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028-210-061
a 7k. 1 s ---w- 028-210-0W (P( 04-2310 MCGOWEN. ROSS APPLICATION FOR CERTIFICATI 5864 LA PORTE RD, BANGOR n- e OF'MERGER (6 Cont: OWNER-Gnn,o APN# REP SERV PANEL e6- 028-210-0_ (et ��q5-oo1 LOOMIS, MARVIN u 5864 LA PORTE RD, BANGOR Cont: OWNER l O NEW WTR LINE I i 028-210-04 (p( OS -1914 LOOMIS, SHIRLEY PORTE RD, BANGOR ont: OWNER NSF(GAR, COV, LIV) 028-210-061 06-2066 LOOMIS, MARVIN 5926 LA PORTE RD, BANGOR _ Cont: SPG SOLAR _SOLAR(GRND MN`r) /D ,- 028-210-061 06-2093 LOOMIS, MARVIN _ n 5926 LAPORTE RD, BANGOP<J N4 ' Cont: POOL BUILDERS' 4 POOL (MSTR#01-516) . y O O 28-210-061 T , 06-2093 t LC,OMIS MARVIN 5926 LAPORTE RD, BANGOR Cl 'NOTES f Cont: POOL BUILDERSPOOL (MSIR#01-516)'y L RESIDENTIAL APN: Permit No. Owner. Site Address- Contractor. Type of Permit - k i 3 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 DATE JOB FINALED• SIGNATURE r� CHECKED BY = OK MANUFACTURED HOME.S - DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test FaIVC/0-Concrete 4 Wtr, Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-CImcs-Cmd 'Amp -Concrete 6 Yard Gas; Loctn-Test Wrap Nat Q or LPQ Inch Sz Ft Lngth 7 Bickng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 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 Dowris Q Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Labet/insignia Numbers Serial Numbers MISCELLANEOUS- 0ECK-rC0VERS'CARP0RTS•GARAGES I-PWs-, SoilsSr-0pthSpacing-CnnctrsSteei 3 Decks. Girders/Joists-Dckdng-Brcing Stairs-DuardlHandralls 4 Wood Awn; Posts-Beams-Rftrs CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs Trusses 9 Siding; Nailing-VeneerStucco-Lath 10 Roof. Shthg-Roofing 11 Ezt; Steps -Doors -Landings 12 Braced Wail pnls ?-Zei ; CompactionStructure Stability 0 Structure; Steel-CnnctrtsThickness Dead,Km4Jning 4 cptds/Lting; Distance -GH Elec fool I.Ang;15 volts -GR 6 Ele clsrs; Conduit Entries-Tgnninals-Listed Wm Bonding; Metal w/5'-Crdtng Egp-Htr Elec Grndng; Eqp w/T Crcltng Eqp-Pool ightg Bares-Epcls4s-ppMoardsansuitn-to Mahn Conduit 9 j"th Dept APpM . . 70 P ; Cir Test Wtr Supply Test nrh . Fendng-Alarms 13 ogdmg. Diving board or Slide =Not RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Gmd Fig Dpth 54 Wtr Pipe; Test & AnchrNail Prtctn 3 Ftg Garage; SailsSteel-Elec Gmd Ftg Dpth 55 DWV; Test Fittings & Anchr•Nail Prfctn 4 Ftg PorcheslDecks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First fir -Tub Acc 5 Stemwalls Main; Steel-Blockouts Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Ace 6 Stemwalls Garage; Steel-Blockouts Wrapped 58 Gas Pipe; Sz & Anchrs t 6a Hold Downs and Special Anchrs 59 Fire Sprinkler, Test 7 Slab, Steel Wrapped 60 Yard Gas Piping 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 DATE M E C H A N-1 C A L 13 Plenums & Ducts; Cimc-MaterialSupportansultn 61 AC Ducts Insulin & Support 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insulin 15 Acc & VnUtn 63 Condensate Drain & Ovrilw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air RhTdVent 115 Outlet 65 Attic Acc & Pltfrm if Furnace In attic s� DATE jFrRAMING 17 Sills Proper Materials & Anchrs DATE F I N A L 18 VUeiis Studs-Nailirig Spacing & Braces-PUtesSound 66 Ext Steps -Door & SideU Pdctn-landings 19 Bearing Walls over G-irders,8� fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof)' 68 Furnace Vnts-Cimc-Comb, Air-Cnnctr 21 Fire Stops; Ftirrea Ceilings -Stairs -Chasers -Tubs In Garage; abv flr-0uds4Nlech Prtctn 22 Headers a;<BearirsS . &'Bearing 69 Bedroom Exiting 23 Hangdd-P.o�*Caps-An�-C:nnctrts70 GFl 8 Bath Fxtrs &Tub Acc-Spa 24 Ce1Rng Joisf-Rffr Tjes-Pur p7Roof Brac TnusShthg 71 GFl Are Fault 25 Frpie Ties or Type A F1d&FVc Throat Cimc 72 Elec Trim & Subpni, Breaker Szs & Labels 26 Attic Acr Sz &.'Rimi Pin -Craft Stop -Ins Baffles 73 Stairs, GuardlHandrails 27 Bdrm Wndws or., Doors -SIR lit & Dimensions 74 Frple or Stove, Chnc-Hearth 28 Garage Fire PrtcM Framing -RC Cfiarjnel 75 Elec Outlets at Wood PnL Int & Ext 29 Prprty Line Firewall & Opngs' . 30 Ext Doors -One 3' -:heck Garage 3rd Story, 2 Exits 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cimc 77 31 Stairs; Wid"drm-Rise4bm-Landing-Fire Prtctn Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Dobr, Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic VntsWr Outrgrs 79 AC Dud In Garage -Damper. 33 Siding -Nailing Veneer 60 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr Horse 3' drain 35 Glazing Area -Class PrtctnSkyLts•Plastic • 81 Plmb; Elec & Mech. Eqp Listed for L.octn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GF) Romex Prtdn 37 Brace IntlExt Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insultn Walls -Ceilings 84 Guard Rails & Deck Cnsbr n -Post Caps 39 Infiltration Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Cimc Dmge Planters D Yes D No a.• �.s} da 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Pimb-Appinc-Frple-Cimc to Opngs DATE JELECTRICAL 90 Wtr Well, Dscnnc:k Elec, Ptmb 91 Ext Elec Trim, GFl Reptcl-Undrgmd 40 Fxtr & Tmsfrrnr Clmcans Prtctn 41 Elec Rcptcts Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndet s Stapled 93 Glass Prtctn 43 Romex installed Close to Edge of Studs & CJ 94 Corrections from previous Irispctns 44 Eqp Gmd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec 45 Gmdng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-CIO to grade -HD Appr A 46 2 Appinc Cires in Ktchn & Cndctr Sz GFl 97 Energy Cmpinc Cert-0ther Certs 47 Subfeed Wire Sz 93CU or AL AC Wire Sz D D 98 Address Posted 93 Cu or AL 99 Fire Sprinkler 48 Range Ciic o. D CU or D AL Oven Circ ya D CU or DAL Insulated Neutral DYes [:]No dr �� mss. 49 Service -Riser Cndctrs & Gmd Main Dscnnd 50 Eqp Cimcs pnls-Motors-Meth Eqp 51 Clothes Closet UShwr LI -Spa Lt 52 Smoke Detector i r 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. BP062093 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: 09/13/2006 APN: 028-210-061-000 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. Class 0_—_r7_3 License Number: 3 3 3q Site Address: 5926 LA PORTE RD BAN License : p % Z OG Contractor:yydl,,)J rs,711 c Map Index: Date: O Description: POOL MASTER #516-01 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: LOOMIS, MARVIN & SHIRLEY permit to construct, alter, improve, demolish, or repair any structure, prior 5926 LAPORTE RD 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 BANGOR, CA the Contractors State License Law (Chapter 9 commencing with Section 95914 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 (530)534-8135 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 Applicant: POOL BUILDERS Code: The Contractors' State License Law does not apply, to an owner of property who builds o0,improves thereon, and who does such work himself or herself or through his or her own employees, 3080 THORNTREE provided that such improvements are not intended or offered for #23 95973 sale. If however, the building or improvements are sold within one 530-899-8988 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 SKIMMERRCH@AOL.COM 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: POOL BUILDERS 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.). 3080 THORNTREE #23 95973 ❑ 1 am Exempt under Article 3 of the Business and Professions Code 530-899-8988 Date: Owner: SKIM MERRCH@AOL.COM License #: 833994 . WORKERS' COMPENSATION DECLARATION I 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. - I have and will maintain workers' compensation insurance, as Engineer: 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 policrye number are: Carrier: T"aE ��,twl�yuc ru0 Total Square Ft: 0 S. F.' Policy #: "? 3 - O (� I Zvl� 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 become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' > I) Ly compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I( Ir Air Date: Vs in 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 hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the the work for which this Is issued (Sec 3097 Civ.) Resolulio s to do work indicate abov for which fees have been paid. _ )n U�. performance of permit By' ��� Date: ; I r J r� Name: _ _ e-) nr _� 1}I PERMIT XPIRES 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. �L 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 Butte County to enter upon the above mentioned property for inspection purposes. Signature: Print Name: l �Fc iZ wl (tiT5 Date: C1 Owner X Contractor EIAgent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 FIRE SAFE REQUIREMENTS PLEASE SCAN INTO TRAKIT FILE Butte County Fire Department California Department of Forestry and Fire Protection 176 Nelson Avenue, Oroville, California 95965 • (530) 538-7888 Property Owners Name: / Co r✓1 1-5 Insppection Date: Building Permit # Property Location: Sri 2-10 Lot (�O✓ --� TZCity: rte- oiv� sr� i -t orw ApN 0 fig -210 —c �0'01 44272.00 MANTMANCE OF DEFENSIBLE SPACE MEASURES 04 ; r; To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued availability, access, and utilization of the defensible space provided for these standards during a wildfire, provisions for annual maintenance shall be included in the development plans and/or shall be provided as a condition of the permit, parcel or map approval. N It is the property owner responsibility to annually provide defensible space measures X around structures an this property as required by law C 4291 PRC 4291 information will be provided at the counter when the permit is issued. (� entrance, a 40' turning radius shall be used. (a) All new driveway construction or an extension of an existing driveway shall 1/ comply with Public Resources Code 4290 roadway requirements. Is the driveway new or was it extended? Yes ❑ No ❑ (b) All driveways shall provide a minimum 10' traffic lane and unobstructed vertical clearance of IS' aloe its entire len th. Drivewaywidth: Vertical Clearance: (c) Driveways exceeding 150' in length, but less than 800' in length, shall �¢ provide a tumout near the midpoint of the driveway. Where the driveway exceeds 800', turnouts shall be 'ded no more than 400' apart. Driveway length: (d) A turnaround shall be provided to all building sites on driveways over 300' in length, and shall be within 50' of the building. DVV= Turnaround distance from build' 8 1273.02^ROAIIWAYSURFACE : ; 5W"l#, '. ? -8x* The surface shall provide unobstructed access to conventional drive vehicles, Xat including sedans and fire engines. Surfaces should be established in conformance xwith local ordinances, and be capable of supporting a 40,000 pound load. 4" of class 2 aggregate base shall be required for all driveways, turnouts and turnarounds. Depth ofaggregate base: 4 � ' 273.03: W GRADES J8 . e? z 3� N'3Gk�" 'r3` fir, , rxN irJ.. 'tt7 The grade for all roads, streets, private lanes and driveways shall not exceed 15%. All grades over 15% shall have 4" of class 2 aggregate base and 2" of asphalt concrete. No drivewa s al owed in excess of 20%. P of % xl i1273.04•ROADWAYRADIUS" (a) No roadway shall have a horizontal inside radius of curvature of less than 50' and additional surface width of 4' shall be added to curves of 50-100' radius; 2' to FX those from 100-200'. Questionable horizontal curve radius: (b) The length of vertical curves in roadways, exclusive of gutters, ditches, and drainage structures designed to hold or diver water, shall be not less than 100'. Questionable vertical curve length ff 273.-Qf.ROAD A3t• UNAS' •: ,M�„ a i t' . c? Turnarounds are required on driveways as specified in this article. The minimum turning radius for a turnaround shall be 40' from the center line of the mad If a length- hammerhead -T is used, the top of the "T" shall be a minimum of 60' in length - I IMofroadny turnaround used' Meaauremmts? IM .' 4273.067ROADWAY, OUTS 'sem'. � c Oz �to-A- f Turnouts shall be a minimum of 10' wide and 30 long with a minimum 25' taper each end. Roadway turnout measurements and location: g - U273.07 ROADWAY MOCTURM (a) All driveway, road, street, and private lane roadway structures (Bridges, culverts, and other appurtenant structures which supplement the roadway bed or shoulders) shall be constructed to carry at least the maximum load and provide the minimum vertical clearance as required by Vehicle Code Sections 35550, 35750 "�/ and 35250. Bride certified by aregistered Civil Engineer'.) Yes ❑ No ❑ (b) Appropriate signing, including but not limited to weight or vertical clearance Xapproved limitations, one-way road or single lane conditions, shall reflect the capability of each bridge. Correct signs installed? Yes ❑ No ❑ (c) A bridge with only one traffic lane may be authorized by the local 4. .01 jurisdiction; however, it shall provide for unobstructed visibility from one end to �- the other and turnouts at both ends. Ttmrout measurements on each end ittll�S�4!` v__�� ia1273.11iGATEENTRAN(:ES'"r�r:..;a t .:; �+•; (a) Gate entrances shall be at least two feet wider on both ends then the width of the traffic lanes serving the gate. Gate measurements on ends: (b) All gates providing access from a road to a driveway shall be located at least 30' from the roadway and shall open to allow a vehicle to stop without obstructing N traffic on that road. Gate distance on driveway from road: (c) Where a one-way road with a single traffic lane provides access to a gated (� entrance, a 40' turning radius shall be used. Turning radius measurements: 1274.08 ADDRESSES FOR BUM131NGS _ All buildings shall be issued an address by the local jurisdiction, which conforms to that jurisdiction's overall address system. Accessory buildings will not be required to have a separate address; however, each dwelling unit within a building shall be separately identified. Is address correct? WsV No ❑ �¢ ? 12 74 09 SIZE OF, tFXrEWMMOXRS AND SYMBOLS FOR ADDRESS" Size of letters, numbers and symbols for addresses shall be a minimum 3" letter height, 3/8" stroke, reflectorized, contrasting with the background color of the si n. Letters, Numbers and S mbols correct? Yes No ❑ DVV= TP1274A0INSTALLATION LOCATION ANDYLSIBILITYOFADDRESSU" (a) All buildings shall have a permanently posted address, which shall be placed each driveway entrance and visible from both directions of travel along the Xat road. In all cases, the address shall be posted at the beginning of construction and shall be maintained thereafter, and the address shall be visible and legible from the road on which the address is located. Correct? Yes No ❑ (b) Address signs along one-way roads shall be visible from both the intended b direction of travel and the opposite direction. Correct? Yes ❑ No ❑ (c) Where multiple addresses are required at a single driveway, they shall be mounted on a single post. Correct? Yes ❑ No ❑ (d) Where a roadway provides access solely to a single commercial or industrial business, the address sign shall be placed at the nearest road intersection providing access to that site. Correct? Yes ❑ No ❑ �. 41276.01 S . CK FOR STRiJCTURE D _ SIBLE SPACE' . � (a) All parcels 1 acre and larger shall provide a minimum 30' setback for buildings and accessory buildings from all property lines and/or the center of the mad. (b) For parcels less than 1 acre, the local jurisdiction shall provide for the same ctical effect. c? ':, SAME PRACTICAL EFFECT. RE UIR_ EMENTS'" r &'r, a 1 t. v3, If a Building Setback is less then 30' from all property lines and/or the center of the road, the following shall apply: I • Class A roof- Correct? Yes ❑ No ❑ • Fully enclosed eaves on entire structure - Correct? Yes ❑ No ❑ • Metal doors toward property line with insufficient setback Yes ❑ No ❑ • Siding on entire structure from the following list: (a) Stucco -3 coat (b) Non combustible Hardi-Board, Plank or similar siding (c) Masonry (d) Metal (e) Other Butte County Fire Department approved materials Correct siding used on entire structure? Yes ❑ No ❑ "�/ `1276.02 DISPOSA OF FLAMMABLE VEGETATION AND FUELS Disposal, including chipping, burying, burning or removal to a landfill site by the local jurisdiction, of flammable vegetation and fuels caused by Xapproved site development and construction, road and driveway construction, and fuel modification shall be completed prior to completion of road construction or final ins ction of a build! mut. Com le[ed? Yes No ❑ 4. .01 OTHER REQ. = IyN_S�yTyA,L,!LATION OF RESIDENTIAVFIIt$ �- 1. K { 7was If your property part of a parcel split after July 1991, you are required to install residential fire sprinklers. It is the property owner's responsibility to review the official aroel m to confirm ifsprinklers are required. Ares rinklers re fired? Yes ❑ NoV Aresprinklers installed? Yes ❑ No No. Violation/Remarks Cleared Distribution: White -Building department Yellow -Fire Prevention Pink -Property Owner 55 6-1 u BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES INSPECTION CARD 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: 06-2066 Issued: 09/27/2006 Address: 5926 LA PORTE RD 8AAf CO R APN: 028-210-061 Permit Subtype: Phtovtaic Sys Grnd Owner: LOOMIS MARVIN L & SHIRLEY A Applicant: SPG SOLAR INC '*—� Sohn Spi(( Description: SOLAR(GRND MNT) &13- 00$0 MUST BE ON JOB SITE JOB SHALL BE READY PRIOR TO CALLING FOR INSPECTION. THE INSPECTION CARD AND APPROVED PLANS MUST BE AVAILABLE FOR EACH INSPECTION OR THE INSPECTION WILL NOT BE MADE AND A RE -INSPECTION FEE MAY BE ASSESSED. ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 t,,�C 1p -2p Foundations / Footings 111 Pier/Column Footings 122 per, Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test 404 Masonry Grout j 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Roof Nail 129 Shower Pan/Tub Test 408 Fire Sprinkler 702 Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Gas Test 404 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Building Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Project Final 801 I PERMITS BECOME NULL AND VOID 1 YEAR FRO IF WORK HAC COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy . . . . . . . . . . . . . . . COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive 9 Oroville, CA * (530) 538-7541 CORRECTION NOTICE LDC)rn i _S r)(0 - 20(0 co OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. . Please call for re -inspection when correction of work is completed. If you have any questions pertaining to -this -matter, or need additional ri explanation, please contact the Building Inspector as indicated below. n ?9ov1bc Rccc-ss (I_0CX67*0 CA:ze__�. - F, PR) otz '7b Nr -x- N 'S /-C- c -r/ (I "-f Date Inspector- >),E W'0411 CAIZPC—_I� 1—C-62— 60 REV 4/05 Phone #ZZ ;1!7 FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE Loom Is OWNER 0(o-zo& PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at + the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional tiv explanation, please contact the Building Inspector as indicated below.r YEW 10 E 19PPR.o uEr) . P[ a A!_S' 01\1 1 n1 s Pec TSL ev s Date / - o REV 4/05 _CJ9- Inspector 1�9njEQi Go'p-1061-yT, Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 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 PROJECT INFORMATION Site Address: 5926 LA PORTE RD Owner: Permit No: 06-2066 APN: 028-210-061 LOOMIS MARVIN L & SHIRLE Issued Date: 09/27/2006 By KEJ Permit type: MISCELLANEOUS 3066 CLEMO AVE Subtype: Phtovtaic Sys Grnd OROVILLE, CA 95966 Expiration Date: 09/22/2007 Description: SOLAR(GRND MNT) (530) 533-5988 Occupancy: Zoning: Contractor Applicant: Square Footage: S P G SOLAR INC S P G SOLAR INC Building Garage RemdUAddn 521 CAL OAK ROAD 521 CAL OAK ROAD OROVILLE, CA 95965 OROVILLE, CA 95965 Other Porch/Patio Total (530) 533-5988 (530) 533-5988 FEE INFORMATION Fund 10 BLDG $384.93 Photovoltaic $0.00 Total Charged: $384.93 Fees Paid: $384.93 Balance Due: $0.00 Receipt No: 461073 LICENSED CONTRACTOR'S DECLARATION I 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 S P G SOLAR INC 759086 / B C10 C46 / 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 09/27/2006 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors 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.). 