HomeMy WebLinkAbout017-050-0243K� �SEY
Plot Plan Att
Floor Plan Afta&ad
Sent to BDIDS
TO:. Building Division — Development Services
FROM: Environmental Health
SUBJECT: Sanitation Clearance
6 A 13 6 9 7 &54,111 A14,11 Rd 17 -666 -624
Owner Location AP#
Plan Approved for: Sewage Disposal: X Water Supply: Public Private Well
-4 ,,, � .1
Clearance for dwelling. Other zr-/,0VY 54eVi
,k A /,'/V r.,-71 e--16 2"?a/ flek/
Hold final for: f;cote— t
V
Final clearance O.K. for:
NOTE:
/o/
Environmental Health Specialist Date
Building Clearance 9/2005
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION '
Site Address: 13097 BEAN FLAT RD
Owner:
Permit NO: 06-1632
APN: 017-050-024
Issued Date: 09/22/2006 By KEJ
Permit type: RESIDENTIAL
Subtype: SFD-Custom/Model
Expiration Date: 09/17/2007
Description: NSF/GARAGE
Occupancy: R-3 Zoning:
Contractor
Applicant:
Square Footage:
OWNER
MICHAEL CLIFFORD
Building Garage Remdl/Addn
13097 BEAN FLAT RD
1,822 1,602
CHICO, CA
Other Porch/Patio Total
3,424
FEE INFORMATION
County Impact - SFD $2,244.02
Dwelling - Custom, Model $1,868.32
Fund 10 BLDG $1,355.53
Impact Processing Auditor $50.00
Impact Processing DDS $50.00
Res Impact Fees - SFD $2,005.09
SMIP - Residential $15.69 Total Charged: $7,683.65 Fees Paid: $7,683.65
SRA Fees $95.00 Balance Due: $0.00 Receipt No: B229
LICENSED CONTRACTOR'S DECLARATION
OWNER /-BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
OWNER / /
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractors 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];
Please eCc one of the following:
1 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.
X 09/22/2006
Contractor's Signature Date
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the 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 improvement is sold within one
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑ Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
❑ 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
The Contractor's License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Carrier: Policy Number: Exp. Date:
(This section nee not be completed if the permit is or one hundred dollars ($100) or less.)
❑ I AM EXEMPT under Section B. & P.C. for this reason:
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'X
09/22/2006
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
provisions.
Owner's Sign a Date
X 09/22/2006
-
I hereb certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
County to enter theabove mentioned property for inspection purposes. I hereby certify that I am the
prop? m riz d to act on the property owner's behalf.
09/22/2006
Ure Date
WARNIN AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
ANDS LL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS $100,000 , IN ADDITION TO THE COST OF COMPENSATION,
( )
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
ttee [SIGN] Print Date
�;70
Contractor OR; Agent for Owner ❑Agent for Contractor
FILE
Lender's Address City State Zip
. 2006-0048460
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
Recorded 1 REC FEE
Official Records I
County of I
Butte I
DWACE J. GR119BS_ I
County Clerk-Recorderl
I
I JC
99:" 19-seo-M I Pape 1 of 3
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 O' 'O io PROPERTY OWNERS -
State of California )
County
of Z>UNMCA , A` ,
On U '�V before me, �t 4 ` t� �IjA t C
personally appeared personally
known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) Ware subscribed
to the within instrument and -acknowledged to me that he/shelthey executed the same in his/her/their authorized
capecity(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) act executed the' instrument.
WITNESS my hand and official ml.
A.P.#
Seal: r JULIE JAMES
V COMM. # 13M507 ;
NOTARYPUBUC-CAUFDRNIAG)
s SONOPA COUNTY (i
COMM. EXP. JAN. I, 2M7
3
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.netldds
**PLEASE PRINT CLEARLY**
OWNER INFORMATION
La N��
eSS i t rlG 4 c
C'
vt K s Stat�,G ll/f��
Phone Fax
E-mail
ARCHITECT/ENGINEER
CONTRACTOR
Name
GvIZ�
`
Address
Ph a Fax
City
State
Zip
Phone
Fax
E-mail
Lic. #
Class
ARCHITECT/ENGINEER
Name.--
Addy
City
State
Ph a Fax
E-mail State License Number
APPLICANT INFORMATION
Name
Address
co
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
For o ce use only:
Zoning -
Flood ZoneSRA Yes No
Occ.
Type Const.
Subdivision Name
Map Book Page Lot #
Planner
Date Approved:
UvtK t`UK SUBMITTAL REQUIREMENTS 11
KAFORMSIBUILDING FORMS1BIdgApp1SubRgmts.doc Page 1 of 3
I PROJECT LOCATION
L-/ t I -U:
rty Address
d�17A 0,
Street
WORKER'S COMPENSATION
Policy Number
Carrier
PERMIT
NO.
1032
BIN # V I
ff hiring anyone other than license contractors=cerdficateof the timet pe
LENDING AGENCY
Name
Address
Description or Scope of Work:
b-nverl
Sq FT- Livino 1%9 Garage p pen Cov
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: V Amount: lF . ES Bldg
1 SRA
Receipt #:q SCb 1 l Sheriff
SMIP
Date:'/ /-(j t1
Other
1 � ' � ) Total
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) gR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer -clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑.
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees -for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSOUILDING F0RMS1BIdgApp1SubRgmts.doc Page 2 of 3 REV 8-12-05
I— ' " - ,,,h. 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
PERMIT APPLICATION DATA SHEET 8 P�
OWNER: ` `�O l \ ASSESSOR PARCEL NUMBER 0 1 1 - O j )
Proposed Building Use: e0l)V. PN 10 4S t/ W P11101 Permit Technician: Q. Date: / r1" MA
Ityriis required in order to apply fo a permit. All boxes MUST b checked OR marked NA in order to apply.
`e Z!Nl1 1. Site plan ! 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.
`d,ZN 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.
)3 ?N 6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate.
❑ 11. Hazardous Material Form
Z -N 12. Acknowledgement of building permit application without required clearances.
❑ 13. Other
ami Items needed to issue the permit. (May require additional plan review uponre,��eipt of the following items.) (�
Sanitation and site plan approval from the Environmental Health Department in`6.Chico ❑ Oroville, as applicableq
0 1r,. Fire Sprinklers.............................................................................................
❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ 17. Soils Report and/or Engineered Foundation required ...........................................
�o Erosion Control Plan Required........................................................................
9. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
❑ City of Chico Plumbing permit........................................................................ a U
21. Site plan and business license approval from the City of Biggs ..............................
/ 22. California Department of Forestry Ian approva��paid. Sent by: O
cv- 23. Planning approval for (A) Use: � (B) Parking: (C) Parcel Check:.......
❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................
25. Fire Marshall Review (commercial projects only). Sent by: ......................
Y_X N 26. NPDES Form.............................................................................................
1:127. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Contractor's license information. (Number, Name Style, Classification) ...................
V7-
29. Worker's Compensation Carrier and Policy Number .............................
.N 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .....................
❑/ 31. Letter of Signature authorization....................................................................
\0 lr2 Recorded copy of Agricultural Acknowledgment Statement .................................
❑ 3. 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 11c1 7 - �,o X -'5?) 1 q obi nw and hold for pickup.
I have been informed of the above items and rgguirements for obtaining a building permit.
