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021-260-051
NOTE8RESIDENTIAL ` PERMIT NO._� 05-1203'-1 021-260051 �. �:.., _. «... �..... ii SWAB SON, DEAN 7 11-� ,`, /G /Y. LOSSER, GRiDLEY _ Y •\ /.. Cont: PROFESSIONAL. CONST NSF/G ARAGE!CO V iN4STR#01-71 SPECUL CONDITIONS CHECKED BY ;. SRA FLOOD CERTIFICATE REQ. FIRE -SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER k f- - OFFICE COPY, _ ..Address '1 a -GAS�- Meter By Date r EL.ECTRLC" Ai1-13 C. Meter By D S \(h(yt0(�LS Date y3 ` ,. JOB FINALED (Date) (� ' - _5 e_&A .`i Signature� . - _.- ..�-�'. �-.-_r•`•��--1,'..`y.•..,.-•.�,.,,+�y..,,,�•�I„-"r.,��r,�..-�•�..,,,�.t-.........y-,.,.,..,{x.�•rw•rT.y'ro .� a'v.•'+.�v w.'__'..R'r..-r�.�.•..+�'+.a CERTIFICATION OF INSULATION WHITE - Builder Copy, GREEN - Builder Copy, YELLOW - Customer Copy, PINK - Attic Copy, GOLD - File Copy ADDRESS OR TRACT SACRAMENTO BUILDING CONTRACTORS 1309 MELODY ROAD, MARYSVILLE, CA 95901 LIC#202026 �1 �U 605 S. AUBURN STREET, GRASS VALLEY, CA 95945 LIC#202026. .❑ 3881 BENATAR WAY,.SUITE A, CHICO, CA.95928 LIC#202026+' �� j� ..� ❑ 8924 AIRPORT ROAD, `REDDING, CA 96002 LIC #202026 r DATE INSULATION COMPLETED ' v ( square feet) ( square feet) ( square feet) TYPE OF INSULATION, ,,. , .. �. , _ TYPS.,OF INSULATION i — �.. - __ TYPE. OF.INSULAT.ION, _ k MATERIAL 1 MATERIAL 4 MATERIAL • FIBERGLASS FIBERGLASS FIBERGLASS FORM BATTS FORM BATTS & BLOW FORM BATTS MANUFACTURER'S PRODUCT I.D. MANUFACTURER'S PRODUCT I.D. MANUFACTURER'S PRODUCT I.D. MANUFACTURER MANUFACTURER MANUFACTURER 1 (CTj OCF KN CT OCF KN !!�� CT OCF t'KN BAGS �' ., • F R -VALUE• APPLIED R -VALUE APPLIED MIN. INSTALLED WEIGHT PER R -VALUE APPLIED INSTALLED THICKNESS INSTALLED THICKNESS SOUAREFOOT INSTALLED THICKNESS � h' j KNEE WALLS IF R -VALUE IS OTHER THAN WALLS ABOVE MATERIAL FORM R -VALUE MANUFACTURER FIBERGLASS BATTS CT OCF KN AIR INFILTRATION SEALANT MATERIAL •-FOAM , ...,...-., �' .. MANUFACTURER. -. - - _ �. ' HILTI -.i �•. - - w + t HANDY FOAM .. THIS IS TO CERTIFY THAT INSULATION AND/OR SEALANT HAS BEEN INSTALLED IN CONFORMANCE WITH APPLICABLE CODES, MATERIAL STANDARDS AND REGULATIONS , r`` SIGNAU�RE -, I�JS •CATION�RAC'O f J�' �j +{� WWAIMM ij �� (^ DATESIGNATURE ji � \` "11FF��11 11 -�(GGENERAL CONTRACTON `. TITLE DATE � REMARKS •� is WHITE - Builder Copy, GREEN - Builder Copy, YELLOW - Customer Copy, PINK - Attic Copy, GOLD - File Copy .r COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 !E CORRECTION NOTICE OWNER _ PERMIT NO. A, routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be.corrected. Please.call for re -inspection when correction of work is completed. If you have any questions pertaining to this matter, or need additional expfanationn,y,,� please contact the Building Inspe organs indicated below. Date Inspector. CA (L L REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 a es Date Inspector. CA (L L REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA o (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please .call for re -inspection when correction of . work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below. - t Date Inspector 2 p REV 4/05' Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 �� uTrF ENCROACHMENT PERMIT 0o 0 o 0 County of Butte Department of Public Works a y� 7 County Center Drive Oroville, CA 95965 U 9 4C WCt�- Phone: (530) 538-7681 Fax: (530) 538-4356 All information except signature must be typed or legibly rinted Permit N: (Zvi NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE STARTEDS Assessor's Parcel Number (Required): Property Owner's Name: PROPERTY Phone: �. 7 �7? •— ZG Property Address: /- & Mailing Address (If Different). i^'��ff : tt OWNER Ke Ic y lit d� C4s�65 Work will be performed by: ❑Contractor Property Owner Contractor's Name: Phone: �� Address: Fax: 2-c i� pJ - s� G A �1 9 (_19 WORD PERFORMED BY Contractor's License 7 L! Number: U ! 7 S� Certificate of Insurance currently on file with Deoartmentl AYes No Applicant is: Property Owner ❑ Property Owner's Agent ❑ Contractor ❑ Other: I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the Cou ro d hijzhways. W4 in r-wrdaftsc with County ordinances and ''eneral laws. Signatur Data Sign Road offted: �- Time and Duratian of Encroachment: Permanent Encroachment ElTemporary: From To LOCATION Type of Encroachment: Driveway Roadway ❑ Culvert ❑ Fence ❑ Pipe/Pipeline ❑ Sign/Billboard ❑ Other Site Plans Attached: ❑ Yes /14 No PERMIT IS: GRANTED ❑ DENIED Conditions: Ih compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) andspecial conditions written below, permission is hereby anted. 