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HomeMy WebLinkAbout024-080-085­7� 0' b80—O85 0 024-080-08.5 24-080- -06-'2103 - SUMMARY SHEET.-'-�,�Q LAND DIVISIONS RUFUS 11 9 3 2 1 3 LA JOHNSON, Gera 213 LARKIN RD, GRIDLEY 1213 Larkin Rd.;,j-, Gridle Co t. 0 Y: - Cont: OWNER 00 = V, RE ROOF 024-080-085 024-080-08' 05-1466 CASEY,RUFUS rB6 2 3 5L3 I ' 1 3 LARK. 0�' . C t. OWN, L 0 AG FBDG MIS B06-2353 024-080-085 1113 LARKIN, GRIDLEY CE LAN MISCELLANEOUS Remodel C011t: OWNER COMPLETE REMODEL- APPRO I I I L 0( AGBLDG 1213 LARKIN RD C S Y , U �y C CASEY, RUFUS L & NA B07'0034 024-0.ao� SC (WNAS+Roa�w dn- -irst M "' W�, 4 T AD N v �S E ��Y'l & NANCY C 613- 0-33d- ��7 v y _ - - � V � f __ � � � �� 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.net\dds PROJECT INFORMATION Site Address: 1213 LARKIN RD Owner: Pennit No: B06-2353 APN: 024-080-085 CASEY, RUFUS L & NANCY C Issued Date: 10/03/2006 By KEJ Permit type: MISCELLANEOUS PO BOX 138 Subtype: Remodel 'COMPLETE BIGGS, CA 95917 Expiration Date: 10/03/2007 Description: REMODEL- APPROX (530) 846-3324 Occupancy: Zoning: A5 Contractor Applicant: Square Footage: CASEY, RUFUS L & NANCY Building Garage Remdl/Addn PO BOX 138 1,900 BIGGS, CA 95917 Other Porch/Patio Total (530) 846-3324 1,900 FEE INFORMATION Remodel - Residential $714.87 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 10/03'/2006 Contractors Signature Date WORKERS"COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by section 3700 of 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: Policy Number: Exp. Date: (Thi :Ted not be completed ifthe permit 'is-Fo—rone hundred dollars ($100)—or-Fess —) se is se Z�CERTICF'Y TH N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS C ISSUED, I s:hlall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n 10/03/2006 Signature I I Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEYS FEES. I CONSTRUCTION LENDING AGENCY I I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for 'he performance of the work for which this permit is issued. (3097 civ. code) Lender's Address city State Zip Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (See. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects ithe applicant to a civil pe ally of not more than five hundred dollars [$500]; Please che ne of the following: S OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE OEMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (See. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or hee own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). 1. As OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). EI AM EXEMPT under Section B. & P.C. for this reason: ] — -4 - I 10/03/2006 Date I hereby certify that I have read this a�plication and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the P1prty1:Vthonzed to act orV property owners bAalf. ,&- - ('.,_-tt;;;tA0/03/2006 1:1 Contractor OR: 1:1 Agent for Owner E]Agent for FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF A PPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" APPLICANUIGNATURE X C4 For office use only: OWNER INFORMATION Last Nam j (Ile r irst Nam Address -2, City Statt -4 Zio, GlYb Phonel��� E-mail Fax E-mail Planner APPLICANUIGNATURE X C4 For office use only: CONTRACTOR Name j (Ile Address x 'Z CA �C' V % 1M City State State Zip Phone E-mail Fax E-mail Planner Lic. # Class APPLICANUIGNATURE X C4 For office use only: ARCHITECTIENGINEER Name j (Ile Address x 'Z CA �C' V % 1M City State Zip Phone F a-) E-mail State License'gumber APPLICANUIGNATURE X C4 For office use only: APPLICANT INFORMATION -1 Name j (Ile Add . ress I " -2— x 'Z CA �C' V % 1M city I No Stat I Type Const. Phone 11k. Map Book Fax�� E-mail Planner APPLICANUIGNATURE X C4 For office use only: Zoning Property Address Flood Zone Cross Street SRA I Yes I No Occ. I Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApp]SubRqmts.doc PERMIT NO. D n � BIN # PROJECT LOCA TION AP# Property Address City, C� 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 2 "Y� I I i�__ j Descriptir or Scope of Work: I ) " -)p IN — \ :�, c) C) FlLmivi,, �2 Garage C, OPV 0 Structune BLfilt about Permits 0 Proposed Change of Occupancy (Note previous use): I I Cov (V � S_k_j 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 reauired. 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. eive Amount: Bldg I SRA 9Rceipt #: Sheriff SUP D.V f Other J Total Page 1 of 2 REV 8-12-05 L_ - 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. 0 1 . Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! 