Applicant
Date: % `
1. Index permit appli�a`i on fog
the ab v ,It 's nu ered:
Plan Check Letter
2. Additional iteaKre 'md-
Z
�1
d�
Contractor, designe caner,
s advi d o he above data by
phone, ❑mail, ❑counter, by
Date:
Contractor, designer, o
as advised of the above data by
❑ phone, ❑ mail, ❑ counter, b Date:
Contractor, designer, o r
Plans reviewed by:
advised of the abov d to by
Date: 5ZI JPCPlans
❑ phone, ❑ mail, ❑ cc r, by
approved by:
Date:
Date:
Structural reviewed by:
Date:
Structural approved by:
Date:
Note transfer by:
Date:
Yellow: Building Division
K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05
BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE, OROVILLE, CA 95965
www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140
RECEIPT OF FEES SCHEDULE - RESIDENTIAL
Owner CLIFFORD APN No: 017-050-024
App Date: 7/7/2006 Permit No: BP 061632
1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION
Plan Check portion of Permit Fee
2 FEMA RYes Flood Elevation Review $109.98
3 SRA* Yes Fire Plan Check - Non -Refundable $95.00
(State Responsibility Areal Building Inspection $109.98
NON-RFFUNDARLF nnrtinn of fppc riup at nnnlir-atinn
Permit Type: Subtype:�er11(��
Permit Desc: Off' RV -1l New
NSE D Wttrg
$3,113.87
$1,245.55 $1,868.32 Balance of Building Permit Fee
0
$95.00 $204.98
$109.98
C4 4AA SS
FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $1;450:53
FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT $6,233.12
$1,868.32
$15.69
RECEIPT DATE Tech/Asst
7/7/06 Kourtni
4
5
6
7
7a
8
Balance of Building Permit Fees (from No. 1 above)
SMIP* - Strong Motion Instrumentation Program (Enter amount from permit system)
Additional Plan Check Fees (NON-REFUNDABLE)
Other*:
Other*:
IMIjAL; 1 1-ttb - Kt51UtN I IAL" Per Dwelling Per Dwelling I Per Dwelling
Applications After 04/15/06 1 ac I SFD MMH
County 1 4249.111 3183.541 3238.72
Chico Urban Area 1 6146.23 4538.821 5648.44
EI Medio Fire District 3249.971 2385.761 2422.68
North Chico Specific Plan
12 SCHOOL DISTRICT FEES* I Chico Unified_School_District-062 I \ i 12a RECREATION DISTRICT FEES* Paradise— � L�_Cl /
At the 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 during the plan
checking process.
App ' n • Date: -7 ;7. Q G
Pursuant to Government e S n 660 u are hereby notified those Items followed by an "* may have been imposed on your project. You have 90 days
from the date of appr al of the porject o rom the impostion of the above referenced items during which you may protest. The requirements for a protest are
specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 041506
A SR -1, SR -3, SR-1/PD 8801.091 7395.041 8486.40
R-1 8897.09 7491.04 8582.40
'L0 R-2 8390.09 6984.041 8075.40
R-3 7604.091 6198.041 7289.40
RECEIPT DATE Tech/Asst
$4,349.11
Processing Fee is automatically added to impact fee total 1 $100.00
WATER TENDER FEE (Not collected when Impact Fees Applicable) Enter Bat.# $200.00
9
DRAINAGE FEES*
10
CHICO STORM DRAINAGE
770 Butte Creek $7,997
MASTER PLAN
771 Comanche Creek $8,341
772 Little Chico Creek $9,088
New construction, vacant
land, on 1 acre or less -
Enter 1 or less acre value
773 Big Chico Creek $6,776
RECEIPT DATE Tech/Asst
774 Lindo Channel $8,267
775 SUDAD Ditch $7,211
776 Mud -Sycamore Creek $6,275
777 PV Ditch $8,893
More than 1 acre, existing buildings - fees to be assessed by Public Works
10a
Fee Determination Sheet Needed - Enter amount determined by PW
11
THERMALITO DRAINAGE AREA 1 $684 Maximum
Per each new living unit on existing lots where full drainage fees have not been paid
Temporary Dwelling T $136 At time of building permit
11a
��
$136 annual renewal fee for first 4 renewals. Not to exceed $684.
PROOF OF PAYMENT OF FEES (BELOW) MUST BE RECEIVED PRIOR TO ISSUANCE OF PERMIT. Forms will be prepared after plan check
is completed for applicant to take to respective district office. i
12 SCHOOL DISTRICT FEES* I Chico Unified_School_District-062 I \ i 12a RECREATION DISTRICT FEES* Paradise— � L�_Cl /
At the 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 during the plan
checking process.
App ' n • Date: -7 ;7. Q G
Pursuant to Government e S n 660 u are hereby notified those Items followed by an "* may have been imposed on your project. You have 90 days
from the date of appr al of the porject o rom the impostion of the above referenced items during which you may protest. The requirements for a protest are
specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 041506
plAT SENT
TrF0Department of Public Works
/1 a°� C o u n t y o f B u t t e
I
�
�` ° I.
-Michael Crump, LAND DEVELOPMENT DIVISION
C o /f Storm Water Management Program
Director 7 County Center Drive
C (J N1 Oroville. CA 95965
Al IC �15 (530) 538-7266
(FAX) 538-7171
National 'Pollutant Discharge Elimination System (NPDES) Phase II
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1
Project Description:
]Project Location and/or Parcel Number: �0 9 �� �G✓���
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water
Permit 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:
7- C-2 ell,
L= than 1 Acre NPDES & SWPPP Compliance Certification
Tr
Butte County Department of'D S'erp ces 0 11,F0
tir..
7 County Center Drive ° �''��
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 ma or labor and material for construction of this proposed
property impro ement: YES .� 1 NO [ ].
2. I HAVE [K,/] AVE NOT [ ] signed an application for a building permit for the proposed
work-
3.
ork3. 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:
ork
NAME: _
ADDRESS:
PHONE:
CONTRACTOR' S LICENSE NO:
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME ADDRESS PHONE- TYPE OF WORK
SIGNED�� �
PROP TY 0 R G (
DATE: � z-- O
NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code.
, „ - _.._ -3 -- - ---- ..L
Butte County Department of Development Services Tr
ADMINISTRATION `BUILDING t GIS PLANNING o 0
p o
o o
7 County Center Drive
Oroville, CA 95965 0 =T —`��� o
(530) 538-7541 Telephone
(530) 538-2140 Facsimile CDU.��
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 Iiability 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 subjed
to several obligations including state and federal income tax withhaldmg, 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 cry out t these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or. through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be 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,
AY
Scott Rutherford
Chief Building Inspector
NOTR- This Owner -Builder Information is reauired by Section 19830 of the California Health and Safety Code.
