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HomeMy WebLinkAbout021-190-0700 2-1 — 19 O — (0-70 021-190-070 06-1663 FALSONE,ELLA 669 PETERSON AVE, GRIDLEY Cont: ALLADIN ROOFING RE ROOF�� 12) i �— os sz 'FALSONE, Leon 453768B r 376-68E 21-19- s/is Peterson Ave. 1st house east o ewis Gridley CONTR: Royce , 210 Sycamore St., Grid (addition) otgi 021-190=070 06-1663 FALSONE,ELLA It 669 PETERSON AVE, GRIDLE, NOTES - ROOFING Conf- •ALLADIN RE ROOF 1 RES IDE'N'T'IAL APN: Permit No. Owner. Site Address: Contractor. Type of Permit: 5 CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: SIGNATURE: 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. BP061663 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. I LICENSED CONTRACTORS DECLARATION I hereby affirm under penally 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. !i 7 U License Class : �_Z� License Number: -�L Date: 0-%-0(-e Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the. basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements see not Intended or offered for sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale.). ❑ 1, as owner•, of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Slate License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code .Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance eccarrier �and policy number are: D Carrier:^�—'^-�" Policy #: 7 t+ 3 t! � 7 / — C� � ❑ 1 certify that in the performance of the work for which this permit is issued,.l shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Is issued (Sec 3097 Clv.) Name: Address: Issued Date: 07/11/2006 APN: 021-190-070-000 Site Address: 669 PETERSON AVE GRI Map Index: Description: REROOF 20 SID COMP Owner: FALSONE, ELLA 669 PETERSON AVE GRIDLEY, CA 95948 (530)846-2876 Applicant: ALLADIN ROOFING P 0 BOX 4262 OROVILLE, CA 95965 (530) 533-2934 Contractor: ALLADIN ROOFING P O BOX 4262 OROVILLE, CA 95965 (530) 533-2934 License #: 532834 Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: hereby is i dp work PERMIT EXPIRES ON: under provisions of the'Butle County Code fees have been paid. / , ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. O Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and stale laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes. Print Name: "i GZ / r r Signature: Date:(J— 77 ❑ YOwner I-gpnlractor - ❑ Agent for Owner 0 Agent for Contractor V-- - -1 rjr-,-� +=OK o = Not OK MANUFACTURED HOMES DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn Test; FaWCIO-Concrete i 4 Wtr, Loctn Test-Easeinent Needed -Regulator 5 Elec Loctn-Cirncs-Grad • Amp -Concrete 6 Yard Gas; Loctn Test -Wrap Nat O or LPO Inch Sz Ft Lngth 7 Blckng; SzSpacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-DImcs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -CIO to Grade 12 Gas and Electricity Tagged 13 Tie Downs Foundation ❑ _ 14 Exits 15 Cert of Occupancy 16 HUD LabeUlnsignia Numbers Serial Numbers oa ds o'e �a MISCELLANEOUS- -,DATE DECKS -COVERS -CARPORTS -GARAGES 1 ZoningSetbacks-Easements 2 Figs; SoilsSz=DpthSpacing-CnnctrsSteei f 3 Decks, Girders/Joists-Dcking-Brcing Stairs-GuardlHandrails 4 Wood Awn; Posts-Beams-Rftrs-G_nnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rttrs Tnisses 9 Siding; Nailing-Vene.erStucco-Lath 10 Roof, Shthg-Roofing 11 Ext; Steps-Doors-Landitgs 12 Braced Wall pnis DATE IPOOLS 1 Setbacks -Easements . 2 Soils; CompactlonStructure Stability 3 Pool Structure; Steel-Dnnctns Thickness Dead Men -Lining 4 Elec Reptcis&Ung; Distance-GR 5 Elec Pool Uirtg;15 volts-GFI 6 Elec.Ekfiws; Conduit Entries Terminals -Listed 7 Elec Bonding; Metal w/5'-Crdtng Egp-Htr S Elec Grndng; Eqp w/5' Crcitng Eqp-Pool Ightg Boxes-Encisrs-pnlboards.4nsul.n-to Main Conduit 9 Health Dept Appm 10 'Plmb; Cir Test Wtr Supply Test 11 Lt Niche , 12 Endsr, Fencing Alarms 13 Bonding, Diving board or Slide 4P �� o Pool Drawing 0 =Not OK RESIDENTIAL (Single & Duplex) DATE JUNDERFLOOR 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd Ft4 Dpth 3 Ftg Garage; Soils-Steel-Elec Gmd Ftg Dpth 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth ' 5 Stemwalls Main; Steel-Blockouts-Wrapped 6 Stemwalis Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchrs 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgitrService Test 12. Elec Undrgmd 13 Plenums & Ducts; Cimc-MaterialSupport-Insultn 14 GirdersSills-Anchr BoltsJoists-Vnts•Crippies 15 Ace & Vntitn 16 Insulation 41 DATE FRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacing & Braces-PlatesSound 19 Bearing Walls over Girders tip fir Nailing 20 Draft Stop In Walls (rat proof)' 21 Fire Stops; Furred CeilingsStalrs-ChasersTutu 22 Headers B.Beaihs* &"Bearing' 23 Hangers-Post'Caps-Anchrt-Ciinctns 24 Ceiling Joist4btr Ties-Purlin-Roof Brac TrussShthg 25 Frplc Ties or Type A Flue=Frplc Throat Clrnc 26 Attic Acc; Sz &.Rink Pitctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or. Exiting Doors -Sill "t & Dimensions 28 Garage Fire Prtcbi Framing -RC Channel 29 Prprty Une Firewall & Opngs' 30 Ext DoorsAne 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run4-anding-Fire Prtctn 32 Plywd on Roof Ovrhng Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Ace 35 Glazing Area -Glass PrtctnSkyLts-Plastic . 