0 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) PR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 0 3. Engineered truss details and layouts in duplicate (if required).. No faxes! M 4. Energy compliance design and supporting documentation in duplicate. 0 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. 0 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, All in duplicate 0 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-si_qned by the engineer. 0 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). E] 9. Site plan and business license approval from the City of Biggs. 0 10. Letter of intent for non-residential buildings. 0 11. Building Permit Application Without Required Clearances Form r_1 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.) 0 1 . Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). El 2. Impact Fees. 0 3. California Department of Forestry plan approval (if required). 1:1 4. NPDES Form. 0 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). 0 6. Contractor's license information. (Number, Name Style, Classification). F-1 7. Worker's Compensation Carrier and Policy Number. El 8. Owner -Builder Verification (if required). r_1 9. Letter of Signature authorization (if required). 0 10. Recorded copy of Agricultural Acknowledgment Statement. D - 11. 0 Legal description from current recorded grant deed, -0 Copy of M.H. Title, Title transfer, or MCO. El 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRqmts.doc Page 2 of 2 REV 8-12-05 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourselffirom possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information foryour benefit and protection: 13 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. a If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal a income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations unders state law, contact the Department of Benerit Payments and the Division ofindustrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons prefessing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not requir3ed to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PLAT-�TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY U%4PROVEMENT.<Gy OR NO) <9R�VE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. 1 HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO_ 4. 1 PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. 1 WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: COMPLETE REMODEL- APPROX 1900 SQ FT Reference Number: B06-2353 Applicant Name: CASEY, R CY C Signature of Property Owne= Date: 4) —R —zV6 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. BP062103 PERMITS BECOME NULL AND VOID I YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE. LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 08/31/2006 APN: 024-080-085-000 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. Site Address: 1213 LARKIN RD GRI License Class License Number: Map Index: Date: Contractor: Description: RE -ROOF 22 SQ.'S COMP OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: CASEY RUFUS permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 1213 LARKIN RD signed statement that he or she is licensed pursuant to the provisions of GRIDLEY CA the Contractor's State License Law (Chapter 9 commencing with Section 95948 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) 846-3328 violation of Section 7031-.5 by any applicant for a permit subjects the a:pplicant 'a civil penalty of not more than five hundred dollars ($500).): 1, as owner of the propirty, 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: CASEY RUFUS Code: The Contractors' State License Law does not apply to an 1213 LARKIN RD owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, GRIDLEY CA provided that such improvements are not intended or offered for 95948 sale. If however, the building or improvements are sold within one year *of completion, the owner -builder will have the burden of (530) 846-3328 proving that he or she did not build or improve for the purpose of sale.). 0 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 Contractor: 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.). 0 1 am Exempt under Article 3 of the Busiotss and Professions Code Date4r � -3 (-- Q Owner: Ll� , i License #: WORKERS' COMPENSATION DECLARATION I 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 workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: C3 1 have and will maintain workers' compensation insurance, as required by Section 3700 the LabOr Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier:— Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: W��cerfi that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of.California. 