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026-100-005
NOTES I RESIDENTIAL , PERMIT NO. _-026-100-005- - OS -0343 CUNNINGHAM, COOPER i 7095 OCCIDENTAL, PALERMO 1j NEW MH PER PND EX SITE OFFICE COPY Address -70016 vGG�b,LJi'R� l�i9t,�r;90 GAS/off Meter By Date ELECTRIC Z)"7/�{ > Meter By Date // p&i� -fr SPECIAL CONDITIONS RA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 30t -:�gi C- JOB FINALED (Date) Signature CHECKED BY J=OK ) = Not QK . = 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 B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. 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; Scils-Size- Depth -Spacing-Connectors-Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8.Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GR 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-Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date 73. Card B-1 Date Card B-1 Date 74. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Garage Fire Door; Swing -Landing -Closure 24. Fixture & Transformer Clearance -Ins. Protection A.C. Duct in Garage -Damper 25. Elec. Receptacles Spacing -Lights & Switches at Doors Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Size Boxes & No. of Conductors Stapled Plb.; Elec. & Mech. Equip. Listed for Location 27. Romex Installed Close to Edge of Studs & C.J. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Insulation -Foam -Looked in Attic 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Guard Rails & Deck Construction -Post Caps 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No Clearance Looked under Floor ❑ Yes 32. Service -Riser Conductors & Ground Main Disconnect Following Instld./Drive O Yes O No/Walks O Yes ❑ No/Planters O Yes ❑ No 33. Equip. Clearances Panels-Motors-Mech. Equip. Stucco Brown -Finish 34. Clothes Closet Light -Shower Light -Spa Light A.C. Unit Disconnect, Electrical -Plumbing 35. Smoke Detector Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 90. 36. A.C. Ducts Insulation & Support 91. 37. Vent Fan, Exhaust above insulation 92. 38. Condensate Drain & Overflow, Size & Grade 93. 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 94. 40. Attic Access & Platform if Furnace in Attic Date Address Posted Card B-1 Date Card B-1 Date Fire Sprinkler Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Date 41. Sills Proper Materials & Anchors Date 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Comments at Final: 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 -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -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. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 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 #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. Following Instld./Drive O Yes O No/Walks O Yes ❑ No/Planters O Yes ❑ No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire 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 M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHI -CO) OFFICE #: (530) 538-7541 PERMIT NO. BP050343 B. C. Building Permit 01-16-04 pg 1 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: 04/04/2005 APN: 026-100-005-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 7095 OCCIDENTAL AVE PAL Date: Contractor. Map Index: Description: NEW MH, EX SITE, PRM FND OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for- the following reason (Sec. 7031.5 Business and Professions Code- Any city or county which requires a Owner: CUNNINGHAM, DOUG permit to construc(, alter, Improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a P.O. BOX,526 signed statement that he or she Is licensed pursuant to the provisions of PALERMO, CA. the Contractors Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Profes@ions Code) or that he or 95968 she is exempt therefrom and the basis for the alleged exemption. Any 530-534-6811 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as Ihelr sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Applicant: CUNNINGHAM, DOUG Code: The Contractors' State License Law does not apply to an P.O. BOX,526 owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, PALERMO, CA. provided that such Improvements are not Intended or offered for 95968 sale. It however, the building or Improvements are sold within one year of completion, the owner -builder. will have the burden of 530-534-6811 proving that he or she did not build or Improve for the purpose of r+ sale.). l� I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Pgofesslons Code. The Contractors' Stale License Law does Contractor: not apply to an owner of properly 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 un'd'er Article 3 the Business an 1`Pr esslons Code Dale: qf' Owner: License #: WORKERS, COMPENSA ON DE LARATION I hereby affirm under penally 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. Engineer: 111 have and will maintain workers' compensation Insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation Insurance carrier and policy number are: Carrier: Total Square Ft: .1316 S.F. Policy N: Valuation: $85,540.00 Census Code: I certify that In the performance of the work for which this permit Is issued, I shall not employ any person In any manner so as to become subject to 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 o secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one l pC �•') 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. j`►r� (�`' C-J)t (^I' CONSTRUCTION LENDING AGENCY This pe it Is hereby ssued under the applicable provisions of the Butte County Code and/or I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Is Issued (Sec 3097 Clv.) Resolu ork Indicated above for YYhrch fees have been paid. 4-4, Date: • Name: gy; _ PERMIT EXPIRE 0 Address: Dale ' 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. ❑ Notification In accordance with Section 19827.5 of California Health li, Safely 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 form or document of Butte County. I hereby authorize represrMilves of Butte County to enter upon the above mentioned property for inspection purp f Prihl Name: Gt1 Signature: • r Date: wrier ❑ Contractor ❑ Agent for Owner ❑ Agent for Conlrac(or B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 991-2834 BP OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION BIN # Website: www.buttecounty.nettdds "PLEASE PRINT CLEARLY" OWNER Last Name Lv ti t t Name _ A res ewlipu UF City Ste Zip 6 Phone 6_3` IS -Fax J State E-mail APPLICANT SIGNATURE :XT C.- I Li:�� if For office use only: CONTRACTOR Name Flood Zone SRA Address Address City r-1 State Zip Phone Page Fax E-mail Phone 3r l ( 0 Lic. # Class APPLICANT SIGNATURE :XT C.- I Li:�� if For office use only: ARCHITECT/ENGINEER Name Flood Zone SRA Address Address City r-1 State Zip Phone Page Fax E-mail Phone 3r l ( 0 State License Number APPLICANT SIGNATURE :XT C.- I Li:�� if For office use only: APPLICANT NAME Name Flood Zone SRA A Address WORKER'S COMPENSATION r-1 City If hiring anyone other than License contractors, a certificate of worker's compensation must be shown at the time of permit issuance. Map Book Page Sta Zi Phone 3r l ( 0 Date Approved: Fax E-mail APPLICANT SIGNATURE :XT C.- I Li:�� if For office use only: AP# 05, Zoning Flood Zone SRA I Yes No Occ. WORKER'S COMPENSATION Type Const. Subdivision Name If hiring anyone other than License contractors, a certificate of worker's compensation must be shown at the time of permit issuance. Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc LOCATION AP# 05, Property Address C' Cross Street IM,11 SRA WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than License contractors, a certificate of worker's compensation must be shown at the time of permit issuance. (/ l (/ LENDING AGENCY Name Address Description or Scope of Work: Nt7AI- i -I t S iTzS raw\ !=w ri Sq. Footage ❑ Structure Built without Permits ❑ 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 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. Page 1 of 2 REV 7-27-04 Received by: Amount: Bldg SRA Receipt #: Sheriff SMIP ` / 6 Date:2 q Other (/ l (/ Total Page 1 of 2 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 permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 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 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. ❑ 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). ❑ 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. ❑ 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 Carrier and 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 Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: �(it!�W t N(,f,/My� 1/D�/f� -ASSESSOR PARCEL NUMBER 07 -6 -160 -00"y - Proposed ZG1O0-B0"y-Proposed Building Use: A4 Lnt, S ter Technician: C j Date: 2 d in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ite plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 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 ornd p an 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 st be ;tam ed and wet si ned b the en ineer. ood 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 5 Sanitation and site plan approval from the Environmental Health Department in ❑ Chico O Oroville, as applicable. �N 16. Other A --Pe L j t) k?ji2 r i 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........................................................................ es 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: Planning approval (A) Use:(B)Parking: (C) Parcel Check: , 25. Contact Land Development about _ Improvements, _ Drainage ......................... N26. 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 .......................................... N 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: 511 y__G 2 if When issued Telephone ���� 1 and hold for pickup. I have been irrmed of the above items and requirements for obtaining a Applicant: ' .v► ( 1. Index permi plication,f r the aboveite �s ed: 2. Additional items require Contractor, designer, owner, was advis ove data by ❑ phone, ❑ mail, ❑ cou er, by Contractor, designer, own r, as advised of the ab a da t by ❑ phone, ❑ mail, ❑ counter, by Plans reviewed by: Date: 1 2�1 Plans approved by: Structural reviewed by: Date: I Structural approved by: Note transfer by: Date: Yellow: Building Division it. Plan Check Letter Date: Date: Date: Date: COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BL 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TE SCHEDULE OF FEES DUE OWNER. Vv/k�NIN�/may✓) I CG"�L R ^r,� I/�V(� PROPOSED BUILDING, USE Ale'N 041 H . C___7 S !r / r'. -V a:�rl. BUILDING PERMIT FEES --Balance Due ........................................................ $ --Additional Fees Due ............................................ $ --Additional Fees Due ............................................ $ --evised Plan Checking Fee .................................. $ r2.SCHOOL DISTRICT FEES (paid at District Office) 3. SHERIFF FEES (paid at Building Division) Residential .................................... Units Commercial (sq. ft.) ...................... Sq. ft. 4. URBAN AREA FEES Residential ............................ x # Units x $360.00 = $ x $0.03 =, $ Amt. Commercial (Sq. ft.) ............. x = $ Sq. ft. Amt. 5. ' RECREATION DISTRICT FEES 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00.(paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE —0$2500.00 (paid at Building Divisio _ 0. OTHER SM l P 39` At time of permit application, I was advised the above fees are required to be paid prior to issuar may be changed during the plan checking pri�ess. n APPLICANT �7Po5__ 013L/'�; ING DIVISION [ONE (530) 538-7541 A.P.#D*2Z DATE 2— RECEIPT # DATE REC. iA;6 of the building permit. These fees DATE 2 ^ 9 —0� Pursuant to Government Code SectionA66020, you are hereby notified that items 2, 3, 4, 5, 6, 7,18, 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 Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 6/00) '1 BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) Building Permit Numbery5?�33 Property Owner (s) Project Location /Address (, S Subdivision Name Assessable Sq. Ftge 3 Type of Residential Development (check one)! New Development Single Family -Detached Single Family -Attached A,lteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home obile home replacement verified p by Assessor Department Demo Permit (date issued ' b5�) verified by Building Department Comments: 0 FRRPD 0 CARD 0 PRPD ❑ DRPD certifies that: Applicant Name Phone Number Mailing Address City State Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Remarks Dwelling Units @ $ Square Feet @ $ _ per unit for a total of $ per sq foot for a total of $ Zip Paid by Check No: Paid by Cash: and Park District Representative KAFORMSWILDING FORMS\park-rec standard form rev Ldoc Receipt No: t 3ha 1 o Date I BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM✓ x (One form per Building) 4 School District ' �+" 1 V/ Building Department No. 11 V A.P. Number 09 —����—(�( �� Jurisdiction: City "County Property Owner � c (,t^ C' -V I "'— Property Location/Address Subdivision tot No, :.................. ...............................................__............. .... ............. ) - Residential Development Q Sq. Footage 1 No of Living Mobile Home Addition) 'Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation Inspection) ..................................................................... . ............. ti Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q Sq. Footage New Addition (Including Exterior N Roofed Areas) �3& O Building Department Representative Date Dis •ct Identification No. ®� i'nl gSchool District certifies that 1�05s T r � , lCitY) has complied with the requirements of Resolution No. representing / square feet. Paid by Check X Remarks: 0 C) P -,O --r (Applicant) (Phone Number) Oil 12V7 � (State) /Os' -90 2926 FULL Mr1GATiON (Zip Code) by payment of $ Date—T �-o � fel c r�u.�a•, Rte/ i S -�i' �, Notfoe: You may protest the imposition of the fess Identified above by submitting a written protest to the District, in compliance with Govrmment Cods Section 66020(a), within 90 days from the dateless are pall. Fallune to submit a tlmey written protest wlll'prohibit c�U you from challenging the Imposition of the hes In any court action. N, subsequent to the School District Reprsswrtatiw signing this Butte County Schools Impact Fee Certification Form, tit School Dbtrlct Is nolilled by the applicable Local Planning Agency that this project le being rovlewed under the California Environmental Quality Act (CEQA). this project may be subject to additional school hes to fully mitigate.lts Impact on the school distrfeft schools. White (applicant), Yellow (building department), Pink (school district) feeform.* (10/03)dmm rXIMM uwner Location Plan Approved for: Sewage Disposafl----,p Water Su ply: Clearance for dwelling. Other i7 '6') n rXIMM uwner Location Plan Approved for: Sewage Disposafl----,p Water Su ply: Clearance for dwelling. Other i7 '6') qQ "+4 w�,y � y 4!" � :��''•�.4� .,� � ( s yid #' m r y + r F' ,�, - Vo LU cr Cl c7'1 W '` V„ fim t ! Q° 'a ,•s vim`• '+.�' d - a - 9y� AS .'•. Vr b 40 ly • r � K �, •lir o -FF3 ...� �..�+ ; ` r �b .'. n f a {C,71 4',E Ya b ,. 4? �'D "� v'� �, �' �,:.� ����X ik Q_ � 3� �$ �.} _�� �� sem;. 'S •�`� �si f R vi. ..1'sTMENl'10 TTF 0c1 B� 1 O C ,oc0UNIys. L@LIC Department J. Michael Crump, Director Public Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE] Project Description: -,L N.5 /AI I1/xr(� Project Location and/or Parcel Number: -0 2 � —ZX ` DL17 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. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality 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 California 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. f Signed: Title: Date: — J Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 Butte County Department ofDevelopinent Services %03 1' 7 County Center Drive 0 0 Oroville, CA 95965 ° ° (530) 538-7601 Telephone ° ;m ° (530) 538-7785 Facsimile cOUN �y BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: • I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained • I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: kxy c� _ W& I k q hm APN: o Z6 —I 1 00 ^ 003 Building site address: 9 O CC % pl U,7 / Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNATU OF APP ANT DATE Copy to Applicant/EH/File K:Fortes/B1dgPertnitwithoutClearances 020705 o-4.4 NME_%U-1 y°tsr£Hz m .C45f JCCI n<§aFiit "r�GP =�EaC:- Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES 1A NO [ ]. 2. I HAVE V) HAVE NOT [ ) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: DATE: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd ] ] /42004 Butte County Department of Development Services ADMINISTRATION r BUILDING' GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538.2140 Facsimile Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. if-v_� Mic el C. Vieirl C.B.O. Ma5ager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. NOTES F RESIDENTIAL PERMIT NO. I "o 3 oZ ;- l00- C2o3^ C �.�►��.JG�ia,r., , alJv �/mss ?off Occ3;o�,.1�-L k i SPECIAL CONDITIONS SRA ! FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. I SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS t SUB -STANDARD HOUSING LETTER OFFICE COPY Address -70-25- oGC/p, G ELECTRIC Meter By Date 2 � I JOB FINALED (Date) Signature I� CHECKED BY .Y r F RESIDENTIAL PERMIT NO. I "o 3 oZ ;- l00- C2o3^ C �.�►��.JG�ia,r., , alJv �/mss ?off Occ3;o�,.1�-L k i SPECIAL CONDITIONS SRA ! FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. I SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS t SUB -STANDARD HOUSING LETTER OFFICE COPY Address -70-25- oGC/p, G ELECTRIC Meter By Date 2 � I JOB FINALED (Date) Signature I� CHECKED BY 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 B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 5. 7. Water and Sewer Connected -C/O to Grade -HD Approval 6. 8. Gas and Electricity Tagged 7. 9. Tie Downs -Type -Installation Cert. 8. 10. Exits; Insp.-Sketch 9. 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Enclosure; Fencing -Alarms Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Date 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclos fres; 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- Panel boards -Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date 73. Card B-1 Date Card B-1 Date 74. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Garage Fire Door; Swing -Landing -Closure 24. Fixture & Transformer Clearance -Ins. Protection A.C. Duct in Garage -Damper 25. Elec. Receptacles Spacing -Lights & Switches at Doors Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Size Boxes & No. of Conductors Stapled Plb.; Elec. & Mech. Equip. Listed for Location 27. Romex Installed Close to Edge of Studs & C.J. Elec. Receptacles in Garage (FF.I.)-Romex Protection 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Insulation -Foam -Looked in Attic 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Guard Rails & Deck Construction -Post Caps 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No Clearance Looked under Floor ❑ Yes 32. Service -Riser Conductors & Ground Main Disconnect Following Instld./Drive ❑ Yes ❑ No/Walks O Yes ❑ No/Planters 0 Yes ❑ No 33. Equip. Clearances Panels-Motors-Mech. Equip. Stucco Brown -Finish 34. Clothes Closet Light -Shower Light -Spa Light A.C. Unit Disconnect, Electrical -Plumbing 35. Smoke Detector Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 90. 36. A.C. Ducts Insulation & Support 91. 37. Vent Fan, Exhaust above insulation 92. 38. Condensate Drain & Overflow, Size & Grade 93. 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 94. 40. Attic Access & Platform if Furnace in Attic Date Address Posted Card B-1 Date Card B-1 Date Fire Sprinkler Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Date 41. Sills Proper Materials & Anchors Date 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Comments at Final: 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 -Connectors 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -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-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 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 #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes _ 83. Following Instld./Drive ❑ Yes ❑ No/Walks O Yes ❑ No/Planters 0 Yes ❑ No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire 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: f NOTES PERMIT NO. `CUUNNINGHAM, DOUG - 7095 OCCIDENTAL AVE, PALERMO Cont: OWNER DEMO SF CONDITIONS ' SRA ' FLOOD GER TIf (ICATE REQ. I FIRE SPRINKLERS REQ. I SPECIAL INSPEICTION ITEMS VERIFY USE PERMIT CONDITIONS I SUB -STANDARD HOUSING LETTER JOB FINALED (Date) i Signature CHECKED BY 4 O 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 B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. 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.; ?osts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men-Lin.ng 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 62. 15. Access & Ventilation 63. 16. Insulation Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 65. 17. Water Htr.; Vent -Access -Combustion Air Baffle 66. 18. Water Pipe; Test & Anchor -Nail Protection 67. 19. D.W.V.; Test Fittings & Anchor -Nail Protection 68. 20. Shower Pan; Test, First Floor -Tub Access 69. 21. Test Tub & Shower, Second Floor -Tub Access 70. 22. Gas Pipe; Sixe & Anchors 71. 23. Fire Sprinkler; Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Card B-1 Date Card B-1 Date Elec. Outlets & Receptacles at Kit. Counter 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. Size 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-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes ❑ No _ 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 87. Water Well, Disconnect, Electrical, Plumbing Date 88. Card B-1 Date Card B-1 Date 89. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Glass Protection 36. A.C. Ducts Insulation & Support Corrections from Previous Inspections 37. Vent Fan, Exhaust above insulation Gas Test -Meters Tagged, Gas -Electric 38. Condensate Drain & Overflow, Size & Grade Water & Sewer Connected -C/O to Grade -HD Approval 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Energy Compliance Certificate -Other Certificates 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date 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 -Connectors 48. Cling. Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -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-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 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 #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes _ 83. Following Instld./Drive O Yes O No/Walks Cl Yes O No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire 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: itt>!1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BPO50330 B. C. Building Permit 01-16-04 pq 1 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: 02/08/2005 APN: 026-100-005-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 7095 OCCIDENTAL AVE PAL Date: Contractor: Map Index: Description: DEMO SF p 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 Owner: DUNNINGHAM, DOUG to its issuance, also requires the applicant for such permit to file a 2510 PALERMO ROAD signed statement that he or she is licensed pursuant to the provisions of PALERMO, the Contractor's State License Law (Chapter 9 commencing with Section CA 7000) of Division 3 of the Business and Professions Code) or that he or 95968 she is exempt therefrom and the basis for the alleged exemption. Any (530)534-6811 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: DUNNINGHAM, DOUG Code: The Contractors' State License. Law does not apply to an owner of property who builds or improves thereon, and who does 2510 PALERMO ROAD such work himself or herself or through his or her own employees, PALERMO, CA provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 95968 year of completion, the owner -builder will have the burden of (530)534-6811 proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Pfofessions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). C ❑ 1 am Exempt under Article 3 he Business nd Professi ns Code Date: 2 Owner: License #: WORKERS' COMPENSATIO ECLARAT N I hereby affirm under penalty of perjury one of the following declarations: 111 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. ❑ 1 have 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: Carrier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 certify that in the performance of the work for which this permit is Census Code: Id1 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, , I and agree that if I should become subject to the workers' `-r j compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. COate: J Vl/ Applicant: WARNING: Failure t secure wor rs' 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 This permit is hereby issued under the applicable provisions of the Butte County Cod and/or I hereby affirm that there is a construction lending agency for the RM'o do work i dicated or which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) �s Name: B U PERMIT EXPIRES ON: Address: D e Cl I 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 He County. I hereby authorize repr tatives of But unty to enter upon the above mentioned property for inspection purp Print Name: v` Signature: Date: ❑ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pq 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" 121YRR, TA NozNFA!les!. For office only: OWNER Las Na a 7 1 irst a Address City City State St Zi Phone 53 6 Fax E-mail Lic. # 121YRR, TA NozNFA!les!. For office only: CONTRACTOR Name , Ida Address SRA Yes City Occ. State Zip Phone Page Fax E-mail Date Approved: Lic. # Class 121YRR, TA NozNFA!les!. For office only: ARCHITECT/ENGINEER Name , Ida Address SRA Yes City Occ. State Zip Phone Page Fax E-mail Date Approved: State License Number 121YRR, TA NozNFA!les!. For office only: APPLICANT NAME Name 0 u 67 , Ida Address e SRA Yes City Occ. Sete Subdivision Name Map Phone _ Page Fax E-mail Date Approved: 121YRR, TA NozNFA!les!. For office only: Zoning Prerty ddress 0-c; Flood Zone Cross Street , SRA Yes No Occ. Type Const. Subdivision Name Map Book Page T707 Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BP ds'o33 BIN # LOCATION AP# 0 o 0 Prerty ddress 0-c; Cit Cross Street , WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Descriptio or Scope of Work: 1 Sq. Footage ! ❑ Structure Built without Permits ❑ 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 Page 1 of 2 REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by Amount: Bldg SRA Receipt #: q l g T 7✓ Sheriff SMIP Date: 1 Other &77b " Total 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 permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 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 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. ❑ 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). ❑ 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. ❑ 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 Carrier and 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 Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 OWNERBUILD`ER `VERIFICATIONs Attention Property Owner: An: `owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the ajor labor and material for construction of this proposed property improvement: YES ] NO [ ]. 