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iCOUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive Oroville, California ,95965 • Telephone (530) 538-7541
(Rev. 12/96) APPLICATION AND-PERMIT-
ASSESSOR
NDPERMIT
ASSESSOR PARCEL NUMBER
028-050-033
ZONING
BUILDING PERMIT
OWNER PEREZ YOLANDA
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
. OWNERS MAILING ADDRESS
CONTRACTOR'S NAME
B,UAZ . HP.ROLD
TELEPHONE
1534-1
CONTRACTORS MAILING ADDRESS
P.O. Box 347 Palermo 95963
IA
CONSTRUCTION LEND 3i
LENDER'S MAILING ADDRESS
Fireplace
Total Valuati $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
Permit F e $ 2-1-00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan heck'
ee $
BUILDING ADDRESS
Palemno i -IO Cut LT<
E rgy Rlq0hecking Fee $
$
PERMIT FEE $
t
LOT NO.
SUBDIVISIONS NAME
I L
PARCEL MAP
I
CLIMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex '❑_ Mobilehome ❑ Other
_V_I /—,TL
Each Trap 7.00
Solar or heat pump water heater 23.00
Water piping 15.00
Each gas water heater or vent 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ InstBila' /00the/r YBuilding
Describe WoreOBIL E HOtf UTILITIES
Gas piping system 1 - 5 outlets 15.00
sewer 15.00
Mobile Home @20.00
60.00
PERMIT FEE S 80.00
z
ELECTRICAL PERMIT Fling Fee 20.00
OR LESS
Main Service 8.0.01V1 OR 23.00 23.00
LICENSED CONT ACT 'S D LARATION
I hereby affirm under penalty of perjury he am li nsed under provisions of Chapter
9 (commencing with Section 7000) of ' on 3 of a Business and Professions Code,
and my license is i full force and eff t. L
License Class Li . No. L
OWNER LDER ECLAR ION
1 hereby affirm under penalty o/ry am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the propertyyees with wages as their sole compensation,
will do the work, and thnot intended or offered for sale.
❑ 1, as owner of the propesively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec.Business and Professions Code for this
reason
Main Service 20OA TO 1000A 46.00
NEW CONST. DWEWNO OCCUP. SO
OR ADDNS. ( a ACC. BLDS. 3.5QFT.
ROESIDD MULTI.OUTLET @7,50
POWER APPARATUS
6 SINGLE OUTLET CIR.
Ex, Occup. OUTLET OR FIXTURES B20 @ I.00
Ex. Occup. Gums PMD°� 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00 20.00
Misc. Wirin 23.00
PERMIT FEE $ 63.00
WORKERV COMPENSATION DECLARATION
I hereby affirm under penally of perjury one of the following declarations:
❑ I have and willm ntein a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of a work for which this permit is issued.
❑ 1 have and will aintain workers' compensation Insurance, as required by Section
3700 of the ,Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
Policy mbar
(The a ve sections need not be completed H the permit is for work of a valuation
of o hundred dollars ($100) or less.)
Ja.,I certify that in the performance of the work for which this permit is issued, I shall
np4 employ any person in any manner so as to become subject to workers'
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
fo with comply with those provisions.
(� Q
X V J�.�`-�� Date ! � aQ - ICZ
Signatur of App (cant - ❑ Owner ,CLContractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
ures over 3 stories in height.
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FET: S
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
corsT. TYPE
TOTAL FEE $ 166.00
HAZ.
D FEES IMP
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FLOOD
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ISSUEcompensation
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.
By Date
PERMIT EXPIRES ON
ate
No. 2(1R2/�1 /$166.00
.D.S.-B.D. —C R - SSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
t
E.H. USE ONLY
• r Y. "1 j _ ,: Plot Plan Attached
Floor Plan Attaeh*4
Sant to S.D. J 0 _7 Z /LiLA—
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
Owner Location AP#
Plan Approved for: Sewage Disposal^ a Water Sully: Public Private Well
Clearance for dwelling. Other
Hold final for:
Final clearance O.K. for:
NOTE:
Ukls 16
Environmental Health Specialist Date
8/96
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COUNTY OF BUTTE - DEPARTMENT OF DEVEO-PMENT SERVICES - BUILDING DIVISION
. ° 7 COUNTY CENTER DRIVE - OROVILLE, (?ALA"NIA 95965 - TELEPHONE (530) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER: PF ASSESSOR PARCEL ER: �-c>S� 3
Proposed Building Use: Building Inspector: Date: Q
At time of permit application, I was advised the following data must be submitted prior to permit process' g and/or issuance:
ate Received By
❑ 1. All iiems have been submitted.---------------------------------------------------------------------------------- -
692�'lot plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- -----
❑3. Complete plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------ ---------
4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be /faxes
ans. -- ----
p 5. Engineered truss details and layout in duplicate (required prior to plan review) N -L -----------
❑6. Energy Design Compliance and supporting documentation. ------------------------- -----------
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. -----------------------2--------------------
j❑ 8. Hazardous Material Form. -------------------------
❑ 9. Manufactured Home data and installation instruc
1 ❑ 10. Fees of $ --------------------
❑ 11. Impact fees as shown on the attached schedule.
