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028-270-174
NOTES RESIDENTIAL F M PERMIT NO: . 4 _ 028-270-174 0�-2493 DICKERSON, HAROLD 207 WEEDY WAY, O•RtYff i.'B ` CONT: OWNER �Pr/J1 D 2 4 DECK(COV) yr - ' E SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS R VERIFY j USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ' rro.vc TEDOy/ JOB FINALED (Date)CdvL.. 41 .4!:K r SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS R VERIFY j USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ' rro.vc TEDOy/ JOB FINALED (Date)CdvL.. -,4 .. COUNTY OF BUTTE . • BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 T CORRE X CION NOTICE 'O NER 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 explanation, please contact the Building Inspector as indicated below. 5e- 9417 `tea -7 -30 Date - 7- Inspector - REV Inspector REV 4/05 Phone # �. • x 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.netWds 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 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Date: Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' Stale 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 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 the Contractor's Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit. subjects the applicant to a civil penally of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their J� sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of properly who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profe$sions Code. The Contractors' State License Law does not apply -to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Stale License Law.). ❑ I am Ex mpt under Article 3 of e B ine s a P o sions Code — Datewner. 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 is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier: Policy ❑ 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Dale: 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 forAn Section 3706 of the Labor code, interest, and attorney's fees. PERMIT NO. BP052493 Issued Date: 10/19/2005 APN: 028-270-174-000 Site Address: 207 WEEDY WAY BAN Map Index: Description: COV(960)OPEN(707) Owner: HAROLD DICKERSON 34035 COUNTY RD # 25 WOODLAND CA 95695 (916) 219-6764 Applicant: PENNY ENGLAND 6366 LINCOLN BLVD OROVILLE CA 95966 (530) 370-3697 fax 533-0107 Contractor: License #: Architect: Engineer: Total Square Ft: 1667 S.F. Valuation: $22,430.00 Census Code: CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte Cnunly Codn enrt/or I hereby affirm that there is a construction lending agency for the Resolutiong to do work IndicaI d above for which fees have been paid. performance of the work for which this.permit is issued (Sec 3097 Civ.) * QJI /� Cp_ p - By: ��[ �(�'yru-iv A•i N Date: �l1` "1 ()`J Name: l /� n 1 PERMIT EXPIRES ON: 10- Irl ' � IIrA 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. 1 agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to eller the substance of any official form or document of Butte C nty. I hereby authorize represe latives of Butte County to enter upon the above mentioned property for inspection purpose Print Name: 2d h� Signature: Date: ( i d Owner 0 Contractor 0 Agent for Owner ❑ Agent for Contractor J=OK o = Not OK . = Not Ready NotAppficable �, ,� ®9' L E HOMES ®ES Date MOBILE HOME UTILITIES (Plans) OK except Vs 1. Zoning Requirements -Setbacks -Easements 2. Sols; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4_ .Water: Location -Test -Easement Needed (Sketch) .5. Electricity; Location -Clearances Gmd-/ , /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ • >° L'ft. .: / P Nat or / . /" L "ft./.. P LPG . 7. Well Clearance & Disconnect 8. Utility Clearance .. Date Card B-1 Date Card B-1 Date Card B-1 .-Date . Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except 1€'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-Connedot 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs Type4nstallation Cert- ert10. 10.Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 : Date Card B-1 Date . - : Card 8-1 ...Date:...'. :.Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requiremerrts-Setbacks-Ease'ments i 2. Footings; $¢e Spacing -Marriage Line,"3. := ,. 4.' Gas; MH Test=Demarid_ idNe ' .:.. .. S. -Electricity; MH Test :.:`:^ =. ....... 6. Water, MH Test :::-7.. Water. and Sewer _Connected . 8. Gas and EleciricityTagged ' LLANEOUS Date DE OVERS, ARPORTS, GARAGES (Plans) OK except 9's quirements-Setbacks-Easements _ F ' gs; Soils-Size-Depth-SPaciny-Connectors-Steel 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,Enciosunes 6: Carports; Windows -Doors 7. EI c nog.; Sills-Anchors-Studs-Rftrs-Trusses 9. Si ng; Nailing -Veneer -Stucco -Mesh IX-Ropf. Shthg-Roofing - :••:i. Steps -Doors -landings .: ` .12- Braced Wall Panels. Date 6% 11/,i Card B-1 [ hv`/ Date Card B-1 Date L :ptp Card B-1 faA.6C . Date Card B-1 Date POOLS (Plans) OK except ff s 1. Setbacks -Easements 2. Sols-, Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness . Dead Men -Lining. _ 4. Elec.; Receptacles and lighting. Qistance-GFI 5. Elec.; Pool Lighting; 15 Volts -GF! S. Bec.; Enclosures; Conduit Entries Terminals -Listed 7. Elec.; Bonding; Metal w/5'-uailating Equip_ Heater 8.: Elea; Grounding; Equip_ w/5' Circulating Equip. -Pool Lghtg. Boxes=Enclosures-Panelboards-Ins. to Main Conduit 9: Health Departmeirt Approval 10,.• Plumb,.: Cir. Test -Water Supply. Test... 11... Light Niche .... 12. Enclosure; Fencing -Alarms Date... Card B-1 Date Card B-1 Date Cana B-1 Data Card B-1 �K Not OK R.,l App6mble Itot Ready RESIDENTIAL (Single & Duplex) UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ r Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ r Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ r Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors T. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation tte Card B-1 Date . • : Card B-1 tte Card B-1 Date Card B-1 ate PLUMBING (Permit) 6K -e' xcept #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle U. Water Pipe: Test & Anchor -Nail Protection 19. D.W.V; Test Fittings 9 Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test late Card B-1 Date Card B-1 late Card B-1 Date Card BA )ate ELECTRICAL (Permit) .OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -lights & Switches at Doors 26. Sire Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Meth Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in IGtchen & Conductor Size GFI 30. Subfeed Wire Sizer /ga. Cu or AI -AC. Wire Sizel /ga Cu or Al 31. Range Circle/ 79a Cu or Al -Oven Circ. / /ga Cu or AI Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. 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. Fumace-Vent Access -Comb. Alt -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 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 HL & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext Doors -One T -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-Nairrng 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.; Dec. & Meal. Equip: Listed for Location 79. Elec. Receptacles in Garage (REQ-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 O Yes 83. Following tnstldJDrive 0 Yes ❑ NoN&Iks 0 Yes 0 No/Pleriters O Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Mg-Appliance-Fueplace-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 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: =► t RECORDING REQU) STED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 Recorded I Official Records I County of I Butte I CAMCE J. GRUBBS i County Clerk-Recorderl I I 01:04PM 07 -Oct -2005 I REC FEE 10.00 CONFORMED COPY 1.00 SA Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. HAROLD DICKERSON REAL PROPERTY OWNEPULESSOR 34035 COUNTY RD. 2S MAILING ADDRESS WOODLAND YOLO CA 95695 CITY COUNTY STATE ZIP 207 WEEDY WAY INSTALLATION MAILING ADDRESS, IF DIFFERENT BANGOR BUTTE CA 95914 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 05-1781 530 538-7541 UIL G PERMIT N TELEPHONE NUMBER " r NATURE OF LOC9L AGENCY OFFICIAL DATE TOM'S MOBILE AND MOTOR DEALER NAME (if not a dealer sale, write "NONE") DL91097 DEALER LICENSE NO. THE KARSTEN COMPANY 2005 KS52001F MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMBWUMBER KC-CA-01-K32456A/B 52 x 13'6" RAD1430495/6 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIAILABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 028-270-174 HCD FORM 433(A) REV. 8/91 WHITE - County Recorder CANARY - HCD PINK - Applicant GOLDENROD - Building Dept. 2 escrow N�0: 041000472 -BJ Locate No.: CArum958-0957-0001-0000410471 Tide No.: 04-410471 EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS: PARCEL A: A portion of Section 31, Township 18 North, Range 5 East, M.D.B.&M., County of Butte, State of California being: Parcel C per Waiver of Parcel Map for Assessor's Parcel Numbers 27-23-47 and 28-27-150, as approved for Louis M. Duncan April 27, 1978, more particularly described as follows: Parcel 2, as shown on that certain Parcel Map recorded in the Office of the County Recorder of the County of Butte, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. EXCEPTING THEREFROM all oil, gas and other hydrocarbons and minerals heretofore reserved to the grantor named in that certain Deed. from Bank of America National Trust and Savings Association, a national banking association to F. H. Thomas and Mattie E. Thomas, his wife, Joint Tenants, dated May 14, 1943 and recorded June 18, 1943, in Book 314 of Official Records, page 152, records of Butte County, California, together with all the rights and privileges of the grantor in said deed set forth with respect to said oil, gas and other hydrocarbons and minerals. Said oil, gas and minerals were quitclaimed to a depth of 500 feet from the surface by document recorded January 11,1979, in Book 2361 of Official Records, pages 410 through 418, Butte County Records. Parcel B: A 60 foot non-exclusive road and public utilities easement lying 30 feet on either side of the following described centerline: Commencing at the centerline of Bangor Park Road at a point from which the North quarter corner of Section 31, Township 18 North, Range 5 East, M.D.B.