1. ❑ Underground Service Alert (U.S.A.) must be notified two working days prior to any excavation. 800-227-2600 2. ❑ All work shall conform to accompanying: ❑ Detail ❑ Plans ❑ Special Conditions 3. ❑ Other Conditions: PERMIT CONDITIONS. Ccs NFZiZ+t'\ c S i A Ski S A i T (To be filled in by County) �✓ Date j Expiration Sure Issued: (� 65 Date: 0 C Surety: Z5 Date Amoun Paid: ZG �S"r (j Paid i��n�+�� .� Check Receipt Paid: �4' I c BY �, y y' I i No: No.: a Mike Crump, Director of Public Works By: Road Dijst-rict: '!v Inspected By: % GF 1onCompleted - OK C1 Completed - Not OK Results: For County ❑ Additional Comments Attached Use Only Comments: Note: If permits are faxed to any number besides 530) 538-4356, they can be delayed up to one week. Form 200506EP Page I of 2 J=OK 0 = Not OK e = Not Ready Ede MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Card B-1 Date 1. Zoning Requirements -Setbacks -Easements Date 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 1. Zoning Requirements -Setbacks -Easements 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft1 P LPG 3. Blocking 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 5. Electricity; MH Test 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date 1. Zoning Requirements -Setbacks -Easements Date 2. Footings; Size -Spacing -Marriage Line 9. Exits 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances S. Drain; MH Test -Fall -Flex Connector 11. Verify #'s with Office 6. Water, MH Test-Regulator-Connecto? 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged Card B-1 Date 9. Tie Downs -Type -Installation Cert. Date 10. Exits; Insp.-Sketch Card B-1 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg- Frg- Bracing 1. Zoning Requirements -Setbacks -Easements 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 2. Footings; Size -Spacing -Marriage Line 7. Electric 3. Blocking 8. Fnng.; Sills-Anchors-Studs-Rftrs-Trusses 4. Gas; MH Test -Demand -Valve 10. Roof; Shthg-Roofing 5. Electricity; MH Test 11. Ext.; Steps -Doors -Landings 6. Water, MH Test 7. Water and Sewer Connected Card B-1 Date Card B-1 Date 8. Gas and Electricity Tagged Date POOLS (Plans) OK except #'s 9. Exits 1. Setbacks -Easements 10. License Decals 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 11. Verify #'s with Office 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 t MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg- Frg- Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Fnng.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date UND L OR (Plans) OK except #'s 1. Ing -Setbacks -Easements ood-Slope 2e"Ftg., Main; Soils-Elec. G .-/ Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. $temwalls, Main; Steel-Blockouts-Wrapped emwalls, Garage; Steel- Blockouts-Wra ed 6 . Hold owns and Special Anchors ab, Steel -Wrapped fl.yrs-Fireplace Ftg.-Steel Or D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground enums & Ducts; Clearance -Material -Support -Ins. it ers-Sills-Anchor Bolts-Joists-Vents-Crippies ccess & Ventilation 16. Insulation Date 41 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLU ING (Permit) OK except #'s 1ater Htr.; Vent-Access-Combustio Air Baffle 1 ,Water Pipe; st & Anchor -Nail Protection . D.W.V.; Teft Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler, Test Date ,G/- Card B-1 4,1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELEC ICAL (Permit) .OK except #'s Ixture & Transformer Clearance -Ins. Protection 2 PK Receptacles Spacing -Lights & Switches at Doors !2!S' a Boxes & No. of Conductors Stapled 27 Romex Installed Close to Edge of Studs & C.J. / 28, quip. Ground m de up w/Mech Fasteners -Bond 19as & Water 24. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ Na. Cu or M-A.C. Win; Size! a /ga Cu or AI 31. Range Circle/ Q /ga 06 or AI -Oven Circ. / /ga Cu or AI Insulated Neutral Qhes 0 No 32/Service-Riser Conductors & Ground Main Disconnect 33 Equip. Clearances Panels-Motors-Mech. Equip. 