36 Shear Walls; Nailing -Bolts 37 Brace IntiExt Wall pnls 38 Insultn-Walls-Ceilings 39 Infiltration Walls Wndws o' o`s' DATE JELECTRICAL 40 Fxtr & Trnsfrmr Cimc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Gmd made up w/Mech Fstnrs 45 Grndng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFl 47 Subfeed Wire Sz w CU or El AL AC Wire Sz ya ❑ CU or ❑ AL 48 Range Circ P ❑ CU cr ❑ AL Oven Circor El Insulated Neutral Hclj Yes ❑ No Q, 49 Service -Riser Cndctrs & Gmd Main Dsennct 50 Eqp Cirncs pnts-Motors-Mech Eqp 51 Clothes Closet LI-Shwr Lt -Spa Lt 52 Smoke Detector s I- 4.11 clo' UAit IPLUMBING 53 Wtr Htr; Vent-Acc•Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr. Nail Prfctn 56 Shwr Pan; Test, First fir -Tub Ace 57 Test Tutt & Shwr, 2nd fir - Tub Ace 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping a DATE IMECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Ace & Pltfrm if Furnace in attic 00 o+`• DATE FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cimc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFl & Bath Fxtrs & Tub AccSpa 71 GFl Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, GuardlHandrafls 74 Frplc or Stove, Cimc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Gmd Air -Gap -Cooking Clmc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door, Swing -Landing -Closure 79 AC Duct in Garage -Damper. 80 Wtr Htr, Vnts-Cimc-Com Air Cnnetr-PRV;' abv fir Mech Prtctn; LPG Appince Undr House 3' drain 81 Plmb; Elec & Mech Eqp Listed for Loctn 82 Elec Rcptcls in Garage (GFl) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Dmge & Wood -Earth 86 Cimc Dmge Planters ❑ Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Pimb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Cimc to Opngs 90 Wtr Well, Dscnnct, Elec, Pimb 91 Ext Elec Trim, GFl Rcptcl-Undrgmd 92 Vntitn thru House 93 Glass Prtctn 94 Corrections from previous lespetns 95 Gas Test -Meters Tagged, Gas-Elec 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 97 Energy Cmpinc Cert -Other Certs 98 Address Posted 99 Fire Sprinkler BUTTE COUNTY 5EPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT'NO. BP061663 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penally of perjury that I am Ilcensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 07/11/2006 APN: 021-190-070-000 the Business and Professions Code, and my license is In full force and effect. License Class: '.'3 License Number: 53� Site Address: 669 PETERSON AVE GRI Date: 0'7-0(e Contractor: Map Index: Description: REROOF 20 SQ COMP p OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: FALSONE, ELLA to Its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 669 PETERSON AVE 7000) of Division 3 of the Business and Professions Code) or that he or GRIDLEY, CA 95948 she is exempt therefrom and the. basis for the alleged exemption. Any (530)846-2876 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: ALLADIN ROOFING owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, P O BOX 4262 provided that such improvements are not Intended or offered for sale. If however, the building or improvements are sold within one OROVILLE, CA 95965 year of completion, the owner -builder will have the burden of (530) 533-2934 proving that he or she did not build or Improve for the purpose of sale.). ❑ I, as owner•, of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, Contractor: ALLADIN ROOFING and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). P O BOX 4262 ❑ 1 am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95965 (530) 533-2934 Date: owner: License #: 532834 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ❑ 1 have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy numb Q Carrier:`� ' Total Square Ft: 0 S. F. 713 ` 1 �! 7 %— y w Policy #: Valuation: $0.00 ❑ I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any persons any manner so as , become subject to the workers' compensation laws of California, U and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This pe mitis hereby issued under the applicable provisions of the Butte County Code nd/or I hereby affirm that there is a construction lending agency for the Resol o o do work I icated o for hich fees have been palc. performance of the work for which this permit Is issued (Sec 3097 Civ.) Date: t! Name: PERMIT EXPIRES ON: /107 Address: (D e) ❑ 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 enterupon the above mentioned property for inspection purposes. Print Name: UZ Q�� r " Signature: / U— 7 _D Date: ❑ "Owner K.Zntractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Bustling Permit 01 -ie -04 pg i 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.net/dds "PLEASE PRINT CLEARLY" APPLICANT INFORMATION OWNER INFORMATION Last Name :IirstNa7e Address D i, Address r_ 1_ "Pete e r� t - City ` 1� t State Zip Phone _ ? So Fax E-mail Lic. # 635#1'3q APPLICANT INFORMATION CONTRACTOR Name Cyt Q . Address D i, 60V Z.