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058-270-008
I 4 58� 427-8 Robert Englund - jog ff SIS o app.150'off SIS Efotw(' o. - Ln. app 2 rLli E -of Co cow Rd.,Concow. Permit�/�7�70927-7P.,E(uS1. ,MH) - A -7 �e ALPU �O se 0 ELEC. 15/ JQ) AS JISliW S POR StRUCTURE REQ. ,v 0 CO ACTION TEST REQ. vp 58-27-8 Permit YP5928 =78m' Issued /..2 _: 7/ /j /�iTi!�j� r1108-1540 11 ! " 058-270-008 MISCELLANEOUS'. Demo-Fife08 DEMO PERMIT - JUNE LIGHTNING F 4176 KAKINI RD' BUZZOTTA, PATRICIA 7 58-27-8 Vit, FK. ousing Inspection Letter R L. ed. -Sand ra -Eng-l-und- 4176 akini Dr. Oroville BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES 1-1 BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds 'PROJECT INFORMATION Site Address: 4176 KAKINI RD Owner: Permit No: B08-1540 APN: 058-270-008 BUZZOTTA, PATRICIA Issued Date: 8/5/2008 By GLB Permit type: MISCELLANEOUS 4176 KAKINI RD Subtype: Demo-Fire08 OROVILLE, CA 95965 Expiration Date: 8/5/2009 Description: DEMO PERMIT - JUNE LIGHTNIN (415) 306-2365 Occupancy: Zoning: FR5 Contractor Applicant: Square Footage: UNKNOWN BUZZOTTA, PATRICIA Building Garage RemdUAddn 4176 KAKINI RD OROVILLE, CA 95965 Other Porch/Patio Total (415) 306-2365 FEE INFORMATION 1 Total Charged: $0.00 Fees Paid: $0.00 Balance Due: $0.00 Receipt No: ".LICENSED CONTRACTOR'S DECLARATION OWNER /BUILDER DECLARATION • Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License UNKNOWN / / Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 8/5/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractor's Signature Date ❑ 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 WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier. Policy Number: Exp. Date: (This section need not be completed if the permit is or one hundreddollars ($100) or Fe- ss -T-0 1 AM EXEMPT under Section B. & P.C. for this reason: ❑ 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 Workers'.- / Compensation Laws of California, and agree that if I should become subject to the workers' , X _ 8/5/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date ' provisio X''~ 8/5/2008 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE injury, including death, and property damage caused arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( 1 the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property o r or am authorized toon the property owners behalf. ��rTj2iC[7a /U 8/5/2008 CONSTRUCTION LENDING AGENCY = 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] . Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner 1:1 Contractor OR; Agent for Owner Agent for Contractor FILE COPY Lender's Address City State Zip 'I f 'Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not cant' out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of lndustrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY P TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPO/HAVE ROOVEMENT. �OR NO) I NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO. 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: DEMO PERMIT - JUNE LIGHTNING FIRE 062208 Reference Number: B08-1540 Applicant Name: BUZZOTTA, PATRICIA Owner's Name: BUZZOTTA, TRIC AP # : 058-270-008 , Signature of Property Owner: Date: C� Q ; • 1�0g - LS<�-v BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. BIN # "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. OWNER INFORMATION Last Name First ,& r �, (.i'�`�AC (�A Mailing Address 1�ar_ b -2-6 City lr StateCA ZQ Ilk I Phone Fax E-mail A �� s �. 3D6� G APPLICANT INFORMATION CONTRACTOR Name City Address Zip City Fax State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT ,S/GNATURE X PROJECT LOCATION AP# Cys -7C).n© Property Address L C7 City WORKER'S COMPENSATION Policy Number Carrier if hiring anyone other than licensed contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Mh 1-f ( M 4 0$ 6 30 Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning FloodZone SRA Yes No Occ. Type Const. BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 95965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Permit Number: FEE08-0216 Job Address: Contractor: Printed: 6/19/2008 2:34 pm Fee Description Account Number Fee Amount Paid Date Pmt Amt CWIF SF CWIFFIREVE SF 1851-0-280-1011853 $709.71 CWIFPWRDS SF 1831-0-280-1011001 $1,342.38 CWIFFIREF SF 1851-0-280-1011852 $367.67 DB R3 Dwelling -Custom, Model 0 DBF R3 DWLNG CSTM/MDL Plan Ch 0010-440001-4210501-10101 $944.00 DBF R3 DWLNG CSTM/MDL Insp Fe( 0010-440001-4210502-10101 $1,416.00 DBEH Building Review Fee 1825-0-280-1011827 $162.04 CWIFSHERFVE SF 0021-540013-4614901-10101 $78.90 DBFIRE Fire Inspection (SRA) 1825-0-280-1011826 $240.89 0100-450001-4617240-10101 $214.00 DBOMSC Fire Safe Standards Rev 0010-440001-4210501-10101 $118.98 DBFIRE SRA Fire Plan Review (S 0100-450001-4617240-10101 $107.00 CWIFAUD Impact Processing Audi 0010-050-4617998-101001 $50.00 CWIFDDS Impact Processing Fee 0010-440001-4617999-1010 $50.00 CWIF SF CWIFSHERFJL SF 090807 1800-0-280-1011811 $425.00 CWIFGGVE SF 1810-0-280-101001 $307.71 CWIFSHERFF SF 1840-0-280-1011841 $314.12 CWIFGGF SF 1808-0-280-101001 $667.21 CWIFLBRYV SF 1825-0-280-1011828 $4.83 CWIFLBRYM SF 1825-0-280-1011827 $162.04 CWIFSHERFVE SF 1840-0-280-1011842 $153.27 CWIFLBRYF SF 1825-0-280-1011826 $240.89 DBSMIP Residential 1001-0-280-1011298 $6.24 Printed By: Gwyn Benedict 79679.95 $0.00 Balance Due: $7,679.95 At the time of permit application, I was advised the above fees are required prior to issuance of the permit. These fees may change during the plan checking process. Signature: Date: 6/19/2008 Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). f PERMIT NO. 5927-78P,E !. PERMIT EXPIRES i2IV7 OWNER Robert Englund CONTR. owner 58-27-8 -LOCATION (A.P. ) App.150'off S/S Do wood Ln., app.2 mi.E. of Concow Rd. Concow' //V 7, .r i� c� r .t. 4S j n rTemp. Power Pole Called PG&E Temp. Elec. Serv. �� G ailed PG&E i mp. Gas Serv. E-- Z �— Called PG&E JOB J� FINAL - igna u—re) i s COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS - BUILDING INSPECTION RECORD BUILDINrxA X BUILDING (Cont'd) PLUMBING` ae[ acK FI' wall !,V\ SoX. Piping ForA Par` ets A 7s •,Floor Main Bldg. Restr .om Finish 2nd .loor Foo ins Windo 3rd FI or Stem all SidingTo out Stab Roof Shea jng Water PI in Piers Roofing Sewer Garage Fdn. Vents Fixtures Footin s Garage Vents N Water.Htr. Stemwa l l Insulation Heaters Jy Slab for ph sicall Appliances Car rt po handicapped Conformance of ex. Gas Pi In &Test Footings structure X Temp. Gas Slab Final Sanitation Patio PIREPIACE Final Relnf. Steef Final Fixtures Bond Bea FIRE SPRINKLE S Motors Framinq Test Water Htr. Stucco Final Subpanels/ Mesh MECHANICAL Gird. FalAt Prot. Scrotch Heatiga Servic oyDwn CoqTing Tqffio. Pole finish D is lAderground I erior Lath entilation/Permanent oor Closer Inal Ntinal MOBILEHOME UTILITIES ---------•------- Elec_ Service Elec. Pedestal 14 - Water Piping y Sewer Gas Piping H MOBILEHOME INSTALLATION -- - -- - - - - - - - - Support Elec. Continuity r Piping Z 2 — Drainage 9Vr Gas Piping DAT REMARKS OR CORRECTIONS d � dnw sx- y T7 4A U j �,y� �nntMnsty ade on tform epth time y isit a job site,s2—� �Z� r 1,2-1Y-79" �0ge4AF- 70 CRr 14zit1?o'u 174.E Tv sc,5- .cl-1,J f� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requiremen s of the California Administrative Code, Title 25, Chapter 5, under permit number . ' '' for the following location: Owner Owner's Address Mobilehome Mfg Model Year Insignia No ✓i,�'. Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date By,,- THIS y,THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White- Owner, Yellow- Installer, Pink - D.P.W. 9. Electrical - A. Is service large enough to provide adequate amperage to mobilehome (must equal rating of mobilehome with a minimum of.l amp) and other facilities on lot, i.e., water pumps, garage, cabana, -etc.? Yes No B. Is the proper clearances around panels? -Yes o_ C. Is power supply cord -or feeder assembly properly fused? Yes 4- No D. Is continuity test satisfactory as per the following procedure? Yes No 1. -De-energize electrical wiring system of the mobilehome at.the pedestal. 2: Make sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. 3. Switch all breakers and switches in the mobilehome to the "on" position. 4. Connect one lead of a test instrument to the mobilehome. grounding conductor and apply the other lead to each mobilehome supply conductor, including neutral. 5. All non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved fJor energizing. 10. Is job card signed -by Health Department for water and sanitation? 11. If everything okay, sign off card and tag services. MOBILEHOME DATA Manufacturer and/or Namestyle / /1011, Length' o5W Width /d � p Vehicle Serial No. J / 21 r State Identification No.