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026-030-002
AP 203-62 N= WHE John Golec 6605 Irwin Ave.., -'Palermo ` contr: Aibel, 0roville Permit{ 4192-75E,M(change se vice 8c install dual pac) I 026-030-00-. �� a 04-2799 GUTIERRE7, MARCOS SS�f UPPE P LETS R ; PAL, MO. CONT:'UN NEW SINGL FA -� - - c IP f f ti 1 I � 9 N CJI M i .. NOTES RESIDENTIAL PERMIT /NO. UT �( 2-- ti MAO E OFFICE COPY Address GAS Meter By Date ✓� ' ' i ELECTRIC Meter By Date r, SPECIAL CONDITIONS j -CHECKED I. BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. !, SPECIAL INSPECTION ITEMS Y: VERIFY .. USE PERMIT CONDITIONS SUB-STANDARD HOUSING LETTER } I JOB FINALED (Date) Signature � r,. J - OK 0 - Not OK -" Not aWe . =Not kady @@((URN B I L E HO M ES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;=/ - P L'ft. / P Nat or/ . /" L'ftJ P LPG nc 7. Well Clearae & Disconnect 8. Utility Clearance' - - 10. Roof; Stog-Roofing Date Card B-1 Date Card B-1 Date Card B-1 Date . Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1.° Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flet Connector S. Water, MH Test-Regulator"Connectot 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert 10. Exits', Insp.-Sketch 11. Cert of Occupancy ' 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; S¢e=Spacing=Marriage Line 3.. Blocki6g to 4.. Gas; MH Test -Demand -Valve 5. -Electricity; MH Test - 6. Water, MH Test 7.- Water and Sewer :Connected 8. Gis and Electricity Tagged" _ 9. Exits -. `10., License Decals " 11.. Verify #'s with Office,. A Date Cana B-1 Date Card 6-.1. Date, Card B-1 _ Date Card B-1 F MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-S¢e 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; Stog-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Cana 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 UghtinM 15 Voles-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Wed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip; Pool Lghtg. Boxes=Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10.- Plumb.; Cir. Test -Water Supply Test -• 11. _Light Niche - .12. Enclosure; Fencing -Alarms _ - Date Card B-1 Date Card B-1 Date Card B-1 Date - , Card B-1 I = OK ! = Not OK = Not AppOMble = Trot Ready RESIDENTIAL (Single & Duplex) late UNDERFLOOR (Plans) OK except Vs 1.Zoning-Setbacks-Easements-Flood-Slope 2.Ftg., Main; Soils-Elec. Gmd. / . P Fig. Del 3. Ftg., Garage; Soils -Steel -Stec. Gmd.-/ - i 4. Ftg., Porches & Decks; Soils -Steel-/ r FI S. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls Garage; Steel-Blockouts-W e 6a. Hold Downs and Special Anchors 7. Stab. Steel-Wraooed _ \j 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test M10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Cana B-1 Date Card B-1 Date AP MBING (Permit) OK extent Ws ' .,4, 17. Water Htr.: Vent -Access -Combustion Air Baffle 19. D.W.V.; Test Fittings & Anchor -Nail Protection 1A • V, 7-20. Shower Pan: Test. First Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire SDrinkler. Test Date ✓ Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Side Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size! /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes.Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except Vs 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps-Anchors-Corinectors 48. Cling. Joist-Rftr. Ties -Pullin -Roll Brac: Truss-Shting: Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdnn. Windows or Exiting Doors -Sill Ht & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Fvewal & Openings 54. Ext Doors -One T -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 59. G Area -Glass Protection -Skylights -Plastic . { hear Walls; Naiir.g-Botts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date . Card B-1 Date Card B-1 Date FINAL (Plans) OK except Vs 64. . teps-Door & Sidelight. Prot n -Lan ngs L17.7 Smoke Detect 66. Furnace V -clearance -Comb, Air-Connector- InL�ge; Above f=loor -Ducts -Meth. Protection 6j. -'Bedroom EOrng 6 .F ath Fu ft_ & Tub Acces pa 69. Elec. Trim & Subpanel, Breaker Sizes & LabehY in Garage; Above Floor -Meth. Protection 78%Plb.; Bec. & Mech. Equip. Listtion 7 eceptacle6 in G FF . - omex Protection 8Q-4nsfilation-Foam-Look