& Z cvR City �f�i /l G Fax State Zip Phone Map Book Fax E mail Planner Lic. # 635#1'3q CI s APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address City State . Zip Phone Fax E-mail APPLICANT SIGNATURE X 42,04 For office se only: Zoning Flood Zone Receipt #: SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # j� ` PROJECT LOCATION '� AP#Vp(_ �V Property Address a City e ers U� r4P Cross Street 1j, WORKER'S COMP NSATION 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: aa- © 9e Zoo D � Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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. Received by: Amount: Bldg SRA Receipt #: Sheriff SMIP Other Date: Total K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation. Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 t July 23, 2004 Department Cou.nti J. Michael Crump, Director Charles Pfister 635 W. Evans Reimer Road Gridley, CA 95948 Re: Lot Line Adjustment AP 021-190-069 & 070 Dear Mr. Pfister: Public f B u t Works LAND DEVELOPMENT DIVISION 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 On July 23, 2004, the Department of Public Works made the finding that the Lot Line Adjustment on the above referenced property is exempt from environmental review, and approved the project subject to the conditions on the attached page. This approval should satisfy your appeal request. Please submit a letter to the Board of Supervisors withdrawing your current appeal. . . Should you appeal the decision of the Department of Public Works, please submit your appeal, in writing, with the appeal fee of $50.00, to the Clerk of the Board of Supervisors, 25 County Center- Drive, Oroville, California, prior to 4:00 p.m., August 2, 2004. The conditions of approval must be met within thirty-six (36) months from the date of approval by the Department of Public Works or the approval will be considered null and void. If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, Stuart Edell Manager, Land Development Division Michael Mays, L.S. Deputy County Surveyor SE/MM/kp Attachment cc: Board of Supervisors Clerk of the Board Environmental Health Department , 3uilding Division GDA (03-046) r Charles Pfister, Lot Line Adjustment, AP 021-190-069 & 070, Reconfiguring 2 parcels, to effect a 1991 Homesite Segregation Use Permit approval, located on the southeast corner of Peterson Avenue and Lewis Oak Road, Gridley area. Engineer/Surveyor: GDA. 1. New lot or parcel lines shall comply with setback requirements of applicable zoning and building ordinances. 2. Deeds and plats (if required) shall be submitted to the Department of Public Works, Land Development Division for checking and approval prior to recordation and shall contain the notes specified below. 3. Provide documentation from a title company of the applicant's choice verifying that any deed of trust affected has been partially re -conveyed or modified to reflect the lot line adjustment and to prevent the creation of any additional lot or parcel. 4. Prior to recordation of deeds, provide documentation verifying payment of taxes as required by Subsection (b) of Section 20-95 of the Butte County Code and as specified in Article 8 of Chapter 4 of Division 2 of Title 7 of the Government Code, commencing with Section 66492. 5. Prior to the recordation of Deeds, prove, to the satisfaction of the Director of Public Works, that the subject parcels were created in conformance with State law and local ordinance. PLANNING DIVISION CONDITIONS: 6. Concurrently with recording the deed(s) to effect the Lot Line Adjustment, the 18.2 acre remaining from AP 021-190-005 (now AP 021-190-069) shall be merged with the 37.2 acres of AP 021-190-008 in order to meet the requirements of the A-40 zone. 7. Concurrently with recording the deed(s) to effect the Lot Line Adjustment, record a restriction binding upon the original owners and their heirs, successors, and assigns which disallows additional dwellings and buildings from being located on the property until either of the following conditions occur: a. The property is rezoned to any non-agricultural zone; or b. At least 10 years`has elapsed from date of recordation;°,and the commission and other:.. properties in the area have changed sufficiently to reconsider the restriction. Deed Note (To be placed on any deed to effect lot line adjustment) The purpose of this deed is to effect a lot line adjustment as approved by the Butte County Director of Public Works on The above described lands are to be combined with and become a part of those lands as described in the deed to as filed for record in Butte County Official Records at Serial Number Book at Page No additional lots or parcels are created hereby. The scope of review of said lot line adjustment was limited as specified in Government Code Section 66412(d), and approval of it does not constitute assurance that future applications for building permits or other land use entitlements on the modified lots or parcels will be approved by the County of Butte. Plat Note (To be placed on any required Plat) This plat does not constitute a legal description of the lots or parcels depicted and does not show all easements of record on or affecting said lots or parcels. ■ Lot Line Adjustment Conditions of Approval - Butte County ■