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HomeMy WebLinkAbout024-160-013i 024-160-013 04-0497 MCMA[NS, CHRIS 322 TURNERAVE,G Cont: HAGBERG, LOWELL 0 NEW SF NOTES RESIDENTIAL 024-160-013 04-0497 } �lj t/ 7VS PERMIT NO. — MCMAINS, CHRIS �Tf�L 4� T�s7 G 3 ZZ TURNER AVE, GRIDLEY Cont: HAGBERG, LOWELL TD � � G G GwST 6Aj o ` NEW SF o� To �N Svc-r�-TC— �oOK_ lj a�l' IV-tkA7 ., 4 a l SPECIAL CONDITIONS .e CHECKED BY SRA � FLOOD CERTIFICATE REQ. - t FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS j VERIFY � USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER * OFFICE COPY Address _30 GAS Da Meter By ELECTRIC Plato _ Meter m me'eroy oa-te, ELECTRIC"; Date Meter By • JOB FINALEp (Date) ✓ Signature ' y . J=OK 0 = Not OK . = NotReadyable 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.6-1 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 Soils; Compaction -Structure Stability 5. Drain; MH Test -Fall -Flex Connector Pool Structure; Steel -Connections -Thickness Dead Men -Lining 6. Water; MH Test -Regulator -Connector Elec.; Receptacles and Lighting, Distance-GFI 7. Water and Sewer Connected -C/O to Grade -HD Approval Elec.; Pool Lighting; 15 Volts-GFI 8. Gas and Electricity Tagged Elec.; Enclosures; Conduit Entries -Terminals -Listed 9. Tie Downs -Type -Installation Cert. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 10. Exits; Insp.-Sketch Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit , 11. Cert. of Occupancy Health Department Approval F `_ 10. Plumb.; Cir. Test -Water Supply Test ` 11. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements . 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card.6-1 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 F `_ 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 o fi• I KM J=OK 0 = Not OK = Not Applicable . =Not Ready RESIDENTIAL Date UN R O (Plans) OK except #'s ni -Setbacks-Easements-Flood-Slope F ., Main; Soils-Elec. Grnd.-/ �&" Ftg. Depth Ftg., Garage; Soils-Steel-Elec. Grnd.-/ ✓ " Ftg. Depth 4. Ft ., Porc '& Decks; Soils -Steel-/ /" Ftg. Depth t s, Main; Steel -Bloc _ walls, Garage; Steel- Bloc kouts-Wra ed 6 old Downs and Special Anchors 7. Slab, Steel -Wrapped 8. P" rs-Fire lace Ftg.-Steel D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test ater Pipe; Test -Anchors- Reg ulaAor­Perv!qe Test . 13. Electric Underground Plenums & Ducts; Clearance -Material up ort ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies . Access & Ventilation 16. Insulation Date Card B-1 471Z I 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 M,Water Pipe; Test & Anchor -Nail Protection gAN.V.; Test Fittings & Anchor -Nail Protection 1. 22. hower Pan; Test, First Floor -Tub Access Test Tub & Shower, Second Floor -Tub Access Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRI L (Permit) OK except #'s xt Transformer Clearance-1rotection ec. ptacles Spacing -Lights & Switches at Doors 2CArS4169,xes & No. of Conductors 4apled - . R ex stalled Close to Edge of Studs & C.J. 2 E p. Ground made up w/Mech Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen & Conductor Size GFI 0. Subed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 1 ange Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al lnsjAated Neutral O Yes O No 32/Sar Lee -Riser Conductors & Ground Main Disconnect 3Li- ui . Clearances Panels-Motors-Mech. Equip. CI es Closet Light -Shower Light -Spa Light woke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECH JAIN1,1CAL (Permit) OK except #'s A . Ducts Insulation & Support 7 V Far( Exhaust above insulation C densate Drain & Overflow, Size & Grade 3 F nace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMJN6 (Permit) OK except #'s 41/SPifProper Materials & Anchors 42' W tuds-Nailing Spacing & Braces -Plates -Sound Baring Walls over Girders & Floor Nailing .il<' 44. Drgft,,StoD in Walls (rat proof) 4Y. ,We Stops, Furred Ceilings -Stairs -Chasers -Tubs tib. Headers & Beams -Size & Bearing Single & Duplex) Date FRAMI Continued) 7 er -Post Caps -Anchors -Connectors . Cl' . Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. ace Ties or Type A Flue -Fireplace Throat Clearance 5 . A Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Gaw�Fire Protection Framing -RC Channel 58!Pr�rty Line Firewall & Openings 54e*f oors-One 3' -Check Garage 3rd Story, 2 Exits St idth-Headroom-Rise-Run-Landing-Fire Protection lywood on Roof Overhang -Attic Vents -Rafter Outriggers 57 Siding -Nailing Veneer Stu Mesh -Drip Screed -Fd. Vents-Underflr. Access 5 . ing Area -Glass Protection -Skylights la ti 60. hear Walls; Nailing -Bolts BraceIaW#Ot/Exterior Wall Panels / 63. Infiltration -Walls -Windows l/ Date Card B-1 Date C rd B-1 Date Card B-1 Date and B-1 Date FlN�tans) OK except #'s a. Ext. Steps -Door & Sidelight Protection -Landings 55 -'Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - I garage; Above Floor-Ducts-Mech. Protection Bedroom Exiting AFI. & Bath Fixtures & Tub Access -Spa 69._g4ec. Trim & Subpanel, Breaker Sizes & Labels St irs & Rails \ 7W.—Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 7,4e,Elec. Outlets & Receptacles at Kit. Counter 75. ge Fire Door; Swing -Landing -Closure C. Duct in Garage -Damper 77. Wtr. Utr; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection ..;O—Plb.; Elec. & Mech. Equip. Listed for Location 79. _Dec. Receptacles in Garage (F.F.I.)-Romex Protection Insulation -Foam -Looked in Attic ere�Reifs & Deck Construction -Post Caps dn. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under Floor ❑ Yes 39'Fol[owingInstld./D ' 0 Yes 0 No/Walks O Yes 0 N Planters 0 Yes 0 No Stucco Br -Finish 45-9-C. Unit Disconnect, Electrical -Plumbing 82,—Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing Exte for Elec. Trim, G.F.I. Receptacle -Underground 8 entilation Throughout House 90. GI ss Protection Corrections from Previous Inspections as Test -Meters Tagged, Gas -Electric 9,1,,< &Sewer Connected C/O to Grade HD Approval 9 nergy Compliance Certificate -Other Certificates 9�dress Posted %Q-50e'Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netldds LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class: License Number: , l3 Date: �' ontraclor.,,,, . 