ttic 81eiar6"Rails & Deck Construe ' st Caps 8 n. VBents & Crawl Hdre Door Drainage Wood -Earth Clearance Looked under Floor 83-SvIl wing hsUdJDrive &-Yes 0 No/Walks Gies 0 No/Plarders 0 Yes 040 8% i . Unit Disconnect, Electci6l-Plumbing 8 eats Above Roof, P pliance-Foe Clearance to Openings 81i -Water Well, Disconnect, Electrical, Plumbing 88. erior Elec. Trim, G.F.I. Receptacle -Underground 89 lati n Throughout House 90. ass Protection 91. Corrections from Previous Inspections 92.a Test-Metersa as-Elecscie 93. W�ewer Connected to Grade -HD Approval Energy Compliance Certificate -Other Certificates 9 . Address Posted in er Date�+SCard 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: A CERTIFICATION OF INSULATION WHITE - Builder Copy, GREEN - Builder Copy, YELLOW - Customer Copy, PINK - Attic Copy, GOLD - File Copy ADDRESS OR TRACT SACRAMENTO BUILDING CONTRACTORS IXO �+.�i/� lJ �� V 1 1�'C�� ��� n QUO vo ,6 ,CAe— 1309 MELODY ROAD, MARYSVILLE, CA 95901 LIC#202026 ❑ 605 S. AUBURN STREET, GRASS VALLEY, CA 95945 LIC#202026 ❑ 3881 BENATAR WAY, SUITE A, CHICO, CA 95928 LIC#202026 ❑ 8924 AIRPORT ROAD, REDDING, CA 96002 LIC #202026 DATE INSULATION COMPLETED ( square feet) ( square feet) ( square feet) TYPE OF INSULATION TYPE OF INSULATION TYPE OF INSULATION MATERIAL FIBERGLASS MATERIAL FIBERGLASS MATERIAL FIBERGLASS FORM BATTS FORM. BATTS & BLOW FORM BATTS MANUFACTURER'S PRODUCT I.D. MANUFACTURER'S PRODUCT I.D. MANUFACTURER'S PRODUCT I.D. MANUFACTURER MANUFACTURER MANUFACTURER CT OCF KN CT OCF KN CT OCF KN BAGS - R -VALUE INSTALLED . ' APPLIED THICKNESS R -VALUE INSTALLED APPLIED MIN. INSTALLED THICKNESS WEIGHT PER SQUAREFOOT R -VALUE INSTALLED APPLIED THICKNESS ` KNEE WALLS IF R -1h EIS OTHER THAN WALLS ABOVE MATERIAL FIBERGLASS FORM BATTS R -VALUE MANUFACTURER CT OCF KN AIR INFILTRATION SEALANT MATERIAL FOAM MANUFACTURER HILTI HANDY FOAM THIS IS TO CERTIFY THAT INSULATION AND/OR SEALANT HAS BEEN INSTALLED IN CONFORMANCE WITH APPLICABLE CODES; MATERIAL STANDARDS AND REGULATIONS I O CON CTO M I E DATE SIGNATURE - GENERAL CONTRACTOR TITLE DATE • REMARKS WHITE - Builder Copy, GREEN - Builder Copy, YELLOW - Customer Copy, PINK - Attic Copy, GOLD - File Copy BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net\dds LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that 1 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: Date: Contractor. OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale 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.). id 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, 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 andel Professions Code Date: 1:2: _6 S Owner: ��il(ULCND .,""`cGcpn/tsz-,l WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is Issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy#: PERMIT NO. BP042799 Issued Date: 01/07/2005 APN: 026-030-002-000 Site Address: 6584 UPPER PALERMO RD PAL Map Index: Description: NSF(1963)GAR(774)COV(324) Owner: GUTIERREZ, MARCOS 7870 FULTON AVE PALERMO, CA 95968 (530) 534-7557 Applicant: GUTIERREZ, MARCOS 7870 FULTON AVE PALERMO, CA 95968 (530) 534-7557 Contractor: License #: Architect: ACQUISTAPACE, JOSEPH Engineer: Total Square Ft: 3061 S.F. Valuation: $151,355.00 Census Code: 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, (t� 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: `1'14 W 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: do PERMIT EXPIRES ON: 5-82- /0d of the Belle County COde endlor been paid. Date: /^ 7^0 O 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. O Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. Cl 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 form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes. Print Name:-U5✓I C1J eoS l o. �f �-e Z Signature Date: / — Ci Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor � �ss4.70 Lo: �OT %A V BUTTE COUNTY 0�0 DEPARTMENT OF DEVELOPMENT SERVICES 0 0 BUILDING PERMIT APPLICATION 0 0 AND SUBMITTAL REQUIREMENTS 0- �� __ • = 0 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 y=ea°- -�� - 0 - 0 OFFICE #: (530) 538-7541 CSU N�� A FEE WILL BE REO UIRED AT TIME OF APPLICATION I Iq 1, g g "PLEASE PRINT CLEARLY" )9`I • 3", APPLICANT NAME OWNER Last