2. I HAVE [] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS SIGNED: PROPERTY OWNER: PHONE TYPE OF WORK DATE: _1Z — 5" O�y V NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION * BUILDING * GIS * PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile (OWNER BUILDER INFORMATIONS Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensedpersons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. ly, Z Milael C. Vieiri C.B.O. Ma ager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. Demolition Permits Asbestos Notification Statement Date AP# Pursuant to section 19827.5 of the California Health and Safety Code, all demolition permit applicants are required to fill out this form. "19827.5. A demolition permit shall not be issued by any city, county, city and county, or state and local agency which is authorized to issue demolition permits as to any building or structure except upon the receipt from the permit applicant of a copy of each written asbestos notification regarding the building that has been required to be submitted to the United States Environmental Protection Agency or to a designated state agency, or both; pursuant to Part 61 of Title 40 of the Code of Federal Regulations, or the successor to that part. The permit may be issued without the applicant submitting a copy of the written notification if the applicant declares that the notification is not applicable to the scheduled demolition project. The permitting agency may require the applicant to make the declaration in writing, or it may incorporate the applicant's response on the demolition permit appli- cation." Attached is a copy of my written asbestos notification to the United States Environmental Protection Agency for the demolition project located at I Signature of Applicant 6R I hereby declare that a written asbestos notification to the United States Environmental Protection Agency is not applicab o this demo lproject. ti Signa re of pp icant 2/19/91 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Read the irt*udons on pages 1- 7. O.M.B. No. 3067-0077 Expires December 31, 2005 SECTION A - PROPERTY OWNER INFORMATION I For►nsuranoe Company use: BUILDING OWNER'S NAME I Pol'rcv Number BUILDING STREET ADDRESS (Including Apt, Unit Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number 7095 Occidental Ave CITY STATE ZIP CODE Palermo CA 95968 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 026-100-005 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, eta Use a Comments area, if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL'DATUM: SOURCE: ❑ GPS (Type): ( sf - ## - ##.W or ##.#####) ® NAD 1927 ❑ NAD 1983 . ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2 COUNTY NAIVEI � STATE Butte Counly Unkorporal ed Areas No. 060017 - Butle 84. MAP AND PANEL 87. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER 85. SUFFD( 1 86. FIRM INDEX DATE EFFECTNEREVISED DATE B8, FLOOD ZONE(S) (Zone A0, use depBr of lbodrg) 06007985 C JM8198 Jun 8,98 AH 157.5 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 139, ❑ FIS Profile - ® FIRM ❑ Community Determined ❑ Other (Describe): _ 811. Indicate the elevafioi datum used for the BFE in 89: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building loud in a Coastal Barrer Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construrdion Drawings* ® Building Under Conshvction* ❑ Finished Co sM don *A new Elevation Certificate will be required when construction of the building is eorro4e. C2. Building Diagram Number 8 (Select the building diagram most similar tote building for which this certificate is being completed - see pages 6 and 7. K no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations—Zones A1 -A30, AE, AH, A (with BFE), VE, V1 430, V (with BFE), AR, ARIA, ARAE, AR/Al", ARIAH, ARIAO Complete Items C3. -a4 below according to the building diagram specified in them C2. State the datum used. If the datum is oftwt from the datum used for the BFE in Section B, convert the datum to that used for the BFE Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum navd 29 ConversionlComments NA Elevation reference mark used BCBM 597 Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No o a) Top of bottom floor (induding basement or enclosure) 156. ff ft(m) o b) Top of next higher floor 158.50 ft(m) o c) Bottom of lowest horizontal structural member (V zones only) NL. ft(m) �W o d) Attached garage (top of slab) NA. _fit(m) $ D o e) Lowest elevation of machinery and/or equipment w `° servicing the building (Describe in a Comments area) 157.50 ft(m) a= E o t) Lowest adtaoent (finished) grade (TAG) 156.25 ft(m) z' 0 o g) Highest adtaoerht (finisthed) grade (HAG) 156. 40 ft(m) C N o h) No. of permanent openings (flood vents) within 1 ft above adacent grade 12 8 j o ) Total area of all permanent openings (flood vents) in C3.h 1200 sq. in. (sq. cm) AJ SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. ' � 1 understand that any false statement may be punishable by fine or im tisonment under 18 U.S. Code, Section 1001. CERTIFIERS NAME Frank James Pursell LICENSE NUMBER 60924 TITLE RCE COMPANY NAME Jim Pursell M 1 80n fi5 Madrahe Ave. SIGNATURE CITY Oroville STATE ZJP COIF CA 95965 TELEPHONE 530.533-2131 FEMA Form 81.31,,Jal.>Y 20Q�3,1 continuation. Replaces all previous ., _., See reverse side for copy IMPORTANT: In these spaces, copy tete corresponding information from Section A- For framance Company use: BUILDING STREET ADDRESS (Inds av Apt, ung, We, and/or Bldg. No.) OR P.O. ROUTE AND BOX N0. Ply Num 7095 Occidental Ave CITY STATE ZIP CODE Palernm CA 95968 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE1 For Zone AO and Zone A (without BFE), complete items E1 through E4. ff the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number_(Seled the building diagram most similar to the building for which this certificate is being completed – see pages 6 and 7. ff no diagram aocura* represents the buik6ng, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, tf available). E3. For Building Diagrams 6$ with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft(m) _in.(crn) above the highest a4acent grade. Complete items C3.h and C3.i an front of form. E4. The top of the plafform of machinery andtor equipment servicing the building is _ ft(m) ^in.(an) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's lkrodplain management ordinance? ❑ Yes E_ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zane A (without a FEMA4ssued or community - issued BFE) or Zane AO must sign here. The statements in Sections A, A G and E are correct to the bestofmyk miedge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME Cooper Cunningham ADDRESS CITY STATE ZJP CODE 7092 Irwin Ave. Palermo CA 95968 SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The kcal official who is authorized by law or ordinance to administer the community's floodplain management ordnance can complete Sectiorns A, B, C (or E), and G of this Elevation Certificate. Complete the applicable iterrn(s) and sign below. G1. ❑ The infomnation in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation irtfo matiorn. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA4ssued or commun"ued BFE) or Zane A0. G3. ❑ The fbibMng information (Items G4 -G9) is provided fox community floodplain management purposes. G7. This permit has been issued for. ❑ New Construction ❑ Substantial improvement G8. Elevation of as -built lowest floor (inducting basement) of the building is: — _ft{m) Datum: _ G9. BFE or (in Zone AO) depth of flooding at the building site is: — _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS Check here N attachments FEMA Form 81-31, January 2003 Replaces all previous editions ,. �. - tr „ i'", t' .; x r? r ..: .+, .i •' ate{ .� � .-+' - x "' +�'. r _ K 2�� t.• Yui, Y' _ I Lf i'E ��1y�.....q(}f+4. a3 `i �,�. ��. � ii • y � � � � { t �-. S t .:. �#; + J � � �. t � �5c: yr- �ti.,� �" t ,,•� � �' t x a,r � � =x. _ r �{ .��-,ir'� � �� .r WE.s.; oo < t Vt � n � �r `, �,� �� � � •* fh i' t s t � � ��� „ xr'tIF«"`� } i ^'t" ux ••}�'�'�, .x to r r� � r� r .r."+'eEk>�'ni► �+.a '�+�.'' �' w.akfc�' C y ',��rx}•LXr� _ �k � r tY t � y�`�� -�,. � � � �Yt* 4 �.�n � "a'4': s-r Y � •. A• � �' ; �` E •1 < �y r'7yi!• `t Y� S '�' �'"�r ' " � i+j+�4�+3c�►r. ! • fV C '' ' w � � �` 4 �" • t h.i�:r T ,�� �1 � ?k xlRD '�Y i1A t ,;�' +# ., v �' �u ;j r � � :.P� > �'� � •�• �:`�R +i-�"•-L �'F-rax 4 �`,* � '� * .. k - �` cif 'i," } n :T t t #-` }•T`j! _ zs �. 1 . . z r#W er1 4j ti -t,� � *�- � ZR i fly 4s i i K i i� JI Zt ,�, �� : f Y4i`.. � . �t .+ t � � " � � '• ,� ; .. �, '�'r' i r � : fix'} 5: ' {�. L. f x't t �, + - ,z�,` t '• ; k t# JLot '.e t.ti ....*��.. x �ry=� ..•� £-.