—DO%y� Additional Information or Comments: A MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with.required separation from lot lines and buildings and generally conform to plot plan? Yes No 2. Does the mobilehome have required clearances, above ground? (Sec.5085) Yes_ No 3. Are footings and supports properly sized, spaced, and braced as pe approved plans? (Note possible variation at spring shackles.) (Sec. 5082 & 5083) Yes__,Z o_ 4. Is the mobilehome level? (Sec. 5088) Yes No_ 5. If mo�jj than a single unit, are crossover connections properly installed? (Sec. 5088) Yes io_ 6. Water A. Is flex/*ble connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes d No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes /No C. Backflow - If coach is not State/4f California approved, does station have backflow device and pressure -relief valve? Yes o_ 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each _end/? Yes f�No B. Does it have minimum 4" per foot slope and is it properly supported? Yes ` No C. Are any leaks detected in drainage system after running 3- lions of.water through each fixture including washing machine standpipe? Yes No_11 D. If#/1 h is not State of California approved, does station have required trap and vent? YesNo BW- 8. Gas.Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connec.not more than 6 ft. long? Note: All piping is to be at least as large as the mobito ome gas line inlet without reductions other than the mobilehome connector. Yes_ No B. .Test OK as per following procedureo YeszNo 1. Open all appliance connector v�tives. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"014" water column or test with slope gauge (minimum 0 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehotle with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes No_ COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS County Center Drive - Oroville, California 95965 �� Telephone: 534-4541 APPLICATION AND PERMIT ���/// i authorize representa th County of Butte to enter upon the above-menti.one ope•ty sp ction purposes. �Date o -6 I naturPe miteee or Agent Recei �t Ngo J l d 0 L`J 0White-D.I7q.. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and resolutions to do work indicated above for which fees ha been aid. DIRECT R OF UBLIC WORKS By A Date/2-F7 7 Building permit expires Date BUILDING Owner R0/199W C/J(,L(fAJr> SO. FT. OCC. BUILDING VALUAT Mailing Address �OX e3oaw / 95—V657 Tel he No. Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee /-1 Building Address vp. %50 dFr- Sls Do6k)bcp Plan Checking Fee &/or Penalty Permit Fee L-4AJoE A -PP. �(Z Mi. E, CONCOA) 12b, PLUMBING No. @ FEE 19 PERMIT FILING FEE $3.00 100 Each Trao 1.50 19 Zoning Vorificafion OnlIlj QA AJ Repair drainage or vent piping 1.50 ��„ .�� ADZ A. P. No. I Caning & Planning Water piping A.&O /Or DO Each gas water heater or vent 1.50 F s S I ire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 4,60 /Qt 00 EOA Parking Plans Parcel Declaration Parcel Map 60' R/W Improv is Each additional outlet .30 Building sewer Bldg. Pla Recd arcel� oval 00, Plans pprovol Lawn sprinkler system .00 NEW ❑ ADDITION TILITIES OTHER ❑ AT Permit Fee $ 3100 .$ Iff7j OZ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 100 1AMP OR LESS 5•�� Main service 10000 OR LESS 5100 Single Family ❑ Duplex ❑ Mobil Home ❑� Others ❑ Main service EA. ADD'L 100 AMP 2.50 215_0 Main service OVER 25.00 100 AMPP OR LESS O Main service EA. ADD'L 100 AMP 1.00 NEW OR ADDNST %ACCLBLDGSLING CCUP. !� 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name st le of: y NEW CONSTR BRANCH CIRCUITS) NON -REBID � BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER APPARATUS .&, NON-RESID. SINGLE OUTLET CIR. Ex. Occur){OUTLETS OR FIXTIIRES g L@; Ex. Occu FIXED APPLNS. OR p•(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 7751" _00 License No. Classification Misc. Wiring 6.25 112 _ " / c 00 I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 06 1 SV MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this 0 permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ as, ao TOTAL PERMIT FEE $ 8 authorize representa th County of Butte to enter upon the above-menti.one ope•ty sp ction purposes. �Date o -6 I naturPe miteee or Agent Recei �t Ngo J l d 0 L`J 0White-D.I7q.. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and resolutions to do work indicated above for which fees ha been aid. DIRECT R OF UBLIC WORKS By A Date/2-F7 7 Building permit expires Date �j COUNTY QF BUTTE — .DEPARTMENT OF PUBLIC WORKS a TCounty Center Drive - Oroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT AA aurnorize represenrar( above-mentioned X or tsurre ro enter upon me purposes. Date LtN !