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. Dat e: 0 Applicant: cag �LI WARNING: Failure to secure workers1compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100.0bo), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. — - . — --- -- - — - -- �, #- 4 -7 CONSTRUCTION LENDING AGENCY This permit is h 'reb issued und e Ii ble provisions of the Butte County Code and/or y 'ca '"aa 1 hereby affirm that there is a construction lending agency for the .te 0 e8foipr which fees have been paid. R I t* s to o work indica performance of the work for whic h this permit is issued (Sec 3097 Civ.) Date: Name: - B PERMIT EXPIRES ON: Address: (Date) - 0 1 hereby certify that the use of this facility shall - comply with Sections 2550.5; 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. C1 Notification in accordance with Section 19827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. 0 Attached are copies of the required E. P.A. notification forms. I I heieby certify that I have read this application, that the above information is'corre�t, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all codhty and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize represe9tatives of Butte Counly to enter upon the above mentioned property for inspection pprp S. ;�-?, yo— Print Name: Signature: '/"Ir !f� Date: (A'Owner 13 Contractor El 'Agent for Owner 0 Agent for Contractor B. C. Building Permit 01-16-04 pg 1 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 FffLL BE REQUIRED A T TIME OF APPLICA TION Welbsite: www.buftecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name/'P , r_ irspme) Address I Z L 5 C'i ty St ate(T. City Phon,.G,,,,--,, Fax E-mail _77 CONTRACTOR Name City Address Zip City Fax State lip Phone LENDING AGENCY Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECTIENGINEER Name City Address Zip City Fax State Zip Phone LENDING AGENCY Fax E-mail State License Number APPLICANT INFORMATION Name A— Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X �9 2==4.4 \1 For office use onl Zoning 721�_Flood Zone __FSi��_FYes I No Occ. I Type Const. Subdivision Name Map Book Page Lot # Nhiring anyone other than license contractors, a certificate of worke compensation must be shown at the Ume of pennit issuance. Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:kFORMS\BUILDING FORMS\BldgAppISubRqmts.doc PERNHT NO. �%_2/ BP BIN # PROJECTLOCATION AID PropertyAddress 'T: �2_k3_ rss "rl . __(" " , r— - WORKER'S COMPENSATION Policy Number Carrier Nhiring anyone other than license contractors, a certificate of worke compensation must be shown at the Ume of pennit issuance. LENDING AGENCY Name Address f —1) / Description or Scope of Work: 7\0�pk- '91 a's -�7,5 142 3 - � -. '2q & (Z/� Sq FT- Living G*6ge Open Cov C] Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by _IP Amount: 17, 6-c) Bldg SRA Receipt #: Sheriff L C" SMIP Ot.h.ar Date: 7-8/_060 /3 r7.,50 Total I I Page 1 of 2 3A -q L3 REV 8-12-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. El 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! 0 2. Complete plan ' s, 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. El 3. Engineered truss details and layouts in duplicate (if required). 'No faxesl 0 4. Energy compliance design and supporting documentation in duplicate. El 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. 0 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, Tie down or fnd plans, all in duplicate 0 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. 0 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). El 9. Site plan and business license approval from the City of Biggs. 0 10. Letter of intent for non-residential buildings. El 11. Building Permit Application Without Required Clearances Form 0 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.) 0 1 . Agricultural Buffer clearance and site plan approval from the Ag Commissioners office (if required). 0 2. Impact Fees. 0 3. California Department of Forestry plan approval (if required). 0 4. NPDES Form. 0 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). 0 6. 'Contractors license information. (Number, Name Style, Classification). 0 7. Worker's Compensation Carder and Policy Number. 0 8. Owner -Builder Verification (if required). 0 9. Letter of Signature authorization (if required). 0 10. Recorded copy of Agricultural Acknowledgment Statement. El 11. 