µL"'�, 'Sa a` •�c. „�'�, t�'f'.; BUTTE COUNrp APPRO�ED11 23-r /A r s r - O r r O a.' +000e r Tr ,7 m O O O Y Y .. O A s M c g i - _o SII Y Y Y O 0 oo o e e o o 0 o r 0c i o T s s O t T o BUTTE COUNrp APPRO�ED11 23-r /A 3 Tr ,7 m N r A i - c � o Z c BUTTE COUNrp APPRO�ED11 23-r /A Vector Dynamics Foundation System INSTALLATION INSTRUCTIONS for the State of California Version 9/212003 INDEX COMPONENT PARTS AVAILABLE UPON REQUEST Approval ] UMWACn3RBD AOMBMMOMM BOMATION SYM M =4WVW$AMYC0D%8==19n AffgOVW WB�CTToCORTZ MONSNOTO AWRWAL DOBE NOT AUTROMM OR AMOW Al MONS OR nBYIA?ION FROM RBQUMOMM ASPIdfiAM STAIS LAWS AND RBGV Obft araucarwa _ =d =1 BUTTE a RUILDING kr ,, .. cli Atlanta GA, 30336 ,, TIE;:`C) PAGE RELEASE SECTION NUMBER DATE INTRODUCTION 2 9/2/03 GENERAL INSTALLATION 3 9/2/03 PARTS LIST 4 & 5 9/2/03 LONGITUDINAL DEVICES 6 9/2/03 PIER HEIGHTS 7 9/2/03 SET-UP INSTRUCTIONS 8 9/2/03 FOOTER SIZES WIND ZONE I - SINGLE 9 9/2/03 - DOUBLE 10 9/2/03 - TRIPLE 11 9/2/03 - HIGH PIER 12 9/2/03 WIND ZONE II - SINGLE 13 9/2/03 - DOUBLE 14 9/2/03 - TRIPLE 15 9/2/03 V -DRIVE & PIER SYSTEMS 16 9/2/03 SOIL CLASSIFICATION 17 9/2/03 CONCRETE INSTALLATION 18 & 19 9/2/03 COMPONENT PARTS AVAILABLE UPON REQUEST Approval ] UMWACn3RBD AOMBMMOMM BOMATION SYM M =4WVW$AMYC0D%8==19n AffgOVW WB�CTToCORTZ MONSNOTO AWRWAL DOBE NOT AUTROMM OR AMOW Al MONS OR nBYIA?ION FROM RBQUMOMM ASPIdfiAM STAIS LAWS AND RBGV Obft araucarwa _ =d =1 BUTTE a RUILDING kr ,, .. cli Atlanta GA, 30336 ,, TIE;:`C) Tie Down Engineering, Inc. VECTOR DYNAMICS INSTALLATION DESIGN INSTRUCTIONS Introduction These instructions describe the proper use of the lateral and longitudinal foundation system. You may also refer to the home manufacturer's installation manuals that include the Vector Dynamics system as an alternate foun- dation system. General The Vector Dynamics Foundation System provides the support to resist lateral, longitudinal and over -turning movement of the home as required by the Federal Manufactured Home Construction and Safety Standards in a specified wind zone when the system is used as described in these instructions. Please verify state or local wind load requirements prior to installation of the home. The Vector Dynamics Foundation System resists lateral & longitudinal wind & seismc loads by anchoring the two longitudinal main rails. The system is approved to be used on single or multi section homes: Nominally 12 feet to 16' feet wide- (single section) with main rail spacing of 95 inches or greater on center; multi section main rail spacing of 75 inches or greater on center. Nominal 8 foot or less top plate height at sidewalls with main rail depth of 12" or less. Maximum roof slope of 20 degrees (4.4" in 12" slope). Maximum eave width (roof overhang of sidewall) of 12" for Zone I, 8" fo Zone II Maximum pier height under main rails -see page 7. The Vector Dynamics Foundation Systems may be used as a part of the vertical or gravity support system con- sidering that each Vector Dynamics pad has two (2) or (3) square feets bearing area. To inquire about the use of the Vector Dynamics Foundation Systems with homes of four or more sections, other widths, or on homes requiring pier heights which are not included in these instructions, contact Tie Down Engineering, Inc. at 1-800-241-1806. The Vector Dynamics Foundation System has not been designed for use on exposure "D" homes within 1500 feet of the coastline. Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, end frame ties and rim plates. Page 2 California 9/2/03 GENERAL INSTALLATION INSTRUCTIONS SITE PREPARATION It is necessary that the home site be properly graded and sloped to prevent water'and moisture from standing or flowing beneath the home. FOOTINGS AND FROST LINES The Vector Dynamics Foundation System was designed to be placed directly on top of the ground (or poured concrete) after clearing all loose vegetation. In areas with frost heave, use Vector for Poured Concrete (see pages 20 & 21) to comply with local requirements for footer depth. FOUNDATION/FOOTING SPECIFICATIONS FOR VECTOR PADS Vector Pads are used in place of conventional foundation pads. One Vector pad provides two or three square feet of bearing support. Vector Systems should be spaced as symmetrically as possible along the length of the home. For pier locations in between the Vector Systems, use the normal foundation pads. LUMBER/MOISTURE - TERMITE SHIELD To cut PVC or lumber (2 - 2x4's,1 - 44 or 1 adjustable steel commpression member per Vector system) for the center compression section,when using concrete blocks for piers, measure center, to center frame (I-beam) dis- tance and subtract 16". When using METAL PIER STANDS, measure center to center frame distance and add 16". ALL WOOD MUST BE PRESSURE TREATED, GROUND CONTACT RATED. Tip: Pre-cut your lumber and mark as to brand or model of homes you will be installing. If frame widths are the same, the pre-cut boards will also be the same length in each Vector set-up. STRAP INSTALLATION All frame ties and diagonal straps must go from the anchor to the top of the I -Beam. See illustration below. 1. Attach frame hook to top inboard location of "I" beam. (Frame hook must be attached to frame at points closest to floor support.) i 2. Keeping in line with the hook, wrap galvanized strap completely around "I" beam. 3. Pull strap past anchor head approximately ten inches before cutting to allow enough strap to give a minimum of five turns around the slotted anchor bolt. 4. Thread loose end through slotted bolt so that the strap is flush with the other side of the bolt. 5. Tighten slotted tensioning bolt a minimum of five full turns. Page 3 California 9/2/03 .Vector Dynamics Foundation Systems Lateral Component Parts List Vector System Lateral Stabilization Block Pads #59018 - 2 sq. ff. single/double block pads with hardware, swivel straps and slotted bolts Vector System Lateral Stabilization for Concrete # 59036 - Single (only) block pads with hardware, swivel straps and slotted bolts. # 59049 - Double block pads with hardware, swivel straps and slotted bolts. Vector System Lateral Stabilization For Difficult/Rocky Soils # 59287 V Drive System Must be used with: # 59018 - Vector for single/double block pads 3 Sq. Ft. Pad Vector System # 59271 - Vector 3 sq. ff. pad (2 required) # 59024 -Vector Lateral Hardware Kit, includes PVC adapter. Strap/Swivel Strap Connectors & slotted bolts not included. oru- Page' 4 California 9/2/03 14 Vector Dynamics Foundation Systems Longitudinal Component Parts List ILI Page 5 Longitudinal Stabilization Hardware Kit. # 10733 - (for use with. 59018 Vector System, single stack blocksets only. Longitudinal struts not included) Longitudinal Stabilization Hardware Kit for Concrete # 59023 - Includes 2 beam clamps, tension brackets, nuts and bolts. (for use with #59036 & 59049, longitudinal struts not included) 3 Sq. Ft. Pad Vector Longitudinal System # 59026 - Includes 2 beam clamps, 2 tension brackets, nuts & bolts. (for use with #59271, longitudinal struts not included) Struts for Longitudinal Systems Part No. Length Pier Height # 59016 30" up to 2 Blocks # 59012 39" up to 3 Blocks # 59013 44" up to 4 Blocks # 59014 53" up to 5 Blocks # 59015 65" up to 6 Blocks PVC Adapter Bracket # 59281 - For use with Schd 40 PVC Center Compression Strut # 48612 - Single Section, 62"- 108" # 48613 - Double Section, 34"- 60" (includes short u -bolts, nuts, washers and 6 self taping screws) California 9/2/03 Longitudinal Stabilizer Devices The use of LSD systems on a single or multi section home replaces longitudinal anchors, stabilizer plates and straps. The Longitudinal Stabilization Device (LSD) is used with the Vector Dynamics System to resist loads in the longitudinal direction (short dimension) of home. The number of LSD required is shown on pages 10-13. LSD Combine Vector Dynamics 1. Longitudinal Foundation Pad 2. Beam Clamp (2 per system) 3. Longitudinal Strut (2 per system) 4. Tie Bracket (2 per system) Note: Two struts =1 L.S.D. system. Can be used on one pad or slipt on opposite ends of the home. Examples of Possible Placement: (Contact TIE DOWN for placment in other Wind Zones) Wind Zone I Single Section I I I I I I I I I I� I I I I I I I I I I I I Wind Zone ( - Double Section 18 Ft. Max. 32 Ft. Max. Forgreater widths use triple section design. Wind Zone I Triple Section 48 Ft. Max. Wind Zone I Tag Section Page 6 . California 9/2/03 50 in max. Maximum Pier Height Vector Dynamics Foundation Systems may be used on single section homes in Wind Zone I which require pier heights (from surface of Vector pads to top of concrete or metal pier) not to exceed 50 inches under one or both main rail(s). Note that a ground anchor must be used at each Vector system location where the pier height exceeds 24 inches for single section homes. On multi -section homes in Wind Zone I, an anchor must be used at each Vector System location with pier heights above 46" with the following exception: double section homes that are 24' wide, in Wind Zone I, have a maximum pier height without anchors of 38". See page 12 for double section home high pier set instructions. 50 in max. Unequal Pier Heights 4aximum Homes with unequal pier heights are limited to 50" maximum pier height. The difference between the taller pier and the shorter pier cannot exceed 26". � 0, <Ku Page 7 California 9/2/03 Set -Up Instructions for Vector System -#59018 A Long U -Bolts 1. Set Vector Pads Clear all vegatation wheret pads will rest. Place along U -bolt in pad as shown. Press or ham- mer pad into the ground. 