAROLD L 8r ARLENE L permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 75 MONTROSE DR the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966-3961 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: MCCANN HAROLD L 8r ARLENE L owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one + year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: - ❑ I Article 3 of the Business and Professions Code �amExxemptt �under s hol Date: L �_I��LL_0j4 Owner: JUL WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following deGarations: O 1 have and will maintain a certificate of consent to self -insure for License #' 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 Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Policy #: Total Square Ft: 96 S. F. I certify that in the performance of the work for which this permit is Valuation: $960.00 issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. �a - d 9. - o U Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is her by issued under the applicable provisions of the Butte County Code and/or 1 hereby affirm that there is a construction lending agency for the Resolutions to do ork indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) s I 0a) Name: By: Date: PERMIT XPI S ON: (� 9 ' <D57 Address: Date O I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ , Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that 1 am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of ButteCounty to enter upon the above mentioned property for inspection purp es. Print Name: Signature: �y J(- Date: zt—_!2 — 40 Owner ❑ Contractor 13 Agent for Owner ❑ Agent for Contractor ' 7 PERMIT NO. 4099-79P,E •�. c oe-�-rsa PERMIT EXPIRES OWNER DONALD W. HENRY CONTR. -nwnar LOCATION (A.P. 34-76-39 75 Montrose Dr, lot -39,KRYKA, Oroville Temp. Power Pole PG&E a Serv. PG&E s Serv. /T.ep. PG&E 7 (Date (Signature) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUM G Setback Firewall Soil Piping Forms Para ets1st Floor Main Bldg. Restroom Finish2nd Floor Footings Windows 3rd Flo StemwaIl SidingTo out Slab Roof SheathingWat Piping Piers Roofing S94er Garage Fdn. Vents fixtures Footings StemwaII rage Vents I n S'dfa tion Water Htr. Heaters Slab Carport Footings Prov. h sically handl app Conformance ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIRE ACE Final Footings Foolina ELECTRICAL Masonry Walls Throat Rough Reinf. Steel Final Z' Fixtures Bond Beam 'FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Fin anels Mesh MECHANICAL Grd. ault Prot. Scratch Heating Service Brown CoolingTemp. Po Finish Ducts Under round Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOME UTILITIES ------------------ Elec. Service Water Piping Z"Z Sewer �� �_ Elec. Pedestal �Q Gas Piping AlOAf� MS2jILEtjOME INSTALLATION - - - - - - - - - - - - - - Support 4777 Elec. Continuity Water Piping Drainage2, u�Gas Piping f DATE lS �� 7 O,<ea REMARKS OR CORRECTIONS NO 5 up a_Q /Lc4' (NOTE: An entry must be made on this form each time you vislt the job site.) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT I� authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. IRX Date SI_ aatu . Ok mites or Aa nt Receipt No. 09. tly 0 b White-D.P.W. — Yella Asea — P)n4-I.. en er�nr _ r:..l .i.., .nA.A�ni��....♦ This permit is hereby issued under the applicable provisions of the BuJW County Code and/or resolutions to do work indicated abrofwhich fees have been paid. L"- F: XOR OF, PUBLIC WORKS •' 'D!Ptp•, BUILDING Owner Donald W. Henry SQ. FT. OCC. BUILDING VA—L——TION '`tel Mailing Address Telephone No. Contractor Carneros Mobile Transport Mailing Address 1290 El Ca itan Fireplace Total Valuation Napa, CA. 94558 Telephone No. 707 252-,2411 Permit Fee Building Address 75 Montrose Drive Plan Checking Fee &/or PenaltyPermit Fee Oroville California 95965 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Lot 39 Unit 4A — Kelly Ride Estates Each Trap 1,50 Repair drainage or vent piping 1.50 A. P. No. 34 -- 76 - 39n J Z. ii, Planning Water piping 1.50 Each gas water heater or vent 1.50 s Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 Bldg. oris Redd Parcel oval Plan oval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER Permit Fee $ $ Installation ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Single Family ❑ Duplex Mobil Home Others ❑ � ❑ Main service 600v OR LE SS loo AMP LESS 5.00 -L Main service EA. ADD'L loo AMP 2.50 IIER Main service 1100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST OR ADDNS. ACCLLING BLDGS,CCUP. 4� 21t:sgft 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: Cameros MObi 1 e Transport NON CONSTR BRANCH CIR T NO N.R ESID � BRANCH CIRCUITS/ 2.50ea NEW CONSTR. fPOWER APPARATUS 5 NON.R ESID. SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTIIRES1 5 L 250 @1 Ex. Occu FIXED APPLNS. OR P•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 259158Misc. Classification C^61 Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ® I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 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 No4 @ 1 FEEPERMIT 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 Mblet Home Installati 30.0( TOTAL PERMIT FEE $ 3 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. IRX Date SI_ aatu . Ok mites or Aa nt Receipt No. 09. tly 0 b White-D.P.W. — Yella Asea — P)n4-I.. en er�nr _ r:..l .i.., .nA.A�ni��....♦ This permit is hereby issued under the applicable provisions of the BuJW County Code and/or resolutions to do work indicated abrofwhich fees have been paid. L"- F: XOR OF, PUBLIC WORKS •' 'D!Ptp•, BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION* SHEET* 1, Owner's name: Donald W. Henry Lot 39, Unit 4A- 2. Installer's name: 3. Is the site currently under permit? Yes,777 No (If yes, furnish permit number ) OR Is the site an existing'°site? :Yes / / No 7 (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 IK No (If no, clarify. ) 5. What is the mobilehome.electrical rating? ---------------------=- 200 Amps 6. What is the mobilehome'.site service rating? --------------------- 200 Amps 7. What is the mobilehome site circuit;breaker rating? ---.---------- 200 Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- Yes / / No /x / (If yes, identify the load and size: (Load) -0- (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- -0 (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? -0 (ft.) 12. What is the mobilehome gas demand? -------=---------------------- -0- (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7'COUNTY CENTS_ R DRIVE OROVILLE, CALIF. -'534-4541 CERTIFICATE OE OCCUPANCY., This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number �� 2 y for the following location: f'• ;. <. Owner Owner's Address%>i Mobilehome Mfg. Modelear Insignia No. �'r!