HomeMy WebLinkAbout022-190-056NOTES RLSIDENTIAL
PERMIT NO. 022-190;056 -T -
05-1206~
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t _ C JATFI:ELD AVE, BIGGS
Cont: PROFESSIONAL CONST
c�O t NSF/GARAGE/COVMSTR##01-71
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SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
OFFICE COPY
Address jll� G
GAS
Meter By4k:i � Date`'i `6•a6
ELECTRIC
Meter By Date
t
JOB FINALED (Date
Signature __
�"� l a b --
J=oK
0 = Not OK
=Nota Applic
= Not Ready able
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements-Setbacks-Easements
2. Soils; Special MH Support Sketch
3. Sewer, Location-Test-Fall-C/O-Concrete
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 "ftJ P LPG
7. Well Clearance & Disconnect
8. Utility Clearance
10. Roof; Shthg-Roofing
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
3. Gas; MH Test-Demand-Valve-Connector
4. Electricity; MH Test-Crossovers-Breakers-Clearances
5. Drain; MH Test-Fall-Flex Connector
6. Water, MH Test-Regulator-Connector
7. Water and Sewer Connected-C/O to Grade-HD Approval
8. Gas and Electricity Tagged
9. Tie Downs-Type-Installation Cert.
10. Exits; Insp.-Sketch
11. Cert. of Occupancy
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
Date
1. Zoning Requirements-Setbacks-Easements
2. Footings; Size-Spacing-Marriage Line
3. Blocking
4. Gas; MH Test-Demand-Valve
5. Electricity; MH Test
6. Water, MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
9. Exits
10. License Decals
11. Verify #'s with Office
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
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. Frmg.; 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 ® g
&
= Not Applicable RESIDENTIAL (Single Duplex)
. = Not Ready
Date UND FLOOR (Plans) OK except #'s
1 oning-Setbacks-Easemen -Flood-Slope
Main; Soils-Elec. d.-/ Ft . Depth
3. Ft ., Garage; Soils-Steel-Elec. Gf6-/ ' P' Ftg. Depth
4: tg., Porches & Decks; Soils -Steel-/ J'r Ftg. Depth
5:` Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a:- Hold Downs and Special Anchors
ab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
A. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
1>49ater Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date ( SD Card B-1 i Date Card B-1
Date o Card B-1 Date Card B-1
Date PLU ING .ermit) OK except #'s
ater Htr; Vent -Access -Combustion Air Baffle
Water Pipe; Test & Anchor -Nail Protection
19, D.W.V.; Test 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 tt Card B-1 Date Card B-1
Date . Card p`1 Date Card B-1
Date ELECnICAL (Permit) .OK exceat #'s
241 Fixture & Transformer Clearance -Ins. Protection
25/ElKc. Receptacles Spacing -Lights & Switches at Doors
26/Size Boxes & No. of Conductors Stapled /
27. R " ex Installed Close to Edge of Studs & C.J. /
28.'- quip. Ground made up w/Mech F steners-Bond Ggs'& Water
_
291." 2 Appliance Circuits ip Kitchen & Conductor Size GFI
30. 'Subfeed Wire Size/ r/ / Cu or AI -AC. Wire Size/ /ga Cu or AI
31. Range Circle/ 6J/ga or AI -Oven Circ. / * /ga Cu or Al
Insulated Neutral es 0 No
32: Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. othes Closet Light -Shower Light -Spa Light
aK Smoke Detector
Date 104Card B-1 Date Card B-1
Date i _Car B-1 Date Card B-1
Date MECAA
NICAL (Permit) OK except #'s
3V C Ducts Insulation & Support
37 nt Fan, Exhaust above insulation
3 . 'ndensate Drain & Overflow, Size & Grade
39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Dat r'/ Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRPOING (Permit) OK except #'s
4 Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43 Rearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)
45. _,Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
4%, Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shtina. Rtno.
4W Fireplace Ties or Type A Flue -Fireplace Throat Clearance
5 Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
drm. Windows or Exiting Doors -Sill Ht. & Dimensions
Garage Fire Protection Framing -RC Channel
Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
5 . Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
5.. jGlazing Area -Glass Protection -Skylights -Plastic
6 . hear Walls; Nailing -Bolts
'1 Brace Interior/Exterior W anels
Insulation -Walls -Ceilings 000l
63. Infiltration -Walls -Windows
Date Card B-1 bate 4^ Card B-1.-'
Date Card B-1 Date Card B-1
Date FINAL (Plan OK except #'s
Steps -Door & Sidelight Protection -Landings
IM. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector-
_ �rarage; Above Floor-Ducts-Mech. Protection
B room Exiting
jd F I. & Bath Fixtures & Tub Access -Spa
. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. _5tairs & Rails
f. Fireplace or Stove, Clearance -Hearth
72. Qpc. Outlets at Wood Panel, Int. & Ext.
197
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
4. EIS. Outlets & Receptacles at Kit. Counter
Garage Fire Door, Swing -Landing -Closure
76..C. Duct in Garage Damper
Wtr. Htr; Vents -Clearance -Comb. Air Connector-P.R.V.
garage; Above Floor -Meth. Protection
n Plb ;'Elec. & Mech. Equip. Listed for Location
7 .--_lec. Receptacles in Garage (FFI.)-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 0 Yes
83. Following lnstldJDrive 0 Yes 0 No/Walks 0 Yes 0 Nc/Planters 0 Yes 0 No
84. Stucco Brown -Finish
85 A.C. Unit Disconnect, Electrical -Plumbing
W'Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings,
a r Well, Disconnect, Electrical, Plumbing ;
00ixterior Elec. Trim, G.F.I. Receptacle -Underground
ef-dation Throughout House
Guess Protection
9 Correctio's from Previous Inspections
92 Gas a -Meters Tagged, Gas -Electric Pl�
93 Water & Sewer Connected -C/O to Grade -HD Approval
Ene y Compliance Certificate -Other Certificates
Address Posted
96. Fire Sprinkler �
Date"$(VCard B-1 ` Date Card B-1
Date Card B-1 i 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 FAX#: (530)538-2140
WEBSITE: www.buttecounty.neAdds
PERMIT NO.