1 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 Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's 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 016178-2006 04/01/2007 STATE FUND 046-0 . Date: Policy olicy Number: Exp Contractor's License Law.). mple (This section need not a corn if the permit is or once hundred dollars ($100) or less. ElI AM EXEMPT under Section B. & P.C. for this reason: E]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 09/27/2006 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X • 09/27/2006 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, in any way connected with HUNDRED THOUSAND DOLLARS $100,000, IN ADDITION TO THE COST OF COMPENSATION, ( ) the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit 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 owner or am authorized to act on the property owner's behalf. CONSTRUCTION LENDING AGENCY 09/27/2006 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; DAgent for Owner Agent for Contractor INSPECTOR COPY Lender's Address City State Zip r 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 PROJECT INFORMATION Site Address: 5926 LA PORTE RD Owner: Permit No: 06-2066 APN: 028-210-061 LOOMIS MARVIN L & SHIRLE Issued Date: 09/27/2006 By KEJ Permit type: MISCELLANEOUS 3066 CLEMO AVE Subtype: Phtovtaic Sys Grnd OROVILLE, CA 95966 Expiration Date: 09/22/2007 Description: SOLAR(GRND MNT) (530) 533-5988 Occupancy: Zoning: Contractor Applicant: Square Footage: S P G SOLAR INC S P G SOLAR INC Building Garage RemdUAddn 521 CAL OAK ROAD 521 CAL OAK ROAD OROVILLE, CA 95965 OROVILLE, CA 95965 (530)533-5988 (530)533-5988 Other Porch/Patio Total FEE INFORMATION Fund 10 BLDG $384.93 Photovoltaic $0.00 Total Charged: $384.93 Fees Paid: $384.93 Balance Due: $0.00 Receipt No: 461073 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 S P G SOLAR INC 759086 / B C10 C46 / 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 Div' ' 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 ffect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X L2 basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 09/27/2006 penalty [$500]; Please check one of the following: Contract s S natur 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 OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractofs License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE the work himself or herself or through his or her own employees, provided that such improvements ❑I 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 l�\J ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compansation insurance carrier and The Contractor's License Law dows not apply to an owner of the property who builds or improves policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the STATE FUND 046-0016178-2006 04/01/2007 Carrier: Policy Number: Exp. Date: Contractor's License Law.). (This section need not be completed if the permit is for one hundred dollars ($100) or fess. ❑ I 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 09/27/2006 compensation provisions of Section 3700 of t or Code, I shall forthwith comply with those Owner's Signature Date provisions. X 09/27/2006 1 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 SignatureDate WARNING: URE TO SE URE 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 HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, including death, and property damage caused arising out of, or in any way connected with te DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND isry, the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the use or occupancy of anysid street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the abov menti ad property for inspection purposes. I hereby certify that I am the pro e m thoriz to acton the property owner's behalf. CONSTRUCTION LENDING AGENCY 09/27/2006 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for a of rmltt We [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner ❑ Contractor OR. Agent for Owner I IWAgent for Contractor FILE COPY Lender's Address City State Zip 1z BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name L Como S Name irst Name V r� ddressr Address,,,, OR l' City tw c,/Z Zip 95%57 State Zip / Phone 3 14 ` 3 lic. # Fax E-mail 7 CONTRACTOR Name S L 1' Name Address ZI C c4L onk no city GQ VIAS State CGI Zip 95%57 Phone,,:,,_ Fax E-mail lic. # s f Class E-mail 7 c.a APPLIC SIGNA RE X For 010 use onl ARCHITECT/ENGINEER Name City Address c U �� City / State Zip Phone —5, I s Fax �. E-mail Map,Book State License Number APPLIC SIGNA RE X For 010 use onl APPLICANT INFORMATION Name City Address c U �� CityO / Stat yy Phone —5, I s Fax E-mail Map,Book APPLIC SIGNA RE X For 010 use onl AP# o -421,6 - o {e" Zoni City Flood Zone I KI SRA Yes INo Occ. LENDING AGENCY Type Const. Subdivision Name Map,Book Page Lot# Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS KAFORMSMBUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BL BIN # PROJECT LOCATION AP# o -421,6 - o {e" Property Address City Cross Street WORKER'S COMPENSATION Policy Number O! Co 1 -78 - 2OD Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: ?V, SoCLAaw0 m6otq 7 Sq FT- Living Garage Open Cov ❑ 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 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: K.6, Amount: c� O Bldg SRA Receipt #16 ��`? Sheriff SMTP Date:,. 0.0( �D a Other 1 Total REV 8-12-05 Af - . PR.. . 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 faxesl ❑ 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. ❑ 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 of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 COUNTY OF BUTTE-DEPARTIV,SNT 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: 00 C I I S ASSESSOR PARCEL NUMBER O Y ` LIQ - OCA) Proposed Building Use: GrOUrd R Il11llf dnP SV�.kn Permit Technician: 1. Date: It tris required in order to apply for a permit. All boxes MUSI 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 faxesl ❑ 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) Installation manual, including 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. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other Raining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) " VSanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑ 18/EFosion Control Plan Required........................................................................ M{OC ,19. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 20. City of Chico Plumbing permit........................................................................ ❑ 21. Site plan and business license approval from the City of Biggs .............................. ❑ 22. California Department of Forestry plan approval ❑ paid. Sent by:2 23! ►�- Planning approval for (A) Use: (B) Parking: (C) Parcel Check:. !.... ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ .29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... . ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legalt"description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone -a33 and hold for pickup. I have been informed of the above items an equirements for obtaining a building permit. i Applicant: Date: .0/e 1. Index permit ;ptitc, tion r4h be e i ems numbered: Plan Check Letter 2. Additional 1ter�uired Contractor, desigAef/.owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner was advised of the abo e d to y ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date:Plans approved by: AW Date: p2+ Structural reviewed by, Date -Structural approved by: Date: Note transfer by: Date: lJ Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 0. 'lZr, • q Plot Plan Altaehad Floor Plan Attadied Sent to 8D/DS TO: Building Division Development Services FROM: ,. Environmental Health SUBJECT: Sanitation Clearance /r /� n Owner Location AP# Plan Approved for: Sewage Disposal: Water Supply: Public Private Well Clearance for dwelling. Other 1090 .-, ��.e �'�-, c0 Hold final for: + Final clearance O.K. for: NOTE: as Environmental Healthp ialist Building Clearance 9/2005 ,i y r� U d� u ,fl G L aQ 68 ANGULAR FITTINGS .msti�t',xattinett Lraph a• -„r. e,-,....r:.c: . B147 -B152 B243 -B253 TWO HOLE OPEN ANGLE FOUR HOLE OPEN ANGLE -Standard finishes: ZN, GRN -Standard finishes: ZN, GRN D1VL—D10, TWO HOLE OPEN ANGLE -Standard finishes: ZN, GRN D l,&i TWO HOLE OPEN ANGLE -Standard finishes: ZN, GRN, SS4 -Wt./C 58 Lbs. (26.3 kg) 11/16" (27.0) / 11/16" (27.0) 25/16" (58.7) 23/8” 11/16" (27.0) 31/4„ A (82.5) 11/16" (27.0) 11/16" (27.0) . / 35/16" J (84.1) 21/16" 11/16" (52.4) (27.0) 11 B-Un&- B322 -B332 TWO HOLE OPEN SHORT ANGLE -Standard finishes: ZN, GRN B162 30° B163 221/20 59 (26.7) B164 15° B165 71/2° D l,&i TWO HOLE OPEN ANGLE -Standard finishes: ZN, GRN, SS4 -Wt./C 58 Lbs. (26.3 kg) 11/16" (27.0) / 11/16" (27.0) 25/16" (58.7) 23/8” 11/16" (27.0) 31/4„ A (82.5) 11/16" (27.0) 11/16" (27.0) . / 35/16" J (84.1) 21/16" 11/16" (52.4) (27.0) 11 B-Un&- B322 -B332 TWO HOLE OPEN SHORT ANGLE -Standard finishes: ZN, GRN B522 THREE HOLE 950 OPEN ANGLE FITTING -Standard finishes: ZN, GRN -Wt./C 54 Lbs. (24.5 kg) 17/8" (47.6) 5° a 35/8" (92.1) I I 13/4" 15/8" (44.4' (41.3) B488 TWO HOLE LEG CONNECTION -Standard finishes: ZN, GRN -Wt./C 100 Lbs. (45.3 kg) Reference page 58 for general fitting and standard finish specifications. AM a r ' B322 71/2° 35 (15.9) B323 15° B324 221/20 B325 30° B326 371/20 B327 450 B328 521/2' B329 60° B330 671/20 B331 75° B332 821/20 B522 THREE HOLE 950 OPEN ANGLE FITTING -Standard finishes: ZN, GRN -Wt./C 54 Lbs. (24.5 kg) 17/8" (47.6) 5° a 35/8" (92.1) I I 13/4" 15/8" (44.4' (41.3) B488 TWO HOLE LEG CONNECTION -Standard finishes: ZN, GRN -Wt./C 100 Lbs. (45.3 kg) Reference page 58 for general fitting and standard finish specifications. AM a r ' 900 ANGLE FITTINGS p�Q B496 B49.I . B371-2 a w TWO HOLE AMSTABLE CORNERANGLE TWO HOLE ADJUSTABLE THREE HOLE ADJUSTABLE s •Standard finishes: ZN, GRN' CORNERANGLE -Standard •Standard' finishes: ZN, GRN, HDG CORNERANGLE ndard •Stafinishes: ZN, GRN d'a •WtJC 85 Lbs.. (38 5 kg) 58 Lbs. (263 kg) •WUC 61 Lbs. (27.6 kg) 23 /8" . _. 23/84' z tee. (603) (6 03) 67/a" 47/8" 15/16" (174.6) I16"'X29/16" SLOT (123.8) 9/16" X 11/2" SLOT (333) ItJ (143) (65.1) 9/16"X29/16"•S1:OT (143) (38.1) 25/8" (143) (65.1) (66.7) 17/e" (47.6) B104SH THREE HOLE ADJUSTABLE CORNERANGLE Standard finishes; ZN, GRN •WtX 68 Lbs. (30.8 kg) 31/2" (�-9) 13/32" O (103 9/16" X 29/16" SLAT (143) (65.1) n B113 FOUR HOLE ADJUSTABLE CORNERANGLE •Standard finishes: ZN, GRN •WUC 256 Lbs, (116.1 kg) 9/16" X 11/2" SLOT -(2) (143) (38.1) 6" (152.4) 17/a" (47.6) B461 TWO HOLE ADJUSTABLE CORNERANGLE •Standard finishes: ZN, GRN •wt/C 87 Lbs. (39.4 W 31/2" 1/2" (12.7) 41/8" 9/16"x 29/16" SLOT nru 4. 1 (143) (65.1) 33/4" (952) 17/8" 21/4" (57.1) B109S TWO HOLE TAPPED CORNERANGLE *Standard finishes: 2N, GRN •WtJC 33 Lbs. (14.9 kg) 31/2" (88.9) '-18 TAPPED 17/8" (47.6) 15/8" (413) 37/8" (98.4) FOUR HOLE ADJUSTABLE CORNERANGLE *Standard finishes: ZN, GRN •WUC 180 Lbs (81.6 kg) 9/16" X 11/2" SLAT.(2) (143) (38.1) " 4 _ • ''� � 65/8" (1683) a •w u • a w _ n �V • � o 33/4" W . (952) w � a rn � 9521 1 r TWO HOLE BUS DUCT ANGLE t, A *Standard finishes: ZN, GRN •fi •WUC 37 Lbs (16.8 kg) 8" 0 (47.6) (so.$) u -4�%40. ...v Reference page 58 for general fitting and standard finish specifications. + + . , L _ • ► _ 67 132,E CM4NNEL Olid =12 Gauge 6 ) - 10' �3.OSm do 20' 6:09 m . f . ' s ljrpe 304 oc 316. Alin . isle ge- 1311C (43)3h" 7y» ' SEMOM PROPFRnm f3 . S B22 1910r. E o B22A 3•E20 (5 1:124 � � O 253 821�C 6649 P 1.956 P A 931 (1! 3905 PAO X651 (1� aid�a6ocs shoo6on 0n'� 701 P72*11456 Cj.%O Ll 12027 • pcvpaGa�rebssodoa�eday��� tbaA 751 t19n . �•Fam�ed S1odDrs�MaamL M Y w �A 1p 1(14 ) X 3 01* b 13/1C' I322A (20.Q wi 3.901bs.JpL (s.651Win) —15/r (413) A 20 Rcf== Pap 14 for cmad Titang wd stamdacd finish ro:('Laviici`::`:. :"i� Via: �", ,. ': ro:('Laviici`::`:. :"i� Via: �", ,. O SELECTION MART for .c aads, M„ta;�IS uta Hole rau&ps it hirrd lit. S mid 1% 110 VI V, WAn • a • 811 •3W (tisj �s�• (413) 12 Go. ._ :.., (4I3) 12 1 822 isM (413) lsh" (4t3) 12 Ga. .105 12 (#� _az 2 ' x2 . 1 13 - 12 BZ4 1 (41� IsK• 1231 11 13 1 12. ' lsfs" His) 14 Gs. �0 14 Ga. 142 123 1 1%i - 12 832 ltft"' 013). Isis" 4 16 Ga. (j4� lsh" (413) 12Qi: 12 Ga, ' Bt2 • 1` lsls" t 12 Ga_ '13. 1 - 13:• - 1 . � ' 852 �l�r, - 12 Ga_ - 13. 1 13 - 1 lsifs" t 1% 12 Gs_ E3. 854 uhr (ap,tj 1SM (4t3) 14 Ga. A0 14 Ga. 14 Ga. - Wtr 1sk• HLA 14 (k _ 1231 1 12.31 12 w CzoA) Wer ou) it Ga_ _ i 1 i• — 1 87x WM is Ga _ - - - - - E?416 (13A) s/s" (tS3) 16 G, _ _ - - - tv - P*ml• 11c scloctioa lu boca perPatt�-b p�� � cc � c Sane mod lttrn �'°°d't�caals,tod Iwk P • MAC" gpcs a�,k fa . pav s m MaAk on vocal oa, "ly • 1MdAG OquiYalmt fOCd&jmcumila0tirp 1fl Cis3[{, • t1- SdOd .+ w w 12 Ga. 2.6 mm . It Ga_=12nom 2-Al„miau,os �' 14 Gu. -13 mm jos m 2,6 loo, 16 G& —1S Max 3 -Typo 304 St>� Sbd 'O `2.0 am i -Type 316 Staia= Sbdpsoputi; a =y Tury dye so oocuumvid kta om of the amer4t o rR Q►anad ]rut 1i � Eumplm Typt Bit SH PatEccrs M,yF•,., - B12 $ GAI.Y 120 V - H178 EM 240 II24 TH' o B26 d 1332 S36 . AL ... B4_2 'd B56 E7016 rp5 .. aa. p,gc 14 too baival fitting *ad s aadaid finish spoafi,= s. 1$ BUS DING ; iVib�u. APPi9nkmp THE NEW VALUE FRONTIER CC KYOEEM3 KC200GT HIGH EFFICIENCY MULTICRYSTAL PHOTOVOLTAIC MODULE U� LISTED MODEL KC200GT HIGHLIGHTS OF KYOCERA PHOTOVOLTAIC MODULES Kyocera's advanced cell processing technology and automated production facilities produce a highly efficient multicrystal photovoltaic module. The conversion efficiency of the Kyocera solar cell is over 16%. These cells are encapsulated between a tempered glass cover and a pottant with back sheet to provide efficient protection from the severest environmental conditions. The entire laminate is installed in an anodized aluminum frame to provide structural strength and ease of installation. Equipped with plug-in connectors. APPLICATIONS KC200GT is ideal for grid tie system applications. • Residential roof top systems • Water Pumping systems • Large commercial grid tie systems • High Voltage stand alone systems ■ MODULE UL1703 certified QUALIFICATIONS ■ FACTORY IS09001 and IS014001 PERFORMANCE WARRANTY BUILDING DRl;���c� 1 year limited warranty on material and workmanship 25 year'' limited warranty on power output 'r) SPECIFICATIONS ■ Electrical Specifications MODEL KC20OGT Maximum Power 20OWatts Tolerance +10%/-5% Maximum Power Voltage 26.3Volts Maximum Power Current 7.61Amps Open Circuit Voltage 32.9Volts Short -Circuit Current 8.21Amps Length 1425mm (56.2ir Width 990mm (39.Oin.' Depth 36mm (1.4in.) Weight 18.5kq (40.7lbs. ■ Thermal parameters Nominal Operating Cell Temperature 47°C Isc Current temperature coefficient (3.18x 10-3) ArC Voc Voltage temperature coefficient (-1.23x 10-t) V/°C Note: The electrical specifications are under test conditions of Irradiance of 1kw/m2, Spectrum of 1.5 air mass and cell temperature of 25°C Kyocera reserves the right to modify these specifications without notice. ■ Physical Specifications (Unit: mm) 990(39.Oin.) 36(1.4in.) 946(37.2in.) _22 (0.9in.) 1 22 (0.9in. _c Q� N� � C ❑ io t6 �n N V 36 0.4 in.) x(Long term output warranty shall guarantee that loss of output is not more than 10% of the minimum warranty value of the product specifications within 12 years and is not more than 20% within 25 years after the purchase of the product by customer. The output values shall be those measured under Kyocera standard measurement conditions. Regarding the warranty conditions in detail, please refer to Warranty issued by Kyocera.) ELECTRICAL CHARACTERISTICS Current -Voltage characteristics of Photovoltaic Module KC20OGT at various cell temperatures 9 IRRADIANCE: AM1.5, 1kW/mz 8 7 6 75°C 50°C 25°C 5 C N 4 U 3 2 1 01 1 0 10 20 30 Voltage (V) MODEL KC20OGT Current -Voltage characteristics of Photovoltaic Module KC20OGT at various irradiance levels 9 CELL TEMP. 25°C 1000W / mz 8 7 800W/m, 6 a 5 600W/m` C 5 4 U 400W / m2 3- 2 200W / m2 1 0 0 10 20 30 40 Voltage (V) QUALITY ASSURANCE Kyocera multicrystal photovoltaic modules have passed the following tests. *Thermal cycling test • Mechanical, wind and twist loading test • Thermal shock test • Salt mist test • Thermal/ Freezing and high humidity cycling test • Light and water -exposure test • Electrical isolation test • Field exposure test • Hail impact test Please contact our office to obtain details without hesitation. IgKYOCEH KYOCERA Corporation ■ KYOCERA Corporation Headquarters • KYOCERA Asia Pacific Pte. Ltd. CORPORATE SOLAR ENERGY DIVISION 298 Tiong Bahru Road, #13-03/05 6 Takeda Tobadono-cho Central Plaza, Singapore 168730 Fushimi-ku, Kyoto TEL:(65)6271-0500 FAX:(65)6271-0600 612-8501, Japa TEL:(81)75-604^3476 FAX:(81)75-604-3475 • KYOCERA Asia Pacific Ltd. hitp://www.kyocera.com Room 803, Tower 1 South Seas Centre, 75 Mody Road, • KYOCERA Solar Inc. Tsimshatsui East, Kowloon, Hong Kong i TEL:(852)2-7237183 FAX:(852)2-7244501 7812 East Acoma Drive Scottsdale, AZ 85260, USA • KYOCERA Asia Pacific Ltd. Taipei Office TEL:(1)480-948-8003 or (800)223-9580 FAX:(1)480-483-6431 10 Fl., No.66, Nanking West Road, Taipei, Taiwan http://www.kyocerasolar.com TEL:(886)2-2555-3609 FAX:(886)2-2559-4131 • KYOCERA Solar do Brasil Ltda. • KYOCERA(Tianjin) Sales & Trading Corporation Energia Renovavel LTDA, Rua Maurisio da Costa Faria, 85 Add:19F, Tower C HeOiao Building 8A GuangHua Rd., 22780-280, Recreio, Rio da Janeiro, Brazil T Chao Yang District, Beijing 100026, China TEL:(86)10-6583-2270 FAX:(86)10-6583-2250 EL.(55)21-2437-8525 FAX.(55)21-2437-2338 http://www.kyocerasolar.com.br • KYOCERA Solar Pty Ltd. Level 3, 6-10 Talavera Road, North Ryde N.S.W. 2113, Australia TEL:(61)2-9870-3948 FAX:(61)2-9888.9588 http://www.kyocerasolar.com.au/ • KYOCERA Fineceramics GmbH Fritz Muller strasse 107, 0-73730 Esslingen, Germany TEL:(49)711-9393417 FAX:(49)711-9393450 _ http://www.kyocerasolar.de/ • N The contents of this catalog are subject to change without prior notice for further improvement. LIE/l07M0601 S5SAGK (Recycled Paper) IFIROMOUS oc GRID -TIED INVERTERS FOR PHOTOVOLTAIC SYSTEMS Light Weight At 42 lbs, the FRONIUS IG inverters are the lightest grid -connected (4 O POWERING YOUR FUTURE APP-7,"WFE inverters making them both easy and cost-effective to install. More Energy MIXT"^ Concept allows your system to output more energy under part -load conditions. Lower Cost Integrated DC / AC breakers reduce installation time and complexity. S LCD Display Comes standard with every FRONIUS IG and tracks more than 20 critical system performance parameters. Powerful At 4000, 4500 and 5100 watts, these inverters deliver more power output for higher performance installations. Reliable Fronius has been in business for over 60 years and has more than 125,000 inverters installed worldwide. (4 O POWERING YOUR FUTURE APP-7,"WFE EEE ;Input data FRONIUS IG 4000 FRONIUS-IG-5100— FRONIUS IG 4500 -LV Recommended PV power (Wp) 3000 -5000 4000- 6300 3600 -5500 Operating DC voltage range (V) 150 -450 150- 450 150 -450 Max. DC input voltage (V) 500 500 500 Max. usable DC input current (A) 26.1 33.2 29.3 IOutput data FRONIUS IG 4000 FRONIUS IG 5100 FRONIUS IG 4.500 -LV Maximum output power (W) @ 104°F/ 4000 5100 4500 Nominal AC output voltage (V) 240 208 Operating AC voltage range (V) 212 - 264 (240 +10% / -12%) 183 - 227 V Maximum AC current (A) 16.7 21.3 21.6 Maximum utility back feed current (A) 0.0 0.0 0.0 Max. continuous output fault current (A) 35.2 35.2 35.2 Nominal output frequency (Hz) 60 Operating frequency range Hz) 59.3 --60.5 (60+ 0.5 /- 0.7) Total harmonic distortion (%) < 5 Power Factor (cos phi) 1 General data FRONIUS IG-4000-1—FRONIUS IG 5100 FRONIUS IG 4500 -LV Max. efficiency (%) 95.2 95.2 94.,4 Consumption in stand-by (night) (W) < 0.15 Consumption during operation (W) 15 Protection Type NEMA 3R Cooling Controlled forced ventilation Size Ixwxh 28.4 x 16.5 x 8.8 in (720 x 418 x 223 mm) Weight 42 Ib. (19 kg) Ambient temperature range -5 to 122 °F (-20 to 50 °C) Integrated DC and AC disconnects standard Protections Ground fault protection Internal GFDI, in accordance with UL 1741 DC reverse polarity protection Internal diode Islanding protection Internal, in accordance with UL 1741 Over temperature Output power derating Surge Protection Internal DC & AC protection, Tested to 6 kV Compliance Safety UL 1741 EMI FCC Part 15; Class A & B Anti-Islanding protection UL 1741 Ground fault detector and interrupter Compliant with NEC Art. 690 requirements, UL 1741 (Miscellaneous _ Maximum AC over current protection Two -pole, 30 A circuit breaker AC wire sizing Use minimum AWG 6 max 194°F (90 °C) copper wire DC wire sizing Use minimum AWG 6 min 194°F (90 °C) copper wire AC disconnect 32 A DC disconnect 40 A Warranty 5 Years; 10 Year extended warranty available Distributed by aL77/7AAAW Fronius USA LLC Solar Electronic Division 5266 Hollister Ave., #117 Santa Barbara, California 93111 E -Mail: pv-us@fronius.com www.fronius-usa.com a N N O O ®® OO O ry ©oaa"U��- OG 3 LSO I' II FRO -1. OO MOMa OC GRID -TIED, INVERTERS FOR PHOTOVOLTAIC SYSTEMS Light Weight At 42 lbs, the FRONIUS IG inverters are the lightest grid -connected (Z Z7 POWERING YOUR FUTURE inverters making them both easy and cost-effective to install. More Energy MIXT"^ Concept allows your system to output