34/Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ME9.KANICAL (Permit) OK except #'s 34' kC. Ducts Insulation & Support 3 . V nt Fan, Exhaust above insulation 38 Condensate Drain & Overflow, Size & Grade 39. umace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & P19,tform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 4 Sills Proper Materials & Anchors 4 alts Studs -Nailing Spacing & Braces -Plates -Sound 4 earing Walls over Girders & Floor Nailing 4 {0'raft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46- Headers & Beams -Size & Bearing Date FRAf ING (Continued) 4 angers -Post Caps -Anchors -Connectors Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance W M5 cess; Size & Romex Protection -Draft Stop -Ins. Baffles 5r pilrm. Windows or Exiting Doors -Sill Ht. & Dimensions k�A V'. Garage Fire Protection Framing -RC Chqp4el roperty Line Firewall & Openings Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits ''Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 516. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer ' 58 Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access A. Glazing Area -Glass Protection -Skylights -Plastic 60,She_4F Walls; iling-B s ce Int or/Exteii r Wall Panels ation-Walls-Ceilings P: 112 Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FIN tans) OK except #'s Steps -Door & Sidelight Protection -Landings 66. Smoke Detector 66. Furnace Vents -clearance -Comb, Air-Connector- _Iwdarage; Above Floor -Ducts -Meth. Protection Broom Exiing 6E( I. & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel, Breaker Sizes & Labels 7 airs & Rails 71f Fireplace or Stove, Clearance -Hearth 72,eEfec. Outlets at Wood Panel, Int. & Ext. 7S. _it. Fixt. &Appliance; Ground -Air -Gap -Cooking Clearance ec. Outlets & Receptacles at Kit. Counter ge Fire Door, Swing -Landing -Closure 7 A -C. Duct in Garage -Damper 7. Wtr Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. _ir(Garage; Above Floor-Mech. Protection 74. Elec. & Mech. Equip. Listed for Location TV' Elec. Receptacles in Garage (F F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor D Yes 83. Following Instld./Drive 0 Yes D No/Walks O Yes O No/Planters 0 Yes D No 84. S co Brown -Finish 8 . 'Unit Disconnect, Electrical -Plumbing 8 . V nts Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings ter Well, Disconnect, Electrical, Plumbing Exterior Elec. Trim, G.F.I. Receptacle -Underground 8 tilation Throughout House 9f. Glass Protection 91. Corrections from Previous Inspections s Test -Meters Tagged, Gas -Electric ater & Sewer Connected -C/O to Grade -HD Approval ergy Compliance Certificate -Other Certificates Address Posted 96. Fire Sprinkler Date ,� k! Card B-1 L A51 - Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP051203 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: 07/28/2005 APN: 021-260-051-000 the Business and Professions Code, and my license is In full force and effect. �Y (7 License Class: Licens umber: Site Address: 1258 LOSSER AVE GRI Date: �- r? 8—yrContractor: Map Index: Description: ( ), 9 ar (576 2310 nsfitlOn: ), COV(312) mstr 01-71 OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: SWANSON, DEAN AND EFFIE to its issuance, also requires the applicant for such permit to file a PO BOX 554 signed statement that he or she is licensed pursuant to the provisions of PENRYN, CA. the Contractors State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95663 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: PROFESSIONAL CONSTRUCTION AND Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does INVESTMENTS INC such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 9840 BUSINESS PARK DRIVE year of completion, the owner -builder will have the burden of SACRAMENTO, CA 95827 proving that he or she did not build or improve for the purpose of (530) 713-3838 sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: PROFESSIONAL CONSTRUCTION AND pursuant to the Contractors' State License Law.). INVESTMENTS INC Cl I am Exempt under Article 3 of the Business and Professions Code 9840 BUSINESS PARK DRIVE Date: owner: SACRAMENTO, CA 95827 (530) 713-3838 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 License #: 843179 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier:�- Policy #: O S� Z. Total Square Ft: 3198 S.F. 010 ❑ 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 Valuation: $168,966.00 / become subject to the workers' compensation