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024-100-092
` NOTES RESIDENTIAL 024-100-092 03-1307 JOIJNSON, MONTE PERMIT NO. S—j OBRIEN RD, GRIDLEY Cont: EQUA ENG41 . NEW SINGLE FAMILY.. �---:tea+ os, SPECIAL CONDITIONS SRA _ Y FLOOD CERTIFICATE REQS ' FIRE SPRINKLERS REQ: SPECIAL INSPECTION ITEM r. VERIFY- CHECKED' BY 'e OFFICE COPY Address ,- ,V %Vy f GAS -`Date Meter By ELECTRIC pate Meter By r i". GAS Date-- Meter By ELECTRI D. Meter By t JOB F CHECKED' BY 'e OFFICE COPY Address ,- ,V %Vy f GAS -`Date Meter By ELECTRIC pate Meter By r i". GAS Date-- Meter By ELECTRI D. Meter By J=OK 0 = Not OK = Not Readyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 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-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance . 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements-Setbacks*Easements Card B-1 Date Card B-1 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 Enclosure; Fencing -Alarms 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 Card B-1 Date Card B-1 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 - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 21 F ain; Soils-Elec. Grnd.-/ /" Ftg. Depth F ., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Ft orches & Decks; Soils -Steel-/ /" Ftg. Depth A /) 5,jogtgptovAls, Main; Steel-Blockouts-Wrapped and Special Anchors 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17—Water Htr.: Vent -Access -Combustion Air Baffle 1 &.-Water Pipe; Test & Anchor -Nail Protection 9. . V.; Test Fittings & Anchor -Nail Protection Sh er Pan; Test, First Floor -Tub Access 1 est Tub & Shower. Second Floor -Tub Access Fire SDrinkler: Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s fixture & Transformer Clearance -Ins. Protection c. Receptacles Spacing -Lights & Switches at Doors 2 ze Boxes & No. of Conductors Stapled ex Installed Close to Edge of Studs & C.J. 28� ip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI �6feed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al _!.Usulated Neutral ❑ Yes ❑ No ce-Riser Conductors & Ground Main Disconnect _540fip. Clearances Panels-Motors-Mech. Equip. 042 AT Clothes Closet Light -Shower Light -Spa Light lmoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Ducts Insulation & Support Vent Fan, Exhaust above insulation C densate Drain & Overflow, Size & Grade F ce-Vent Access -Comb. Ait-Return Air Vent 115 Outlet j4WAttic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRA G (Permit) OK except #'s 414ip Proper Materials & Anchors O)Ws Studs -Nailing Spacing & Braces -Plates -Sound Baring Walls over Girders & Floor Nailing 4 raft Stop in Walls (rat proof) W 5. re Stops, Furred Ceilings -Stairs -Chasers -Tubs •At Headers & Beams -Size & Bearing Date 4T -Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. it ce Ties or Type A Flue -Fireplace Throat Clearance Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles rm. Windows or Exiting Doors -Sill Ht. & Dimensions arage Fire Protection Framinq-RC Channel 54. E8.Doors-One 3' -Check Garage 3rd Story, 2 EAU Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56 ood on Roof Overhang -Attic Vents -Rafter Outriggers iding-Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access azing Area -Glass Protection -Skylights -Plastic -p _ e_ar Walls; Nailing -Bolts 63. Infiltration -Walls -Windows 1C r " ' ' Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINA OK except #'s 6*.St -Door & Sidelight Protection -Landings S e Detector urnac nts-clearance-Comb, Air -Connector - I rage; Above Floor-Ducts-Mech. Protection Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access-SDa 69. Elec. Tr' & Subpanel, Breaker Sizes & Labels 70. Stairw& Rails 74!�eplace or Stove, Clearance -Hearth W'Kit. t. & ppliance; Ground -Air -Gap -Cooking Clearance 14,ets & Receptacles at Kit. Counter 76-"GaEUd'Fire Door; Swing -Landing -Closure 7 Duct in Garage -Damper tr. Htr.; Vents -Clearance -Comb. Air Conn ct . in G e; Above Floor-Mech. Protection . & Mech. Equip. Listed for Location rec. Recept cies in Garage (F.F.I.)-Romex Protection W. Insulati oam-Looked in Attic 81. Gu Rails & Deck Construction -Post Caps n. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under or ❑ Yes 83. Followin nstld./Driv s D No/Walks No/Plante es ❑ No 84. Stu o Bprfi-Finish nit Disconnect, Electrical -Plumbing CAVVent ove Roof, Plbg-Appliance-Fireplace-Clearance to Openings We,11rDisconnect, Electrical, Plumbing 887Ex�or Elec. Trim, G.F.I. Receptacle -Underground e dation Throughout House 9t_66godions from Previous Inspections as Test -Meters Tagged, Gas -Electric 93 _ Water & Sewer Connected -C/O to Grade -HD Approval ( 94JEner6lComDliance Certificate -Other Certificates 981A ress Posted ire Sprinkler71 Date /GAP/ Card B-1 Date Card B-1 Date'( /1 .' Card B-1 /7/ .4 Date Card B-1 Date UW _VJUV Card B -,7V/ )// / Date Card B-1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. (ReV.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 024-100-092 ZONING A-5 BUILDING PERMIT OWNER Monte Johnson 846-5028 TELEPHONE SO. FT. OCC. BUILDING VALUATION 2947 R 159 X38.00 OWNERS MAIuNG ADDRESS .7 492 Johnson Clan Ave Gridley 714 U 12 852.00 CONTRACTOR'S NAME ua Engineering TELEPHONE 7110 C 9)230.00 CONTRACT10G ADDRESS MAI000 Spring Valley Road Ma sville CA 95901 CONSTRUCTION LENDER LENDERS MAIUNG ADDRESS Fireplace 1560.00 Total Valuation $182.72 .00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 930.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 604.50 SS BUILDINGADDRE591 O'Brien 5 Brien Road Gridley Energy Plan Checking Fee $ 23.00 $ PERMIT FEE $ 1577.50 LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 98,00 Solar or heat pump water heater 23.00 Water piping 15.00 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: new sf w/ garage Gas piping system 1- 5 outlets 15.00 1 9_00 Building sewer 15.00 19-00 Mobile Home I S I G I W 920.00 PERMIT FEE ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION 1 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, ( 9 ) and my license is in fu force and effect.G License Class Lic. No. / I D � OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. SO OR ADDNS. ( & ACC. BLAS. 3.54FT. 128.1 NEW CONS . MULTI -OUTLET NON REBID. @7.50 POWEPPARATUS d SINGLER AOUTLET CIR. EX. OCCU . OUTLET ORFDRURES 20 ''0° BAL @ .SO Ex. Occup. .RXED R6li DEp 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 171.14 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 1 certify that in the performance of the work for which this permit is issued, I shall employ any person in any manner so as to become subject to 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 withthose rovisions. 5 �a X _ Date _ Signatu e f Ap licant - Owner gr Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep nd demolition ork1prIstruction of structures over 3 stories in heig t.By MECHANICAL PERMIT Fling Fee 20.00 Heating 20,00 Cooling 25,00 Hood 6.50 Ventilation gas f ireplar-P q9_00 1 PERMIT FEE s104.50 Mobile Home Installation Fee $ Energy Inspection Fee $ 46.00 oc R-3 T PE I N" TOTAL FEE $ 2077.14not D. FEES IMP _ FLOOD __ CDF pggCEl Pp HD SSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. ate�FA /0z PE MIT EXPIRES ON / IDef Receipt No. ✓ 07 r WHITE-D.D.S.-B.D. CANARY -A S SCIPINK:INS=0T1 GOLD N D-APPLI 0 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES i 411 Main Street • Chico, CA • (530) 891-2751 `7 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 s).duld be corrected. Please notice this office when correction of work is completed. If yowl ave any questions pertaining to this matter, or need additional explanation, please contact t¢is office immediately. G J A!m/ is 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: ASSESSOR PARCEL NUMBER 7 /DD Proposed Buildingse: I) S / Counter Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1.. Plot plans, 3 or 4 sets, signedty the preparer of the plans. Complete plans, 3 or 4 sets, signed by the preparer of the plans. _ R 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. No faxes! 