more energy under part -load conditions. Lower Cost Integrated DC / AC breakers reduce installation time and complexity. LCD Display Comes standard with every FRONIUS IG and tracks more than 20 critical system performance parameters. Powerful At 4000, 4500 and 5100 watts, these inverters deliver more power output for higher performance installations. Reliable Fronius has been in business for over 60 years and has more than 125,000 inverters installed worldwide. (Z Z7 POWERING YOUR FUTURE Input data FRONIUS IG 4000 FRONIUS IG 5100 FRONIUS IG 4500--LV— Recommended PV power (Wp) 3000- 5000 4000 -6300 3600 -5500 Operating DC voltage range (V) 150- 450 150 -450 150 -450 Max. DC input voltage M 500 500 500 Max. usable DC input current (A) 26.1 33.2 29.3 Output data FRONIUS IG 4000 FRONIUS IG_5100 FRONIUS IG 4500 -LV Maximum output power (W) @ 104°F/ 4000 5100 4500 Nominal AC output voltage (V) 240 208 Operating AC voltage range M 212 - 264 (240 +10% / -12%) 183 - 227 V Maximum AC current (A) 16.7 21.3 21.6 Maximum utility back feed current (A) 0.0 0.0 0.0 Max. continuous output fault current (A) 35.2 35.2 35.2 Nominal output frequency (Hz) 60 Operating frequency range Hz) 59.3 - 60.5 (60+ 0.5 /- 0.7) Total harmonic distortion (%) < 5 Power Factor (cos phi) 1 (General data__ FRONIUS IG 4000 FRONIUS IG 5100FRONIUS IG 4500 -LV Max. efficiency (%) 95.2 95.2 94.4 Consumption in stand-by (night) (W) < 0.15 Consumption during operation (W) 15 Protection Type NEMA 3R Cooling Controlled forced ventilation Size Ixwxh 28.4 x 16.5 x 8.8 in (720 x 418 x 223 mm) Weight 42 Ib. (19 kg) Ambient temperature range -5 to 122 T (-20 to 50 °C) Integrated DC and AC disconnects standard Protections - - Ground fault protection Internal GFDI, in accordance with UL 1741 DC reverse polarity protection Internal diode Islanding protection Internal, in accordance with UL 1741 Over temperature Output power deeating Surge Protection Internal DC & AC protection, Tested to 6 kV Compliance_ _ _ - Safety UL 1741 EMI FCC Part 15; Class A & B Anti-Islanding protection UL 1741 Ground fault detector and interrupter Compliant with NEC Art. 690 requirements, UL 1741 Miscellaneous Maximum AC over current protection Two -pole, 30 A circuit breaker AC wire sizing Use minimum AWG 6 max 194°F (90 °C) copper wire DC wire sizing Use minimum AWG 6 min 194°F (90 °C) copper wire AC disconnect 32 A DC disconnect 40 A Warranty 5 Years; 10 Year extended warranty available Distributed by ius Fronius USA LLC Solar Electronic Division 5266 Hollister Ave., #117 Santa Barbara, California 93111 E -Mail: pv-us@fronius.com www.fronius-usa.com 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. BP062093 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 Date: Issued Da • 09/13/2006 APN: 028-210-061-000 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. Licensee Class r3 License Number: , •301 Site Address: 5926 LA PORTE RD BAN : Z Map Index: Date: O 00 Contractor: J%OULA Description: POOL MASTER #516-01 OWNER -BUILDER DECLARATION 1 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: LOOMIS, MARVIN & SHIRLEY permit to construct, alter, improve, demolish, or repair any structure, prior 5926 LAPORTE RD 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 BANGOR, CA the Contractor's State License Law (Chapter 9 commencing with Section 95914 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 (530)534-8135 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 Applicant: POOL BUILDERS i Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 3080 THORNTREE provided that such improvements are not intended or offered for #23 95973 sale. If however, the building or improvements are sold within one 530-899-8988 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 SKIMMERRCH@AOL.COM 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: POOL BUILDERS 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.). 3080 THORNTREE #23 95973 ❑ 1 am Exempt under Article 3 of the Business and Professions Code 530-899-8988 Date: owner: SKIMMERRCH@AOL.COM License #: 833994 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 Labor Code, for the performance of the work for which this permit Architect: is issued. f I have and will maintain workers' compensation insurance, as Engineer: 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:—"]4"OE -�- r "(t,cl/V "111 d& Total Square Ft: 0 S. F. Policy #: 1 ® 0 1 Valuation: $0.00 Census Code: ❑ 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' I compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 4 1 G j l it Date: O 2_51 6Z (- f I I `J 8-2q If 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 hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the ResWfil do work i0dicate abov for which fees have been paid.performance of the work for which this permit is issued (Sec 3097 Civ.) Date: -n-Oct) q--n-OcName: BY� �gPERMIT XPIRES ON: -1 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 Butte County to enter upon the above mentioned property for inspection purposes.��\ b Q—(rLvYt Print Name: K -e- Signature: Date: ❑ owner X Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 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 Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** APPLICANT SIGNATURE X - �- For office use only: OWNER INFORMATION Name Last Name00 (S irsl e yu ey 10 Address 6 LA iq_ 0,0 po City P- State Phone Phone .3 _ t 3 Fax E-mail E-mail I ' 9 APPLICANT SIGNATURE X - �- For office use only: CONTRACTOR Name Name ®oL 5 SRA Address rr p rr' t21 0c City Stftlrt Zi Phone R _ g gg . Fax E-mail Lic. # 9 9 Clas� APPLICANT SIGNATURE X - �- For office use only: ARCHITECT/ENGINEER Name % Address SRA City I No State Zip Phone Map Book Fax E-mail Stat State License Number APPLICANT SIGNATURE X - �- For office use only: APPLICANT INFORMATION Name % Cross Street tv �-I 1 w i4 SRA Address I No Occ. _?090 Subdivision Name Map Book City C, Lot # Stat Zip 33 Phone ql _,W 0 Fax E-mail APPLICANT SIGNATURE X - �- For office use only: Zoning Property Address squ Flood Zone Cross Street tv �-I 1 w i4 SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BPr(o- BIN # PROJECT LOCATION AN Property Address squ City Cross Street tv �-I 1 w i4 WORKER'S COMPENSATION Policy Number f3 _d01`)_64 Carrier v� Tr` Ot21C. MANS' 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 Scoplf Work: D —�f Sq FT- Living Garage Open Cov ❑ 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 reqwired. 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. Page 1 of 2 Received by: A Amount: Bldg SRA Receipt: lISher enAu 1-0(1- 0�^_ Other Date: L-. v (0 ) I/ f-, 1-t Total REV 8-12-05 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 of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. 11 OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 C6unty Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 n PERMIT APPLICATION DATA SHEET _OWNER: 1�V ASSESSOR PARCEL NUMBER IDC�F-;, 10 -" "' 1 1 Proposed Building Use: -Poo Permit Technician: C"XDate: Items required in order td apply for a 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. E]-il 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in i du licate. 11. 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. 0 11. Hazardous Material Form 12. Acknowledgement of building permit application without required clearances. 0 13. Other items needed to issue the permit (May require additional plan review upon receipt of the following items.) 14. Sanitationand site plan approval from the Environmental Health Department in ❑Chico ❑ Oroville, as applicable 15. Fire Sprinklers............................................................................................ ,❑ 16: Agricultural Buffer dr and site plan apr from the Ag Commissioner Sent by " , O 17'. Soils Report and/or Engineered Foundation required ........................................... ;� ❑ 18. Erosion Control Plan Required........................................................................ ❑ 19. Fees as shown on the attached Schedule of Fees Due Sheet .............................. "o 20. City of Chico Plumbing permit........................................................................ a 21. Site plan and business license approval from the City of Biggs .............................. l7 22. California Department of Forestry plan approval ❑ paid. Sent by: 23... Planning approval for (A) Use: AV- (B) Parking: (C) Parcel Check:. r/ ....... D 24. Contact Land Development about _ Improvements, _ Drainage ........................ h ❑ 25. Fire Marshall Review (commercial projects only). Sent by '> T:❑ 26. NPDES Form ........................................t.................................................... ;0 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits .................................................. '..... ❑ 34. Deed Restriction ............................................... .M ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ............ 'A........... ❑ 36. Other r. ❑ 37. Other. When issued Telephone ! ! "� u and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. �l Applicant: Date: v 1. Index permit applicatl n for the above items numbered: - Plan Check Le er 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: c_ Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division ' Plot Plan Attached LH USE ONLY Floor Plan Attached' Sent to BD1DS I TO: Building Division — Development Services FROM: Environmental Health SUBJECT: Sanitation Clearance. f� j 71 Owner Location AP# Plan Approved for: Sewage Disposal -=..,,_ Water Supply: Public Private Well Clearance for dwelling. Other23 � Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Date Building Clearance 9/2005 7Y `llrii;F;f �pa D rtrrle�� o� Public Works jv .0 o u n t f 6 Q t t e J. Michael Crump, Director LAND DEVELOPMENT DIVISION ti. a Storm Water Mana;enent Pmarem 7 County Center Drive `�\ Q (1 N ( Oroville, CA 95965 UC WWOF�S (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (MPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement LLESS THAN � ACRE1 Project Description: 6.1 ---Project Location andJor.Pareel hIumber: � �-� � Z-� a `— ©� � -- � + By signing below, L the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L 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: Title- Date: itle:Date: 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.netkdds PERMIT NO. BP051914 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: 11/09/2005 APN: 028-210-061-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 5926 LA PORTE RD BAN Date: Contractor: Map Index: Description: NSF(2680) GAR(1080) COV(972) 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 permit to construct, alter, improve, demolish, or repair any structure, prior Owner: LOOMIS MARVIN L & SHIRLEY A to its issuance, also requires the applicant for such permit to file a 3066 CLEMO AVE 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 7000) of Division 3 of the Business and Professions Code) or that he or 95966 she is exempt therefrom.and the basis for the alleged exemption. Any (530) 534-8135 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: LOOMIS MARVIN L &SHIRLEY A Code: The Contractors' State License Law does not apply to an PP owner of property who builds or improves thereon, and who does 3066 CLEMO AVE such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95966 year of completion, the owner -builder will have the burden of (530) 534-8135 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, Contractor: . and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 f the Bu in iss and Pro essions Code Date: //— q 0y0wner: License #: WORKERS' COMPENSATION D ARATION I hereby affirm under penalty of perjury one oft a following declarations: O 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carder and policy -number are: Carder: Total Square Ft: 4732 S.F. Policy #: Valuation: $215,672.00 Census Code: 13I certify that in the performance of the work for which this permit is issued, 1 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' ap /� i �J compensation provisions of Section 3700 of the Labor Code, I shall 1f !`}Y� (�l�j I O� r forthwith comply with those provisions. Date: 11056 1 I _ _ ns ` 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...._ Y CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Bdite County Cody ?nrUor I hereby affirm that there is a construction lending agency for the Reso utio s to do workindicat above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By Date: 1 PERMIT XPIRES ON: Date Address: O 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. O 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 Butte County to enter upon the above mentioned property for inspection purpose . ` y� S Print Name:/ / `Signature: 'Lll Date: Owner 13Contractor ❑Agent for Owner 13Agent for Contractor ` Iq 331j <� jt 1JP_ i.�Q E COUNTY `� DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 i OFFICE #: (530) 538-7541 ut A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION U' Q Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** V d1 OWNER Last Name1 L irst Name ' Address 301o(o C LIz�,Mo vL City O QQ VI L LL State G 6 City PhonS30 _ S 3 L{ —� � Fax — E-mail 12 e. i CD CC'm Ca -'s— efi APPLICANT NAME CONTRACTOR Name A Address Zip City Fax State Zip Phone Map Book Page 'Fax E-mail er S 6 a Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name N Address Zip City Fax State Zip Phone Map Book Page Fax E-mail er S 6 a State License Number APPLICANT NAME Name S � Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X 2A.,uj / For office use onl Zoning JA—J Tlood Zone I X I SRA Yes I No Occ. Type Const. Subdivision Name Map Book Page # Pla er S 6 a Date Approved: r OVER FOR 5UBM1 TTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. IBIN #8+5 LOCATION AP# - a,;,k- 40.- o r operty Address � (fl L- o l2t� City '8 NG o,P Cross Street MT. Al. o Lf+ aor2r4 f 0Q6 $RNGo,e WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address Page 1 of 2 Description or Scope of Work: w im uC 2 Ntw 4 Gn Gar ( ►o$O) Sq. Footage19 9e <z� �V N72-kOV ❑ Structure Built without Permits J ❑ 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 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. 4D'/ BP Ft t Received by: �. �j Amount: i' A o� ` Bldg 2(x-1 _ q j sRA Receipt #:q 3 L1 C -5q Date: — I Q -0 Sheriff SMIP nn Other "A 1 Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETESUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. w 1. Site plans!,_�lorets, signed by the preparer of the plans. No graph paper! 2. Complete plan , 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 inst, (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. Detached Accessory Building Form filled out by the owner (if required). 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. ❑ 1 ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. anitation 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 of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538.7601 Telephone (530) 538.7785 Facsimile TO: FROM: I 1 SUBJECT: Im DATE: WILLDAN o�uTrFa 0 0 - 0 •. 0 0 0 UN Scott Rutherford (530) 538-7160 srutherfordna buttecountv.net Plans Transmittal For Review Per Contract 7/21/2005 Applicant: Loomis, ShirleyPermit No: 05-1914 Project Type: NSF/Gar/Cov 028-210-061 100% 70% Plan Check Fees $ 1,324.41 $ 927.09 - $ 1,324.41 $ 927.09 WILLDAN Fee $ 927.09 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other 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 APPLICATIO DA r_ SHE - OWNER: HW OWNER: Lo V' V i'1 ASSESSOR PARCEL NUMBER vT Aw 0� I Proposed Building Use: ' `tw S r om Permit Technician: <v VDate: ItIms required in order to apply for a 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. %X.'M 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. �y 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. �33•( 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. Cl 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. Letter of intent for non-residential buildings ❑ 12. Hazardous,Material Form \Ef�W 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other �AR ai in Items needed to issue the permit. (May require additional plan rEview upon receipt of the following items.) 1) Sanitation and -site plan approval from the Environmental Health Department in O Chico ❑ Oroville, as applicable 16. Fire Sprinklers ....................................... :.......................................... :.......... q -11- 6 S K G. O , . 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ 19. Erosion Control Plan Required........................................................................ NA9 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ 22. Site plan.and business license approval from the Cid of Biggs .............................. 23. California Department of Forestry Ian approval► paid. Sent by: 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check:..... "Q a ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ 26. Encroachment nt Permit for driveway from ttie ...• •... 'Works ................................. 33t�J y r Public Works Dept ........................... ❑ Contractor's license information. (Number, Name Style, Classification) ................... ❑/ 29. Worker's Compensation Carrier and Policy Number .......................................... �7 N 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑,�,1(J31. Letter of Signature authorization .................................................................... 1C�7' ` X`Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ ,33.j Existing violations and/or expired permits......................................................... ❑ 34.a Dted Restriction:......................................................................................... ❑ 35.101egaI descripti n, M.H. �o Other: ❑ 37. Other: MCO ..... R....:�............ d 4 R . When`[issuedgTelephone, 53 L� ?13 T and hold for pickup. erC I have been iinformed of thb' bove items and requirements for obtaining a building permit. Applicant Date: /9- D 1. Index permit application for the _ bove items numbered: Plan Check Letter 2. Additional items re u d V Contractor, desig r, ow , was advised of the above data by Picone, ❑ mail, ❑ counter, by , ate: Contractor, designe , wrier, was advised of the above data by ❑ phone, ❑ mail, ❑. counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: 1. 1 11JA Date: Structural reviewed by: Date: Structural approved by: t Date: Note transfer by: Date: Yellow: Building Division � i - TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H. USE ONLY Plot Ran Attached Floor Ran Att$chad Sans to G.D. Owner Location AP# Plan Approved for: Sewage Disposal ✓ Water Supply: Public ✓ Private Well Clearance for / dwelling. Other Hold final for: Final clearance O.K. for: NOTE: --- -- -- --- - Environmental Hea 8/96 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 SCHEDULE OF FEES DUE OWNER. �OOI All PROPOSED BUILDING USE NU U Nkt iI (n Q 1. BUILDING PERMIT FEES �ry rA --Balance Due ........................................................ $ i "1 --Additional Fees Due ............................................ $ --Additional Fees Due ............................................ $ --Revised Plan Checkin Fee $ A.P. # 02q-�10h I DATE 7110 .-) RECEIPT # DATE REC. g................................. 2. SCHOOL DISTRICT FEES CMI I& Qil a_ G iuen q,�b/p 5 11-q-05 (paid at District Office) r4E;�3.tvt S n g ) Residential ................................ x $360.00 = $�5 ( G �,p.c+ F��: 'y 00 Commercial (sq. ft.) ...................... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES Residential ............................ x = $ # Units Amt. Commercial (Sq. ft.) ............. x = $ Sq. ft. Amt. b N. 5. RECREATION DISTRICT FEES �� � � �I��.f' Gt eg/9DIO 11-5 -0) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK ��� (paid at Building Division) 3 5 �� r6. ao`i ,9t 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9 CSA 87 TRAFFIC FEE PO 2500.00 (paid at Building Division)THER a At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT ^ 4"DATE Pursuant to Government Code S&Aon 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original - Building Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 6/00) Butte Count De artment of'Develo inentSemCes Y P A agu!'