HomeMy WebLinkAbout026-070-023' 026-070-023 i -06-1763X
BIBLE, ANN „nE.
NOTES ?" 2396 IRWIN AVE, PALERMO
Cont:. WATKINS PLUMBING
GAS LINE
11-4 - __
�r
RESIDENTIAL
APN: Permit No.
Owner.
Site Address:
Contractor
'4.
Type of Permit:
r
SRA
FLOOD CERTIFICATE EQUIRED
FIRE SPRINKLERS REQUIRED
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUBSTANDARD HOUSING LETTER
ENCROACHMENT PERMIT
REINSPECTION FEE PAID
ENV HLTH CLEARANCE
CHECKED BY
DATE JOB FINALED:
t,
SIGNATURE.
c
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP061763
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 07/21/2006 APN: 026070-023-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class License Number: 7./
Site Address: 2396 IRWIN AVE PAL
: S
7 //
— ke, � ;
Map
ap Index:
Date:'= Contractor.. . w++4
Description: GAS LINE REPLACEMENT
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: BIBLE, ANN
permit to construct, alter, improve, demolish, or repair any structure, prior
1341 HUNTOON ST
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
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95965
7000) 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 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
Applicant: WATKINS PLUMBING
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
50 BUTTE GLEN DR
owner of property who builds.or improves thereon, and who does
OROVILLE, CA
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
95966
sale. If however, the building or improvements are sold within one
530-534-7773
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
Contractor: WATKINS PLUMBING
not apply to an owner of property who builds or improves thereon,
50 BUTTE GLEN DR
and who contracts for such projects with a contractor(s) licensed
OROVILLE, CA
pursuant to the Contractors' State License Law.).
95966
❑ 1 am Exempt under Article 3 of the Business and Professions Code
530-534-7773
Date: Owner:
License #: 727962
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:_1490 �2
Total Square Ft: 0 S. F.
Valuation: $0.00
Policy #: 12 /� ��2
❑ 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
Census Code:
! l/
J
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
�� 1
forthwith comply with those provisions.
Date:
i
Applican
WARNING: Failure tj secure workers' co pensation coverage is
unlawful, and shall subject an employer to cri final penalties and one
hundred thousand dollars ($100,000), in a clition 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 permi is hereby issued under the applicable provisions of the Butte County ode and/or
I hereby affirm that there is a construction lending agency for the
Civ.)a�
Resolutio do work indicated ab ve tor which fees have been paid.
performance of the work for which this permit is issued (Sec 3097
By Date:
Name:
PERMIT EXPIRES ON: O
Address:
D to
❑ 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 owher. 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 for ocument of Butt County. I hereby
authorize representatives of Butte County to enter up the above mentioned property for inspection pu oses.
rint Name: �?n c>rLi`CL Signature:
Date:
1
Owner ❑ Contractor EI Agent for Owner ❑ gent for Contractor
B. C. Building Permit 01-16-04 pg 1
+=OK
o = Not OK
MANUFACTURED HOMES
DATE PERMANENT FOUNDATION SOFT -SET
1 Zoning -Setbacks -Easements
2 Soils; Special MH Support Sketch
3 Sewer; Lorin Test; FalllCIO-Concrete
4 Wtr, Loctn-Test-Easement Needed -Regulator
5 Elec Loctn-DImcs-Gmd 'Amp -Concrete
6 Yard Gas; Loctn-Test Wrap Nat ❑ or LPQ
Inch Sz Ft Lngth
7 Blckng; SzSpadng-Marriage Llne
8 Gas; MH Test -Demand Valve-Cnncir
9 Elec MH Cntnty Test-Crossovers-Breakers-Clmcs
10 Drain; MH Test -Fall -Flex Cnnctr
11 Wtr & Sewer Connected -CIO to Grade
12 Gas and Electricity Tagged
13 Tie Downs El Foundation
14 Exits
15 Cert of Occupancy.
16 HUD Label/lnsignla Numbers Serial Numbers
Drawing
MISCELLANEOUS-
)ECKS+C9VERS'CARP0RTS•GARAGES
1 Zoning3etbacks-Easements
2 Ftgs; SoilsSz=DpthSpacing-CnnctrsSteel
3 Decks, Girders/Joists-Dcking-Brcing
Stairs-Guard/Handrails
4 Wood Awn; P6sts-Beams4Utrs-CnnctmShthg.
Frmg-Brcng
5 Alum Awn; Columns-CnnctnsSplice-Decal-Encisrs
6 Carports; Wndws-Doors
7 Electric
8 Frmg; Sills-AnchrsStuds-Rftrs Trusses
9 Siding; Nailing-VengerStucco-Lath
10 Roof. Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wall pnis -
1 Setbacks -Easements
2 Soils; -CompactionStructure Stability
3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptds/Ung; Distance -GR
5 Elec Pool L ting; 15 volts-GFi
6 Elec.Endsrs; Conduit Entries Terrninals-listed
7 Elec Bonding; Metal w/5-Crcltng Egp-Htr
8 Elec Gmdng; Eqp WISE Crcltng Eqp-Pool Ightg
Boxes-Enclsrs-pnlboardsansultn-to Main Conduit
9 Health Dept Apprvl
10 •Plmb; Cir Test Wtr Supply Test
11 Lt Niche ,
12 Endsr, Fencing Alarms
13 Bonding, Diving board or Slide
RESIDENTIAL (Single & Duplex).