� !'/>�/ ;.?%-;'�°f'</(1 ' Serial No.*+ It is hereby certified for occupancy at the above. described. location and may be occupied. Director- f Public Works Date r'� ` By 7, 1�4. THIS CERTIFICATE IS. VOID WHEN MOBILEHOMEAS RELOCATED" White - Owner, Yellow - Installer, Pink - D.P.W. MOBILEHOMEINSTALLATION INSPECTION CHECK.LIST 1. Is the mobilehome located Nith re ed separation from lot lines and buildings and generally conform to plot plan? Yes 2. Does the mobilehome have required clearances aboveground? . Sec round? Yeses No g ( ) 3. Are footings and supports properly sized, spaced, and braced as approved plans? (Note possible variation at spring shackles.) (Sec. 2 & 5083) Yes— No 4. Is the mobilehome level? (Sec: 5088) Yes No 5. If more/��an a single unit, are crossover connections properly installed? (Sec. 5088) Yes Y No 6. Water A. Is flexi connector of adequate size and properly installed (1/2" ID mein:)? (Sec. 5566) Yes o B., Test - Does water piping withstand working.pressure or 50 lbs. air test? Yes No "Aandkflow - If coach is not State Qf.�.alifroxnia�proved, does station have backflow device 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 Lipo C. Are any leaks detected in drainage system after running 3 -gallons f water through each fixture including washing machine standpipe? Yes No.. coach is not Staff of California approved_ does. station have required trap and vent? Yes No 8. Gas Piping nd Gas Vents A. Connector Is mobilehome connected'`to the ga's'supply mobilehome c nector not more than 6 ft. long? Note. large as the m ilehome gas line inlet without red :rt connector. Yes No ti B. Test OK as per followin rocedure? Yes o 1. Open all appliance con ctor valves. 2. Shut off appliance burner anldpi�o t valves. AK an approved 3/4" minimum 11 piping is to be at least as s'other.than the mobilehome 3. Air test with manometer t 0"-14 ater column, or test with slope gauge (minimum 6oz.-maximum 8 oz.)cal' rated in to h pound increments. Test for 10 min. without drop. 4. Connect gas mete to mobilehome with connec r, turn on gas, test connections with soapy water. C. 'Are all applia ce vents properly installed? Yes No. 9. Electrical A. Is service large enough to provide adequate amperage -to mobilehome (must equal ioeting�of mobilehome with a, minimum of 10 amp) and other -facilities on lot, 'i.e., water pumps, garage, cabana, etc.? Yes_& -`-No_ B. Is there proper clearances around panels? Yes — No C. Is power supply cord or feeder assembly properly fused? Yep" No D. I ontinuity test satisfactory as per the following procedure? Yes o De -energize electrical wiring system of the mobilehome at the pedestal. . 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. :. /-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 the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 5/ 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. 1 Zs'job card signed by Health Department for water and sanitation? ' 1 f everything okay, sign off-.c.ard and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle O ,4_ Length Width Vehicle Serial No. .S e a3;;0.2 State Identification No. c,44 eltlO / -.14 `IV6 ,boo Additional Information or Comments: t/ COUNTY 0'F BUTTE — DEPARTMENT OF PUBLIC WORK 7 County Center Drive — Oroville, California 95965 . Telephone: 534-4541 APPLICATION AND PERMIT BUILDING Owner Donald W. Henry SO. FT. OCC. BUILDING VALUATI Mailing Address 19172 Oxnard Street Tarzana, CA 91356 Teleph ne No 213—X343-910 --- Contractor Mailing Address Fireplace Telephone No. Total Valuation Permit Fee Building Address 75 Montrose Drive Plan Checking Fee &/orPenalty Permit Fee Oroville, CA 95965 PLUMBING No.1 @ FEE PERMIT FILING FEE J$3.00 .00 Lot 39, Unit 4A — Kelly Ridge Estates Each Trap 1.50 Repair drainage or vent piping 1.50 A. P. No. 34 — 76 — 39/L1l Zonin tanning Water piping 1.50 Q.00 Each gas water heater or vent 1.50 F s V1FrGl Sa Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel I Peciaration I Parc ap 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Bldg. P ns Rec'd P cel A roval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES,N OTHER ❑ Permit Fee $ .00 $cpa7C ELECTRICAL N0.1 @ FEE PERMIT FILING FEE $3.00 OGi Single Family ❑ Duplex ❑ Mobil Home,2 Others ❑ Main service 600v OR LESS 100 AMP OR LESS 5.00 5-.00 Main service EA. ADD'L 100 AMP 2.50 O.W Main service OVER BOOV 1100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1,00 NEW CONS. DWELING OOR ADDNST ( ACCLBLDGSCCUP, 51) 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: NEW CONSTR BRANCH CIRCU NON -REBID ( BRANCH CIRCUITS 2.50ea NEW CONSTR. /POWERAPPARATUS & NON-RESID. `SINGLE OUTLET CIR. Ex. Occuo(OUTLETS OR FIXTURES S0@ BAL@1 Ex. Occup. (FIXED ALNSOUTLETS P(RESID )REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 X00 License No. Classification Misc. Wiring 6.25 KI am exempt from the Contractors License Laws of the State of Califomia. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL N01 @ FEE $ PERMIT FILING FEE $3.00Heating 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 authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Date . �f, Signature of Permmiiltee or A 9911,Ar Receipt No. 2`-'S a7 3 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Land Development Fee $ TOTAL PERMIT FEE $ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date wilding permit expires Date - 7—!/ - w PERMIT NO. 6528-79B PERMIT EXPIRES OWNER Donald Henry Holmes Mobile Home Serv., orove CONTR. 34-76-39 LOCATION (A.P. 75 Montrose Dr., lot 39, KRIKA, Oroville Temp. Power Pole Called PG&E Temp. Elec. Serv. h Called /PG&E Temp. Gag 7 Serv. Cal,Wd PG&E., JUM5 FINALED (Date) (Signa r—e)— PLUMBING ELECTRI Mesh COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) Scratch Setback Flrewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Foot in s Windows 3rd Floor Stemwali SidingTo out Slab Roof SheathingWater PI Inc Piers Roofing Sewer GarageFdn. Vents Fixtures Footings s Stemwal I Garage Vents Insulation Water Htr. Heaters Slab Carport Footin s Prov. for ph sically hand(ca ed Conformance of ex. structure Appliances Gas PI in Temp. Gas Slab Final z Sanitation Patio FIREPLACE Final Footings • _ _ ���� Footing Aasonry Walls Throat Rough Reinf. Steel Final Fixtures Bond Beam FIRE SP-RIN!SIARS Motors PLUMBING ELECTRI Mesh MECHA CAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under rou Interior Lath Ventllation Permane . Door Closer Finalmxwp� Final MOBILEHOME AILITIES ----=------------- Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 Telephone: e34-4541 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned p operty r in p tion purposes. X — Date ZZ Signature of PPerrmmitee or Agent Receipt No. ���/ng;;" 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 