1 OWNER -BUILDER DECLARATION " I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 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. Dave 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: PERMIT NO. BP040497 Issued Date: 05/11/2004 APN: 024-160-013-000 Site Address: 322 TURNER AVE GRI Map Index: Description: NSF (1772), ATT GAR (917) Owner: MCMAINS, CHRISTOPHER PO BOX 676 GRIDLEY, CA 95948-0676 Applicant: MCMAINS, CHRISTOPHER Contractor: HAGBERS, J. LOWELL 1151 FRENCH AVENUE GRIDLEY, CA 95948 530-682-1533 cell License #: 381195 Architect: Engineer: Carrier: .I S Total Square Ft: 1772 S.F. Policy a: i % z4 1 --3(10 --o Valuation: $115,180.00 ❑ I certify that in the performance of the work for which this permit is Census Code: issued. 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Address: Peetp� �Ct5G1(, f�/YtliU� l i� oNe� /,, �ecet'pt #, y058'(0�l s hereby issued under the applicable provisions of the Butte County de anrt/or or which fees have been paid. Date: PERMIT EXPIRES ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official for_ or document of Butte County. I hereby authorize representatives of Butte County to enter upon, the above mentioned property for inspection purpos Print Name: \)l• �.aLt)-i L OA), nL,1J>Signature: - ❑ Owner 6—Contractor ❑ Agent for Owner ❑ Agent for Contractor M D WOOD SYSTEMS 4MI'I'm Certificate of Conformance Certificate 054086 THIS IS TO CERTIFY that the glued laminated timber products identified with a collective mark of Engineered Wood Systems (EWS) were manufactured in accordance with the applicable standards and associated specifications indicated below: ANSI Standard A190.1-1992, For Wood Products - Structural Glued Laminated Timber NER-486 Glued Laminated Timber Combinations And "GAP" Computer Program For Determining Design Stresses AITC 117-93 - Manufacturing - Standard Specifications For Structural Glued Laminated Timber Of Softwood Species IT IS HEREBY CERTIFIED that the APA EWS trademarked structural glued laminated timber members were produced in a manufacturing facility subject to regular audits in accordance with the Engineered Wood Systems (EWS) Quality Assurance Program. Routine audits include inspection of ,the manufacturing process and evaluation of the in -plant QA program with adequate sampling to verify conformance to industry standards for lumber grade and glueline bond quality. �,�� x l `I - x l -7 by e) L .1J A`u-rte Thomas G. Williamson Executive Vice President ENGINEERED WOOD SYSTEMS is a related corporation of APA — THE ENGINEERED WOOD ASSOCd4TION 7011 South 19th Street - P.O. Box 11700 - Tacoma, WA 98411-0700 Telephone: (253) 565-6600 - Fax Number: (253) 565-7265 � /Vner�nak re 1 o " Ala. f31zAG�b WALL o. 0//I000 HOLPOWN WIIH IBQONMN CyA�I'��A��GyyIt��Y�� ( 51AW501 OR U.Lm ) MIN. 1 / 2" PIA. ANG. OL VAtH I" eAWt7AAeW A rAN5L R r 1 ' PI& X 8" AW, t;Mi3evml2 m 59MWAL w/ 5" ewoxY 21' O. MR 5t>zONGr E W/ FW ANP NUf 130TH CNP5 AGH RX. 0 o 0-0�, #4 IMPAR, COW. Of. & 0. OF 5 WWA I. 2' ° X 4" M1N. 50L112 MKNG. ( 2) 2"X tOF MAIE MOV. a %LAVING JOINTS i C OMW rAa tO 5HEAINING • - ONE FAa, NAIL �'COMMON OR 6c• NALS a61OA E0695, AW IT JWA Al CERTIFICATION OF INSULATION ADDRESS OR TRACT SACRAMENTO BUILDING CONTRACTORS 1309 MELODY ROAD, MARYSVILLE, CA 95901 LIC#202026 605 S. AUBURN STREET GRASS VALLEY CA 95945 LIC#202026 ,�nSiR_( A To3881 BENATAR WAY, SUITE A, CHICO, CA 95928 LIC#202026 r r ❑ 8924 AIRPORT ROAD, REDDING, CA 96002 LIC #202026 1 (I(il le DATE INSULATION COMPLETED ( square feet) ( square feet) ( square feet) TYPE OF INSULATION TYPE OF INSULATION TYPE OF INSULATION MATERIAL MATERIAL MATERIAL FIBERGLASS FIBERGLASS FIBERGLASS FORM BATTS FORM BATTS LOW FORM BATTS MANUFACTURER'S PRODUCT I.D. MANUFACTURER'S PRODUCT I.D. MANUFACTURER'S PRODUCT I.D. MANUFACTURER MANUFACTURER MANUFACTURER CT 1 1 OCF KN CT OCF KN CT OCF KN BAGS ; � J 4 R -VALUE APPLIED R -VALUE APPLIED MIN. INXrALLED WEI T PER R -VALUE APPLIED INSTALLED THICKNESS INSTALLED THICKNESS SOME FOOT INSTALLED THICKNESS ta KNEE WALLS IF R -VALUE HER THAN WALLS ABOVE • MATERIAL FORM R -VALUE MANUFACTURER FIBERGLASS BATTS CT OCF KN AIR INFILTRATION SEALANT MATERIAL MANUFACTURER FOAM HILTI HANDY FOAM THIS IS TO CEi'ITIFY THAT INSULATION AND/OR SEALANT HAS BEEN INSTALLED IN CONFORMANCE WITH APPLICABLE CODES, MATERIAL STANDARDS AND REGULATIONS TU -E -INSUL T ACTOR TI LE SIGNATURE - GENERA CON RACTOR TITLE DAT REMARKS • WHITE - Builder Copy, GREEN - Builder Copy, YELLOW - Customer Copy, PINK - Attic Copy, GOLD - File Copy COUNTY OF BUTTE Y BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street - Chico, CA - (530) 891-2751 7 County Center Drive - Oroville, CA - (530) 538-7541 CORRECTION NOTICE Mc 1�r��ni s 0`1 •c)q q7 OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. OCL. POUr�r7 1 G (1 E -f, 47' CAP) LTJ.47Cfi U OE 04 -A) /t1 s v bA-7C . A Q4 Gv o-arw a AIG— G"t%'C•-�) . t'REV 10/92 COUNTY OF BUTTE a BUILDING DIVISION f DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico; CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 53877541 # CORRECTION NOTICE ER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. C0 W— 4yewn- Date 'w V y Inspector REV 10/92 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE R -v( 7� PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, ( 1 r COUNTY OF BUTTE f BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 53877541 CORRECTION NOTICE PA OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, tt a contact this office immediately. 