DATE JUNDERFLOOR -
1 Zoning -Setbacks -Easements -Flood -Slope
2 Ftg Main; Soils-Elec Grnd Ftq Dpth
3 Ftg Garage; Soils-Steel-Elec Gmd Ftg Dpth
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth
5 SWmwalls [Main; Steel-Blockouts Wrapped
6 Stemwalls Garage; Steel-Btockouts Wrapped
6a Hold Downs and Special Anchrs
7 Slab, Steel Wrapped
8 Piers-Frplc Ftg-Steel
9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
11 Wtr Pipe; Test-Anchrs-RgltrService Test
12- Elec Undrgmd
13 Plenums & Ducts; Clrne-MaterialSupport-Insultn
14 GirdersSills-Anchr Bolts—Joists—Vnts—Cripples
15 Ace & VnUtn
16 Insulation
DATE FRAMING
17 Sills Proper Materials & Anchrs
18 Walls Studs -[Jailing Spacing & Braces-PlatesSound
19 Bearing Walls over Girders,& fir Nailing
20 Draft Stop In Walls (rat proof)•
21 Fire Stops; Furred Ceilings—Stairs—Chasers—Tubs
22 Headers & BeaihsSz &'Bearing'
23 Hangers-Post'Caps-Anchrs-Citnctns
24 Ceiling Joist-Rftr Tjes-Purlin-Roof Brac-TnrssShthg
25 Frpic Ties or Type A Fiue=FrPic Throat Cimc
26 Attic Act; Si &'Binz Pite(rt-Draft Stop -Ins Baffles
27 Bdrm Wndws orExiting goorsSili kit & Dimensions
28 Garage Fire Prtctri Framing -RC Channel
29 Prprty Line Firewall & Opngs' .
3'
30 Ext Doors -One -Check Garage 3rd Story, 2 Exits
31 Stairs; Width-Hdrm-Rise-Run4-anding-Fire Pdctn
32 Piywd on Roof Ovrhng Attic Vnts-Rftr Outrgrs
33 Siding -Nailing Veneer
34 Stucco Lath Weep Screed-Fndtn Vnts-Undrfir Ace
35 Glazing Are PrtetnSkyl-ts-Plastic .
36 Shear Wails; Nailing -Bolts
37 Brace Int/Ext Wall pnls
38 insults Walls -Ceilings
39 Infiltration -Walls -W ndws
d d� d da
DATE JELECTRICAL
40 Fxtr & Trnsfrmr Clmc4ns Prtctn
41 Elec Rcptcls Spacing-Lts & Switches at Doors
42 Sz Boxes & No Of Cndctrs Stapled
43 Romex Installed Close to Edge of Studs & CJ
44 Eqp Gmd made up w/Mech Fstnrs
45 Grndng Electrode Bond Gas & Wtr
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
47 Subfeed Wire Sz ❑ CU or ❑ AL
AC Wire Sz oa ❑ CU or ❑AL
48 Range Circ pa ❑ CU or LJ AL
Oven Circ oa ❑ CU or ❑AL
Insulated Neutral ❑Yes ❑No
49 Service -Riser Cndctrs & Gmd Main Dscnnct
50 Eqp Cirncs pnls-Motors-Meth Eqp
51 Clothes Closet UShwr Lt -Spa Lt
52 Smoke Detector
URIC [PLUMBING
53 Wtr Htr; Vent-Acc•Cmbstn Air Baffle
54 Wtr Pipe; Test & Anchr-Nail Prtctn
55 DWV; Test Fittings & Anchr. Nail Prtctn
56 Shwr Pan; Test, First fir -Tub Ace
57 Test & Shwr, 2nd fir - Tub Ace
as Pipe; Sz & Anchrs Te—Te'