..)lrf° a �a 7 County Center Drive Oroville, CA 95965 °�, • (530) 538-7601 Telephone y° (530) 538-7785 Facsimile 0U 14" BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building pen -nit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: a I need to submit applications for septic and/or well to Butte County Environmental Health immediately. s I an: required to bring the approved Environmental Health site plait and approved sanitation clearance to the Building Division as soon as clearance is obtained a I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the. plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: S H/ 2. L Ei'( APN: Building site address: L14 p o p T/L R -D., T prIU662 Permit No.: 11 [ have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNATURE OF PPLICANT DATE OSP T p� �v T rF 0 \\CIO tic Wp�� Department C o u n t Y J. Michael Crump, Director of Public o f B u t t 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 II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement rLESS THAN 9 ACRE1 Project Description: %��� S',��A - Project Location and/or Parcel Number: rNOrfc�—, RD, 1541�GUkt 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 frcn 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. V Signed: Title: Date: 3t Less than I ACTe NPDES & SWPPP Compliance Certification Butte Cot:nty Storm Water Management Program Revised SP -4/04 t^•Y l -lir =ka ::.,:•'>_. _., v..+ '. v.'x .�.��x `J.'.: � � � ;O2 CIID RIn�C 4TH.`.gFi"a'4XI^...."�fu.'.t..8`'Y?'z: i.N..v'k.:'=T.^t. Ei:.;.:. j;.�a;Y'in.4'fiFits'i„as'i:Gi:R%�.aTs3L.:Y.?:•�.mn...: Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building pen -nit will be issued until this verification is received. X1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES NO [ ]. ik 2. I HAVE C -A HAVE NOT [ J signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS PHONE:' CONTRACTOR'S 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: PHONE: CONTRACTOR'S 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 SIGNED: PROPERTY OWNER: DATE: %— D NOTE: This Owner -Builder verification is required by Section, 19831 and 19832 of the California Health and Safety Code. , This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION t BUILDING' GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile Dear Property Owner: 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials' and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o 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 Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "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 in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. I It ON-, MicVael C. Vieir4 C.B.O. Mailager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. .r 't A WILLDAN Serving Public Agencies September 14, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX 2399 Gateway Oaks Drive, Suite 210 Sacramento, California 95833 916/924-7000 fax 916/924-3644 www.willdan.com BUTTE COUNTY PLAN REVIEW REPORT } Status: Approved Jurisdiction Job No: 05-1914 Assessor's Parcel No: 028-210-061 Description: Loomis NSF/Gar/Cov, La Porte Road Willdan Project No: 14353-1800 Dear Mr. Rutherford: Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2"d page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: * Plans: Two (2) copies, sheets 1 through 8 dated 09/07/05, by Shirley Loomis. * . Truss Calculations: Two (2) copies dated 7/15/05, by MiTek. * Enerlay Calculations: Two (2) copies dated 6/25/05, revisions dated 08/23/05, by Barry Rubanoff. The plans have been stamped with the Willdan approval stamp and dated. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. A W I LLDAN Serving Public Agencies APPLICABLE CODES Our review was based on requirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code (CBC). • Part 6, known as the California Energy Code, and Energy Commission Standards (CECS). CODE ANALYSIS Our plan review revealed the following information regarding the occupancy designation, type of construction, and other ertinent features. This information is consistent with that shown on the plans. Specific Use Type of Occupancy Type of Construction Stories 1s1 Floor Sq Ft Total Sq Ft Dwelling R-3 V -N 1 2,680 2,680 Garage U-1 V -N 1 1,080 1,080 Cov'd Patio R-3 V -N 1 972 972 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and/or notes as red -lined on the plans. 3. All plan sheets shall be signed by designer or person responsible for the plans as required by California Health & Safety Code Section 5536.1. 4. Field inspector to verify installation of existing or new smoke detectors in all existing bedrooms and -hallways leading to bedrooms (may be either battery operated or 110 volt .with battery backup) as required when the valuation of any addition made to a Group R - occupancy exceeds $1000 per CBC 310.9.1.2 through CBC 310.9.1.5 5. Gable -End Truss calculation submittal is deferred to Butte Co.'s review at their discretion. . i , Ir SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals. Sincerely, Tom Trueb Plans Examiner Cc: Alice Mefford, amefford@buttecounty.net Shirley Loomois, mleel comcast.net Page 2 of 2 County of Butte Willdan 1.4353- 1800PC2F CDF FIRE SAFE REQUIREMENTS '? AP# Ao29-.2 16:- o 6 / PERMIT # 05 l fl,- l NAME: Under authority of Public Resources Code Sec. 4290, the following checked items are required T by the Butte County Fire Department and made a part of this permit. These requirements are 11 Jl minimums and may be superseded by Butte County local regulations, which equals or exceeds these standards. Butte County Building Inspectors will make compliance inspections. Driveway Standards IXl All new driveway construction or an extension of an existing driveway shall comply with Public Resources Code 4290 roadway requirements. [Xl Surface. All driveway surfaces and structures (bridges, culverts and other appurtenant structures which supplement the roadway bed or shoulders) shall provided unobstructed access to conventional drive vehicles, including sedans T Il and fire apparatus weighing up to 40,000 pounds. [Xl Grade. Not to exceed 16 percent unless paved or concreted. Grade will not R exceed 20 percent. Driveway Radius VI No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional surface width of 4 feet shall be added to curves of 50-100 feet radius; 2 feet to those from 100-200 feet. T [Xl The length of vertical curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 E feet radius. [Xl Turnarounds. Required if driveway is over 300 feet in length, will have a minimum turning radius of 40 feet from the center of the road and be located within 50 feet of the buildings. T T U [Xl Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 -foot taper on each end. I T [Xl Width. All driveways shall provide a minimum 10 -foot traffic lane and i unobstructed vertical clearance of 15 feet along its entire length; T 11�\ (Xl Turnouts. Driveways exceeding 150 feet in length, but less than 800 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. Gates 1' [Xl .1. Gate entrances shall be at least two feet wider on each end than E the roadway they serve. 2. The gates must be located at least 30 feet from the roadway and N shall open to allow a vehicle to stop without obstructing traffic on the roadway. 3. Where a one-way road with a single traffic lane provides access to a gate entrance, a 40 -foot turning radius shall be used. C Addressing [X] All buildings shall have a permanently posted address, which shall be visible and legible from both directions of the road the address is located. The address shall be posted at the beginning of construction and maintained thereafter. Accessory buildings are not required to have a separate address posted. (X] Size of letters, numbers and symbols for addresses shall be a minimum of 3 inch letter height, 3/8 inch stroke, reflectorized, and contrast with. the background color of the sign. [X] Where addresses cannot be seen from the roadway, the address shall also be posted a single post located at the intersection of the driveway and the road. Setback for Structure Defensible Space [X] Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued availability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provided for by the landowner. [ ] 1. All parcels 1 acre and larger shall provide a minimum 30 -foot setback for buildings and accessory buildings from all property lines and/or the center of the road. 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See "Other Requirements below. [X] 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. Disposal shall be completed prior to completion of road construction or final building permit inspection. Other Requirements T ' U If Building Setback is 15 to 30 Feet: ✓ Class A roof I . ✓ Fully enclosed eaves [ ] If Building Setback is Less Than 15 Feet: R ✓ Class A roof with fully enclosed eaves and choose any 2 of the following: ❑ Metal or no doors on side toward property line with insufficient setback ❑ Interior automatic sprinkler system per NFPA 13D ' ❑ Glass area not to exceed 10% of wall area toward property line with insufficient M setback ❑ Siding from the following list: T o Stucco — 3 coat HL o Hardi-Board or Plank . o Masonry � T o Masonry Veneer o Metal Date I AND W,'-;0 P.ECORDED MAIL TO. BUTTEtOUAI: BUILDING -DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 . 2005-0053312 Recorded I Official Records I County of I Butte I Cffim J. 6k ffin I County Clerk-Recorderl I 012:47PH 09 -Sep -205 1 REC FEE 10.00 COWORNED COPY 1.00 BY Page I of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situatAn the County of Butte, State of California, described as follows: see atta-G�eck . Date 9Z7/PR PERTY OWNERS: 4"v a ✓' V/ �o o .yl l S S mmo - `/ Z OCA/%/_ t State of Californi ) County of L- �) OnC'sbefore me, oczcU�\l, l `-\A-GXL� personally appeared \ppm�s personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNES my nd and official seal Signat Seal: DEBORAH K. BEER; g COMM. # 1594101 A.P.# ©-', 9-A10- OlO I O TARY PUBLIC=CALIFORNIA D BUTTt: COUNTY 0 COMM. EXP- JULY 9.2009'' I tblusH f6Miliu 5Jl3i& I 2BM} A I�reb^ta�h-sl�rsl� �srva3 1 S 10 ! tpa9 I EMS- 5249, IN4616 F iII111141111.1{1111141111111111111 HAP -08-0 " t tOtt•R�'t T .tv�l+:i'» (s .il:�:ifl'!t}h�-,�yi �e::i� iit�t'�!�' � �,! • r A Policy No. CAFNT0958-0958-0001-0000104793-FNTIC-2004-01-0 LEGAL DESCRIPTION I EXHIBIT "A" All that certain real property situated in the South half of the Southeast one quarter of Section 22, Township 18 North, Range 5 East, M.D.M., in the unincorporated area of Butte County, California and being more particularly described as follows: Commencing at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mound of rocks set at the Southwest corner of said Section 22 bears North 890 56' 20" West 2667.94 feet distant; thence leaving said South line of Section 22, North 020 24' West 53.25 feet to a point in the centerline of the Bangor -La Porte Road; thence along said road centerline, North 550 01' East 135.15 feet to a curve concave to the Northwest having a radius of 1000 feet and a central angle of 160 10' ; thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 380 51' East 45.23 feet to a curve concave to the Northwest having a radius of 300 feet and a central angle of 180 20' ; thence along said curve, a distance of 96.00 feet to THE TRUE POINT OF BEGINNING for the herein described parcel; thence continuing along said 300 foot radius curve, through a central angle of 180 20' ; for an arc distance of 96.00 feet; thence along the tangent to said curve, North 020 11' East 293.64 feet to a curve concave to the West, having a radius of 400 feet and a central angle of 130 09' ; thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 100 58' West 169.57 feet to a curve concave to the Southwest, having a radius of 300 feet and a central angle of 140 45' ; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, North 250 43' West 87.23 feet to a curve concave to the Northeast, having a radius of 350 feet and a central angle of 100 1743" ; thence along said curve, a distance of 62.89 feet to. a point in the North line of the Southwest one quarter of the Southeast one quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49' East, 707.54 feet; thence South 490 40' East 236.24 feet; thence South 260 58' East 780.53 feet; thence South 400 41' East 298.87 feet; thence South 160 16' East 79.69 feet; thence South 060 28' West, 143.38 feet to a point on the South line of said Section 22; thence Westerly along said Section Iine,.North 890 56' 20" West 900 feet, more or less to a point that bears South 450 East from the Point of Beginning; thence North 450 West 630 feet, more or less to the POINT OF BEGINNING. The Basis of Bearings for this description is the South line of the Southwest one quarter of said Section 22, taken as North 890 56' 20" West, as per the Deed to Roger W. Shortz, et ux, recorded in the Office of the Butte County Recorder under Serial Number 2000-24972. All new structures must meet the Fire Safe Regulations of Butte County and Public Resources Code 4290. APN: 028-210-0:61 CLTA Standard Coverage Policy - 1990 BUTTOUNTY DEVELOPMENT FEE CERTIFICATION FORM FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) 0 PARADISE RECREATION AND PARK DISTRICT (PRPD) 0 DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) M—S -9-1( ©W Building Permit Number Property Owner (s) L(W l S Project Location /Address Subdivision Name New Development Alteration/Addition(s) Mobile home Assessable Sq. Ftge 2G Type of Residential Development (check one) Demo Permit (date issued Comments: Single Family -Detached Non -Residential to Residential Mobile home replacement Single Family -Attached Multi -Family Dwelling verified by Assessor Department verified by Building Department 0 FRRPD 0 CARD ❑ PRPD 0 DRPD certifies that: S1-+ 2 LL`- Applicant Name Phone Number CL&Mo i 1-9 e�;11,11 & Lr Mailing Address City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ Square Feet @ $ Remarks: Paid by Check No: Paid by Cash: and Park District Representative KAFGRMS\BUILDING FOR,\iSlpark-rec standard form rev Ldoc per unit for a total of $ . per sq foot for a total of $ Receipt No: a I I School District A.P. Number Property Owner BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) TSR 052 -CO2 orovilit "f6 Building Department No. SA o-00 Jurisdiction: City �ounty Looms Property Location/Address [a Wit Kd , �l Subdivision r•. Commercial/Industrial 0 0 New r Addition Lot No. ......................................................................................� Sq. Footage 2- CH Residential Development Q No of Living Mobile Home Units Installation r•. Commercial/Industrial 0 0 New r Addition Lot No. ......................................................................................� Sq. Footage 2- CH Addition/ 'Supplemental to (Group. R) Conversion Permit #" 11 -16 -dation inspection) ........................................................................................ Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Sq. Footage;."i, �• (Including Exterior Roofed Areas) 9 -2D-n Date District Identification No. V b X11 c r uv,-) , 111 Dn SCK'661 District certifies that Lo L) M t 5 (Applicant) 53L4 S 13 S (Street Address (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. (V5 "— by payment of $ (p d' representing �p� _ square feet.. = 1�13 2926 $ ULL MITIGATION $ School District Representative Date Paid by Check # Remarks: Notice: You may protest the Imposition of the fees Identified above by submitting a written protest.to the District, In compliance with Government Code Section 66020(a), within 90 days from the date hes are paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the fees In any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is notified by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school hes to fully mitigate Its Impact on the school dist ict's sehools. White (school district), Yellow (building department), Pink (applicant) feetorm.xls (305)drbm e �y A SITE PLAN REVIEW APPLICATION Date: AP# Permit Number (if applicable) APPLICANTINFORMATION Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: Residential Wf New Single Family Residential ❑ Single Family Addition ❑ 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 T❑ Industrial Addition Bin Number Parcel Size: _ � N lld� J Email: ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel Other , Septic ❑ Well Agricultural Exempt Building ❑ Agricultural Buffer Form ❑ Applicable ❑ 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 *Site Plan Stamped Approved By Date QS No sTTF-- PCA-kj 1—n ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) 4 ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required)/,, -&T -i M SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See ached) Flood Zone: Flood Panel No.: O --Z S D Index Date: `% 00 ❑ 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) ❑ Oroville Enterprise Zone 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: Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Zoning Code Streets & Highways Fire Prevention Subdivision Map- Front a 36 Side c Side Street Rear f 30 Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. 0 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:[] No ❑ Yes o Comments: r d'�n irtii t- r'i'A 1/" It A /�s1 , �:/ -/",� � /_r r��i� /�i�o�,,,, i/ A,/' //Z Parcel Deemed to be legal_M . Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice 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 ❑ Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: Page: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None ❑ 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. �al e Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CALanys\Building Permit Site Plan Reviewl .doc RECORDING REQUESTED BY: Fidelity National Title Corqq4nXof California Escrow No.: 03 -104793 -CC w. Locate No.: CAFNT0958-0958-0001-0000104793 Title No.: 03 -104793 -RN When Recorded Mail Document and Tax Statement To: Mr/Mrs Marvin L. Loomis 3066 Clemo Ave. Oroville, CA 95966 Recorded • I Official yof Records I CoButteI CMCE J. 6RUBBS I County Clerk-Recorderl 1 I 09: 15-Jul-2l..I REC FEE 16.0 NZ Page 1 of 2 . APN: 028-210-061 (PRIOR AP # = PORTION OF 028-210-036 AND SPACE ABOVE THIS LINE FOR RECORDER'S USE PORTION OF 028-240-028) CORRECTION GRANT DEED The undersigned grantor(s) declare(s) Documentary transfer tax is $.0.00 City Transfer Tax is $ 0.00 DTT in the amount of $64.90 [ x ] computed on full value of property conveyed, or has already been paid. [ ] computed on fu!! value less va!-.:e of liens or encumbrances remaining at time of sale,. [ ] Unincorporated Area City of Oroville, FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Roger W. Shorn, a m'arri'ed man as his sole and separate property hereby GRANT(S) to Marvin L. Loomis and Shirley A. Loomis, husband and wife as Joint Tenants the following described real property in the City of Oroville, County of Butte, State of California: SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF THIS DEED IS BEING RECORDED TO CORRECT THE LEGAL DESCRIPTION AS SHOWN IN THAT CERTAIN GRANT DEED RECORDED JUNE 22, 2004 UNDER BUTTE COUNTY RECORDER SERIAL N0. 