2. Set Block or piers on pads. Center foundation blocks or piers on pads. Place pre-cut center compression member between blocks, resting cn pads, centers between U -bolts as shown. 3. Outside Tension Bracket Attach outside tension bracket as shown to out- side of pads. Page 8 4. Inside brackets & straps Attach the inside tie brackets to the U -bolts over the compresion member. Attach a strap w/hook or swivel strap w/nut & bolt. Place other end of the strap over opposite 1 -bear & down to out- side tension bracket. Cut strap 12 - 15 inches past bracket. Attach strap & sotted bolt in bracket. Tighten strap until tight with 4-5 wraps around bolt. Repeat with opposite strap. California MMIX W Note: L.S.D.= Longitudinal Stabilization Device See Page 6. w K 0 sv' WIND ZONE I \2 sq. ft. pad/ Soil Classifications: Soil Bearing Capacity: Anchors Required: 2 �. mac. tyP tt mom, o.c.�1P NOTE: Vector. Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers' 2, 3, 4A, & 4B instructions and/or state requirements. 1,000 PSF minimum 30" with 2-4" helix anchor (59095), 12" stabilizer plates (59292), 1-1/4" frame ties Home Length Vector Systems Required Anchors Required Per Side or 24 Pier 24+" Piers L.S.D. 0 to 72' 3 2 3 2 73' to 90' 4 3 4 2 WIND ZONE 1, SEISMIC ZONE 4 Vector Dynamics, Systems Required for Single Section Homes I (Materials Required) - \ klome 1 ft sing section . _ 711 01 a 01- " Jaz ' 04 3 - — r K. .n W Note: L.S.D.= Longitudinal Stabilization Device See Page 6. w K 0 sv' WIND ZONE I \2 sq. ft. pad/ Soil Classifications: Soil Bearing Capacity: Anchors Required: 2 �. mac. tyP tt mom, o.c.�1P NOTE: Vector. Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers' 2, 3, 4A, & 4B instructions and/or state requirements. 1,000 PSF minimum 30" with 2-4" helix anchor (59095), 12" stabilizer plates (59292), 1-1/4" frame ties Home Length Vector Systems Required Anchors Required Per Side or 24 Pier 24+" Piers L.S.D. 0 to 72' 3 2 3 2 73' to 90' 4 3 4 2 Each Vector System requires one of the following: 1-44 or 2-2x4's pressure treated wood compression member, Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) -o w CD 0 CJ w 0 Lis WIND ZONE 1, SEISMIC ZONE 4 Vector Dynamics Systems Required for Double Section Homes e (Materials Required) _ - _ - _ _ - " ' _M;on h°m _ - NOTE: Vector Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers' instructions and/or state requirements. No anchors required. For pier heights up to 46" for WIND ZONE 28'-36' wide, 38" for 24' wide. See Pg 12 for high pier instructions. 2 sq. ft. pad Soil Classifications: 2, 3, 4A, & 4B Soil Bearing Capacity: 1,000 PSF minimum Anchors Required': None ('Marriage wall anchors may be required by home manufacturer) Home Length Vector Systems Required Anchors Required Per Side L.S.D. 0 to 40' 2 0 2 41' to 66' 3 0 3 67' to 84' 4 0 4 85' to 90' S 0 4 Each Vector System requires one of the following: 1-4x4 or 2-2x4's pressure treated wood compression member, Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) Note: L.S.D.= Longitudinal Stabilization Device See Page 6. WIND ZONE I SEISMIC ZONE 4 - "-" - �orhomsems- I Vector Dynamics Systems Required for - - _ - ' _ - - " , _ _ - 'Irofit mu�t� Seo t�ectc� sy - _ % ` \\ nc Triple Section Homes ' - - _ - ' ' " �e o� e�gva%,Ns Sp (Materials Required) - - - -K _ anon shO NOTE: CD When a pier height at Vector locations exceeds 46", an anchor must be used on the outside wall/beam at that approximate location. NOTE: Vector Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers' instructions and/or state requirements. Tag ori► full triple C5 - ►� 2 sq. ft. pad 2 sq. ft. pad Soil Classifications: 2, 3, 4A, & 4B Soil Bearing Capacity: 1,000 PSF minimum Anchors Required*: None (*Marriage wall anchors may be required by home manufacturer.) Home Length Vector Systems Required Anchors Required Per Side LSD Main TAG 0to48' 2+2 on Tag 0 2 1 49'to71' 3+2 on Tag 0 2 1 72'to84' 4+2 on Tag 0 2 2 85' to 90' 5+ 2 on Tag 0 2 2 Each Vector System requires one of the following: 1-4x4 or 2-2x4's pressure treated wood compression member, Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) >y CD Na Iv -- -- WIND ZONE I, SEISMIC ZONE 4 (High Pier Sets) _ - - -- I , Vector Dynamics Systems Required for Double Section Homes ` (High Pier Sets with Diagonal Ties) t,O� h°me --_"dou b1e Sec NOTE: Vector Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers' instructions and/or state requirements. WIND ZONE I Max. Height Unit Width 129 See Page 7 c� N CD ? I -Beam CAJ spacing R2 sq. ft. pad • 0 to 48' .2 2 2 49' to 71' 3 3 3 72' to 84' 4 4 4 85' to 90' 5 5 4 Soil Classifications: 2, 3, 4A, & 4B Soil Bearing Capacity: 1,000 PSF minimum Anchors Required*: 30" with 2-4" helix anchor (59095), 12" stabilizer plates (59292) 1-1/4" frame tie with connector Each Vector System requires one of the following: 1-44 or 2-2x4's pressure treated wood compression member, Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) WIND ZONE 11, SEISMIC ZONE 4 (Hurricane) Vector Dynamics Systems Required for Single Section Homes (High Pier Sets with Diagonal Ties) ,e se6o or s1st ... al guide\fines ' - - - o{ a �2 �a sPacinme°o stallat,On V in EXampSh°Ws 9mtjst be to h° _ - = OLnd spa°in9 n pas 1 3 i I EEW501-6 ........... . wi CD 24" N O w f WIND ZONE II (not to scale) Soil Classifications: Soil Bearing Capacity: Anchors Required*: 2,3, 4A & 4B 1,000 PSF minimum 30' with 4' helix anchor (59095), 1-1/4' vertical ties w/4725 lbs. min. breaking strength. Home Length Vector Systems Required Anchors Equired per side LSD 0to48' 3 5 2 49' to 60' S 6 2 61" to 72' 6 7 2 73' to 84' 7 8 2 85' to 90' 8 9 2 2K m�c.�YP• NOTE: Vector Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers' instructions and/or state requirements. Maximum allowable working drag load for the Vector System with steel compression strut is 4,000 lbs. per the K2 Engineering test report. Each Vector System requires one of the following: �2 sq. ft. pad 1-4x4 or 2-2x4's pressure treated wood compression member, Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) co cc CD n co WIND ZONE 11, SEISMIC ZONE 4 Vector Dynamics Systems Required for _ " _ - ' " - - n h°me s ' • es• Double Section Homes - ' - oe se0vectot s ma0Ual g��de,�� - = NOTE: Vector Systems should be spaced as symmetrically as possible along the length i home. Pier spacing must be consistent with manufacturers' instructions and/or state req Maximum allowable working drag load for tl System with steel compression strut is 4,001 the K2 Engineering test report. WIND ZONE II (not to scale) bon bearing capacity: 1,uuu F'bl- minimum Anchors Required*: 30° with 4° helix anchor (59095), 1-1/4° vertical ties w/4725 lbs. min. breaking strength. Home Length Anchors Equired per side Vector Systems Required LSD 0to48' 4 4 3 49' to 60' 5 5 3 61" to 72' 6 6 3 73' to 84' 7 7 4 85' to 90' 8 8 4 Each Vector System requires one of the following: 1-4x4 or 2-2x4's pressure treated wood compression member, 2 sq. ft. pad Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) WIND ZONE II, SEISMIC ZONE 4 Vector Dynamics Systems Required for - -eckxo 7g ft t SIS ma in9 for V ,l I 1 o1 a ®rad sP - '�}� ` ♦ I ` "ampies strat�O V\ s ♦ — — — — —� - EX hoW $ ' �3ic�gd3. '.'i. ♦ I . . 1 ♦ ♦ ♦ I �u�ii ♦ ,, i � s M f� 1j ♦ '� fit` I � ,"' . � }4 ��b3i �{ t � ♦ I ,r- s E e Triple Section Homes (Materials Required) r NOTE: When a pier height at Vector locations exceeds 46", an anchor must be used on the outside wall/beam at that CD approximate location. 1 NOTE: Vector Systems should be spaced as symmetrically as possible along the length of the home. Pier spacing must be consistent with home manufacturers' instructions and/or state requirements. Soil Classifications: Soil Bearing Capacity: Anchors Required*: Tag or �• 2, 3, 4A, & 4B full triple 1,000 PSF minimum 3/4" x 30" with 4" helix anchor (59095) 1-1/4" vertical ties w//4725 lbs. min. breaking strength. Home Length Vector Systems Required Anchors Required Per Side LSD Main TAG 0to48' 3+2 on Tag 4 2 1 49'to71' 4+2 on Tag 6 3 2 72'to84' 4+3 on Tag 7 3 2 85'to90' 5+3onTag 8 3 2 Each Vector System requires one of the following: 1-4x4 or 2-2x4's pressure treated wood compression member, Schedule 40 PVC Pipe or 1 adjustable steel compression (see parts list) 2 so. ft. Dad 2 so. ft. Dad Vector Dynamics Metal Pier & V -Drive Installation METAL PIER FOUNDATIONS For metal piers, place the piers in the center of the Vector pads. Set the single 44 or two 2x4's through the piers, centered in the U - bolts. Outside Tension brackets attach the same, Inside tie brackets mount "upside down" as shown in drawing. Metal piers using the Vector System can only be used on level ground sets. Conventional pier adjusters must be placed under beam with upturned edge directed towards the outside of the home. Pier spacing must be consistent with home manufacturers' installation instructions and/or state requirements. To cut lumber (2 - 2x4's or 1 - 44 per, or 1 adjustable steel commpression member, part #59043 Vector system) for the center com- pression