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot 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 ..................................... ❑ 2. Hazardous Material Form .............................................. o. w t. .....�.Q ....... 3. er. Fi ►�__S A t ., k l ,r - c 'i S a l e Remaining items needed to issue the permit. (May require additional plan review upon receipt of the fo lowing items.) ZI5. ees as shown on the attached Schedule of Fees Due Sheet..... �� G oo j t, n+ tatement of Intent for Non -heated and A/C Buildings........... anitation and plot plan approval from the Environmental Health Department in ity of Chico Plumbing permit......................................................................... ❑ 18. California Department of Forestry plan approval ❑ paid. Sent. by: ...................... ❑ 19. Planning approval for (A) Use: ®fi (B)Parking: (C) Parcel Check: 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... Letter of Signature authorization ................. ntSt............................................. 7 2 ecorded copy of Agricultural Acknowledgment Statement .................................... �. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits......................................................... ❑ 39. ❑ Grant Deed, ❑ NJ.H. Title/Sateme�t of Facts Letter from Legal Owner, ❑ Check to H.C.D. $ W6- Other: fj 19*1 J. When issued Te p / and hold for pickup. .7eeen infor a of a abo tems qui eft orobtaining a building permit.nt: -/ 42 baKei ../Jaer,a. NC r ' • �t F 3 of 6f Tarr T. Index permit application for the ab it mb rPlan Check etter 2. Additional items re uired G Contracto"des—V_<—o�wn w ` v c e bove a by phone, mail, ounter, Date:y3-�v- Contracto,er, own r, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: o Structural approved by: Date: C Note transfer by: Date: V-11 .... D..:IA:-- Il:..:..:.._ r FROM :EQUA ENGINEERING FAX NO. :5308465028 Jul. 16 2003 04:05PM P1 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION -FORM I;One form per Building) School District C?i %�Ot' r h t Building Department No: A.P. Number Jurisdiction: City- �CodMY Property Owner Ma✓- ,1 o k-" s Property Location/Adams IT Ar;e.., All Subdivision Lot No. ..-Residential Dove"ment No 91 Living- Q MoblteMome- ....................... ................ _........................... _........ _... _.................... _...... I O ! Addition/ . 'Supplemental to _ Sq. Footage ;? 9y 7 (Group R) Unita InatatlauonConversion Permit d i '(No foundation ineQecfion) CommoroieUlndustrial New Q Addition. Sq. Footage (including EJ derlor Rooted Areas) Dale Pons. revievtled- oy-. senor u..istnc- Dib rict.Identificabon.No. . ti✓1 a �Ctk _ V R�t�' 1 .�►. School District certifies that (Applicant).- "Ro (Phone Number) ICityl- has complied with the requirements of Resolution No. representing. OLP '3 square feet IStetel 12ip Code) by payment of b to • `., AB 2926 Z iULLMi.TIGATtoN. i_ - Paid by Check p Remarks: Date Notice; You may protest the imposition of tha fees identified above by submitting a vrritten protest to the District, in cortr08ettce-with. Government Code Section 88020(9), within 90 days fmfn the date fees are paid. Faitue to submit a tlmelY written protest will prohibit you from challenging the imposition of the fees In any court action. if, subsequent to the School DisMet RepresoMetive signing this Butte County 8e11ods Impart Fee Certificnion Form, this Sctrool pbtrin IS notified by the applicable Local Planning -Agency that -this project is beim reviewed under the California Environmental Quality Act ICEQA). this project may be subject to additional school fees to fully mitigate its impact on the school distriet's schools. � white (applicant), Yellow (building -department), Pink (school district) t"formJda I10/96ld, OWNER PROPOSED 1. 3 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 USE SCHEDULE OF FEES DUE 0 BUILDING PERMIT FEES Balance Due .......................$ Additional Fees Due ................. $ Additional Fees Due ................. $ 1 Revised Plan Checking Fee .............$ /SCHOOL DISTRICT FEES -d," (paid at District Office) (Available after Plan Check) SHERIFF FEES (paid at Building Division) e Residential x $360.00 Units Commercial (sq. ft:) ............... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ................... -x-=$ # Units Amt. Commercial (sq. ft.) ............ -x_=$ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) pa -18. WATER TENDER FEES (Battalion #�� ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A. P. # 0C � 7" °r/ DATE RECEIPT # DATE REC. At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APP CANT Pjd E Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 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 - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner ' (Rev. 6/00) .,r.. _ ti.+' a » a_N z � _ a, R e-. ....r ..xyr�fx, � ..i'.,. tia f.-.. . .. ..••, -^4 •,:V..s-.. HSi ��.A'. _ ._. - .�;ti,'i�� �^ .. - t.: t r �;• -- r r Y 0241e100-092Im fir4 t' i 03-1306 JOHNSON,aMO1VTE a *i OBRIEN RDh, GRIDLEYS ;.Cont: SIMPFEX-GRINNEL, r ;i , FIRE SPRINKLERS r , I l I G w.. r � r a � A • l COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 'PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT --o � /5& ASSESSOR PARCEL NUMBER 024-100-092 ZONING A -S BU I LDI NG P ERM IT OWNER ^" %4 -mm 530 � TELEPHONE 46-5023 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 492 JOHNSON Q= CLAN AVE. 713-M33 �j 0^ 726 0 F, 6L 715. CONTRACTOR'S NAME SIMBLU GRINNEL 916 .83-03,10 TELEPHONE CONTRACTORS MAILING ADDRESS 4650 ?11DIT DR. SACRAMMrM CA958335 CONSTRUCTION LENDER LENDER'S MPJUNG ADDRESS Fireplace Total Valuation $ A 1 C 1r,ARCHITECT OR ENGINEER LICENSE NO. - Filing Fee $ 20.00 Permit Fee $ 72 01 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ / c O BUILDING ADDRESS 591 OBRIEN RD GRIDa 94S Energy Plan Checking Fee $ PERMIT FEE $ 1 'I;z LAT NO. 7 SUBDNISIO SHAM YM 1 4-�6 6.35 AC PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF Q Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Fti;'TtF rPRT?M T'-" Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W I@20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service .°ovL OR mss 23.00 LICENSED CONTRACTOR'S 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 f II force and effect. /•� License Class Lic. No. TTT 7 9 / D OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for 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 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed R the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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 comp y witothose rovisions. X Date Signature' of Ap 1i ant- Owner 13Contractor ❑ Agent An OSHA permit is require for excavations over 60" deep and demolition or construction of structures over 3 stories in heig I. �/ Main Service �A 46.00so NG CCU000A NEW CONST. DWELLING OCCUP. 3.5¢F°. ( NRA cors . MUL"OCou�nEST NON-RESID. @7.SO POr APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BqL ':� Ex. Occup. oLI Ao .oma 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood ,-6.50 Ventilation ,. PERMIT FEE $ ;IM"'o `e Installation Fee $ `Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HA2. D. FEES IMP FLOOD CDF PARCELFD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. ' �- r By 1 .: 6 l 1 �s✓ Date i �; PERMIT EXPIRES ON Deta Receipt No. 71 7b% r0 n % �' n� 4 . ' i ..� I WHITE-D.D.S.-B.D. ' CANARY -ASSESSOR PINK -INS CTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT - n 3 ---./ 3d ASSESSOR PARCEL NUMBER 024-100-092 A-5 ZONING BUILDING PERMIT OWNER MnN' JOuPI.S^^I 530 TELEPHONE 46-5028 SO. Fr. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS4,715.00 492 JOHNSON IMM CLAN AVE. 713-8638 CONTRACTOR'S NAME SIMBLEX GRINNEL 916 TELEPHONE 83-0300 CONTRACTORS MAILING ADDRESS 4650 BELOIT DR. SACRAMENTO CA. 95833 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ 4-719-00 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 72-00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 46.80 BUILDING ADDRESS OBRIEN RD. GRD Energy Plan Checking Fee $ $ PERMIT FEE _ LAT NO. SUBDIVISIONS NAME PM 134-56 6.36 AC PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Q Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New Y Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: EMEE SPRTNKTE.RS Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S 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 force and effect./ c License Class LIC. NO. / OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service TO 1 46.00 WEU200A NEW CONST. DWELLING OCCUP. sO U OR ADDNs. ( a ACC. BLAS. 3.5¢Fr: NON-aEESID. BRANCH IRCUITS MULTI -OUTLET �a 7,50 POWER APPARATUS 8 SINOIE OUTLET CIR. OUTLET OR FIXTURES 20 Q 1.00 Ex. Occup. BAL 0 .50 Ex. Occup. OFlxED s R D OR 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) } I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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 comp y with those rovisions. S - S / �3 X _ Date V _ Signatur of ppllcant- Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in heig t. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TTPE TOTAL FEE $ HAZ. D. FEES IMP FLOOD CDF PARCEL -___ PD _ HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicate a ve for which fees have been paid. ^ B&44��/Qf.te 0 PERMIT EXPIRES ON I F De ReceiptNo. , 3 2 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -IN CTOR GOL ENROD-APPLICANT -•a !�'� � pM's. r.-..�,r .vv •- -.. ... wr - - s �a �_. '''q�..('�4�tnt��, niv'�'��r�,.• +,�N!�*,,,, ri, �;. ��, �� � _ Y�.w�.�,� �.�,''s}siYr++'w.r^.r.-�r r. I COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENTVERVICES-BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)53 `7541 Fax (530)538-2140 PERMIT APPLICATION DA�A.,SHEET OWNER: ASSESSORIMCEL NUMBER L` l v� U 7C -,2 - Proposed Building se: !" �(,-[r Counter Technician. Date: S Items required in order to apply for dpermit. All boxes MUST be checked OR marked NA in order to apply. .. Plot plans, 3 or 4 sets, signed,k the preparer of the plans. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ngineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7.. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review.f checked i ems have not been received, plan review cannot proceed. The permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot 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 ..................................... ❑ 12. Hazardous Material Form............................................................................... _ ❑ 13. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of th following items.) 14. Fees as shown on the attached Schedule of Fees Due Sheet.......................................7 ❑ 15. Statement of Intent for Non -heated and A/C Buildings ............................................. ❑ 16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit......................................................................... ❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ...................... ❑ 19. Planning approval for (A) Use: ,(B)Parking: (C) Parcel Check: ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ............................................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization ...................................... :.............................. ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29.xisting violations and/or expired permits......................................................... FC-� ❑ 30. ❑„Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone 3 and hold for pickup. I have been informed of the a ve items and requirements for obtaining a building permit. Opp',ant: _ at 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised cf the above data by ❑ phone, ❑ mail, ' ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ maid, ❑ . counter, by Date: Plans reviewed by: Date: Plans approved by: Date: d Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Buildine Division OWNER PROPOSED 1. 0A.3->30,6 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 n SCHEDULE OF FEES DUE USE BUILDING PERMIT FEES Balance Due ....................... $ Additional Fees Due ................. $ Additional Fees Due ................. $ Revised Plan Checking Fee .............$ 2. SCHOOL DISTRICT FEES (paid at District Office) (Available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential ...................... x $360.00 = $ Units Commercial (sq. ft:) ............... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ................... -x-=$ # Units Amt. Commercial (sq. ft.) ............ -x_=$ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A.P.# DATE �� J RECEIPT # DATE REC. 9*1 -7NeD3, At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. 61PLICANT Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 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 - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner ' (Rev. 6/00) June 10, 2003 Monte Johnson 492 Johnson Clan Ave. Gridley, CA 95948 !I r Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7.541 (530) 538-2140 FAX Assessor Parcel Number: 024-100-092 Building Permit Number: 03-1307 Thank you for submitting the plans for your building project. The plans have been reviewed, and the plan examiner's comments are listed below. Please respond in writing to each item by completing and returning the enclosed PLAN REVIEW RESPONSE FORM. Your complete and clear response will expedite the re -check and aprroval of this project. NON-STRUCTURAL COMMENTS: 1. Provide a typical section through the house show=ng construction methods and materials. 2. Indicate manufacture's name and series number cf floor joists on foundation plan. 3. Correlate floor, foundation, roof framing plans and truss layout at bedrooms 2 and 3. 4. Fuel burning appliances located in bedrooms to b-, direct vent. Provide manufacture's listing for the unit being installed in the master bedroom . 5. Due to a requirement of the recorded parcel map fou must submit plans and apply for a permit for fire sprinklers and supply for the dwelling. The system must be designed by a C- 16 contractor. The building permit will be issued concurrent with the permit for the fire sprinkler system. 6. Enclosed you will find the school impact fee four_.. Take form to the Gridley Unified School District and pay any fees and return the Building Dept. copy. 7. The recorded parcel map states a $200.00 fees is required for water tender fees for Fire Battalion #18.This fee is payable at the Building Dept. 8. Pay Sheriff s impact fee of $360.00.Payable at the Building Dept. 9. Provide Environmental Health clearance. 10. Provide encroachment permit for tke driveway. STRUCTURAL COMMENTS: 1. Provide drag trusses as specified on the plans and in the structural calculations. 2. Provide truss blocking panels at the den/study ane dining room as required by the truss manufacturer. The truss layout sheet indicates that the blocking panels are to be designed by others. 3. Provide documentation from the engineer stating that he has reviewed the truss package and that it conforms to his design requirements. 4. Provide ST6224 straps along wall line P8 as specified in the structural calculations 1 of 2 5. Provide shear transfer details of the roof diaphragm connections to the interior shear walls and key details to the plans. 6. Please include items 8, 9 and 10 on interior footing detail 14/1)1 and depict shear transfer requirements to transfer lateral forces to the foundation. Specify sill nailing and connection of blocking to the mudsill. 