2004-0037572. DATED: April 22, 2005 STATE OF CALIFr NIA ' COUNTY OF ✓) %L. DS� ON 'i ar�.e 15 o�G before me, the undersigned Notaw Public personally appeared personally known to medor moved to me on ha nasi, _f satisfactory evidence) to be the erso ) whose (s) Ware subscribed to the within instrument and acknowledged to me that�she/they executed the same in his her/their authorized ca aci les), and that by homer/their sianature(s) on the instrument the person s), or the entity upon behalf of which the person(s) acted, executed the instrument. " Witness my han and official e L r Signature PATF1 L. VAN HORN Commission # 1443220 @,My Notarl Public - California Contra Costa County Comm. E)pines Oct 30, 2007 MAIL TAX STATEMENTS AS DIRECTED ABOVE FD -213 (Rev 7/96) GRANT DEED (grantAl)(10-04) 02- 19� �:. LEGAL DESCPIPTION EXHIBIT "A" TV j All that certain real property situated in the South half of the Southeast one quarter of Section 22, Township 18 North, Range 5 East, follows: M.D.M., in the unincorporated area of particularly described as Butte County, California and being more Commencing at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mound of rocks set at the Southwest corner of said Section 22 bears North 890 56' 20" West 2667.94 feet distant; thence leaving said South line of Section 22, North 020 24' West 53.25 feet to a point in the centerline of the Bangor -La Porte Road; thence along said road centerline, North 550 01' East 135.15 feet to a curve concave to the Northwest having a radius of 1000 feet and a central angle of 160 10' ; thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 380 51' East 45.23 feet to a curve concave to the Northwest having a radius of 300 feet and a central angle of 180 20'; thence along said curve, a distance of 96.00 feet to THE TRUE POINT OF BEGINNING for the herein described parcel; thence continuing along said 300 foot radius curve, through a central angle of 180 20' ; for an arc distance of 96.00 feet; thence along the tangent to said curve, North 020 11' East 293.64 feet to a curve concave to the West, having a radius of 400 feet and a central angle of 130 09' ; thence along said curve, a distance of 91.80'feet• thence along the tangent to said curve, North 100 58' West 169.57 feet to a curve concave to the Southwest having a radius of 300 feet and a central angle of 140 45' ; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, North 250 43' West 87.23 feet to a curve concave to the Northeast' having a radius of 350 feet and a central angle of 10° 1743" ; thence along said curve, a distance of 62.89 feet to.a point in the North line of the Southwest one. quarter of the Southeast one quarter of Section 22• thence South 490 40' East 236 thence along an existing fence line, the following courses and distances: South 890 49' East, 707.54 feet; .24 feet; thence South 26° 58' East 780.53 feet; thence South 400 41' East 298.87 feet; thence South 160 16' East 79.69 feet; thence South 060 28' West, 143.38 feet to a point on the South line of said Section 22; thence Westerly along said Section line, North 890 56' 20" West 900feet, more or less to a point that bears South 450 East from the Point of Beginning; thence North 45° West 630 feet more or less to the POINT OF BEGINNING. The Basis of Bearings for this description is the South line of the Southwest one quarter of said'S taken as North 890 56' 20" West, as per the Deed to Roger W. Shortz, et ux, recorded in the Off ice the, Butte County Recorder under Serial Number 2000-24972. All new structures must meet the Fire Safe Regulations of Butte County and Public R esources Code 4290. APN: 028-210-036 (portion), 028-240-028 (portion) CLTA Standard Coverage Policy -1990 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CA 95965 COPY of Document Recorded 9 -Sep -2005 2005-0053912 Has not been compared with original BUTTE COUNTY COUNTY RECORDER AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT R Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real.property situataakn the County of Butte, State of California, described as follows: See aft axz., ect . Date 9/y/O� PR PERTY OWNERS: State of Californi ) County of �� ) On Q before me, personally appeared �2 Or» S Q p pmt personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESmy nd and official seal : DEBORAH K. BEIM Signator Seal: o COMM. # 1594101 A.P.#_Q-), a -A/0-- 0b / O TARY PUBLtC=CgUFpRNIA D BUTTE COUNTY O COMM. EXP. JULY 9. 2009 -' Policy No. CAFNT0958-0958-0001-0000104793-FNTIC-200401-0 LEGAL DESC62IPTION EXHIBIT "A" All that certain real property situated in the South half of the Southeast one quarter of Section 22, Township 18 North, Range 5 East, M.D.M., in the unincorporated area of Butte County, California and being more particularly described as follows: I Commencing at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mound of rocks set at the Southwest corner of said Section 22 bears North 891 56' 20" West 2667.94 feet distant; thence leaving said South line of Section 22, North 02° 24' West 53.25 feet to a point in the centerline of the Bangor -La Porte Road; thence along said road centerline, North 550 01' East 135.15 feet to a curve concave to the Northwest having a radius of 1000 feet and a central angle of 160 10' ; thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 380 51' East 45.23 feet to a curve concave to the Northwest having a radius of 300 feet and a central angle of 18° 20'; thence along said curve, a distance of 96.00 feet to THE TRUE POINT OF BEGINNING for the herein described parcel; thence continuing along said 300 foot radius curve, through.a central angle of 180 20' ; for an arc distance of 96.00 feet; thence along the tangent to said curve, North 020 11' East 293.64 feet to a curve concave to the West, having a radius of 400 feet and a central angle of 131 09' ; thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 100 58' West 169.57 feet to a curve concave to the Southwest, having a radius of 300 feet and a central angle of 140 45' ; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, North 25° 43' West 87.23 feet to a curve concave to the Northeast, having a radius of 350 feet and a central angle of 101 1743" ; thence along said curve, a distance of 62.89 feet to a point in the North line of the Southwest one quarter of the Southeast one quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49' East, 707.54 feet; thence South 490 40' East 236.24 feet; thence South 260 58' East 780.53 feet; thence South 40° 41' East 298.87 feet; thence South 160 16' East 79.69 feet; thence South 060 28' West, 143.38 feet to a point on the South line of said Section 22; thence Westerly along said Section line, .North 890 56' 20" West 900 feet, more or less to a point that bears South 450 East from the Point of Beginning; thence North 450 West 630 feet, more or less to the POINT OF BEGINNING. The Basis of Bearings for this description is the South line of the Southwest one quarter of said Section 22, taken as North 890 56' 20" West, as per the Deed to Roger W. Shortz, et ux, recorded in the Office of the Butte County Recorder under Serial Number 2000-24972. All new structures must meet the Fire Safe Regulations of Butte County and Public Resources Code 4290. APN: 028-210-061 CLTA Standard Coverage Policy - 1990 ENCROACHMENT PERMIT County of Butte Department of Public Works 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 53811356 Download Forms: www.buttecounty.net/publicworks/forms.htmI NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Permit Number District Phone (530) 538-7157 Ext. 2016 APPLICATION I WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads td highways, all in accordance with County ordinances and general laws. (All information except signature must be typed or legibly rinted.) Applicant's Name- t la. Company Name: Address: 4. Assessor's Parcel Number. >�. 4/0 -C),4y -Phone 63 4/-V 361�-0r �- �, � v - � 7C- LocationWork to b*D ogee j70%� % �(, R -/U 6 C - ---- - Applicant's Si ature �� 7. Date. l I� CONTRACTOR'S INFORMATION Contractors Name 1� 1 \ %��1;A L U J 4- S i 0QCZ L.!} SJS C0: ;-P-,� C.77.L)c Address Jl' i Lr 0/9 '9S964- 3. Phone: �. 11. Fax % 2. Contractor's License Number. Q 13. Certificate of Insurance: Yes No: ❑ 4. Contractor's Signatu j&O_,, 14a Date Signed: /� o S. Authorized Agent / TYPE OF WORK TO BE DONE 6. Please Check:17. If Driveway List Type: Curb: EJ Gutter: ❑ Sidewalk: ❑ i.1 j ETIla ;�.( 8. Other Work - ❑ Yes 1R No PERMIT GRANTED -icompliance with the above request, and subject to all terms, conditions (mcluding those on page 2 of this permit form) and special conditions written below, ermission is hereb nted 0. Conditions / / — - t/ /_ . /. r- Inderground Service Alert (U SA) must be notified two working days prior to any excavation. 800-227-2600 1 lel All work shall conform to accomuanvina: Detail ❑ Plans ❑ Special Conditions ❑ .2. Date Issued � J 23. Expiration Data. � 24. Surety: , 5. Date Paid: / 26. Amount P id: 27. Paid By: 28. Recel�i)IjNo.::Aw '� dike Crump, Director .of Public Works ��.. By. - y.29. nor County 29.Final Inspection Date: 30. Inspected By: ❑ Completed - OK LID Completed — Not OK ❑ Additional Comments Attached Use Only: 31. Comments: dote: if permits are faxed to any number oesiaes U-y 1— �z �� 'o ur •� �__� -^• NOTES x RESIDENTIAL PERMIT NO. _028'210-036 05-0701 LOOMIS, MARVIN 5864 LA PORTE RD, BANGOR f Cont: OWNER 4 NEW WTR LINE J f 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),? Signature J=OK 0 = Not OK . = Not Readyable 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 MISCELLANEOUS Date 7. Well Clearance & Disconnect 8. Utility Clearance 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 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 Date 8. Gas and Electricity Tagged Date 9. Tie Downs -Type -Installation Cert. Date 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 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 Date 8. Gas and Electricity Tagged Date 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 DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 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 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-Wra ed 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/0 -Sewer Test 1 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test-Anchors-Requlator-Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Mab 14. Girders -Sills -Anchor Bolts -Joists - 15. Access & Ventilation 16. Insulation Dates Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Dat PLUMBING (Permit) OK except #'s 26.Size 17. Water Htr.; Vent -Access -Combustion Air Baffle _ 18. Water Pipe; Test & Anchor -Nail Protection Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water , 19. D.W.V.; Test Fittings & Anchor -Nail Protection 29. 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI 22. Gas Pipe; Sixe & Anchors 31. 23. Fire Sprinkler; Test . 32. Da Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Clothes Closet Light -Shower Light -Spa Light 24. Fixture & Transformer Clearance -Ins. Protection Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-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 0 Yes 0 No/Planters 0 Yes 0 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/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler 1 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: 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26.Size Boxes & No. of Conductors Stapled 27.Romex 28. Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water , 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date 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 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-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 0 Yes 0 No/Planters 0 Yes 0 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/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler 1 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: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICJO) OFFICE #: (530) 538-7541 PERMIT NO. BPO50701 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 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 03/16/2005 APN: 028-210-036-000 the Business and Professions Code, and my license is In full force and effect. License Class: License Number: Site Address: 5864 LA PORTE RD BAN Date, Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW WATER LINE Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MARVIN L. LOOMIS to its issuance, also requires the applicant for such permit to file a SHIRLEY A. LOOMIS signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 3066 CLEMO AVE 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE CA 95966 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 Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: MARVIN L LOOMIS owner of property who builds or improves thereon, and who does SHIRLEY A. LOOMIS such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 3066 CLEMO AVE sale. If however, the building or improvements are sold within one OROVILLE CA 95966 year of completion, the owner -builder will have the burden of 530 534-8135 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, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am•Exempt under Article 3 of the Buusin/X��ss and Professions Code Date: _ 6- U-!6wner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by. Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: Is Issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: 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: otal Square Ft: 0 S. F. Policy #: Valuation: $0.00 I certify that In the performance of the work for which this permit Is Census Code: 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' „ compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3 — Q� Date: Applicant: Failure to workers' compensation coverage is WARNING: sec,e unlawful, and shall subject an mployer 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-oermit is hereby issued unde/t e a plicable provisions of the Butte County Code and/or 1 hereby affirm that there is a construction lending agency for the of the work for which this is Issued (Sec 3097 Civ.) ResQlutlons� b do work Indicated above or �hlch fees have been paid. I) �6 performance permit BY� Dale:. Name: ��} �} PERMIT EXPIRES ON: Address: (Date) O 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. O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O 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 stale 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 Butte County to enter upon the above mentioned property for inspection purpose §. Print Name: S /7`/ Lk:� 111 4 on /-1 / C,– Signature: Date: .Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor C. l,. ouuumy renin v r 1v-vY vH BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHI(;O) BPO50701 OFFICE #: (530) 538-7541 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 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 03/16/2005 APN: 028-210-036-000 the Business and Professions Code, and my license is in full force and effect. License Class; License Number: Site Address: 5864 LA PORTE RD BAN Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW WATER LINE Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MARVIN L. LOOMIS to its issuance, also requires the applicant for such permit to file a SHIRLEY A. LOOMIS signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 3066 CLEMO AVE 7000) of Division 3 of the Business and Professions Code) or that he or OROVILLE CA 95966 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 penally of not more than five hundred dollars ($500).): I, as owner of the properly, 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: MARVIN L LOOMIS owner of property who builds or improves thereon, and who does SHIRLEY A. LOOMIS such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 3066 CLEMO AVE sale. If however, the building or improvements are sold within one OROVILLE CA 95966 year of completion, the owner -builder will have the burden of 530 534-8135 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, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 airm--Ex''e//mp--tunder Article 3 of the Busin s and Professions Code Date: Q wrier: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ 1 have and will maintain workers' compensation insurance, as Engineer: 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: otal Square Ft: 0 S.F. Policy #: Valuation: $0.00- I certify that in the performance of the work for which this permit is Census Code: 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: — Q� Applicant: WARNING: Failure to sec re workers' compensation coverage is unlawful, and shall subject an ployer 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 hereby Issued under e a plicable provisions of the Butte County Code,and/or I hereby affirm that there is a construction lending agency for theRes performance of the work for which this permit is issued (Sec 3097 Civ.) lulions do work indicated bove or Which fees have been paid. Name: BY Date: PERMIT EXPIRES ON: Address: Date ❑ 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 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 Butte County to enter upon the above mentioned property for inspection purpose . Print Name:/ 2 L� % �� / S Signature: ' �� - t/ , Date: �� ":Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Buildinq Permit 01-16-04 pq 1 :Ju �xi.[n:A�i._k`n�o:ll.:�..u'�'a•'.;�r.=1_. '1..''�k7s :.tet .... n"c. .. �N.,r .. !t'^., ��?sxc»%Y:;�. a...-.... ... ._tb=,:.. �:::::i,�, >,. Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES [ No[ ]. 2. I HAVE [ ] HAVE NOT ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ��- ADDRESS: PHONE: CONTRACTOR'S 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: PHONE: CONTRACTOR'S 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 SIGNED: PROPERTY OWNER: DATE: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department ©f Development Services ADMINISTRATION * BUILDING * GIS * PLANNING 7 County Center Drive Orovilie, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile Dear Property Owner: 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o 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 Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their"own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "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 in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Micel C. VieirJ C.B.O. Mai7t ager, Building Inspection NOTE: This. Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. 11�'- I r 1* RECORDING REQUESTED BY: Fidelity National Title Company of California Escrow No.: 03 -10.4793 -CC Locate No.: CAFNT0958-0958-0001-0000104793 Title No.: 03 -104793 -RN When Recorded Mail Document and Tax Statement To: Nkr: and Mrs. Marvin L. Loomis 3066 C1emo Avenue Oroville, CA 95966 210014-00375-72 Recorded Official -Records County Of BUTTE CANDACE J. 6RUBBS Recorder ROSEMARY DICKSON Assistant 09:00AM 22 -Jun -2004 REC FEE 13.00 TAX 64.90 MONUMEN 10.00 Barbara Page 1 of APN: 028-210-036 (portion), 028-240-028 (portion) SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED The undersigned grantor(s) declare(s) Documentary transfer tax is $64.90 A. % ( X ] computed on full value of property conveyed, or L� [ ] con-iputed on ruli vaiue less value of liens or encumbrances remaining at time of sale, [ ] Unincorporated Area City of Oroville, FOR A VALUABLE CONSIDERATION, receipt.of which is hereby acknowledged, Roger W. Shortz, an unmarried man hereby GRANT(S) to Marvin L. Loomis and Shirley A. Loomis, husband and wife the following described real property in the City of Oroville, County of Butte, State of California: SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF DATED: June 10, 2004 STATE OF CALIFQ�NIA COUNTY FQ.vr x► ON before me, W�7cr,' L,r personally appeared roved to me on the basis of satisfactory evidence) to be the personX whose name,() is/ate subscribed to the within instrument and acknowledged to me that he/may executed the same in his/herttreirauthorized capacity(je&), and that by his/her4their signature(gf on the instrument the persor�, or the entity upon behalf of which the person acted, executed the instrument. Roger W. Shortz MAIL TAX STATEMENTS AS DIRECTED ABOVE FD -Z13 (Rev 7/96) GRANT DEED (grant)(3-04) Escrow No.: 03 -104793 -CC Locate No.: CAFNM958-0958-0001-0000104793 'ride No.: 03 -104793 -RN EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA AND IS DESCRIBED AS FOLLOWS: All that certain real property situated in the unincorporated area of Butte County, California, and being the South one half of the Southeast one quarter of Section 22, Township 18 North, Range 5 East, M.D.N., and Lots 42, 43, 44 and 45, as shown on that certain map entitled_ Town of Bangor_. Which map was recorded in the Office of the County Recorder of Butte County, California, on March 21, 1901, in Book 7 of Maps, at Page 77 lying in Section 27, Township 18 North, Range 5 East, M.D.B.