laws of California, Census Code: 1 v and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall ` f 1� v\ forthwith comply with those provisions. — 2- r— or Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars (8100,000), 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 h y issued u er thea licable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions do work' di ed above r r whw fees have been paid. yy-� �% 2 (_0 — Name: By: Date: / c—� PERMIT EXPIRES ON: Address: Dale ❑ 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 a o�formocument of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpose . �^�S Print Name: r/"J Signature: Date: -7 Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 /0R5s�o -?/ 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 REO UIRED AT TIME OF APPLICATION Website: www.buttecounty.netldds "PLEASE PRINT CLEARLY" OWNER Last Namel J S ,1Sse�J ust Name /1jL,__, Address City State, Zip`f-66 Phone S3 6c°�j`� Fax 6-6Gj-2.6o0 E-mail CONTRACTOR Name Addre s O /10 J0 City �y State r,,l Zip.J-06 Phoneyo_ 330_fP37 Fax —746-663—Z6� E-mail Lic. # Y31 Class6 ARCHITECT/ENGINEER Name Address City State Zip PhoneS3 0 —&Y6 — 6 ?74 Fax E-mail State License Number l 9 � 'Z APP ANT SIGNATURE X For offic use only: Zoning APPLICANT NAME Name Yes Address Occ. City Type Const. State Zip Phone Page Fax E-mail Date: �.1sxl APP ANT SIGNATURE X For offic use only: Zoning AP# ©'Z, — _a6 (9 -& S_ / Flood Zone SRA Yes No Occ. WORKER'S COMPENSATION Type Const. Subdivision Name If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. Map Book Page Lot # Planner Date: �.1sxl Date Approved: OVER FOR SUBMITTAL REQUIREMENTS u•%cnRnnc%Ri in nimr: FnRMS%BltloAoolSubRamts.doc PERMIT NO. 12C> BIN # LOCATION AP# ©'Z, — _a6 (9 -& S_ / PropertYZ�/� L 6 ss City ��� � L± Cross Street AWOWSRA 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: 4:9 17-4SeDF -.ca . �- 25-7GCoA- - Sq. Footage ❑ Structure Built without Permits ❑ Proposed .Change of Occu anc (Note previous use):—7 / 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. Pape 1 of 2 REV 2-24-05 (2- EXPIRATION 2 aD Received by: Amount: Bldg %� AWOWSRA Receipt #: " t I I Sheriff 14 SMIP 40"W.Other Date: �.1sxl 15(2 Total Pape 1 of 2 REV 2-24-05 (2- EXPIRATION 2 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 KAFORMSMILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 po/ W, _Z�> COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET /,., OWNER: 5W i "�/ SU r ASSESSOR PARCEL NUMBER Proposed Building Use: %y 5F l' l 0r Permit Technician: rr-_ Date: 5-5 Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. IN 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate: ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 112. Hazardous Material Form 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Imamng items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 715. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable 16. Fire Sprinklers............................................................................................ hl t 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by 18. Soils Report and/or Engineered Foundation required ........................................... �xfE6� 19. Erosion Control Plan Required........................................................................ 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 21. City of Chico Plumbing permit ...................................................... '................. ❑ 22. Site plan and business license approval from the City of Biggs .............................. 23. California Department of Forestry Ian approval ❑ paid. Sent by: ........ n.,`,C- f - ) 24. Planning approval for (A) Use: �(B)Parking: (C) Parcel Check:.c5 ..... '% Z-a� ❑ 25. Contact Land Development about -Improvements, -Drainage ........................ 26. NPDES Form............................................................................................. N, 27. Encroachment Permit for driveway from the Public Works Dept..."1431AG 5.X,..... E 050 (D ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... 31. Letter of Signature authorization ..................................... ....... ......:................ . 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... 