7. Please omit detail 5/D1 if not applicable. Detail 6/D1 is appropriate for holdowns installed at the garage slab but is keyed in the wrong location. 8. Please key shear transfer details 7 and 8 on sheet D2 to indicate where they apply. 9. Revise footing detail 2/1)1 keyed below master suite/living/dining room wall to 14/1)1 to reflect raised floor condition. 10. Specify post sizes or number of studs required at girder trusses and beam supports. 11. Indicate all header sizes at roof truss bearing points on roof framing plan. 12. Truss details for trusses 01 and OF shows a span of 12'. Floor plan indicates a span of 11'4". Please correlate. 13. Truss detail for truss AG shows a span of 28'. Plans indicate a span of 26'. Please correlate. 14. Truss details to reflect additional weight of fire sprinklers system and attic furnace. If you wish to discuss any of these requirements, please call (530) 538-7541 between the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday. To discuss non-structural items, ask for Russell. Philo will answer your structural questions. Please refer to your Data Sheet for remaining non -plan check items. (You received this form when you applied for your permit.) The counter staff will answer any questions concerning the Data Sheet. Russell Bloomfield Philo Hunt, P.E. Plans Examiner Plan Check Engineer cc: Ronald Key, P.E. 2 of 2 =. 4 June 10, 2003 Monte Johnson 492 Johnson Clan Ave. Gridley, CA 95948 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX Assessor Parcel Number: 024-100-092 Building Permit Number: 03-1307 Thank you for submitting the plans for your building project. The plans have been reviewed, and the plan examiner's comments are listed below. Please respond in writing to each item by completing and returning the enclosed PLAN REVIEW RESPONSE FORM. Your complete Z ar response will expedite the re -check and approval of this project.STRUCTURAL COMMENTS: , ,� Provide'a typical section through the house showing construction methods and materials. Indicate manufacture's name and series number of floor 'gists on foundation plan. Oorrelate floor, foundation, roof framing plans and'tivss ayou at bedrooms 2 and 3. �uel burning appliances located in bedrooms to be direct vent. Provide manufacture's listing ./for the unit being installed in the master bedroom.. Due to'a requirement of the recorded parcel map you must submit plans and apply for a permit for fire sprinklers and supply for the dwelling. The system must be designed by a C- 16 contractor. The building permit will be issued concurrent with the permit for the fire sprinkler system. ® Enclosed you will find the school impact fee form.. Take form to the Gridley Unified School District and pay any fees and return the Building Dept. copy. – --- - -- The recorded parcel map states a $200.00 fees is required for water tender fees for Fire Battalion #18.This fee is payable at the Building Dept. V -J Pay Sheriffs impact fee of $360.00.Payable at the Building Dept. A,�- � ovide Environmental Health clearance. � M1s Provide encroachment permit for the driveway. 1 f pZ j S CT[JR AL COMMENTS: u55 N� Ovide drag trusses as specified on the plans and in the structural calculations. 9 -6 v55 «acs so-rr6 fop o Provide: truss blocking panels at the den/study and dining room .as required by the truss } VW u. You manufacturer. The truss layout sheet indicates that the blocking panels are to be designed by n1RNfFIF9 thers. r p'-iP, Provide documentation from the engineer stating that he has reviewed the truss package and S'ttvt-N IAO that it conforms to his design requirements. ? 60 4. -'Provide ST6224 straps along wall line P8 as specified in the structural calculations RD 9� N> D 1 of 2. % " . 4- OQ Provide shear transfer details of the roof diaphragm conn6ctions to the in erior shear walls and key details to the plans. Ma 0►e, be, +4, rto -A L 13'p2 ( IJ1 t 6. Please include items 8!9 and 10 ("terior footing detail 14/D 1 and depict shear transfer "1 ` requirements to transfer. lateral forces to the foundation. Specify sill nailing and connection f blocking to the mudsill. j' � L N A c. r " Om � �-' ��, ��� �� eplease fir. y3LOC_Vj +(, ToAA%jv #J v��4 lL omit detail 5/D 1 if not applicable. Detail 6/D 1 is appropriate for holdowns installed at p the garage slab but is keyed m the wrong location. S I ! P I (E) please key shear transfer details 7 and 8 on sheet D2 to indicate where they apply. 3 91 Revise footing detail 2/D.1 keyed below master suite/livi_ngldining room wall to 14/D 1 to reflect raised floor condition. - Specify post sizes or number of studs required at girder trusses and beam supports. -102r woNF— ? 'cate all header sizes at roof truss bearing points on roof framing plan. t4 o, -q ► 3 OW S r IO Truss Truss details for irusses O1 and OF shows a span of 12'. Floor plan indicates a span of 11'4". SPe Ls a, lease correlate. „ so`„a paI%TT Truss detail for truss AG shows a span of 28'. Plans indicate a span of 26'. Please correlate. 3" r i°Q`�J `runs details to reflect additional weight of fire sprinklers Z �;� .. gh sp system and attic furnace. A0D6V W6w OFI-A IL DI-5.TIOT6p�©e PDNy-&JA-tt, y �< If you wish to discuss any of these requirements, please call (530) 538-7541 between the hours N oN of 1:00 p.m. and 4:00 p.m., Monday through Friday. To discuss non-structural items, ask for �' N 3 f1 t c Russell. Philo will answer your structural questions. Please refer to your Data Sheet for remaining non -plan check items. (You received this form when you applied for your permit.) The counter staff will answei any questions concerning the Data Sheet. Russell Bloomfield ans Examiner , cc: Ronald Key, P.E. l:::>cScvsSen wt 1PP Hun, P.E.Check Engineer rA -7 [ 1 OS NtA-OC��2vL�-n,onrs -1b pcA-hlf V P--t�- UesT- VZo- K W l L L Pt W Y2 rzF S S' (D R -PT . 7U 3 f ES 2 of 2 PLAN REVISION Please complete the following information in order to process your submittal. If this form is not complete, corse and legible, it may cause a delay in processing. Owner's Name: C 1(`b, rtMliAp Received By: 7 Date:- ` A.P. #: 61Q I/- Permit #: Time: ContactPhoneNumber. Purpose of submittal: 17 Permit Application Data Item 0 Engineering 0 Plan Revision 0 Requested by Building Inspector or CorrectionNotice - Inspector's Name: Requested By Plan's Examiner- Examiner's Name: O Other- If therIf you are revising a plan which has already been issued, submit two(2) drawings reflecting the revisions for pla review. If engineering is involved in this revision, the engineer must put his requirements on these drawings ant stamp and sign the drawings. Include two (2) sets of wet signed engineering. Revised dra_ bgs must clearly shor When Approved, Process as Follows: 13 Mail to Owner at this address: 0 Mail to Contractor at this address: 17 Call . and hold for pickup at the 13 Chico Office O Orovwe Office 17 Deliver with nest inspection. Revised Plan Check Fee: 0 546.00 Receipt #: Additional Fees Not Require( Additional fees may be due based upon complexity and time involved to process this submittal Additional Fees: Receipt #: t,.J � 4 KEY & ASSOCIATES CIVIL ENGINEERS 1646 POOLE BOULEVARD - YUBA CITY CA 95993 (530) 674-1565 - FAX (530) 674-3528 PROJECT BY DATE CHECK .7s; DATE SHEET OF x, -P 1 -7- 4 + 13VESS/Ov 0 L C-0 T `F 8842 4— E P;;6/30/05 T- ------- - --- CIVIL OFQP, GN i ;w5�00M,oi =27-41 J K-Zb 4r -V 5x 24,14 15, X '2 0,! o_+- + A-- -4 LJ BUTT k0tlNTY-- im 4- I A�- BUILDIN,M-DEPAA TMEN, 4- A P" 71/6 j4—: ,^KEY & ASSOCIATESCIVIL ENGINEERS1646 POOLE BOULEVARD - YUBA CITY CA 95993 PROJECT EY— reLUeft? 