& M. EXCEPTING THEREFROM all that portion of said south one half of the Southeast one quarter of Section 2.2 and said Lot 42 lying WESTERLY of the writeriine of the Bangor -La Porte. Road. ALSO EXCEPTING THEREFROM all that portion of said south one half of the Southeast one quarter of Section 22 and said Lot 45 lying EASTERLY of the following described line: COMMENCING at an iron pipe set at a fence corner in the South line of Section 22, said Township and Range from which point an iron pin in a mound of rocks set at the Southwest corner of said Section 22 bears North 890 56_20_ West 2667.94 feet distant; thence leaving said South line of Section 22, North 020 24_ West 53.25 feet to a point in the centerline of the Bangor_La Porte Road; thence along said road centerline, North 550 01_ West 135.15 feet to a curve concave to the northwest having a radius of 1000 feet and a central angle of 160 10_; thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 380 51_ East 45.23 feet to a curve concave to the northwest having a radius of 300 feet and a central angle of 360 40_; thence along said curve, a distance of 191.99 feet; thence along the tangent to said curve, North 020 il_ East 293.64 feet to a curve concave to the west, having a radius of 400 feet and a central angle of 13° 09_; thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 100 58_ East 169.57 feet to a curve concave to the southwest, having a radius of 300 feet and a central angle of 140 45_; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, North 250 43_ West 87.23 feet to a curve concave to the northeast, having a radius of 350 feet and a central angle of 100 17_43_; thence along said curve, a distance of 62.89 feet to a point in the North line of said South half of the Southeast one-quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49; East, 707.54 feet the TRUE POINT OF BEGINNING; thence South 490 40_ East 236.24 feet; thence South 260 58_ East 780.53 feet; thence South 400 41_ East 298.87 feet; thence South 160 16_ East 79.69 feet; thence South 060 28_ West, 143.38 feet, more or less, to a point on the North line of said Lot 45; thence leaving said North line South 060 28_ West, 147.89 feet; thence South 250 06_ West, 223.26 feet; thence South 440 27_ East 597.33 feet; thence South 040 40_ East 372.30 feet; thence South 140 43_ East 227.24 feet to a point on the South line of -said Lot 45 and the end of the herain described lin-. ALSO EXCEPTING THEREFROM all that portion of the South one half of the Southeast one quarter of said Section 22 more particularly described as follows: Commencing at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mound of rocks set at the Southwest corner of said Section 22 bears North 89°56_20_ West 2667.94 feet distant; thence leaving said South line of Section 22, North 020 24_ West 53.25 feet to a point in the centerline of the Bangor -La Porte Road; thence along said road centerline, North 550 O1_ East 135.15 feet to a curve concave to the northwest having a radius of 1000 feet and a central angle of 160 10_; thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 380 51_ East 45.23 feet to a curve concave to the northwest having a radius of 300 feet and a central angle of 180 20_; thence along said curve, a distance of 96.00 feet to THE TRUE POINT OF BEGINNING for the herein described parcel; thence continuing along said 300 foot radius curve; through a central angle of 18020 for an arc distance of 96.00 feet; thence along the tangent to said curve, North 020 11_ East 293.64 feet to a curve concave to the west, having a radius of 400 feet and a central angle of 130 09_; thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 100 58_ West 169.57 feet to a curve concave to the southwest, having a radius of 300 feet and a central angle of 140 45_; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, North 250 43_ West 87.23 feet to a curve concave to the northeast, having a radius of 350 feet and a central angle of 100 17_43_; thence along said curve, a distance of 62.89 feet to a point in the North line of the Southwest one quarter of the Southeast one quarter of Section 22; thence along an existing fence line, the following courses and distances: South 89° 49_ East, 707.54 feet; thence South 490 40_ East 236.24 feet; thence South 260 58_ East 780.53 feet; thence South 400 Initials: /�-.f� T 41_ East 298.87 feet; thence South 161 16_ East 79.69 feet; thence South 06° 28_ West, 143.38 feet to a point on the South line of said Section 22; thence westerly along said Section line, North 89°56_20_ West 900 feet, more or less to a point that bears South 45° East from the Point of Beginning; thence North 450 West 630 feet, more or less to the POINT OF BEGINNING. The Basis of Bearings for this description is the South line of the said Section 22, taken as South 890 56_ 20_ East. Initials: /�v BUTTE COUNTY A A DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS_ 24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834il OFFICE #: (530) 538-7541 C� U A FEE WILL BE REQUIRED AT TIME OFAPPLICATIA— Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY* OWNER Last Namet _ 00/19 Name F'-//2 L-1-7- 1-yAddress Address 41 6 C City v/ L Ll State C City Phon�3 r / X35— Fax E-mail APPLICANT NAME CONTRACTOR Name _ I. Address Zip City Fax State Zip Phone Map Book Fax E mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Ow 2 Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Property Address ,- A PokTe 2c_ Flood Zone Cross Street F SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. CB -(�7G BIN # LOCATION AP# =�7_L/D --0.28 Property Address ,- A PokTe 2c_ City Cross Street F 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 rk: Sq. 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 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: —P Amount: Bldg SRA Receipt #: Sheriff SMIP I I Date 16 SS' c d I I Total Page 1 of 2 REV 2-24-05 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 inst, (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. Detached Accessory Building Form filled out by the owner (if required). ❑ 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. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 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 of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done: Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 ri p �C/C WO�� Department C o u n t y J. Michael Crump, Director Warner C. Phillips, Assistant Director June 16, 2004 f Roger Shortz P.O. Box 619 Pinole,•CA 94564 i of Public Works o f B u t t e Re: Application for Certificate of Merger AP 028-210-036 / 028-240-028 Dear Mr. Shortz: LAND DEVELOPMENT DIVISION 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 Enclosed please find the Certificate of Merger that was issued by the Butte County Department of Public Works and recorded on May 20, 2004, under Serial Number 2004-0030015, in the office of the Butte County Recorder. If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, t Stuart Edell Manager, Land Development Division SE/kp Enclosure cc: Building Division Environmental Health Dept. Michael Evans Ted George , " RECORDING REQUESTED BY and AFPER RECORDING RETURN TO: Butte County Public Works LAND DEVELOPMENT DIVISION 7 County Center Drive Oroville, CA 95965 Recorded Official Records Count CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 12:21PM 20 -May -2004 LANDS BEING MERGED: CERTIFICATE OF MERGER REG FEE 31.00 PENALTY 27.00 Barbara Page 1 of 9 AP NUMBERS 028-210-036 028-240-028 NUMBER OF EXISTING PARCELS: three (3) EXISTING PARCELS CREATED BY: ❑ PATENT aGRANT DEED ❑ GIFT DEED ❑ PARCEL MAP ❑ SUBDIVSION MAP ❑ OTHER RECORDING DATA:. YEAR 19 06 BOOK/ PAGE OR SERIAL NUMBER: 1508 D -P . 7-4o SUBDIVISION/ PARCEL MAP: BLOCK LOTS) As of the date of recordation, those lands noted above are merged to create three 3 parcel(s) of land as described in Exhibit(s) A B. C attached hereto. MIKE C UMP DATE Director of Public Works OWNERS' CONSENT TO MERGER THE UNDERSIGNED, as. owners of all that real property to be merged, do hereby consent and agree to the merger of such lands into that / those parcels) as described in Exhibit(s) A. 8. C attached hereto. Sheral L. Shortz, Owne CGNED IN COUNTERPART Date October 31, 2003 Date Edward G. bryan, Co-, stee of the 1981 Bryan Trust Dated March 18, 1981 112-x_63. Date /a -2VA. Bry&-�ru�stof2�1Bryrust -D� Dated March 18, 1981 Date li NOTARY ACKNOWLEDGEMENT STATE OF CALIFORNIA ss COUNTY OF CONTRA COSTA On6lZr..3/ . 2003 before me ,n,g � , ,� ff�'�ii-+�s 7�loG/ G personally Appeared P (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/sX executed the same in his/` authorized capacity, and that by his/W signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal. NOTARY PUBLIC, STATE OF CALIFORNIA STATE OF OREGON, SS. County of--.A_...I.......d.f.... f. --- -- ARMA ATKINS Commission # 1402519 @MY Notary Public - California Contra Costa County Comm. Expires Mar b, 2007 FORM NO. 23 — ACKNOWLEDGMENT STEVENS-NESS LAW PUB. CO.. PORTLAND. ORE. BE IT REMEMBERED, That on this --_9 ....................... day of..-..-. --...... --------, before me, the undersigned, a Notary Public in and for said County and State, personally appeared the within named. 1i fi .�... .-.-� ?-fZil t�-•--•--.. A. A ---•-D Ay4.[V ----•------•-------------•---•-•---•---------------•---- ---------------•-----.....---•--.........-----------........---•----•-----••-------•---•-----------------------...------------•-----...--------•---•----------------------------------.......------•----.. ............................................•------.............---..........-----••---••----------......------.....----....--•--------...................------•------------•-----•--------•--•-------... known to me to be the identical individual ---A described in and who executed the within instrument and acknowledged to me that ..�ii.t!4:f?............ executed the same freely and voluntarily. IN TESTIMONY WHEREOF, I have hereu my hand and affixed OFFICIAL SEAL my of1h I seal the a d year st above written. CLARE L. STEVENS NOTARY PUBLIC -OREGON ------ 2 COMMISSION NO N0.346759 Notary Public for Ore on. MY COMMISSION c,PIRES JUNE 29, 2005 M p �/� My Commission expires - --9 0.--• -------------------------- C, CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of Contra Costa On October 31, 20Q$efore me, Melanie O. Browning , Date Name and Title of Officer (e.g., 'Jane Doe, Notary Public") personally appeared SHERAL L SHORT? , Name(s) of Signer(s) MlI i iR i0mo mbn I I44ii77 Hdwy Nuc - cawwft Gado caft co,,* Carton. &PW Slap 23.2007 Place Notary Seal Above RI personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) . whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Cee ifi c -a of ?4Prgr Document Date: Signer(s) Other Than Named Above: Number of Pages: Capacity(ies) Claimed by Signer Signer's Name: Sheral L. Shortz XJ Individual ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact b Trustee Guardian or Conservator Other: Signer Is Representing: RIGHT THUMBPRINT. ;r5 SIGNER,?' Top of thumb here 0 1997 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 Prod. No. 5907 Reorder. Call Toll -Free 1-800-876-6827 EXHIBIT A Shortz Parcel A - Northerly Parcel All that certain real property situated in the South half of the Southeast one quarter of Section 22, Township 18 North, Range 5 East,. M.D.M., in the unincorporated area of Butte County, California and being more particularly described as follows: Commencing at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mound of rocks set at the Southwest corner of said Section 22: bears North 8905.6120" West 2667.94 feet distant; thence leaving said South line of Section 22, North 02024' West 53.25 feet to a point in the centerline of the Bangor - La Porte Road; thence along said road centerline, North 550 01' East 135.15 feet to a curve concave to the northwest having a radius of 1000 feet and a central angle of 160101; thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 380511 East 45.23 feet to a curve concave to the northwest having a radius of 300 feet and a central angle of 180201; thence along said curve, a distance of 96.00 feet to THE TRUE POINT OF BEGINNING for the herein described parcel; thence continuing along said 300 foot radius curve, through a central angle of 180201; for an arc distance of 96.00 feet; thence along the tangent to said curve, North 02011' East 293.64 feet to a curve concave to the west, having a radius of 400 feet and a central angle of 130091; thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 10°58' West 169.57 feet to a curve concave to the southwest, having a radius of 300 feet and a central angle of 140451; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve,*North 25°43' West 87.23 feet to a curve concave to the northeast,.having a radius of 350 feet and a central angle of 100 17143"; thence along said curve, a distance of 62.89 feet to a point in the North line of the Southwest one quarter of the Southeast one quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49' East, 707.54 feet; thence South 49°40' East 236.24 feet; thence South 26°58' East 780.53 feet; thence South 40041' East 298.87 feet; thence South Pg. 1 of 2 Pg. 2 of 2 160 16' East 79.69 feet; thence South 060 28' West, 143.38 feet to a point on the South line of said Section 22; thence westerly along said Section line, North 89056120" West 900 feet, more or less to a point that bears South 450 East from the Point of.Beginning; thence North 450 West 630 feet, more or less to the POINT OF BEGINNING. The Basis of Bearings for this description is the South line of the Southwest one quarter of said Section 22, taken as North 89056120" West, as per the Deed to Roger W. Shortz, et ux, recorded in the Office of the Butte County Recorder under Serial.Number 2000-24972. All new structures must meet the Fire Safe Regulations of Butte County and Public Resources Code 4290. Q�JF E��JQ� � ?E I coo G, W f�'I rn; No. 12.483 OF CAO 2L 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.netkdds PERMIT NO. BP042310 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: 08/11/2004 APN: 028-210-036-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 5864 LA PORTE RD BAN Date: Contractor: Map Index: i OWNER -BUILDER DECLARATION Description: REPLACE SVC PANEL 200 AMP 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: ROSS MCGOWAN 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 P O BOX 161 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 BANGOR, CA 95914 she is exempt therefrom and the basis for the alleged exemption. Any (530) 679-1201 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: ROSS MCGOWAN Code: The Contractors' State License Law does not apply to an owner'of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, P O BOX 161 provided that such improvements are not intended or offered for BANGOR, CA 95914 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (530) 679-1201 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: 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.). ❑ I am Exempt under Article 3 of the n�nd ssions Code ` Date• /tea Owner: Soo" WORKERS' COMPENSATION DECLARATION License #: I 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 Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: 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 r insurance carrier and policy number are: l Carrier: Total Square Ft: 0 S. F. Valuation: Policy #: - Census'Code: OFFICE COPY 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, Address 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. GASgo. Date: MeterDate ELE Applicant: MeterD 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 ofcompensation, damages as provided for in Section 3706 of the Labor `�1 O code, interest, and attorney's fees. 6 CONSTRUCTION LENDING AGENCY`This per`:sit is -hereby i ued�, d the applicable provisions of the Butte unty Code and/or n I hereby affirm that there is a construction lending agency for the Resolutions to do in icat above for which fees have been paid. ( performance of the work for which this permit is issued (Sec 3097 Civ.) V 1 V Name: By: Date: PERMIT EXPIRES ON: V 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 aut o ed agent 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 offi ' or docu nt of Butte County. I hereby authorize representative Butte County to enter upon the above mentioned property for inspection purpos Print Name: yyB5 ` " Signature: Date: fkOwner ❑ Contractor ❑ Agent for Owner 0 Agent for Contractor 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. BP042310 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: 08/11/2004 APN: 028-210-036-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 5864 LA PORTE RD BAN Date: Contractor. Map Index: Description: REPLACE SVC PANEL 200 AMP OWNER43UILDER 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• ROSS MCGOWAN 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 P O BOX 161 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 BANGOR, CA 95914 she is exempt therefrom and the basis for the alleged exemption. Any (530) 679-1201 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: ROSS MCGOWAN Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, P O BOX 161 provided that such improvements are not intended or offered for BANGOR CA 95914 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of (530) 679-1201 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: 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.). ❑ 1 am Exempt under Article 3 of the n�nd ssions Code /-O �� Date: Owner: License M WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: 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: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwithcomplywith those provisions. Date: Applicant: J 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 LaborI code, interest, and attorney's fees. , 6 l Q i O _ J I ( I CONSTRUCTION LENDING AGENCY"--- W-- -This-permitis•hereby i sued and r the applicable provisions of'the Butte County'Coda an3c I hereby affirm that there is a construction lending agency for the Resolutions to do in ica above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) 1 - Name: BY //`` Date: - V Address: PERMIT EXPIRES ON: 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 aut o ' ed agent 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 offs ' or docu nt of Butte County. I hereby authorize representative Butte County to enter upon theabove mentioned property for inspection purpos S C` Print Name: `�v Signature: yyd Date: AOwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder' building permit has been applied for in your name and beam your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit No building permit will be issued until this verification is received. " )�I. I personally plan to provide the major labor and materials far construction of the proposed property 'ovement : YES NO ❑ 2. I HAVE HAVE NOT signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed const mction: NAME: ADDRESS: CITY.. PHONE: CONTRACTOR'S LICENSE NO. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAMM ADDRESS: CITY: PHONE: CON'TRACTOR'S LICENSE NO. . the work indicated: NAME ADDRESS PHONE TYPE OF WORK , .=DATE:_ NOTE: TMs Owner -Builder Yerifim on is required AY Section 19831 and 19831 of the California Health and Safety Code. This verification m=t be completed and returned to our office before we are permitted to issue the permit OWNER BUILDER IlNFORAIATION Dear Property Owner. zmpmve men aPHc--d M for a building pew has been submitted in yoca name listing yourself as the bm der of property For your protection, You should be aware that as "owner -builder" you are the responsible party ofrecord on such a Pte'Building Permh are not required tD be signed by property owners unless they are personally perfo own worm If your work is being performed by someone other than ou se � their liability if that person applies for the Y You �3' Protect Yourself from possible Proper in his or her name. Contractors are req*ed 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 Ifyou apply. be aware of the foplan II to do Your own work with the exception of various trades that you plan to subcontract, you should wing information for your benefit and protec iM a If you employ or otherwise engage any Parsons other than your immediate fam ly, and the work (mciuding materials and other costs) is $300 or more for the entire Pmject and such persons are not licensed as contractors or subconraators, then You may be an employer. ♦ If you are an employer, you most register widL the State and Federal Go subject to several obligations Governments as as employer and you are warps DOmpeosatton ��, iUy ''ince costseral �� = tax �A�� �I social security . + There may be financial risl�s for you if yon do not . - � �l compensation cov�bvd?ons. with ed to worms S CaaY out these Dbligafipns, and these iislx are especially SeriDI1S �P compensation �stnaace. ♦ For more speck kftnation about yow obligations under Federal Law if you wish, the U.S. Small Business .. ). . pct the Internal Revue Service (and, Stale Law, contact the D For mare specific mon about your obligations under apartment of Benefit Payments and the Division of k&stdal Accidents. If the strachae is intended for sale, PrOPM17 owners who are not licensed contractoConditions. am allowed to perfDrM their work 9 or �roug$ their own employees, bout a licensed contraCtDr �conbra. only tinder limited A frequent practice of MHeensed persons Professing to be coanactm is to secure an �o Perm eaoneovsIy implying that Ste properly owner is providing his or her own labor sad caner bmldea" building Perzaits ve not required to be signed by property on d eb o am Pig Szem own w nary. g community or at 1020 N Street; Sacra CA, 95814. Staff Board in your Please complete the ` Builder Verification" on the reverse side of tris fiDrm So that we can confirm that you are aware of these matters, The big P� Vvfil not be issued tmnl the VMf fS rte. V027- nk 0rvrter-Buffderlprf0miaror2 is required by Section I3830 ofthe Cafrfortrfa ted& mid Safety Coda d' lr ID 1 RECORDING REQUESTED BY: Fidelity National Title Company of California Escrow No.: 03-104966-78 Locate No.: CAFNT09SB-0958-0001-0000104966 Title No.: 03-104966 When Recorded Mail Document and Tax Statement To: Ross W. McGowan P-OAX i � 3a'41T,"' C� 'Fo/y APN: 028-240-028 (portion), 028-210-036 GRANT DEED 2004-4b103281 7 Recorded Official Records L'oBU9EOf CANDACE iJ. GRUBBS Recorder ROSEMARY DICKSON Assistant 09:=N 02 -Jun -M4 REC FEE 13.00 TAX 336.60 Kathyh Page 1 of 3 SPACE A60VE THIS UNE FOR RECORDER'S USE The undersigned grantor(s) declare(s) Documentary transfer tax is $336.60 [ x ] computed on full value of property conveyed, or [ ] computed on full value less value of liens or encumbrances remaining at time of sale, [ ] Unincorporated Area City of Oroville, FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Roger W. Shortz a married man as his sole and separate property hereby GRANT(S) to Ross W. McGowan the following described real property in the City of Oroville, County of Butte, State of California: c>f f DATED: May 27, 2004 STATE OF CALIFORNIA a.f�k--'o !2'ctiwbjj- op.e COUNTY OF Butte ON 9. before me, The Und stoned Nota personally appeared Roger W. Shortz personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) Is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Roger W. Shortz A. BURCHAM 0 Comm- #1281413 0 o NOTARY pUBLIC CALIFORNIA BUTTE COUNTY -� My f�rrmfsum F�t ��f pires Oct 22, ,..