35. ❑ Legal descrip'on, ❑�.H. Title, title s�istration or MCO ......................... rrbD 36. Other: 37. Other: 330 0���/ When issued Telephone 4 -MU _W Afi_W% and hold for pickup. I have been inf rm- of thea ve items and requirements for obtaining a building permit. Applicant: Date: Sy` 1. Index permit appfiegrion for t ove i s umbe Plan Check et r 2. Additional items required 6::M - on rac , esigner, owner, wa adv ed of the aboveata phone, mail, C3ounte,, by Date: on rac or, designer, owner, was advised of the above data by phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: _ Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by:t1Z Date. Note transfer by: Date: __---- Yellow: Building Division 1 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER IrN PROPROSED BUILDING USE 1. BUILDING PERMIT FEES --- Balance Due ..................... $ (�lJ� --- FEMA Flood elevation review ... $ -- itional plan checking Fee.... $ , SCHOOL DISTRICT FEES CDC (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. ib K4RECREATION DISTRICT FE aid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ SEL MEDIO FIRE DISTRICT (per dwelling) $ TH CHICO SPECIFIC PLAN (per dwelling) Zoning 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) A.P. # DATE RECEIPT # DATE REC. 7WATER TENDER FEES BATTALION # V._120.00 (paid at Building Division) O� SMI 9. OTHER 10. OTHER 11. OTHER At time of permit application, I was adv the above fees are required to be paid prior to issuance of the permit. These fees may be changed during"an chec g process. APPLICANT DATE Y_ Pursuant to Government � Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) ' TO•Building Department f j` , FROM: a Environmental Health 4 , t SUBJECT: Sanitation Clearance i Owner L'oca � Plan'Approved for: Sewage Disposal— # Water Sup Clearance for dwelling. Other , Hold final for: ' Final'clearance O.K. for: I E.H. USE ONLY Plot Plan Attached Floes Plan Attached Saint to S.D. / f AP# i Pul�liA Private Well NOTE: 1i 0 20 Envi onmental Health Specialist Date 8/96 -..-r .•P1,�.r...,�$..r-•z..y....�-.:+w r �... .-... ...,ter._ .....�4-.,r r� .. .. _ - i BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) a School District c Building Department No. A.P. Number 0�.� .����w•'0 1;,�.1 Jurisdiction: � City ©County Property Owner Property Location/Address Subdivision Lot No. :........................................ ...................... :...................................... Residential Development Q Q Q I• Footage No of Living Mobile Home Addition/ Supplemental to (Group R) Units I Installation Conversion Permit # i *(No foundation inspection) ........................................................................... ................... _... , Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Building Depaitrneiit Representative Addition Sq. Footage (Including Exterior Roofed Areas) Date District Identification No. ,1 �\ 11 t �� School District certifies that �v IF A n Uj A (19'6 U (Applicant) (City) has complied with the requirements of Resolution No.—(A. representing representing3 ! n square feet. (State) (Phone Number) (Zip Code) by payment of $ (�) I —) iv Lf b 2926 $ FULL MRIGATION $ Paid by Check # Remarks: 1 �� 4. . -1..Gln-b� Date Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with Govenimud Code Section 66020(a), within 90 days from the date less are paid. Failure to submit a timely written protest will'prohibit you from chsllerging the Imposition of the fees In any court axtlon. N, subsequent to the school District Representative signing tfds Sutte County Schools Impact Fee CerdNcatlon Form, the School District In Y Iiod by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQAh this project may be subject to additional school fere to fully mitigate.its Impact on the school distrieft schools. . White (applicant), Yellow (building department), bink (school district) feeform.xts 0O/O3)dmm . Q�PP'F�E+VT �v T r� / o '. C. 1\ o �ouNti 0 Department of Public Works C o u n t y o f B u t t e ° J. Michael Crump, Director LAND DEVELOPMENT DNISION / Storm Water Management Program 7 County Center Drive A %Mfz� 5 Oroville, CA 95965 4/a<<C wof`� (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase Il Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE) Project Description: Project Location and/or Parcel Number: mss 6 ?