�� e or Agent Recei 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. DIREC R F PUBLIC WORKS By Date /z - /,P- 7'P ilding permit expires Date ri BUILDING Owner Roe> EIv/-LVA) 6 SQ. FT. OCC. BUILDING VALUATION Mailing Address /�% / go Y, Telephone No. 6 —, Contractor Mailing Address Fireplace Total Valuation Telephone No. Permit Fee Building Address APP. /SQ DFF $ s Plan Checking Fee&/or Penalty Permit Fee 106 14h,W7D Z_AAJ6 4M. �Z M/ . C PLUMBING No.1 @ FEE OF p„A1� , ) �� W lt/ PERMIT FILING FEE $3.00 Each TraD 1.50 Repair drainage or vent piping 1.50 p._ Z7 �� A. P. No. O Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F s C. -4&4n I FireDept. I FireZone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel Declaration Parcel Ma 60' R/W Improvements Each additional outlet .30 .Building sewer 5.00 Bldg. PIns Recd I Parcel ifoporovol Plans proval Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER � Permit Fee $ $ "14 f-0,_ d 1 L7&(7 / Pg2M O72 -17V ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 00V O Main service 100 AMP ORSLESS 5.00 Single Family ❑ Duplex ❑ Mobil Home [� Others ❑ Main service EA. ADD'L 100 AMP 2.50 Main service OVER 600V 25.00 100 AMP OR LESS Main service EA. ADD•L 100 AMP 1.00 NEW CONS. DWELING O OR ADDNST ( ACCLBLDGS,CCUP. Y) 20sgft CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style le of: NEW RESID,CONSTBRANCH CIR T NON -REBID BRANCH CIRCUITS 2.50ea NEW CONSTR. POWER APPARATUS 6 NON.RESID. (SINGLE OUTLET CIR, Ex. Occuo(OUTLETS OR FIXTIIRES g L1�n 0 11 FIXED APPLNS. OR Ex. OCCU p•�OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 L"Pam 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. certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner fo 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 1 2.00 Permit Fee $ $ I certify that 1 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 e $ c) TOTAL PERMIT FEE $ C7 aurnorize represenrar( above-mentioned X or tsurre ro enter upon me purposes. Date LtN !�� e or Agent Recei 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. DIREC R F PUBLIC WORKS By Date /z - /,P- 7'P ilding permit expires Date ri J 1. Owner's name: BUTTE COUNTY DEPARTMENT OF -PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541• y y, MOBILEHOME INSTALLATION SHEET L. Installer s name. 3. Is the site currently under permit? Yes (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No J 8. Is there any other electri`crload•to be served by the mobilehome siteservice? (If yes, furnish two (2) plot plans.) No / (If yes, identify the load and size: lief ?ith,� J (Amps) 4.", -"Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and `3/� clear of all setbacks and easements? Yes 75Z No t ( If no, clarify is the type of gas service? ----------------------------- ) LPG T 11. What is the gas pipe length from meter or tank to the mobilehome? 12. What is.the mobilehome gas demand? ------------------------------ 5. What is the mobilehome electrical rating? ----------------------- Amps 6. What is the mobilehome site service rating? --------------------- - OLO D Amps 7. What is -the mobilehome site circuit breaker rating? ------------- Amps 8. Is there any other electri`crload•to be served by the mobilehome siteservice? --------------------------------------------------- Yes / No / (If yes, identify the load and size: lief ?ith,� (Load) (Amps) 9. What ------ is the mobilehome site gas pipe size. ---------------- `3/� (in.) t 10. What is the type of gas service? ----------------------------- Natural / / LPG T 11. What is the gas pipe length from meter or tank to the mobilehome? 12. What is.the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) MOBILEHOME SUPPORT DATA r Mobilehome Mfr./�%j%%/�I%f .,.- If other than single wide, C' furnish Model Year Setup No. IQ� Width 10 (ft.) Box Length_LJ (ft.) Tagalong or Expando Size ft. x ft. _ (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973;•furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. • �l a Footings (check one) Single �1. Wood either --. . Apressure A treated o foundation grade. (ft.)(in:) x (in.) (in.) 2. Other (specify) Center support Center support locations* footing sizes Supports (check one) (in.) 1: Concrete block. 2. Other (specify) (ft.)(in.) (in.) (in.) 4----Tagalong or Expando, show support details. (ft.)(iri.),.. (in.) (in.) 12 x30 -- Typical Support (in.) (in.) Footing Size L�J l X J 04 O (ft.)(in.) (in.) (in.) -- Max. Pier Spacing Max. Overhang (ft.) (in.) (in.) (in.) (ft.)(in.) BUTTE COUNTY BUILDING DEPARTMEN'i APPROVES *If ce._nter piers are other than drawn above,. -draw in--locations, spacing, and dimensions. F, OFFIVfE. RECORDS r'1TTE COV:ITt-CALIF e I -M Co1itliY MLE 4275 JA..q 14 11 41 RH 19br C:VH71 PEti•3_3 F. FEE EASEMENT AGREEMENT AGREEIKENT, Sade this 10th day of January, lr4'O. between Jessie D. Harris and husband and wife, 1st parties, James X. Bush and Ililda Bush husband and wife, as Joint Tenants, 2nd parties, __.... Esther T. Bradfleld 3rd party, all of said 1st to 3rd parties being hr.rein called Owners. and _ Butte Grange Federal Credit Union 4th party, being herein called Beneficiary, and Butte County Title Com -)any, a rnrleoration nth