59 Fire Sprinkler; Test
60 Yard Gas Piping
DATE MECHAN-ICAL
61 AC Ducts Insults & Support "
62 Vent Fan, Exhaust abv Insulin
63 Condensate Drain & Ovrflw, Sz & Grade
64 Furnace Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Ace & Pltfrm if Furnace In attic
DATE FINAL
66 Ext Steps -Door & SideLt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Cimc-Comb, Air-Cnnctr
In Garage; abv-fir-Ducts-Mech Prtctn
69 Bedroom Exiting
70 GFl A Bath Fxtrs & Tub Ace -Spa
71 GFI Arc Fault
72 Elee Trim & Subpni, Breaker Szs & Labels
73 Stairs, Guard/Handrails
74 Frplc or Stove, Cimc-Hearth
75 Elec Outlets at Wood Pnl, Int & Ext
76 Ktchn, Fxtr & Appinc; Gmd-Air-Gap-Cooking Cimc
_ 77 Elec Outlets & Rcptcls at Ktchn Counter
78 Garage Fire Door, Swing -Landing -Closure
79 AC Duct In Garage -Damper.
80 Wtr Htr, Vnts-Cimc-Com Air Cnnctr-PRY; abv fir
Mech Prtctn; LPG Appince Undr House 3" drain
81 Plmb; Elec & Meeh Eqp Listed for Loctn
82 Elec Rcptcls in Garage (GFl) Romex Prtctn
83 Insults -Foam -Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth
86 Cimc Dmge Planters ❑ Yes ❑ No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Pimb
89 Vnts abv Roof, PlmbAppinc-Frplc-Cimc to Opngs
90 Wtr Well, Dscnnct, Elec, Plmb
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
92 Vntltn thru House
93 Glass Prtctn
94 Corrections from previous Irispctns
95 Gas Test -Meters Tagged, Gas-Elec
96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl
97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99 Fire Sprinkler
o`er` d••
BUTTE COUNTY
6E�PATMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP061763
PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS,
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
Issued Date: 07/21/2006 APN: 026070-023-000
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class : , License Number. �
Site Address: 2396 IRWIN AVE PAL
Date: -� — /106Contractor: e.� 7
Map Index:
�,�
Description: GAS LINE REPLACEMENT
OWNER -BUILDER DECLARATION
ItheContractors'
I hereby affirm under penalty of perjury that I am exempt from
State License Law for the following reason (Sec. 703Business
and Professions Code: Any city or county which require
Owner: BIBLE, ANN
permit to construct, alter, improve, demolish, or repair any structure, prior
1341 HUNTOON ST
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
OROVILLE, CA
the Contractor's State License Law (Chapter 9 commencing with Section
95965
7000) 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 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
Applicant: WATKINS PLUMBING
Code: The Contractors' State License Law does not apply to an
50 BUTTE GLEN DR
owner of property who builds.or improves thereon, and who does
OROVILLE, CA
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
95966
sale. If however, the building or improvements are sold within one
530-534-7773
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
Contractor: WATKINS PLUMBING
not apply to an owner of property who builds or improves thereon,
50 BUTTE GLEN DR
and who contracts for such projects with a contractor(s) licensed
OROVILLE, CA
pursuant to the Contractors' State License Law.).
95966
❑ I am Exempt under Article 3 of the Business and Professions Code
530-534-7773
Date: Owner:
License #: 727962
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Architect:
Labor Code, for the performance of the work for which this permit
is issued.
Engineer:
❑ 1 have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurancecarrierand policy number are:
Carrier: /V J 6e
Total Square Ft: 0 S. F.
Policy #:�,��, Z �� Ll %
Valuation: $0.00
Census Code:
❑ 1 certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
/ / r 3 l /
SIL J
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
J
0 4
Date:
Applican
ecure workers' co pensation coverage is
WARNING: Failure trect
unlawful, and shall suban employer to cri final penalties and one
hundred thousand dollars ($100,000), in a clition 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 permi is hereby issued under the applicable -provisions of the Butte County ode and/or
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Resolutio do work indicated ab ve r which fees have been paid.
By'f Date: a� O
Name:
PERMIT EXPIRES ON: Q
D to
Address:
❑ 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 I am the owner or the duly authorized agent of the ow er. 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 for ' ocument of Butt County. I hereby
authorize representatives of Butte County to enter up the above mentioned property for inspection purposes.
rint NameSignature:
Date:
Owner ❑ Contractor ❑ Agent for Owner ❑ gent for Contractor
B. C. Building Permit 01-16-04 pg 1
i
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 OFAPPLICATION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Nameirst
,
Na
Address
34-I
City 0 mv,
Staten
l�
06-z _
Zip `�
lJ
P one
Y � 33-43
Fax
E-mail
APPLICANT INFORMATION
CONTRACTOR
Name
City
Address
^5Q/.
Zip
Ci
Fax
Ste
Zip,
PhoD'-'-3
Map Book
Fax
E-mail
Planner
Lich. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
APP ICA T SIGNATU E
X
For office use only:
Zoning
Proert Address
1 L.
Flood Zone
Cross Street
SRA
I Yes
INo
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
BP 66- %7
BIN #
PROJECTLOCATION
AP# 0 a — O 7( --0a--
Proert Address
1 L.
Ci
iCIN�
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
Name
Address
Description or Scope of Work:
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
K:\FORMS\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: Amount: Bldg
SRA
Receipt #: 453`/ Sheriff
Date:
SMIP
Other
Total
REV 8-12-05
J
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5.-- Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate ,
❑ 7. 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.
❑ 8. Flood Elevation Certificate, Wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑ 1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2.
Impact Fees.
❑ 3.
California Department of Forestry plan approval (if required).
❑ 4.
NPDES Form.
❑ 5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6.
Contractor's license information. (Number, Name Style, Classification).
❑ 7.
Worker's Compensation Carrier and Policy Number..
❑ 8.
Owner -Builder Verification (if required).
❑ 9.
Letter of Signature authorization (if required).
❑ 10.
Recorded copy of Agricultural Acknowledgment Statement.
0 11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑ 12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date
issued; however, on issued permits refunds can only be made if no construction work has
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
of permit issuance for permits
been done. Filing fees, plan
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
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