&M. bears North 370 18' 50" East; 1169.08 feet; thence South 320 40' 02" East, 36.78 feet; thence along a curve to the right having a radius of 200 feet, a central angle of 37° 2559", and an arc length of 130.67 feet; thence South 040 45' 57" West, 790.43 feet; thence along a curve to the left having a radius of 1500 feet, a central angle of 030 55'24", and an arc length of 102.71 feet; thence South 000 50'33" West, 548.62 feet; thence along a curve to the right having a radius of 600 feet, a central angle of 620 46' 27", and an arc length of 657.31 feet; thence South 630 37' 00" West, 2196.30 feet; thence along a curve to the right having a radius of 400 feet, a central angle of 340 23'00" and an arc length of 240.04 feet; thence non -tangent to the preceeding curve South 300.09' 26" East, along the line between Parcels A and B, per said Waiver 1323.90 feet; thence leaving said line North 890 13' 06" East, parallel with and 100 feet Northerly of the South boundary of Parcel B, 951.04 feet to the Westerly boundary of Parcel C per said Waiver at a point from which the Southwesterly corner of said Parcel C bears South 050 26' 36" West, 100.59 feet. Parcel C: A 60 foot non-exclusive public easement for ingress and egress and public utilities as shown on that certain Parcel Map recorded in the Office of the County Recorder of the County of Butte, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. Initials: Butte County Department ol'Developnent Serpices vrr� 7 County Center Drive ° Oroville, CA 95965 0"`� (530) 538-7601 Telephone °� �.� ° (530) 538-7785 FacsimileN<Y Ny BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit 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: I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained. 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 buildingplansto 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: APN: Odd' - g 7 b - 7 Building site address: Permit No.: I have read, understood and accept the terms and conditions as expressed herein submission of the above -referenced building permit application and my signature below as indicated by my IGNATU F APP CANT DATE w Copy to Applicant/EH/File K:Fomes/BidgPermirwithoutClearances 020705 t SITE PLAN .. ... -- .. ._ ..... .- . •. .. .. .. .. .. -• . • ............. •• .. ................................_ .. .. .............. .... .. .. 1% t :.. = .. ...................... ..... .. ... j_ - :.. ----.................... -...._ .. ..... ... ... _. ....... ..... .. ..... .............. ........ - '-'. '- • •. .. ....................................._............ _-...... .. .. .. .. ........ ..... ...... ...... ............ ............ .. .. ........... ............ ...... ..__...................•'. .... ... '... .._ ... ..- . . ................................... C J V .. ... _. .. ... ._ .. ... .. .. ... .. .. .. .. .. ... _. .. ... .. .................. ... .. ... .. .. ... .. .. ... .. .. .. .. .� .. ... .. .. ... .. .. ... ..... .. ... .. .. ._ ... ... :y ......................% __ .. ............ .. .. .. _. .. ..------... ............ ....................... .. .. _ 1' I \ Q' ;.............:......:.. .................._.i......:.....r. ... .. __ .. ... _ .. .. ... _. .. + _ %_ .... ..... ... 5P�� ag.. 0 B n� �iA U � �: ..........._......................... . ; k 1. ... .. ... .. ... `... .. ................. .. Q.............. ............ .. ............. .. ............. .. ............. . - .. .. ............. .. . ......./ ... .. .. ...................... .. .. .....:. ;..... ......................... .. .. ............. ............. .. .. .. .. ... .. .. .. .. ... .. ............ ...... ............. -- t :� G- :C- 7 ... �1 .. .. ...f ......: .. .. .. .. ._ .: ..........------- . .. ... .. .. Assessors Parcel Number 0 5 ®- 5�F21 © - Q 0 Scale: 1" _ Owner Name �VP'cy 0 P" -- Address " -Address / Phone No. 3 L4 Q 35 0-c; t,,, ±a- ►,� �n�i A..,a ,�q� 9s bss Site Location lie�J!. LL, -y Contact: Name -\T 'A' �/1t.a- -� .��Phone Sib .XWy 3b� 7 oarw a 2 . FOR OFFICE USE ONLY PROVIDE FOR ALL Zoning: ADJACENT PARCELS SIZE (AC): General Plan Desig: ZONING: Size, Acres GEN PLAN: a.00r USES: (0 co 66.> ul 12 a -N Q X No � aI. K jQ v1 Y. Y t� 1 j . > J •��> ? H N, . 1 46 S J Y BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE M (530) 538-7541 FAX#:(530)538-2140 WEBSITE: www.buttecounty.netWds 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 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: . Date: Contractor. 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 to its issuance, also requires the applicant for such permit .to rile a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): �y I, as owner of the property, or my employees with wages as their j� 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 owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Ex mpt under Article 3 of e B ine s a P o sions Code Date;—a&4_5�11ner. 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 is issued. ❑ 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: Policy #: ❑ 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure' workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. PERMIT NO. BP052493 Issued Date: 10/19/2005 APN: 028-270-174-000 Site Address: 207 WEEDY WAY BAN Map Index: Description: COV(960)OPEN(707) Owner: HAROLD DICKERSON 34035 COUNTY RD # 25 WOODLAND CA 95695 (916) 219-6764 Applicant: PENNY ENGLAND 6366 LINCOLN BLVD OROVILLE CA 95966 (530) 370-3697 fax 533-0107 Contractor: License #: Architect: Engineer: Total Square Ft: Valuation: Census Code: 1667 S. F. $22,430.00 CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of'the Butte Cnunly Coda ?nrVor I hereby affirm that there is a construction lending agency for the Resolution to do work indica d above for which fees have been paid. performance of the work for which this -permit is issued (Sec 3097 Civ.) By: �( ( t�91 Date: ll JJ `1 1 1 Name: ' - i //�� PERMIT EXPIRES ON: 10 I`-1` 1 ' OrA Address: _ rn�#.l ❑ 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 C nty. I hereby authorize represe tatives of Butte County to enter upon the above mentioned property for inspection purpose v Print Name: �G/a P Signature: Date: 0Z ,V —a C3 Contractor 0 Agent for Owner C3 Agent for Contractor 0 M BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS,! 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE P. (530) 538-7541- A FEE WILL BERkQUIRED AT TIME OF APPLICA TION **PLEASE PRINT CLEARLY.". , OWNER . last Name i C v Name Address City State�R • b Phone aI - 10 7b Fax /% / E-mail Al /A APPLICANT NAME CONTRACTOR Name % 1� City Address City "Fax State Zip . Phone Page Fax E-mail Date Approved: lic. # Gass APPLICANT NAME ARCHITECTIENGINEER Name City Address City "Fax state, Zp Phone Page Fax E-mail Date Approved: State license Number APPLICANT NAME N Address City State SRA Phone . "Fax E-mail /v la APPUCANTSIGIVATURE X or office use on - Zoning I A _j Flood Zone Cross Street SRA es No Occ. 23 1 Type Const VQ— Subdivisi6n Name Map Book Page Lot # Planner Date Approved: PERMIT .a BP BIN # LOCATION AP# Properly Address vtJe City. )ice Cross Street WORKER'S COMPENSATION Policy Number N Carrier - Nhiring anyone other than license contractors, a certificate of workers compensation mustbe shown at the time of permit issuance. LENDING AGENCY Name /V 1-12 Address Descrip 'on orScope f Work: C k =q4aC� Sq. Footage / L2 ❑ 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 Refimds 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. Ffling fees, plan cbeck fees for work plan checked and other department costs are not refundable: rz) //00 �p Received by 1�. Amount: /,2rO . Bldg 1 SRA Receipt # / Sheriff SMTP Other Date: q r/sem SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGLBLE AND LNLNK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPERI ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER 1 OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAMI). '❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes:) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (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. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GR,4PHPAPERI ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ S. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPERI ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6.- 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (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. ❑ 9. Letter of intent ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. 1� Zf OVR FOR BUILDING PERT APPLICATION s PERMIT Z �3Cv Q(�d COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: �L°l iC�%' �VY�, f r/r �GASSESSOR PARCEL NUMBER (" off -c� / ZO P74 Proposed Bu(.C'� ilding Use: �( l(� O�UJ((I (t!YJtq (7J Permit Technician: NY Date: Items required in order to apply fora permit: All boxes MUST be checked OR marked NA in order to apply. ' 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. - 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No 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. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other When issued Telephone 7 e:2 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicants �/I�I� «� � 0 Remainin s needed to issue the permit. (May require additional plan review upon receipt of the following items.) 1. Index p9(mit application fo he ove ite umbe Rd 15. anitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable r ❑ 6. Fire Sprinklers............................................................................................ Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by 0 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by Date: ❑ 18. Soils Report and/or Engineered Foundation required ........................................... Date: OErosionControl Plan Required..................................................................................................... Yellow: Building Division ed' ry 2�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 City of Biggs .............................. 23. California Department of Forest'plan approval ❑ paid. Sent by: 24. Planning approval for (A) Use: L. (B)Parking: -(C) Parcel Check:...... ❑ 25. Contact Land Development about _ Improvements, _Drainage. o ...................... 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/ . .......... .............................. fidwner-Builder Verification (_ Given to owner, /Mailed to owner) ..................... Letter of Signature authorization... %killLZ�.. ick4O..11.9:................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone 7 e:2 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicants �/I�I� «� � 0 Date: / /�s /0 1. Index p9(mit application fo he ove ite umbe Plan Check Letter �- 2. Additional items required 10, Contractor, designer, owner, Sas a ised o t ab ne, ❑ 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: Tr7 Date: Plans approved by: :Td Date: 2�7 OS Structural reviewed by: Date: Structural approved by: Date: Note transfer by: - Date: - Yellow: Building Division E.H. USE ONLY Piot Plan Anschod Floor Plan Attachad sent to ®.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance LJ Owner Locati n AP Plan Approved for: Sewage Dispos Public Private Well Clearance for dwelling. Other WA�P:a:nr,,Suqply: /U ^ I- )� �1 A 0 h A n,,, IN Hold final for: Final clearance O.K. for: NOTE: Environmental Health 8/96 cialist Date COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER PROPROSED BUILDING USE(W�,eG' (W(a-f014M) *. BUILDING PERMIT FEES --- Balance Due ..................... $ rJ� T --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $_ Sq.rtg. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ A. P. # MK—,276-1, DATE lrs'"rJ -5 RECEIPT # DATE REC. NORTH CHICO SPECIFIC PLAN (per. dwelling) Zoning $ 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION $200.00 (paid at Building Division) q 1/ 8. SMIP 9. OTHER 10. OTHER 11. OTHER At time of permit may be changed c APPLICANT n, I was advised the above fees are required to be paid prior to issuance of the permit. These fees plan checking process. J DATE M Pursuant to Government Code Sebti6n 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 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 Division Yellow -Applicant Pink -Owner (rev. 3/05) OWNER -BUILDER VERIFICATION 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 [k] NO [ ]. 2. I HAVE [ ] HAVE NOT (.y�] 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: 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 of Development Services ADMINISTRATION ° BUILDING t GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile OWNER -BUILDER INFORMATION 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 infonnation 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 contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board 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. Sincerely, tw Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. r3` `. Department o Public Works �. ep f t ' '\ C o u n t Y o f B it t t e ji ' ;✓ -� LAND DEVELOPMENT DIVISION 0 J. •Michael Crump, Director storm Water Management Program \'•. s ® 7 County Center Drive \;\Al U N �� 5 / Oroville, CA 95965 (530) 538-7266 t2Llc y�pF� (FAX) 538-7171 National Pollutant Discharge Elimination System(NPDES) Phase l Construction Storm Water Permit and Storm Water Pollution Prevention Pian (SWPPP) Acknowledgement BLESS THAN I A Project Description: I 1PC'i Project Location and/or Parcel Number: 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: Butte CourTtyDepartmei2toi-Developxzier2tSez-vlces o$`',Tr�o 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone c --� (530) 538-7785 Facsimile oUNt BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit 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: • I need to submit applications for septic and/or well to Butte County Environmental Health immediately. o I am required to bring the approved Environmental Health site plan 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: Pah9. &41/1,-,11/ Ir Building site address:1�7 APN: Cg�?- 2 0`1 7gtioy Permit No.: o5. 24/ ,?,3 I 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: q_&E /0S IGNAT OF PLICANT DATE F SITE PLAN ............. :......:...: ... ..... .. t 7111* 711 :. :.... ::....... ...... ...... ...::....::::......................... --....................................::::.' .-..........................................::......:. .- ...:::.............................................................-::: ._ - •• ._...... ..-........ •........ ...•--•.... f J' V .. ... _. .. ... .. .. ............ .. ... .. .. ... ._...................... ... .. .. .. .. ............ ... .�.................................. _. .. .. .............. .. ._ ... ... ... .. ... .. .. ... .. .. ... _. .. .. ....................... _. .. ... ... .. ........................ .. .................. ... .: ............ .. ._ ... - - —— • � -�•:. .sem.. ..y. . r :j .j -.-.. .:.. ..:.. ..:. .:.. ..:.. = 7 �t :k.. ... .. :- ................................ .. .. .. .. .. .. .. ............ .. .. .. . • •• . •. .. . •• • • •• 1 � \ ... • .. .. .. .. ... . . • . .. .. .. .. .. .. .. .. ... .. .. ... .. .. X ... ..:moi- ... .. .. ... ......................... ... .. .. .. _. .. ... .. .. ... .. .. ... ._ .. ... .. ... .. .. ... .. .. ... .. ... .. .. .. ... ._ •; .. ... .. .............. .. .. .. ..:._.. �....:......:......:.....:......:.......:.....;......:......__....:......:........ .. .. . -. -' - - .. .. .. .. ... .. .. _ ............ .. ... .. .. ... .. .. ... .. .. ... .. .. .. .. .. ... _. .. ... .. ... .. .. .. .. .. ... .. .. ... .. ... .. .. .. ... _. .. ... .�:. ... D VIS! = BU 6� PVR :......:.....:......:......:.....:......:....__.... = :......:.....:......:... : ..:......:......:.....:. :......... :. �.:......:.....:. ....••-•....... 7 ..... ..... PLANNING .:I..._: �N - ;.... • •.. .. .. .. .: .. ... .. ...... ....... ....... . ;....:. ;.. . U . . . . . : :ndsOp ng: .. ............. ............ .- .. .. ............ .. .. ..- • .. Palk _.:'.�' :....:.. Oh APPROVED- ............. ............_....._................- .... .. .. .. .. . •• • • ... .. ... .. .:.. .. - tore`......... Assessors Parcel Number. DO ®— [,� ?0 ®— 0 [� Scale: 1" Owner Name ' k Psry lj Address/ Phone No. 3 y Q 3 S b;Q �-v 11j. t6 -S_, k?Qnil L -,, j IO, 5s' 655 Site Location W e-ecJ L/ Contact: Name - oaobw 23,2M3 FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres i 4.Oo" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: _FL&5 C6PY if 'o BUTTE C I���°TY BUILDING DlVlbi-.oj APPROVED 1 2- ��ri 2dC6 Joy s�' . SITE PIAN REVIEW APPLICATION Date: j ``� �:__( APS ? Permit Number (if applicable) 0 1,,L:,, a-, Bin Number APPLICANT INFORMATION Owners Name: Owners Address: & 5 w 10 Telephone No.: Situs Address: Proposed Use: Parcel Size: e3 26 _" 1 f � Email: Residential ❑ 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 ❑ Industrial Addition . Other ® Septic ❑ Agricultural Exempt Building ❑ Other: Brief 'Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial. Remodel ❑ Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval JR Site Plan Stamped Approved By �/% Date 3 `I 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) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: X � „j `� • Flood Panel No.: / / S L Index Date: �j ❑ Sacramento River Reclamation District (Approval must be obtained from the ali ornia 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: -h ---�, 6P- A - 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 Side 3d Side Street Rear 30 Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Applicable Development Fees: Standard Fees ❑ 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) Amount Formula * 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 g, Deeds: Date of Creation: Deed of Reference: Parcel Frontage on Publicly Maintained Road: Complies with County Standards for Deed Cre Comments: /1U f d JA Parcel Deemed to be legal 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 Legal Access Provided: ❑ No ❑ Yes Legal Access Required ❑ No ❑ Yes ❑ No ❑ Yes, Road Name: ❑ No ❑Yes, e ❑, Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Page: 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. ❑E E 0 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. CALarrys\Building Permit Site Plan Reviewl.doc :O SITE PLAN :.....:. - .. .. ..._ .. -.. .... ...... ..... .. .. .. ._ .. . .. .... .:....... ........... -- ... ..... ..... .... .. .. .. .. ...... •. .. .. .. .. .. .. .... ..... . ...._ ......_ ........ ..... .. -- .. ...... .. -- .. ...............:............ .... .. .. .. ._ .. • -- . -- . . ..:.. . ... ....... -- . . ..... ....... ..... - ... ..:....:..:....:.. ..:...:....:.. : ;........_......._...............-..-.....:::...:..:.. %._ .. ....................... :.. ::::...::. ::::::. :::::::::::::::::::.... ...::. ::::. ......:::::::::::::::::::: ::::::::::: :::::....:::::::::::::::. ........................... ........:: .......... . . ........... . ....... ... ..... _... _.._-. ..... .... ............. .._... . .... .... .............. .. ...... .... _ _ _ .:................... 4 1 ..... - ............... _.......... .......... - .. .. ..........................• -- -• .. .. ... .. .. ... .. ... .. ............ .. .. x.. -- .. .. ............. ------------ •.............. ... . --------------- -----*..... .. ...... �� ::.. 1 ... .. .. ... ....... ... ` .. .. ... ... .. .. .. _.. .. .. .-`... .. ..- . ... .1_ n. i `�:-;.