Name �� Jl City irst Name Address 'W ? b 1+o^ City Pn (', Jin State StateC Zp 9S P/, Phone _53q -?5S-7 Fax Fax E-mail Lic. # APPLICANT NAME CONTRACTOR Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State Li en a t APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning I -AE:2V Flood Zone Cross Street SRA I Yes Occ. Type Const. Subdivision Name Map Book Page 7-1— Lot#Planner Planner Date Approved: PERMIT NO. BP Q q ;�_7 BIN # LOCATION AP# O ©30 00 Property Addres fo5E3� City Cross Street WOR ER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. FootageK�SF Ig ❑ Structure Built without Perml s ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application,.plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. I I Received b4c Amount: 142"7. Bldg I I OVER FOR SUBMITTAL REQUIREMENTS 11 KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 1 of 2 Receipt #: 4 (P—.258-0), Date: Sheriff IP Other • 33_Tota1 REV 7-27-04 SUBMITTAL & PERMIT REQUIREMENTS The.following drawings and specifications must be submitted to the Building Division in order to apply for a par ,mit, INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK 1. Site plans,or 4 ets, signed by the preparer of the plans. No graph paper! 2. Complete planr 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 3. Engineered truss details and layouts in duplicate (if required). No faxes! 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non-heated and A/C for Non-Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ' ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet-signed by the engineer. ❑ 8. Flood Elevation Certificate, wet-stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). — V/ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. e ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carder anb Policy Number. ❑ 8. Owner-Builder Verification (if required). ❑ 9. " Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS merunas can only'De made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing -fees, plan check fees for work plan checked and other 'department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVI90V 2 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: (--r ���� V11 ASSESSOR PARCEL NUMBER `U " U� -0t Proposed Building Use: r cl t� S F Counter Technici Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. . Eq- 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. 6. Energy compliance design and supporting documentation in duplicate. 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) 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 A j 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ 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............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... 20. Erosion Control Plan Required........................................................................ ........ e0q 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit........................................................................ 0 23. California Department of Forestry plan approval ❑ paid. Sent by: ............. ;o,-- 24. Planning approval (A) Use: OIL (B)Parking: (C) Parcel Check: 0 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....... ❑ 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.................................................................... 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 C ? I f _ "'1 �; �, �`7 and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: 4:1, : Date: e7-,23 - c- cr 1. Index permit application for ov ite s m red: Plan Check Letter 2. Additional items required Contractor, designer o was advi ed o the abo data by I�phone, ❑ mail, ❑ counter, by' Contractor, designer, ner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Plans reviewed by: (it//L-�-P/rK/Date: Plans approved by: Structural reviewed by: Date: Structural approved by: Note transfer by: Date: Yellow: Building Division Date: ' U Date: Date Date: W E 3E ONLY Piot Plan Attach Floor Plan Attachad wv Sant to B.D. ! TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance hr, ATj ?J6 r 2 Q Owner Location AP Plan Approved for: Sewage Disposa Water Sup ly: Pu lic Private Well PP Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: 8/96 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 ' "J) PROPROSED BUILDING USE V11. BUILDING PERMIT FEES --- Balance Due ..................... --- Additional Fees Due........... $ IL+aZ3S_ 1� Revised Plan Checking Fee.... $ . SCHOOL DISTRICT FEES Lo d at School District Office) (form available after lan heck)/ -7/0 5 3. SHERIFF FEES (paid at Building Division) i T Residential........... X $360.00 =$ �. a V Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. URBAN AREA FEES A.P.