party, being herein called Truster., WITNFSSF711; IOffR EAS, the 1st to 3rd parties are. Owners of the land conveyed by the. herein- after set forth Deeds, the following Dooks and Pages hcing the nooks and Pales of the Official Records of Butte County in which the various Deeds to the Owners are record- ed and the lands owned by the respective, Owners bring the lands conveyed by such Deeds, all of such lands being parts or portions of S,:r.tion ID and II, Township '2 North, Range 4 East, B.D.B. 6 51., hereinafter referred to in the description of the easement parcels; -3 _ 14 —9 7 B00K PAGE OWNFRS 1475 67 1st parties, 1500 491. _n parties, 1498 642 3rd party, and /® bMFREAS, the Beneficiary and Trustee are respectively the Item:fir.iary and Trustee under that certain Deed of Trust constituting liens and encumbrances upon various of the parcels of land owned by certain of the. Owners, the, said Trust Decd being respectively recorded in the, following (look and Park or the Official Re -cords of Butte Cointy: DM PAGE TRUSTEE BF:NFYTCI,1RY 0W\1`31 1500 493 ith party •1th party 2nd parties, and IMEREAS, the parties mutually desire to r.ri:atr. and establish the- hr:r::inarte.r set forth easement for roadway pgrfwses and ingress and egress to and from the lands respectively owned by the Owners and wish to make the easemr:nt.: hereby crcated appur- tenant to each of the respective parcels of Iand owned by the Owners, and MIEREAS, the Owners desire to subject any right, title, or interest ar.quirvil in the said easements by -this instrument to the: lien, operation and e:fre:r.t of the: above respective Deed of Trust constituting encumbrances upon the land of the rr:spec- Live Owners now subject to said Deed of Trust to the same r:xtr•nt as though such r:ase- ment rights hereby acquired were originally made subject to and encumbered by the lien of said Deed of Trust, and VIDREAS, the Beneficiary and Trustee, exr.npt as in the last above paragraph set forth, desire to subordinate their Deed of Trust and the lien, operation anderrer.t thereof, to the easement rights hvrrhy cre:ate:d In any Owners nthcr than the respe:r.tive. Trustors.l■ the said Deed of Trust. 3413144 r0? r:-557 .1 - 2, n c 71 NM, THEREFORE, in consideration of the premises and of the mutual covenants and grants herein contained, it is expressly covenanted and agreed as follows: That the hereinafter described parcel of land shall be and constitute a mutual easment and roadway for ingress and egress to and from the various lands owned by the owners, and each of the owners hereby grants and conveys to each other Owner am] to each Beneficiary and Trustee and and all such right, title or interest in and to such easement parcel as shall be necessary to fulfill the intent and purpose of the _ within agreement, and to grant to each parcel of land owned by the Owners such ease - sent and roadway rights. Said easement and roadway rights shall be appurtenant to each of said parcels of land and shall inure to the benefit of anti may be used by all persons who may hereafter become the Owners of said appurtenant properties, or any parts or portions of all or any of said properties. The Beneficiary and Trustee, except in so far as the respective Owners in the above Deed of Trust hereby specifically subject said Owner's right, title and interest in the easement parcels to the lien of said Deed of Trust, hereby subordinate the said Deed of Trust -and the lien thereof to the easement and roadway rights hereby created and conveyed. It is understood and agreed that there are presently in existence various easement rights in some` -portions of said easement parcels and in favor of some of the lands owned by the Owners. It is further agreed that the easement rights hereby created shall after the execution of the within agreement by all parties hereto, being the Owners of all lands adjoining said easement parcels on the. North and South, anti the recording of the within agreement in the office of the Recorder of Hutte County constitute the sole rights and easements for roadway anti ingress and egress to and from the various lands owned by the parties and each of the Owners anti Beneficiary and Trustee hereby release and quitclaim to each other, to such extent as may be necessary, any and all other heretofore existing casements or rights of ingress and egress to and from the various lands of the Owners. The easement parcel above referred to and hereby created as a mutual easement for roadway purposes and for ingress and egress to anti from the lands of the. Owners is more particularly described as follows: A right of -way for road purposes and public utility purposes over a strip of land, 60 feet in width, the center line of which is described as follows: Commencing at the Southwest corner of Section 11, Township 22 North, Range 4 East, M. D. B. L M.; thence North 09' 57' 13" East along the South line of said Section 11, a distance of 36.1."'