� .. ... .. : -, .. .. .......................... ............................. ....._;.................;...........: .. ... .. .. .. .. .. .. ... .. .. ... .. .. . . ..:. .:.. ..:. N .. ..:. .:.. ..:.. ..:. .:. • �.. ....-� P1� N1 LIfV1510N=BCIELIII(�i :• •: G PIAN APP�tDVAC ... ..:. .:.. ..:.. ..;. .;._ ..:.. ..;. .:.. ..;.. ..;. .: �.... .. .. ... _ 0; ................... .....<.................... i .. .. .. .. ... ... .. .. ... .....;....;. ... : : : : : : : : : :... �� ai�dscaping Ather.. ............ .. .. .. ............. Si nature: Assessor's Parcel Number. E [� ®— ?1 E — 0 E 121 Scale: 1" Owner Name Address/ Phone No. fy 0 3S Rj. 4 �& kx� 'OAL'g"')na 13s;-65 Site location Contact: Name -�rU:- (����%-:? 1��•.������/�.��Phone C3�� -� 3 Octubw 23, FOR OFFICE USE ONLY PROVIDE FOR ALL ADJACENT PARCELS Zoning: SIZE (AC): General Plan Desig: ZONING: .Size, Acres GEN PLAN: 4.0(r USES: -'.`'rte �^_---L.e•,• ` Q;. p�llp WOF�S Department of Public C o u n t y o f B u t J. Michael Crump, Director Works t e LAND DEVtLUFI\Atry i UwIJIMAN Storm Water Manal.ement Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES)Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement (LESS THAN 9 ACRE1 Project Description:J�V571-� �t N �2✓ %� .v �'� �'�y'"` `"'L ����' /����' Project Location and/or Parcel Number: – 2U — L: zx-� 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 fon 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: 7P Title: 1 Date: /40 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 7 -Jul -2005 2005-0039439 Has not been compared with original BUTTE COUNTY COUNTY RECORDER 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 situate in the County of Butte, State of California, described as follows: Date�%3v /tzS State of California County of�'6L*) <— known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) ware suDscriDea to the within instrument and acknowledged to me that he/shelthey 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 in a d and offi(JII s Signatur Seal: PENNYC. ENGLAND k Commission #1465W4 U Notary �eic-Calilbmia A.P. #t by*- �7c� 17�/ comm. E9 County2�; zoos EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS:, PARCEL A: A portion of Section 31, Township 18 North, Range 5 East, M.D.B.&M., County of Butte, State of California being: Parcel C per Waiver of Parcel. Map for Assessor's Parcel Numbers 27-23-47 and 28-27-150, as approved for Louis M. Duncan April 27, 1978, more particularly described as follows: Parcel 2, as shown on that certain Parcel Map recorded In the Office of the County Recorder of the County of Butte,, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. EXCEPTING THEREFROM all oil, gas and other hydrocarbons and minerals heretofore reserved to the grantor named in that certain Deed from Bank of America National Trust and Savings Association, a national banking association to F. H. Thomas and Mattie E. Thomas, his wife, Joint Tenants, dated May 14, 1943 and recorded June 18,.1943, in Book 314 of Official Records, page 152, records of Butte:County, California, together with all the rights and privileges of the grantor in said deed set forth with respect to said oil, gas and other hydrocarbons and minerals. Said oil, gas and minerals were quitclaimed to a depth of 500 feet from the surface by document recorded January 11,. 1979, in Book 2361 of Official Records, pages 410 through 418, Butte County Records. Parcel B: A 60 foot non-exclusive road and public utilities easement lying 30 feet on either side of the following described centerline: Commencing at the centerline of Bangor Park Road at a point from which the North quarter corner of Section 31, Township 18 North, Range -5 East, M.D.B.&M. bears North 370 18' 50" East, .1169.08 feet; thence South 320 40' 02" East, 36.78 feet; thence along a curve to the right having a radius of 200 feet, a central.angie of 370 25'5T, and an arc length of 130.67 feet; thence South 041145' 5T' West, 790.43 feet; thence along a curve to the left having a. radius of 1500 feet, a central angle of 030 55'24", and an arc length of 102.71 feet, thence South 000 50' 33" West, 548.62 feet; thence along a curve W the right having a radius of 600 feet, a central angle of 620 46' 27", and an arc length of. 657.31 feet; thence South 630 37' 00" West, 2196.30 feet; thence along a curve to the right having a radius of 400 feet, a central angle of 34° 23' 00" and an arc length of 240.04 feet; thence non -tangent to the preceeding curve South 300 09' 26" East, along the line between Parcels A and B, per said Waiver 1323.90 feet; thence leaving said line North 89° 13' 06" East, parallel with and 100 feet Northerly of the South boundary of Parcel B, 951.04 feet to the Westerly boundary of Parcel C per said Waiver at a point from which the Southwesterly corner of said Parcel C bears South 050 26' 36" West, 100.59 feet. Parcel C: A 60 foot non-exclusive public easement forif�ress and State of Californias, ublic utilities ason March 11t 1983certa, nPBook 92 of n Parcel Map recorded in the Office of the County Recorderot County of Butte, Parcel Maps, at page 43. MrA I'K rI T GROUP 417 STEW PSON ROAD OROVILLE, CA 95965 530-370-3697 INVOICE Date: 02/17/05 To: . Butte County Building Department From: Truitt Group, Hayden T. Leen, Contractor I, Hayden T. Leen, hereby authorize Butte County Building Department to release to Penny England, Tommie Rinehart, Reba Fahey and Patrick Pitts permits and any applicable information regarding the Truitt Group. Hayden T. Leen CDF FIRE SAFE REQUIREMENTS AP# 028-270-174 PERMIT # 05-1781 NAME: Dickerson Under authority of Public Resources Code Sec. 4290, the following checked items are required by the Butte County Fire Department and made a part of this permit. These requirements are minimums and may be superseded by Butte County local regulations, which equal or exceed these standards. Butte County Building Inspectors will make compliance inspections. Drivewav Standards [X] 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 and fire apparatus weighing up to 40,000 pounds. [X] Grade. Not to exceed 16 percent unless paved. Drivewav Radius [X] 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. [X] 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 feet radius. [X] Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. [X] Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 -foot taper on each end. [X] Width. All driveways shall provide a minimum 10 -foot traffic lane and unobstructed vertical clearance of 15 feet along its entire length. N 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 [X] 1. Gate entrances shall be at least two feet wider than the roadway they serve. 2. The gates must be located at least 30 feet from the roadway and shall open to allow a vehicle to stop without obstructing traffic on the roadway. 3. Where a one-way road with a single traffic lane provides entrance, a 50 -foot turning radius shall be used. �4e eopq C D F F I N 10 E Q U I R E M E N T S 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. [X] 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 [ ] If Building Setback is 15 to 30 Feet: ✓ Class A roof ✓ Enclosed eaves [ ] If Building Setback is Less Than 15 Feet — ✓ Class A roof with 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 setback ❑ Siding from the following list: { o Stucco — 3 coat o Hardi-Board or Plank o Masonry o Masonry Veneer o Metal o Other Butte County Fire Department approved materials [] 07/13/2005 Darren Read Date Signature C D F F I R E E Q U I R E M E N T S 3/4" DIA. x 18' LG. 1/2"x 3 1/2' i/2 -x 8' LONG (4) REQUIRED EXPANSION ANCHOR ANCHOR BOLT 3/8' CAD PLATED BOLT. NUT A WASHER (4) REQUIRED (4) ACQUIREDCOUNTER BORED FLUSH WITH BOTTOM AT 6" O.C. \ (B) REQUIRED CONCRETE PAD 1NSTALU►TION f 'Ilk POURED IN PLACE 16xl6xl2 CONCRETE FOUNDATION INSTALLATION 1/4' GRIPPER PLATE (2, REQUIRED 1/4- GRIPPER BASE 1/2-13UNC-A307 x 4' BOLT WITH NUTS (4) REQUIRED 01 1/2- SCH 40 PIPE RKER WITH 01/2 'ADJUSTER HOLES AND 3/8" THICK TOP PLATE 021" SCH 40 PIPE STAND %ITH TWO 01/1' ADJUSTER HOLES Q AIESCO ICES PAC #503 STEEL FRAME--, yJ LIGHT HEAVY—WEIGHT PLASTIC PAD INSTALLATION TI --tans tit�18 8D t1mE VMl11 HOOF NE 24 HONE 1 1 -1 ffVq It IR 12 t 8 6 B e MR Ut -"L 'b am lo IQ to To NU- 0 OF NF -1 REtMUSER OF TUF-t REGUutm E: SW= WIDE LINKS ItFQVIRE (4) E i TIE PADS. GUS QUAD TUF-1 WEBS ARE TO 6E PLACED AT AIRMORIVATMLY "AM IMMIyALS ALM OWN Mgt RWL •fJ :. TUF-1 PERMANENT FOUNDATION SYSTEM �w E -Z TIE PAD I PH: (nae) aa2-. WAYNE T. STATE APPROVAL yMBACrOR1;p IM POUlf"moN BYBTT,lt TIlANDBAFBTYOQD$, BiC:1011 lifll AFPR+OV6D MM -OM 9W IJ8181:! TOOOR>L8C?)t�ltiptDOBS OR DrMTJON PROM R3gUIIOla16M5 D3 ABLEBPATBLAWBANDASM"J M MA 81t1sefO�ifaeh AND �1 �N9�5 0'- -�_S_CiI M ■h F94249 SNFET 3 of 3 o GEN URAL NOTES GUS G lean T Ii+ 1 1. M@SIGN Id AR& LIVE LOAD - 30 I.B. FLOOR LIVE LOAD - 40 PSF WIND LOAD - BD MPH EXPOSURE -C- SEISMIC ZONE -L' •XP SNOW LOAD ICO PSF (SEE NOTE /15) 2. THIS FOUNDATION SYSTEM IS A DESIGNED TO BE CONSTRUCTED ON FA4LY LEVEL SITE WITH N7 EXISMG SOIL PROBLEMS. 3. CHASMS BEAM SUPPORIS SHALL BE LOCATED AID SIZED FOR THE LOADS AS SHOWN IN THE -MOBILE HOME OLSTALLATION INSTRJCTMNS'. 