section, when using METAL PIER STANDS, measure center to center.frame distance and add 16". Optional Moisture Termite Shield may be required in certain regions. ALL WOOD MUST BE PRESSURE TREATED, GROUND CONTACT RATED. Tip: Pre-cut your lumber and mark as to brand or model of homes you will be installing. If frame widths are the same, the pre-cut boards will also be the same length in each Vector set-up. V-1 for rocky sc re used only in tion homes. V -Drive anchors are used only in Zone I, single section homes in areas where rocky soil conditions do not allow helix style anchors to be installed. Vector Systems are set following the general set up instructions provided. With the V -Drive anchor, the short 2x4 boards used with the outside tension brackets are discarded. In place of the short 2x4's, a longer 2x4 is used as per the diagram above. This 2x4 board should extend from the base of the Vector pier set to 5 inches from the side wall of the home. Place the V -Drive head over the end of the longer board. Using a heavy hammer or electric hammer gun, drive the three V -Drive anchor rods through the V -Drive heads at an angle of approximately 45 degrees under the home. The rods must come to a complete stop on the V -Drive head. Attach a strap with hook or buckle to the frame and attach to the V -Drive head with a slotted bolt. Cut the strap end about 12 to 15 inches past the anchor head to allow at least four or five wraps around the slotted bolt. Continue tightening strap until all slack is out and strap is tight. f Page 16 Californias 2/03 c^•i, . r VECTOR DYNAMICS INSTALLATION DESIGN INSTRUCTIONS I Vector Dynamic Foundation Systems may be used only on homes set on soils classified as Class 2, 3, 4A and 4B as described in the table below: SOIL CLASSIFICATIONS Soil Class Types of Soils Blow Count (ASTM i Soil Test Probe (1) D2586) Torque Value (2) 1 Sound hard rock...... NA I NA Very dense and/or 40 -up More than 550 lbs - in. cemented sands, coarse 2 gravel and cobbles, preloaded silts, clays, and corals I Medium -dense coarse 24-39 350-549 lbs - in. 3 sands, sandy gravels, very stiff silts and clays I 4A Loose to medium dense 14-23 275-349 lbs - in. sands, firm to stiff clays 4B and silts, alluvian fill 175-275 lbs - in Peat, organic silts, 0-44 j 175 lbs - in. 5 inundated silts, loose fine and lower sand, alluvium, loess, j varied clays, fill, fly ash. i (1) The purpose of the soil test probe is to gauge the strength of the soil below the surface and near the anchor's helical plate. The strength of the soil is estimated in terms of its resistance to penetration (flow) under load by means of the torque probe and is measured in Ib -in. The testprobe has a helix on it. The overall length of the helical Section is 10.75 in.; the major diameter is 1.25 in.; the minor diameter is 0.81 in.; the pitch is 1.75 in. The shaft must be of suitable length for anchor depth. (2) A measure synonymous with moment of a force when distributed around the shaft of the test probe. Vector Foundation Pads Equivalent to Footer Pads* Footer Size: Footer Size: , 16x16 = 256 sq. in. 20x20 = 400 sq. in. or 16x18 = 288 sq. in. _ or 17x25=425 sq. in. EQUALS - = ® EQUALS -_ 2 -Vector Pads # 59275 = 1 -Vector Pad # 59271 288 sq. in. or 432 sq. in. 1 Vector Pad # 59130 Vector Pad(s) exceed the surface area required when used as the equivalent listed above. *Foundations in soil with a bearing capacity of less than 1,000 PSF must be designed by a Registered Professional EWinee, amiliar with site conditons I Page 17 California j 9/2/03 Vector Dynamics System for Concrete Applications Instructions These instructions are an addendum to the standard Vector Dynamics instructions. Read and follow all applicable instructions and guidelines in the Vector instructions and home installation manual. The Vector system for concrete pads applies to concrete footers, runners and slabs. Minimum size of concrete per Vector pier is 24"x24" x 4" or 18" round (min) x 10" deep. The bottom of footers must be below the frost line or a minimum of 4" below finished grade whichever is greater. Concrete must be sufficiently cured and set to accommodate an anchor bolt to its' full load resistance. 1. Determine location of pier sets where the Vector systems will be located. 2. Place one Vector concrete pad (galv. metal) on the concrete where the pier will be located, centered under the* I-beam of the home. Place the upturned edge towards the center of the home and directed to the opposite Vector pier. Do the same for the opposite Vector pier. 3. Measure the distance between the two Vector system pads at the base where the Vector pad meets the concrete. Cut two ground treated 2x4's or Schedule 40 PVC pipe, or 1 adjustable steel commpression member, part #59043 this length and place between the piers as shown. 4. Place a long u -bolt under the 2x4's and through the holes of the Vector pad as shown. 5. Place the concrete pier blocks on the Vector pad. Center the blocks under the frame. The upturned edge end of the Vector pads should be up against the inside of the pier blocks. 6. Build vector piers but do not wedge at this time. 7. Using a concrete drill bit, drill two holes on each side into the concrete using the holes in the Vector pad as a guide. Drill the 3/8" diameter holes 3 inches deep. 8. Place an outside tension bracket on the Vector pad as shown in Illustration one. Line up the holes in the bracket, Vector pad and concrete pad. Illustration One of a Single Section Set -Up Vector ps for concrete footer Page 18 California Wood Cap and wedge Outside Tension Bracket Wedge Bolt 9/2/03 Vector Dynamics System for Concrete Applications Instructions 9. Put a washer and nut on one of the 3/8" x 3-3/4" wedge anchors. The nut should be screwed on enough to have 1 or 2 threads showing on the top of the bolt. Place the wedge end of the bolt into one of the holes, going through the outside tension bracket, metal Vector pad and into the concrete. 10. Using a hammer, tap the wedge bolt into the hole. Maximum height for expansion bolt 0 above concrete is 2". i 11. Repeat for the other hole in the outside tension bracket and the two holes on the other Vector system pier set. 12. Place an inside tie bracket over the u -bolt so that the lip of the bracket is between the Vector plate and concrete blocks. Place washers and nuts on each U -bolt. Do not tighten yet. 13. Attach a strap with hook or crimp seal to the inside tie bracket, with sufficient length to go over the opposite pier and down to the outside tension bracket, plus 12 inches for wrapping the slotted bolt. Repeat for the opposite side. 14. Tighten inside u -bolts at this time. 15. Use the outside tension brackets to remove any space between the outside tension brackets, concrete blocks and the inside edge of the Vector pad, by tapping the brackets with a hammer. Wedge the pier set at this time. i 16. Using a 9/16" socket wrench, tighten all of the wedge/anchor bolts, securing the outside tension bracket and Vector pad to the concrete. 17.- Usinga slotted bolt in the outside tension brackets, insert strap th 9 rough slotted bolt with end of strap aligned with outside edge of bolt. Turn slotted bolt until straps are tight using at least five turns on the slotted bolts. Illustration T Inside Tie Bracket Compressh boards of PVC Pipe r-ayu 1 Z7 vamui mai Vector pad for concrete Concrete footer $am - 9/2/03 f f� SITE PLAN REVIEW APPLICATION Date: �J 30 — ?16d AP# 6) /,00 'By Permit Number (if applicable) " �3� J? Bin Number APPLICANT INFORMATION Parcel Size: Owners Name: ' kh'," Ij Owners Address: Telephone No.: Situs Address: Proposed Use: '76) fs ac,a � A/ 4e,i, ,. e,- /� /e/7n ro Residential ❑ New Single Family Residential ❑ Single Family Addition Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary- Travel -Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other ❑ Septic ❑ Agricultural Exempt Building ❑ Other: ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A Brief Explanation (if necessary): Le1-V",A4 1 DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) i Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site P Stamp Approved By ✓ Date Paize 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: k �/ • Flood Panel No.: 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: 6 0 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 716 e Side , `Q Side Street Rear 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 ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * 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 i' Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: �- S4t, r -- Hk 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 61 ❑ 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 Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. 