OE -,PUBLIC WORKS BY �� Date—z-10- z. -f' 7 Bu ding permit expires Date BUILDING Owneri4� edis� SQ. FT. OCC BUILDI G A TION (� Mailing Address J75' rLO�� _T elephone No. Contractor m E KE E2U , Mailing Address 51A1/ .4Aoz- ,,,Pe Fireplace Total Valuation 0 �20U,AF_ Telephone No. .1-34t- 5-5O/ Permit Fee 00 Building Address Plan Checking Fee&/or Penalty Permit Fee ,OD Gt PLUMBING No.1 @ I FEE PERMIT FILING FEE J$3.001 �T 3 y �� T/ Each 1.50 Repairr drainage or vent piping 1.50 A. P. — 7 ' 39 onin Planning Water piping 1.50 Each gas water heater or vent 1.50 es -6ertitattott- Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EQA P arking plans Parcel Declaration parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 /� �• /1�1� laezd� Parcel Approval Plan pproval Lawn sprinkler system 2.00 NEW JZ ADDITION ❑ UTILITIES ❑ OTHER ❑ permit Fee $ $ 11,Y 3gii:i 016_rcje__ lax/ ,t/ ELECTRICAL No. @ FEE �a o �lvly PERMIT FILING FEE $3.00 800V OR LESS Main service 100 AMP OR LESS 5.00 Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 .[ AA,14 (241� �� Main service OVER 6o0v 25.00 100 AMP OR LESS Main service/ EA. ADD'L 100 AMP 1.00 NEW CONSTr OR ADDNS. \ ACCLBLDGS.CCUP. 7i) 20 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*( T NEW CONSTR NCI -OUTLET NON.RESID BBRR NCANCH CIRCUITS) 12.50ea NEWC ONST R. ( POWER APPARATUS 8 NON -RESID, SINGLE OUTLET CIR. Ex. OCCUD(OUTLETS OR FIXTURES50 g @25 FIXED Occup. FIXED APPLNS, OR P• OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.. 3421—��� Classification �"� Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. n I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 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 Land Development Fee $ TOTAL PERMIT FE E r7 $ lid 00 authorize representatives of the County of Butte to enter upon the above-mentioned p operty r in p tion purposes. X — Date ZZ Signature of PPerrmmitee or Agent Receipt No. ���/ng;;" 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 OE -,PUBLIC WORKS BY �� Date—z-10- z. -f' 7 Bu ding permit expires Date SITE PLAN REVIEW APPLICATION Date: �CG , �Y. %SDS ( AP# ®6 �- l`79 P -O, Permit Number (if applicable) 3 37 7 Bin Number APPLICANT INFORMATION Parcel Size: Owners Name: G� Owners Address: Telephone No.: Situs Address: 75- mpyr+eizF Proposed Use: Residential ❑ New Single Family Residential ❑ Single Family. Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel -Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition ❑ Commercial Remodel.' ❑ Industrial Remodel 5 Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A In Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ' ❑ Resolve Problems Prior to Approval Site Play) Stamped Approved A A z c Date 612 - 5 "04v</ Page 1 of 5 0.13 0 K ASSOCIATES ENGINEERING CONSULTANTS 2060 PARK AVENUE OROVILLE. CALIFORNIA 95965 PHONE (916) 533.6457 August 24 1979'.. REPORT OF CONTROLLED COMPACTED FILL PROJECT: Kelly Ridge Estates `. Unit4A Lot 39 Henry . Re: 79551 GENERAL Compacted fill was placed to provide support for a mobile home.. .The maximum depth of compacted fill .is about._3 feet. DESCRIPTION OF FILL Prior:to placement of fi11,.the area to receive structural fill was cleared of.weeds.and debris. The material used for the fill was obtained .from the site -and import_ and consisted of a variety of soils, as shown on the "Summary of. Tests". Fill was placed in loose layers about six inches in thickness and compacted by.track rolling: Water was added to the fill prior to placement of additional fill. During construction of the mobile home pad,. fill was placed outside the structural fill. -This fill was .not tested'during grading and is considered to be a non-structural fill. A typical cross-section (Plate 1) depicting this condition is attached. The approximate extent of the grading is shown on the. attached drawing "Location of Density Tests". TESTING Field density .tests were taken at frequent intervals near the fill surface. Representative samples of the.soil were taken to the laboratory for compaction tests.. The compaction tests were performed in accordance with the laboratory standard ASTM 1557 Method A & C The relative density.of the fill.was determined from the compaction tests. Where tests indicate insufficient compaction the material was removed, recompacted and retested.. The location of the field density tests are shown on the attached drawing. The results of - the:tests,are given on the table "Summary of Tests".' CONCLUSIONS Based.on intermittent observation, it is concluded that the structural fill was placed in an orderly and .efficient manner and that the field density tests are representative of.. the-. structural fill placed. It is our opinion that all portions of -the structural .fill are compacted. to at least 90% of the maximum density, in accordance with the requirements of the County of Butte. COOK ASSOCIATES By Lein Hiatt .Civil Engineer RPL/cab J 11P11',^,\1 yr JLI:.J1J PROJECT:- KELLY RIDGE. ESTATES Lot 39.�, Unit 4A Henry Re: 79551 . FIELD DENSITY TESTS: Field Test Density Percent :Maximum Degree of No. Date Elev. pcf Moisture-- Density Compaction Remarks 1 8/9./79 +11Fill 111 13 .126 88 Fail 2 8/17/79.+1'Fill 121 15 128 95. Retest .3 8/20/79 +2°Fill 119 12: 132 90. 4. 8/21/79 +31Fill 121. 13 132 92 COMPACTION TEST: Maximum dry density, pcf : 126 .132.... 128 Maximum size tested: #4 - 3/4 .. 3/4" Optimum moisture,, percent: 11 VISUAL CLASSIFICATION: Soil type: Clayey Sand Silty Sand' Sandy _Clay' LOCATION OF DENSITY LOT 39 UNIT ,4A `F E. ST S HEnl2Y L� ' A R Z�l = 04' tq-oo" Y' j J LEGEND. o� o M p • j Lacr�+tov: c� t°• U DeP `Vi .C�i _ Stop Z. .�.' 1' No cc=SS S 2t a 2Q 7 TE !� /�lOL3 79 5 -Z Z =77 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Facsimile www.buttecou ntv.neVdds www.butte-generalplan.net ADMINISTRATION * BUILDING * PLANNING REQUEST FOR COPIES Please furnish me with copies of the building file documents I have indicated for the assessor's parcel number(s) and address(s) I have listed below. I understand there will be a copy fee of $.25 for the first page and $.06 for each additional page thereafter payable at the time the copies are picked up. I further understand that Butte County has up to 10 days to respond to this request based on the Public Records Act. Assessor's Parcel Number a69• ► o • o3q Address 15 MpuTRose, DQj 0,.c, Name of document(s) requested Linc,,"". F,L-E Assessor's Parcel Number Name of documents) requested Assessor's Parcel Number Name of document(s) requested Assessor's Parcel Number Name of document(s) requested Assessor's Parcel Number Name of document(s) requested Address Address Address Address Please Note: Copies of building plans are not covered by the Public Records Act but instead are under California Health and Safety Code Section 19851-19853 and require written authorization from the property owner and the Registered Design Professional before being duplicated and a separate fee of $127.00 is required HAKE a-. A-c-WiE HArnA�1z Printed Name Contact Phone Number/Email Address Signa e Date *When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. 3-1-1OJ:\2010 Handouts and Policies for approvahApproved Handouts and Website forms\Request For Copies 3 3 10.doc This'set of plans and specifications MUST be kept' on the iob at all times and it is unlrywful +o make any chconges or•'alterertions on some without written permission from the Department of Public Works, County of Butte. NOTE:—All Materials Workmanship Shall Bnd nizd Gdirattea Accordance with the of a quality prescribed for tone Specified use in and Uniform. Building. Plumb"' ech a��o_nrthe National 6 G 00 0 0o O Z ZO p _A�t_P All utility cony located within 4 Aird section of on the left (road) 4�' -71.57' The Bldg. Setback s ..._.side property line, centerline of the ro mum of a 2 ft. eave out of alt easemen Q - ILI IW A permit will be rqui a fora f e U N installation of t ilehom lxrn o O M i SQ. FL MINIMU EOR MOBILES' cti4s shall ' 6e . ouWe the reef-- _ _ ,he n-obile home si e emo - G4.04' - � = 04 119" oo., P, ='650' L = 64.o4' LOT 39 UNIT 4A A1/7-/%/, 1-/01� i'E_ _�KS ".,e <-Z, 2 ' /\/V 7' all be 5 ft, from the ,d .50 ft. from the , permitting a maxi- verhang but entirely it will be -required for the, lio / L -CIO J /, v BUTTE COUNTY BUILDING DEPARTMENT 7 1"NO-AC = APPROVED -SS s 2i a -/e O 7-A 7-E',C7 MDQ/L -e /gyp ` S /� 79 /?f/ci- 5 -2 2 -77 MOB ILEHOME8UPP,6ft DATA If other than single wide, Mobilehome Mfr. Mountain Valley Home furnish Setup Model No. 2BDR, LPK Year 1979 NET Width 24 (ft.) Box Length 62 (ft.) Tagalong or Expando Size 10'10" ft. x 32 ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October'7, 1973; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. Footings (check one) Single X❑ 1. Wood either pressure treated of 24 30 foundation grade. (ft.)(in:) x (in.) (in.) �� � ❑ 2. Other (specify) Center support. locations* Center support footing sizes Supports (check one) (in.) x,` ❑ 1: Concrete block. 14'0 36 30 ❑ 2Other (specify) (ft.)(in.) x (in.) (in.) l�--Tagalong or Expando,. show support details. 24'11 24 30 a x3 z (ft.)(in.) (in.) (in.) I 1 x 30 -- Typical Support (in. (in.) Footing Sizd (ft.)(in.) (in.) (in.) S-_ -- Max. Pier Spacing Max. Overhang (ft.) (in.) (in.) (in.) (ft.)(in.) WZ, Cowry =VY- 6UILDING DEPARP IEN' -APPROVED *If center piers are other than drawn above, draw in --locations, spacing, and dimensions. 6' WE' s 4•ufo ! •ran mviannn nr_ 1:vr �r • L4•xfi. 'DF" z : L2"x!d DECI(ING . GIRDERS .. n.v.fltnnn PP CVT \- I oD "� FRMIU ' CLI P • %• x 112 STAIR ST-ru llGE1z. hfS'a.�: MAX. Itox12"PIV9 .?DP VIEW (pn lit vie x�.a. iiGot, 1) H RkID�41L : NOT 511OW M •FDR CLRIZITY. • 3/g� 00LT ' S pct c e6f :50 -fly cL+ �- . ` 1�=- j{'( Sphere, cnnne� #2'%(4? � 4h ro co t . MOBILE- 110MC c o OR DEtz LVE A 1hid". MR. F W MAX. CUP�EI1. DE _.. ' q'MIN. �y • � al• u4 POST— •z r-= GUARDRAIL ' i'21]F.� •' � � e"MIN. I; 4 "'-A'AX DEMI HG' • .GIRDER � A A PREUST • ° 41-1" POST j1priQU4T�' DIAGONAL 6 IIL BRACING. TO 14 ak •a • �.�.. VOUN ,1��xI ��MIN. roo7'1N6 V-10" PRFSSIME- �7 RlAT-rD Ph RFDWo00'PZArbr BUTTE COUNTY BUILDING DIVISION APPROVED 1�,_ 4 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP043377 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 12/09/2004 APN: 069-170-039-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 75 MONTROSE DR ORO Date: Contractor: Map Index: Description: NEW OPEN DECK(96) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: MCCANN HAROLD L &ARLENE L permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of 75 MONTROSE DR the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE, CA she is exempt therefrom and the basis for the alleged exemption. Any 95966-3961 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: MCCANN HAROLD L &ARLENE L owner of property who builds or improves thereon, and who does pp such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ❑ I am Exemptunder Article 3 of the Business and Professions J,(Code a Aum � Date:21'6 L_0j4 Owner: 2A.- �. l� . WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of peoury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for License #' 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 Architect: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 96 S. F. Policy #: I certify that in the performance of the work for which this permit is Valuation: $960.00 issued, I shall not employ any person in any manner so as to Census become subject to the workers' compensation laws of California, Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall with those provisions. forthwith complyL ( J fa — D — o `t Date: _ Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. 418584 4 Iso CONSTRUCTION LENDING AGENCY This permit is her by issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do ork indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) v� a_ J / I o+ Name: By: ���rs �� Date: PER XPI S ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of ButteCounty to enter upon the above mentioned property for inspection purp S. Print Name: v C C-AI V N ► /� J— j Signature: Date: 4a -,Q!2 ^ 4J Owner 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor Wkl SITE PLAN REVIEW APPLICATION Date: AP# ®6 tel- 179 Permit Number (if applicable) Oq' 3 3Z 7 Bin Number APPLICANT INFORMATION Parcel Size: Owners Name: G C� Owners Address: Telephone No.: Situs' Address: 75- Proposed use: 1 Residential ❑ New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling Temporary Mobile Home (Aunt Minnie) ❑ TemporaryTravel-Trailer. ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition ❑ Single Family Remodel t ❑ Commercial Remodel • ❑ Industrial Remodel Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building E] Agricultural Buffer Form El Applicable El N/A Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ' ❑ Conditionally Approved ' ❑ Resolve Problems Prior to Approval Site373T amped Approved j By Date Page 1 of 5 I r ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: El Verify residence can be built per contract F-1Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: )c • Flood Panel No.: Q 525: Index Date: 6 ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance -------=------------------------------------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: (T — '( (U D 2% Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front U, Side 51 �6 Side Street Rear 5-r Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 9. Electrical A. Is service large enough -to provide adequate -amperage- to mobilehome (must equal ruing=of mobilehome with a•minimum of 100 amp) and other•facilities on, lot,'i.e., water pumps, garage cabana, .etc.? Yes_ B. Is there proper clearances around panels? Yes — No_ C. Is power supply cord or feeder assembly properly fused? Yeg No D. I ontinuity test satisfactory as per the following procedure? Yes De energize'electrical wiring system of the mobilehome-at the pedestal. 15 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. �. 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 the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 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. 1�'s`job card signed by Health Department for water and sanitation? 1�feverything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle 00",&[ .1/A L films Length Width Vehicle Serial No. s �© State Identification No. Additional Information or Comments: 0 / '44C n MOBILEHOME INSTALLATION INSPECTION CHECKLIST 1. Is the mobilehome located Nith re "ed separation from lot lines and buildings and generally conform to plot plan? Yes _ 2. Does the mobilehome have required clearances above ground? (Sec.5085) Yeses �No 3. Are footings and supports properly sized, spaced, and braced as p approved plans? (Note possible variation at spring shackles.) (Sec. 2 & 5083) Yes_ No 4. Is the mobilehome level? (Sec. 5088) Yes_ No_ 5. If more /�'�an a single unit, are crossover connections properly installed? (Sec. 5088) Yes Y No 6. Water A. Is flexi connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes o B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes "Mkflow - If coach is not Stat_e�£._Calif =ia_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? YesL�I�o C. Are any leaks detected in drainage system after running 3 -gallons f water through each fixture including washing machine standpipe? Yes No - -coach is not State of California app=34ed- does station have required trap and vent? Yes No 8. Gas Piping Kd Gas Vents A. Connector- Is mobilehome connected to the gas°supply mobilehome c nector not more than 6 ft. long? Note: large as the ilehome gas line inlet without red t connector. Yes No B. Test OK as per followin rocedure? Yes o 1. Open all appliance con ctor valves. 2. Shut off appliance burner an-&,pXot valves. wian approved 3/4" minimum XA11 piping is to be at least as ions other than the mobilehome 3. Air test with manometX-rated 0"-14 ater column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) cin to h pound increments. Test for 10 min. without drop. 4. Connect gas mete to mobilehome with connec r, turn on gas, test connections with soapy water. C. Are all applia,ce vents properly installed? Yes _No COUNTY OF BUTTE_ ! DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OE OCCUPANCY. This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Cl ter' -5, under permit number gfor the following location: 75 pLi Owner 10n IA L L Owner's Address SA�%1T— Mobilehome Mfg. !y»N. X1,4 L . Model Insignia No. C44 Serial No. s h i hoop y It is hereby certified for occupancy at the above described location and may be occupied. Directtoor/of Public Works ,% t Date r By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. PERMIT NO. 6528-79B i k PERMIT EXPIRES Z2 5��+ r _ Donald Henry -4OWNER °{• o mes Mobile Home Serv., Oroville r CONTR. 34-76-39 LOCATION (A.P. ) 75 Montrose Dr., lot 39, KRINA, Oroville r i �4 tl ` I / 11 If Temp. Power Pole Called PG&E Temp. Elea Sew. Called ' &E c Temp. Gas Serv. Called PG&E J t FINALED (Date) A. kvy (Signa re) s� . .F I I{ . � I a 1 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTIM RECORD BUILDING BUILDING (Cont'd) - PLUMBING Setback Firewall Soil Piping Forms Parapets tst Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footin s Stemwall Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for phsically handica ed Conformance of ex. structure Appliances Gas PI in & est Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Relnf. Steel Final Fixtures Bond Beam FIRE SPRINK RS Motors Framing ' Test Water Htr. Stucco Final Subpanels i Mesh MECHAlikCAL Grd. Fault Prof. Scratch Heating Service Brown Cooling -Temp. Pole Finish Ducts Under rou Interior Lath Ventilation Parma— . Door Closer I MOBILEHOME ILITIES ------•---------- Final Elec. Service Final Elec. Pedestal Water Piping OBILEHOME INSTALLATION - - - - - • - - - - - - - - Sewer Support Gas Piping Elec. Continuity Water Piping Drainage Gas Piping in 9 DATE REMARKS OR CORRECTIONS (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: K4-4541 �% Q APPLICATION AND PERMIT An au ulul Icv ICFlIGACIILQLIV0J UI UIC %aUUIIty UI OUlle IU CIIICI UPU11 Lilt: above-mentioned p operty or in rpurposes. !!�^, ,i9 X Date v ZZ Signature of Per�mitl/0ee or Agent Receipt No. ��SP, White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF,PUBLIC WORKS By Date Buding permit expires Date BUILDING Owner P&AbOl SQ. FT. OCC BUILDI G A TION (�Mailing Address's j7,i— 20�C'"Telephone No. NFireplace Contractor E2CJ Mailing Address 3/A// Total Valuation 0 -- �+ Telephone No.,1-34(-5-50! Permit Fee I DO Building Address Plan Checking Fee&/or Penalty Permit Fee 1677 L5i PLUMBING No.1 @ FEE ��efCa' PERMIT FILING FEE $3.00 , Each Trap 1.50 2 c n T/ Repair drainage or vent piping 1.50 y Q A. P. Lj/ "' ! "' 3 % oning Planning Water piping 1.50 Each gas water heater or vent 1.50 es -6erritatioTf Fire Dept. FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking plans Parcel Declaration Parcel Map 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 Parcel A roval Plan pproval Lawn sprinkler system 2.00 FIM NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ permit Fee $ $ ELECTRICAL No. @ FEE /a yQ WA-) PERMIT FILING FEE $3.00 Main service 1100V DR LESS 00 AMP OR LESS 5•00 Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 l AA.J4 924/ _E/L ' .- 100 AMP OR LESS Main service OVER 800V 25.00 Main service EA. ADD•L 100 AMP 1.00 NEW CONST. DWELLING OCCUP. 4 OR ADDNS. % ACC, BLDGS. / 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: ' NEW RESID. BRANCH CIR T NON.CONST BRANCH CIRCUITS) 2.50ea NEW CONSTR. POWER APPARATUS & NON.RESID. SINGLE OUTLET CIR, Ex. OCCUD(OUTLETS OR FIXTIIRES g L2j FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID•) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification e—ta' Misc. Wiring 6.25 ❑ 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. iecertify 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. @ I FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 1 1 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ TOTAL PERMIT FEE $ 7_1y Oo au ulul Icv ICFlIGACIILQLIV0J UI UIC %aUUIIty UI OUlle IU CIIICI UPU11 Lilt: above-mentioned p operty or in rpurposes. !!�^, ,i9 X Date v ZZ Signature of Per�mitl/0ee or Agent Receipt No. ��SP, White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF,PUBLIC WORKS By Date Buding permit expires Date NOTES RESIDENTIAL r G69-170-039 04 377 ( PERMIT NO. _'!..iMCCAN_N7-- 7,5 MONTROSE DR, OROVILL J Cont: MYRON LWNDQUIST CONT � NEW DECK y i 11 SPECIAL CONDITIONS 11 CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) Signature J=OK 0 = Not OK . = NotReadyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except ff's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L -ft. / P Nat. or / /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 9. Siding; (Jailing -Veneer -Stucco -Mesh 10. Poof; Shthg-Roofing Date 101." Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line Card B-1 Date Card B-1 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances } 5. Drain; MH Test -Fall -Flex Connector ! 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval i 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date 11. Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line Card B-1 Date Card B-1 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DEC , COVERS, CARPORTS, GARAGES (Plans) OK except #'s Zoning Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel ecks, Girders and/or Joists -Decking -Bracing -St ' -Ra s 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric B. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; (Jailing -Veneer -Stucco -Mesh 10. Poof; Shthg-Roofing 101." Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date orf Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements } 2. Soils; Compaction -Structure Stability ! 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI i 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 Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) Date Hangers -Post Caps -Anchors -Connectors Card B-1 Date Card B-1 Date Cling. Joist-Rftr. Ties- Purl in- Roll Brac.-Truss-Shting.-Rtng. Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test 57. Siding -Nailing Veneer Date 58. Card B-1 Date Card B-1 Date 59. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Shear Walls; Nailing -Bolts 24. Fixture & Transformer Clearance -Ins. Protection Brace Interior/Exterior Wall Panels 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled Date 27. Romex Installed Close to Edge of Studs & C.J. Date 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Date 29. 2 Appliance Circuits in Kitchen & Conductor Size GF] 64. 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI 65. 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes O No 66. 32. Service -Riser Conductors & Ground Main Disconnect 67. 33. Equip. Clearances Panels-Motors-Mech. Equip. 68. 34. Clothes Closet Light -Shower Light -Spa Light 69. 35. Smoke Detector 70. Stairs & Rails Date Fireplace or Stove, Clearance -Hearth Card B-1 Date Card B-1 Date Elec. Outlets at Wood Panel, Int. & Ext. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date 79. Card B-1 Date Card B-1 Date 80. Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Guard Rails & Deck Construction -Post Caps 41. Sills Proper Materials & Anchors Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Clearance Looked under Floor 0 Yes 43. Bearing Walls over Girders & Floor Nailing Following Instld./Drive 0 Yes 0 No/Walks D Yes 0 No/Planters 0 Yes O No 44. Draft Stop in Walls (rat proof) Stucco Brown -Finish 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs A.C. Unit Disconnect, Electrical -Plumbing 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purl in- Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. 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 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes _ 83. Following Instld./Drive 0 Yes 0 No/Walks D Yes 0 No/Planters 0 Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/0 to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler 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: �13T�'�. BUTTE COUNTY 0 o DEPARTMENT OF DEVELOPMENT SERVICES ° ° BUILDING PERMIT APPLICATION ° ° AND SUBMITTAL REQUIREMENTS o - - �- . ° 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 �Ou 14. A FEE WILL BE REO UIRED AT TIME OF APPLICATION **PLEASE PRINT CLEARLY** OWNER Last First Name Address._, Address State, Zp Phone Fax E-mail CONTRACTOR ARCHITECT/ENGINEER Name Address—) 4 \ Address Ci "\ �'��� iRtA,, City��-�`.4_at�t�c„ State�f Zip��Sct� —Phon eta �.��, —Fa Lot# E-mail�����.� E-mail Date Approved: Class APPLICANT NAME ARCHITECT/ENGINEER Name Address—) 4 \ Address Ci "\ �'��� iRtA,, City Zi State Zp Phone Lot# Fax E-mail Date Approved: State License Number APPLICANT NAME Name Zoning Address—) 4 \ Occ. Ci "\ �'��� iRtA,, State- Zi k— ��11C� Fax E-mail�� Lot# APPLICANT SIGNATURE X�, _ Sin t For office use only: Ayj ( ` (� Zoning Flood Zone X SRA 1<esj No Occ. WORKER'S COMPENSATION Type Const, Subdivision Name If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. Map Book Page Lot# Planner Date Approved: PERMIT NO. 33 7 9 BIN N LOCATION Ayj ( ` (� Property ddress-\_- \ City Cross Street � WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY -Nam Address Description or Scope of Work: rl n Sq. Footage ❑ Structure Built v4thout Permits ❑ Proposed Change of Occupancy (Note previous use): OVER FOR SUBMITTAL REQUIREMENTS L K:IFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by f Amount: 1 c56, 6' Bldg SRA Receipt # Sheriff SHIP other Total REV 7-27-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING. DIVISION. 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ! I CA /1 6, firLt, / ASSESSOR PARCEL NUMBER Proposed Building Use: / 1i) ! j� LC 1�� Counter Technician: Date: Items required in order to Apply for a'permit. Al boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. O 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. O 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or find plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form 0 �P( 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ k23. 24. California Department of For stry plan approval ❑ paid. Sent by: ............ Planning approval (A) Use: (B)Parking: (C) Parcel Check:_ D� 0 ❑ 25. Contact Land Development about_ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... O 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... O 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone 111dJa or and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: (� b 4, g, I Q-� �DnLa, J Date: 0- A `1n v 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items re Contractor, designer owner was advised of the above data by ff phone, ❑ mail, ❑ counter, by Date: o'Z. 6 b Contractor, designer, - e -r, was advised of the above data by ❑ phone, ❑ mail, ❑ co nt , by Date: Plans reviewed by: Date: Plans approved by: Date: Structural 3.reviewed ..Date:.-_._... Structural approved by: Date: Note transfer b . Date: Yellow: Building Division IQ N WTMEN? Or, o c ��lC WO5 �CRD Depa-rtment J. Michael Crump, Director Public Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE] Project Description: 1� " r-) P_c_,� Project Location and/or Parcel Number: Lo 2 ` D --:S Cj By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB - 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm. Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: D A. Q 4 AA -Z Ai O Title: Date: t o2 D ci - Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 flO Subdivision MR/Parcel Map: Map Date of Recording: &4Z 25. d Gol Lot: 9�-q ❑ Use Permit/Minor Use Permit Permit Number: Book: 113 Page: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the .National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. Page 4 of 5 Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other ------------------------------------------------------------------------------------------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation: El No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 Ci PERMIT NO. 4099-79P,E PERMIT .EXPIRES ;OWNER DONALD W. HENRY ,?CONTR. -nwnar ',"LOCATION (A.P. 34-76-39 ) 75 Montrose Dr,lot '39,KRIKA, Oroville i i - f r 1 Temp. Power Pole Called PG&E Temp. Sec. Serv. C lied PG&E Te p. Gas Serv.. Called PG&E JOB FINALED (Date g (Signature) L ' Setback Forms Main Bldg. Footings Stemwal I Slab Piers Garage Footings Stemwa I I Slab Patio Footings isonry Walls Reinf. Steel 4 COUNTY OF BUTTE — DEPARTMENT -OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUM G - Firewall Soil Piping Parapets 1st Floor Restroom Finish 2nd Floor " Windows 3rd Flo Sidina To out Roof Sheathing Wat Pi in Roofing S 4 er Fdn. Vents i fixtures rage Vents Ins tion Water Htr. Heaters Prov. h sically n C Conformance ex. structure Appliances Gas Piping & Test Temp. Gas Final Sanitation FIREi ACE Final I Footin Motors Mesh / MECHANICAL Grd. ault Prot. Scratch Heating Servlce Brown Cooling Temp. Po Finish Ducts UndergroundIX Interior Lath Ventilation Permanent Door Closer Final Final - MOBILEHOMEUTILITIES------------------ Elec. Service Elec. Pedestal Water Ptiping & - 3.Z- Sewer ._a Gas Piping E INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity 9, - r Water Piping Drainage Gas Piping .�� DATE G �• -rr 7 l 7—ba.� REMARKS OR CORRECTIONS �o®,� .4� &Xxu NO .5"p �o � yes (NOTE: An entry must be made on this form each time you visit the job site.) u COUNTY 0'F BUTTE — DEPARTMENT OF PUBLIC WORK ' 7 County Center Drive - Oroville, California 95965 _ Telephone: 534-4541 [1 APPLICATION AND PERMIT L00, authorize representatives of the county of tsutte to enter upon the above-mentioned property for inspection purposes. XX Date Signature of Permitee or Ag t Receipt No.S White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date uilding permit expires Date 7—t/- P(3 BUILDING 00, Owner Donald W. Henry SQ. FT. OCC. BUILDING VALUATI Mailing Address 19172 Oxnard Street ' Tarzana, CA 91356 Tel phone No. 21-343-29]Fireplace Contractor Mailing Address Total Valuation Telephone No. Permit Fee Building Address 75 Montrose Drive Plan Checking Fee&/or Penalty Permit Fee Oroville, CA 95965 PLUMBING No. @ FEE PERMIT FILING FEE $3.00.00 Each Trap 1.50 Lot 39, Unit 4A - Kelly Ridge Estates Repair drainage or vent piping 1.50 A. P. No. 34 - 76 - 39 /Lf�( Zoning lanning Water piping 1.50 C).DD Each gas water heater or vent 1.50 F s I *.e Sa Fire Dept. Fire Zone Use Permit Gas piping system 1 -5 outlets 1.50 EGA Parking Plans Parcel eciaration Parc fvlap 60' R/W Improvements Each additional outlet .30 Building sewer 5.00 tq,Qo Bldg. P ns Recd P cel Approval Plans Approval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES,® OTHER ❑ Permit Fee $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 B. OC? Main service 6001 OR LESS AMP LESS 5.00 5,00 Single Family Duplex Mobil Home Others ❑ P ❑ ,� ❑ EA -L Main service EA. ADD•L 100 AMP 2.50 Main service OVER eoov 25.00 100 AMP OR LESS Main service/ EA. AOD'L 100 AMP 1.00 NEW CONSTOR ADDNS. C ACCDWELBLDGS.LING CCUP. 'd)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 st le of: Y NEW CONSTR MULTI NON.RESID � BRRANCANCHH T CIRCUITS) 12.50ea NEW CONST/POWER APPARATUS a NON.RESI D. ,SINGLE OUTLET CIR. Ex. Occuo(oU'TLETS OR FIXT11PES 5 L: Ex. OCCU FIXED APPLNS. OR p•�OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00SOO License No. Classification Misc. Wiring 6.25 KI am exempt from the Contractors License Laws of the State of California. Permit Fee $ x. $alrlsc 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. 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 State Laws relating to building construction, and hereby%3 Land Development Fee $ 00 isand TOTAL PERMIT FEE authorize representatives of the county of tsutte to enter upon the above-mentioned property for inspection purposes. XX Date Signature of Permitee or Ag t Receipt No.S White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date uilding permit expires Date 7—t/- P(3 "" • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC C WORKS 4 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 Date SI atu of mi tee or g nt Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Bu County Code and/or resolutions to do work indicated abo fo which fees have been paid. /1 L A-I.RECAOR OF PUBLIC WORKS I!C/./,/2�///111:A .. _ BUILDING Owner Donald W. Henry SQ. FT. OCC. BUILDING VAL TION Mailing Address Telephone No. Contractor Carneros Mobile Transport Mailing Address 1290 El Capitan Fireplacen Total Valuation Napa, CA. 94558 Telephone No. ]0] 252,2411 Permit Fee Building Address 75 Montrose Drive Plan Checking Fee &/or PenaltyPermit Fee Oroville California 95965 PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Lot 39 Unit 4A - Kelly Ridge Estates Repair drainage or vent piping 1.50 A. P. No. 34 r 76 - 39 ��I Zonin 8 Planning Water piping 1.50 Each gas water heater or vent 1.50 Fk-J s SIa,� Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Map 60' R/W I Improvements Each additional outlet .30 Building sewer 5.00 Bldg. ens Recd Parcel oval Plan oval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER fVPermit Fee $ $ Installation ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Single Family ❑ Duplex ❑ Mobil Home Others P � Main service eoov OR LESS loo AMP OR LESS 5.00 Main service EA. ADD100 AMP 2.50 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST V ADWECCLBLDGS.LING CCUP. '6)2¢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:Occu Carneros Mobile Transport NEW CONSTR. BRANCH CIRCUITS) NON.RESID BRANCH CIRCUITS) 2.50ea NEW CONST R. POWER APPARATUS .&, NON-RESID, SINGLE OUTLET CIR, Ex. Occup{OUTLETS OR FIXT11RES) 5 L@:1¢ FIXED APP LNS. OR Ex. Occup. LETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. 259158Misc. Classification C-61 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. ®I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 M9030MIDODWAKIM Mble. Home Installatiog 30.01 TOTAL PERMIT FEE $ 3 authorize representatives of the County of butte to enter upon the above-mentioned property for inspection purposes. X Date SI atu of mi tee or g nt Receipt No. White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Bu County Code and/or resolutions to do work indicated abo fo which fees have been paid. /1 L A-I.RECAOR OF PUBLIC WORKS I!C/./,/2�///111:A .. _ BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: -534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: Donald W. Henry Lot 39, Unit 4A- ' 2. Installer's name: 3. Is the site currently under permit? Yes /X % No ( If yes, furnish permit number ) OR ' Is the site an existing'°site? ;Yes / / No 7x7 (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 /y% No / / ( If no, clarify. ) 5. What is the mobilehome electrical rat'ing?----------------------- 200 Amps 6. What is the mobilehomp',site service rating? --------------------- 200 Amps 7. What is the mobilehome-site circuit breaker rating? ---.=--------- . 200 Amps 8. Is there any other electric load to be'served by the mobilehome site service? ---------------------- ---.-------------- ------------- Yes / / No /x / (If yes, identify the load and size: (Load) -0 (Amps) 9. What is the mobilehome site gas pipe size? ----------- ------------ -0- (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG 11. What is the gas pipe length from meter or tank to the mobilehome? -0 (ft.) 12. :What is the mobilehome gas demand? -------=---------------------- -0 (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) COOK ASSOCIATES ENGINEERING CONSULTANTS 2060 PARK AVENUE _ OROVILLE, CALIFORNIA 95965. PHONE (916) 533.6457 August 24, 1979 REPORT OF CONTROLLED COMPACTED FILL PROJECT: Kelly Ridge Estates Unit4A Lot 39 Henry . Re: . 79551 GENERAL Compacted fill was placed to provide support for a mobile home.... The maximum depth of compacted fill.is about. .,3 feet. - DESCRIPTION OF FILL Prior:to placement of fill, the area to receive structural fill was cleared of weeds and debris. The material used for the fill was obtained from the site and import and consisted of a variety of soils as shown on the ."Summary of . Tests". Fill was placed in loose layers about six inches in thickness and compacted by track rolling Water was added to the fill prior to placement of additional fill. During construction of the.mobile home pad, fill was placed outside the structural fill. This fill was .not tested during grading and is considered to be a non-structural fill. A typical cross-section (Plate 1) depicting this condition is attached. The approximate extent of'th-s grading is shown on the. attached drawing "Location of Density Tests". , ® 0 ASSOCIATES ENGINEERING CONSULTANTS 2060 PARK AVENUE - OROVILLE. CALIFORNIA 95965 - - PHONE (916) 533<6457. August 24, 1979 J ames G lander Department of Public Works 7 County Center Drive Oroville, California 95965 Re: 79551 Dear Jim: We are.pleased to submit the enclosed Report on Controlled Compacted Fill .for: KRE Unit 4A, Lot 39 Henry If you have any questions, please do not hesitate to contact us.' Very truly yours, .COOK ASSOCIATES Lew Hiatt Civil -Engineer' LH/cab Enclosures cc: Doyle Carter TESTING Field density tests were taken at frequent intervals near the fill surface. Representative samples of the soil were taken .to the laboratory for compaction tests.. The compaction tests were performed in accordance with the laboratory standard ASTM 1557 Method A & C The relative density of the fill was: determined from the compaction tests. Where tests indicate insufficient compaction :the material was removed, recompacted and retested. The location of the field density tests are shown on the attached drawing. The results of the tests are given on the table "Summary of Tests". CONCLUSIONS Based on intermittent observation, it is concluded that the structural fill was placed in an orderly and .efficient manner and that the field density tests are representative of. the structural fill placed. It is our opinion that all portions. of the structural fill are compacted.to at least 90% of the maximum density, in accordance with the requirements of the County of Butte. COOK ASSOCIATES B y Lena Hiatt Civil Engineer RPL/cab COMPACTION TEST: Maximum dry density, pcf: 126 132._ 128 Maximum size tested: #4 3/4" 3/4" Optimum moisture, percent: 11 11. 11 VISUAL CLASSIFICATION: Soil type: Clayey Sand Silty Sand Sandy. Clay uuLuacv.�i Vr 1�,u1.� .. PROJECT: KELLY RIDGE ESTATES . Lot 39.2 Unit 4A . Henry Re: 79551 FIELD DENSITY TESTS: Field Test Density Percent Maximum Degree of No. Date Elev. pcf Moisture.. Density Compaction Remarks 1 8/9./79 +l'Fill 111 13 '126 88 Fail 2 8/17/79 +11F.ill 121 15 128 95 Retest 7 :3 8/20/79 +2°Fill 119 12 132 90 . 4 8/21/79 +3'Fill 121 13 132 92 COMPACTION TEST: Maximum dry density, pcf: 126 132._ 128 Maximum size tested: #4 3/4" 3/4" Optimum moisture, percent: 11 11. 11 VISUAL CLASSIFICATION: Soil type: Clayey Sand Silty Sand Sandy. Clay LOCATION OF. DENSITY. LOT 39 UNIT ,4A. CAAoN oS 0 = 04' R = 95p• l:5 '� o 57' L- - lo4.04- Y- Qr cq (/ ---- _Y`� SCALE- `�� = 20• rl , � - LEGE- ND I I00 oM 0 .� Lacr�iiov: of �25� DeP t�11 2 .Fill Flo P.e f� Cui . slope_ /-\cc_ss s v jZj P. /c n 7A TSD /�O� /L /d4 Q S-/c�. 79 /7/--i _ 5 -Z Z -77 0�.�. 1 J r� SITE PLAN f... :�. ._ .. _ .. .. .. .. .. .. .. ............. .. .. •. ............................ .. .. ........ .. .. ... .. .. .. ..................... ., .. .. .t.... •�•• .. .. .. .. ... .. .. .. .. .. .. .. .............. _.............. .. .. .. .............................. .. .. .. .. .. .............. • .. .............................. . ............................. .. .. ............. .. .. .. .. .. .. .. .......... .. ... .. .. .. .. .. .. ._ .. ... ........... .. :F / J .0 . i . ............ .. ". / . .... ... .. ....r.. ..... .... . PLANN -f-. t Buo NG-PCANAP 'E' • i�at .. ............ .. ................ . . ,. 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R' .. . `.. .. .. ... .. .. .. .. .. .. . i.....:................: _...... .................. ............ ................................. ................................................................................................................ ............ ....... _............................................ Assesses Pal Number:5° v T T - Scale: " ®� F® Owner Name Address / Phone N®. --7 'r-) Site Location 'Ac-, �,kt-ozp- V) U N Contact: Name \Ar- Phone cd2h 4 2M3