4. IN AREAS WHERE DIFFERENTIAL SETXEk1EHT (0 MANUFACTURED NONE SMALL SE READJUSTED WHESD• S EXCEEDS CURS ORr WHEN IT WILL ADVERSELY AFFECT MOBILE HONE UNIT, 5. ARE CARRY ALL FOOTINGS DOWN TO FIRM.GNED FOR 1. UNDISTJRBEO SOIL, FOOTINGS SHALL BE COMPATIBLE WITH QLFSF OCAL SOILCONDITI.ONSIL MPacTED AND SAND MAY BE USED TO FILL LOCAL VOIDS UNDER PA)S. E. STRUCTURAL STEEL: FABRICATED ACCORDING M AISC SPECIFICATION. WELD ACCORDING TO AWS SPEiSFICATIOJK. A36 BDLTS-SITE GR 5=ASTM A449 -ASTM ASELEELECTRODES-b70 PLATES -ASTM 7. THE GUS GWD ASSET MM SHOWN ON THIS PACE SHALL 8E USIED AND LABEUO By BZ AND ASSOCIATES FOR THE FCUMNO LOADS: ALUMNUX.r ; RORIZONTAL VERIYCAL GUS GUARD TUF-S CJS GUARD MGP PAD6000 2 OOy 6000 GJS GUARD E -Z TIE PAD 2200/ GDOC 8. OURIAG PRELIMINARY :11SPECTI3N, THE ESTIMATOR SHALL ENSUE THAPP ' • MOBILE NOME CHASSIS "AIS ARE OF STANDARD $MON. B. EXISTING COACHES MAY BE R1Tim RL@SlSEIS6UORCES BY INSTALLING OTS GUARD TUF-1 UNITSETROiAS SHOWNTO DM ST TIS PACE C FORMS TYPICAL FOUNDATION .PIANS, 10. THE CUS GUAM TUF-1 SYSTEMS ARE SAFE FOR INSTALATION IN FLOOD PLAIN AREAS WHEE CEPTH OF FLOODINC DOES HOT EXCEED THE HEIGW OF THREE FEET. Ill. MULTIPLE UNIT INSTALLATION IS ACCEPTABLE PROVIDED THE NUMBER OF TUF-1 UNITS UNDER EACH UNIT IS THE SAME AS SAOWN REQUI3ED PER EACH UNIT. 12• SINGLE -WIDE UNITS REQUIRE ALDITMNAL RESTRAIVT. • (SEE SWEET 13. ALL FETAL COWONQITS AHD AITRCHMENPS ITEMS SMLL BE PROTECTTYE COATED 14. WHEN CONCRETE .SLAB IS IN EXISTANCE. PAD IS NOT REQUIRED. ANCHOR STAND TO 16. FOUN)ATION BLOCKS 16'x 18"XTY POURED IN PIACE AT GROUND LLVEL MAV 8E USED AT WTALLFRS DISCRETION ALERH4WE TQ PAN. E SINGLE 2' MINE COACHES AMAX.s DOUBLE/MULTIPIF COACHES S= 6' MIN. %16' MAXc- 2. M'N' / i t , MAX. - 6 MIN./ 22 MAX. VARIES 1C'-70' (SEE TABLE ON SHEET 83) E S S r— S uU ❑ ❑ RIDGE BEAM SUPPORT AS a `REQUIRED BY�wC� �RER 0 E3 Cl P:T ❑ ❑ ❑ 8NOM. 2 NOM• ❑ PADS IN ANY PAIR MAY BE STANDARD M.H. FOUNDATION ROTATED 00 DECREES Oi jGINEEXRSAS RECOMMENDEDBYOFFSET i0 OTHER E MANUFACTURER OP THEAVON) CLEARANCES. TYPICAL TIIFOUGNOUT 'a SOF CALM FOUR (4) 1/2-1 3 1/2- EVA%ma"LIL no NSI011 WC1DRS. WITH TUE'–� PERMeNFtvT IS. GUS GUARD NF=L FOUNDATION SYSTEM( ,"VIDESALLOFOIN STALLM UNDATION SYSTEM WITH SEXISTWO S3LE SNOW TANDARDS REQUIRED AD TO tQQ pSr �BY COACH F.Ad%nA%-- CO.OU9GUAJWCohPANyMANUFACTURER OR WpLACE THEM ON A ONE TO WMN-PERIM ROAD ONE BASIS, _ STATE APPROV E L PVC SERIES PAID f TRYTP) lFAWACRgDV*MLWOMmoW RBAL7AAi/D��TfON srST81f APNOVIa t&am cm BC7f�FRjf91 BuwacrTDCOnaC y09y� AtPROVAt OOBBIRO'tw � OA11tS10te;B Qa DByAflp�p pRpM ��� . . APPLTCABLB 61A381AWB AINDZOMAM.t AM latpMaj��L 4i SPA No._j9U-f F WO" %-Wu Jest -e"31 J FAX: (s1-3) 3a3-5207 WAYNE T. POLVADO, PE -LISTING N0. F942a9 SHEET 2 or 3 • Faw Fab/[FaFa4 0L:40 0 �tvaoa.��c� t c ►Niv o � �Aa � V1 • p a rn rr N �o 1 A7'X fOt . P C� 4 O P� s HIA m m in 86 moz I ' B IN 4m MMME ZONE ONLY (30f ONLY) WUMM PAR AND 1{IDDLE ZONES 60 S OR ABD1fE HBt Rl Siff Rg1UP;fD IDS pFIER (� R) PM ltiS) t400 P5F iwe !4 PfR F0 IM WE MRiD (SB IN) Fn rom SI p0i � � � IN.) 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Assessor's Parcel Number 2 © 2-1 El F21 — 12 1Z � Scale: 1" = 611- 6 7 Owner ilame -&- pz, a, Address/ Phone No. 6, An 1jva dn o f - Site Location 14, !-1 K! I 3 FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres i 4.Oao PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: Villa 2700 1404 SQUARE FEET * 2 OR 3 BEDROOM * 2 BATH OPTIONAL Q BEDROOM 3 52'-0' t #-- 9'-7' MODEL 52001F 10'-9' Ad"& .. — 00C Q;xE Q m B C W ■■ : - MEMO■■ 1 II i►■r ii i■■► /'11 ��©■ ■�1 _ 11 • T,11 ,7 I — n•n a L 02b -MASTER BEDROOM IJ\(ING ROOM #-- 9'-7' MODEL 52001F 10'-9' Ad"& .. — 00C Q;xE Q m B C W SITE PLAN REVIEW APPLICATION Date: 7 �q 4'� AP# 0,9- -70 17Y x Permit Number (if applicable) Q.�_— i7 d APPLICANT INFORMATION � �� Parcel Size: Owners Name: t ' �' SOy_) Owners Address: '? C/o Telephone No.: 9/9-676 `f Situs Address: b__)j Proposed Use: Residential New Single Family Residential Single Family Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ Commercial Remodel ❑ New Industrial ❑ Industrial Addition ❑ Industrial Remodel Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) M C14 9S_e�57 Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ® Site Plan Stamped Approved* By Date �S Page 1 of 5 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) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: X • Flood Panel No.: � f 7 - C Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment -Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: /�-5 Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 I. Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear 5� ( 1 Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 I. Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ 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 Date of Creation: Deed of Reference: Parcel Frontage on Publicly Maintained Road: Complies with County Stand ds for Deed Cre Comments: lel p r—d , ,( -7 dot70- 0 ,�� Legal Access Provided: ❑ No ❑ Yes Legal Access Required ❑ No ❑ Yes ❑ No ❑ Yes, Road Name: kion: F] 110 ❑ Yes n n / Parcel Deemed to be legal ❑ Verify Legal Parcel '❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 ❑ Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Page: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development.. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for roa u Page 4 of 5 0 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. CALarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005-0039439 Recorded I REC FEE 10.a Official yRecords I CoButteof i CO�tORKEO COPY 1.Q CWCE J. GRUBBS I County Clerk-Recorderl I I CP 011:43M 07 -Jul -2005 I Page 1 of 2 (III ISI II" ('I' I II I I�II�I II �I II III 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 situate in the County of Butte, State of California, described as follows: Date �/35/0-s PROPERTY OWNERS: 0 State of California County persunauy appeareu 1`IfNi-ald N . 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. WITNESS in a d and officT'l s Si natur � Seal: g T PENNY C. ENG(AND Commission 11465804 b NCJootm PuuueiCc�C,arylibmia A.P. (�- %D- 7�� m. Exp. JAI�f 27, 2008 G2 r EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS: PARCEL •A: A portion of Section 31, Township 18 North, Range 5 East, M.D.B.&M., County of Butte, State of California being: Parcel C per Waiver of Parcel..Map for Assessor's Parcel Numbers 27-23-47 and 28-27-150,6s approved for Louis M. Duncan April 27, 1978, more particularly described as follows. Parcel 2, as shown on that certain Parcel Map recorded in the Office of the County Recorder of the County of Butte, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. EXCEPTING THEREFROM all oil, gas and other hydrocarbons and minerals heretofore reserved to the grantor named in that certain Deed from Bank of America National Trust and Savings Association, a national banking association to F. H. Thomas and Mattie E. Thomas, his wife, Joint Tenants, dated May 14, 1943 and recorded June 18, 1943, in Book 314 of Official Records, page 152, records of Butte County, California, together with all the rights and privileges of the grantor in said deed set forth with respect to said oil, gas and other hydrocarbons and minerals. Said oil, gas and minerals were quitclaimed to a depth of 500 feet from the surface by document recorded January 11, 1979, in Book 2361 of Official Records, pages 410 through 418, Butte County Records. Parcel B: A 60 foot non-exclusive road and public utilities easement lying 30 feet on either side of the following described centerline: Commencing at the centerline of Bangor Park Road at a point from which the North quarter corner of Section 31, Township - 18 North, Range -5 East, M.D.B.&M. bears North 370 18'50" East, 1169.08 feet; thence South 321 40'02" East, 36.78 feet; thence along a curve to the right having a radius of 200 feet, a central angle of 370 2559", and an arc length of 130.67 feet; thence South 040 45' 57" West, 790.43 feet; thence along a curve to the left having a radius of 1500 feet, a central angle of 030 55'24", and an arc length of 102.71 feet; thence South 000 50'33" West, 548.62 feet; thence along a curve to the right having a radius of 600 feet, a central angle of 620 46' 27", and an arc length of 657.31 feet; thence South 630 37' 00" West, 2196.30 feet; thence along a curve to the right having a radius of 400 feet, a central angle of 34' 23'00" and an arc length of 240.04 feet; thence non -tangent to the preceeding curve South 30° 09' 26" East, along the line between Parcels A and B, per said Waiver 1323.90 feet; thence leaving said line North 890 13' 06" East, parallel with and 100 feet Northerly of the South boundary of Parcel B, 951.04 feet to the Westerly boundary of Parcel C per said Waiver at a point from which the Southwesterly corner of said Parcel C bears South 050 26' 36" West, 100.59 feet. Parcel C: A 60 foot non-exclusive public easement for ingress and egress and public utilities as shown on that certain Parcel Map recorded in the Office of the County Recorder of the County of Butte, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. e SITE PLAN REVIEW APPLICATION(, Date: i B AP# Permit Number (if applicable) Bin Number APPLICANT INFORMATIONPeel Size: 1 - . Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: Residential ❑ 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 ❑ Industrial Addition Other ❑ Septic ❑ Agricultural Exempt Building ❑ Other: ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A DEVELOPMENT SERVICES INFORMATION (For Staff Use) E Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Approved R By Date A15 paaP 1 of S 69,x_ 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) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: • Flood Panel No.: Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the Califomia 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: 11 J 5 6P—QP— Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 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) r * 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 In Deeds: Date of Creation: % 2 f� 7 Legal Access Provided: ❑ No ❑Yes Deed of Reference: ILegal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road:. ❑ No ❑ Yes, Road Name: Complies with County Sta ards fo Deed eation:❑ No ❑ Yes Comments: kja c >� -- 7 0'a8 - 2-76- OSS . Parcel Deemed to be legal ❑ 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 Page 3 of 5 Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Page: 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. C ❑D Page 4 of 5 0 0 V 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. CALarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 ,✓` '.s>*` - 'eat". - -t-Loa Adh fy 'Ouffe &0un Je �.f LAND OF NATURAL WEA -LTH AND BEAUTY DEPARTMENT OF PUBLIC WORKS CLAY CASTLEBERRY, Director 7 COUNTY CENTER DRIVE, OROVILLE, CALIFORNIA 95965 Telephone; (916) 534-4681 H. W. McDONALD Deputy Director July 27, 1978 Peter Bradley RE: A 28-27-52 2553 Tait Oaks Blvd., .Suite Ill AP. 28-27- 9 Sacramento, California 95825 Dear Mr. Bradley: At the regular meeting of the Butte County Subdivision Violation Committee held July 26, 1978, the committee has removed the possible violation on the above -identified subject beca-2se you 'lave completed the conditions on your waiver application for AP 27-23-46 and 28-27-149. Should you have any questions concerning this matter, please contact this office. Very truly yours, 0 Clay Castleberry Director of Public Works _ Li)JA A-An"o".