BP051206
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: 06/29/2005 APN: 022-190-056-000
the Business and Professions Code, and my license is in full force and
effect. (9 9 Site Address:,&'�HATFIELD AVE BIG
License Class: License Number:
Date: 6 Z oS Contractor. e6 Map Index:
OWNER43UILDERDECLARATION
Description: NSF(2310), GAR (576), COV(312) MSTR 0 1 -71
1 hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: SWANSON, DEAN
permit to construct, alter, improve, demolish, or repair any structure, prior
p0 BOX 554
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed, pursuant to:the'proGisions df
PENRYN, CA
the'Contractor's State License Law (Chapter 9 commencing with Section
95603
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:
(530)330-0834
violation of Sectio' 7631.6 by any applicant for a permit subjects the
applicant to a civil.penalty;of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or. offered, for, sale. ($_eq,. 7Q44,. B.usiness..and P„rofessions,..
_...., .. Applicant:_ PROFESSIONAL CONSTRUCTION AND
Code: The Contractors' State license Law does not apply to an
INVESTMENTS INC
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 are not intended or offered for
9840 BUSINESS PARK DRIVE
sale. If however, the building or improvements are sold within one
SACRAMENTO CA 95827
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
(530) 713-3838
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,
Contractor: PROFESSIONAL CONSTRUCTION AND
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
INVESTMENTS INC
❑ 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:
0 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
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are
Carrier: -!5 7--k IGGA'f
Policy#: Total Square Ft: 3198 S.F. �Q
❑ I certify that in the performance of the work for which this permit is Valuation: $168,966.00 r
issued, I shall not employ any person in any manner so as to Census Code:
become subject to the workers' compensation laws of California, ( I
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 permit is h eby issyy6r the ap tic a provisions of the Butte County CodR ?nri/o
I hereby affirm that there is a construction lending agency for. the Resolutions do wo ifirlud�a bove r i h fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.) �, , 2.7'
Name: B,r Date: i—�
Address: PERMIT EXPIRES ON:
❑ 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 to document of Butte County. I hereby
authorize representatives of Butt County to enter upon the above mentioned property for inspectionpurposes
Print Name: ' 7'y�", Signature' Z
Date:
contractor 0 Agent for Owner ❑ Agent for Contractor
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
sw aKn
❑ 605 S. AUBURN STREET, GRASS VALLEY, CA 95945 LIC#202026
` �� � ��
r �t� �t "� (r��1
❑ 3881 BENATAR WAY, SUITE A, CHICO, CA 95928 LIC#202026
❑ 8924 AIRPORT ROAD, REDDING, CA 96002 LIC #202026
DATE INSULATION COMPLETED
-
( square feet)
(� t square feet)
( square feet)
TYPE OF INSULATION
TYPE OF INSULATION
t TYPE OF INSULATION
MATERIAL
MATERIAL '
MATERIAL 4, +
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
CT
OCF
KN
CT
OCF
LKN)
CT
OCF
KN
BAGS � �+"�
R -VALUE
INSTALLED
APPLIED
THICKNESS
R -VALUE
INSTALLED
APPLIED
THICKNESS
MIN. INSTALLED
WEIGHT PER SOUAREFOOT
R -VALUE
INSTALLED
APPLIED
THICKNESS
KNEE WALLS IF R -VALUE IS OTHER
THAN WALLS ABOVE
MATERIAL
FORMR-VALUE
MANUFACTURER
FIBERGLASS
BATTS
CT OCF
KN
AIR INFILTRATION SEALANT
MATERIAL
MANUFACTURER
FOAM _ _ _ . :,
.HILTI ..
,HANDY FOAM
r
THIS IS TO CERTIFY THAT INSULATION AND/OR SEALANT HAS BEEN INSTALLED IN CONFORMANCE WITH APPLICABLE CODES,
'
MATERIAL AND REGULATIONS
STANDARDS
SIGN+1�
R� '�
TT•�
DATE,,L�Ji" )jt,
1.1 �✓ iv��1T /A,
!' 1 '�
SIGNATURE - GENERAL CONTRACTOR
TITLE
DATE
REMARKS
WHITE - Builder Copy, GREEN - Builder Copy, YELLOW - Customer Copy, PINK - Attic Copy, GOLD - File Copy
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive - Oroville, CA 9 (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.
A
A
It
4
0,
4
Date Inspector
REV 4/05 Phone#
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
l • . COUNTY OF BUTTE
BUILDING DIVISION
F. DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (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
explanatio ; please contact the Building Inspector as indicated below.
