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
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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
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o.
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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
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#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
•
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OR 6c•
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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
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MAG U IRE Professional Building Desilpter, A.I.B.D
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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
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BUILDING DESIGN General Building Contractor
"Be Your Own Builder" B HIC # 530213
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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
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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
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