6 v Sttih I c - 1 0\4 ILd P. c 11... ... ` COUNTY OF BUTTE BUILDING DIVISION z DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 C ER CORRECTION NOTICE _-`z PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. Date � - - Inspector J \. REV 10/92 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)536-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP040497 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/11/2004 APN: 024-160-013-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: 3 S Site Address: 322 TURNER AVE GRI Date: S, 04ontractor: Map Index: Description: NSF (1772), ATT GAR (917) OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: MCMAINS, CHRISTOPHER 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 PO BOX the Contractor's State License Law (Chapter 9 commencing with Section 676 7000) of Division 3 of the Business and Professions Code) or that he or GRIDLEY, CA 95948-0676 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: MCMAINS, CHRISTOPHER Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor:. HAGBERS, J. LOWELL and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 1151 FRENCH AVENUE ❑ I am Exempt under Article 3 of the Business and Professions Code GRIDLEY, CA 95948 530-682-1533 cell Date: Owner: License #: 381195 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. ave and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: r Carrier:�,t Cr))� , �i�IS tC� Total Square Ft: 1772 S.F. f �i� -`�� � Policy #: Valuation: $115,180.00 ❑ I certify that in the performance of the work for which this permit is Census Code: 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. Applicant:f�OEeR/cZr /7 JS (p. •s lleCel•p�€, WARNING: Failure to secure workers' compensation coverage is y05glo�! unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars in � - I, t9 g ($100,000), addition to the cost of A�ylGririf 7Ce��eiVecl compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County de.an(Vor I hereby affirm that there is a construction lending agency for the Resolutions to ork i d d a ev or which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: By:/ � Date: v Address: PERMIT EXPIRES ON: V D e 44 ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official for or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos Print Name:V - Signature: 11.t� / Date: `T l ❑ Owner &Contractor ❑ Agent for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. CAQHq'7 DATE: APN: r ZONIN NEAREST CROSS STREET: , �p TRACTILOT#: SITE ADDRESSo��� 5 Ac— CITY. ZIP: OWNER NAME: a�A PHONE: C STREET ADDRESS: FAX CRY, ZIP: E-MAIL: APPLICANT NAME: kA PHONE: 62'92- / — STREET ADDRESS: — V CIN, ZIP: �` E -MAIL - CONTRACTOR NAM : PHONE: STREET ADDRESS: / e e FAX, e V� CITY. ZIP: E-MAIL: cxl LICENSE NUMBER: 1 LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: FAX CIN, ZIP: LICENSE NUMBER: E-MAIL: ti DESCRIPTION OR COPE OF WORK: �IC10 G -e ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) PLft;�;X ))Iac� 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 fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: Notes: / Application Received by: � Date: p� Receipt number:�S q6G /� ���� Amount Received: �/ S� B. C. Buildina Permit 01-23-04 oa 2 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 / ►�j OWNER: ( {] j (I ASSESSOR PARCEL NUMBER Proposed Building Use: N Counter Technician: Date:'" Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1DV _ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. OJ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. �. ✓ 4. Engineered truss details and layouts in duplicate. No faxes! 5. Letter from Engineer or Architect for truss design review. fjf 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form Tip) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chicoo/oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ p-' 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by .. 0 1< ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ....... g 20. Erosion Control Plan Required........................................................................ ........ �- 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ............., ❑ 24. Planning approval (A) Use:0 KAParking: (C) Parcel Check: -S ) - g ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... IV ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... 32. Letter of Signature authorization ......................................: I............................ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone / X 9 - f:� �'(� . and hold for pickup. U.- _ - v . L . . . I have been informed of�the above items and requirements for obtaining a building permit. Applicant: - / A,�_L4 - Date: 1. Index. permi application for the above items numbered: Plan Check Letter o2.. n igs required �% n esigner, owner, was advised of the above data by phone, ❑mail, ❑counter, by Date - Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date : n Structural reviewed by: Date: Structural approved by: Date: (/ Note transfer by: Dale: Yellow: Building Division TO: FROM: Building Department Environmental Health E. USE ONLY Fiat Pian Attncho Roos Plan Atu.ft.4 :! Son tm s.o. I O&JrCIC-ky 9-1?�6i' SUBJECT: Sanitation Clearance oJi &ILA P -MA) os ir-!:, ea A P, --- Owner Location AFS# Plan Approved for: Sewage Disposa Water Supply: � Public Private Well Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: LIZ Environmental Health pecialist Date 8/96 ,q -611q 7 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER . l I �I.�� r� 1 , f[��,J A.P. # PROPROSED BUILDING USEDATE O RECEIPT # DATE REC. lie 1. BUILDING PERMIT FEES �j q� Q --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ I 2. SCHOOL DISTRICT FEES �� `64 l h H(Q h (paid at School District Office) (form availabl of r Plan Check) 3. SHERIFF FEES (paid at Building Division Residential............ X 360 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ V11— Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) VN7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. Ftg. Amt. 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the *n checking prgcess. APPLICANT DATE Z— 19-0 Pursuant to Goverijfient Code Section 66020, you are hereVy notiM that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement rLESS THAN 1 ACREI Project Title: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs 1 acre or more 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 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more 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 provided by law. i - Y f \ - °t ; RECORDING REQUESTED BY Bidwell Title & Escrow Company AND WHEN RECORDED MAIL TO Name CHRISTOPHER MCMAINS Street Address P.O. Box 676 City, State Zip Gridley, CA 95948-0676 Order No. 00212259-004 204—�1��6gE34 Recorded I REC FEE 10.1 Official Records I TAX 118.4 County Of I MONUMEN 10.1 BUTTE I CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant 09:00AM 06 -Feb -2004 I Myles I Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 024-160-013 GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY The Undersigned Grantor(s) Declares) DocumentaryTransfer Tax is $110.00 ❑ City/Town of El computed on full value of interest or property conveyed, or * Unincorporated Area ❑ full value less value of liens or encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, JESS R. CANTRELL JR. and JEWELL L. CANTRELL, husband and wife hereby GRANT(s) to CHRISTOPHER MCMAINS the following real property in the ❑ City of 0 Unincorporated Area County of, State of California: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF i JESS R` CANTREL Document Date; January 29, 2004 State of California County of But t e SS. On �.QYVRCu Jc- ,t�o�4 , before me, the undersigned, a Notary Public in and for said County and State, personally appeared JESS R. CANTRELL JR. and JEWELL L. CANTRELL Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me,that he/shelthey executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. FOR NOTARY SEAL OR STAMP Z.I.�Y�k�.C9 Otti�o11 C,ow�w.� 13513 q , `ARS3 LYNME GARTQN e COMM1 1351379 NOTARY PUBLIC-CIWFORNIA y q COUNTY OF BUTTE w Comm. Expires April 17, 2006 EXHIBIT "A" All that certain real property situate.in the County of Butte, State of California, described as follows: A parcel of land situated in Section 18, Township 17 North, Range 3 East, Mount Diablo Base and Meridian, more particularly described as follows: Commencing at the Southeast corner of said Section 18; thence North 1042' West along the East line of said Section 18 a distance of 1,310.98 feet to the intersection of said East line with the line dividing the South half of said Section. 18 into North and South halves, which point of intersection is the Point of Beginning of the lands herein described, and running thence from said Point of Beginning South 89°18' West along said dividing tine a distance of 660.0 feet; thence South 1"421 East parallel with said East line of said Section 18 a distance of 330.0 feet; thence North 89°18' east parallel with said dividing line, 660.0 feet to a point in said East line of said Section 18; thence North 1 °42' West along said East line 330.0 feet to the Point of Beginning. Reserving therefrom, an easement for ingress, egress and public utility purposes, over the East 60 feet of the herein described parcel. Residential Development No o Living Units Commercial/Industrial 3 New Building District Identification No. MobileHome Installation Coz 0 Addition ........................... _.................................. :...................................... Sq. Footage Addition/ 'Supplemental to (Group R) (; Conversion Permit # . l I *(No foundation I�nspectkm) '�Restricted :1 O I Deed Re tr cts ted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facilitydocument) Sq. Footage (Including Exterior Roofed Areas) Date [+� School District certifies that roc C'h A i r+ e (Applicant) (Street Address) (Phone Number) (City) has complied with the requirements of Resolution No. 1 - representing ' I 1 �L- ' square feet. School District Representative Paid by Check # �' Remarks: (State) (Zip Code) by payment of $ �� n r 2926 $ FULL MMGATION = Date t Notice: You may protest the Imposition of the fess Identified above by subs tting a Witten protest to the District. In compliancewith Govrmrnent Code Section 66020(a), wlMdn 90 days from the dab fees on paid. Failure to submit a tlmely written protest will prohibit you from challenging the Imposition of the hes In any court actlon. If. subsequent to the School Dlsbict Representative signing this butte County Schools Impact Fee Certification Fom% the school District is notified by the applkable Local Planning Agency that nits project Is being reviewed under the Callfomeis Environmental Quality Act (CEQAh VO project may be subject to additional school hes to hilly mltigata Its Impact on the school dhok: s schools. White (applicant), Yellow (building department), Pink (school district) feeform.>de (10/03)dmm O �,V�TTE` ° o ° RESIDENTIAL PLAN ° �� = ° REVIEW GUIDE SINGLE FAMILY, DUPLEXAND A47SCELL9.NE0US ONLY O«rzr. ;�i Building Permit Number: 6--? - Plans Examiner: ;Ada 54.rnp on A. P. Number: c� ? _ o -61-3 GErERAL: Zoning requirements — (number of permitted living units). Plans signed by the designer. Proper description of work on the application. E:tisting -solations on the property. ecorded notice of ,iolation. 6 uilding permit valuation. LOT PLAN: Complete parcel size and dimensions. Setbacks, side yard, easements, etc. Other buildings or structures. Grading. fills andior drainage. Flood hazard. Special conditions on Parcel Map: Noise ❑ SR.