01 FEE Page 4of5 •J 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. CALarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 fr •J 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. CALarrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 ii , BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP043478 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: 12/08/2004 APN: 026-100-00"00 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 7095 OCCIDENTAL AVE PAL Date: Contractor: Map Index: Description: NEW ELECTRICAL SERVICE/ UP -GRADE OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: DOUG CUNNINGHAM permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 2510 PALERMO RD signed statement that he or she is licensed pursuant to the provisions of PALERMO CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95965 she is exempt therefrom and the basis for the alleged exemption. Any (530) 534-6811 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: DOUG CUNNINGHAM 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 Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: License #: 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 Architect: is issued. Engineer: ❑ 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: Cartier: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Y 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. I � — "/b 014 Date: i Applicant: C 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 This epmit is horreby.issued under the Iicable provisions of the Butte County Code anrt/or _ 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.) Resol tions t o work indicated a -` f whjclif` e's' have been paid: + Name: _ By Date: PERMIT EXPIRES ON:��� Date Address: ❑ I 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 form or document utte County. I hereby authorize repr ntatives of Butte ounty to enter upon the above mentioned property for inspection pu ose r r I Print Name: Signature: 12 2,^�( Date: AOwner 0 Contractor O Agent for Owner ❑ Agent for Contractor BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES N BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BP OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION BIN # Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER st Name!U _f 1 Fi ame Ad res 5/0 �, /Pxo 410 led City ^ ate �O City Phone53 I Fax E-mail APPLICANT SI NATURE X For office only: CONTRACTOR Name Flood Zone Address �O City F No State Zip Phone _ /' f7 Fax E-mail Planner Lic. # Class APPLICANT SI NATURE X For office only: ARCHI TECTIENGI NEER Name Flood Zone Address �O City F No State Zip Phone _ /' f7 Fax E-mail Planner State License Number APPLICANT SI NATURE X For office only: APPLICANT NAME Name Flood Zone Address �O City F No StAe A Zip i Phone�r-3 _ /' f7 Fax E-mail Planner APPLICANT SI NATURE X For office only: Zoning Property Address o -- pcC'A A,% Flood Zone Cross Street O 7A_ SRA Yes F No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc LOCATION AP#01 Z-6 — 00 — 00 Property Address o -- pcC'A A,% City �� v Cross Street O 7A_ WORKER'S COMPENSATION WORKER'S 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: 7-h5 l C, S_rv•C0L hk),rk F04 Zo Sq. Footage ❑ Structure Built without Permits ❑ 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 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. II Received by Amount: GCS Bldg I I Page 1 of 2 Receipt #:-4 l ast� OA Date: . SRA Sheriff SMIP Other C Total 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 permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 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 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. ❑ 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). ❑ 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. ❑ 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 Carrier and 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 Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Read the in*ucdons on tl>asles 1- 7. O.M.B. No. 3067-0077 Expires December 31, 2005 SECTION A - PROPERTY OWNER INFORMATION I For Insurance C rnpany Use: BUILDING OWNER'S NAME BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.I Company NAIC Number I 70% Oocldental Ave CITY STATE ZIP CODE Palermo CA 95968 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) 026-100-005 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Commends area, N neoessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (type): ( #0 - #9 - ##Mf or ##.#####) ® NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2 COUNTY NAME B3. STATE Butte Courtly Unincorporated Arra No. 060017 Bulla CA B4. MAP AND PANEL 156. 65 ft(m) B7. FIRM PANEL ft(m) B9. BASE FLOOD ELEVATINS) NUMBER 135. SUFFIX B6. FIRM INDEX DATE EFFEMEREVISED DATE B8. FLOOD ZONE(S) (Lone AO, use depth of Iloo ft) 06007985 C Jun 8,98 Jun 8,98 AH 157.5 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): 611. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): _ B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Desigrtation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ® Building Under Construction* ❑ Finished Construction 'A new Elevation C tkate will be required when construction of the building is a nnplete. C2. Building Diagram Number 8 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. K no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 430, V (with BFE), AR, ARIA, ARAE, ARIA1-A30, ARIAH, ARIAO Complete Items C3. -a4 below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used forte BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum ngvd 29 Convemon/Comments NA Elevation reference mak used BCBM 597 Does the elevation reb ence mak used appear on the FIRM? ❑ Yes ®No o a) Top of bottom floor (including basement or enclosure) 156. 65 ft(m) o b) Top of next higher floor158.80 ft(m) a o c) Bottom of lowest horizontal structural member (V zones only) NL. _ft(m) q c o d) Attached garage (top of slab) NA. Lft(m) E E- o e) Lawest elevation of machinery arxd or equipment w `° a servicing the building (Describe in a Comments area) 157.50 ft(m) E o 0 Lowest adjacent (finished) grade (LAG) 156.25 fL(m) z' m o g) Highest adjacent (finished) grade (HAG) 156. 40 fL o h) No. of permanent openings (flood vents) within 1 ft above adjacent grade 0 8 J o i) Total arm of all permanent openings (flood vents) in C3.h SEE NOTE sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIERS NAME Frank Jaynes Pursell LICENSE NUMBER 60924 TITLE RCE COMPANY NAME Jim Pursell Engineering ADDRESS CITY STATE ZIP CODE fi5 Madrahe Ave. Orarille CA 95965 SIGNATURE DATE TELEPHONE 530-533-2131 FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A For Insmarme Camany Use: BUILDING STREET ADDRESS pndudrg Apt, Unit Suil e, andlor Bidg. No.) OR P.O. ROUTE AND BOX NO. Po&,y Number 7095 Occidental Ave CITY STATE ZJP CODE Canpany NAIC Number Palermo CA 95968 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) inwance agenUoanpany, and (3) burg owner. COMMENTS At the time of this certification, there is no skirting around moblie home, subsequently no flood vents. ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WR'HOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number _(Select the building diagram most similar to the buil ft for which this certificrdte is being completed – see pages 6 and 7. If no diagrarn acouratdy represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is _ t(m) _in.(am) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6.8 with openings (seepage 7), the red higherfloor o elevated flux (elevation b) of the building is _ ft(m) _in.(crm) above the highest adjacent grade. Complete iterms C3.h and C3.i on front of form. E4. The top of the platform of machinery andlor equipment servicing the building is _ R(m) _in.(on) ❑ above or ❑ below (check one) the highest adaoe nt grade. (llse natural grade, if available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordnance? ❑ Yes ❑ No ❑ Unknown. The local official must doertify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community - issued BFE) or Zone AO must sign here. The daterne* in SeWons A, A G and E are oohed to tris beat of my krvafe a. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIWS NAME Cooper Cunningham ADDRESS CITY STATE ZJPCODE 7092 Irwin Ave. Palermo CA 95968 SIGNATURE DATE TELEPHONE C�•_�_ �,�, /l —.. r_ 1 S� I[�� 53a,534s592 ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community s floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ The information in Section C was taken from otter documentation that has been Wined and embossed by a licensed surveyor, engineer, or archited who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA4ssued or oommunity4ssued BFE) or Zane A0. G3. ❑ The following information (fterrs G4 -G9) is provided fir community floodplain management purposes. G5. DATE PERMIT ISSUED G7. This permit has been issued for. ❑ New Construction ❑ Sutstantiaf Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: —ft(m) Datum: G9. BFE or (n Zane AO) depth of flooding at the building site is: — _ NO Datum: LOCAL OFFICIAL'S NAME Tru COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS Check here if attachments FEMA Form 81-31, January 2003 Replaces all previous editions f.1_1L STFRUCTURES MD EQU:P?,.*ENT HNCLUDINQ T SITE PLAN OVERHAN!3S SHALL BE CUE.AROPAU LA'S'S EM ............ ...... 7 ..... 7'-*:--7 **"7"* ... ---- — --- ...... ............ ..... ...... . .......... 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