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' Lt 26 co N0, 18842 oc EXP. 6/30/05 � CIVI1_ p, Z�o�c2 4 - -- - t5 �iMv'Fs11.S j .. r. f � oK • • r KEY & ASSOCIATES CIVIL ENGINEERS 1646 POOLE BOULEVARD • YUBA CITY, CA 95993 (530) 674-1565 • FAX (530) 674-3528 PROJECT ��%% Jd41- 5�/ S• P� BY 9t,L DATE CHECK DATE SHEET OF KEY & ASSOCIATES CIVIL ENGINEERS 1646 POOLE BOULEVARD • YUBA CITY, CA 95993 (530) 674-1565 • FAX (530) 674-3528 PROJECT BY 4,c" DATE -7/t,343 CHECK DATE SHEET _OF - KEY & ASSOCIATES PROJECT joc�-,�sou�S�(� CIVIL ENGINEERS EY DATE 1646 POOLE BOULEVARD • YUBA CITY, CA 95993 (530) 674-1565 • FAX (530) 674-3528 CHECK DATE SHEET OF KEY & ASSOCIATES CIVIL ENGINEERS 1646 POOLE BOULEVARD • YUBA CITY, CA 95993 (530) 674-1565 • FAX (530) 674-3526 1 PROJECT BY DATE CHECK DATE SHEET 12 OF l z yi(PSTC.. 744 I ck?cr -7, 5� z 37, eel? 9 - ���U�� �oQ?,�3FESSIpNq�� S 9 b7/z- w : o. 18e4 m `L EXP, 6/30/05 KEY & ASSOCIATES CIVIL ENGINEERS 1646 POOLE BOULEVARD • YUBA CITY, CA 95993 (530) 674-1565 • FAX (530) 674-3528 PROJECT BY DATE iglu ' CHECK DATE SHEET OF m KEY & ASSOCIATES CIVIL ENGINEERS 1646 POOLE BOULEVARD • YUBA CITY, CA 95993 (530) 674-1565 • FAX (530) 674-3528 PROJECT _ J604JIW BY— DATE DATE CHECK DATE SHEET OF D le"Ae, T -ye -055 TZ zx4 rae -. ¢fits 456 ¢2;, s � 343 2 4 -t4d t41 4,2! 1174 5C5 S x,33 s:�i ti y 3-IGa��41= 4�3.:lS /� t V dl� J55, Nor Les U47N PE01 CM, fL 509 `IVB P�'1�G� rdc»J ;"pGIJ.S F 5 vu Fs-LI►'�11� T ;ET -hit -. �QEESS'441 C. KF` F�G-� C13. No. 18842 EXp WOO TgTE 0 F C PL\F m=70 m M� � r- 70mz > -0 r— A z > > -�M— m0 01 N=�M m z >7� rno� m T /Q�pFES Sl pay\ k, C• k �F2 188884_2 ^' `r EXP. 6130105 \sT c ivixt- TE OF CP��F�/ 2X6 .FLAT AT 16" 4-16d TO TOP PLATE AND 3-16d EACH END TO TRUSS TRUSSES AT 24" O.G_ 2X STUDS AT 16" O.G. SHEAR HALL SEE 5(,-PHEDULE 1/2" GYP. BD. OFF-5ET TRU55/5.HEAR' ..HALL �o QROF DSS/p�,9\ l 2 w o. 18842 m `r EXP.6/30/05 \civil. J' P TF OF CA rROM' : 'Butte County Public Works FAX NO. : 530-538-4356 May. 20 2002 09: 12PM P2 ENCROACHMENT PERMIT COUNTY Of BUTTE DEPARTMENT OF PUBLIC WORKS 7 County Center Drive Oroville, CA 95965 Phone: (530) 538-7264 Fax: (530) 538-4356" Download Forms: www.buttecounty.neV2ublieworks NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE JPermitNumber Distri t Phone: (530) 538-7261 APPLICATION I / WE. the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads and highways, all in accordance with County --ordinances— and general laws. All information except signature must be typed or legibly rinted. 1. Applicant's Name: L 30 SO V t, Ia. Company Name: r L� y� ��ING 2. Address: 9 Z - h,n s � w - -i - - �c� CG r , d le C A 3. Phone: (53 - 2N V . 5 Q 2 rl `113' O 3 p 6. Assessofs Parcel Numb er:-2— —:-L'-O ! O Z S. location of work to be Done: Rz r E 0. Applicant's Signaturc: 7. Date: .. / e"_ Q Z CONTRACTOR'S INFORMATION c�J7 [Contractor's Contractors Name: S }gel v� 11. Fax: tor's Number.13. Certificate of Insurance: Yes D No 9 tors Signature: zed Agent TYPL. OF WORK TO BE DONE 19. Pleaseeheck: Curb: El Gutter: O Sidewalk: O - 17. Driveway (List Typc):� 18. Other: PERMIT GRANTED In compliance with the above request, and subject to all terms, conditions (including those printed on the back of this form) and special conditions written below, permission is hereby ranted. p -19. Conditions All wq rk S"11 ern V., -1'b ,'t6 r Fie -R e Y led T-er rn Underground Service Alert U.S.A, must be notified two working days priorYto any excavation. 800-227-2600 20. X All work shall conform to accompanying: Detail XPlans O Special Conditions,ti� 21. Date Issued: . OZ 22. Expiration Date: Z 23. Surely: Yes No 0 Mike Crump, Director of Public Works By: "Note: If permits are faxed to any number besides (530)538-4356, they can be delayed up to one week. "E_ # Pege t ort vZ ' Ocneral Conditions See Pasc 2 -U National Pollutant Discharge Elimination System (NPDES) Phase II Construction Stormwater Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement Project Title: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1 acre of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctions provides by law. Signed: Title: Date: National Pollutant Discharge Elimination System (NPDES) Phase II Construction Stormwater Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement Project Title: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs more than 1 acre of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP) and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs more than 1 acre of land. I, further, certify that this project will not disturb more than 1 acre of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctions provides by law. Signed: Title: Date: NPDES &. SWPPP Non -Compliance Certification Butte County Stonn Water Management Plan Revised 5/22/03 R PLAN REVIEW RESPONSE FORM In order to expedite the review of your pbA pkam complete the following i ib mstion and return this form with your re -submittal. this form is not oompkte, as to aU corr+ation items, we wM not be able to aompt your res -submittal for review. There must be a v response to every item requested in our plan eortection letter. 'AY Odmf is Oct considered a valid response. Pkase indicate y responw to each item and the location where the in mi em be found on the pWWcdcs. ATTACH THIS FORM TO A COPY OF YOUR PLAN MMLATTER AND RETURN 1AfITH REVISED AND ORIGINAL PLANS OWNERS NAME DATE: ASSESSORS PARCEL NUMBER PERMIT NUMBER RESPONSE FOR PLAN CHECK LETTER DATED: PLAN CHECK ITEM 0 RESPONSE BY: LOCATION ON PLANS /CALCS: %J 4�c�`�� �c- s�V-m ( -rte COMMENTS: , e 2 0 cD r S Q til �/ 'Uj/L_�j ; C v 6k- CGWf M-1- n, Mil PLAN CHECK REM !/ RESPONSE BY: LOCATION ON PLANSICALCS: COMMENTS: ON )CATION ON RESPONSE FOR PLAN CHECK PLAN CHECK REM # DATED: RESPONSE BY: TION ON PLANS/CALLS: COMMENTS: PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK REM # RESPONSE BY: LOCATION ON PLANS/CALCS: PLAN CHECK REM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK REM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK REM # RESPONSE BY: LdCATION ON PLANS/CALCS: COMMENTS: PLAN REVIEW RESPONSE FORM in order to expedite the review of your Pham please oompkte t* fottowing information and return this form with your re -submittal. this form is not complete, as to all eonvWoa items. we wiU not be able to accept your M -A bmittal for review. There must be a v response to every item requested in our plan eonection tecta. '8y od ad' is not considered a valid response. Please indicate y response to each item and the toation wbere the information as be fond on the &Wcalcs. - - - u.��wl�Alrw AWE%AafwM.�. IrlCV\ V� s o V-�- SESSORS PARCEL NUMBER C)Pq --goo-oq )_ TED: 0 3 - 130'-7 PLAN CHECK ITEM 9 RESPONSE BY. Nb S-4 V a 1✓4t" rd- LOCATION ON PLANS/CALCS -✓t�cN�- COMMENTS: , 5 COMMENTS: pe- � + u L YK , PLAN CHECK ITEM f � RESPONSE BY: rr PM4�, LOCATION ON PLANS/CALCS: COMMENTS: pe- � + u L YK , y✓�'l��l. oC S S6,0 T nAC4 Ck- Ca - T PLAN CHECK ITEM X RESPONSE BY: RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS:�v y✓�'l��l. oC S S6,0 T nAC4 Ck- Ca - T 1 ( Yl GL PLAN CHECK ITEM 0 RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: � PLAN CHECK ITEM 0 (� '10 rV N 0A - S� /,L�&� Lt v -a ( , PONSE BY: l_ LOCATION ON A VN �f— Eli M f � 'ONSE FOR PLAN CHECK LETTER DATED: I CHECK ITEM # / _ j , /' RESPONSE BY: MENTS: 'Pe- C)I G. ✓ S .,, LOCATION ON PLANS/CALCS: N PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS: COMMENTS: >Jul lb U.i Ul:q-1p '!f AND WHEN RECORDED MAIL TO - BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLIE, CA 96965 P.2 COPY of Document Recorded 16 -Jul -2003 2003-0046718 Has not been compared with original . BUTTE COUNTY RECORDER 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 building Permit. The property described herein is adjacent to land or inclLfded within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences o: including, but not limited to herbicides discomfort from the use of agricultural chemicals, pesticides, and fertilizers; and from the pursuit of agricultural operations smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, 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: Date PROPERTY O 1✓RS: f-. �b �1 ✓l �fl i/L State of California ) County of YOM ) On before me, Personally appeared �' known to me � ersonally to the within instrument and acknowledged to me that he/ ke the persons}whose name(s�is//are-subscribed capacity(ies), and that b his/h executed the same in his/� authorized y �I�-signatur" on the instrument, tt a person(4or the entity upon behalf of which the person(s) acted, executed the instrument. W17—my and official seal. Sig Seal. ,- ROGER KEITH H- ANL comm. #1361380 A.? y ,a� .._ NOTARY PUBLIC • CALIFORNIA'A F' YUBA COUNTY I My Comm, Expires Mey1, 2006 -j Description The land referred to herein is situated in the State of Ci.ifomia, County of Butte, and is described as follows: PARCEL I: PARCEL 2, AS SHOWN ON THAT CERTAIN PARCEL Jv AP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE of CALIFORNIA, ON RUNE 20, 1994, IN BOOK 134 OF MAPS, AT PAGE(S) 56. APN 024-100-092-000 PARCEL II: A NON-EXCLUSIVE EASEMENT FOR IRRIGATIIO>'I: WATER PURPOSES LYING 15 FEET EASTERLY OF, RUNNING PARALLEL WITH AND ADJACENT TO THE WEST LINE OF PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL htAP `RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STAVE OF CALIFORNIA, ON JUNE 20, 1994, IN BOOK 134 OF MAPS, AT PAGE(S) 56, FROM'. TIS NORTHERLY AND WESTERLY MOST CORNER OF SAID PARCEL 1, 239.34 FEET TO THE.. SOUTHWESTERLY MOST CORNER OF SAID PARCEL 1. THE EAST LINE OF SAID EASEMENT SHAH `.BE .LENGTHENED OR SHORTENED AS NECESSARY TO INTERSECT THE NORTH AND. SOUlH LINE OF SAID PARCEL 1. FROM :EQUR ENGINEERING j��'nI: R�ssct FRX NO. :5308465028 Jul. 16 2003 04:1BPM P1 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (one form per Building) School District Gi:d IC G •-r /': t /4 Bu(lding.Dep .No. A.P. Number D'p Jurisdiction: _City' . r�county Property -Owner- 0.✓ v Property-Location/Address- IT A e... Add Subdivision Lot No. -- .....� Residential Development Q . ..............._.._._......_..-.._......_�..._ , 0 € 'Supplemental to Footage (Group R) No.ol Living_ Mobilo-Home_ Adddionl_ Units Installation Conversion permit!! '(No foundation inspection); Commercial/IndustrialE-3Sq. Footage New Addition (Including Exterior Rooted Areas) Plans. reviewed-bV- Scnbol District Identification 'No.. 1 -s V 11ii1 t c�. School District certifies that (City) has complied with the requirements of Resolution No. Arepresenting -I square feet. School District Paid try Check 8 Remarks: istate) to - /D-_ D- 3 - Date Cta4e —e hnc8 •�- (Applicantl— (Phone (Tip Code) by payment of $ AB 2926 $ uLLMITIGATION- t_ . �1- Cl- a3 - Date NO&O:_ you may protest the imposition of the fees identified above by submitting a wr`_tten protest to the District. in compliance with Government Code Section 66020(8), within 90 days from the date fees are paid. Faikim to submit a timely written -protest -will -prohibit, you from ung the Imposition of the fees in any court action. if, subsequent to the School District Represerrtative signing this Butte-County-Schools.blpact-Fee Certification Form.. the- School Disuiat is notified by the applicable Local Planning Agency that this prolect Is being reviewed under the California Environmental Quality Act (CEOA), this-protea.may-be subject. to. edditionetischooi fees to fully mltlgete Its impact on -the school district's schools. White tapplicant), Yellow lbuilding department), Pink (school district) feeform.xis (1019e1dmrn _ s E.N. USE ONLY Flat Ran Attached Floaa Ran Attach �anato S.D. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well a/ Clearance for ✓ dwelling. Other LSE6 iZvxp v Hold final for: Final clearance O.K. for: NOTE: /--\ /"7 vironmentai HeaitK-$pecialist 8/96 4003 ite SITE PLAN REVIEW APPLICATION Date: S- - AP# 0 2y,. i Cao - o g 2 Permit Number (if avOicable) 3 _ 3 0 -7 APPLICANT INFORMATION Parcel Size: 13 % A C' Owners Name: J O H QsoDo f, Owners Address: y 2- J 0 HA)SOPJ GLA 1J A Vill- Telephone No.: 1 Situs Address: Qt> 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 ❑ Single Family Remodel Commercial Remodel ❑ Industrial Remodel Other N Septic Well ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For ,Staff Use) K Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ® Site Plan Stamped Approved By Date Page 1 of 5 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.: )1 ) OC- Index Date: 6-8-96 ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ------------------------------------------------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: Q Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. k Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street S I LA 12� )Z 1 KJ Rear s" Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. k Page 2 of 5 Applicable Development Fees: Standard Fees Amount Formula ❑ 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) * Cbeck with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 PI Subdivision Map/Parcel Map: Map Date of Recording: ( - 2- O— �1) ❑ Use Permit/Minor Use Permit Permit Number: Pr Book: 3 y Page: S to Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: �j 0 N C— [:] ❑ 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 `4 1p,p OZ -4312-5 BUTTE COUNTY AGRICULTURAL BUFFER UNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not available for lots being divided or subdivided. Applicant must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601 � � �5.30> Name: l " I 0 0 � C,�C� 1r1.� o�� Phone: Assessor's Parcel Number. �GA Ll - / Q n - o R Reason you believe you qualify for the unusual circumstances exception: D /a (,e-- A k0 L�SA— " ; (\- -qA-9.- V &le ^cel aPAd - e. V\ C_ V-6CLCJA—1 H 0,0 ; A +L- &,,o K- * 6 -3 - 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 ........................................................................................................................... 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: ,zcc t)vvLAt:o c�,� 74- s Agricultural Department Signature: Date: b � YMC 4/20/03 County Of Butte Department of Development Services 7 County Center Drive Oroville, CA 95965 asit" tt Vol", n : SEP 06,03 ," '52 E 0 31 l .•l' j531U.S.-te TAGEJw w BUTTE COUNTY SEP 19 2003 Vicky Johnson DEVELOPMENT 492 Johnson Clan Avenue SERVICES Gridley, CA gr-GAQ- ---- ---- - - - -- - — JOHN492 959482203 1603 81 09/14/03 RETURN TO SENDER JOHNSON I 1755 SYCAMORE ST r GRIDLEY CA 95948-2855 RETURNTO':SENDER !l,1,l,fi„lfi=,t,rr.,,r,r,lfill ,,rr,,,ar„r�,rrr,,,►,,,rr,r„r a COPY County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Vickiy Johnson ADDRESS: 1755 Sycamore Street CITY a3 STATE: Gridley, CA 95948 IMPORTANT:SEE INSTRUCTIONS DATE OF CLAIM: 9/19/2003 ON REVERSE SIDE SUBMIT CLAIM TO nFPdRTMFIUT R?�I'Cnnl►►� r►nnn� /10 c+cn�ni+�n DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELA AMOUNT Reason for the Refund: Owner decided not to build g Permit App No.: 02-3125 AP No: 024-100-092 Receipt No.: 364335 Receipt Date: 11/8/02 Bldg Permit Fees: Owner's Name: Vicky and Monte Johnson TOTAL FEES PAID: $83.00 TOTAL FEES RETAINED (Breakdown Below): $83.00 Building Permit Filing Fees: $20.00 Plan Checking Fee: $23.00 Plumbing Permit Filing Fees: $20.00 Energy Plan Checking Fee: Electrical Permit Filing Fees: $20.00 Refund Processing Fee: Mechanical Permit Filing Fees: Inspection Fee: SRA Fee: $0,00- 1, the undersigned, declare under penalty of perjury thafthe services or articles claimed have been performed or delivered, and that this claim is true and correct as stated Dated this day of , 2003, at Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this day of , 2003, at _Oroville Calif. Dept. Code 440-001 Dept. Code Dept. Code Department Head or Authorized Deputy Exp. Code 4210500 PAYABLE FROM Construction Permits FUND Exp. Code PAYABLE FROM FUND Exp. Code. PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY GROSS AMT. DEPT & SUB. PROJ. SUB. OBJ CLAIM NO. INV. NO. INV. DATE ENCUMB CLAIMANT: ADDRESS: �Q 9/s/0 County of Butte ' Oroville, Cali ornia GENERAL C AIM Vicky Johnson 492 Johnson Clan Avenue IMPORTANT: CITY & STATE: Gridley, CA 95948 SEE INSTRUCTIONS ' . DATE OF CLAIM: 8/12/2003 ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVIN(r nnnnc nip 4zj=Pwr%=c " DATE DESCRIPTION OF CLAIM(DESCRIBE FULLY TO AVOID DELAY AMOUNT Reason for the :� : ° grx:.....I..:..9:....::.....:..i;...... ........" :Decided not to build .."