-� ❑ Fire Sprinklers ❑ Water Tender ❑ Traffic and Drainage fees ❑ Federal :did Route and/or Federal Aid Secondary Route setback requirement. Building or utilities across lot lines (Lot merger approval by Butte County Land Development) LOOR PLA`: Plans and specifications drawn to scale with dimensions and of sufficient clarity (UBC section 106.3.3). 101,10 of natural light and 5% of ventilation (Uniform Building Code section 1203). Escape or rescue windows shall have a minimum net clear operable area of 5.7 square feet The miMrmnn nes clear openable height dimension shall be 24". The minimum net clear operable width dimension shall be 20". When %indo« s are prodded as a means of escape or rescue, they shall have a finished sill height not more than 44" above the flcor (Uniform Building Code section 310.4). Skylights (Uniform Building Code section 2409 & 2603.7). Glazing in Hazardous locations (Uniform Building Code section 2406). Habitable space shall have a ailing height of not less than 7 feet 6 inches except as otherwise perp itted in this section. Kitchens. halls, bathrooms and toilet compartments may have a ceiling height of not las than 7 feet measured to the lowest projection from the ceiling (Uniform Building Code section 310.6.1 All habitable rooms except kitchens shall have an area of not less than 70 square feet and not less than 7 fat is any dimension (Uniform Building Code section 310.6.2 dt 310.6.3). GFCI in baths. garage, kitchen. wet bar, and exterior r=ptacles (NEC 210). Water heaters a hich depend on the combustion of fuel shall not be installed in a room used or designed to be used for sleeping purposes, bathroom clothes closets or in a closet or other confined span opening bw abath r bedroom (Uniform Plumbing Code section 509.0). jUauel buming equipment shall not be installed in a closet, bathroom or a room readily usable as abed=- rn- or is rooms. compartment or alcove opening directly into any of these (Uniform Mechanical Code section 304 or fire%vall separation - required on garage side including supporting walls and posts (Uniform 8 ode section 30m'_.4 exception #3). nder no circustances shall a private garage have any opening into a room used for sleeping purposes Uniform Building Code section 312.4). Wood store locztion - Alcove - URIC section 205 confined space tit 223 unconfined space tit 304.2). moke detectors (Uniform Building Code section 310.9.1). Page 1 of 2 Water closet clearances (Uniform Plumbing Code 408.5). Shower compartment minimum 1024 sq. in 8 30" circle (Uniform Plumbing Code 412.7). Bearing walls shall be supported on masonry or concrete foundations that shall be of sufficient size to support all loads (Uniform Building Code section 1806.3). STRUCTURAL DETAILS: Braced wall panels shall start at not more than 8 feet from each end of a braced wall line. Braced wall panels must be in line or offset from each other by not more than 4 feet (UBC section 2320.11.3). Spacing shall not exceed 34 feet on anter in both the longitudinal and transverse directions NBC section 2320.4.1_) Braced wall lines must be continuous throughout the structure. A California licensed architect or registered engineer must prepare a lateral analysis for the area of the building that do not comply with the Uniform Building Code. This must include the designees' stamp, signature, registration number and expiration date on all sheets of plans depicting the designed elements and cover sheets of calculations. Clerestory requiring balloon framing and/or engineering. Foundation plans complete enough to construct building (Uniform Building Code Table 184-C). Floor construction details complete enough to construct building. e6Y Elevations and wall construction details complete enough to construct building. P—IRoof construction details complete enough to construct building. Fireplace construction details and calculations if necessary. Garage door header size(s). Porch header size(s). . Typical header size(s). . Stud heights. . High expansive soil - special foundation design required. Retaining calls requiring design. . (33Tsum wallboard nailing inspection required. If the area below the lowest floor .is fully enclosed, than a minimum of two openings are required With a total net arra of at least one square inch for every square foot of area enclosed with the bottom of the openings no more than one foot above grade. Alternatively, certification may be provided by a registered professional engineer or architect that the design Hill allow equalization of hydrostatic flood for on a. -ter or Walls. Building must be designed and anchored to prevent floatation, collapse or lateral movement. Construction design requirements must be shown on the building plans. . Electric, heating, ventilation, plumbing and air conditioning equipment and other service facilities shall be desigped and/or located so as to prevent water from entering or accumulating with the components during conditions of flooding. MISCELLANEOUS ITEMS: Stairway details — landings, rise and run head clearance, handrails (Uniform Building Code section 1003). Guardrails (Uniform Building Code section 509). Brick or stone veneer (Uniform Building Code section 1403). Exterior plaster— weep screeds (Uniform Building Code section 2506.5). Roof pitch for roof covering (Uniform Building Code Table 15-B-1 & 2, 15-D-1 & 2). Foam insulation — protection. 36" halls and stairways (Uniform Building Code section 1004.3.3.2). t . TAv exits on three — stor)- dwellings (Uniform Building Code section 1004.2.3.2). Underfloor access and ventilation (Uniform Building Code section 2306.3 8 2306.7). Attic access and ventilation (Uniform Building Code section 1505). Sound requirements. Energy design compliance and supporting documentation. . CDF responsible area requirements. BUII.DING PERMIT REQUIREMENTS: 1. ❑ SRA. 2. ❑ Flood elevation cenificare. 