— Joh Mendonsa Assistant Director JJX:ds1 --rc: Planning Department Health Department Building.Department A! SITE PLAN ..•••••:................ . ........... .. .. .. .. ....................... .. .. ............ .. ............. .. ............ ............ :............................... .. ... .. .. .. .. .. ... .. .. ... .. .. ... ........................ .. }; .............. .. ............. .. .. .. �f ... .. .. .. _ ... .. .. .. ... .. .. .. .. .. ... .. .. .. ......................... .. .. .. ... .. ... .. .. ... .. .. .. .. 1. �:�.. _ .. .:.. !y ..................` - - .. .. j... ............................................................. ... {ppm .�....:._..... .. .. ............. .. 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FOR OFFICE USE ONLY PROVIDE FOR ALL ADJACENT PARCELS Zoning: SIZE (AC): General Plan Desig: ZONING: Size, Acres GEN PLAN: 4.0o° i r USES: RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 COPY of Document Recorded 7 -Oct -2005 2005-0061178 Has not been compared with original BUTTE COUNTY COUNTY RECORDER SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. HAROLD DICKERSON REAL PROPERTY OWNERILESSOR 34035 COUNTY RD. 2S MAILING ADDRESS WOODLAND YOLO CA 95695 CITY COUNTY STATE ZIP 207 WEEDY WAY INSTALLATION MAILING ADDRESS, IF DIFFERENT BANGOR BUTTE CA 95914 CITY COUNTY STATE S ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY ' COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY. CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 05-1781 530 538-7541 UI7NG PERMIT VN TELEPHONE NUMBER ATURE OF LO L AGENCY OFFICIAL DATE TOM'S MOBILE AND MOTOR DEALER NAME (if not a dealer sale, write "NONE") DL91097 DEALER LICENSE NO THE KARSTEN COMPANY 2005 KS52001F MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME NUMBER KC-CA-01-K32456A/B 52 X 13'6" RAD1430495/6 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) UAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 028-270-174 HCD FORM 433(A) REV. 8/91 a. escrow No.: 04 -1000472 -BJ Locate No,: CAFNT0958-0957-0001-0000410471 Title No.: 04-410471 EXHIBIT ""A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS: PARCEL A: A portion of Section 31, Township 18 North, Range 5 East, M.D.B.&M., County of Butte, State of California being: Parcel C per Waiver of Parcel Map for Assessor's Parcel Numbers 27-23-47 and 28-27-150, as approved for Louis M. Duncan April 27, 1978, more particularly described as follows: Parcel 2, as shown on that certain Parcel Map recorded in the Office of the County Recorder of the County of Butte, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. EXCEPTING THEREFROM all oil, gas and other hydrocarbons and minerals heretofore reserved to the grantor named in that certain Deed from Bank of America National Trust and Savings Association, a national banking association to F. H. Thomas and Mattie E. Thomas, his wife, Joint Tenants, dated May 14, 1943 and recorded June 18, 1943, in Book 314 of Official Records, page 152, records of Butte County, California, together with all the rights and privileges of the grantor in said deed set forth with respect to said oil, gas and other hydrocarbons and minerals. Said oil, gas and minerals were quitclaimed to a depth of 500 feet from the surface by document recorded January 11,1979, in Book 2361 of Official Records, pages 410 through 418, Butte County Records. Parcel B: A 60 foot non-exclusive road and public utilities easement lying 30 feet on either side of the following described centerline: Commencing at the centerline of Bangor Park Road at a point from which the North quarter corner of Section 31, Township 18 North, Range 5 East, M.D.B.&M. bears North 370 18'50" East, 1169.08 feet; thence South 320 40' 02" East, 36.78 feet; thence along a curve to the right having a radius of 200 feet, a central angle of 370 25' 59", and an arc length of 130.67 feet; thence South 04° 45' ST' West, 790.43 feet; thence along a curve to the left having a radius of 1500 feet a central angle of 030 55'24", and an arc length of 102.71 feet; thence South 000 50'33" West, 548.62 feet; thence along a curve to the right having a radius of 600 feet, a central angle of 620 46' 27", and an arc length of 657.31 feet; thence South 63° 37' 00" West, 2196.30 feet; thence along a curve to the right having a radius of 400 feet, a central angle of 340 23'00" and an arc length of 240.04 feet; thence non -tangent to the preceeding curve South 300 09' 26" East, along the line between Parcels A and B, per said Waiver 1323.90 feet; thence leaving said line North 890 13' 06" East, parallel with and 100 feet Northerly of the South boundary of Parcel B, 951.04 feet to the Westerly boundary of Parcel C per said Waiver at a point from which the Southwesterly corner of said Parcel C bears South 05° 26' 36" West, 100.59 feet. Parcel C: A 60 foot non-exclusive public easement for ingress and egress and public utilities as shown on that certain Parcel Map recorded in the Office of the County Recorder of the County of Butte, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. Initials: • % - - BUILDING PERMITS NUMBER: 05-1781 Address or location of unit: 207 WEEDY WAY BANGOR, CA 95914 Legal Description of Real Property: 028-270-174 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: HAROLD DICKERSON Owner's address: 34035 COUNTY RD. 2S WOODLAND, CA 95695 INSIGNIA OR HUD NUMBER: RAD1430495/6 SERIAL NUMBER OR V.I.N.: KC-CA-01-K32456A/B MANUFACTURER'S NAME: THE KARSTEN COMPANY YEAR: 2005 OFFICIAL APPROVING INSTALLATIO DATE: �'A3 - CIO PHONE: (530) 538-7541 H.C.D. 513C Lr - /1 STATE OF CALIFORNIA NUMBER: AGENCY -60 16 • � I DEPARTMENT OF HOUS NG AND CSPORTATION OMMUNITYI DEVELOPMENT 874107 %� • DIVISION OF CODES AND STANDARDS V 7 `! 1 0 7 MANUFACTURED HOUSING PROGRAM MANUFACTURER CERTIFICATE OF ORIGIN DISTRIBUTION: ORIGINAL (PINI) FORWARD TO THE INVENTORY CREDITOR UNLESS THERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 95812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER HCD 483.0 - Side 1 - (7/97) ❑ CHECK IF THIS IS A DUPLICATE MCO -ENTER ORIGINAL MCO NO. MANUFACTURED HOME OR MULTI -UNIT MANUFACTURED HOUSING NUMBER OF L MFO ❑ MUMH MANUFACTURED HOUSING TRANSPORTABLE SECTIONS (SINGLE FAMILY DWELLING) (MULTI -UNIT COMMERCIAL COACH: OCCUPANCY GROUP _ MANUFACTURER NAME: MANUFACTURER LICENSE NUMBER: THE Y.AP.STEN COMPANY 90153 MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE: 9995 OLD PLACERVILLE ROAD SACRMIENTO CA 95827 91,040.00 Street Ci StatB zip) MANUFACTURER TRADE NAME: MODEL "NAME AND/OR NUMBER: DATE OF MANUFACTURE: VILLA KS52001F 08-17-05 NAME OF DEALER OR TRANSFEREE (OWNERSHIP TRANSFERRED TO): CALIF. DEALER NUMBER OR DATE OF TRANSFER: 1OM! C MOBILE LYV MOTOR TRANSFEREE DESIGNATION: DL9109 7 08-31-07 DEALER OR TRANSFEREE ADDRESS: 6366 LINCOLN BL•ZTD OROVILLE CA 95965 street Ci state(zip) INVENTORY CREDITOR NAME: INVENTORY CREDITOR ADDRESS: street City state (r SECTION MANUFACTURER SERIAL NUMBER HCD INSIGNIA OR HUD LABEL NUMBER LENGTH WIDTH WEIGHT 1.6 INCHES INCHES (POUNDS) 1 KC—CA-01—K32456 A. RAD 1430495 624 163 28080 2 KC—CA-01—K32456 B RAD 1430496 624 162 28080 TRANSPORTER NAME: BENNETT TRANSPORT TRANSPORTER ADDRESS: P. Ce BOK 569 MC DONOUGH GA 30253 Street C' State DESTINATION FOR UNIT DESCRIBED ABOVE: TOM'S MOBILE 6366 LINLOLN BlUvD OROVI.LLF CA 95965 NAME Street C" State(zip) I candy under penalty of perjury under the laws of the State of Catitorm that the above facts are true and correct. Executed on 08-31-05 at SACRAJtiENTO SACRAMENTO CA (Date) (City) (County) (State) SIGNATURE OF AUTHORIZED AGENT: DISTRIBUTION: ORIGINAL (PINI) FORWARD TO THE INVENTORY CREDITOR UNLESS THERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 95812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER HCD 483.0 - Side 1 - (7/97) TOF STATE OF CALIFORNIA NUMBER: BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT O • DIVISION OF CODES AND STANDARDS Q 41074 MANUFACTURED HOUSING PROGRAM n oe►� MANUFACTURER CERTIFICATE OF ORIGIN DISTRIBUTION: ORIGINAL (PINI) FORWARD TO THE INVENTORY CREDITOR, UNLESS THERE IS NONE. THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 85812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. ❑ CHECK IF THIS IS A DUPLICATE MCO -ENTER ORIGINAL MCO NO. MANUFACTURED HOME OR MULTI -UNIT MANUFACTURED HOUSING NUMBER OF L MFD (SINGLE FAMILY DWELLING) ❑ MUMH (MULTI -UNIT MANUFACTURED HOUSING TRANSPORTABLE SECTIONS COMMERCIAL COACH: OCCUPANCY GROUP v MANUFACTURER NAME:-- MANUFACTURER LICENSE NUMBER: THE YAPS 'Fra' COMPANY 903-53 MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE: 9998 OLD PLACERITILLE ROAD SACPWIENTO CA 95827 91,01$0.00 street C Stag MANUFACTURER TRADE NAME: MODEL NAME AND/OR NUMBER: • DATE OF MANUFACTURE: VILLA KS5200 F 08-17•-05 NAME OF DEALER OR TRANSFEREE (OWNERSHIP TRANSFERRED TO): CALIF. DEALER NUMBER OR DATE OF TRANSFER: TOWS MOBILE AND MOTORDL9109 TRANSFEREE DESIGNATION: 7 0E-31-05 DEALER OR TRANSFEREE ADDRESS: 6366 LINCOLN BLVD OROVILLE CA 95965 scree C state (z INVENTORY CREDITOR NAME: INVENTORY CREDITOR ADDRESS: Street C' State SECTION MANUFACTURER SERIAL NUMBER HCD INSIGNIA OR HUD LABEL NUMBER LENGTH WIDTH WEIGHT 1-6 INCHES INCHES (POUNDS) 1 KC—CA-01—K32456 A 4 RAD 1430495 624 163 20080 ;c KC—CA-01—K32456 B RAM 1.430496 624 IL62 28060 TRANSPORTER NAME: BENNETT TRANSPORT TRANSPORTER ADDRESS: P. O. BOX 569 MC LONOUGE GA .30253 steel C' State (zip) DESTINATION FOR UNIT DESCRIBED ABOVE., TOMOS MOBILE 6366 LINCOLN BLVD ORO-VILLE CA 95965 NAME Steel C' Stets 1 cwt dy under penally of pw"y under the Ims of the State of CaW=m Mal the above faele aro true and CM, Exewtedan 0831-05 SACRAME-NTO SACRAMENTO CA (Date) (City) (County) (State) . `,. F;,./ •-...� arm, �, SIGNATURE OF AUTHORIZED AGENT: DISTRIBUTION: ORIGINAL (PINI) FORWARD TO THE INVENTORY CREDITOR, UNLESS THERE IS NONE. THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 85812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. • � I�III') ��ll�� �li�'( RECORDING REQUESTED BY: IIII1����) III) Fidelity National Title Company of California 120 0 4125 0 7 7 9 1 S Escrow No.: 04-1000472-B] Locate No.; CAFNT0958-0957-0001-0000410471 Recorded I REC FEE 10,00 OfficialRecordsI TAX 60.50 Title No.; 04-410471 CoPUTTOf When Recorded Mail Document E CANDACE J. GRUBBS I and Tax Statement To: Recorder I Mr. Harold A. Dickerson ROSEMARY DICKSON I Assistant I Lisa 09:00RM 22 -Dec -2004 I page 1 of 2 APN: 028-270-174 SPACE ABOVE THIS UNE FOR RECORDER'S USE GRANT DEED The undersigned grantor(s) declare(s) J� Docume tary transfer tax is $60.50 [ i 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, Debra D. Burns, also known as, Debra Burns England hereby GRANT(S) to Harold A. Dickerson, a single man 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: December 16, 2004 STATE OF CAL f R J.P - COUNTY OF (J ON t 2 Z OQ before me, t d i n Public personally appeared (=� personally known. to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose names) 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(sj, or the entity upon behalf of which the person(s) acted, executed the instrument. Witness my hand a I al. Signature MAIL TAX STATEMENTS AS DIRECTED ABOVE FO -213 (Rev 7/96) GRANT DEED (grant)(09-04) . E. MEFFORD 0COMM. A 1333947 NOTARY PUBLIC-CALIFORNIAUI SOLANO COUNTY 0 COMM. EXP. DEC. 9, 2005'` Witness my hand a I al. Signature MAIL TAX STATEMENTS AS DIRECTED ABOVE FO -213 (Rev 7/96) GRANT DEED (grant)(09-04) . Escrow No.: 041000472 -BJ Locate No.: CAFNT0958-0957-0001-0000410471 Title No.: 04-410471 EXHIBIT "'A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE UNINCORPORATED AREA, COUNTY OF BUTTE, STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS: . PARCEL A: A portion of Section 31, Township 18 North, Range 5 East, M.D.B.&M., County of Butte, State of California being: Parcel C per Waiver of Parcel Map for Assessor's Parcel Numbers 27-23-47 and 28-27-150, as approved for Louis M. Duncan April 27, 1978, more particularly described as follows: Parcel 2, as shown on that certain Parcel Map recorded in the Office of the County Recorder of the County of Butte, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. EXCEPTING THEREFROM all oil, gas and other hydrocarbons and minerals heretofore reserved to the grantor named in that certain Deed from Bank of America National Trust and Savings Association, a national banking association to F. H. Thomas and Mattie E. Thomas, his wife, Joint Tenants, dated May 14, 1943 and recorded June 18, 1943, in Book 314 of Official Records, page 152, records of Butte County, California, together with all the rights and privileges of the grantor in said deed set forth with respect to said oil, gas and other hydrocarbons and minerals. Said oil, gas and minerals were quitclaimed to a depth of 500 feet from the surface by document recorded January 11, 1979, in Book 2361 of Official Records, pages 410 through 418, Butte County Records. Parcel B: A 60 foot non-exclusive road and public utilities easement lying 30 feet on either side of the following described centerline: Commencing at the centerline of Bangor Park Road at a point from which the North quarter corner of Section 31, Township 18 North, Range 5 East, M.D.B.&M. bears North 370 18' 50" East, 1169.08 feet; thence South 321 40' 02" East, 36.78 feet; thence along a curve to the right having a radius of 200 feet, a central angle of 370 25'59", and an arc length of 130.67 feet; thence South 040 45' 57" West, 790.43 feet; thence along a curve to the left having a radius of 1500 feet, a central angle of 030 55' 24",.and an arc length of 102.71 feet; thence South 000 50'33" West, 548.62 feet; thence along a curve to the right having a radius of 600 feet, a central angle of 620 46' 27", and an arc length of 657.31 feet; thence South 63137' 00" West, 2196.30. feet; thence along a curve to the right having a radius of 400 feet, a central angle of 340 23'00" and an arc length of 240.04 feet; thence non -tangent to the preceeding curve South 300.09' 26" East, along the line between Parcels A and B, per said Waiver 1323.90 feet; thence leaving said line North 890 13' 06" East, parallel with and 100 feet Northerly of the South boundary of Parcel B, 951.04 feet to the Westerly boundary of Parcel C per said Waiver at a point from which the Southwesterly corner of said Parcel C bears South 05° 2636" West, 100.59 feet. . Parcel C: A 60 foot non-exclusive public easement for ingress and egress and public utilities as shown on that certain Parcel Map recorded in the Office of the County Recorder of the County of Butte, State of California, on March 11, 1983, in Book 92 of Parcel Maps, at page 43. Initials: r NOTES RESIDENTIAL PERMIT NO. ' ff 8-270-174 OS-1781ICKERSON, HAROLD i� �4�P�`f b'dAY, OR9�t,LE .6ie.,r� Cont: TRUITT GROUP (NE M/H'PERM FND j • F �J 2_p? WGeo 9 OFFICE COPY Address L ( ��'�✓'�'/ % GAS Meter By Date Q ELECTRIC p / Meter By ` Date SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER Iry �o w ey . A P i VI 'JOB FINALED (Date) Signature J J=ow , 0= Not OK _ = Not ReadyApplicable BILE HOMES . =Not Ready Date } MOBJtE HOME UTILITIES (Plans) OK except #'s 2. Soils; Special MH Support Sketch - 3. Sdwer, Location -Test -Fall -C/O -Concrete to , Location -Test -Easement Needed (Sketch) Ele tricity, Location-Clearances-Gmd-/ /Amp -Concrete as; Location -Test -Wrap; -/,5 P' L -ft. / P Nat or/ / L -ftJ � /-LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date LtJ �p Card B-1 Date Card B-1 Date Card4-1 Date Card B-1 Date MOBIWE HOME INSTALLATION (Plansi OK exceot #'s P: Wings; Size -Spacing -Marriage Line a"s; MH Test -Demand -Valve -Connector MH Test -Crossovers -Breakers -Clearances S. &h n; MH Test -Fall -Flex Connector 8' W ter; MH Test -Reg lator-Connectoe 7. at¢r'and Sewer. nnected-C/O to Grade -HD Approval as and Electriqfy Tagged Sr Yie Downs -Type -Installation Cert. 1 Exits; Insp.-Sketch 11. Cert of Occupancy Date Card B-1 Date Card B-1 Date ItCard B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date 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 1 Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 (IDate ,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 -GA 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 -4=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. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Ming -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation Date 16. Insulation 47. Hangers -Post Caps -Anchors -Connectors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) .OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors Date 26. Size Boxes & No. of Conductors Stapled Date 27. Romex Installed Close to Edge of Studs & C.J. Date 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or Al -Oven Circ. / /ga Cu or AI Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 71. Fireplace or Stove, Clearance -Hearth Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. AC. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-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 AFlue-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.; Bec. & 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 InstldJDrive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: 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. , BP051781 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 08/11/2005 APN: 028-270-174-000 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. 3 Site Address: 207 WEEDY WAY BAN License Class : I License Number: 7 n Date: -Contractor: /Ru fTT 11-2 Map Index: Description: NEW MH ON PERM FND(1512) 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 gily or county which requires a Owner: DICKERSON, HAROLD permit to construct, alter, improve, demolish, or repair any structure, prior 34035 COUNTY RD. 2S to its issuance, also requires the applicant for such permit to file a statement that he or she is licensed pursuant to the provisions of WOODLAND, CA. signed the Contractor's State License Law (Chapter 9 commencing with Section 95695 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Applicant: TRUITT GROUP intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 417 STIMPSON ROAD such work himself or herself or through his or her own employees, 95965 provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one (530)521-6449 year of completion, the owner -builder will have the burden of proving that he or she_did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business Contractor: TRUITT GROUP and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed 417 STIMPSON ROAD pursuant to the Contractors' State License Law.). 