__.:_:..:.:::._.._.:::mac ..................� .. Witness my h o ci a I. A. BURCHAM CU _ 0,a; Comm. #1281413 I� Signature ' " NOTARY PUBLIC CALIFORNIA Q �, ra BUTTE COUNTY My Commission Expires Oct, 22, 2004 MAIL TAX STATEMEN'T'S AS DIRECTE FD -213 (Rev 7/96) GRANT DEED (grant)(3-04) N EXHIBIT "ONE" PARCEL I: Order No. 104966 A portion of the Southwest quarter of the Southeast quarter and the Southeast quarter of the Southeast quarter of Section 22, Township 18 North, Range 5 East, M.D.B. & M., and a portion of Lots 44 and 45, as shown on that certain Map entitled, "TOWN OF BANGOR", which Map was recorded in the Office of the Recorder of the County of Butte, State of California, on March 21, 1901, in Book 7 of Maps, at Page(s) 77, and being more particularly described as follows: BEGINNING at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mount of rocks set at the Southwest corner of said Section 22 bears North 890 56' 20" West, 2667.94 feet distant; thence North 20 24' West, 53.25 feet to a point in the centerline of the Bangor -La Porte Road; thence along said road centerline, North 55° 01' East, 135.15 feet to a tangent curve concave to the. Northwest, having a radius of 1000 feet and a central angle of 16 ° 10% thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 380 51' East, 45.23 feet to a tangent curve concave to the Northwest, having a radius of 300 feet and a central angle of 360 40% thence along said curve, a distance of 191.99 feet; thence along the tangent to said curve, North 20 11' East, 293.64 feet to a tangent curve concave to the West, having a radius of 400 feet and a central angle of 13° 09% thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 100 58' West, 169.57 feet to a tangent curve concave to the Southwest, having a radius of 300 feet and a central angle of 140 45'; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, North 251 43' West, 87.23 feet to a tangent curve concave to the Northeast, having a radius of 350.0 feet and a central angle of 100 17' 43"; thence along said curve, a distance of 62.89 feet to a point in the North line of said Southwest quarter of the Southeast quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49' East, 707.54 feet; thence South 490 40' East, 236.24 feet; thence South 260 58' East, 780.53 feet; thence South 400 41' East, 298.87 feet; thence South 160 16' East, 79.69 feet; thence South 60 28' West, 291.27 feet; thence South 25 ° 06' West, 223.26 feet; thence South 440 27' East, 597.33 feet; thence South 40 40' East, 372.30 feet; thence South 140 43' East, 227.24 feet to a point in the South line of said Lot 45; thence along said South line of Lot 45, North 890 15' West, 240.09 feet to a point in the East bank of the Bangor Lateral Irrigation Ditch, said point being 4.0 feet East of the centerline of said Ditch; thence along said Ditch, North 390 54' West, 94.30 feet; thence North 540 05' West, 152.28 feet;'thence North 670 30' West, 257.42 feet; thence North 85° 35' West, 167.23 feet; thence South 771 32' West, 306.82 feet; thence South 671 00' West, 149.58 feet to a point in an existing fence line; thence along said fence line, North 200 46' West, 768.99 feet; thence North 26° 58' West, 237.34 feet to an iron pipe; thence leaving said fence line, North 56° 32' West, 106.88 feet; thence North 87° 41' West, 390.08 feet to a point in an existing fence line; thence along said fence, North 20 24' West, 209.75 feet to the point of beginning. EXCEPTING THEREFROM all that portion described as Parcel "B" in Deed to County of Butte, recorded July 29, 1977, in Book 2196, Page 145, Official Records of Butte County, California. 2 rr EXHIBIT "ONE" PARCEL I: Order No. 104966 A portion of the Southwest quarter of the Southeast quarter and the Southeast quarter of the Southeast quarter of Section 22, Township 18 North, Range 5 East, M.D.B. & M., and a portion of Lots 44 and 45, as shown on that certain Map entitled, "TOWN OF BANGOR", which Map was recorded in the Office of the Recorder of the County of Butte, State of California, on March 21, 1901, in Book 7 of Maps, at Page(s) 77, and being more particularly described as follows: BEGINNING at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mount of rocks set at the Southwest corner of said Section 22 bears North 890 56' 20" West, 2667.94 feet distant; thence North 20 24' West, 53.25 feet to a point in the centerline of the Bangor -La Porte Road; thence along said road centerline, North 55° 01' East, 135.15 feet to a tangent curve concave to the. Northwest, having a radius of 1000 feet and a central angle of 16 ° 10% thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 380 51' East, 45.23 feet to a tangent curve concave to the Northwest, having a radius of 300 feet and a central angle of 360 40% thence along said curve, a distance of 191.99 feet; thence along the tangent to said curve, North 20 11' East, 293.64 feet to a tangent curve concave to the West, having a radius of 400 feet and a central angle of 13° 09% thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 100 58' West, 169.57 feet to a tangent curve concave to the Southwest, having a radius of 300 feet and a central angle of 140 45'; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, North 251 43' West, 87.23 feet to a tangent curve concave to the Northeast, having a radius of 350.0 feet and a central angle of 100 17' 43"; thence along said curve, a distance of 62.89 feet to a point in the North line of said Southwest quarter of the Southeast quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49' East, 707.54 feet; thence South 490 40' East, 236.24 feet; thence South 260 58' East, 780.53 feet; thence South 400 41' East, 298.87 feet; thence South 160 16' East, 79.69 feet; thence South 60 28' West, 291.27 feet; thence South 25 ° 06' West, 223.26 feet; thence South 440 27' East, 597.33 feet; thence South 40 40' East, 372.30 feet; thence South 140 43' East, 227.24 feet to a point in the South line of said Lot 45; thence along said South line of Lot 45, North 890 15' West, 240.09 feet to a point in the East bank of the Bangor Lateral Irrigation Ditch, said point being 4.0 feet East of the centerline of said Ditch; thence along said Ditch, North 390 54' West, 94.30 feet; thence North 540 05' West, 152.28 feet;'thence North 670 30' West, 257.42 feet; thence North 85° 35' West, 167.23 feet; thence South 771 32' West, 306.82 feet; thence South 671 00' West, 149.58 feet to a point in an existing fence line; thence along said fence line, North 200 46' West, 768.99 feet; thence North 26° 58' West, 237.34 feet to an iron pipe; thence leaving said fence line, North 56° 32' West, 106.88 feet; thence North 87° 41' West, 390.08 feet to a point in an existing fence line; thence along said fence, North 20 24' West, 209.75 feet to the point of beginning. EXCEPTING THEREFROM all that portion described as Parcel "B" in Deed to County of Butte, recorded July 29, 1977, in Book 2196, Page 145, Official Records of Butte County, California. 2 Order No. 104966 PARCEL If: Lots 42 and 43, as shown on that certain Map entitled, "TOWN OF BANGOR", which Map was recorded in the Office of the Recorder of the County of Butte, State of California, on March 21, 1901, in Book 7 of Maps, at Pages? 77, and being more particularly described as follows: BEGINNING at the Northwest corner of said Lot 42, from which point the Northwest corner of Section 27, Township 18 North, Range 5 East, M.D.B. & M., bear South 89° 33' 39" West, 1410.49 feet distant; thence South 890 20' East, 1257.49 feet along the North line of said Lot 42 to -the Northeast corner of said Lot 42, said Northeast corner being also a point in the West line of that certain parcel of land conveyed to 0. W. Hawn by Deed recorded June 10, 1952, in Book 633, Page 548, Official Records of Butte County; thence along the West line of said Hawn Parcel, South 2° 24' East, 209.75 feet; thence South 870 41' East 390.08 feet; thence South 56° 32' East, 106.88 feet; thence South 260 58' East, 237.34 feet; thence South 201 46' East, 768.99 feet to the Southwest corner of said Hawn Parcel; thence South 200 46' East, 145.10 feet to the Southeast corner of Lot 43; thence North 89 ° 24' West, 2144.14 feet along the South line of said Lots 43 and 42 to the Southwest corner of said Lot 42; thence North 10 24' West, 1343.14 feet along the West line of said Lot 42 to the point of beginning. EXCEPTING THEREFROM all that portion described as Parcel "A" in Deed to County of Butte, recorded July 29, 1977, in Book 2196, Page 145, Official Records of Butte County, California. PARCEL ill:, BEGINNING at a point in the Southerly line of the North half of the Northeast quarter of Section 27, Township) 8 North, Range 5 East, M.D,B. & M., distant thereon North 87° . 56' East, 823 feet from the Southwest corner of Northwest quarter of Northeast quarter of Section 27; running thence along said Southerly line, North 870 56' East, 974.3 feet to a point on the East bank of the Bangor Lateral Irrigation Ditch, said point being 4.0 feet East of the center of said Ditch and 2.0 feet West of a live oak tree 18 inches in diameter; thence along said Ditch, the following courses and distances: North 41 ° 26' West, 93 feet 11 inches; North 600 22' West, 149.3 feet;.North 680 46' West, 260.5 feet; North 820 1.9' West, 164 feet 2 inches, North 850 20' West, 307 feet 4 inches; South 65° 18' West, 149.0 feet to a point on the North bank of said Ditch, 3.0 feet from center line thereof; thence leaving said Ditch along a barbed wire fence, South 22° 44' East, 145.0 feet to the point of beginning. Assessor's Parcel No: 028-240-028& 028-210-036 3 I IN PRE -INSPECTION REPORT OWNER: t" ` ��w�-1 DATE: 6-4-v+- LOCATION: .4•v4- LOCATION: SIB 61 �o2-r� 12a, �A-�1&c2 A.P. # 0�8• a �o • 03 CONTRACTOR: ZONING: REASON FOR PRE-INSPECTIONc-- DATE TO INSPECTOR: 0-5-64- PERMIT HISTORY (&, '1 ONE (-3-SEE ATTACHED BUILDING INSPECTOR'S REPORT Building Description: Commercial/Usage: Residential # of Units: Currently Occupied ( ) Yes AbandonedNacant: Electric: Electric Currently ( ) On ( ) Off Condition of Electric Gas: ( ) No Currently ( ) On Condition Sanitation: Plumbing Worldng () Yes Obvious Sewage Problems ( ) Yes A ACTION RECOMMENDED: Hold for permits or verify: ISSUE ( ) Off ( ) No ( ) No Yes I Mobile home # of Units: ( ) No Inspector: Date: cuvrrrU uTrrT.nnvr_c niv uRVT+'.RCF. ANTI. TNT)TCATF. 1r,0CATTnN ON PRnPFRTV_ iO APPLICATION FOR CERTIFICATI OF MERGER APN# n zS1- Z yo - oZ,�r 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 REQ UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Last Name�'/ `j 6'J ?p irst Name S 5 Address City State Ig 1 Zip /�l�1 Phone 67,� lz0 Fax E-mail APPLICANT NAME CONTRACTOR Name city }Nc�o.� Address W City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name city }Nc�o.� Address W City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name o_5 Address city }Nc�o.� StateC,4 W Phone � Fax E-mail IN ww- 1 //// For office use on y: Zoning Property Address / Flood Zone Cross Street SRA Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BP 47423 r O BIN # LOCATION AP# p28 • ?- (� • O 3 to Property Address / 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 pennit issuance. LENDING AGENCY Name Address UVt:K 1 -UK SUUMITTAL RaQUIREMENTS L KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Description or Scope of Work: . t2EPL•4r_—E SG Psi-?JeT_, Sq. 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 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: ' >�l Receipt #: 41 Date: g..4.0+ Amount IIO.' Bldg SRA Sheriff SMIP Other 11 P Total REV 6-16-04 OA, Department of Public Works o C o u n t y o f B u t t e O J. Michael Crump, Director LAND DEVELOPMENT DIVISION 0 7 County Center Drive Warner C. Phillips, Assistant Director Oroville, CA 95965 A yr 5 (530) 538-7266 %6C Wo09 (FAX) 538-7171 June 16, 2004 BUTTE COUNTY JUN 16 2PO4 DEVELOPMENT SERVICES Roger Shortz P.O. Box 619 Pinole, CA 94564 Re: Application for Certificate of Merger AP 028-210-036 / 028-240-028 Dear Mr. Shortz: Enclosed please find the Certificate of Merger that was issued by the Butte County Department of Public Works and recorded on May 20, 2004, under Serial Number 2004-0030015, in the office of the Butte County Recorder. If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, Stuart Edell Manager, Land Development Division SE/kp Enclosur e cc: Division Environmental Health Dept. Michael Evans Ted George RECORDING REQUESTED BY and AFTER RECORDING RETURN TO: Butte County Public Works LAND DEVELOPMENT DIVISION 7 County Center Drive Oroville, CA 95965 IIII III III I IIII I II 1111111 I II II ILII Recorded I REC FEE 31.00 Official Records I PENALTY 27.00 County Of I BUTTE I CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Barbara 12:21PN 20 -May -2004 I Page 1 of 9 'CERTIFICATE OF MERGER LANDS BEING MERGED: AP NUMBERS 028-210-036,028-240-028 NUMBER OF EXISTING PARCELS: three 3 EXISTING PARCELS CREATED BY: ❑ PATENT ®-GRANT DEED ❑ GIFT DEED ❑ PARCEL MAP ❑ SUBDIVSION MAP ❑ OTHER RECORDING DATA:. YEAR H06 BOOK/ PAGE OR SERIAL NUMBER: 1500 o.P.. Zg.� SUBDIVISION / PARCEL MAP: BLOCK LOT(S) As of the date of recordation, those lands noted above are merged to create three 3 parcel(s) of land as described in Exhibit(s) A, i3 C attached hereto. c MIKE C UMP Director of Public Works DATE OWNERS' CONSENT TO MERGER THE UNDERSIGNED as owners of all that real properly to be merged, do hereby consent and agree to the merger of such lands into that / those parcel(s) as described in Exhibit(s) A, B. C attached hereto. Sheral L. Shortz, Owne cJi J -- Edward G. ryan, Co-. stee of the 1981 Bryan Trust Dated March 18, 1981 IGNED IN COUNTERPART '0"10 Date October 31, 2003 Date Date Virgini A. Bryan, Co -Trust of the 1981 Bryan Trust Dated March 18, 1981 Date NOTARY ACKNOWLEDGEMENT STATE OF CALIFORNIA ss COUNTY OF CONTRA COSTA On 4cr 3/ , 2003 before me personally a peared ' p (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument and acknowledged to me that he/sX executed the same in hislVf authorized capacity, and that by his/W signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. WITNESS my hand and official seal. ARMA ATKINS Commission # 1402519 r� Notary Public - California Contra Costa County MY Comm. Expires Mar 6, 2007 NOTARY PUBLIC, STATE OF CALIFORNIA STATE OF OREGON, .SS. County of -------------------- FORM NO.23 - ACKNOWLEDGMENT STEVENS-NESS LAW PUB. CO.. PORTLAND. ORE. BE IT REMEMBERED, That on this .........................day of....._..�C-......_.. -- before me, the undersigned, a Notary Public in and for said County and State, personally appeared the within named ....i�_Lix.al----...C�.)1_A0--------4---- �t- I1.10t.<�1---_A-..--� -YAIii............................. -------------------------- --------------------------------------------------=----------------------------------------------------------------------------------------------------------------------------- --------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------ known to me to be the identical individual_described in and who executed the within instrument and acknowledged to me that ... i"tl-��:Q............ executed the same freely and voluntarily. IN TESTIMONY WHEREOF, I have hereu my hand and affixed OFFICIAL SEAL my offic' 1 seal the Aad year 1 st above written. CLARE L. STEVENS NOTARY PUBLIC -OREGON _air ......_..�:----------------------------------------------------- COMMISSION NO. 346759 Notary Public for Oregon. MY COMMISSION E„pIRES JUNE 29, 2005 My Commission expires ...... ���9��y.��-. .......................... CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California ss. County of Contra Costa On October 31, 209$efore me, Melanie O. Browning Date Name and Title of Officer (e.g., "Jane Doe, Notary Public") personally appeared SHERAL L. SHORTZ , Name(s) of Signer(s) Ulu" Q t =11ftdii ! 1441377 Nafty has - caromb �blp caCato couNy MV COM. bV11111111S 64 Xl personally known to me ❑ proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. D Place Notary Seal Above ^� Signature of Notary Public (\ OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Certificate of I4ercger Document Date: Signer(s) Other Than Named Above: Number of Pages: s Capacity(ies) Claimed by Signer Signer's Name: Sheral L. Shortz X7 Individual . Top of thumb here ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 1997 National Notary Association - 9350 De Soto Ave., P.O. Box 2402 - Chatsworth, CA 91313-2402 Prod. No. 5907 Reorder. Call Toll -Free 1-800.876-6827 EXHIBIT A Shortz Parcel A - Northerly Parcel All that certain real property situated in the South half of the Southeast one quarter of Section 22, Township 18 North, Range 5 East, M.D.M., in the unincorporated area of Butte County, California and being more particularly described as follows: Commencing at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mound of rocks set at the Southwest corner of said Section 22 bears North 89056120" West 2667.94 feet distant; thence leaving said South line of Section 22, North 02024' West 53.25 feet to a point in the centerline of the Bangor - La Porte Road; thence along said road centerline, North 550 O1' East 135.15 feet to a curve concave to the northwest having a radius of 1000 feet and a central angle of 160101; thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 38°51' East 45.23 feet to a curve concave to the northwest having a radius of 300 feet and a central angle of 18°20'; thence along said curve, a distance of 96.00 feet to THE TRUE POINT OF BEGINNING for the herein described parcel; thence continuing along said 300 foot radius curve, through a central angle of 18°20'; for an arc distance of 96.00 feet; thence along the tangent to said curve, North 020 11' East 293.64 feet to a curve concave to the west, having a radius of 400 feet and a central angle of 130 09'; thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 10°58' West 169.57 feet to a curve concave to the southwest, having a radius of 300 feet and a central angle of 14°45'; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, *North 25°43' West 87.23 feet to a curve concave to the northeast,.having a radius of 350 feet and a central angle of 10°17'43"; thence along said curve, a distance of 62.89 feet to a point in the North line of the Southwest one quarter of the Southeast one quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49' East, 707.54 feet; thence South 49°40' East 236.24 feet; thence South 26°58' East 780.53 feet; thence South 40°41' East 298.87 feet; thence South Pg. 1 of 2 F r f Pg. 2 of 2 160.16' East 79.69 feet; thence South 060 28' West, 143.38 feet to a point on the South line'of said Section 22; thence westerly along said Section line, North 89056120" West 900 feet, more or less to a point that bears South 450 East from the Point of Beginning; thence North 450 West 630 feet, more or less to the POINT OF BEGINNING. The Basis of Bearings for this description is the South. line of the Southwest one quarter of said Section 22, taken as North 89056120" West, as per the Deed to Roger W. Shortz, et ux, recorded in the Office of the Butte County Recorder under Serial Number 2000-24972.. All new structures must meet the Fire Safe Regulations of Butte County and Public Resources Code 4290. 