3. ❑ Fire Sprinklers require& 4. ❑ Special Inspection requirements. 5. ❑ Use Permit conditions. 6. ❑ Sub -Standard Housing lever. Pzee = , f AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 �J G 2Q1iO4—ioio 1 io6 1 1 Recorded Official Records County Of BUTTE CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 09:07AM 26 -Feb -2004 REC FEE 10.00 CONFORM 1.00 Kathy Page 1 of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: r� x'F A 7-rAC._ Date _-fib, 2 L. , 2do!j PROPERTY OWNERS: State of California Countyof BLk-1�l -e- On f�2hcv,r,r LA a6 ZO-0q Ir 0-1+0-isropiAe-2 NLcMA-199 me, (;�, .usz S . personally appeared C.hr`s -%+- r" 1'4 r M1 no, �*r\ s personally known to me (or proved to me on the bans of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. lip YOLANDA G. REYES Comm. * 1460799 Signature Seal: NOTARYPueuC-CALIFORNIA y Q County of Butte W Comm. Expires Jan. 6, 2008 A.P. # 024- iI00• 01!) EXHIBIT "W1 All that certain real property situate in the County of Butte, State of California, described as follows: A parcel of land situated in Section 18, Township 17 Ndrth, Range3 East, Mount Diablo Base and Meridian, more particularly described as follows: Commencing at the Southeast .corner of said Section 18'; thence North 1 °42' West along the East line of said Section 18 a distance of 1,310.96 feet to the intersection of said East line with the line dividing the South half of said Section. 18 into North and South halves, which point of intersection is the. Point of Beginning of the lands herein described, and running thence from said Point of Beginning South 89°18' West along said dividing line a distance of 860.0 feet; thence South 1 °42' East parallel with said East tine of said Section 18 a distance of 330.0 feet; thence North 89°18' east parallel with said dividing line, 660.0 feet to a point in said East line of said Section 18; thence North 1 °42' West along said East line 330.0 feet to the Point of Beginning. Reserving therefrom, an easement for ingress, egress and public utility purposes, over the East 60 feet of the herein described parcel. PLAN REVIEW RESPONSE FORM In order to expedite the review of your plans, please complete the following information and return this form with your re -submittal. this form is not complete, as to all correction items, we will -not be able to accept your re -submittal for review. There must be a va response to every item requested in our plan correction letter. `By others" is notconsidered a valid response. Please indicate yc response to each item and the location where the information can be found on the plans/calcs. ATTACH THIS FORM TOA OWNERS COPY OF YOUR PLAN REVIEW LETTER AND RETURN WITH REVISED AND ORIGINAL PLANS. NAME ADATE: C �`(� S MC Mai' 101 S MESSORS PARCEL NUMBER O PERM,T NUMBER dZcA ((o® o l3 OL4 - Oq RESPONSE FOR PLAN CHECK LETTER DATED: 14- es. 4-ruSs deJ April 20, 2004 • M� Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX Lowell Hagnerg-Chris McMains 1151 French Ave. Gridley, CA 95948 Assessor Parcel Number: 024-160-013 Building Permit Number: 04-0497 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 approval of this project. NO STRUCTURAL COMMENTS: our energy calculations say the house faces west, the plot plan shows north. Please revise the calc's. STRUCTURAL COMMENTS: Truss T10 is missing from the truss package. Please provide it. Please specify the connection of trusses to the girder trusses. Please provide documentation from the truss company that the trusses will withstand the furnace loads. The big garage door header is not large enough. Please revise the size. � Please indicate exterior header sizes on the plans. 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 Linda. 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 heet. 0in1aa`4SiAmApL Philo Hunt, P.E. Plans Examiner Plan Check Engineer 1 of 1 MAG lJ I��A T7� `~ 1 R r BUn DING DESIGN "Be Your Own Builder" -27 Apt %L o4-, Professional Building Designer, A.I.B.D General Building Contractor B MC # 530213 QICXpp^,%T -r&-A3T Or pm Sce0ices - �d�GI Reree,ew list -roz-A� 6uif La�rcvG.,Lr».T �� O¢- 0497 PLS A-rr�c.�r n�oJ? i l'• LArQ �a6 GrtQA" 'El"M $'kAl>M - To 13 E 3 O/Z `* 34 i 4 2.®� t�,ea C L�r� ps L • 4 -mi? DF u' Z 0 3020 Industrial Drive Suite B Yuba City, CA 95993 Phone: (530) 673-6838 Cell: (530) 713-4313 Pager. (530) 7906261 Fax. (530) 673-3290 MAG U IRE Professional Building Desilpter, A.I.B.D BUILDING DESIGN Gencral Building Contractor "Be Your Own Builder" B HIC 11530213 -17 dpR.L od- 15unrio Coy N7 eewcE - t®wew 94&13vVW-=cµ2�s iM�%rJA-,mss SaI `WoJ4, .... 7 —5tn-,,T Vp 04- 0 97 1 • LQ t��6 Goya X02. �ia-�r. - To f3. 3'�Z">K 14" 2,os F1ra4 L L**" ps L • • E �Ee�®Q 1 anus �reE ro`' /yi��+.e 4,r 12 D' Ai Z J° ° =f . , 8•',�_AfrOJOAj;.000NGtL Oa n A,,• . 1 6 1132 MAG RE ,. TION NO. 6• 7 3020 Industrial Drive Suite B Yuba Qty, CA 95993 Monc: (530) 673-6838 Cell: (530) 7134313 Pager. (530) 790-62(i1 Fax: (530) 673-3290 J 9 C'" PLAN REVISION Owner's Name:�410JS BP#: e> 4--,64'R7 Date: s • - b4 - Contact Person & Phone Number: Lwet"L— AP#: o= 4 - (4,0 - v I'S Received By: t�M`-' Time: Z4jc__ 402-1533 PURPOSE OF RE -SUBMITTAL OR REVISION ❑ Permit Application Data Sheet Item ❑ * Engineering K *Plan Revision ❑ *Requested by Building Inspector's Correction Notice — Inspector's Name: ❑ Requested by Plan's Examiner — Plan Examiner's Name: ❑ Other: *If revising a plan which has already been issued, submit two (2) drawings reflecting the revision for plan review along with your approved plans. If engineering is involved in this revision, the engineer must put his requirements on these drawings and wet stamp and sign two sets of engineered drawings. Revised drawings must clearly show changes proposed and locations involved. WHEN APPROVED, PROCESS AS FOLLOWS: ❑ Mail to Owner/Contractor at this address: 2 -'Call C 93. -153 3 ❑ Deliver with next inspection. and hold for pick-up. Minimum revised plan check fee to be collected at time of submission of revision, plans examiner will determine if additional plan checking fees are needed: Minimum $54.99 Receipt #: 46& t73 Fee not required for revisions requested by plans examiner prior to issuance of permit. Additional Fee Amount: , Receipt #: Revised 2/04 K "°BUTTE COUNTY AGRICULTURAL BUFFER NOTIFICATION AND/OR UNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601 A 536 c1 V, Name: � 1l\`r\S RC 9C4 ( VIS Rhone: l 0 J g 3 �C Mailing Address: E -Mail address `3 -2-2- -77 � vNv - V Assessor's Parcel Number. 