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' 21-15-5
C. Sheppard
W/S Block Rd. ,app.700'S.of -West.,,Liberty
Rd. -Gridley
Permit #4579-76P,E(util:,MH)
IIEC . '.
GAS t.
SUPPORT STRUCTURE REQ.
COMPACTION TEST REQ: -
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LAND DEVELOPMENT
OROVILLE / CHICO
BUILDING / ENVIRONMENTAL HEALTH - PERMIT CLEARANCE Building Permit No.
OWNERS / �/ j A.P. l�j !J �
NAME �! I1 n i�Ci N NUMBERo2f d0�
PRINT LAST NAME FIRST
ADDRESS /LOCATION: Moog R '
COUNTY ZONING`�
DESIGNATION: ��d FLOOD MAP: -,&;-
. FLOOD ZONE:
APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL
PARCEL CREATION BY DEEDS OR MAP 70
DEED INFORMATION:
DATE OF CREATION: DEED REFERENCE: _.
LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO
COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO
COMMENTS/CONDITIONS:
MAP INFORMATION:
DATE OF RECORDING: LOT 3� BOOK PAGE �g
COMPLIANCE WITH OLD SWDMSION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT
PAGE 23): YES ✓ NO. IF YES, MARK APPROPRIATE ITEM(S) BELOW: -
A. Construct road to B. Meet parcel size required by zone. C. Meet cument E.H.D. requiremeft
CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP. ALL FEES TO BE PAID TO THE BUILDING DIIRSION UNLESS OTift�lWL4EN011®
X1. Maintain a 50 % building setback from centerline of road.
—2. Maintain a R building setback from right-of-way/centerline
—3. Comply with Zoning code for building setback from road.
—4. Maintain a 100 R leachtield setback from all existing wells.
—5. Maintain a R leachfield setback from
—6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Departrat
—7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290.
—8. Connect to a public water supply.
—9. Conned to a public sewer system.
—10. Automatic fire suppression sprinkler systems shall be installed in all residential structures to accordance with the National Fire
Protection Association Standard for thb installation of sprinkler systems in one and two family dweftp and rrrobk homes. NFPA
Standard 130, unless a pressurized community water system, with hydrants that meet Fire Department spedticatlow genres the
parcel.
RECEIVED
_ 11. Pay T.D.D. (Therrnalito Drainage Distrid) fee in the amount of $ DEC 3 1 1998
_ 12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See pho 0 NTY OF BUTTE
WET DIV.
—13. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010.
—_14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ -- as stated in the
Oroviile Area Traffic Mitigation Fee Agreement. Payment to be made to the Planning Wvftlon.
—15. All new residential bull its shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety.
Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3 requirements of
the Uniform Building Code.
—16. Deer Mitigation fees are to be paid, If such fees have been adopted by the Butte County Hoard of Supervisors.
X,17. Pay school Impact mitigation fees.
, X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article 11 of the Butte County
Code.
—19. Wood stoves and fireplace Inserts shall be EPA approved and designed to meet the emission requirements of the California
Clean Air Ad of 1988 as amended. —.
—20. ff any cultural resources are encountered during ground disturbing activities, all work shall cease In the area of the find pending
examination of the site by a professional archaeologisL This person would then be able to assess the site significance and
suggest appropriate mitigation measures.
—21.
22.
—25.
26.
LD 6198
FORMS\BLDG PERMIT CLEARANCE
PERMIT NO. ., 45Z9-n:76P,E
PERMIT EXPIRES B11-4/2
OWNER T. C. Sheppard
b
CONTR. owner
LOCATION (A.P. 2.1-15-5
W/S Block Rd.,app.700'KS.of.West LibertyRd.,Gridl
,
j
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
Called PG&E
Temp. Gas Serv.
Called PG&E °
JOB
FINALED
(Date)
(Signature)
"
COUNTY OF BUTTE — DEPARTIMENT"OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
• Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Stemwa l I
Garage Vents
Insulation
Water Htr.
Heaters
Slab
Carport
Footings
Slab
handicar pehysically
Conformance of ex.
structure
Final
Appliances
Gas Piping & Test
Temp. Gas
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE REMARKS OR CORRECTIONS
0
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive' , oeoAIIe, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
!�6 7 -7�
zl_----,
aUL"Orcc ICFIICSCIILatIVCS UI ine County ai Butte to enter upon the
above-mentioned property for inspection purposes.
l�i y_x2,Pd�� Date
Signature of Permitee or Agent
Receipt No. /S_1Ael or
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
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.
DIRECTOR F PUBLIC WORKS
By DateJ(.- /l" _
wilding permit expires Date B —116 ^72-7
BUILDING
Owner te J
SQ. FT. OCC. BUILDING VALUATION
Mailing Address_
I r (�n
Mefe
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
Building Address (� S OG k
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 �
QB S ^— P
Each Trap 1.50
4
Repair drainage or vent piping 1.50
Water piping 1.50 Q , p0
20nTng Verificatiotl Ort%9
Each gas water heater or vent 1.50
A. P. No. pC / S�- �j
a
/�+0 ing
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
t�
W.C.
Sa t
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
IParking
Plans
Parcel
Declaration
parcel Ma P
60' R/W
ImprovementsLawn
sprinkler system 2.00
dp-_�'!e
Bldg. Plans Recd
''
Parcel Approval
Pla s royal
Permit Fee $
$ QZ
NEW ❑ ADDITION ❑ UTILITIES OTHER ❑
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
,�
Main service 10000 AMP ORV OR LESS5.00
Main service EA. ADD•L 100 AMP 2.50
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service OVER 600V
100 AMP OR LESS 25•��
Main service/ EA. ADD'L 100 AMP 1.00
500 SQ. • MINIMUM
FOR MOBILES
NEW CONST.OR ADDNS. ( ACCDWELBLDGS.LING CCUP. &) 2¢syft
NEW CONSTR MULTI -OUTLET
NON.RESID. BRANCH CIRCUITS) 12.50ea
PO ER A PARATUS
NON NEW -ESIRES 0. ( SINGLE OUTLET CIR.&
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Ex. Occup(OUTLETS OR FIXTURES)@tea
BAL@1
Ex. OCCU FIXED ALNS. OR
Occup. (PPRESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
® I am exempt from the Contractors License Laws of the State of California.