0 Legal description from current recorded grant deed, 11 Copy of M.H. Title, Title transfer, or MCO. 0 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 5EE 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 KAFORMBUILDING F0RMS\B1dgApp1SubRqmts.doc Page 2 of 2 REV 8-12-05 BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. a -/ 'Pe!; Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. QQZ71- n 'g -o os�-y - 000 ZONING OWNER I P D PHONE NO. 1 LY6 -3-262 L OWNER'SADDRI '4S. LOCATION OF BUILDING USE OF BUILDING SIZE OF STRUCTURL" yak —SO. FT. �7 TYPE OF CONSTRUCTION: WOOD FRAME STEEL— CONCRETE— OTHER(Specify) TYPE OF SIDING, ROOF COVERING FLOOR TYPE - C C -k-) c'& CZ, -,4& b ESTIMATED COST OF CONSTRUCTION $ AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the a plicable County Ordinances as ;P follows: 0/ FRONT.N��- SIDESN REAR 146*t' AG Buildings shall be a minimum of five (5) feet from any septicrank ' or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a -V. mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated about, and the purposed use confirms with the --t V AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and . . obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date - 'e"', - 7- e, 5— — Permit Fee - ) 09 - q 15 Receipt No. Y3V 86 6 Signature of Owner,2;1 The above described AG Building is exempt from a building permit. J F 00 1 P;KEL I P D ROO G White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant I A NS 41 V4 Z; ip W, 4 mv tv "ll 'h -'A 61, zc,.,vlf BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24&OUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: Owner: Permit No: B07-0034 APN: 024-080-085 CASEY, RUFUS L & NANCY C Issued Date: 02/15/2007 BY GLB Permit type: MISCELLANEOUS PO BOX 138 Subtype: Room Addn-First Stry BIGGS, CA 95917 Expiration Date: 02/15/2008 Description: ADDITION 48 SQ ITT Occupancy: Zoning: A5 Contractor Applicant: Square Footage: CASEY, RUFUS L & NANCY C CASEY, RUFUS L & NANCY Building Garage Remdl/Addn PO BOX 138 PO BOX 138 48 BIGGS, CA 95917 BIGGS, CA 95917 Other Porch/Patio Total 48 FEE INFORMATION EH Building Review Fee $70.00 Room Addition - First Story $255.65 Room Addition - First Story PC $170.47 SMIP - Residential $0.50 Total Charged: $496.62 Fees Paid: $496.62 Balance Due: $0.00 Receipt No: B1434 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License CASEY, RUFUS L &NANCY C OL:CRW-003571 01 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed 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 pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civill nalty than five hundred 02/15/2007 of not more dollars [$500]; Please &a ne of the following: Contractors Signature Date .. S OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE CaOMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS'COMPENSATION DECLARATION - I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR the 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 improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 the Labor Code, for 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: of the performance of the work for which this permit is issued. My WorkerEV Compensation insurance carrier and policy number are; The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). carrier Policy Number. Exp. Date: (This ctil n need not be completed if the permit-is-To-r-o-n-a-Fu-n-d-reUToilars ($1 00)_o_r1e­ss_�_ t'o I AM EXEMPT under Section B. & P.C. for this reason: Z:��El ERTIFY THAT IN THE PERF RMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 02/15/2007 of Sectio compensatio n 3700 of the Labor Code, I shall forthwith comply with those A provisions. Tisions Ovvntr%_SjW@'re Date X 02/15/2007 1 hereby certify that I have read this application and state that the above information is correct'. I agree to comply with all City and County ordinances, §g`nature Date WARNING: FAILURE TO SECURE WORKERS'CAPENSATION COVERAGE IS UNLAWFUL, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, personal injury, including death, and property damage caused by, arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any side Ik str ,-Or subsidewalk. I hereby authorize representatives of Butte ATTORNEYS FEES. 0 t bo ;2tile= property for inspection purposes. I hereby certify that I am the o u i d P'ope rora to act on the property owner's behalf. CONSTRUCTION LENDING AGENCY 02/15/2007 a — I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for m Nam f rmittee-150NI—Prin Date t1( 3 the performance of the work for which this permit is issued. (3097 civ. code) Own er 1:1 Contractor OR: 0 C tract Agent for Owner