#�— 3 DATE RECEIPT # DATE REC. +0 X11 �1(v (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. 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) 7. 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. J Amt. /. !1 10. OTHER 51 / 1 P � ! �I /��iV 11 -7105 - At /1/05 - At rime 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 plan checking process. APPLICANT DATE'7- 2 3•_0 c( Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) 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 PROPROSED BUILDING USE Y�1. BUILDING PERMIT FEES --- Balance Due ..................... $ 1 qa---L 3 S_ --- Additional Fees Due........... $ 1� Revised Plan Checking Fee.... $ 55SCHOOL DISTRICT FEES 'd at School District Office) (form available after Plan theck/-7 I 015 3. SHERIFF FEES (paid at Building Division) T Residential........... X $360.00 =$ 0.6 V Units Commercial (sq. ftg.). 4. URBAN AREA FEES Residential (per unit). X $0.03 = $ Sq.Ftg. A.P. # Oa c� - 3 a ao� DATE RECEIPT # DATE REC. c p< 100 7a) (O,Z �"_+A_ J-0 Q ) /00 (paid at Building Division) X =$ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. 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) 7. 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. ;onunercial (sq. ftg.) ......... X = $ Sq. Ftg. Amt. 10. OTHER SI/ 1 I P c 15-/q 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 plan checking process. APPLICANT DATE q-2- 3-6 '-( Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) . v �� BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM cA,,. • (One form per Building) SchooLDishict {u Building Department No. _ A.P. NumberUy V Jurisdiction: CityCounty Property Owner Property Location/Address V0.0a Y 1z-c� Subdivision Lot No. 1 :..................... .................................................................... ...... Residential Development Q Q Q € Sq. Footage No of Living Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation inspection) :............................................................................................... _... a Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) t Commercial/Industrial Q Q ' Sq. Footage New Addition (Including Exterior Roofed Areas) Building Department Representative Date identification No. 050197 tl6J jLn 6)1 ,q School District certifies that 6 y � J(A ppli cant) 7SS (Street Address) ! J (Phone Number) [0 eV", (City) has complied with the requirements of Resolution No. I resenting / C �� square feet. on rtc`, X16 U Z School District Representative Paid by Check d Remarks: IState) /C)�-9v (Zip Code) .. by payment of $ J 7 ff 6n1GATiON $ orlo���s Date Notlew: You may protest the Imposition of the fess Identified above by submitting a written protest to the District, in compliance with Govemms a Code Section 66020(a), within 90 days from the date fees aro paid. Failure to submit a timely written protest will'prohibit you from cha[WVlrq the Imposition of the fees in any court action. N. subsequent to the School District Representative signing thisButte County Schools Impact Fa Certification Form,, the School District is enUR by the applicable Local Planning Agency that this project Is being reviewed under the California Emrlronmer" Quality Act (CEQA� this project may be subject to additional school fess to fully midgste.ks Impact on the school district's schools. White (applicant), Yellow (building department), mink (school district) feeform.xls I10/03)dmm REQUEST FOR ADDRESS VERIFICATION DATE: i 7. to 5- AP# OWNER'S NAME C=7 u -r+ C 0-j2e Zj OWNER'S PHONE # 530 534 - -7 55 OWNER'S MAILING ADDRESS 7870 F' -LU -roil A-ve. C-��e P-" 4n, C,o q 5q G 8 PRESENT ADDRESS OF BUILDING(S) 1. 2. 3. 4. ASSIGNED ADDRESS(S) 1. 