Permit Fee $ 6
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
ERI 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 Workmen's Compensation Laws of
California.
MECHANICAL No. @ I FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
aUL"Orcc ICFIICSCIILatIVCS UI ine County ai Butte to enter upon the
above-mentioned property for inspection purposes.
l�i y_x2,Pd�� Date
Signature of Permitee or Agent
Receipt No. /S_1Ael or
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
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.
DIRECTOR F PUBLIC WORKS
By DateJ(.- /l" _
wilding permit expires Date B —116 ^72-7
.o h TI,. S/°
J V
,� oe
J
d •
®� �Y , porc
ILL
a
I
� e
S ` PN Z
MA -4o nal
o 'Pe"IY i' 45 7q-74 The Setback shall be 5 ft. frog
("All All uti l onne tions shall be � "�
located i , 4 f outside the rear r, -� the side property line and 50 ft. frorg
4he centerline of the road, permitting
�– l�third self of a mobile home a maximum of a 2 ft. eave overhancjS
tt `• on the left r 6I) a of the mobile s
o home.
o Septic sy t an location
to be as per
Butte County ealth Dept. Re-
p9 quiremen s.
'3 c U_
s )
c
chis set of` pians &MWNMMMUST od..
kept on the" job at all times an i is un a
make any changes or alterations on same without
;or
itten permissorr from the Department of Publirks, County of-,. Butte.
BUTTE COUNTY
i
NOTE:—All Materials_&- Workrnc+Ashi $h II Be ,n BU -1 ING DEPARTMENT"
Accordance ; with - Recogniikd Good Practices incl --
of a �ali-ty- `Prescr--ibed for the Specified use in the A P -P P O V.� D
Uniform Building, Plumbing & Machanical Codes and
p the' National Electrical Code.
.l1N�r/ouc( do a �_'v7 L» oS
v
r+4!
DECLARATION RUARDING LOTS OR PARCELS
I•certify that as owner of the property acquired by deed in Volume ,
Page Official Records of Butte County, (AP#
I am requesting permission to build or install an.additional living unit on this
property. I will not divide the aforementioned property for sale, lease, rent, or
financing unless all applicable land division -laws and map requirements are com-.
plied with.
I am conversant with the present zoning regulations affecting the afordmentioned
property, and declare that I shall not violate same. I represent that.the proposed
use of the additional living unit is
22Z�
and that further I shall not change this proposed use of the additional living unit
unless and !until I receive written approval therefor from the County of Butte.
I fully understand that pursuant to Chanter 20 of the Butte County Code and §11535
et seq of the Business and Professions Code that if I, in the future, sell, lease
or finance the area on or adjacent to said improvement without fully complying with
the applicable laws and ordinances, that I shall be guilty of a misdemeanor and
therefore, subject to the aforesaid penalties and imprisonment pursuant to law.
Further, this -,statement shall -be properly acknowledged and -recorded -at -the -re quest ---
of the County of Butte:
OFFICIAL RECORDS
U i't COUNTY; CRL1 .
�0?.D FEOJ
+�c 1 I Q c6 P4� 19
I.DUISE KLUEi�DEft D�
CflUP9TY RECflftDEft EE
474
01,mer
July 6, 1976.
NOT COMPARED WITH Date
ORIGINAL DOCUMENT
VIM% W1121
STATE OF CALIFORNIA ) ss
COUNTY OF CA1J?0RXAA )
On this 6th day of July , 197 6, before me, Ruth H. King
, a Notary Public in and for the County of
State of California, residing therein, duly commis-
sioned.and sworn, personally appeared T. C. Shdpipard known
to me to be the person whose name is subscribed to the within instrument and
acknowledged to me that he executed the same.
IN WITNESS WHEREOF I have hereunto set my hand and affixed my official seal in the
County of Butte the day and year in this certificate first above
written.
®111A111A8111A1¢At¢IIAAI1919AB91101111A919A1111111111AAA11�1
c
RUTH H. KING
�"yRuA
NOTARY PUBLIC - CALIFORNIA o 4Ntary
FSUTTE COUNTYH. King
My Commission Expires Sept 19, 1976'
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S96-1275
—June -9a 4.9 1976-
Gridley, Cali%;
it T. C9 Sheppard, do here by give authorization
to my son, James t. Sheppard & My daughter— in— law Chessie d:` Sheppard .
to put a mobile home on my,property: r
A. P.## 21— 2-5— 5 Located on Block Rd. Gridley, calif. R'
Signature o u orization.
T. C. Sheppard
t
Subscribed and sworn to before me t, dersigned otary public
this 6th day of July 1976.
My Commission Expires Sept. 19, 1976
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—June -9a 4.9 1976-
Gridley, Cali%;
it T. C9 Sheppard, do here by give authorization
to my son, James t. Sheppard & My daughter— in— law Chessie d:` Sheppard .
to put a mobile home on my,property: r
A. P.## 21— 2-5— 5 Located on Block Rd. Gridley, calif. R'
Signature o u orization.
T. C. Sheppard
t
Subscribed and sworn to before me t, dersigned otary public
this 6th day of July 1976.
My Commission Expires Sept. 19, 1976
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