�fi California Department of Forestry plan approv
1113 Flood elevation certificate.-----------------------
ksanitation and plot plan approval
❑ 15: City of Chico plumbing permit. -------- M
❑ 16. Plot plan and business license
❑ . Planning approval for (A) Use:
18. Contact Land Development ab(
Encroachment Permit for dr6Iv
❑20. Pre -inspection for_
❑21. Contractor's license
022. Workers' Compens,
including Tie
Of
Pa
Parcel.
approval prior to occupancy).
required Request to Building Inspector on
, Name Style, Classification).
policy number.
1123. Owner -Budder Verification (Qken to owner ❑, Mailed to owner ❑)
24. Letter of signature authorriza ,fon. -----------------------------------------
2 Recorded copy of Agricu al Acknowledgment Statement. ----------
❑26. Letter of intent on build g use. --------------------------------------------
❑27. Manufactured Home tility clearance. ------------------------------------
❑ 28. Existing violatio and/or expired permits. -------------------------------
❑29. ❑433 A, 071
E130. Other:
Deed, ❑ M.H. Title, ❑ Check to H.C.D $
l o-2�-cam
(Date)
6 you issue tl% permit, process as follows ❑ Mail to owner, ❑Mail to oontractor.
Telephone 1 (� hold for ❑ Deliver inspector.
and pickup at office. with
Applicant:y/ Date:
/ QJ� "-ce
Copy off az-Mat form sent 13Health Department, ❑ Fire Department, ❑ Air Pollution Date: By:
Copyof plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By:
1. Index permit application for the above items numbered: _ 2
❑ Plan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by
Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by
Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by
Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by
Date:
Plans reviewed by: Date: , Plans approved by: 1A Date:
Sets of plans on hold in ❑ Plan Cabinet, 11 A.P. folder. Note transfer by: Date: Ir
Yellow Copy - Department of Development Services, Building Division.
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CDF FIRE SAFE REQUIREMENTS
Z-
AP# PERMIT # NAME/
Under authority of PRC 4290, the following checked items are required
by the Butte County Fire Department 4nd are made a part of this permit.
These requirements are minimums and will be superseded by Butte County.
local regulations which equal or exceed these standards. Field
inspections will be made by the Butte County Building Department for
compliance.
( 1272.00 Maintenance of Defensible Space. To ensure continued
maintenance of properties in conformance with these
standards and measures and to assure continued avail-
ability, access and utilization of the defensible space
provided for in these standards, annual maintenance
must be provide for by the land owner.
Driveway Standards
[ 1273.02 Surface. All driveway surfaces and structures (bridges.,
1273.07 culverts and other app -rte -cant structures which supple-
ment the roadway bed er shoulders) shall provide unob-
structed access to conventional drive vehicles, includ-
ing sedans and fire apparatus weighing up to 40,000
pounds.
(� 1273.03 Grade. Not to exceed 16 percent unless paved.
\ 1273.04 Driveway Radius
[� 1. No roadway shall have a horizontal inside radius of
curvature of less than 50 feet and additional sur-
face width of 4 feet shall be added to curves of 50-
100 feet radius; 2 feet to those from 100-200 feet.
12. The length of verti:al curves in roadways exclusive
101 of gutters, ditches and drainage structures designed
to hold or divert water shall be not less than 100
feet.
^6,/J 1273.05 Turnarounds. If required, will have a minimum turning
J� radius of 40 feet from the center of the road.
1273.05 Turnouts. Shall be a minimum. of 10 feet wide and 30
/ feet long with a minimum 25 foot taper on each end.
[ 1270.10 Width. All driveways shall .provide a minimum 10 foot
traffic lane and unobstructed vertical clearance of 15
feet along its entire length.
Page 1 of 3.
D Z - D Dc,t
AP # PERMIT #
'[ 1273.10 Turnouts. Driveways exceeding 150 feet in length, but
/ less than 8.00 feet in length, shall provide a turnout
near the midpoint of.the driveway. Where a driveway
exceeds 800 feet, turnouts shall be provided no more
than 400 feet apart.
i 1273.10 Turnaround. A turnaround shall be provided at all
building sites -on driveways over 300 feet in length and
shall be within 50 feet of the.building.
1273.11 Gates
Lj 1. Gate entrances shall be at least two feet wider than
/ the roadway it serves.
[ 2. The gates must be located at least 30 feet from the
roadway.and shall open to allow a vehicle to stop
without obstructing traffic on that roadway.
3. Where a one -way -road with a single traffic lane
I provides entrance, a 50 foot turning radius shall -be
used.
Fuel Modification
1276.01 Setback for Structure Defensible Space.
[X 1. All parvels 1 acre aid larger shall provide a mini-
mum 30 foot setback for buildings and accessory
buildings from ul] property lines and/or the center
of the road.
[ J 2. For parcels less than 1 acre, local jurisdiction
shall provide for the same practical effect. See
Other Requirements below.