6,584 LIPPF_-ie P-YL-C-i"o 2. a 9 utte County Department of Development Services DNNE CHRISTOPHER, DIRECTOR WILLDAN Scott Rutherford (530) 538-7160 srutherford (ftuttecou nty. net Plans Transmittal For Review Per Contract 9/24/2004 Applicant: Gutierrez, Marcos Permit 04-2799 Project Type: NSF/Gars e/Cov APN: 026-030-002 100% 70% Plan Check Fees $ 1,141.88 $ 799.32 $ 1,141.88 $ 799.32 WILLDAN Fee $ 799.32 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other 7 County Center Drive Oroville, CA 95965 (530) 538.7601 Telephone (530) 538.7785 Facsimile N TO: ' FROM: 1 SUBJECT: O � DATE: WILLDAN Scott Rutherford (530) 538-7160 srutherford (ftuttecou nty. net Plans Transmittal For Review Per Contract 9/24/2004 Applicant: Gutierrez, Marcos Permit 04-2799 Project Type: NSF/Gars e/Cov APN: 026-030-002 100% 70% Plan Check Fees $ 1,141.88 $ 799.32 $ 1,141.88 $ 799.32 WILLDAN Fee $ 799.32 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other .0 Department of Public Works 00 C o u n t y o f B u t t e O LAND DEVELOPMENT DIVISION � J. Michael Crump, Director Storm Water Management Program O 7 County Center Drive L Oroville. CA 95965 116P(530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPD)Phase 11 Construction Storm Water Permit and Storm Water LESS THAN 7 ACREt onPrevention Plan (SWPPP) Acknowledgement Project Description:�t^ Project Location and/or Parcel Number: ,�2 6� — 0 31® (90 21 By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of Califomia Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. YI iped: Title: Date: s Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program W I LLDAN Serving Public Agencies December 22, 2004 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL Willdan Project No: 14353-1167 Jurisdiction Job No: 04-2799 Assessor's Parcel No: 026-030-002 Description: Gutierrez Residence Dear Mr. Rutherford: Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: �k Plans: Two (2) copies cover page dated 09-09-04, drawn by Barry Rubanoff, two (2) sheets page 1 of 7, dated 08-04-04, drawn by Barry Rubanoff, two (2) copies sheet 2 of 7 dated 08-31- 04, drawn by Barry Rubanoff, two (2) copies sheet 3 of 7 dated 08-24-04, drawn by Barry Rubanoff, two (2) copies sheet 4 not dated, not signed, two (2) copies sheet 5 of 7 dated 08-04- 03, drawn by Barry Rubanoff, two (2) copies sheet 6 of 7 dated 08-28-04, drawn by Barry Rubanoff, two (2) copies sheet 7 of 7 dated 09-09-04, drawn by Barry Rubanoff. # Structural Calculations: Two (2) copies dated 09-16-04, Prepared by Dave Wasney Jr. - Joseph Acquistapace A.I.A. # Energy Calculations: Two (2) copies dated 09-13-04, by Barry Rubanoff. # Truss Calculations: Two (2) copies dated 09-10-04, by MiTek-James Bourez P.E. The plans have been stamped with the Willdan approval stamp and dated the date of this letter. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. W I LLDAN Serving Public Agencies APPLICABLE CODES Unless noted otherwise, all comments are based on requirements of'the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code and abbreviated herein as "CBC" • Part 3, known as the California Electrical Code and abbreviated herein as "CEC" • Part 4, known as the California Mechanical Code and abbreviated herein as "CMC" • Part 5, known as the California Plumbing Code and abbreviated herein as "CPC" • Part 6, known as the California Energy Code, and Energy Commission Standards, and abbreviated herein as "CECS" CODE ANALYSIS Type of Occupancy Type of ' Construction Sprinklers Stories 1" Floor Sq Ft 2ndFloor Sq Ft Total Sq Ft R-3 V -N No 1 1963 NA 1963 U-1 V -N No 1 773 NA 773 Cov. Porch V -N No 1 144 NA 144 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and/or notes as red -lined on the plans. 3. All plan sheets shall be signed by designer or person responsible for the plans as required by California Health & Safety Code Section 5536.1. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals noted at this time. SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. Plans Examiner Gordon Wright, P.E. Plan Check Engineer Cc: Alice Mefford, E-mail: amefford@buttecounty.net Marcos Gutierrez, 7870 Fulton Ave., Palermo, CA 95968 Dave Wasney, 1280 Orchard Way, Chico, CA 95928 Email: wasneyjrchi@aol.com .Pa ;e 2 of County of Butte Permit .Number 04-2799 WiLldan P.re lect Number 14353-1167 SITE PLAN REVIEW APPLICATION Date: AP# -6 30 '00.2 Permit Number (if applicable) APPLICAIVTINFORMATION Parcel Size: �(Q• D GZC/l�Q S Owners Name: --1 �SUU Z Owners Address: g70 a,,. W�no a+ Telephone No.: 755 7 Situs Address: Proposed Use: Residential ® 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 i ❑ New Industrial ❑ Industrial Addition ❑ Industrial Remodel Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) ® Approved . ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ® Site Plan Stamped Approved' By, Date Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY' Parcel Is In: ❑ 'Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) Watershed Protection Overlay Zone (See'attached standards and :requirements) ,/ Expansive Soils (Test for expansive soils and if verified proper foundation design required) /'tc. A E], SRA - (CDF to determine specific requirements) / ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: • Flood Panel No.: aQ27CO `l9f Index Date: L112-1910 ❑ 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: 11-k '2- 'A' 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 '2o, Side !0 r Side Street Rear d r 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 ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other Amount Formula ---------------------7--------------------------------------------------------------------------------------------------- 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 IS Deeds: Date of Creation: - i%Z Legal Access Provided: ❑ No ® Yes Deed of Reference: / 7 - Pd.?, Legal Access Required ❑ No ® Yes Parcel Frontage on Publicly Maintained Road: ❑ No ® Yes, Road Name: Complies with County Standards for Deed Creation: E] 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 7 , IN Subdivision Map/Parcel Map: r a&/V-2 0 Map Date of Recording: / 6� 9 1 Lot: I � 3' ❑ Use PermitJMinor Use Permit Permit Number: Page: 0&0 3 Date of Approval: Parcel Map/Subdivision MapfUse Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional `and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage .Aank,' 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 roa IN Page 4 of 5 e. C Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CAL,arrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 r Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 . (530) 538.7601 Telephone (530) 538.7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING November 5, 2004 Marcos Gutierrez 7870 Fulton Ave. Palermo, CA 95968 Subject: APN — 026-030-002 Dear Mr. Gutierrez, The Butte County Department of Development Services, Planning Department, has reviewed the submitted Building Permit Application 04-2799, and has found your application in compliance with .the established planning criteria. The site plan you submitted meets the setback requirements for your zone as well as applicable map or use permit conditions. The Permit Application has now been forwarded to the Building Division for their consideration and action. Should you have any questions please feel free to contact me between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538-7601. Sincer y,' a Adler Assistant Planner 4 AND WHEN RECORDED MAIL'TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 G eiizi`i - fzyYJ!ESc3 1 4B I Recorded Official Records Coy;nty Of BUTTE CAI'LACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 11:47AM 24 -Sea -2004 REC FEE ie.00 COPIES 2.50 Jason Nage i 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: Date PROPERTY OWNERS: i `Ct'd C CrST 1� r J y 2— State of California County of 94-' -Aze OnO `� �� -� `� before me, personally appeared_ s personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature,G��%� Seal d RICHARD FEUERS i EIN Commission !1299529 v v Notary Public - California to CO (/� r� r^ Butte County A.P. # V O" `� " V�a v My Comm. Exp. APR. 13, 2005 Order No. BU -218554-3 AM Description The land referred to herein is situated in the State of California, County of Butte, and is described as follows:. LOTS 1 AND 8, IN BLOCK 88, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP 01 PALERMO AND SUBDIVISIONS 1 AND 