U
t l
� S �
OV'lC� 'wG 'A ;Pe.,;kS Or
} t
E'r'1
' y Date 7S^ `' ^ Inspectory °u1 V.J, nen
°REV 4/05 Phone #
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
COUNTY OF BUTTE t
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (530) 538-7541 r
CORRECTION NOTICE
OWNER
s /ZhlC
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 ha.4e any questions pertaining to this matter, or need additional r
explanation, please contact the Building Inspector as indicated below. ;}
A���Y
ckilfA(
mc
ce/
7-
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n'
? 7j �
�`
Date
Inspector
3'6 3
}
REV 4/05
Phone #
•
1J
t
S
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
s.
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAM (530)538-2140
WEBSITE: www.buttecounty.netldds
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
the Business and Professions Code, and my license is in full force and
effect. 3
License Class: is License Number: (9
6Y ( �
Date: ZIFoS Contractor: jeGi
PERMIT NO.
BPO51206
Issued Date: 06/29/2005 APN: 022-190-056-000
Site Address:5CHATFIELD AVE BIG
Map Index:
OWNER43UILDERDECLARATION Description: NSF(2310), GAR(576), COV(312) MSTR 01-71
1 hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a Owner: SWANSON, DEAN ^ ^ ~•- �-
permit to construct, alter, improve, demolish, or repair any structure, prior • • r .,
to its issuarice;-also requires the applicant for such permit to file a PO BOX 554
signed statement that he or she is licensed pu7suant tb:the'pWVisibns cif," . PENRYN, Ck .
the'Contractor;s State* License Law (Chapter`9 commencing with Section 95603
7000) of Division,3•of tliii Business and Professions Code) or that he or
she is exempt. therefrom"and the basis for the alleged exemption. Any, (530)330-0834
violation of Section 703,1.5 by any applicant for a permit subjects the
applicant to.a civil,penalty;of not more than five hundred dollars ($500).):
O I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and. the structure is not pp PROFESSIONAL CONSTRUCTION AND
intended or. offered.,fo/,.sale._($ec.,,704.4„Business andprofessions __._,._ Applicant:.. _.
Code: The Contractors' State License Law does not apply to an INVESTMENTS INC
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 are not intended or offered for 9840 BUSINESS PARK DRIVE
sale. If however, the building or improvements are sold within one SACRAMENTO CA 95827
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 (530) 713-3838
sale.).
O -I, as owner-of..the..property, am a. 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' State License Law.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Date: • ` Owner:
WORKERS': COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
AP I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued. _
I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier: --57P/77, F�'t
Policy #
O 1 certify that in the performance of the work for which this permit is
issued. I shall not employ any person in any manner so as to
become subject to the workers' compensation taws of California.
and agree that if I should become subject to the workers'
compensation provisions of Secfion 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 attomey'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 Civ.)
Address
Contractor: PROFESSIONAL CONSTRUCTION AND
INVESTMENTS INC
9840 BUSINESS PARK DRIVE
SACRAMENTO, CA 95827
(530) 713-3838
License #: 843179
Architect:
Engineer:
Total Square Ft: 3198 S.F.
Valuation: $1681966.00
Census Code: f I
This permit is Z.7
eby issyyd u r the ap lir• a provisions of the Butte County Codi+ andlor
Resolutions t do wo iftdi ed above r i h fees have been paid.
By: ` Date.y � �/�`� '
PERMIT EXPIRES ON: / r�� 91-41 C1
❑ 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 8 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 state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official forrrw document of Butte County. I hereby
authorize representatives of Butt County to enter upon the above mentioned property for inspection purposes
Print Name: le149 -' J v'9�°� Signature
Date:i-
contractor ❑ Agent for Owner L1 Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER
Last Name • ��
First Name nC ,
Address�y
City 2
Stated
Zip I�Ua6_3
Phon
Fax 6�3
E-mail
CONTRACTOR
Name
Addre s y 66>. -
e>. -City
City
HN2
State
Zip
�Phone� v
Fax �1lG�ct1T - 2�av
E-mail
Lic. #g4 jZ 7
Class
APP ANT SIGNATURE
X
For office use only:
ARCHITECT/ENGINEER
Name
/4'
47
Address
SRA
City
No
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APP ANT SIGNATURE
X
For office use only:
APPLICANT NAME
Name
Vis✓ G..q..{s e J
Address
SRA
City
No
State
Zip
Phone
Map Book
Fax
E-mail
Planner
APP ANT SIGNATURE
X
For office use only:
Zoning
I Aq
Flood Zone
Cross Street
SRA
I Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT
NO.
BIN #
LOCATION
Property A dress �
Cit 66S
Cross Street
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
OVER FOR SUBMITTAL REQUIREMENTS II
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Description or Scope of Work:
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change o
(Note previous use):�.4,—_7.�z
EXPIRATION OF A ICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
1p C/p0
Received by: Amount: / Bldg
SRA
Receipt #: Sheriff
nn SMIP
Date N� Other
�� ne2 I/ i5v
Total
REV 2-24-05
6
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District i� / 6 5 Building Department No. ��o � / za 6
A.P. Number 0% Z �' —� Jurisdiction: City /� County
Property Owner �j (/L% /h"y�J 5�`� / 1)� ILS *�"� /j'✓
Property Location/Address ��`►� , f /�
Subdivision Lot No.
............ ... ..................................... ........:......................................
Residential Development Q Q Q Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to (Group R)
Units Installation Conversion Permit #
'
*(No foundation Inspection)
......................................................................................................
Deed Restricted Sq. Footage . .
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Commercial/Industrial Q Q Sq. Footage
New Addition (Including Exterior
Roofed Areas)
Building Department Representative Date
District Identification No.