�s REHS
SITE PLAN REVIEW APPLICATION
Date: AP#
Permit Number (i€ applicable) Bin Number
APPLICANT INFORMATION Parcel Size:
Owners Name: M ' e- " ° Jj Li e -.p
Owners Address:
Telephone No.: I o 7 S'n R IN/7
Site Address: 697 &�a Z
�
Proposed Use:
Zone:
Residential
GP:
New Single Family Residential
❑ Single Family Addition
❑ Single Family Remodel
BUTTE
❑ Mobile Home
0UNTY
❑ Residential Accessory
JUN 2 7 2005
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
DEVELOPMENT
❑ Temporary Travel Trailer
SERVICES
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
tAseptic
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation/Issue:
❑ Commercial Remodel
❑ Industrial Remodel
Well
Agricultural Buffer Form
DEVELOPMENT SERVICES INF'ORIMIATION (For Staff Ise)
10 Approved ❑ Conditionally Approved
mm a
❑ Resolve Problems Prior to Approval
❑ Resolved
Date 0�
2006
ALL ITEY,1S CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Williamson Act Minimum Acreage: ❑ Residence can be built per contract
❑
Watershed Protection Overlay Zone
❑ SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain:
o Flood Zone:
a 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 California Reclamation Board)
❑ North Chico Specific Plan
❑ Chapman/Mulberry
❑ Cohasset Area
Use Requires:
❑ Use Permit
❑ Variance
❑ Agricultural Worker;Afdavit
❑ Administrative Permit
❑ Minor Use Permit
❑ Minor Variance
Zoning: -20 General Plan:
IL—
Applicable Building Setbacks:
❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number: Date of Approval:
2
2006
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
r ,2-O
Side
Side Street
Rear
Height
Waterway
N/A
N/A
N/A
❑ Setbacks identified on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
❑ Use Permit/Minor Use Permit
Permit Number: Date of Approval:
2
2006
Parcel Created By:
Q Deeds:
Date of Creation: Legal Access Provided: ❑ No ❑ Yes
Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No ❑ Yes
Comments:
❑ 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
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
Is Subdivision Map/Parcel Map: �( q
Map Date of Recording: b" I(fI
2
Lot: 2 Book: l) 3 Page:
3 2006
OWNER'S
We, Eu..a. S. Clifford end Ba,b are A. Ci//ford a. ovnen of the land as shown
o1, Ina aa .... d map, endAmerlca. 51111111,, COmpaay, a cerparanao as trustee under
.-it o/ Trust recorded August 9. 1990 under Rune Calvary Recorders Serial Number
90-33939 sad as -one under
Dead al T ..i recorded under B111s County Records,. Serial Number
do hereby aerfify mar we are the only persons rhes. consent is
*...... ry to pods dear fill. to said lord and w. consent to the Preparation and
reaardslian of laid map a. shorn within the border linea. The 60' Road E ... meal
a, ,h..a oa sold map 1, h... by Offered for dedication Io the County o/ Bulla.
Eugene S. Clifford Berbor A. Clifford
American Securifies Company, o carporalion by 11
�,eltu WeE VAOIRMT
df JWe&
NOTE:
An aflid,vit of amarsnly is being can.... sally recorded
in the office of the Bulls C ... ly Retarder uade,
Recorder's Serial Number 9/- 3880 9 .
1 hereby c 'ly the, (Dere era M lien: of unpaid County pr Se.eial 0ntrict Tates
again.! any o land! ahorr, an fhe aC,.mpanyinq Porcel Map, eteepl which
or.,
a lien DUI Iqt poraDle. TOses er Special Afselamrat r o lien but
net yet payable 1 aalim G to De in Me amount of f eO.peslt of
which is hereby ockmwl.d"d
Da led:
James J. -hR1I is County hrdilar
Deputy
GLE'RK OF THE BOARD OF
I h ... by .eknowleege ecsip
l o/ Jarietaetbrr ...rity in ,he a estimated
.moue, of f o insure payment of I..es • bare 0 lien but not
yet payable.
Voted: ,198 -
A.P. 11-36-02
5270
Martin J. Ni
Clerk of the
STATE OF CALIFORNIA
COUNTY OF BUTTE
m—, 1991 , before me, the undenigned, a Notary Public, in and
for Said State and County, panouslly appeared Fuaan. 5. Clifford end Bernara A. Clifford
proven as me M the basis of Satilialloly evidence 1. be the person wn.a. n
subscribed 10 the vifhin ,n 11—at and aahnorledged to me that he ase -led the
s
,amo.
STATE OF CALIFORNIA
COUNTY OFSqv V, C.1 -u.01-
On , 1991 ,Dolor, me Me lndmsigned, a Notary public, m and for
,aid Store and County, personally appeared G-7, 5- wren KwTdpr (myi I Ian
proven to me Lim Daais d soils lsctory evidrnro la be he parson nno ese<uf.d the rlmin
Inatrumanl O,. caar'.,,iriena Mg 96sir el: an behalf of Amerle.n _ erilis. COmaany.
_. fns car'.,
lnerela named and oclnorledged 1, me that such
corporaflim alocated /he Wlftla Instrument pursuant to Its by -lows or a resolution of Its
e..rd of dlredors.
WI rNESS my he'd and official seat
+. . 1 -al
STATE OF CALIFORNIA
COUNTY OF BUTTE
On ,198-, before me, the underelgned,a Notary Public, In and for
laid State and County, personally appeared
proven to me an the basis of satisfactory evidence a be the Pon" whose name is
subscribed to the rlllun esfromen, and acknooedged to me that he e,Kvted the some.
- /a3 -9(e
SURVEYOR'S STATEMENT
rhe anae,ed mop ease prepared by me or under my direction and is Dosed upon a hold
survey in ounformance vim the requirements of the Subdivision Map Act and local
ordimmee al the request of Eugene S. Clifford an October 7. 1986
1 hereby Jlots Ihot his parcel mop substantially contorme 1. the approved or
conditionally approved tentative map it any. 1 hereby certify that the survey is true
and ematilets ae shmm, the --.call )he- a+ill and are of the character and
occupy the positions indicated andaresufficient to enable the survey to be retraced.
Conon L. Saiide LS 3346
BF C411F
Espires 6130:92
COUNTY SURVEYOR'S STATEMENT
This map conforms with the reaWrements of the Subdivision Map Act and local ordinance.
rhe road aasea,eal off ... d tar dedication is not acc.pl.d .1 Is/, it...
RBE/fN
Voted
p. B111e Cataty
Chaff Su�veyor y
Willivm R -E 10 ZZS
R.pi,lr.li.e E-1— 3131/93
RECORDER'S CERTIFICATE
Filed tldsl(�ddoy of 4IIG1197' , 1991 , in Book /.Z'5 of Parcel Maps a/
01 PogasY�i3r 4'B at fns rooves! a1 Slerro Weat Surveying.
B:O/ q• M.
Serial No. 9/-33H/0
Nasse ,t. G,Puf3as
Laren Counly Recorder
M.
Br---
Oeputr
PARCEL MAP
FOR
E. S. CL IFFORD
PARCEL 2 OF 89 P.M. 90 IN SECTIONS 5 AND B
T. 22 N., R. 3 E., M.D.B.BM.
BUTTE COUNTY CALIFORNIA
SIERRA WEST SURVEYING
5457 BLACK OLIVE DR (916)877 6255
PARADISE, CALIFORNIA 93968
sheet I of 3
PARCEL I
61.66 At.
BSRl'd. s10
1930951M1 � -� e16.ea
N e'a4c'1e� r lar / l
g �(
V
Q
V
0 Ir
e �l'ar
1
/ / o
'
PARCEL
i
i
r f NO. 52.4r- W
2.47 -W
`1 7890 )
I •
� IS
_r
LOCATIONMAP— N.T.S.
SCALE 1-+200
RAS/S OF BEARING
TAe Sou/A Rns aI Poreel I sAorn os N B4. OB' S2' E on B9 PM 90.
LEGEND
O+ 5113/4 -Iron P/ae. L.S. JJ46
Q. Sal 3/4' Iron Pipe L.S. 3346/, Lleu al ce/culoled polnl per 89 PM 90
+ Found J/4' Iron Pips L.S. 3346 per 89 P.M. 90
. Found W" Rebar L.S. 2843 par 89 P.M. 90
. Found 314'1ran Pipe L.S. 2843 per 89 P.M. 90
0 + 511 314- Iron PIP, L.S. 3346 M lieu of 112 -Rebar L.S. 2843 per 69 P.M. 90
• CO -Wed Pa/n1 Only
NOTES
All Boundary D/menslon, are Record and Measured per 89 P.M. 90, LM... noted.
Bean Flat Read
An exls/Ing 60' nan-exelu,lve sa,emenl for Ingress and .press and for
Publlc WWII,, per Ree Ser. No. 91-19653, to be rasa. rad M dead$ o,d, oflared
for dedmoll- Io the County of 8u11e.