-1 — 266 —oS" 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: V . . Date: Less than I Acre NPDES & SWppp Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 Butte County DepartmentofDevelopnelitSei-vices ,uT,r 0 7 County Center Drive "'= ° Oroville CA 95965 " (530) 538-7601 Telephone o o (530) 538-7785 Facsimile c�UN'�y BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES - I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: a I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained o I am responsible for notifying Development Services, in writing,- to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from .the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not -limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: L-) (F -4-J Sty 4 .s ej -J APN: 6 Z t L 6 o Building site address: Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: Z-/J-/Oj- §_IGN4KURE OF APPLICANT DATE Copy to Applicant/EWFile K Fonns/BldgPermitwithoutClearances 020705 AND WHEN RECORDED MAIL T.U>• , _ ..'� .w BUTTE COUNTY BUILDING DIVISION - 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005-0043605 Recorded I REC FEE 10.00 Official Records I County of I COPIES 2.50 Butte I CIINDACE J. GRUBBS I County Clerk-Recorderl I I BW 02:38PN 26 -Jul -2003 I Page 1 of 2 IIII III III I IN I 111111111111111111 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: 4 f6,F4rj197CN (.644 40 If GR,t,�77d-J Date lS of State of California County of � J_�F�if S�� s o.✓ On -;�— 13' "��-, before me, S4 /'/J personally appeared1���L{JGf1---- personally known to me nr proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by h' signatures) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted ecuted the i rument. WITNESS my ha d and o a seal. A.P. # Seal: V,JANF_T'8'R'A'2'M-�MSR C( i4M. #1310312Y�yRJ�,CAUFORNIA bUaA COUNT/m, EX - lbiY 15 2005 ..-'`-" _ w LEGAL DESCRIPTION THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: Order No.: 00221407-004 ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON OCTOBER 21, 1983, IN BOOK 93 OF MAPS, AT PAGE 73. AP, NO. 021-260-051 cc�"'U , e7�� - SITE PIAN REVIEW APPLICATION Date: Permit Number (if applicable_ 12 APPLICANT INFORMATION Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: Parcel Size: Residential New Single Family Residential ❑ Single Family Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residegtial ❑ .New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other ® Septic ❑ Agricultural Exempt Building ❑ Other. ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well Brief Explanation (if necessary): 0 DO NOT WRITE BELOW THIS LINE DEYELOPMENTSERVICES INFORMATION (For Staff Use) (& j Jq Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: X • Flood Panel No.: Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance -------- : Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: 41.5— Applicable 1.S Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. n..-^ 11) —r c Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. n..-^ 11) —r c Applicable Development Fees: Standard Fees ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) Amount Formula # Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By ❑ 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 ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Jj Subdivision Mapiparcel Man: Map Date of Recording: Lot: q Book: - q.3 ❑ Use Perm-it/Minor Use Permit Permit Number: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and PRC. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the Califomia Clean Air Act of 19883, as amended_ ❑ Provide an erosion control plan for building and land disturbance, The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development . Approved dust control measures are found in the fi4ative dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for roa U Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING April 28, 2005 Dean Swanson P.O. Box 554 Penryn, CA 95663 Subject: Environmental Health Permits (APN: 021-260-049, 050, 051); Septic Dear Mr. Swanson: The Butte County Department of Development Ser/dardbuffer. PIg Division, has reviewed the submitted applications. These parcels are zoned Agrih a five acre minimum parcel size. A house proposed on a parcel in an area dericulture uses is subject to a buffer of three hundred (300) feet from each propertytion of a proposed house may also be adjusted on properties that cannot support a s The applicant is welcome to 'fill ' he/she believes that their proposed residence location is the most suitable. Tt be based on unusual circumstances related to topography or other limiting fercel. The form included and a site plan must be submitted directly to the Agricuoner's Office ote: you will be required to pay a fee for their review). After theparcel, please return the forms to Development Services. Agriculture Comm' sinner 316 Nelson Ave e Oroville, CA 965 (5 30) 538- 31 Should you ve any questions please feel free to call them directly at Chris Tolley, Assistant Planner, een the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538- 7603. Sine y, I/ T-1 Uphen Streeter / Planning Manager -�5 e W O�`W gib" 2r W eohQm°v°��Wa Di W aQnn�?cQoa`^�mv O v 44C�QVOa �wQ bL3" 1 1 1 1 1 1 1 1 1 1 lk r 1v X WC�O OCA �Q6v° e��y4 �Q�iOy� VIW.V �2o•w h�:o�� m a���n,�,yo�y�Wa�Q �Q`�We �aQW�;~� vh��2a2�°i�aeWe Chuen �1Q Q�h �. gk "QT`IA vW°a �l`QW $SAW des °WO poiy�HW�gm�22 �N.�v2eNQQ Y.O J@QOJ�WokY,2 2WZAAQOh°s�2°a'P'` CNN2;vo.W nC`�O�QSvQQOWOQvo a e �141 � o O % 0 �OzOZ 9 a, \N V O v VW •:. " b� r 1 A h I N Z.- �N NQ o YAM C� X30 W bo 'o` � • nu/olora/ Y `a W 'fie dQ M V m_ b A b� r 1 A h I N _I � 1 i\crai `Y W 'fie dQ M V m_ b A qp y .-li'm � C� 2 C• V� n \ V V Q� �v sl .ev+o�s �I`tr r•• i (+b/ n� ian 2r n n b� r 1 A h I N _I .-li'm Ia. i .��A V� n \ V V IPP Ivy V V �v sl gW/�, �I`tr r•• 2r OI�V I g LLJ ,. Il T �{v of ossvnss��\ q CI L�95507 i Q a0 u a C b� r 1 A BUTTE COUNTY AGRICULTURAL BUFFER NOTIFICATION AND/OR UNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601 Name: b FA Phone: -no `3 30 3Y Mailing Address: o �a 7` Y OFi✓� y..� �J"GG E -Mail address Assessor's Parcel Number: 07-1 - Reason you believe you qualify for the unusual circumstances exception:gti�� �O/L- ,S%yiNOA2a r1y �I��'.L Owner or AuthVized Agent's signature Date UNUSUAL CIRCUMSTANCES DEFINITION: An exceptional or extraordinary condition where the existing lot size or shape or an existing improvement (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone. SITE PLAN REQUIREMENT: submit 4 copies with this form Refer to the Site Plan Submittal handout for specific requirements ................................................................................................................................................... Internal Dept. Contact Info: ❑ Env. Health ❑ Planning ❑ Building (m Other Contact Person: Phone: ......................................................................................................................................................................................... For Agricultural Commissioner office use only: (to be completed after submittal) DISCRETIONARY PERMITS (Planning) MINISTERIAL PERMITS(Building) ❑ Exception Recommended Exception Granted with the ❑ Exception NOT Recommended following conditions: Reason/Conditions/Specific setbacks from adjacent agricultural operations: pNit!1 3*C_Lu: « ^a4 Agriculturalbepartment Signature: Date: D A, e_an,� . YMC 7/1/03 60' R.O.W. ly .W VI O J 146' SETBACK Ll 20' MIN. S. CLEAR 6' PORCH MIN. c�— O I 100' LEACH LINE — — — — — o —� — — — — — — — — — — — - - — — — — — — — — — — — - iREPLACEMENT LINES— — — — — - _�-- - - - -- - - - -- m 50' MIN. LEACH FLO CLEARANCE 20' DRIVE %A PROJECT w' NEW SINGLE FAMILY DWELLING. MASTER PLAN SP04-1854 MP 01.11 A.P.N. 021-260-051 \ LOSSER ROAD BUTTE COUNTY, CA 298.68 \ APN 021-26OLOSI 36.61' SIDEYARD 1.0.4 AC \ \ SEPTIC TANK 1 Ill' -O" REAR YA O\ ol 36' I \ 3 BDRM PROPOSED SFD WATER WELL \ \ 20' 51DEYARD 100' CLR I \ O \ P L O T P L A N SIZE/SCALE: 18"x 24"= 30', II"x Il"= 40'. 8 1/2"x II'= 50' PER INCH OWNER PROFESSIONAL CONSTRUCTION t DEAN SWANSON PHONE (530) 330-0834 P.O. BOX 554 PENRYN, CA 95L33 LOT AREA SUMMAR LOT AREA Area- 1.04 AC a NEW RESIDENCE Area- 2310.00 eq .rt NEW GARAGE Area- 514 aq rt NEW COVERED PORCH AREA Area- 452.00 aq rt TOTAL COVERED AREA 3.538 SQUARE FEET SHEET INDEX Saq.o Sht.o SHEET TITLE CS COVER SHEET, SITE PLAN 2 A2 FLOOR PLAN 3 A3 EXTERIOR ELEVATIONS and ROOF PLAN 4 A4 FOUNDATION PLAN. ROOF FRAMING PLAN 5 A5 BUILDING SECTIONS 4 A4 ROOF FRAMING PLAN l Al ELECTRICAL PLAN 8 A8 DETAILS BUILDING SUMMARY and CODES: 2001 CALIFORNIA BUILDING CODE 2001 CALIFORNIA ELECTRICAL CODE 2001 CALIFORNIA PLUMBING CODE 2001 CALIFORNIA MECHANICAL CODE 2001 CALIFORNIA ENERGY STANARDS WATER WELL and SEPTIC SYSTEM UNDER SPERATE PERMIT BY BUTTE CO ENVIROMENTAL HEALTH OCCUPANCY GROUP: R-3. U-1 TYPE V -N CONSTRUCTION. I STORY 1 �: `,uui fir"."" a{""y'LL•yc..C..e�' N. � , fiWP. 4x12 '--- --– ----- 4xI2---- --- = _-- --------------- p+ +.. 4x12 a --.--------- .^ .. 22'-10 l/ G'-5 �I/2' '' . a �+ 4x12 t~ 6 3 4 3 I/2 + 4 �. 6�-7� 4�'6�� 5'- 6' a 404 H.5. A I Y lr A 303 H.S: 3020 N. 5040 N.S. A 4, 404 N.S. fig. , VAULTED 4' a' A - He and n window, - f I 12 GOG8 ATRIUM , '4 e' (V 4' O C A8 A2 1 •Dw A coOlt = II--------� e' s- • �- . & wove vexr s O y -- =la;------------ -- ---v--10-2mUsI '_. - 9 ---- -- MA5TER5ATH N II I i i. l i &CEILING —.------------- -----.--- - - NDKY -�-- ' 3' 111 ' 1' 8' CEILING QA I = 3 I _ coM�o I - A8 ,�, B T i i N N 22X30' I & ` vim= TATFr C ACCE$$ r � ap KITCNEId a CeIUNG A - I vAUI.TED CEIu ; =—; 31 - 2'-8 I $ 6 I . MSTK BEDROOM NOOK , • . , ' IdILt� celuNGs ro ' VAULTED CEILINGS 1 �A , ' APPROVED e Butte County N I i - & nviro ®ntal aKALF , � -' ` -- inn - "pA9VTRY I • –CEI NG RIDGE C , cm O – – – – – I • Z _� �----------- ' O I N I ------- i &CEILING I p I '-4' W - /8' TYPr 9(' GWB ; 119 PAN 4' n c\ 3 Q WALLS, AND CEILING f , N I0 -9' ------------------- n I ING ROOM -- ' FIRMACE INSERT TLD CEIUNGS I" I R 1A vf0 i i I = `� — +: M#1 cli B b & CEILING 4 ALTERNATE � O I GO GARAGE DOOR LOCATION '— - 0 BEDROOM #2 I vim c W/ 3 112;K 14 ft -3080 VER5ALAM BM N 3 I &CEILING A in IG - I ,. 4' I ' r1 A I A I 4' 4' A 41 404 N.S. 40 H.S. A 4 A O N g 5040 H. q 4' 5 H.5. —F— I I pip T— x s -y G050 F ED I He I I ro l 2' N � 8'- I I° COTTAGE LAP 91095 I CON WALK I G'- I' 7'-2" i 3/B' APA RATt� 09B I I - ° --- - _ 4x12---- a --- --- 4x12 ----4x12 _---- Y+F ----- 4x12 F; I GONG. WALKWAY - -- — - — - — - } I _L - G' ' 12' - ... - 2' 9" . - '-8 I /2' 4'-3 I /2' � 2^' - PLOT PLAN 1"=30' ,_,s'r l,COVED Bulte County cn'ro�nmental Health ate Slgnaturp I, D PROJECT NEW SINGLE FAMILY DWELLING MASTER PLAN BP04-1859 MP 01.11 A.P.N. 021-260-051 LOSSER ROAD BUTTE COUNTY, CA' OWNER l L"I INVESTMENTSL CONSTRUCTION E DEAN SWANSON PHONE (530) 330-0834 P.O. BOX 554 PENRYN, CA 95633 LOT AREA SUMMARY LOT AREA Area= 1.04 AC NEW RESIDENCE Area= 2310.00 aq ft NEW GARAGE Area= 514 aq ft NEW COVERED PORCH AREA Area= L52.00 aq ft TOTAL COVERED AREA 3.538 SQUARE FEET SHEET INDEX Seq.x Sht.a SHEET TITLE CS COVER SHEET, SITE PLAN 2 A2 FLOOR PLAN 3 A3 EXTERIOR ELEVATIONS and ROOF PLAN 4 Al FOUNDATION PLAN. ROOF FRAMING PLAN 5 AS t \ I L AL ROOF FRAMING PLAN 1 Al ELECTRICAL PLAN 8 A8 DETAILS 60' R.O.W. \ 146' SETBACK 6' PORCH p . CLEAR 20' MINMIN. IN. i O \ 298.68 3--- ----\ 6 ----- - - - -_-- - ------- - �APN — 021-2�0\\051 O I 100' LEACH LINE — — — — — — j 1.04 \ \\ A CZ. F SEPTIC TANK _ ----— — — — — —— --————— — — — — — -i 36' I \ Uj REPLACEMENT LINES— — — _ — - I 3 BDR1"I WATERPROPOSED WELL � \ SFD --————— — — — — —- \ 150' CLR co 1 I \ \ 20' DRIVE ry 20' SIDEYARD I \ 351.61 . I PLOT PLAN 1"=30' ,_,s'r l,COVED Bulte County cn'ro�nmental Health ate Slgnaturp I, D PROJECT NEW SINGLE FAMILY DWELLING MASTER PLAN BP04-1859 MP 01.11 A.P.N. 021-260-051 LOSSER ROAD BUTTE COUNTY, CA' OWNER l L"I INVESTMENTSL CONSTRUCTION E DEAN SWANSON PHONE (530) 330-0834 P.O. BOX 554 PENRYN, CA 95633 LOT AREA SUMMARY LOT AREA Area= 1.04 AC NEW RESIDENCE Area= 2310.00 aq ft NEW GARAGE Area= 514 aq ft NEW COVERED PORCH AREA Area= L52.00 aq ft TOTAL COVERED AREA 3.538 SQUARE FEET SHEET INDEX Seq.x Sht.a SHEET TITLE CS COVER SHEET, SITE PLAN 2 A2 FLOOR PLAN 3 A3 EXTERIOR ELEVATIONS and ROOF PLAN 4 Al FOUNDATION PLAN. ROOF FRAMING PLAN 5 AS BUILDING SECTIONS L AL ROOF FRAMING PLAN 1 Al ELECTRICAL PLAN 8 A8 DETAILS BUILDING SUMMARY and CODES: 2001 CALIFORNIA BUILDING CODE 2001 CALIFORNIA ELECTRICAL CODE 2001 CALIFORNIA PLUMBING CODE 2001 CALIFORNIA MECHANICAL CODE 2001 CALIFORNIA ENERGY STANARDS WATER WELL and SEPTIC SYSTEM UNDER SPERATE PERMIT BY BUTTE CO. ENVIROMENTAL HEALTH OCCUPANCY GROUP: R-3. U-1 TYPE V—N CONSTRUCTION, I STORY Matthew It Kisson, Architect 1490 Highway 99. Suite B Gridley. Colifomio 95948 fox 846— 6358 (530) 846-6376 NEW SINGLE FAMILY DWELLING A.P.N. 021-260-051 __ LOSSER ROAD BUTTE COUNTY. CA M We: 3/31/2005 .*t N. Dote 03/09/05 set rue COVER BHT. PLOT PLAN .est Na CS .set Na of Toted Sheets