C.6 ` 1 /School District certifies that
Lf
S�.y��r��
(Applicant)
a - 671?d
(Street Address)pgil
l } (Phone Number) ( fi
Y) �16-?1
(City)
has complied with the requirements of Resolution No.
representing a3/0 square feet.
School District
(State)
(Zip Code)
by payment of $ S 17q; q ; / V
2926 =
FULL MRIGATION $ % /J
if ✓' _ /_ Date
/ i
Paid by Check 8 C1 Remarks:
Notba: You may protest the Imposition of the fess IdsnGfisd above by submitting a written protest to the District, in compliance with
Gov.mmsrht code section 66020(a), within 90 days from the date fees are paid. Failure to submit a dmey written protest wilfprohibit-
you from challenging the Imposition of the fees In any court action., f
N. subsequent to the school Distrkt Reprasentatw signing this'8ude County Schools Impact Fee CertMation Fonn, the School District Is
notified by the applicable Local Planning Agency that this project b being revlewed under the California Emriromnental Quality Act (CEQA).
t is project may be subject to additional school fees to fully mKilpate. its Impact on the school dbtrkft schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls 00/031dmm
butte County Department of Development Services
°�V t rF°
7 County Center Drive
° "= °
Oroville, CA 95965
'' "
(530) 538-7601 Telephone
° °
(530) 538-7785 Facsimile
coUN
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:
0 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:zz' J L��sa
Applicant Name: APN:
Building site address: C�97? c, P �! o Permit No.:
I have read, understood and accept the terms and conditions as expressed herein as indicated by my
submission of :above-�refereed building permit application and my signature below:
-5 -S
SIGNAT OF APPLICANT DATE
Copy to Applicant/EH/File K:Forms/BldgPennitwithoutClearances 020705
•S�
°� v T
o� �` G
�° G
o c
U t4
�Lic Wc��
Department
.0 o u n t i
J. Michael Crump, Director
Public
f B u t
Works
LAND DEVELOPMENT DIVISION
Storm Water Management Program
7 County Center Drive
Oroville. CA 95965
(530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Prase 11
Construction Storm Water Permit and Storm Water Pollution Prevention
Pian (SWPPP) Acknowledgement [LESS THAN 1 ACRET
Project Description: AJ" C,_Icr.
Project Location and/or Parcel Number: f-0
Q 2 Z --- / 7d — as -6
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 'S'tate 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: l.J•r/A,-
Date: .5 --s'— os --
Less than l Acre NPDES & SWPpp Compliance Certification
Butte County Storm Water Management Program
Revised 5/24/04
E.H. USE ONLY
Plot Plan Attached
Real Plan Attached
Seem to B.D. /
TO: Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
juld QQ— (41--l�_1
lfaN � t�
Owner Location AP#
Plan Approved for: Sewage Disposal Water Sup P b 'c Private Well
Clearance for dwelling. Other
Hold final for:
Final clearance O.K. for:
NOTE:
1�d 11
ID
Environmen ! Health Specialist Date
8/96
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REVI5ED PER LP2A PIAN
CHK. JULY 23, 20D4. G.K.
ImT ME01 •,ArLCILCtl
C-19423
up. -5/-d2:2, ):�
Drawn by:' f- Date
CK 0511210-1
Checked by: Date
W. r, 051 12104
Pr0jCCL Deaenpclon
5CWIN RE51DENCE
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: 5W1 , v _(�ON I ^ el� ; ASSESSOR PARCEL NUMBER o 2-2-,-
2 / g o ^ b S--6
Proposed Building Use: Ns� /YV5 7) Permit Technician: Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
/ N 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
❑ 12. Hazardous Material Form
/ 1�%/ 13. Acknowledgement of building permit application without required clearances.
❑ 14.Other•-
Remaining items: needed to issue the permit. (May regUire additional plan review. upon receipt of the following items:) '
15. Sanitation and site plan approval from the Enviropmejlfal Health Department in p'Chico p Oroville, as a iplika$e .
`\- 16. Fire Sprinklers .......... 1................................................................................. R'
�l 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by---.,.-..
❑ 18. Soils Report and/or Engineered Foundation required ...........................................
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 Forestr plan approval ❑ paid. Sent by:
24. Planning approval for (A).Use: , " (B)Parking: (C) Parcel Check:...'
❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................
n% 26. NPDES Form............................................................................ .......:....
27. Encroachment Permit for driveway from the Public Works Dept. k 06 D C
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 ................................. tU► ��/.
❑ 33:4Existing violations and/or expired permits......<................................................
❑ 34. Deed Restriction..........................................................................................
❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... /
❑ 36. Other:
❑ 37. Other: `
When issued Telephone ,%�L /�/tl 3AIA 3O�/ and hold for pickup.
-
I have beeninform f the a � items and requirements for obtaining a building permit. -
Applicant: Date:
1. Index permit app'y on for the ove 'ems nu Plan Check Letter
2. Addit nal items required U
onirac or esigner, was advi ed of th above datalby ph ne, mail, ❑ counter, Date:
kGGO-ator, design owner as advised of the above data by phone, ❑ mail, ❑ counter, b6LA2 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: Date:
Note transfer by: Date:
,i• . Yellow: Building Division
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
Weebssite:'www.buttecounty.net/dds
OWNERA.P.
# l/
PROPROSED BUILDING USE / " r /`' I /4-57b/z- DATES` S ��
_ 1. BUILDING PERMIT FEES
--- Balance Due ..................... $
--- FEMA Flood elevation review ... $
dditional plan checking Fee.... $
2. SCHOOL DISTRICT FEES D/66t>
(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.
RECEIPT # DATE REC.
V3129 -7-q
4. RECREATION DISTRICT FEES
at Recreation District Office) (form available after Plan Check)
L/
5. RESIDENTIAL DEVELOPMENT IMPACT FEES2
COUNTY WIDE (per dwelling) $
CHICO URBAN AREA (per dwelling) $
EL MEDIO FIRE DISTRICT (per dwelling) $
NORTH CHICO SPECIFIC PLAN (per. dwelling) Zoning
6. SRA FIRE INSPECTION AND PLAN CHECK FEE
$204.98 (paid at Building Division)
7. WATER TENDER FEES BATTALION #
. 0 (paid at Building Division)
7
8. SMIP
9. OTHER
10. OTHER
11. OTHER
At time of permit applicationI was dvised the above fees are required to be paid prior to issuance of the permit. These fees
may be changed duri gg-t4 pia; cking process.
APPLICANT
DATE
Pursuant to Governr(ient Code 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)
`I
X600 2005-0026964
AND WHEN RECORDED MAIL TO: Recorded 1 REC FEE 7.00
Official Records I
BUTTE COUNTY BUILDING DIVISION County
tteof i COPIES 2.00
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965 CA9AM J. 6RLMRS I
County Clerk-Recorderl
I CP
03:49PN 12Kay-2805 I Page 1 of 1
IIII lil III11111 I III III II II IIII II I{
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:
That portion of Lot 49 of Biggs Colony No, 1, as shown on that certain Map entitled, "Map of Biggs Colony No.
1", which Map was filed August 16, 1907, in Book 6 of Maps, at Page(s) 88, in the Office of the Recorder of
Butte County, State of California, and more particularly described as follows:
Commencing at the Northeast corner of said Lot 49 and running thence South 891 59' West, 234.8 feet along
the North line of said Lot; thence South 60 29' East, 69.9 feet to a point; thence South 180 46' East, 69.5 feet
to a point; thence South 27° 20' East, 65.4 feet to a point; thence South 400 27' East, 40.0 feet to a point;
thence South 700 08' East, 53.0 feet to a point; thence South 890 45' East, 98.6 feet to a point on the East line
of said Lot, thence North along said East line a distance of 242.4 feet to the point of beginning.
APN: 022-190-056__
Date "
State of Cali[or�ag�
County of �Y
On -:�Jbefore me,
personally appeared 1l,U11tkJA-- personally
known to me (or 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 his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, execut 'nstrument.
WITNESS Q ha nd offibaA seal.
A.P. #
Seal: r JANET BRAMMER
CAMM. #1310312 c.
eo NOTARY PUBLIC • CALIFORNIA
tooYUBACOUNTY
a� ` Comm. Ex iros JULY 15 2005
Date: �- / 3 _0T
SITE PLAN1 REVIEW
�� S
,GS/ AP#
APPLICATION
Permit Number (if applicable) 6�___ /Z Ob Bin Number
APPLICANT INFORMATION (' Parcel Size:
Owners Name:/H 6�� rout
Owners Address:
Telephone No.:
Situs Address:
Proposed Use:
Residential
New Single Family Residential
❑ Single Family Addition
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel -Trailer,
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
❑ Septic
❑ Agricultural Exempt Building
❑ Other:_
Brief Explanation (if necessary):
027--1-70- 6rbl
❑ Single Family Remodel
❑ Commercial Remodel
❑ Industrial Remodel
Well
Agricultural Buffer Form ❑ Applicable ❑ -N/A
S--- /3
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
s Sit an Sta d Approved
By Date 11.4-
Page 1 of 5
. l
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:
• Flood Panel No.: 017 6 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
ermitAgricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning: 4- -5 (6FC)
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
2,0'
Side
Side Street
Rear
S
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Applicable Development Fees:
Standard Fees Amount
❑ Fire
❑ School*
❑ Parks/Recreation
❑ Roads
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Drainage Area
❑ Thermalito Urban Area
❑ Other
Subdivision Map Special Fees
❑
Water Tender
❑
Road Improvement
❑
North Oroville Area
❑
Other (per map)
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
Date of Creation: ! of 6q /1170 Legal Access Provided: ❑ No Yes
Deed of Reference: 12!f, cj% °I Legal Access Required Yes
Parcel Frontage on Publicly Maintained Road: El,
No Yes, Road Name: No
-WW
Complies with County Standards for Deed Creation: El 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
Page 3 of 5
❑ Subdivision Map/Parcel Map:
Map Date of Recording:
Lot: Book: Page:
❑ Use Permit/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 P.R.C. 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 California Clean Air Act of 1988, 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 fugitive 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 road maintenance, and stop sign maintenance.
Page 4 of 5
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
May 13, 2005
Dean Swanson
P.O. Box 554,
Penryn, CA 95663
Subject: Environmental Health Permits (APN: 022-190-056); NSF
Dear Mr. Swanson:
The Butte County Department of Development Services, Planning Division, has reviewed the
submitted application. These parcel is zoned Agriculture (A) with a five acre minimum parcel
size. A house proposed on a parcel in an area designated for agriculture uses is subject to a
buffer of three hundred (300) feet from each property line. The oca ion of a proposed house may
also be adjusted on properties that cannot support a s an uffer.
The applicant is welcome to fill out a form, -i e/she believes that their proposed residence
location is the most suitable. T ' claim mus be based on unusual circumstances related to
topography or other limitin es on the parcel. The form included and a site plan must be
submitted directly to the 'culture Commissioner's Office (Note: you will be required to pay a
fee for their re vie er they review the parcel, please return the forms to Development
Services.
Agric pure Commissioner
316- elson Avenue
Oroville, CA 95965
(530) 538-7631
Should you have any questions please feel free to call them directly at Chris Tolley, Assistant
Planner, between the hours of 8:00 a.m. and 4:00 p.m. Monday hrough Friday at (530) 538-
7603.
Sin reelY , 5e/961
�
Stephen S4reete
Planning Manager
BUTTE COUNTY MAReceived
-Y lfi 2005
AGRICULTURAL BUFFER NOTIFICATION AND/OR 9 a
UNUSUAL CIRCUMSTANCES REQUEST c9�c��TUaE°�
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: brzqS J�Afjsdj Phone: .S -3o- 334-683y
Mailing Address: e0 3o y- fl—Y /%' if v -7---' 64 1,ro/ 6 3
E -Mail address
Assessor's Parcel Number: b Z Z-- 116 6S6
Reason you believe you qualify for the unusual circumstances exception: At-.4LC
.L A AC- i (a"I2 A e `"
GP y bFL
Owner or AuMorized Agent's signature
t„CA- t !lo/>•s..
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
Contact Person:
❑ Building
Phone:
)dlother
.........................................................................................................................................................................................
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:
-, �I ,r�3wtr} 1DJJ . V�� :�tuc.U_t as e_�V"
w;.1\
Agricultural Department Signature:
(Za-VV%V U_ .
Date: J -I
YMC 7/1/03
OWNER
11CO N EST SIINTSL CONSTRUCTION and
DEAN SWANSON PHONE (530) 330-0834
P.O. BOX 554 PENRYN, CA 95633
PROPOSED
WATER WELL
LOCATION
PROJECT
NEW SINGLE FAMILY DWELLING
BUTTE CO. MASTER PLAN X04 d 185'9
A.P.N. 022-190-054
BUTTE COUNTY, CA
CHATFIELD AVE
20' DRIVE
SOUTH 89° 89' 59" WEST 234.80'
y.
'A'
25' CLR Q
PROPOSED
LPG TANK
m
,t
\ 30' \
1B1 SETBACI
'C'
A=
5 6°29' EAST,69.9' 0.
B=
5 18°46' EAST, 69.5'
C=
5 21" 20' EAST 65.4'
D
5 40° 21' EAST, 40.0' 'D'
E=
5 10" 08' EAST 53.0'
F=
S 89" 45' EAST 98.6'
Matthew McKiaeon, Architect
1490 Hlghr ay 99. SLke 0
Oridey, Cdifomla 95948
fax 848- 9358 (530) 848-8378
80'
so' -o"
Ill' -O"
P L O i
PLAN I"=50'
O 4
PROPOSED SEPTIC
i
TANK LOCATION
—
— — — — —
16
— — — —
rl
I
—100' LEACH LINE—
-- — — — — — —
N
I
— — — -
I
I
I
-- — — — — — —
— —REPLACEMENT LINES
— — — - I
— —
l
1E1
'F'
P L O i
PLAN I"=50'
i
1
yy a"
00 k
46
r
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Y •l
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rtffll\♦�►\♦4�\'41•lNw! rih iii;l
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•...,.r+•rr�a.'1► fir' 1..,.,.� �1 w . t. � ..... \.
M+ate•.•♦ ,� �r•!�+'r\M'�•h e! si! �. �i ��L - 1 R
Ilk
ML »wM+wr++•ori ,
a.•.. .•A •Y•M N •._ ♦ � ++S�EE. + �
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••EE7 I+� G y�
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E • ="rte It
a
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li • , ,� . � _ .r,�i.�� .-^ a _- .1 r••-� I�. 'i=ce i
f
Cep- o�
u•Ar n -
A-4- ' . X012
PROPOSED
WATER WELL
LOCATION
CHATFIELD
20' DRIVE
SOUTH 890 89' 59" WEST 234,80'
F= S 890 45' EAST 98.6'
E, IO'
,F,
U. 7 a.V.--�.�.. Data:
r
0 Vier
f4
P LOT P L A K
mI
OWNER
PROFESSIONAL CONSTRUCTION and
INVESTMENTS
DEAN SWANSON PHONE (530) 330-0834
P.O. BOX 554 PE.NRYN, CA 9533
and
MARK B011JIN CONSTRUCTION, CLL 356543
LOT AREA SUMMA
LOT AREA . = 1.04 4C
NEW RESIDENCE ?a. 2510.00 aq lit
NEW GARAGE Sig aq fit
NEW COVERED PORCH AREA F 1.82.00 aq I't
TOTAL COVERED AREA J, SQUARE FEET
S DEET IND E X +w
Seq.9 Sht.0 SHEET TITLE
I CS COVER SHEET. 817E PLAN
2 A2 FLOOR PLAN
3 A3 EXTERIOR ELEVATIONS ax, '=F PLAN
4A4 FOUNDATION PLANT. R0 '' i-RAMING PLAN
5 A5 BUILDING SECTI®N.5
G ASG ROOF FRAMING PLAN ,
1 Al ELECTRICAL PLANT qUILDING
6 A8 DETAILS
BUILDING SUMMARY ani �� ODES:
2001 CALIFORNIA BUILDING CO DE
2001 CALIFORNIA ELECTRICAL CODE
2001 CALIFORNIA PLUMBING iCODE
2001 CALIFORNIA MECHANICAL CODE
2001 CALIFORNIA ENERGY S'TANARUS
WATER WELL and SEPTIC SYSTEM
UNDER SPERATE PERMIT E3Y BUTTE CO. ENVIROMENTAL HEALTH
OCCUPANCY GROUP: R-3, U-1
TYPE V—N CONSTRUCTION, I STORY
Matthew W Ki;sson, Architect
1490 Highway 99, suite B
Gridley, California 9:948
fax 846— 6358 (530) 846-6376
Progjc .
NE ,W SINGLE
r-A.MILY DWELLING
A,P,V '. 022-190-056
_ CHATFIEL.D AVE
BUTTE COUNTY, CA
'�ewriiona:
Print Date.
3/8/2005
Project No. Date
03/04/05
Sheet Title
COVER SHT, PLOT PLAN
Sheet No.
Sheet No. of Total Sheets
1
\ -
lli,_a„
00m
24'
IT
,B, SETBAC
i o
iz
\
o
PROPOSED SEPTIC
TANK LOCATION
\
®100'®LEACH LINE
1
I
I
— REPLACEMENT LINES
—
A=
S
6029' EAST, 69.9'
B=
S
18046' EAST, 69.5' '\
I
—
-----------
10'
C=
S
210 20' EAST 65.4'
D
5
400 21' EAST, 40.0' t®1
�'
------------1
1
E=
S
100 08' EAST 53.0'
F= S 890 45' EAST 98.6'
E, IO'
,F,
U. 7 a.V.--�.�.. Data:
r
0 Vier
f4
P LOT P L A K
mI
OWNER
PROFESSIONAL CONSTRUCTION and
INVESTMENTS
DEAN SWANSON PHONE (530) 330-0834
P.O. BOX 554 PE.NRYN, CA 9533
and
MARK B011JIN CONSTRUCTION, CLL 356543
LOT AREA SUMMA
LOT AREA . = 1.04 4C
NEW RESIDENCE ?a. 2510.00 aq lit
NEW GARAGE Sig aq fit
NEW COVERED PORCH AREA F 1.82.00 aq I't
TOTAL COVERED AREA J, SQUARE FEET
S DEET IND E X +w
Seq.9 Sht.0 SHEET TITLE
I CS COVER SHEET. 817E PLAN
2 A2 FLOOR PLAN
3 A3 EXTERIOR ELEVATIONS ax, '=F PLAN
4A4 FOUNDATION PLANT. R0 '' i-RAMING PLAN
5 A5 BUILDING SECTI®N.5
G ASG ROOF FRAMING PLAN ,
1 Al ELECTRICAL PLANT qUILDING
6 A8 DETAILS
BUILDING SUMMARY ani �� ODES:
2001 CALIFORNIA BUILDING CO DE
2001 CALIFORNIA ELECTRICAL CODE
2001 CALIFORNIA PLUMBING iCODE
2001 CALIFORNIA MECHANICAL CODE
2001 CALIFORNIA ENERGY S'TANARUS
WATER WELL and SEPTIC SYSTEM
UNDER SPERATE PERMIT E3Y BUTTE CO. ENVIROMENTAL HEALTH
OCCUPANCY GROUP: R-3, U-1
TYPE V—N CONSTRUCTION, I STORY
Matthew W Ki;sson, Architect
1490 Highway 99, suite B
Gridley, California 9:948
fax 846— 6358 (530) 846-6376
Progjc .
NE ,W SINGLE
r-A.MILY DWELLING
A,P,V '. 022-190-056
_ CHATFIEL.D AVE
BUTTE COUNTY, CA
'�ewriiona:
Print Date.
3/8/2005
Project No. Date
03/04/05
Sheet Title
COVER SHT, PLOT PLAN
Sheet No.
Sheet No. of Total Sheets
9
I
7 POSTS EQ. SPACED
@ 13'-4" O.C,=50'
24'
121-011
311 12'-10 1/2" 101
1- —1A5
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42!�
CONC, WALKWAY 311 ------
12' 6-5 112" 4'-3 1/21 1-2." 80-911 6- 1 1/2" 13'-7 1/2" 131-911
M G' K
4' 23'-8 112" 25- 10" /1\ 301-1 1/2"
28'-7" 13'-2" 381-311
\v 4 P05T5 EQ. SPACED @ 14'0.C.=5G'
2868
F_,0
a
I
DEN
GARAGE
rlALTERNATE DOOR/ WALL LAYOUT
A2 ) (NO HOLDOWN5 REQUIRED)
.1
SCALE: 3/1 G" = V-0"
FA7,-41
INSULATE WJH CL05ET WALLS
BfDROOM5 SHALL HAVE A MIN. OPENING Of 5.7 50. FT.
wl R_ 13 BATT IN5ULATION, ALL 51DE5.
NTH MIN. WIDTH Of 20" AND MIN. CLR. HEIGHT OF 24".
RANGE HOOD EXHAUST THRU WALL
SILL HEIGHT SHALL BE 44" MAX. A.F.F. MEANS Of ESCAPE
1
at G'-6" ABOVE fIN15H FLOOR
5 HALL OPEN INTO A PUBLIC WAY, 5TRfET, ALLEY OR, YARD.
VENT TO ROOF IN LAUNDRY RM
2. DOORS AND PANELS FOR SHOWER. AND BATHTUB ENCLOSURES
PROVIDE 2x FURRING at I G"O.C. 90FFIT
SHALL BE FULLY TEMPERED, LAMINATED 5AfffTY GLA55 OR
w/ 1/2' GYP. WALL BOARD.
APPROVED PLASTIC.
LIGHT TUBE, 5ELF FLAMING
3. SHOWER AND TUB/ 5HOWER TO HAVE A SMOOTH HARD NON -
TINTED INSULATED GLAZING
Eil
40,000 BTU GA5 FIRED TANKLE55
tlb5ORDENT
LAYMENT TO A HEIGHT Of 70" ABOVE FLOOR DRAIN.
IN5TANT HOT WATER HEATER
4. OINIMUM CEILING HEIGHT SHALL BE 7-G".
PROVIDE COM5U5TlON AIR, VENTING
5. MINIMUM WATER CLOSETS TO BE I.G GPF.
PER CPC'
GENERAL NOTES:
I , MINIMUM UQUIRED MEANS OF EMERGENCY ESCAPE FROM
7. SHOWER AND TUB/ SHOWER COMBINATIONS SHALL BE
BfDROOM5 SHALL HAVE A MIN. OPENING Of 5.7 50. FT.
SUPPLIED WITH INDIVIDUAL CONTROL VALVES or THE
NTH MIN. WIDTH Of 20" AND MIN. CLR. HEIGHT OF 24".
PKE55URI! BALANCE OR THERMOSTATIC MIXING VALVE TYPE.
SILL HEIGHT SHALL BE 44" MAX. A.F.F. MEANS Of ESCAPE
1
5. GFCI (GROUND FAULT CIRCUIT INTERRUPTER) SHALL BE INSTALLED
5 HALL OPEN INTO A PUBLIC WAY, 5TRfET, ALLEY OR, YARD.
IN ALL DATHKOOM5, GARAGES, ACCESSORY BUILDINGS, OUTDOOR
2. DOORS AND PANELS FOR SHOWER. AND BATHTUB ENCLOSURES
Rf--CffIFTACL�, AND ALL RECEPTACLES SERVING KITHCHEN
SHALL BE FULLY TEMPERED, LAMINATED 5AfffTY GLA55 OR
A
APPROVED PLASTIC.
COUNTER TOPS.
3. SHOWER AND TUB/ 5HOWER TO HAVE A SMOOTH HARD NON -
9. ALL FRAMING MEMBERS SHALL BE D.F. #2 OR BETTER AND
A
SURFACE OVER A M015TURE RE5151TANT UNDER
ALL BEAMS SHALL BE D.f. #1 OR BETTER U.N.O.
tlb5ORDENT
LAYMENT TO A HEIGHT Of 70" ABOVE FLOOR DRAIN.
10. WATER, HEATERS (GENERATING A GLOW, SPARK, OR FLAME
4. OINIMUM CEILING HEIGHT SHALL BE 7-G".
CAPABLE Or IGNITING FLAMMABLE VAPORS) SHALL BE INSTALLED
5. MINIMUM WATER CLOSETS TO BE I.G GPF.
18" ABOVE COMPARTMENT FLOOR. (if APPLICABLE).
G. OHMIC ANCHORAGE OF WATER HEATER TO INCLUDE ANCHORS OR,
.TRAPS AT POINTS WITHIN THE UPPER AND LOWER ONE-THIRD
Of ITS VERTICAL DIMENSION WITH THE LOWER ANCHOR TO 13F
4" ABOVE CONTROLS.
CONTRACTOR5 NOTE: TH15 FLOOR PLAN MAY BE CONSTRUCTED IN
MIRROR IMAGE DEPENDING ON CONTRACTOK5 CHOICE. ALL OTHEI
A5PECT5 Of THE FLOOR PLAN REMAIN UNCHANGED U.N.O.
SCALE: 3/1 G"= P -O"
klatthew '
lutl-" "lflw'�iolvj Dr' '90634
646-0174 F.V-. (60U) u4lufllw�
LEGEND.
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KEY NOTE
05/1 ?/04
FOR PREFIX Eh E. M, P, SEE BHT.
Date
Ivi K
05/ 1 ?J04
PREFIX A SEE THIS SHEET.
BRACED WALL PANEL:
A
WALL TYPE.
A
TYPICAL EXTERIOR WALL U.N.O.
TEXTURE PLYWOOD SIDIffC 5/8"
THICK, HAIL wd Od GALV. of 6" EDGE
and l 2" FLD . C.
OR
HARDBOARD PANEL SIDING OR
3/8- -iHK SHIP LAP EDGE PANEL
DING w/ CORROSION RESISTANT
EDGES; Bi -O -C. at
INTERMEDIATE SUPPfpTa
MIN. WALL LENGTH 4-0.
1Z27'�GYPIRD�Ly 6d'CQCtER5NAl�S
O.C. VN8 C Od ot
t 'KED
THICK WALLBOARD.
MIN, WALL LENGTH 5' ONE SIDE ONLY
APPLY VERTICALLY.
0
RNATE BRACED WALL PANEL
3 PLYWOOD C)ii APA RATED
3/
OSB W(SINIP50N STHDO HOEDOWN
AND D)UBLF. 2X4 POSE
SHIP LAP SIDING OVER PANEL
REV15ED PER LP2A PLAN
CHK. JULY 23, 2004. C.K.
I)r-dwn by:
ua�e_
cr\
05/1 ?/04
Checked by.
Date
Ivi K
05/ 1 ?J04
Froject I)c!5cnVtiofi
Drawing Title
fl -00K PLAN