...:..r..x:............... ,x.::.: Refund. ::.: : I,: :...x.x...:::. .:. x:•":.�i3...... .., xwxx >y xx C....: x.. ..:.xxxx.xx'•.xx;;..:.:,..xxxxxx.x..xxxTx:.:........:... x.......�.x xxxx:.x :...x ..xx:xxxxx.x� x; x .." ..xxx xx.. .xxxx.. x .:..xx.„xx......xxxxxx.... .xxyr.xxxx xx:.:.x___._......._......F.?!...Rr_x._,.....,,x..sr....:...x-xxxx.rx ........:...- x:..xxxx:x.:::.xxxxx.x.x:...xxxaxxx Rx ..xx...xx..zxx.x:K.,n<ax _:._xxx..p...x g erml pp .:. .;........:.; a. F ..K. ..IMMUNE:.>:::::::.:::.:::. ,..:::.:;.....:. .y;. 1 —:SS. ..:...x... .`:3.:..CS No.: .Q2:. 3 :... ............. AP No: °i :EM ::::::::::::::.:..:; ...::.. ..............:..,.....::.:..:..:......" ,...xx-..... ,. xx,..,.x _.............._._ xxxxx...:...xxxxx .`.:"..''..x".•x...:.::x.zx::..',keii.4. .x.xxxx...x�.x.•xr�xxxx.xxx.":...x.mxwxxxx.. .,.r.xxxxv.x.xi.•sxs.•x�wxx�.�zRt �....".y:.;z. ...::.R...."..`::..'.:.....::.:xwxxx. �„ .a.. F........:".'....r.............xvy. MIE....::`t«':::.:....:..... Receipt No.: €:3'643'.3`5€€=xx.... :.::......:..y:: ......."...:.,...............:; . _.x_ ..-.....:x.- xx.x xx...x ....xxx....xxxx. w P,x„ Receipt Date:;;....�xxxxx,.... Bldg Permit Fees: .• :...........: y.. :.xxx u... �..;... .....:. _.............._................_.r,.c.,c::ccc.-„—.:........ Owner's Name: Monte �OhnS011 .. :i TOTAL FEES PAID: $$3,00 TOTAL FEES..RETAINED (Breakdown Below): $$3.00 .;;':.0..v...v..fli:.z v..::}....e ...e...xx....'xi..xxxx:::••: x. w:••.•.•:.” xxx"-tirvu:i .xx.x.u:':z..`xx.x�,�xxlxuwy,xx .:.....�x � g Permit Filing Fees: �........ - Building ..x.. ZO?0,0 ., n.. •'; 9�...,,..,.........,,.. Plan Checking Fee: .::.:;:..,..2Q'Q� ...:........: ::::::.:.x" ....... .:...; a ..::::x...::...�;:�:�:::;:. Plumbing Permit Filing Fees: ::.:...,x $2O QO Enemy Plan Checking Fee: ... ryi7.Axx.x..y...:.:...'•<...........".".k U..1iE1Hl".:..�>.::.:. .x. CPx. ...�.x..;; Electrical Permit Filing Fees: M.. 0.0 i Refund Processing Fee: `€ R ;:R.....$2o ...::.;....:: :.:1 i .... Mechanical ° Permit Filing Fees: "% HE' ..................... .:..::..:....; ...;.„.. 9 Inspection Fee: ,,. ..... :......: _ SRA Fee �° x._,r ' :. $0.00 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated Dated this day of , 2003, at Calif. Signature of Claimant 1, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specif ad above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this day of , 2003, at _Oroville Calif. ” Department Head or Authorized Deputy Dept Code 440-001 Exp. Code 4210500 PAYABLE FROM Construction Permits FUND Dept. Code Exp. Code PAYABLE FROM FUND Dept. Code Exp. Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S. USE ONLY DEPT & SUB. PROJ. SUB. OBJ CLAIM NO. INV. NO. INV. DATE ENCUMB GROSS AMT. i� $utte,County Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on the receipt issued for the fees paid. Any refund checks wir' be made payable to the name on the receipt. 2. The request must be made within two years from the date of fea payments on permits not issued, and two years from the date of permit issuance for permits issued - if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Develo ment Services for payment processing. CLAIMANT'S NAME: Vicky Johnson MAILING ADDRESS: 492 Johnson Clan Avenue PHONE: (530) 846-5028 ASSESSOR'S PARCEL NO.: 024-100-092 [Please use one claim form per permit.] BLDG PERMIT NO.: 02_3125 $83.00 Receipt No. 1 Receipt No. 2 Receipt No. 3 364335 RECEIPT NO.: 11/08/02--/--/-- 1/08/02//RECEIPT RECEIPT DATE: $83.00 RECEIPTAMOUNT: REASON FOR REFUND REQUEST: Owner decided not to build Check those fees which you wish to have considered for refund: OX Building Permit Fees OSheriff Fees OSRA Fees (CDF Fire Planning) DOther (specify): Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may ick them up prior to that time. Signature K:/Forms/Refund Application 082203 Date Butte County Department of Development Services Building.Division REFUND CLAIM APPLICATION REQUEST FOR REFUND Refunds can only be made upon written request by the person who paid the fee(s). 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 are not refundable. Fees paid to other County Departments are not covered by this claim. [Butte County Code section 341(t)] CLAIMANT'S NAME: MAILING ADDRESS: Coq 7 / 3 -,::�l 3 ASSESSOR'S PARCEL #: BUILDING PERMIT #: / c;2�- r- RECEIPT NUMBER(S): A request for refund of fees paid on the above receipt number(s) is for.the f'Q owing reasons: a 9 Please refund any applicable fees in the following categories: (Check those fees which you wish to have refunded.) ( ) Building Permit Fees ( ) Sheriff Fees ( ) SRA Fees (CDF Fire Planning) ( ) Other (specify): Disposition of Plans: ( ) Plans returned to me at counter ( ) Please mail plans to me at above address ( ) Please dispose of plans Si ature D e A COUNTY OF BUTTE GENERAL CLAIM FORM WILL BE MAILED TO YOU FOR SIGNATURE AFTER REVIEW BY BUILDING OFFICIAL. J:\My DocumentAREFUND CLAIM APPLICATION.doc 12/17/02 FOR BUILDING DIVISION USE ONLY.- Receipt NLY:Receipt Information: Number: 36Y3 3 3.5 � Date:01 s,, , �f Issued To: Amount -.,3 _ Fees Retained: BP#1�,2 -3L�BP# Processing Fee: $ Processing Fee: $ Bldg Filing Fee: $ _�'� �� Bldg g Filin Fee: $ lbg Filing Fee: $ �, � �--- -� Plbg Filing Fee: $ lec Filing Fee: $ =-�� -- Elec Filing Fee: $ Mech. Filing Fee: $ Mech Filing Fee: $ Energy P/C Fee: $ Energy P/C Fee: $ Plan Check Fee: Plan Check Fee: $ Inspection Fee: $ Inspection Fee: $ SRA P/C Fee: $ SRA P/C Fee: $ Other: $ Other: $ 1 Total Amount Retained: $ $ TOTAL REFUND DUE: $ 3 $ Amount from 440-001 $ Amount from $ \ Amount from $ Amount from $ J:\My Documents\REFUND CLAIM APPLICATION.doc 12/17/02. ;;,May 22 03 02:55p Design May 22, 2003 Building Permit Butte County Building Department 7 County Center Drive Oroville, CA 95965 Dear Butte County Building Department: 5307414299 p.1 I applied for a building permit in December 2002, for z. modular home. Due to appraisal values and financing issues I had my permit put on hold for a custom-built stick framed house. I re- applied for the same parcel on May 5, 2003. 1 have ha3 a construction loan running since September 2002. All site developments are done the only thing that is holding me up is the building permit. My loan is up this September, and I reed to start forming my foundation to have the house completed by September. I would like to ask for you to look at my plans as a special circumstance, to allow it to be expedited. I hope the fact that everything on site is it open since December 2002 will help to expedite my plan completed and that I have had a perm check to allow me to meet my construction loan dead brie. I would really appreciate your help. If you have any questions my phone number is 713-8638. Thanks. Sincerely, Monte Johnson Owner & Contractor 6) Wej &V T -LIF" 19 5 #15 Su 15 �-f CIA f �76r- Co COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 D� 12196 * APPLICATION AND PERMIT �E fl _ A:SES:oAPARCELNUM6Ep Z°M"° BUILDING PERMIT Q - loo — o aA. CwNEA T[IFDNONE S, _ Johnson Q_ ... EA s .