[ 1276.02 Disposal of Vegetation and Fuels. Disposal, including
chipping, burying, burning or removal to a landfill site
approved by the local jurisdiction, of flammable
vegetation and fuels caused by site development and
construction, road and driveway construction and fuel
modification shall be completed prior to completion of
road construction )r f__ial inspection of a building
permit.
Page 2 of 3
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AP # PERMIT # NAME/
Other Requirements
[ ] If Buildina Setback is 15 to 30 Feet:
- Class A or B roof
- Enclosed eaves
[ ] If Buildina Setback is Less Than 15 Feet.
Choose any.3 of the following:
Metal or no doors on aide toward property line with insuffi-
cient setback
- Class A or B roof with enclosed eaves
Interior automatic sprinkler system per NFPA 13D
Glass area not -to exceed 10% of wall area toward property
line with insufficient setback
Siding from the following list:
Stucco - 3 coat
Hardi-Board or Plank
Masonry
Masonry veneer
Metal
Other Butte County Fire Department approved materials
Dat igna re
Page 3 of 3
APP-OVED
Butte County
environmental Health
Date
Signature
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Permit #: D - 2 `Z,
_ Date: 1-.C4p: •,:
Genera/Infof Madon
Owners Name: y0 L:A N'! AAr P �`(� �"Z, y 9 3 A
Parcel Acreage: �
Owners Address.
Building Site Address: r
Pronertivinf mabron
. - ._ .. . .... . • 'ice •. - .._ •y1 `
Permit Type: C] Agriculture Building ❑ Commerdal ❑Industrial Mobile Home❑ SFD ` ` " ❑ Residentlal AGp�pry
❑ 2nd Dwelling ❑ Murd-Family >2 units per parcel ❑ Septic ❑ Well ❑ other
Zone District:
General Plan: A q
Date of Zoning Ordinance: (0 '
Development Agreement:
Use Permit: Variance:
Parcel Is tn: land Conservation Agreement ;-VNo ❑Yes, check use Minimum Acreage:
Nitrate Action Plan ® No ❑ Yes
Violation Area fe No ❑ Yes
Specific Plan No ❑ Yes ❑ Chico ❑ D2N
Enterprise Zone No ❑ Yes, check use
Floodplain No ❑ Yes ,X ,
Zone:
® ❑
Watershed Protection `Zone No Yes
Proposed Use Complies With: ® General Plan ® Zoning
Proposed Use Recuires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit
Commerdal/Industrial/Multi-Family Uses:
Parking: ❑ Parking Requirements are OK as Shown
Landscaping: ❑ Landscaping Requirements are OK as Shown
Road and DrairaSe Improvements Required: ❑ No ❑ Yes
Applicable Setbacks:
❑ Other
J Other
❑ Cohasset
Panel Number:
❑ Accessory Building Use
—Zcnirq Ccde
Street & Hi hwa s
Fre Prevention
❑ APPROVED
NDMONALLY APPROVEp❑RESOLVE
_' .'.'1.'•�.a — «iS..Z4rx+v.:. .:�:'i.•Y'4*.'!sk'Ar;.v!.::�='; ./�
PROBLEMS PRI OR TO APPROVAL
PERMIT CLEARANCE
Permit #: D - 2 `Z,
_ Date: 1-.C4p: •,:
Genera/Infof Madon
Owners Name: y0 L:A N'! AAr P �`(� �"Z, y 9 3 A
Parcel Acreage: �
Owners Address.
Building Site Address: r
Pronertivinf mabron
. - ._ .. . .... . • 'ice •. - .._ •y1 `
Permit Type: C] Agriculture Building ❑ Commerdal ❑Industrial Mobile Home❑ SFD ` ` " ❑ Residentlal AGp�pry
❑ 2nd Dwelling ❑ Murd-Family >2 units per parcel ❑ Septic ❑ Well ❑ other
Zone District:
General Plan: A q
Date of Zoning Ordinance: (0 '
Development Agreement:
Use Permit: Variance:
Parcel Is tn: land Conservation Agreement ;-VNo ❑Yes, check use Minimum Acreage:
Nitrate Action Plan ® No ❑ Yes
Violation Area fe No ❑ Yes
Specific Plan No ❑ Yes ❑ Chico ❑ D2N
Enterprise Zone No ❑ Yes, check use
Floodplain No ❑ Yes ,X ,
Zone:
® ❑
Watershed Protection `Zone No Yes
Proposed Use Complies With: ® General Plan ® Zoning
Proposed Use Recuires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit
Commerdal/Industrial/Multi-Family Uses:
Parking: ❑ Parking Requirements are OK as Shown
Landscaping: ❑ Landscaping Requirements are OK as Shown
Road and DrairaSe Improvements Required: ❑ No ❑ Yes
Applicable Setbacks:
❑ Other
J Other
❑ Cohasset
Panel Number:
❑ Accessory Building Use
—Zcnirq Ccde
Street & Hi hwa s
Fre Prevention
Subdivision M
aptFron
Side
3D
Side street
Rear
Height
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