Agent for Contractor FILE COPY Lenders Address city State zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED A T TIME OFAPPLICA TION Website: www.buftecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name F_ r irst Nam Mailing Address /-,2 �V& 'e City State zir Phone 1:6 lax E- mail APPLICANT INFORMATION CONTRACTOR Name City Address zip city Fax State Zip Phone Lot # Fax E-mail IDate Approved: Lic. # Class APPLICANT INFORMATION ARCHITECTIENGINEER Name City Address zip city Fax State Zip Phone Lot # Fax E-mail IDate Approved: State License Number APPLICANT INFORMATION Name Address City State zip Phone Fax E-mail APPLICANT SIGNATURE I For office use only: AP# C3 a4, 0 C�_� . Zoning Flood Zone SRA I Yes No Occ. I Type Const. Subdivision Name Carrier Map Book I Page Lot # Name Address IDate Approved: PERMIT NO. BIN 9 PROJECTLOCATION AP# C3 a4, 0 C�_� . Property Address / 2 L3 XG ckk %h Cross Street I ­ ;'C 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: Sq FT- Living G e Open Cov rag 0 Structure Bi1iltwithdUlPermits 0 Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be 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. ton; Receipt #: Date: X � Amount: AIG -(O_�_Bldg SRA Sheriff SMIP Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, , CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourselffrom possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for yourbenefit and protection: 13 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. • If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal • income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. 13 For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division oflndustrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing t6be contractor is to secure an "owner -builder" building permit erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I . I PERSONALLY �P� PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT ��R NO) 2. PVE VE N �T) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. 1 WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: ADDITION 48 SQ FT Reference Number: B07-0034 Applicant Name: CASEY, RUFUS L & NANCY C Owner's Name: CASEY, S C AP # : 024-080-085 Signature of Property Owne�r:vmea Date: BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 75965 Permit Number: B07-0034 Job Address: Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Contractor: CASEY, RUFUS L & NANCY C PO BOX 138 BIGGS, CA 95917 Printed: 01/08/2007 10:56 am Fee Description Account Number Fee Amount Paid Date PmtAmt EH Building Review Fee 0021-540013-4614901 -1010 $70.00 01/08/2007 $70.00 Room Addition - First Story 00 10-440001-4210500-1010 $255.70 01/08/2007 $255.70 Room Addition - First Story PC 00 10-440001-4210500-1010 $170.47 01/08/2007 $170.47 SMIP - Residential 1001-0-280-1011298 $0.50 01/08/2007 $0.50 Printed By: Gwyn Benedict 496.67 $496.67 Balance Due: $0.00 At the time of permit application, I was advised the above fees are required prior to issuance of the permit. These fees may change during the plan checking process. Signature: Date: 01/08/2007 Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPM[ENT DATISION Storm Water Managment Program 7 County Center Drive Oroville, CA 75965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds k -%ft- 's-Nop- am 1l;71C 0 0 0 0 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE I Reference Number: B07-0034 Date: 01/08/2007 Location: By: GLB Parcel Number: 024-080-085 Sub Type: Room Addn-First Str Owner Name: CASEY, RUFUS L & NANCY C Phone: Description: ADDITION 48 SQ FT By signing below, I the project owner/owners' 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 buildouts 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 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 this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: Date: 01/08/2007 Title: FILE Butte County Department of Development Services TIM SNELLINGS_DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Reftinds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municir)alcodes.lexisnexis.com/codesibutteco/ Reference Number: B07-0034 Location: Parcel Number: 024-080-085 Date: 01/08/2007 Owner Name: CASEY, RUFUS L & NANCY C Phone: Description: ADDITION 48 SQ FT — �' Z 4 Signature of Property Owner: Date: 01/08/2007 Butte County Department of Development Services TIM SNELUNGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourselffrom possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. 13 If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations unders state law, contact the Department of Benerit Payments and the Division ofIndustrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform thier work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing theirown work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY P�A�TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENI(!��?OR NO) G6�VE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. 1 HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. 1 PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY PHONE CONTRACTORS LICENSE NO_ 5. 1 WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: ADDITION 48 SQ FT Reference Number: B07-0034 Applicant Name: CASEY, RUFUS L 8j NANCY Signature of Property Owner: ',A C.,gn_k, A Date: Butte County Department of Development Services TIM SNELLTNGS,.DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Penter Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B07-0034 Date: 01/08/2007 Location: By: GLB Parcel Number: 024-080-085 Sub Type: Room Addn-First Str Owner Name: CASEY, RUFUS L & NANCY C Phone: Description: ADDITION 48 SO FT The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No 0 0 0 M WSW M 0 0 OM of. DRAINAGE DISTRICTS Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 PARKS & RECREATION DISTRICTS Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 SCHOOL DISTRICTS Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 Cii0k'h tO OWW Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: Other: Other: Signature of Property Owner:�� go ast� Date: 01/08/2007 FILE \ BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District Building Department No. -)7 A - nO3 Tax 'ete Area No. A.P. Number 02-q -M-MS Jurisdiction: = city N�County Property Owner I Property Location/Address 1-2)3 CA Subdivision Lot No. Residential Development = No of Living Mobile Home Units Installation Commercial/Industrial New Addition *Supplemental to Conversion Permit # *(No foundation Deed Restricted Sq. Footage (Attach a signed copy of Deed Restdction and Notice of Limited Use Facility document) District Identification No. r\%� School District certifies that (Street Address) (City) Sq. Footage (Including Exterior Roofed Areas) Date o �)Aort,- (Payor) �) (Zip Code) (Phone Number) has complied with the requirements of Resolution No. or�,o6 by payment of $ representing square feet. B 2926 $ ULL MIT rFULL MITIGATION $ School District Representative -�4— i r,. o -7 Date Paid by Check # Remarks: 0 Q Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (school district), Yellow (building department), Pink (applicant) feeform.)ds (12/06)dmm W Sq. Footage (Group R) Cr. Demo - existing sq. ft. see attached Net total sq. ft. Deed Restricted Sq. Footage (Attach a signed copy of Deed Restdction and Notice of Limited Use Facility document) District Identification No. r\%� School District certifies that (Street Address) (City) Sq. Footage (Including Exterior Roofed Areas) Date o �)Aort,- (Payor) �) (Zip Code) (Phone Number) has complied with the requirements of Resolution No. or�,o6 by payment of $ representing square feet. B 2926 $ ULL MIT rFULL MITIGATION $ School District Representative -�4— i r,. o -7 Date Paid by Check # Remarks: 0 Q Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (school district), Yellow (building department), Pink (applicant) feeform.)ds (12/06)dmm SUMMARY SHEET FOR LAND DIVISIONS APPLICANT ADDRESS OWNER Same PROJECT DESCRIPTION TENTATIVE PARCEL MAP 6/1 LOCATION 2 parcels located on the northwest corner of Richards Avenue and Larkin Road. Gridley area. ASSESSOR'S -PARCEL NUMBER(S) 24-08-85 / 24-10-81 ZONING -A-5 GENERAL PLAN AR.-Resi. PROJECT CONSISTENT? YES GENERAL PLAN CONFORMANCEREPORT M�rch 18, 1993 LAND CONSERVATION ACT -CONTRACTS? NO DATE APPLICATION RECEIVED May 21, 1993 AGENT/SURVEYOR/CIVIL ENGINEER Barnhart -Brown & Associates -.ADDRESS P.O. Box 1576, Oroville, CA- 95965 DATE PLANNING DIRECTOR'S REPORT PREPARED ENVIRONMENTAL CATEGORICAL EXEMPTION DATE FILED DETERMINATION AND DATE NEGATIVE DECLARATION DATE ADOPTED MIT.NEG.DECLARATION DATE ADOPTED ENV,.IMPACT REPORT DATE CERTIFIED STATE CLEARINGHOUSE NO. DEVELOPMENT REVIEW COMMITTEE HEARING DATE - APPEALED APPEAL HEARING DA BOARD ACTION- -'COMMENTS'FOR-PLANNING DIRECTOR'S REPORT A SSIGNED TO DIS ',7 ­RECEIPT NUMBER 1005 (11/92) z 4 P-ji -pi 5 t., CA ss -r , (1413 (AIZWN AD ;eVrT9. CO. / CA ITS11 4-% -OZ4- 060- 055 44 4t. ft I 6T'e T.WC TT laa A-' 1604 Tv COUN Bull lOwner: �P#Isw ';�!z; N:Q;?4-QaO-CeG ILE CO Y. jo"A& ca.& Ltworo A4JP, NAIM w "r E; i . 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