0 2 `� l &,o 015 Reason you believe you qualify for the unusual circumstances exception: VV lrt p�w-e Owner or Autho " d Agent's signature P IV Date QA. An exceptional or extraordinary condition where the existing lot size or shape or an existing improvement (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone. SITE PLAN REQUIREMENT: submit 4 copies with this form Refer to the Site Plan Submittal handout for specific requirements ...................................... Internal Dept. Contact Info: ❑ Env. Health ❑ Planning ❑ Building ❑ Other Contact Person: Phone: FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING ......................................................................................................................................................................................... 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: The present setback for the residence footing from the easement stated on the plot plan and the distance across the Turner Ave. easement to the adjacent parcel forms an acceptable agricultural buffer. Agricultural Department Signature:o iy11�G UIRE Professional Building Designer, A.I.B.13 BUILDING DESIGN General Building Contractor "Be Your Own Builder" B HIC # 530213 Z" kl OPS Gi�D ,� F.r2/G��vc� ��•��i� � ' �oine0oc��TS o 7'�fs� C�joLy. c�";.raav►oaap cQu,i�aee`.ov''® 3020 Industrial Drive Suite B Yuba City, CA 95993 Phone: (530) 673-6838 Cell: (530) 713-4313 Paget: (530) 790.6261 Fax (530) 6733290 MAGUIRL Professional Building Designer, A.I.B.D BUILDING DESIGN General Building Contractor "Be Your Own Builder" B HIC H 530213 i7 Zee 4 % C•N, �� ��C�,Cv� �� �-�i•� ��, �m�n�Doc��TS o 7�� C��,�7 7w Oe�- 3020 hidustrial Dhive Suite B Yuba City, CA 95993 Hone: (530) 67Uii338 WI: (530) 713.4313 Yager. (530) 790.6261 Tau: (530) 6733290 i VI ' AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE,CA9'5965" COPY of Document Recorded 26 -Feb -2004 2004-0010611 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 a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established- agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows; cF Date 4� b . 2 (. , 2oo�j PROPERTY OWNERS: State of California County of guk-�-C- On bgfore me Y D "0.n cJ�c — G ..�u.` 1 S personally appeared Chr,I-qr M'!c n0,k*r\ personally known to me (or proved to me on the basis of satisfactory evidence).to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatures) on the instrument, the person(s) or the entity upon behalf of which theperson(s) acted, executed the instrument. WITNESS my hand and official seal. ••••• YOLANDA G. REYES Comm. * 1460799 Signature Seal: NOTARY PUBLIC -CALIFORNIA y Q County of Butte W Comm. Expires Jan. 6, 2008 A.P.#` 0aq— Iio0- 01'5 EXHIBIT "A„ All that certain real property situate in the County of Butte, State of California, ' described as follows: A parcel of land situated in Section 18, Township 17 North, Range 3 East, Mount Diablo Base and Meridian, more particularly described as follows: Commencing at the Southeast corner of said Section 18; thence North 1042' West along the East line of said Section 18 a distance of 1,310.96 feet to the intersection of said East line with the line dividing the South half of said Section. 18 into North and South halves, which point of intersection is the Point of Beginning of the lands herein described, and running thence from said Point of Beginning South 89°18' West along said dividing line a distance of 660.0 feet; thence South 1 °42' East parallel with said East line of said Section 18 a distance of 330.0 feet; thence North 89°18' East parallel with said dividing line, 660.0 feet to a point in said East line of said Section 18; thence North 1 °42' West along said East line 330.0 feet to the Point of Beginning, Reserving therefrom, an easement for ingress, egress and public utility purposes, over the East 60 feet of the herein described parcel. y,•T� SITE PLAN REVIEW APPLICATION Date: I/) -.� G 113 AP# 'Ca U 1 Permit Number (if applicable) V y- • APPLICANT INFORMATION ay-oy1%Parcel Size: Owners Name: W&2Address: Telephone No.: U() 5 C) L1 Situs Address: Proposed Use: Residential j0 New Single Family Residential ` ❑ Single Family Addition ❑ .Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition - ❑ Commercial Remodel ' ❑ New Industrial ❑ Industrial Addition ❑ Industrial Remodel Other Septic ❑ Well Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRI BELOW THIS LINE DEVELOPMENT SERVICES INFORMATIONPLANNINGBLDG DIVISION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Approved By Date J I 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: X • Flood Panel No.: m o (° Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ------------------------------------------------------------------------------------------------------------------------------------ ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: W —H Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. • Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front S L Side Side Street Rear 21S- SHeight Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. • Page 