An exbling R.M.A. per 2775 O.R. 426
PARCEL MAP
FOR
E.. Se CL IFFORD
PARCEL 2 OF 89 P.M. 90 /N SECT/ONS 5 AND B
T. 22 N., R. 3 E., M.D.B.SM,
BUTTE COUNTY CALIFORNIA
SIERRA WEST SURVEYING
5437BLACK OLIVE DR. (916) 877 6253
PARADISE, CALIFORNIA 95969
'`� SAe,I 2.1 J
N 88. 35'41'W
a 1�
681.304.
r \ S•
211.73
Z b
p
N
b
�0,
£0�
l
PARCEL 2
- 17 E
79G66 \
`
20.02 At.J/
— 239 i
2 .2
N 89. 56'44- W
�C / /�
/ N J2' 00' 00" E 610.00
Z
M&34 E. /,16 cs.,
Y� N 26, 00.00' E
0.y
Cj(
\ 17400
41..0
\\ •'o,� \lBEAN FLAT ROAD
9g
\ \ , �•��_f E,b/Ing 60' easement Per 2392 O.R. J30 and 2396 O.R. 466
Exfsltng R.M.A. 2393 O.R. 204
Er/alinp P.O.ef. and P, T.BT. easement
/ abh
2453 O.R. 124 along arts/!ng 60' eoaemenl.
-----
NO TES
9y
Eosemenls of ra cord nal aharn on Jbi, may. Erocl /o callous
$
o,d of/ecb It any lndelerminols.
'
L, -',T 5
4'
Book -F- Palanls Page 13
Be.* 90 Deeds 'Pape 24
M. 4 j
l
�
&.095 Os ads Page 4
a
Id 'v
Book 97 Dead. Page 471
Book 101 Deeds Pope 209
LOT 6
<
Book 132 O.R. Peg o 2/8
'
104 M. 57
2
•�
+%
Book 613 O.R. Page 308
,1
Bonk 613 O.R. Pope 315
'
Book 2063 O.F. Page 207
Book 2J96 O.R. Page 466
.
5270
PARCEL
i
i
r f NO. 52.4r- W
2.47 -W
`1 7890 )
I •
� IS
_r
LOCATIONMAP— N.T.S.
SCALE 1-+200
RAS/S OF BEARING
TAe Sou/A Rns aI Poreel I sAorn os N B4. OB' S2' E on B9 PM 90.
LEGEND
O+ 5113/4 -Iron P/ae. L.S. JJ46
Q. Sal 3/4' Iron Pipe L.S. 3346/, Lleu al ce/culoled polnl per 89 PM 90
+ Found J/4' Iron Pips L.S. 3346 per 89 P.M. 90
. Found W" Rebar L.S. 2843 par 89 P.M. 90
. Found 314'1ran Pipe L.S. 2843 per 89 P.M. 90
0 + 511 314- Iron PIP, L.S. 3346 M lieu of 112 -Rebar L.S. 2843 per 69 P.M. 90
• CO -Wed Pa/n1 Only
NOTES
All Boundary D/menslon, are Record and Measured per 89 P.M. 90, LM... noted.
Bean Flat Read
An exls/Ing 60' nan-exelu,lve sa,emenl for Ingress and .press and for
Publlc WWII,, per Ree Ser. No. 91-19653, to be rasa. rad M dead$ o,d, oflared
for dedmoll- Io the County of 8u11e.
An exbling R.M.A. per 2775 O.R. 426
PARCEL MAP
FOR
E.. Se CL IFFORD
PARCEL 2 OF 89 P.M. 90 /N SECT/ONS 5 AND B
T. 22 N., R. 3 E., M.D.B.SM,
BUTTE COUNTY CALIFORNIA
SIERRA WEST SURVEYING
5437BLACK OLIVE DR. (916) 877 6253
PARADISE, CALIFORNIA 95969
'`� SAe,I 2.1 J
\/\ 4 6.83 /: 78.90
\ so's•,rc s.ie,ce un) 1350.95 /� ./
377.10 \ , I// 0qQ (I
� ,<,Iler S•leae, l
342.06 a6
lel y
I 4:
PARCEL / o !
R 1'
61.66 A r,
I I
hO
r� ^
NOTES
rhi. °ddillo°ol mop ,heel /, /or Inform -Ilona/ purpo,.,,
Dory, de,crlD/n9 —dflf— e, of The dole 4/ 111119 and
1, 00l lnlended to afferl Record TIlle /niers, I.
Bul/dlh9 po mRt may re yule poyme°I of Chi- Vn///ed
School D1,1r10 fee, e, par Rulle Cou°It 014l°enre 2463
end Resolollen 83 - 40.
/ / v
to
\ o
of • O'
L2
ml
� PARCEL 2 � � � � 396.66 \ �
\\ 20.02 Ac.
�I38.34 130.00
/175.00 \ m
\�\ Nomesif.
ADDITIONAL MAP SHEET
PARCEL MAP
FOR
E. S. CLIFFORD
PARCEL 2 OF 89 P.M. 90 /N SECTIONS 5 AND B
\T. 22 N., R. 3 E., M. D. B. 8
BUTTE COUNTY, CALIFORNIA
m 9h
'0.
SIERRA WEST SURVEYING
5437 BLACK OLIVE DR. (916) 877- 6253
PARADISE, CALIFORNIA 95969
Sheet 3 el 3
5270
I
California Department of Forestry and Fire Protection
Butte County Fire Department
Fire Safe Requirements
Permit# <N
Under authority of Public Resources Code Section 4290, the following checked items are required by CDF/Butte
County Fire Department and made part of this permit These requirements are minimums and may be superseded by
Butte County local regulations, which equals or exceeds these standards. Butte County Building Inspectors will
make compliance inspections.
1272.00 Maintenance of Defensible Space Measures
[X] To ensure continued maintenance of properties in conformance with these standards and measures and to
assure continued availability, access, and utilization of the defensible space provided for these standards
during a wildfire, provisions for annual maintenance shall be included in the development plans and/or
shall be provided as a condition of the permit, parcel or map approval. Public Resources Code 4291
information will be provided.
1273.10 Driveways
[X] (a) All new driveway construction or an extension of an existing driveway shall comply with Public
Resources Code 4290 roadway requirements.
[X] (b) All driveways shall provide a minimum 10 foot traffic lane and unobstructed vertical clearance of 15
feet along its entire length
[XJ (c) Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the
midpoint of the driveway. Where the driveway exceeds 800 feet, turnouts shall be provided no more than
400 feet apart
[X] (d) A turnaround shall be provided to all building sites on driveways over 300 feet in length, and shall be
within 50 feet of the building.
1273.02 Roadway Surface
[X] The surface shall provide unobstructed access to conventional drive vehicles, including sedans and fire
engines. Surfaces should be established in conformance with local ordinances, and be capable of supporting
a 40,000 pound load. 4" of class 2 aggregate base shall be required for all driveways, turnouts, and
turnarounds.
1273.03 Roadway Grades
[X] The grade for all driveways shall not exceed 15 percent. Grades above 15% shall have 4" of class 2
aggregate base and 2" of asphalt concrete. No driveways allowed in excess of 20%.
1273.04 Roadway Radius
[X] (a) 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] (b) 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.
1273.05 Roadway Tumarounds
[X] Turnarounds are required on driveways and dead-end roads as specified in this article. The minimum
turning radius for a turnaround shall be 40 feet from the center line of the road. If a hammerhead -T is used,
the top of the "T" shall be a minimum of 60 feet in length
1273.06 Roadway Turnouts
[X] Turnouts shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end.
Revised 02/28/06
C
IC
F
R
E
Q
U
1273.07 Roadway Structures
[X] (a) All driveway, road, street, and private lane roadway structures (Bridges, culverts, and other appurtenant
structures which supplement the roadway bed or shoulders) shall be constructed to cagy at least the
maximum load and provide the minimum vertical clearance as required by Vehicle Code Sections 35550,
35750 and 35250.
[X] (b) Appropriate signing, including but not limited to weight or vertical clearance limitations, one-way road.
or single lane conditions, shall reflect the capability of each bridge.
[X] (c) A bridge with only one traffic lane may be authorized by the local jurisdiction; however, it shall provide
for unobstructed visibility from one end to the other and turnouts at both ends.
1273.11 Gate Entrance
[X] (a) Gate entrances shall be at least two feet wider on both ends then the width of the traffic lane(s) serving
that gate.
[X] (b) All gates providing access from a road to a driveway shall be located at least 30 feet from the roadway
and shall open to allow a vehicle to stop without obstructing traffic on that road.
[X] (c) Where a one-way road with a single traffic lane provides access to a gated entrance, a 40 foot turning
radius shall be used.
1274.08 Addresses for Buildines
[X] All buildings shall be issued an address by the local jurisdiction which conforms to that jurisdiction's
overall address system. Accessory buildings will not be required to have a separate address; however, each
dwelling unit within a building shall be separately identified.
1274.09 Size of Letters. Numbers and Symbols for Addresses
[X] Size of letters, numbers and symbols for addresses shall be a minimum 3" letter height, 3/8" stroke,
reflectorized, contrasting with the background color of the sign.
1274.10 Installation. Location and Visibility of Addresses
[X] (a) All buildings shall have a permanently posted address, which shall be placed at each driveway entrance
and visible from both directions of travel along the road. In all cases, the address shall be posted at the
beginning of construction and shall be maintained thereafter, and the address shall be visible and legible
from the road on which the address is located.
[X] (b) Address signs along one-way roads shall be visible from both the intended direction of travel and the
opposite direction.
[X] (c) Where multiple addresses are required at a single driveway, they shall be mounted on a single post.
[X] (d) Where a roadway provides access solely to a single commercial or industrial business, the address sign
shall be placed at the nearest road intersection providing access to that site.
1276.01 Setback for Structure Defensible Space
[ (a) 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.
[ ] Your parcel is larger then 1 acre but your minimum setback for buildings and accessory buildings is less
then 30 feet from all property lines and/or the center of the road. You are required to meet the same
practical effects requirements fisted on page three.
[ J (b) For parcels less than 1 acre, the local jurisdiction shall provide for the same practical effect. See page
three for same practical effect requirements.
Revised 02/28/06
Same Practical Effect for Buildings less then 30 feet from property line:
[) If the Building Setback is less then 30 Feet from all property lines and/or the center of the road, the
following shall be required;
• Class A roof
• Fully enclosed eaves on entire structure
• Fire rated metal doors on side toward property line with insufficient setback
• Siding on entire structure from the following list:
(a) Stucco -3 coat
(b) Non combustible Hardi-Board, Plank or similar siding
(c) Masonry
(d) Metal
(e) Other Butte County Fire Department approved materials
1276.02 Disposal of Flammable Vegetation and Fuels
[X) Disposal, including chipping, burning or removal to a landfill site approved by the local jurisdiction, of
flammable vegetation and fuels caused by site development and construction, road and driveway
construction, and fuel modification shall be completed prior to completion of road construction or final
inspection of a building permit
Other Reuuirements- Installation of Residential Fire Sprinklers
[X) If your property was part of a parcel split after January 1, 1991, you are required to install residential fire
sprinklers. It is your responsibility to inspect the official parcel map to confirm if sprinklers are required.
JUL 1 .9 2006
Date
Revised 02/28/06
Darren Read
Fire Protection Planning
BUTTE COUNTY SCHOOLS IMPACT..FEE CERTIFICATION FORM
(One form per Building)
School District C V ��
A.P. Number vl 1 - Go - v: L Jurisdiction: City
Property Owner
Property Location/Address
�.
:. Subdivision
Residential Development
r�.. .< <• ;,} No of Living
Units
-0
Commercial/Industrial 0
New
Building Department
Building Department No.
County
Lot No.
Q ':• Sq. Footage i a Mobile A ditioN 'Supplemental to (Group- R)
Installation Conversion Permit #
*(No foundation inspection)
:........................................................................................
0
Addition
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Sq. Footage
(Including Exterior
Roofed Areas)
Date
District Identification No.. 09 6 Z -121 &
School District certifies that y
(Applicant)
(Street Address)
(City) y (State)
has complied with the requirements of Resolution No.
representing + �, �po� square feet.
waw f z �,
School District,
a
Paid by Check # Remarks:
a
S 8/'7
(Phone Number)
(Zip Code)
by payment of $
B 2926 $
ULL MITIGATION f
Date /
Notice: You may protest the Imposition of the tees Identified above by submitting a written protest to the District In compliance with
Government Cods Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the Imposition of the fees In any court action.
H, subsequent to the School District Representative signing tills Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agancy that this project is being reviewed under the California Environmental Quality Act (CEOA),
this oroleet may be sublsct to additional school tees to fully mltloste Its knoact on the school district's schools.
White (school district), Yellow (building department), Pink (applicant) feetorm.xh (3it 5WflM
BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM
D FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD)
l CHICO AREA RECREATION AND PARK DISTRICT (CARD)
❑ PARADISE RECREATION AND PARK DISTRICT (PRPD)
❑ DURHAM RECREATION AND PARK DISTRICT (DRPD)
Assessor Parcel Number (s) b
I
Property Owner (s) k1l G
Project Location /Address
Subdivision Name
6!
Building Permit Number bt - ) &3
\, ; C: D
Assessable Sq. Ftge
Type of Residential Development (check one)
-New Development Single Family -Detached Single Family -Attached
:e�ration/dition(s) Non -Residential to Residential Multi -Family Dwelling
Mobile home Mobile home replacement verified by Assessor Department
T)Pmn Permit (date issued 1
Comments:
verified by Building Department
Building Dep kenj Representative
Date
❑ FRRPD B'CARD ❑ PRPD ❑ DRPD certifies that:
-Of
Applicant Name p Phone Number
4- ��-15'
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:
RrrrPatinn and Park District
Paid by
per unit for a total of $
per sq foot for a total of $
e4z.h d74
Receipt No:
J
/.& -3z
-fl CEF! v I L Lc
BUTTE COUNTY
DEPARTMENT OF DE"vlLOPMENT SERVICES
o& INSPECTION CARD
• 0 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico)
c�UNty Office: (530) 538-7541 Fax: (530) 538-2:40 Website: ww%v buttecounty.net/dds
Permit No: 06-1632 / Issued: 09/22/2006
Address: 13097 BEAN FLAT RD
APN: 017-050-024 Permit Subtype: SFD-Custom/Mode
Owner. _
Applicant: MICHAEL CLIFFORD
Description: NF'lfrlG'A_1UGE 170
MUST BE ON JOB SITE
JOB SHALL BE READY PRIOR TO CALLING FOR
INSPECTION. THE INSPECTION CARD AND
APPROVED PLANS MUST BE AVAILABLE FOR EACH
INSPECTION ORTHE HE INSPECTION WILL NOT BE
MADE AND A RE -INSPECTION FEE MAY BE
ASSESSED.
ALL PLAN REVISIONS MUST BE APPROVEI! BY THE COUNTY BEFORE PROCEEDING
Inspection Tye
IVR INSP DATE
Setbacks
132
Foundations / Footings
III
Pier/Column Footings
122
Grade Beams
114
Eufer Ground
216
Forms/Steel/Holdowns
122
Do Not Pour Concrete Until Above are Signed
Pre -Slab
124
Gas Test
404 p
Masonry Grout
120
Masonry Bond Beam
119
Underfloor Framing
149
Underfloor Ducts
319
Shear Transfer
136
Under Floor Plumbing
412
Under Slab Plumbing
411
Gas Piping
403
Do Not Install Floor Sheathing or Slab Until Above Signed
Rough Framing
128
Rough Plumbing
406
Rough Mechanical
316
Rough Electrical
208
Gas Piping
403
Roof Nail
129
Shower Pan/Tub Test
408 ZC
Fire Sprinkler
703
Do Not Insulate Until Above Signed
Wall Insulation
117
Ceiling Insulation
118
Do Not Cov r Until Above Signed
T -Bar Ceiling / RC
145 y
Gas Test
404
Stucco Lath
142
Stucco Scratch
143
Stucco Brown
144
Building Final
802
Electrical Final
803 Z
Mechanical Final
809
Plumbing Final
813
Pr
oject Final 801 J/
PERMITS BECOME NULL AND I YEAR FF.
OFFICE COPY
Address-_ _
GAS '
Meter By (� � D � b a?
ELECTRIC/ �I�, ,�j/
Meter By �� Date/ t-*
M THE DATE OF ISSUANCE. IF WORK HAS
COMMENCED, YOU MAY PAY FOR A I YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION
Inspector Copy
��3�1381 4*I5.(eq
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES .
BUILDING. PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 89.1-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.nettdds
"PLEASE PRINT CLEARLY"
srnz
OWNER INFORMATION
CONTRACTOR
Name -
/Z.� `
G 4c
A
City
C'
sit .��.•-r
Stat
Zip
Phone
Fax
E-mail
ARCHITECTIENGINEER
CONTRACTOR
Name -
/Z.� `
Address`
zzi S
j
City
Fax
State
Zip
Phone
LENDING AGENCY
Fax
E-mail
Iia #
Class
ARCHITECTIENGINEER
Name
Add
o
Sta
zzi S
j
Ph a
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
Address
city
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
For o ce use -only:
Zoning - Flood Zone SRA Yes No
Com. I
Type Const
Subdivision Name
Map Book
Page Lot #
Planner
Date Approved:
UV CK rvK ZsUt51vn I I AL REQUIREMENTS
K:\FORMSIBUILDING FORMS1BIdgApp1SubRgmts.doc
Page 1 of 3
PERMIT
NO.
1039
` I BIN # I{ . l'
PROJECT LOCATION
AP#
l - -0
Pr�ddress
Ci
�Ca
Cross Street
❑ Structu uilt vftout Permift
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a cert�cate of worker's
compensation must be shown at the lime of permit Issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
1, t 1 l
Sq FT- Lwin
$2 Garag Taen Cov
❑ Structu uilt vftout Permift
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been .done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by. . V - Amount: lF �� , EJ Bldg
2)q 11L_SRA
Receipt Sheriff
OWK fi d�
SMTP
Date: r7-V7-/(j
� l � � • 5' � Total
REV 8-12-05
4
BUILDING DIVISION
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: (530) 538-7541
AGRICULTURAL BUILDING EXEMPTION PERMIT
PERMIT NO.
EPo4z'�
Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm
implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human
habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a
place used by the public.
ASSESSOR PARCEL NO.ZONINt6-,-7-�
�-
of •�So- 02 4 • a
jj��
O IzR/
PHONE NO.
`G l�Fa ��
OWNER'S ADDRESS
C9 90
LOCATION OF BUILDING
USE OF BUILD G
r
SIZE 6F STRUCTURE
c
C 5�' X' 2,'S q..
L-2 Q. FT.
TYPE OF CONSTRUCTION:
WOOD FRAME STEEL CONCRETE
OTHER (Specify)
TYPE OF SIDING
ROOF COVERING
FL�R TYPE
—ll
ESTIMATED COST O CONSTRUCTION
AG Buildin s shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as
follows:
/
O
FRONT SIDES—C40
REAR
AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields.
AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a
mobilehome, and 23 feet from a commercial building.
Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a
mobilehome, and 40 feet from a commercial building.
I declare under penalty of perjury that the building will be used as stated about, and the purposed use confirms with the
AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and
obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before
occupancy.
Date /`�2 - �� Signature of Owner:tz�
Permit Fee. $WU0/The above described AG'B'
Receipt No. d -lam, 3 -f ER—A-
Manager
Building ivision
By l
White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod —Applicant
Iding is exempt from a building permit.
IMPIVA
�. ii
A S01000 29: Main
Name CLIFFORD MICHAEL J & JAZELLE R
Addr1 11290 GOODWI N AVE
Addi2 PENNGROVE CA 94951
Addr3
Addr
Assessor Inaui
Comments email from 011-360-024-000
Creating D oc#J 1991 RP123-96 Date 811611991
Current Doc# 19978 28196 D ate 713011997
Killing Doc# Datel -
Asmt D escBEAN FLAT RD . S uplCnt
Zoning D well U set R
AcreslS g Ft' 20.02 � N 1C 011 U set
Val'd Event D k Appr AprCd F—
SSN#1 SSN#2
NOT . PHY 1 OWN I EXP I HON
"I'10- 1 "1j- uprate
SOP 16, 2004 12:35 pffi
Asmt # 0-17-050-024-000 Fee # Pi T-050-024-000
Status ACT IVE Status Date 18/16/1991
Tax [000 [NORMAL OWNERSHIP TRA 062-016
S itus
Base D t Activity D t
Timber Preserve
AgPres
�..� E tal
Notes
B onds
Multi Situs
Flag1
Flagg
r! 910 MH
Asmt PP Pen
Tax PP Pen
Appeal Pending
,T Split Pending I
Land
Structure
Fixtures
O rowing
Total L&I
Fix. RF
MH PP
PP
Exempt
67,37967,379
12/18/1997
0
0
0
0110111900
67,379
67,379
0
0
0
0
0
Net I . 67,3791 67,379
.R/C#.R/C#j enrolled is
T 1R D t base year
� /c S tat — r� I_-,,- j 0,
S L AT T 1 SIT I APRJ FURL SAL 1 R /R I WKS
I: Find - z
.—
AS0100029: Mara
Name I CLIFFORD MICHAEL J & JAZE LLE R
Addr-I 11290 000DWI N AVE
Addr2 I PE N N G R OVE C�4 94951
Addr3�-
Addr4 -
Assessor Maui
Comments I Remap to 017-050-024-000
Creaking D oc#1 1991 R P123-96 Date 8116/1991
Current D oo# 11997R 28196 Date 7/30/1997
Killing Doo# 120051REMAP Dake 9/14/20041
Asmt D eso BEAN FLAT RD S uplCnt
Zoning D well U set R
Adres/S g Ft 120.02 � N /C 011 U set
Val'd Event D k Appr I AprCd F—
SSN#1 SSN#21
NOT I_PHY I OWN I EXP
f'I'I►I►�I Update
Sep 16, 2004 • 12:315 PM
Asmt # 101, 1 -360-024-000 Fee # 011-360-024-000
Status Status Date 19/14/2004-1
Tax 000 NOR MAL OWNERSHIP TRA 062-016
Situs
Base D k EGON MM Activity D t
Timber Preserve
AgPres
E tal
N otes
Bonds
Multi Situs
Flag1
Flagg
910 MH
Asmt PP Pen
Tax PP Pen
Appeal Pending
Split Pending
ON I TAX I VH5 I ATT I SIT
Land
S truoture
Fixtures
Growing
Total L&I
Fix. RF
ISH PP
PPI
0
67,37912/18/1997
0
0
0[Ti
/01 /1900
67,379
0
0
0
0
Exempt 01 0
Net 101 67,379—
R /C#1 enrolled is
T iR Dtj base year
R /C S tat i+--- 1 0! M I
APR. I PCL I SAL I R /R
V�P' Find
\r.
Z
'i
4
L -,T 5
LOT 6
104 M. 57
PARCEL 2
20.02 Ac.
PARCEL I �' 1 v
0
SCALE i - .zoo'
6466Ac.
It /
BASIS OF BEARING
Iq
'41
'The S.wh /in. of Porto/ l sharp as N 84. 08'52"E on 89 PM 90.
p,
PARM
I!l'o
LEGEND
I as ryI'd. Sl0
&
4 �/
Q� Sol 314"lAt 90
..aeponper 69P
( 0
0 • Found 314- Iron Pip. L.S. 3346 per B9 P.M. 90
l
0 + Found 112' Rebar L.S. 2843 per 89 P.M. 90
0 . Found 314-1.. Pipe L.S. 2843 per B9 P.M. 90
- Sal 314hon Pip. L.S. J346 /n H.. of 112-Rebor L.S. 2643 or B9 P.M. 90
N 88. 31' 47• W
Calculated
I
♦ • Point Only
L31D95 fMl
\/ ..
4MAJ 1 f N O'3P7-4W
7Z
N 84. 08. 52.E
NOTES
\
39&66234.2
— i
All Boundary Dimons/one are Record and At.—d par 89 P.M. 90,. Unless no/ad
N 89.49' 39-E
Been Fla/ Rood
! 1� N ��Do- E /3(LOO
/ E.ln6c r.
An esl&1/np 60' non-.re/us/ve eosemenl /or ingr.0 and e
Po61/eU/7////as per Rec.Sar, No. 91-/961J, to be rarervaglass ead a,d,olle.ad
for dedication to the County o/ Bull.,
N 26' 00' OO'E' �
f7100
An ..Wing R. M.A. par 2775 O.R. 426
/
R 3r eru•
BEAN FLAT ROAD
fExisting 60' oosement pe, 2392 O.R. 350 cod 2396 O.R. 466
PQr , •j9 �\ Eslslleg R.M.A. 2393 O.R. 284
Erleling P.6.8E. P.T8T.
PARCEL MAP
pp p0 and easem.nl
! y 2453 OR. 124 along --sling 60'—- nl,
FOR '
/
E. S. CLIFFORD
oTEs
Ea.. -11 of record not ,he— on Mb mop. C ..I locations
PARCEL 2 OF 89 P.M. 90 /N SECTIONS 5 AND B
.no o,facts N any /ndet.rm/nule.
Book 'F- Patents Peg. IJ
22 N.,
T. R. 3 E., M.D,B.SM.
Book 90 Dads Pogo 24
LOCATIONMAP— N.T.S.
Book 95 Dead& Peg, 4
.. CALIFORNIA
Book 97 Dead. Page 47/
Book q/ Deeds . P.g. 209
Book 232 O.R. Page 218
Book 6/3 O.R. Page 308
Book O.R. Pope 311
20
Book 2063 O.R. Pope 207
SIERRA WEST SURVEYING
Book 2396 D.R. Pog. 466 -
PARCEL 2
20.02 Ac.
PARCEL I �' 1 v
0
SCALE i - .zoo'
6466Ac.
Q to �1
�'
BASIS OF BEARING
Iq
'41
'The S.wh /in. of Porto/ l sharp as N 84. 08'52"E on 89 PM 90.
p,
I!l'o
LEGEND
Q • Set 3/9'11on Pipe, L.S. 3346 �
&
4 �/
Q� Sol 314"lAt 90
..aeponper 69P
( 0
0 • Found 314- Iron Pip. L.S. 3346 per B9 P.M. 90
l
0 + Found 112' Rebar L.S. 2843 per 89 P.M. 90
0 . Found 314-1.. Pipe L.S. 2843 per B9 P.M. 90
- Sal 314hon Pip. L.S. J346 /n H.. of 112-Rebor L.S. 2643 or B9 P.M. 90
N 88. 31' 47• W
Calculated
27L 73 % O
!
♦ • Point Only
o
?2 � � b
NOTES
\
39&66234.2
— i
All Boundary Dimons/one are Record and At.—d par 89 P.M. 90,. Unless no/ad
N 89.49' 39-E
Been Fla/ Rood
! 1� N ��Do- E /3(LOO
/ E.ln6c r.
An esl&1/np 60' non-.re/us/ve eosemenl /or ingr.0 and e
Po61/eU/7////as per Rec.Sar, No. 91-/961J, to be rarervaglass ead a,d,olle.ad
for dedication to the County o/ Bull.,
N 26' 00' OO'E' �
f7100
An ..Wing R. M.A. par 2775 O.R. 426
/
R 3r eru•
BEAN FLAT ROAD
fExisting 60' oosement pe, 2392 O.R. 350 cod 2396 O.R. 466
PQr , •j9 �\ Eslslleg R.M.A. 2393 O.R. 284
Erleling P.6.8E. P.T8T.
PARCEL MAP
pp p0 and easem.nl
! y 2453 OR. 124 along --sling 60'—- nl,
FOR '
/
E. S. CLIFFORD
oTEs
Ea.. -11 of record not ,he— on Mb mop. C ..I locations
PARCEL 2 OF 89 P.M. 90 /N SECTIONS 5 AND B
.no o,facts N any /ndet.rm/nule.
Book 'F- Patents Peg. IJ
22 N.,
T. R. 3 E., M.D,B.SM.
Book 90 Dads Pogo 24
BUTTE COUNTY
Book 95 Dead& Peg, 4
.. CALIFORNIA
Book 97 Dead. Page 47/
Book q/ Deeds . P.g. 209
Book 232 O.R. Page 218
Book 6/3 O.R. Page 308
Book O.R. Pope 311
20
Book 2063 O.R. Pope 207
SIERRA WEST SURVEYING
Book 2396 D.R. Pog. 466 -
5437BLACK OLIVE DR. (916) 977 6253
t •
PARADISE, CALIFORNIA 95969
Shoal 2 of J
q/6
OWNER'S
yy, rM onmsEud.n. S ford and Berbora A dwrare Clifford a1 of be [and Os ehawn
w ed CR/Meq andpm.,fcdn a.curflla, Com my, a orporallo � ds nus/N under
Dead atTr recorded Aueu,l 9, 1990 Il"e, Buns CWhy Racorde, a $.,,a, Num of
90-77979 ppd rrvllp undo,
Dead of Trus) io dod under BUIre Ca ly RecordW. Sa bl Number
do beroby —lify that ora ora Me only P.,—..Note comenr i,
necelwry td pass dear Iifle or said land and r ant M the prpara Non and
I .... dation d eaid map as Boos', within IM D.rder Ii"
.. The 60' Read E ...... I
as char on ,ofd map Is her, by I Il d for d.dl,allon to the C... I, of 8.1t..
Eoo.n, S. C/Ifford Barbara A. Clifford
Amer/can seWrufe, eemaany, o eorvwonw A•S 9IeV. ov(
� .Boors ear.'
NOTE:
A. offid-11 of orn,r,hrp ts 111., cencurr.nl/y recorded
/n the office of the Bull. County Records unser
Recorder's Serial Number 9/- 3380 9
1 Mreq c fy rMI Ilpre aro M lions of unpaid County w Speal01 pbhh:I lases
apainef any o lands alwn w me aecomparry,rp Poreal bran, e,ropt whieb
e a lion but hat payable. Teres or Spacial Assolaments whi a lion put
.at yet payable, I pti to
be M Me amount of f f e —*it of
whish is hereby ackri—Iodgad.
Dated: , 198_
Jamas plat—' BON C.uny 4udimr
OF THE BOARD OF
1 Mreq aeknoledps receipt M sarialaerwr security in rhe e r I M
estimated
payment
amaml o/ s in re of 'a,b1 we lien but t
Yet payable. w�+
Dated:
Afarlin J. Nit
perk of be Bear Superriears
tt
} A.P. I1-36-02
1270
STATE OF CALIFORNIA
COUNTY OF BUTTE
Dn ,1991 , before —, the undetaioned o Notary Public, in and
W. said Scare ond CWnry, poo vlly appeared Espana 5. C/Iflard and Barbaro A Cltfford
Protan Io me on the blots of 1.60actwy -id—. to M the person w. nano Is
subscribed m the ori Min instrument and acAnawledped to n that he executed Me
pule.
STATE OF CALIFORNIA
COUNTY OF (pkkvx 0-mrOL-
On lC`aYw I ,.1991 , M/we me, the undani9lpd, o fplary P.M., a and for
said Smta and County, personally appeared G.A. DEMOawl, kw149 (OATban
pt 61 I. me on the basis of satisfactory evidence m he the person Ma 0 .... led IM .11,41,
Ih,/roman! a, ELI} e.a %bit `<rRon behalf of - Ammrtc..
a corflier_Comoon r.
Me carawauan, Md,.i. nomad wd adno.htdf,d /, me Mel ... h
corpora/len —..led Ina .IM/n /n,lrumenl pw,uanl to IIs by -/..s ar „./.Ilan of /I,
board of dh.Of—.
WITNESS my hand and official ... 1.
lPA/4/`
.eNr•,n I -dl -9
STATE OF CALIFORNIA
COUNTY OF BUTTE
0. ,198_, before m,, the und—Ighea,d Ndl.ty P.bllc, In and I.,
sold Stare and Cewly, personally dppeared __
prawn m me on IM basis of wtisfoctwy evidence m be the porsan AN.re n me M
wbs ibea to rhe within InlIma f and acknorledsod to me Mat M e tdd IM some.
/a 3 _ 9CP
SURVEYOR'S STATEMENT
Th. OhM *d map was prepared by me w under my direafion and is based upw . field
sarvq in aonfwmanro with the re9uiremonis of the Subdivision bfaP Act and tocol
Ordlnance al to. r.du.,l of --a
f. Cll/fdrd p„ 0".I., T. 1986
1 hereby stats that Mi. parrot m P wbsbntialy conforms M the approvedOr
rondiriwally dpwored twtalive map it my. 1 Meby certify that IM.nurrey is Irue
dnd rompfeh as eha-, the monumeafs Shawn edet and aro of 'be waraater wd
acwP7 Mr posi liaM indiOated and are wfficienl he enable the wrvay teW retraced.
o W1
OtA L„B�(y{p
* C7 L&3706 y * fiudoh L. Shields LS 5746
d�
OF
E,Pi/e, 6/!0/92
COUNTY SURVEYOR'S STATEMENT
MI leap conforms with the reauiremanM o/ Me Slbdrviei.n hap Act wd loo.- ardieaMe
Th. road aa,em,nt o11Ir.d Ion dedication ts nal ....pt,d of rots IIm,. /
�17_
m
4reW.mH..RCE 14221
Repfilralioo Erplre, J/3I/93
RECORDER'S CERTIFICATE
Filed MisJk2d.y of411611157,.1991 , in B -A 123 of Potcel Map. oI
Of P.W.94,92 99 ar he rewaer .1 Sierra West Surveyino.
Fee OAM.eo roris-B:O/AM.
Seri.- Na. 9/-339/0
44AIZ ed7 _: G,Pueas
W10.Ca/' 1Y RReeecede,
BY.�eW, GI
Y
PARCEL MAP
FOR
E. S. CL IFFORD
PARCEL 2 OF 89 P.M. 90 IN SECTIONS 5 AND B
T. 22 N., R. 3 E., M.D.B.8M.
BUTTE COUNTY CALIFORNIA
SIERRA WEST SURVEYING
3437 BLACK OLIVE DR (9/6)877 61233
PARADISE CALIFORNIA 93988
Sheer I of J
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 13097 BEAN FLAT RD
Owner:
permit No: B06-2666
APN: 017-050-024 '
MICHAEL J CLIFFORD
Issued Date: 11/16/2006 By KEJ
Permit type: MISCELLANEOUS
960 ELYSIAN AVE
Subtype: Fireplace/Wood Stove
PENNGROVE, CA 94951
Expiration Date: 11/16/2007
Description: TWO FREESTANDING WOOD STO
(707) 508-5817
Occupancy: Zoning:
Contractor
Applicant:
Square Footage:
MICHAEL J CLIFFORD
Building Garage Remdl/Addn
960 ELYSIAN AVE
PENNGROVE, CA 94951
Other Porch/Patio Total
(707)508-5817
FEE INFORMATION
Fireplace - prefab/metal $220.00
Total Charged: $220.00 Fees Paid: $220.00
Balance Due: $0.00 Receipt No: B885
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X 11/16/2006
the applicant to a civil penalty of not more than five hundred dollars [$500);
Please eck one of the following:
Contractor's Signature Date
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued,
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractors License Law dows not apply to an owner of the property who builds or improves
My Workers' Compansation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Carrier: Policy Number: Exp. Date:
(This section need not be competed if the permit is or onhundredollars ($100) es—or s )
❑ I AM EXEMPT under Section B. & P.C. for this reason:
CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
���LLLJJJ ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
X 11/16/2006
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owner gnature Date
provisions.
11/16/2006
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNIN : FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and al all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
the issuance o1 this permit. 1 hereby acknowledge that issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
prope am a ed to act party owner's behalf.
CONSTRUCTION LENDING AGENCY
r 11/16/2006
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
N�IP eeeSIGN] ript Date
the performance of the work for which this permit is issued. (3097 civ. code)❑
Contractor OR. Agent for Owner Agent for Contractor
FILE COPY
Lender's Address City State Zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
CONTRACTOR
OWNER INFORMATION
Last V e
G 14S
First Name
Add
�5
KSS
Cit t
State
Sta �
Class
P o
Fax
�" S
E -m 'I
State License Number
�C
4
CONTRACTOR
r
Addressel Ia 14 cl-'Ce
s, ,
G 14S
Address
Zip
Ph oe
Fax
State
Lic. #
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
For of rice use only:
Zoning
Flood Zone
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
`�P
a
BP ��
BIN #
WORKER'S COMPENSATION
Policy Number
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
�o �> `9�s ��uSr�"AA /CJI
Sq F1'- Living Garage Open Co
❑ 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
required.
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.
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Received by: Amount: �� Bldg
SRA
Receipt Sheriff
SMIP
Date: ' (Q Other
-----Total
REV 8-12-05
a
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by.the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5.- Statement of Intent for Non -heated and AIC for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B), Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title -transfer, or MCO.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date
issued; however, on issued permits refunds can only be made if no construction work has
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
of permit issuance for permits
been done. Filing fees, plan
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 75965
(530) 538-7601 Telephone
(530) 538-7785 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations unders state law, contact the Department of Benerit 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 thier work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons prefessing 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 requir3ed to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
1. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. (YES OR NO) V p _,�'
2. I (HAVE/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE F LLr G PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
NAME
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
NAME
ADDRESS
PHONE CONTRACTORS LICENSE NO
S. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: TWO FREESTANDING WOOD STOVES
Reference Number: B06-2666
Applicant Name: MICHAEL J CLIFFORD
Signature of Property Owne - --Date:
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