001 Q�cj E�aiQ� r 12 m 183 s� Cave F OF CAt�F_.. EXHIBIT B Shortz Parcel B - Southerly Parcel All that certain real property situated in the unincorporated area of Butte County, California, and being the South one half of the Southeast one quarter of Section 22, Township 18 North, Range 5 East, M.D.M., and Lots 42, 43, 44 and 45, as shown on that certain map entitled' "Town of Bangor". Which map was recorded in the Office of the County Recorder of Butte County, California, on March 21, 1901, in Book 7 of Maps, at Page 77 lying in Section 27, Township 18 North, Range 5 East, M.D.M. EXCEPTING THEREFROM all that portion of said south one half of the Southeast one quarter of Section 22 and said Lot 42 lying WESTERLY of the centerline of the Bangor -La Porte Road. ALSO EXCEPTING THEREFROM all that portion of said south one half of the Southeast one quarter of Section 22 and said Lot 45 lying EASTERLY of the following described line: COMMENCING at an iron pipe set at a fence corner in the South line of Section 22, said Township and Range from which point an iron pin in a.mound of rocks set at the Southwest corner of said Section 22 bears North 89°56'20" West 2667.94 feet distant; thence leaving said South line of Section 22, North 02°24' West 53.25 feet to a point in the centerline of the Bangor -La Porte Road; thence along said road centerline, North 55001' West 135.15 feet to a curve concave to the northwest having a radius of 1000 feet and a central angle of 160101; thence along said curve, a distance of 282.16 feet; thence along the tangent to said curve, North 38°51' East 45.23 feet to a curve concave to the northwest having a radius of 300 feet and a central angle of 36°40'; thence along said curve, a distance of 191.99 feet; thence along the tangent to said curve, North 020 11' East 293.64 feet to a curve concave to the west, having a,radius-of 400 feet and a central angle of 130091; thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 10°58' East 169.57 feet to a curve concave to the southwest, having a radius of 300 feet and a central angle of 14°45'; thence along said curve, a distance of 77.23 feet; thence along the tangent to said curve, North 25°43' West 87.23 feet to a curve concave to the northeast, having a radius of 350 feet Pg. 1 of 3 Pg. 2 of 3 and a central angle of 100 17'43"; thence along said curve, a distance of 62.89 feet to a point in the North line of said South half of the Southeast one quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49; East, 707.54 feet the TRUE POINT OF BEGINNING; thence South 49°40' East 236.24 feet; thence South 260 58.' East 780.53 feet; thence South 400 41' East 298.87 feet; thence South 16°16' East 79.69 feet; thence South 060 28' West, 143.38 feet, more or less, to a point on the North line of said Lot 45; thence leaving said North line South 060 28' West, 147.89 feet; thence South 250 06' West, 223.26 feet; thence South 44°27' East 597.33 feet; thence South 04°40' East 372.30 feet; thence South 14043' East 227.24 feet to a point on the South line of said Lot 45 and the end of the herein described line. ALSO EXCEPTING THEREFROM all that portion of the South one half of the Southeast one quarter of said Section 22 more particularly described as follows: Commencing at an iron pipe set at a fence corner in the South line of said Section 22, from which point an iron pin in a mound of rocks set at the Southwest corner of said Section 22 bears North 89056120" West 2667.94 feet distant; thence leaving said South line of Section 22, North 02024' West 53.25 feet to a point in the centerline of the Bangor - La Porte Road; thence along said road centerline, North 550 01' East 135.15 feet to a curve concave to the northwest having a radius of 1000 feet and a central angle of 160101; thence along said curve, a distance of 282.16 feet; thence along the tangent'to'said curve,.North 38°51' East 45.23 feet to a curve concave to the northwest having a radius of 300 feet and a central angle of 180201; thence along said curve, a distance of 96.00 feet to THE TRUE POINT OF BEGINNING for the herein described parcel; thence continuing along said 300 foot radius curve; through a central angle of 180201for an arc distance of 96.00 feet; thence along the tangent to said curve, North 020 11' East 293.64 feet to a curve concave to the west, having a radius of 400 feet and a central angle of 13009'; thence along said curve, a distance of 91.80 feet; thence along the tangent to said curve, North 100581 West 169.57 feet to a curve concave to the southwest, having a radius of 300 feet and a central angle of 140451; thence along said curve, a distance of 77.23 feet; thence along the tangent to said Pg. 2 of 3 Pg. 3 of 3 curve, North 25°43' West 87.23 feet to a curve concave to the northeast, having a radius of 350 feet and a central angle of 100 17143"; thence along said curve, a distance of 62.89 feet to a point in the North line of the Southwest one quarter of the Southeast one quarter of Section 22; thence along an existing fence line, the following courses and distances: South 890 49' East, 707.54 feet; thence South' 49°40' East 236.24 feet; thence South 26°58' East 780.53 feet; thence South 40°41' East 298.87 feet; thence South 160 16' East 79.69 feet; thence South 060 28' West, 143.38 feet to a point on the South line of said Section 22; thence westerly along said Section line, North 89056120" West 900 feet, more.or less to a point that beats South 450 East from the Point of Beginning; thence North 450 West 630 feet, more or less to the POINT OF BEGINNING. The Basis of Bearings for this description is the South line of the said Section 22, taken as South 89°56' 20" East. All new structures must meet the Fire Safe Regulations of Butte County and Public Resources Code 4290. ®�Vik � F bd�RE J, CFD m M No: 12,483 �,, 61,;,x_ ,.. e EXHIBIT C Shortz Parcel C' -.Westerly Parcel All that certain real property situated in Section 27, Township 18 North, Range 5 East, M.D.M.,,in the unincorporated area of Butte County, California, and being that portion of Lot 42, as shown on that certain map entitled' "Town of Bangor", which map was recorded in the Office of the County Recorder, of Butte County, California, on March 21, 1901, in Book 7 of Maps, at Page 77, lying WESTERLY of the centerline of the Bangor -La Porte Road. All new structures. must meet. the .Fire Safe Regulations of Butte County and PublicResources Code 4290. Q�,pF ESS/6 o�pRE J.rM SFO `Fti CO w m. foo3 sr ccf�.�, �e not �FO� Zoo S END OF DOCUMENT p�PP�T M�►t 0 0 TTF0 Department 0 0C o u n t y 0 0 0 0 J. Michael Crump, Director 0 0 AL'QU N , Warner C. Phillips, Assistant Director �LtC W�� May 6, 2004 Roger Shortz P.O. Box 619 Pinole, CA 94564 Re: Application for Certificate of Merger AP 028-210-036 / 028-240-028 Dear Mr. Shortz: of Public o f B u t Works t e LAND DEVELOPMENT DIVISION 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 BUTTE COUNTY MAY 01 2004 DEVELOPMENT SERVICES On, May 6, 2004, the Department of Public Works made the finding that the Certificate of Merger on the above referenced property is exempt from environmental review, and approved the project subject to the following note(s) to be added, by the engineer, to the Certificate of Merger: The following note shall be placed on the legal description for Parcel A: Provide 100 feet leach field free setbacks from existing wells and ponds. The Certificate of Merger cannot be recorded until this note has been added. After the recording and processing of your Certificate of Merger by the Butte County Recorder's office, we will return your certificate to you. If the note(s) has not been added to the certificate within one (1) year from the date of approval by the Department of Public Works, the approval will be considered null and void. This action will be final if an appeal is not filed with the Clerk of the Board of Supervisors within ten (10) days of the date of this letter. You or any interested person must do so in writing, with the appeal fee of $50.00, to the Clerk of the Board of Supervisors, 25 County Center Drive, Oroville, California 95965, prior to 4:00 p.m., May 17, 2004. If there are no appeals, we will submit the Certificate of Merger to the Butte County Recorder's office, for recording. If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, Stuart Edell Manager, Land Development Division SE/kp cc: �nvironmental Health Department ,/wilding Division Michael Evans Ted George OWNER: n } DATE LOCATION :Z, - n2LLe. &A . P . # CONTRACTOR: ZONING PRE -INSPECTION FOR: DATE TO INSPECTOR ---------------------------------------------=----=----------------------------------- -------------------------------------------------------------------------------------- PERMIT HISTORY: NONE AS FOLLOWS: 0 TYPE OF OCCUPANCY ------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------- FIELD - INFORMATION t BUILDING USAGE: TENNANT: OCCUPIED CJ HAS ELECTRIC Q HAS GAS HAS SANITATION FACILITIES [� HEATED -COOLED PERSON CONTACTED OTHER COMMENTS: ACTION RECOMMENDED: ISSUE /nAHOLD FOR In 11 , % A / _ i C 4-[,e_Ao 'f i C r BY DATE y RAIN • �� TOTAL PAGE 1 OF CDF / BCFD DAILY INCIDENT LOG DAY/DATE FROM 0800:Ln, DAY/DATE TO 0800 INC # o FIRE # NAME ��� � l- TYPE'S �--1 r,r REPORT TIME VH5 START TIME CONTROL TIME,::- R.O. LOCATION:/�- yY CAUSE: G / _ _ '� r'-� �� / �°'� z ' �- 3 6 ENGINES: CDF I BAT. BCFD CO# 6OFFICER:62,fil DAMAGE: SQ r 5 WT DOZ CREW AA AT HC ! SAVED: �� ����� ' OTHER EQUIP: 4! ►mA /ugo MEDICS - '' LAND USE: X0/1 Lam''%IL- ACRE/TYPE TOTAL ` 1 n OWNER/TENANT T� - l_%.1- r?L�� WRA DAMAGE: SQ WT DOZ CREW AA AT HC SAVED: OTHER EQUIP: MEDICS Cdld I Awn I ICF• AIRF/TYPF TnTAI 0 UVVNtK/ I t NAN I VVK/i I — a7 ✓ R.P. yS' L �-�/ �'0 l B.I. MISC. INC # 04233 FIRE # NAME TYPE , .l.i'1 t11�e,4 DAMAGE: SQ, WTv DOZ V CREW AA AT HC l V MIDI-.: ✓ DAMAGE: SQ WT DOZ CREW AA AT HC _ SAVED: OTHER EQUIP: MEDICS -L- T DAMAGE: SQ , WT DOZ CREW AA Al HC_ SAVED: OTHER EQUIP: MEDICS COUNTY•OF BUTTE BUILDING DIVISION -' DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA (9Y16) 891-2751 7 County Center Drive, Oroville, CA - (916:) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 ti CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately.; 839 RICHLAND ROAD YUBA CITY (916) 673-4789 YUBA CITY, CA 95991 SACRAMENTO (916) 646-4446 C) ro vt Vy W vy�t �./ ry-) e&A� - OL lcrn,#z�.,� rn� , Y"A Ac� WA 4-tAl- qszi, q AIC DUCTS F.ABR.IC VINYL WALLS 0 DRAPES & MINI BONDS UPHOLSTERY N tA'7-: i 839 RICHLAND ROAD YUBA CITY (916) 673-4789 YUBA CITY, CA 95991 t " - � SACRAMENTO (916) 646.4446 x — 14bil) — 14 ' e'; r,L � C),4 CVCt_j (tom t� t• �,( , i_� -17A1 fie" .1" u1A.-04- OL U-Aht-e-� �� , a�) -J d,() k"PlIL) � uF 1�c 10 A A/C DUCTS () FABRIC 8, VINYL WALLS Q DRAPES & MINI BLINDS 0 UPROLSTERY- CDF / BCFD DAILY INCIDENT LOG DAY/DATE FROM 0800,\<f&'i DAY/DATE TO 0800 wr * Am x Clot -m NeMF /lr • TYP fay�6K � )L I IMt L--' Z f -2.1 - RAIN - 02/ TOTAL PAGE 1 OF DAMAGE: SO WT DOZ CREW AA AT HC SAVED: OTHER EQUIP: MEDICS 6014- V MISC. 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N6 -2= FOR OFFICE USE ONLY PROVIDE FOR ALL ADJACENT PARCELS Zoning: SIZE (AC): General Plan Desig: ZONING: Size, Acres GEN PLAN: a.oar USES: 1 LOOMIS 6KW PV ARRAY PLAN VIEW @ 1 / 4" = 1' SCALE UNICLIPS KC20OGT PV MODULES 12" WIDE BY 36" DEEP B22A POSTS RUN TO BOTTOM B22 STRUCTURAL CHANNEL 40 t1 2-0 Z/O� ®� / VWIV IWQII I VV.. I "IQ wT%mvv"lV NNV PUN I , wmIr YGJVRIf I IVIv, ^iNLJ OTHER INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE EXCLUSIVE PROPERTY OF SPG SOLAR, INC. AND SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN WHOLE OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SPG SOLAR, INC. ALL RIGHTS RESERVED. Z O U � O O O W Q w 3 wrn O =w rn F -O V °Q cc EL III 0 a. > c9 U) ... 0 �aCDQ toZ C � a Lo Co 71, Z SOM= =o3�?o v�i�!_XM Z 00M009 O T0 M ��oum> n y�2om� vvv � cv�m�� G)No0;uomo°_ am MM .� �o m tmn�0AOZD p in Ammo vD 0 p -i3 m TO p �mm( oCo�n �Nm�00 N ;u G) izz��Z 0�o �Zr— m m ,czi v f� y cn c lr GT) EnEn cn a o C7 CA TD N W rTj CD 06 o�� CA) zoa cn CD 0 �� d N C=i •'1l f o o a 000) w v Z Z tib �� 863 EAST FRANCISCO BLVD, SUITE A �0 f� y IT, 'b lr GT) p O. N o a CA TD N W > G CD 06 o�� CA) zoa cn CD 0 �� d N C=i •'1l f o o CA) 000) w v Z Z v� 863 EAST FRANCISCO BLVD, SUITE A �0 (n(nN SAN RAFAEL, CA 94901 4154594201 ^^ l� J ^^_ UJ M 0 ooh CA LIC. #759086 f� y IT, 'b lr GT) p O. N o a CA TD N W > G CD 06 o�� CA) zoa cn CD 0 �� d N C=i •'1l f o o CA) 000) PROPERTY OWNER/LOCATION: MARVIN and SHIRLEY LOOMIS 5926 LA PORTE ROAD BANGOR,CA 95914 (530) 534-8134 GT) CA TD N W > G z O :3OO�a CA) -0 1> 00 CA) 000) v Z Z v� O �0 (n(nN ^^ l� J ^^_ UJ M 0 ooh UI 00 OOG r- <N O 0 22 m> mmmX m� mm m� PROPERTY OWNER/LOCATION: MARVIN and SHIRLEY LOOMIS 5926 LA PORTE ROAD BANGOR,CA 95914 (530) 534-8134 gLl M fl A CA TD N W > G z O :3OO�a CA) -0 1> 00 CA) ��_< _L v� O gLl M fl A UNICLIPS (36) KC20OGT PV MODULES PORTRAIT ORIENTATION B1045H 90 DEC CORNER BRACI 22 DEGREE OPEN AP BLINE BRACKET! B22 STRUCTURAL CHANNEL URAL CHANNEL CONCRETE FOOTINGS: 12" WIDE X 30" DEEP B22A POSTS RUN TO BOTTOM UNICLIPS CONCRETE FOOTINGS: 12" WIDE X 30" DEEP -B22A POSTS RUN TO BOTTOM 01 CHANNEL PROPERTY OF SPO SOLAR, INC. CONFIDENTIAL THIS DRAWING AND ANY DATA, DESCRIPTION, AND OTHER INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE EXCLUSIVE PROPERTY OF SPG SOLAR, INC. AND SHALL NOT BE, PUBLISHED, REPRODUCED; COPIED, DISCLOSED, OR USED, IN WHOLE OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SPG SOLAR, INC. ALL RIGHTS RESERVED. ISSUE Z O U � OO O W wQ m O w Lon,Ict �ccOU o azgo 0 co Q NZ Ch a�U)mu? ARRAY VIEWS JOB: LOOMIS ATOM MCCAMBROGE 415/147-7039 7/8!8 SCALE 1/4'■1' GROUND MOUNTED PV ARRAY �2 DEGREE TILT, 220 DEG AZIMUTH PV INVERTERS LOCATED ON BACK OF RACK (SEE STRUCTURAL DETAIL SHEETS) TURN -AROUND OAK TREES GATE POND 'I -AN VING DIVISION - BUILDING PLAN APPROVAL Jse: ' Date: q S o parking: Landscaping: 3ther. Signature: AAbA GATE I 50 - ?VM EXISTING RESIDENCE GARAGE APPROVED u to County I Enviro ental Health _© - Date ` Si nat / �9 POND n WELL SEPTIC / LEACH FIELD PV ARRAY 1� E POLE i POND 40FT AC RUN 3 / 4" PVC @ 18" MIN. DEPTH (2) #10 THWN-2 (1) #8 THWN-2 GROUND PGE POLE F1 PROPERTY OF SPO SOLAR, INC. CONFIDENTIAL. THIS DRAWING AND ANY DATA, DESCRIPTION, AND OTHER INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE EXCLUSIVE PROPERTY OF SPG SOLAR, INC. AND SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN WHOLE OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SPG SOLAR, INC. ALL RIGHTS RESERVED. z O U � 0 00 LU W < u, �ccaVC9 M az go CeQ 04 Z M a 2 to m v PROPERTY LAYOUT LOOMIS DRAWN EY:.. .. .. ATOM MCCAMBRDGE 4151747-7099 7/8B SCALE-* v12e•-r n- 00 oo= p LaipwmT' �v �m z�m-Zs o�m0 �pMzO co coMz a opo�oz com T Q) "a 0 mm �p0� mmo(1) z mm$.ppODO N_ m. �mz;uv � f �mvnmai So o Omuciai�� tnmmpp: G) � ? z OH a 0 pzmm<= z �zA v NIS n , L G) SPG. O crl W Z Q Q SOtAR 14 0 863 EAST FRANCISCO BLVD, SUITE A c 0 0 Mm< 4l 0 G) --I m�o- SAN RAFAEL, CA 94901 N C 415-459-4201 � G) > CA LIC. #759086 NIS n , L G) O crl W Z C) 0 m c 0 0 Mm< 0 G) --I m�o- N C �v-o � G) > C M m B104SH 90 DEGRE CORNER BRACKE' CONCRETE FOOTINGS: 12" WIDE BY 30" DEEP B22A POSTS RUN TO BOTTOM UNICLIPS KC20OGT PV MODULES B22 STRUCTURAL CHANNEL LOOMIS 6KW PV ARRAY PLAN VIEW @ 1 / 411 = 1' SCALE CONFIDENTIAL THIS DRAWING AND ANY DATA, DESCRIPTION, AND OTHER INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE EXCLUSIVE PROPERTY OF SPG SOLAR, INC. AND SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN WHOLE OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SPG SOLAR, INC. ALL RIGHTS RESERVED. ISSUE Z O U � OJ O O Q W w �_ rn = w cyi 1- c O U o cc LLj (L Z g 0 cr QN Z M CL U) on v a 0 O V N rJ►S�at 00 y� _ Q W of 0o DRAWING TYPE: PV LAYOUT JOB: LOOMIS DRAWN BY: .. . ATOM MCCAMBRIDGE 41&747-7039 DATE: psis scue t�a•ar 0 22 DEGREE OPEN ANGLE BLINE BRACKETS KC20OGT PV MODULES PORTRAIT ORIENTATION UNICLIPS B104SH 90 DEGREE - CORNER BRACKETS 5'6" B22 STRUCTURAL CHANNEL I B22 J STRUCTURAL CHANNEL B22A STRUCTURAL CHANNEL Z a O U � O JO O W w¢ m ����llq Of� O U �- °Q c>s a azgo > aCLO 0 0 a .. a Wim., CONCRETE FOOTINGS 12" WIDE X 30" DEEP w B22A POSTS RUN TO BOTTOM 00 DRAWING TYPE:. SIDE VIEW JOB: . LOOMIS 40 DRAWN 9Y: eS1 f ATOM MCGAMBFWGE 415/747.7039 PROPERTY OF SPG SOLAR, INC. oATE: CONFIDENTIAL. THIS DRAWING AND ANY DATA, DESCRIPTION, AND OTHER 7/8!8 INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE EXCLUSIVE PROPERTY OF SPG SOLAR, INC. AND SHALL NOT BE ScAlE PUBLISHED, REPRODUCED, COPIED. DISCLOSED, OR USED, IN WHOLE V.1, OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN SHEET: PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SPG SOLAR, INC. ALL RIGHTS RESERVED. a 0 0.�1aoa, a� CONCRETE FOOTINGS 12" WIDE X 30" DEEP w B22A POSTS RUN TO BOTTOM 00 DRAWING TYPE:. SIDE VIEW JOB: . LOOMIS 40 DRAWN 9Y: eS1 f ATOM MCGAMBFWGE 415/747.7039 PROPERTY OF SPG SOLAR, INC. oATE: CONFIDENTIAL. THIS DRAWING AND ANY DATA, DESCRIPTION, AND OTHER 7/8!8 INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE EXCLUSIVE PROPERTY OF SPG SOLAR, INC. AND SHALL NOT BE ScAlE PUBLISHED, REPRODUCED, COPIED. DISCLOSED, OR USED, IN WHOLE V.1, OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN SHEET: PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SPG SOLAR, INC. ALL RIGHTS RESERVED. (12) KC200 PV MODULES (IN SERIES) (2) #10 RHW-2 CONDUCTORS (1) #12 BARE COPPER GROUND 1 (12) KC200 PV MODULES (IN SERIES) (12) KC200 PV MODULES (IN SERIES) LOOMIS 6KW PV ARRAY #10 RHW-2 CONDUCTORS #10 RHW-2 CONDUCTORS (36) KYOCERA 20OW MODULES (1) FRONIUS IG -4000 INVERTER (24) (177.2W CEC) (94%) = 3,997.6W AC (1) FRONIUS IG -2000 INVERTER (12) (177.2W CEC) (93.5%) =1988.2W AC 5,985.8W TOTAL SYSTEM SIZE PER MODULE: MAXIMUM POWER: 20OW MAX POWER VOLTAGE: 26.3V OPEN CIRCUIT VOLTAGE: 32.9V MAX POWER CURRENT: 7.61A SHORT CIRCUIT CURRENT: 8.21A (12) STRING TOTAL: TOTAL OPEN CIRCUIT VOLTAGE: 394.8 VOLTS TOTAL MAX POWER VOLTAGE: 315.6 VOLTS 1. ALL WORK PER CEC 690 2. ALL DISCONNECTS TO BE CLEARLY LABELED ED XND WITHIN SIGHT OF EACH OTHER 8. INSTALL A PERMANENT, RED -ON -WHITE, SIGN ON OR ADJACENT TO THE MAIN SERVICE PANEL WARNING THIS BUILDING SUPPLIED WITH ALTERNATE POWER SOURCE. DISCONNECT IS LOCATED WARNINGII ELECTRICAL SHOCK HAZARD. DO NOT TOUCH TERMINALS ON BOTH UNE AND LOAD SIDES. MAY BE ENERGIZED. FRONIUS IG -2000 INVERTER: PEAK EFFICIENCY: 93.5% MAX DC INPUT CURRENT: 13.6A MAX AC OUTPUT CURRENT: 8.35A FRONIUS IG -4000 INVERTER: PEAK EFFICIENCY: 94% MAX DC INPUT CURRENT: 26.1A MAX AC OUTPUT CURRENT: 16.7A METER 200A MAIN SERVICE W/ (1) 35A AC BREAKER 3 / 4- EMT (MIN.) j COMPLY WITH CALIFORNL4 ELECTRICAL CODE- ARTICLE '690 REQUIREMENTS FOR 'SOLAR PHOTOVOLTAIC .SYCT-_EMS COMPLY WITH CALIFORNIA ELECTRICAL CODE- ARTICLE 250 REQUIREMENTS FOR GROUNDING AND BONDING EACH INVERTER: - 1 / 2° EMT (MIN.) (2) #10 THWN-2 (1) #8 THWN-2 GROUND 60A AC DISC CUTLER HAMMER NON-FUSABLE LOCKABLE NEMA 3R 2 -POLE 240V DG222URB AC DISCONNECT: LOCATED WITHIN 10FT OF MAIN SERVICE. POINT OF CONNECTION. THE OUTPUT OF A PV POWER SOURCE SHALL BE CONNECTED AS SPECIFIED IN 690.64(A) OR (B). FRONIUS IG -4000 4KW INVERTER 240 VAC UL#1741 INTERNAL AC/DC DISCS 40FT AC RUN 3 / 4- PVC (MIN.) FRONIUS IG -2000 2KW INVERTER 240 VAC UL#1741 INTERNAL AC/DC DISCS G 25A AC I I 15A AC BREAKER BREAKER AC SUBPANEL PROPERTY OF SPG SOLAR, INC. CONFIDENTIAL THIS DRAWING AND ANY DATA, DESCRIPTION, AND OTHER INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE EXCLUSIVE PROPERTY OF SPG SOLAR, INC. AND SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN WHOLE OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SPG SOLAR, INC. ALL RIGHTS RESERVED. Z O U :2 O O w W rn U)F- c }O F- c O U cca Ill CL >5 > 11 0 Ir CID (N Z M M0) a )mv TYPE: SINGLELINE LOOMIS DRAWN BY: ATOM MCCAMBRIDGE 415/747-7039 7/6/6 NTS 3080 Thorntrce, #k25 Chico, Cs�liforni:w. 95973 Office: <530� 899-8988 PA&F. I Cell: <530> 624-3639 �� � Liceriise #W: 833994 sF00,L LE AC14LsEsN3 TANK � PLar=woman% 0 4t fG C f" a Irk • s7 ............. •.. Q --� . .. .. ...: i ...... :......: .. .. .... 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License #833994 J L� ter. s�, V -0q3 BUTTE :EOUNTY BUILDING DIVISION APPROVED p 10 20 30 ` AO so GRAPHIC SCALE ORIGINALALSCALE:1" = 30' Size (Acres) • Z Assessors Parcel Number:❑ ©® ❑ ❑ Owner Name / Address / Phone No. Site Location LAo2r - o Zoning General Plan Contact: Name Phone 69- 4 — Z, 40 7 qL4# %° q 11 3 APPROVED 30ca t _ _ , - -- -