2 of 5 . • ` Applicable Development Fees: Standard Fees Amount Formula . F-1 Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other -------------------------------------------------------=----------=------------------------------------------------------ Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ' ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee, if pre-application review. A final determination will be made at the time of the building permit. Parcel Created By Deeds: Date of Creation: 12— I Z— Legal Access Provided: ❑ No ® Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No N Yes, Road Name: -M 2 N GQ A 1 . Complies with County Standards for Deed Creation: EJ No, ❑ Yes Comments: ® Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access -❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ' ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: Page: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control PI 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. 0 Page 4 of 5 • r� 0 4 November 3,i Jewell Cantrell P.O. Box 676 Gridley, CA 95948 RE, Septic Permit for AP 024-160-013 (Turner/Cowee Rd.) Dear Mr. Cantrell, Your application was sent to the Agricultural. Commissioner for review and he requested that you move the dwelling back 100 feet from the right -of way due to agricultural uses adjacent to your parcel. We need a new plot plan showing the dwelling 100 feet from the road right-of-way.. I tried to call you at the phone number listed on the Septic Permit application (821-2005) and received the message from the phone company that this number has been disconnected. Please call me for any questions at 530-538-7977. Sincerely, Larry Painter Planning Technician II Butte County Planning Division See Attachment tte Coun� ' LAND OF NATURAL WEALTH AND BEAUTY PLANNING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530)538-7785 RE, Septic Permit for AP 024-160-013 (Turner/Cowee Rd.) Dear Mr. Cantrell, Your application was sent to the Agricultural. Commissioner for review and he requested that you move the dwelling back 100 feet from the right -of way due to agricultural uses adjacent to your parcel. We need a new plot plan showing the dwelling 100 feet from the road right-of-way.. I tried to call you at the phone number listed on the Septic Permit application (821-2005) and received the message from the phone company that this number has been disconnected. Please call me for any questions at 530-538-7977. Sincerely, Larry Painter Planning Technician II Butte County Planning Division See Attachment L� 4P BUTTE COUNTY AGRICULTURAL BUFFER NOTIFICATION AND/OR UNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601 Name: _ C. Ank '. I' Phone: Mailing Address: E -Mail address Assessor's Parcel Number: D 24 Reason you believe you qualify for the unusual circumstances exception: vwner or wutnorized Agent's signature Date UNUSUAL CIRCUMSTANCES DEFINITION: An exceptional or extraordinary condition where the existing lot.size or shape or an existing improvement (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone. SITE PLAN REQUIREMENT: submit 4 copies with this form Refer to the Site Plan Submittal handout for specific requirements inte .............p.....ntact Info Internal Dept. Contact Info: ❑ Env. Health ❑ Planning ❑ Building ❑ Other Contact Person: Phone: FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING ...............•i::::::::::::::::::::::::::::::::i::::::::::::� .:...... ii ....V VY ....... ff!........................................i........I..1............................... 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: Parcel size and will not accommodate a standard buffer. Mature orchards on the north and east boundary. East / West location is ideal. Building should be placed 100 ft from the north boundary to . create an adequate buffer.��- Department Signature: &6ert C. Ifill (DevuUAg. COMM Date: LO [6 L /03 ENCROACHMENT PERMIT County of Butte Department of Public Works, 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (30) 538-4356 Download Forms: www.buttecounty.net/publicworks/forms.htmi NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Permit Number q ! U 3 C/ �_ District R J 7 Phone (530) 538-7157 Ext. 2016 o 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:dyl la.omp�yName: 1 2. Address: C " 3. Phone: S � S?b i ?q3 4. Assessor's Parcel Number: OZL- Q) C >1 3 5. Location of Work to be Done a*—? �� .. 6. Applicant's Signature7. Date:� Z— � CONTRA TO s' INFORMATION• 8. Contractor's Name 9. Address 1 k 1 F t," C(,, V/- V \ d V CC,,. 10. Phone: 1• .Fax: , 53b SLtb W-7 12. Contractor's License Number: 5 13. Certificate of Insurance: Yes ❑ No: ❑ 14. Contractor's Signature: y. tLC� 14a. Date Signed: 15. Authorized Agent: TYPE OF WORK TO BE DONE 16. Please Check:17. Curb: 11 Gutter: El Sidewalk: ❑ If Driveway List Type: 18. Other Work - Describe: 19. Plans Attached: ❑ Yes ❑ No PERMIT GRANTED In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) and special conditions written below, permission is hereby granted. 20. Conditions +1 f+ ! 'r ...,j - o t �Je Cm rej coUA9-iA J �i7� o Q� i I 6"L fto {I .� Underground Service Alert U.S.A. must be notified two working days prior to any excavation. 800-227-2600 21. 19 All work shall conform to accompanying: Detail 4�Q Plans ❑ Special Conditions 22. Date Issued/ / G �� 23. Expiration Date: t y ��% 71 24. Surety: 25. Date Paid: �� a ,/ ! T 26. Amount Paid: i 0 Co 27. PPaai�By: z / e c o c 28. Receipt No.: - /d U z9fa �! Mike Crump, Director of Public Works By: 29. Final Inspection Date: 30. Inspected By: ❑ Completed - OK EfCompleted — Not OK For County ❑ Additional Comments Attached Use onty: 3 L Comments: Note: if permits are faxed to any number besides (530) 5384356, they can be delayed up to one week. Page l of 2 lp nT 0 0