„ 39 feet; thence North 15° 10' 211" West. 1435.51 feet to the point of`beginning of said center line; thence South 33° •10' 39" WeA . 27.92 feet: thence South 58' 01' 17" West, 110.011 feet; thence South 76° 06' 25" West. 400.08 feet;. thence South 41° 07' 43" West 10.1.5�1 fret; thenr'. South 51° 38' 41- West, 138.26 feet; thence South 33° 17' '10" West, 162.111 feet; thence South 01° 56' 56" West, 292.79 feet; thence North 7D' 17' 511" West, 119.32 feet; thence South 64° 5B-07- West. 90.12 feet; thence South 41' 16' a3" West. 106.80 feet; thence South 69' 06' 46- West. 177.06 fret. thence. South iii" 10' 06- West, 322.42 feet; thence South 71° •10' 52" West, 107.77 Pert; thence.. North 79° 15' 48" West 391.01 feet. North 511° 57' 53" West, 145.46 rent, North 85° 52' lo" West 158.20 feet; thence South 69° 47' 34" West. 122.911 fent; theme South 771 12' 12" West`, 164.33 feet; thence South 04` 17' -1 West, 411.60 fret; thence. North 68° 19' 42" West, 11.77 feet; thence North 51° 37' 16" West 2110.(,() feet; thence North 37° 42' 36" West, 121.58 feet; thence North 59° 06' 26" West 263.91 feet to a point In the center line of Concow Road anti the end of said line. ALSO a non-exclusive easement for road purposes and public utility purposes over a strip of land 60.00 feet- in width, lying 10.00 fret on each side of a line beginning at a point in .the West line of Section 11, Township 22 North, Ranye 1 -2- East, X.D.B. L M., which paint bears North 0'59115" East, 30.00 feet from the Southwest corner of said Section 11; thence from said point of beginning, along tho following courses and distances: North 89'57'13- East, 515.00 feet; Korth S3'05'16- East, 242.68 feet; North 79'02'02" East, 207.11 feet; Nbrth 53' 12'16" North51'55'3914 Ea0s8tf�1e60.60rfeet; South 71'43' -Ll' East. 111.15 feet; North 4743'X-' East,. 102,14 feet; North 01'44'45" East, 151,25 feet; North 3:;'37'22' East, 126.19 feet; North 53°07'21' East, 258.77 feet; and North 70120'13' East, 163.92 feet to the center line of an existing 60.00 foot road easement. ALSO a right of way for road purposes and public utility pur- poses over a strip of land, 60 feet in width, lying 30 feet on each side of the following described center line: Beginning at a point in the West line of Section 11, Township 22 North, Range 4 East, M.D.B. Gil, which point bears North 0°59'15" East, 30.00 feet from the Southwest corner of said Section 11; thence from said point of beginning, South 89'47' 02" pest to a point -in the center line of an existing road and the end of said, line. In Witness Whereof, ^the parties have set their hands the day and year first above written. Jessie 0. Harris � - ^-•r-� "' • J / Esther I. Bradfield BUTIT GRAME FEDERAL CREDIT UNION By:-SS.LnsLi> G t< 84JTI1 G@ANGE EEDERAI C2_tr i By: PNvfJE a•� ��_ IT Jr:;::;; P. 0. BOX I =F HIGGS• CALIF. 95917 01 ? f•/ SEY ar.,es b. Bush Hilda Bush �BLT1E COUNTY TITLE C01T 1\Y //�2 By:--L�/ .-/33:.)7 .JCL. STATE. OF CALIFORNIA, ll _C-dy BUtte --I� 0. tAir 1 1 t h —_daT oJ-_...al1117ry ____—u fAl Tra+ tta. a"d .i•r A a drrd a d �ILbt/a.r ter__. tl_..1'.i.ry i.aLL.l_i.ndscy— a A'afarT /'.blit. Marr aJ C* -IU .ria, ddy n,u,,.,uri.,..d -d r.... w, /n .-Ey atr. rd —E r- r.p 1 C-; -- k.ur.. to br the v r"brr+Zb d 10 t4 a.tAi. u.rlrr,wrwr w tkr • cr • 6 ny_T-..t...,l finial.-------- -.._ ----- af ark.avlydyrd to nr tAaf _-J.r I-brr.ibed tit-.e..._-,.1--_.__-- Esthr ft.aillirld _..----------- _—tMrfo u Iri•riJu/.-, a.d A_.iz._-._ ar,. •e,.r ar uff..,.rr. i. J, t IN II'ITATSS If'IIEREOF / A—, A.-rn,•r., .rr mr And _d a3rn1 nr .i.:.f ,nd �" 1 4 I!vC_ Yf al VuJ T Air t fr f m.n.� a nrtrw.� C u' r _ M. Virginia tin, sey -- �aarr c..c r«.SirG.,r,,;.tl.... June 3U, .1'171. I� uwl (ff/// c>E m Septic system and location s i' at to be per Yu+ie County Health Dept Re- �;�.;°re:::er.;s. All utility connec ions s all be located within 4 ft. outside 'he rear. -Aird section of the mobilD home on the left (road) side of th mobile 19cr�e. Irt BUTTE COUNTY RUI!.r)!NLG DEPARTMENT APPROVED This set,of. plans and specifics ' ns MUST b® keit 014- es at all times an is unlawful to n� mra., rinv ch=r .qes or alterafio on same without written from 4 partment of Public permission Works, County of Butte. i NOTE:—All Materials & Workmdnship Sl all --Be` In ra.---- Accordance wii-h Rccogn ed Good Pracfice�/and _. ~ _. of a qualify prescribe-; fcr the Specified"use in,*he r Uniform Guiiding, Plumbinc & Mechanic 61 o es and ' A p rmit will be"°required fo the the National Electrical Co le. Inst Ilation of the4 mobilehome. The . Setback shall be 5 ft. from the ; ide property line and 50 ft..From the IN :.enferline of fhe road, permitfin a maxi- AC • murn of a 2 ff. eave overhung bL f entirely gut of aul easements, y Septic system and location s i' at to be per Yu+ie County Health Dept Re- �;�.;°re:::er.;s. All utility connec ions s all be located within 4 ft. outside 'he rear. -Aird section of the mobilD home on the left (road) side of th mobile 19cr�e. Irt BUTTE COUNTY RUI!.r)!NLG DEPARTMENT APPROVED - -Eutte Count L A N D O F NATURAL WEALTH AND BEAUTY = DEPARTMENT OF PUBLIC HEALTH - DIVISION OF ENVIRONMENTAL HEALTH. Address ❑ 196 Memorial Way ❑ 7 County Center Drive ❑ 747 Elliott Road Reply to Chico, California 95926 Oroville, California 95965 Paradise, California 95969 Telephone: 916/891-2727 Telephone: 916/538-7281 Telephone: 916/872-6308 November 14, 1989 R.L. and Sandra Englund P.O. Box 396 Paradise, CA 95969 RE:_ Housing Inspection.- 4176 Kakini Drive, Oroville, CA (Conc.ow area) - AP# 58-27-8 Dear Mr. and Mrs. Englund: This department. had* received a complaint alleging health and/or safety hazards in the above listed rental dwelling. On October 25, 1989, I visited the property and the tenant permitted me to inspect her rental unit.. The following conditions were observed which are in violation of the California Health and Safety Code, Section 17920.3 (a)(6)(11)(13).(14), (d), (e), (f,), (g).(2); Butte County Code Section 19, Chapter. 19-4 "Unlawful Sewage Disposal," Chapter 26, Section 26-1 "Building Code Adoption;" The Uniform Housing Code Section 505d; The Uniform Building. Code Section 301A, Permits Required, 305A, D - Inspections required, and which pose health and/or safety haz.ards to the tenants. 1. The home does not have continuous running water under pressure. 2.. The.home's source of heat is a wood stove in the mobile which installation is improper, inadequate, and an.immediate fire danger. 3. There isa building addition to: the -mobile which was constructed without permits or inspection.. 4. The dwelling is not weatherproof. 5. The ,roof leaks through the light fixture in the kitchen,.at the roof swamp cooler, and between the mobile and the addition. 6. The oven door falls.off. 7. Two of the four.stove burners do not work. 8. The bathtub fixtures leak. I R.L.and Sandra Englund November 14, 1989 Page 2 9. The tenant claims that the water tank does not have a.cover. 10. The water from the washing. machine is discharged above r ground. I 11. The electrical box is open and has exposed wires. 12. Louver windows at front of mobile are not weatherproof. These conditions shall be corrected as follows, and within THIRTY. (30) DAYS from receipt of this notice. Obtain any required permits from the Butte County Department of Public Works, 7 County Center Drive, Oroville, CA prior to making repairs. 1. Vacate and do not rent unit until the above noted violations are corrected. 2. Provide continuous running water under pressure, provide automatic fill switch in water tank. 3. Provide water tank which is completely enclosed and sealed off of the elements. 4. Provide a source of heat for the dwelling which is adequate,. approved and installed under permits. issued by Butte County Department of Public Works. 5. Obta.i.n permits and clearances from County of Butte Building Department for mobile addition. 6. Repair roof so as to eliminate all leaks. 7. :Repair oven', or provide new oven.in.working condition. 8. Plumb all waste water including wash water into. the septic system. 9. Repair/replace all plumbing fixtures as needed .to be in good .working order. 10. Repair electrical panel -.so as to be.saf.e and protected to meet current codes. 11. Louver windows.are to be ma de. weatherproof. A reinspection will.be `.made. :Failure to comply will result in . the Franchise Tax Board being notified of your non-compliance. You will then be prevented-from.claiming state tax deductions for taxes, depreciation, amortization, or interest expenses connected a R.L. and Sandra Englund: November 14, 1989 Page 3 with the property as long as it remains substandard. This notice is given to you pursuant to. Sections 17299 and 24436.5 of the. California Revenue and Taxation Code. If you have any questions regarding this letter, please feel free to contact me at the ..above listed address or telephone number. between 8:00 - 10:00 A.M. weekdays. Sincerely yours, -3� Thomas Hughes, E.H.S. Division of Environmental Health TH/mlf cc: Butte County Building Department State Department of Housing l� BUTTE BOUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION, CARD r,.4UST BE ON JOB SITE N Hour Inspection Lir',- (IVR) :(530) 538-4365 Office: (530) 538-7601 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B08-2117 Issued: 04/ Address: 4176 KAKINI RD, OROVILLE APN: Owner: Permit Type: SFD-Mobile Home PFS Description: NEW MH EX SITE PERM FNDN (1395) AREA 3 SRA Area: Yes Front: Centerline of Road: Rear: 10 SRA: Side: 10 AG: Other: Total Setback from Centerline of Road: 1010. ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Set acs 131 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams . 114 Eufer Ground 216 Forms/Steel/Holdowns 112 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House or Yard 404 Gas Piping House or Yard 403 Masonry Grout 120 Masonry Bond Beam 119 Under"` Undej Shea j Undej Undej Do .�Rr ,------ --- -- OFFICE COPY = Bldg Permit: rAddress: ► - '_ + Strap Sheaij GAS By: c Electric By: _ Date: Date yned 612 / She 611 Roo 613 Do Not Install Siding/Stucco or Roofing Until Above Signed •'137 37,1 Rough Framing 153 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 4 -Way Rough Framing 128 Gas Piping House or Yard 403 Shower Pan/Tub Test 408 Fire Sprinkler Test or Final 702 Do Not Insulate Until Above Signed Permit Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Swimming Pools Setbacks Inspection Type IVR INSP DATE T=Bar Ceiling / RC 145 Stucco Lath 142 Stucco Brown 144 Swimming Pools Setbacks 131 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 131 Blocking/Unde ining 612 / .Tiedown/Soft Set System 611 Permanent Foundation System 613 Site Utilities/Trench Insp. •'137 37,1 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Inf Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Public Works Fina 538-7681 Fire Department/CDF 538-6226 Env. Health Final 538-7281 Sewer District Final **PROJECT FINAL 801 *Project Final is a Certificate of Occupanvyser- enti 1 ) PERMITS BECOME NULL AND VOID,1 YEAR FROM THE DATE OF 1SS11ANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A I YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy t N L _ , •yTtu " ,y STATE OF CALIFORNIA NUMBER: e. BUSINESS, TRANSPORTATION AND HOUSING AGENCY. DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT ry �'� ^ m DIVISION OF CODES A14D STANDARDS r L MANUFACTURED HOUSING PROGRAM. .MANUFACTURER CERTIFICATE OF ORIGIN:'..' DISTRIBUTION: ORIGINAL (PINKY.- FORWARD TO THE INVENTORY CREDRORKNLESS T 1ERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD.TOTTHE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 85812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THI UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER HCD 483.0 - Side 1 - (7/97) ❑ CHECK IF THIS IS A DUPLICATE MCO -ENTER -ORIGINAL MCO NO. MANUFACTURED HOME OR MUI TI unllT IuANUFACTUREQ HOUSING 1 SFD (SINGLE FAMILY DWELLING) ❑ MUMH (MULTI -UNIT MANUFACTURED HOUSING-. NUMBER.OF ... 2 TRANSPORTABLE: SECTIONS COMMERCIAL COACH: OCCUPANCY GROUP I MANUFACTURER NAME: MANUFACTURER LICENSE -NUMBER ' CMh_ Y—ANUFACTURING WEST INC M71 12645.8 MANUFACTURER ADDRESS: 1 _ 9998 OLD PLACERVILLE ROAD SACRAMENTO CA 95327 SUGGESTED RETAIL PRICE: 70,750.00 Street Ci State Zi MANUFACTURER TRADE NAME: MODEL NAME AND/OR .NUMBER: DATE OF MANUFACTURE:• BERKSHIRE FIRESIDE 27523A, 02-20-08 NAME OF DEALER OR TRANSFEREE (OWNERSHIP TRANSFERRED TO): CALIF. DEALER NUMBER OR - DATE OF TRANSFER: CMH HOMES, INC. TMNSFEREE DESIGNATION: IDL1127080 02 -29 -06 - DEALER OR TRANSFEREE ADDRESS: j P. 0. BOX 9790 HARYVILLE TN 37802-9790 t street Ci (State). INVENTORY CREDITOR NAME: - Zi' " INVENTORY CREDITOR ADDRESS: Street State - ', . ( SECTION 1� MANUFACTURER.SERWL NUMBER HCO INSIGNOR HUD LABEL NUMBER LENGTH - W'IDTH WEIGHT f INCHES '" INCHES POUNDS 1 SAC033354CA A RAD 1;4.67226 624 .162 18200 SAC033354CA B RAD 167227 624 162. '18200 TRANSPORTER NAME: BENNETT TRUCK TRANSPORTER ADDRESS: P. 0. Bax 569 MC DONOUGH GA 30253 Street State (zip)' DESTINATION FOR UNIT DESCRIBED ABOVE: ) FREEDOM HOMES 2243 FEATHER RIVER BLVD OROVIL.E CA 95965 NAME Street C' State Zi I certify under Penalty of Penury under ttro laws of the State of California that dte above fads an true end twrreat7 Executed an 02-29-08 at SACRAMENTO SACRAMENTO CA (Date) (C' (County) .(State) SIGNATURE.OF AUTHORIZED AGENT: DISTRIBUTION: ORIGINAL (PINKY.- FORWARD TO THE INVENTORY CREDRORKNLESS T 1ERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD.TOTTHE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 85812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THI UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER HCD 483.0 - Side 1 - (7/97)