95965 ❑ 1 am Exempt under Article 3 of the Business and Professions Code (530)521-6449 Date: owner: License #: 771326 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 Engineer: is issued. ❑ 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: S-rATE U fel) D Total Square Ft: 1512 S.F. Valuation: $98,280.00 Pony #: 0 D 6 b 3 a 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' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: - Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one n� / / / (A GGG f� oL/ 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. ( / /` ) i,i�a _ -q (''hereby CONSTRUCTION LENDING AGENCY This permit i issuedSuntoeeapplicable provisions of the Butte Countty Code and/or to do work.indvfor which fees have been paid. I hereby affirm that there is a construction lending agency for theResolution performance of the work for which this permit is issued (Sec 3097 Civ.) ( Date: ZJ )5 B Name: %_ ) 2� � 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 for document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: _,t S tq Signature: h Date: $�f / / 0 5 ❑ Owner ❑ Contractor ❑ Agent for Owner Agent for Contractor I 0.01A;n D. -it ni_i a -nn AA i /V'r�'�. BUTTE COUNTY o " 0 DEPARTMENT OF DEVELOPMENT SERVICES 0 0 BUILDING PERMIT APPLICATION 0 0 AND SUBMITTAL REQUIREMENTS o A 0 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 _0 OFFICE #: (530) 538-7541 c0U Nay A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION **PLEASE PRINT CLEARLY** APPLICANT NAME OWNER Last Name i City0rc?L; P_e First Name res 3sCo 2 J �9-S City O L State ZiPLI Phone Fax E-mail E-mail APPLICANT NAME CONTRACTOR Name City0rc?L; P_e Address I SRA City L�. State Zip�S�b. -Phone Subdivision Name fa S3 3-6) b E-mail %R Lia. # t a b Class1 APPLICANT NAME ARCHITECT/ENGINEER Name City0rc?L; P_e Address I SRA City Fax - 770 State Zip Phone Subdivision Name Fax E-mail Page State License Number APPLICANT NAME Na Address 10 L J e-4':>-' City0rc?L; P_e State I SRA Phone3'�(7 10' Fax - 770 E-mail Al 14- �.APPLICANT SIGf4ATURE For office use WT. 27 Zoning - City (Trout �� Flood Zone I SRA JLYes21 No Occ. LENDING AGENCY Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BPp S/7 BIN # LOCATION Property Ad ress C -e -i I.vA City (Trout �� Cross Street edj L� n WORKER'S COMPENSATION Policy Number Carrier _ If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY -Nam l Address Description or Scope of Work: �-v-uwrcl Ov✓� Sq. Footage ❑ Structureuilt without P its ❑ Proposed C ange of Occupancy (Note previous use): Page 1 of 2 EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received b Amount: 2 I D Bldg V-! �d g�SRA Receipt #: Sheriff SMIP Other Date: /�] �� ( Total REV 7-27-04 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. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and 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. t Hazardous Material Form (for Commercial Buildings only). _0 --13.S.anitation-md-site plan-appiovaLfrom_the_EavironentaLH.ealth-Depariment 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, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application 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 7-27-04 �"'Ff+`t.,,Jia•vSd.FS'9w.Ni"5f«-'"+ir,�'fwe:n�K °.$,�.7 C',H... �,A ,S,... .,r c=_�:�,.'.�i' w� ,+`, ,, :- -74 P6��7�? COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET G /L (fig 6�N OWNER: ASSESSOR PARCEL NUMBER N f r NNvg •yzc- PPW !F -'O G '� -?-2--6:) - Proposed Building Use: / Permit Technician: Date: Items required in order to apply for.a permit. All boxes MUST be checked OR marked NA in order to apply. N 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 AIC for Non -Residential Buildings. (,1 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down orflans, 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 F must be stamped and wet -signed by the engineer. ❑ 10. Flbod.:Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form , / i1J 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ���Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable -jh!! j 16. Fire Sprinklers............................................................................................ 0 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 .............................. 20.......................................... ' ees as shown on the attached Schedule of Fees Due Sheet .............................. 21. City of Chico Plumbing permit........................................................................ \ ❑ X22: Site plan and business license approval from the Cit of 'ggs::....... :................. 23. California Department of Forestry plan approva paid. Sent 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............ \❑- 25. Contact Land Development about _ Improvements, _ Drainage ........................ `4r -J 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 ............... :.......................... \❑ rj 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... �d 31. Letter of Signature authorization.................................................................... t N 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits ................................. . ............. ❑ 34. Deed Restriction ........................................... gist ......................................: 35. Legal description, ❑ M.H. Title, title search, registrati n or MCO..........eu+ r...r.�! ❑ 36. Other: ❑ 37. Other: When issued Telephone N 370 36 and hold for pickup. I have been informed of the above items andlrequirements for obtaining a building permit. 717A Applicant:" Date: 1. Index pe(mit applicatio00 the above ite . s numbered: Plan Check Letter nal items required 4CoZnra*c*to , designer, owner, was advised of the above data by phone, ❑ mail, ❑ counter, by Date: r, 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, ba Date: Plans reviewed by: Date: ns approved by: Date: Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division `" 4 TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance k E.H. USE ONLY Plot Plan Anacho�— Floor Plan Attachod�— San% to ®.O. / Owner Location AP# Plan Approved for: Sewage Disposal X Water Supply: Public Private Well X Clearance for __L dwelling. Other 3 19,rd cltt)e,t 1'( nq Hold final for: Final clearance O.K. for: NOTE: nvironmental Health Specialist Date s/ss ��j/��5� W6 �__ ) ? & / r COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE; CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER l Ll e -(--72-56y\) A.P. # 2Zo /7 PROPROSED BUILDING USE ATE RECEIPT # DATE REC. 1. BUILDING PERMIT FEES w --- Balance Due ..................... $ , --- FEMA Flood elevation review ... $ --- Ad ' ' al plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Chec 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Com tial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. /— �(� f �4. RECREATION DISTRICT FEES / A 17 LZ�Q /G 1/(— 23"/ C�.S aid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FES COUNTY WIDE (per dwelling) $3// 7 — CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ H CHICO SPECIFIC PLAN (per. dwelling) Zoning SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200. 0 (paid at Building Division) 8. SMIP —� OTHER 10. OTHER 11. OTHER 7,7--(9 At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed du^ the plan checking pro,�ess. APPLICANT DATE 16 /0.5 Pursuant to Government Code Siction 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 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 Division Yellow -Applicant Pink -Owner (rev. 3/05) BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM �EATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (P,RPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) 0 2 5 —'Z70 7 / Building Permit Number /�P6 Property Owner (s)� Project Location /Address Subdivision Name Assessable Sq. Ftge Type of Residential Development (check one) New Development Single Family -Detached Single Family -Attached Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) erified by Building Department Comments: 0 FRRPD 0 CARD ❑ PRPD ❑ DRPD certifies that: ,9r. 3—)c),-� Applicant Name Phone Number 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: (7 Paid by Cash: Recreation and Park District Representative K:\FORMS\BUILDING FORMS\park-rec standard form rev Ldoc per unit for a total of $ d a • ow per sq foot for a total of $ Receipt No:. 1 T% ( O l� School District A.P. Number Property Owner I BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM e (Or* form per Building) bi 17 Jurisdiction: Q city Building Department No. I . Z:;--�J-C—ou-nty Property Location/Address Subdivision 9, Lot No. ...................... -57 Residential Development Q Q Sq. Footage No of Living MobileHomeAddition/ *Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation Inspecdon) .............................. .................................... . ........... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/industrial Sq. Footage New Addition (Including Exterior Roofed Areas) e-7— Building Depai��nt.Roipresentative Date District Identification No. 060030 6" School District certifies that 'A U 06 f -5� r\ (Applicant) . V3 e -es \-1 ��'c-- 1-f (Street Address) (Phone Number) (City) has complied with the requirements of Resolution No. representing School District 115 square feet. Paid by Check # Remarks: (State) (Zip Code) by payment of $ 33� U 1" 2926 $ PFULL MMGATION " 8 ))log' Date N.60ce: You nay protest the Imposition of the fen Identified above by submitting a written protest to the District, In compliance with Government Code Section 66020(a). within 90 days from the date fen are paid. Failure to submit a timely written protest will'prohlbit you from challenging On Imposition of the fen In any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certiftatlon Form, the School District Is -o"ll by the applicable Local Planning Agency" this project Is being reviewed under the California Environmental Quality Act (CECA), this p nj- r may be subject to additional school fen to fully midgalleAs Impact on the act" d1stricrs R Mi. White (applicant), Yellow (building department), Pink (school district) feeform.As (10/03)dmT