2, WITH ADDITION TO NO. 1 OF THE PALERMO CITRUS TRACT",WHICH MAP WAS RECORDED IN THE OFFICE OF .THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 17, 1888. RESERVING THEREFROM: ALL THAT CERTAIN REAL .PROPERTY SITUATED IN THE UNINCORPORATED AREA OF BUTTE COUNTY, CALIFORNIA, BEING A 60 FOOT WIDE NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITIES PURPOSES, ON OVER AND UNDER A STRIP OF -LAND BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: THE NORTHERLY 60.00 FEET OF LOT 1 AND THE NORTHERLY 60.00 FEET OF THE WESTERLY 180.00 FEET OF LOT 8, BOTH IN BLOCK 88, AS SHOWN -ON THAT CERTAIN MAP ENTITLED, "MAP OF PALERMO AND SUBDMSIONS 1 AND 2, WITH ADDITION TO NO. 1 OF THE PALERMO CITRUS TRACT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 17, 1888. APN 026-030-002-000 ENCROACHMENT PERMIT County of Butte Department of Public Works 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext 2016 Fax: (530) 538-4356 Download Forms: www.buttecounty.net/publicworks/forms.html NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Permit Number District Phone (530) 538-7157 Ext 2016 Z t �'/j' --Of 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 td highways. all in accordance with County ordinances and general laws. (All information Cot si must be b or le rioted ApplicanfsNamc:AA _ /' 1 . - - - — la ompany Name Phone: -• • - - _ - - --- _. �8 53 4-1 75 , [.action of Work to be Done - _ 7. Date: 2. Date Issued CONTRAC'TOR'S INFORMATION Contractors Name1�'E / e— �A�Rasr,.lks Address .sem! i�TN 9. Phone. v 2. Contractors License Number Z/8 Z7 r17 1 13. Certificate of huvrnncc Yes No: ❑ 4. Contractor's Signature: t4a. Date Signed 5. Authorized Agent TYPE OF WORK. TO BE DONE 6. Please Check Curb: ❑ Gutter: ❑ Sidewalk ❑ 17. If Driveway List Type: S. Other Work - Describe: By: 19. Plans Attached: ❑ Yes ❑ No PERMIT GRANTED i compliance with the above request, ermission is hereby granted. and subject to all terms, conditions (including those on page 2 of this permit form) and special conditions written below, O. ConditionsDi2 • 11'1AKGA`ti�'D 1�Kfk►U NA�i ❑ Additional Comments Attached -,orC".ry )ndergmund Service Alert (U.SA) mixt be notified two working days prior to any excavation. 80x227-2600 1. ❑ All work shall conform to accompanying: Detail ❑ Plans ❑ Special Conditions ❑ 2. Date Issued 23. Expiration Daw 24. Surety: -Z -O -o .5. Date Paid: 26. Amount Paid- 27. Paid By. 28. Re_ m -t No_- dike Cramp, Director of Public Works� � j� j By: 29. Final Inspection Date 30. Inspected By ❑ Completed - OK Completed — Not OK ❑ Additional Comments Attached -,orC".ry ustony: 31. Comments: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2004—®059181 Recorded Official Records County Of BUTTE CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 11:47AM 24 -Sep -2004 REC FEE 10.00 COPIES 2.50 Jason 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 discomfortfrom 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: Se e /J 1-4-1,o 04- Date -,Z &( - O '-( PROPERTY OWNERS: — fill >17 /la,r e o -S State of California ) County of 9u � ) On 09- 241— 07<1 before me, n 0111 e - personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and offs ial seal. _ Signature Seal: RICHARD FEUERSTEIN »12sss2s � C/3 Commission v Q- Notary Public -California cn (^ U Butte County A.P. # My Comm. Exp. APR. 13, 2005 Order No. BU -218554-3 AM Description The land referred to herein is situated in the State of California, County of Butte, and is described as follows: . LOTS 1 AND 8, IN BLOCK 88, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF. PALERMO AND SUBDIVISIONS 1 AND 2, WITH ADDITION TO NO. 1 OF THE PALERMO CITRUS TRACT", WHICH MAP WAS RECORDED IN THE OFFICE OF .THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 17, 1888. RESERVING THEREFROM: ALL THAT CERTAIN REAL PROPERTY SITUATED IN THE UNINCORPORATED AREA OF BUTTE COUNTY, CALIFORNIA, BEING A 60 FOOT WIDE NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITIES PURPOSES, ON OVER AND UNDER A STRIP OF -LAND BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: THE NORTHERLY 60.00 FEET OF LOT 1 AND THE NORTHERLY 60.00 FEET OF THE WESTERLY 180.00 FEET OF LOT 8, BOTH IN BLOCK 88, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF PALERMO AND SUBDMSIONS 1 AND 2, WITH ADDITION TO NO. 1 OF THE PALERMO CITRUS TRACT", WHICH MAP WAS RECORDED IN THE OFFICE OF TIS RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON SEPTEMBER 17, 1888. APN 026-030-002-000 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive —' OroviIIe, California 95965 Tel ephone``534-4521 APPLICATION AND PERMIT authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent Date Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By r r ' Date Building permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address Telephone No. ' Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone Na. Permit Fee $ Building Address PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees W. C. Sanitation Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking Plans I Parcel Declaration Parcel Ma p 60' R/W Im rovement. p Lawn sprinkler system 2.00 Bldg. Plans Recd I Parcel Approval Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service incl. 1 meter Additional meters, each 1.00 Sub -panel (12 or less) (more than 12) ; r~ — Single Family ❑ Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1.00 Water Heater or Space Heater 1.00 Light fixtures :5025 a 10 Receps., switches & fix outlets CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump., Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring ❑ 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑1 have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. F -1I certify that in the performance of the work for which this permit .is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. PERMIT FILING FEE $3.00 Heating - ,'il , �., Cooling ' r Ventilation Hood 2.00 Permit Fee $ / $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE ' authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. X Signature of Permitee or Agent Date Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By r r ' Date Building permit expires Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive —; Oroville, California 95965 Tel ephohe: 534-4541 APPLICATION AND PERMIT, BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing ddress = Telephone No. Fireplace Contractor _ _ Total Valuation ` Mailing Address eLe7 tea �,�� Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address OS' PLUMBING No.1 @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 Grrc� Repair drainage or vent piping 1,50 , Water piping 1.50 Each gas water heater or vent 1.50 A. P. No. 1p'— 3 _ Oo2 .( Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fes .C. Sewisa2i�, Fire Dept. Fire Zone Use Permit 4Lawn Building sewer 5.00 EQA Parking Flans Parcel Declaration Parcel Ma p 60"R/W Improvements p sprinkler system 2.00 481d9rRIQ-6-6&_C;d Parcel Approval Plans Approval Permit Fee $ $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3.0-0 Main service incl. 1 meter 00 Additional meters, each 1.00 Sub -panel (12 or less) •(more164KI2) Single Familypa Duplex ❑ Mobil Home ❑ Others ❑ Range, Cook -top or Oven 1,00 Water Heater or Space Heater 1.00 Light fixtures b 270 Receps., switches & fix outlets —bal in CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & P ofessions C e under the name s . I of Hood, Ex. Fan or F.A. Furh: Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pumA -7 0?, 10 Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 '/ C� License No. -24 7 7 7"� Classification Misc. wiring ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ d $ L� MECHANICAL No. @ FEE WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. �I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. ❑1 certify that in the performance of the work for which this permit ,is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California.. PERMIT FILING FEE $3.00 ,7.0- Heating ,OO Cooling Ventilation Hood 2.00 Permit Fee $ /1j%�Sfj I certify that I have read this application and state that the above information is correct. I agree to comply'to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. ' r X Date Signature of Permitee>orr Agent Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant TOTAL PERMIT FEE Is a Od This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By ��i>i"" Date BuUdiWpermit expires Date /9 %