�,° �' 5=�O g -5oa8 I I IN TTO h CI �idlle� 954' COM I TELfYNONE 1 1 co,rTRACTCAS MAAJNO ADOAESS Y CO,,s raucr�ON LENDER --- UoEa s .wuNc ADDRESS Fireplace Total Valuatlon$ -- AAC. ,I`ECT OR ENC�NE EA UCV41! NO A4A4E —Filing Fee S 20 C _ •ACN,TEcr OR ENCwEEAS AIAUND ADDRESS Permit Fee S - Plan Checking Fee S aWLOn4C ADDRESS � U Qd Energy Plan Checking Fee 5 dr—LILn PERMIT FEE i Lar P.D. SUBDIVIS IONS NAME PARCEL MAP X32- 5 7 3-� `J� PLUMBING PERMIT Filing Feel 20.C,: USEOFSTRUCTUR,I( Ac SF ❑ Duplex ❑ Mobilehome 9 Other SPECIFY Each Trap Solar or heat pump water heater 23.001 Water piping1 5.00, CC 1 TYPE OF WORK `ems ❑ Addit ❑ emodel ❑ Utilities ❑ Installation rkfnOth/er ❑ Each gas water heater or vent 1 1 15.00", Gas i in stem 1 • 5 outlets 1 5.001 � Buildingsewer 15.00 I Describe Wor Y7'1 -H►�Q Ylrl � 6Y1 t,7Pr Mobil1 S I GI W @2, e Home � j � 0.00' I - PERMIT FEE f c{ I - ELECTRICAL PERMIT I Flling Fee` 20.03 ? Main Service eoovORLEss ' moA OR IESs I 23.00 Main Service 2a" TO IOWA I j 46.00; NEW CONST Ows.LfaG OCCUP. --- oR ADONs. ( a ACC. mns. 3.ScSoFT.. N YULi4 No N-RE`Sio.' 0UTLET @7.50; POWER APPARATLM — a sINDLE OUTLET CIR I I EX. Occup. OUTIFT OR nxTUREs *PEPAIT FEE PoUb 5n A . . 1 FIXED APOR Occup. RESID) EA I I 5.00 Temporary Service I 23.00 Mobile Home Facilities i 20.00; Misc. Wiling ! i 23.00: SNER.IFF � I I PERMIT FEE _ OTHIE�R MECHANICAL PERMIT Filing Fee 1 20 C7 Heatingi Cooling Hood 6.50 ; Ventilation i AAk6VNT RECEXWO PERMIT FEE S - Mobile Home Installation Fee E Energy Inspection Fee S NV� To N �r 211," CoARR occ I coNsr nP[ TOT Al_ E $ KAZ. I V1 Ir D E1r. This permit is hereby issued tind'e"t the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Rec*iptNo. PERMIT EXPIRES ON wNITE•O.O.S.•B.O. CANARY-ASSE33OR PINK•INSPECTOR OOLOENROO•APPLICANT Date ___ ;. rk-i". r •"`'�' 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: ASSESSOR PARCEL NUM. Proposed Buildi g Us��� (.W //` Counter Techni ian. �'j Date: Items required in order to apply for a permit. All boxes MUST be the ked R marked NA in order to apply. 9Plot plans, 3 or 4 sets, signed,yby the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. N3 -./Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. d 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Energy compliance des $n arO supporting documentation in duplicate. ❑ 6. Manufactured homes: Vbata sheets and installation instructionsi rriage line informatior�¢ r Plan, (D) Tie-dowit-or— foundation plans, all in duplicate. ❑ 7: Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views -in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................:.. ❑ 11. Detached Accessory Building Focht filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... ❑ 13. Other. Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) � Q 1 Fees as shown on the attached Schedule of Fees Due Sheet ....................................... . ❑ 5. Statement of Intent for Non -heated and A/C Buildings .................................. .. ... r 6. anitation and plot plan approval from the Environmental Health Department in 17. City of Chico Plumbing permit......................................................................... t 8. California Department of Forestry plan approval ❑ paid. Sent. by: ...................... 19. Planning approval for (A) Use: Pi< (B)Parking: (C) Parcel Check: ❑ 2D Contact Land Development about ❑ Improvements, ❑ Drainage ............................... Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification)........ p 2 Worker's Compensation Carrier and Policy Number ..............:.............................. 5. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... Zetter of Signature authorization.................................................................... 7: ecorded copy of Agricultural Acknowledgment Statement .................................... 8. anufactured home utility clearance............................................................... ❑ 29. ti g violatioW,�nor expired permits ................................................ 0 3 ; rant eed Title/Statement of Facts, ❑ Letter from Legal Owner, heck to H.C.D. $ Other: r G S®r'�i �✓ l� l r� 5.,.- ,n �.� n issued Telephone and hold for pickup. wK -7y t-410 I have been informed of the above items and requirements for obtain ng.a building permit., Applicant: I V��o/); y�_, Date: 1 �` �� 0 I. Index permit appli�on for the above items numbered: 2. Additional items regn / 4 ; 2 f t}. 2 Contractor, Contractor, designer —,o, dans reviewed by: Structural reviewed by: Note transfer by: flvas advisefl of the above data by phone, ❑ mail, ❑ counter, by was advised of the above ata by ❑ phone, ❑ mail, ❑ counter, by Date: OZ Plans approved by: Date: Structural approved by: Date: Yellow: Buildine Division Plan Check Letter _Date: _Date: _Date: Date: 4 TO: FROM: SUBJECT: Building Department Environmental Health Sanitation Clearance E.H. USE ONLY Piak.Plan Attschod - `.. Raw Plan A crad�_ Sent to S.D. N� n �� ��� env C� IV�.1►, �.� (LVA r� �' -�) oy Owner Plan Approved for: Sewage Disposals Location Water Supply: AP# Public Private Well �( Clearance for dwelling. Other L= Hold final for: Final clearance O.K. for: NOTE: t Environmental Heal. pecialist Date 8/96 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY C R DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 OF FEES DUE OWNER PRO O BUILDING USE f f ' 1. BUILDING PERMIT FEES Balance Due ....................... $ Additional Fees Due ................. $ Additional Fees Due ........... $ Revised Plan Checking Fee ......... ...$ 2 SCHOOL DISTRICT FEES Ad (paid at District Office) (Available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential ...................... x $360.00 = Units Commercial (sq. ft.) ............... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ................... -x-=$ # Units Amt. Commercial (sq. ft.) ............ -x_=$ Sq. ft. Amt. 5. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) T1 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A. P. #02 gz� DATE RECEIPT # DATEREC. At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed du Ian checking process. APPLICANT DATE I I- y-0 f)-- Pursuant to Government rodeection 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been imposed on your project. ave 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 - Buiding Div. 2nd Copy - Applicant ' 3rd Copy - Owner ' (Rev. 6/00) COUNTY OF BUTTE - DEPARTMENT OF DEVELO DMENT SERVICES - BUILDING DIVISION o 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 alllf?(Rev.12/96) +'' APPLICATION AND PERMIT,� ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDNISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 LESS Main Service . q OR LESS 23.00 LICENSED CONTRACTOR'S 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.POWER License Class Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permitis issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service sooq To ,000A 46.00 NEW CONST. DW ."NG OCCUP. OR ADONS. ( a ACC. Blas. so. 3.5¢FT: NEW CONST, MULTI -OUTLET CUITS @7,50 APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FDRURES 20 @ I'50 SAL p .so Ex. Occup. oun EEDTs RESID.OEq 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirin 23.00 PERMIT FEE _ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' mpensa I laws of California, and agree that 'rf I should become subject t•D the Irkers' compensation provisions of section 3700 of the Labor Code, I shall fort with comply with those provisions. X Date -0 U� Si ture plicant - Owner ❑ Contractor ❑Agent An OSHA p it requir d for excavations over 60" deep and demolition or constru:tion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. p. FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Date Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT $potted GDOg GDesI'gD (;on�inercL�l * Caston * I{esiden6i�l * �iddicions * l{emodeds 2016 Bridge Street 7u6 City, CA 9Ml dip * 530. 674.167n (px * 530 . 671.4R2Z 01 1 M JCAdIs1l ' JWJM 17 o%plq JL�JG►IJIJiJJG17 �.rJG PROJEGT:JOHN50N,2g47 GUSTOM RESIDENGE O'BRIEN ROAD, 6RIDLEY, GA A.P.N.: 24-100—Oq2 DRAWN :6RG DATE :04-01-03 CHECKED: SCALE. :1" =.100' REVISED: