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Home My WebLink About021-060-025=R 021 050 025 , x ', '#98-`1638"'' ��k " RORREN -' -'j OA } t h a p xl':553}BLOCKROADrf "GRIDLEY,` ,�� ^a' s C �y7sj'.''.Yu 1 WIDENERS� R00 ING =`' " ,. ',REROOF 'IFlY1�� %9�ig;x t ter•.. r X , ` o 1 1 i u =R 021 050 025 , x ', '#98-`1638"'' ��k " RORREN -' -'j OA } t h a p xl':553}BLOCKROADrf "GRIDLEY,` ,�� ^a' s C �y7sj'.''.Yu 1 WIDENERS� R00 ING =`' " ,. ',REROOF 'IFlY1�� %9�ig;x t ter•.. r X , ` o 1 t u !� 1 r, r FORREN, Harry 9-66B# _5831B._ 10-66E* 4450P k. oZl-Dlo - ods 5556E a -- e, r! w/s,Block Rd mi. so., Colusa-Gri ey wy Gridley r (new single family) -=- #(add carp rt &convert garage to family rtaesm ! 4 r / • n f.F t ' C •-i r° COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-75 P IT NO. (Rev. 12/96) APPLICATION AND PERMIT ��3 ASSESSOR PARCEL NUMBER 021-050-025 ZONING BUILDING PERMIT OWNER Forren, Joann TELEPHONE SO. FT. OCC. BUILDING VALUATION 3000.00 OWNERS MAILING ADDRESS 1553 Block Road, Gridley95948 CONTRACTOR'S NAMETELEPHONE Widener's Roofing CONTRACTORS MAIUNG ADD 7921 Richard Road, Live Oak 95953 CONSTRUCTION LENDER Fireplace LENDERS MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 54.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 1553 Block Road, GridleyEner gy Plan Checking Fee $ $ PERMIT FEE $ 74.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF EX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other] Describe Work: re — roof 50 sq. comp Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 LE Main Service 20 A OR LESS 23.00 LICENSED CONTRACTOR'S 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.q License Class L"-� : `7 Lic. No. SG SJlI / OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑. 1 am exempt under Sec. Business and Professions Code for this reason 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. O 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shallTOTAL not employ any person in any manner so as to become subject to 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 fo it'comply with those provisions. Ll q X Date 7 /6? 44ignapd e f Applicant - ❑ Owner ❑ Contractor ❑ Agent An 09KA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. OW NG occuP. so OR ADDNS. ( 8 E111ACC. S.3.5QFT. NO.FIEOSI�T. MULTI-OUTLETU ITS 97.50 POWEPPARATUS a SINGLER AIJRET oCIA. 20 @IOD EX. Occup. OUTLET OR FDRURES BAL @ .S0 Ex. Occup. oFlxur rs M 1 RE 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee I $ Energy Inspection Fee $ Occ CONST. TYPE FEE v 74.00 HAZ. D FEES IMP I FLOOD CDF PARCEL PD I HD I ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. ` By /`L E Date PERMIT EXPIRES ON % Dee Receipt No. 1H:) WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I a f ` COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PER NO. (Rev. 12/96) APPLICATION AND PERMIT _C ASSESSOR PARCEL NUMBER ®� `� J ZONING BUILDING PERMIT OWNER nn /I TELEPHONE SO. FT. OCC. BUILDING VALUATION nry OWNERS "UNG S 155 L C NTPACMWS NAME TELEPHONE M41LI AD KESS gb. g ION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAIUNG ADDRESS Plan Checking Fee $ BUILDING ADDRESS 75753 4 QC Energy Plan Checking Fee $ $ 1LC' PERMIT FEE $ LOT NO. SUBDN6pN3 NAME P CEL MAP PLUMBING PERMIT Filing Fee, 20.00 Each Trap 7.00 USEOFSTRUCTURE SF K Duplex ❑ Mobilehome ❑ Other SPEe�v Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Describe Work: 0 XYL10 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W (x]20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service s'ow 0. RR L ss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby gffirm 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 LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 workers'HAZ. compensation laws of California, and agree that f I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SG OR ADONS. ( a ACC. SLOS. 3.5QFT: NEW NST7 NON-HEOSIMULTI._0=. 17G 7.50 P.0=APPARATUS a DLrnEr. EX. Occup. OUTLET OR FIXTURES 20 BALL O 1.550 OR Ex. Occup. GvneDis IR I EEn 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ CONST. TYPE TOTAL FEE $ 7 VThispermit D FEES IMP FLOOD CDP PARCEL PD HD ISSUE is hereby issued under the applicable of te utte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. fe Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT II COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT. q 9- l 1OR ASSESSOR PARCEL NUMBER 021-060-025 VV 21 060 "' 025 ZONING - BUILDING PERMIT Foren, Joann OWNER ren, Joann TELEPHONE SQ. FT. OCC. BUILDING VALUATION. (�[�(� (� 3000.00 .OWNERS MAILING ADDRESS 1553 Block Road, Grid1ey95948 CONTRACTOR'S NAME Widener' S Roofing TELEPHONE CONTRACTORS MAILING ADD4921 Richard Road, Live Oak 95953 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER UCENSE.NO. Filing Fee $ 20..00 Permit Fee $ 54.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS G JJJ .4 k l 155] Block Road, Gridley .7. Energy Plan Checking Fee $ $ PERMIT FEE ,s 74.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF t]; Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK A New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ClOther d7 Describe Work: re — roof 50 8q. comp Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 OOOVOil LE Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S 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 r t Lic. No. tJ [Gl �7 �7 C1611/1 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the 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 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed H the permit is for work of a valuation of one hundred dollars ($100) or less.) IR 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 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. % pis T Li Date �%' La% "" ff� ,wSignature;of.� Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction/' of structures over 3 stories in height. Main Service 200A TO tOOOA 46.00 NEW CONST. DWELLING occuP. so OR ADDNS. ( 8 ACC. BLOS. 3.50FT. NEW CONST.MULTI.OUTLET NON-RESID. 97.50 POWER APPARATUS & SINGLE OUTLET CIR . 20 @ 1.00 Ex. Occup. ourLtT OR FDTTUREs SAL Q .50 Ex. Occup. ourtEEDrs AES16OFR-n 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 74.00 NAZ. D. FEES IMP FLOOD CDF, PARCEL PD HD ISSUE, 600, This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. f By l i t•c� - ' Date / PERMIT EXPIRES ONp�- I f Dae i Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 1-1 021-060-025 #98-1638 FORREN, JOANN. 1553 BIOCK ROAD, GRIDLEY WIDENERS ROOFING' REROOF 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. - BPO52106 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 08/08/2005 APN: 021-060-025-000 the Business and Professions Code, and my license is in full force and effect. Site Address: 1553 BLOCK RD GRI License Class : License Number: Map Index: Date: Contractor. Description: REPLACEMENT OF 9 WINDOWS OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: FORREN JOAN N permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 1553 BLOCK RD signed statement that he or she is licensed pursuant to the provisions of GRIDLEY, CA the Contractors State License Law (Chapter 9 commencing with Section 95948-9524 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: FORREN JOAN N Code: The Contractors' State License Law does not apply to an .1553 BLOCK RD owner of property who builds or improves thereon, and who does GRIDLEY, CA such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 95948-9524 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 Contractor: JACKSON'S GLASS CO not apply to an owner of property who builds or.improves thereon, 2900 MYERS ST and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). OROVILLE, CA 95966 ❑ I am Exempt under Article 3 of the Business and Professions Code 530-533-3696 �I 5 Date: Owner: License #: 347219 WORKERS' COMPENSATION DECLARATION 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 Architect: Labor Code, for the performance of the work for which this permit is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Total Square Ft: 0 S. F. Valuation: $0.00 Policy #: Census Code: ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to �) become subject to the workers' compensation laws of California, 22� and agree that if I should become subject to the workers' o compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: lJ WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation,- damages -as -provided for in Section 3706 of the Labor -� code, interest, and attorney's fees. - - CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated a ove for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) (�— u' _ 0 5 BY Date: Name: 9V 0en PERMIT EXPIRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby. authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. -RO A C b ex �i1FO r r e n Signature: Print Name: 9j -.R— O S Date: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 :;_j 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 OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER Last Name �rr First Namer��ber-+ Address// Is53j°,�OC(L i20i-� City C- Ck(e State Cid zip g5q�f8 Phone 6L4 (o _ .049 Fax E-mail /-0/C 700 J- %Yf 2 h Z i1 C C �`►-I APPLICANT SIGNATURE X 17W, -t, - C X,&s,� For office use only: CONTRACTOR Name 3ack-sotl Gloss Address Q9 06 Iq Cl< c rC City &rov I I le. tate CR Zip Phone gU to ` O Fax E-mail Date Approved: Lic. #3 4 a 1'j Class APPLICANT SIGNATURE X 17W, -t, - C X,&s,� For office use only: ARCHITECT/ENGINEER Name . Fpr re Address so -me- cts abOJ e - City Occ. Slate Zip Phone Page Fax E-mail Date Approved: State License Number APPLICANT SIGNATURE X 17W, -t, - C X,&s,� For office use only: APPLICANT NAME Name Fpr re Address so -me- cts abOJ e - City Occ. State Zip Phone Page Fax E-mail Date Approved: APPLICANT SIGNATURE X 17W, -t, - C X,&s,� For office use only: Zoning Property AddressCity�I 15 3 l l oa- f� Flood Zone Cross Street SRA Yes INo Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. 5 BIN # LOCATION AP# 1-0 - 0 Property AddressCity�I 15 3 l l oa- f� l�t�ICr ) Cross Street WORKER'S-COMFILNSATION 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: Ye lace, 9 Wind605c, Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change 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 woik plan checked and other department costs are not refundable. Received by: K Amount: 2.2-0 03 Bldg SRA Receipt #: 3CJ�� Sheriff SMIP Other Date: .at _ Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which. a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05