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Insulation Certificate _
_ - • BuLDn�c Pier. � �� ., �.3��� .
BUILDING OWNER: f/
BUILDING LOCATION:
A
Description.of installation
ROOF •
Material�� ---
Thickness (inches)---- tet
Brand Name�35--�#►1�I:
Thermal Resistance (R-Value)3�-
CEILING � -
-S N ✓ c
Batt or Blanket type T-1 "" j C SSS a A"tT
` '
Brand Name o HO Ct.i
Thermal Resistance. (R -Value)
Thickness (inches)/ /�
-
Brand Name
Loose Fill Type
Contractor's minimum installed weight/fft lb
Minimum thickness inches
Manufacturer, s installed weight per square foot to acheive Thermal Resistance (R -Value)
EXTERIOR WALL
' Ja.�1 V1:5
Material f:�!
>
Brand Name
Thermal Resistance (R -Value)
Thickness (inches) /z
RAISED FLOOR
1r7 ILLC L .IS � r
j- ;✓- di q
,
Brand Name
Material _
Thickness (inches) _ S �I2 "
Thermal Resistance (R -Value) -A 9
SLAB FLOOR ' °�•
Material
.
Thickness (inc
Brand Name ,
Thermal Resis e- Value)
Width. es)
FOUNDATION WALL
Material
Brand Name
Val
Thickness (in s) .`'" armal Rest a (R ue)
Declaration
I herebY certify that the above insulation was installed in the building at the -above location in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the .
California Administrative Code.
` General Contractor (Builder) License Number
Signature and Title
Date
Sub -Contractor (Insulation Installer) License Number.
Signature and Title Date
THIS CERTIFICATE MUST -BE PROVIDED "TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION
APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. �.
JANUARY.1993 .
NOTES
ell 1 ,/ JD:
t• -
RESIDENTIAL
a PERM027-06IT Nn
i 0-065 04-2887
PAAP, DAVID
30�/ CYNTHIANN AVE, PALERMO
Cont: OWNER
r NEW SINGLE FAMILY
OFFICE COPY
Address 3 O`( C y,,4 `A ") `�t
o��J�ll�
GAS ►2. I q, DS
Meter By Date I
ELECTRIC 0�
Meter By Date
•
SPECIAL CONDITIONS
CHECKED
By-
SRA ,
— FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ. .
t
SPECIAL INSPECTION ITEMS
VERIFY w.
USE PERMIT CONDITIONS
— SUB -STANDARD HOUSING .LETTER
FA LCr2MO
's
a�
.:'JOB FINALED (D �v
�x
t Signature �lfo�
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
2. Ftg., Main; Soils-Elec. Grnd-/ Z /" Ftg. Depth
Oe"Fig., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
g., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
Sitemwalls, Main; Steel- Bloc kouts-Wrapped
60,'Hold Downs and Special Anchors
7. ' Slab, Steel -Wrapped
K D.W.V.; Fall -Fitting -Test -2 Way C/O -S er Test
10. UF, Gas Pipe; Size Anchors -Yard �A Piping; Size Test ,jj,
11 Water Pipe; Test -Anchors -Regulator -Service Test
1 . Electric Underground
13/Plenums & Ducts; Clearance -Material -Support -Ins.
14/'Girders-Sills-Anchor Bolts-Joists-Vents-Crippies
15Z Access & Ventilation
16. Insulation
Date J//,•/p',-'Card B-1 L/,/ . Date Card B-1
Date Card B-1 6^ Date Card B-1
Date PLUMBIN er - except #'s
I�_-17. W r Htr Vff cces5.-ConilaCstion Air Baffle
1 *1D.W.V.; Te,%tT-4Tngs KAnchor Nail Protection
20. Shower Pan; TeeC, First Floor -Tub Access
21. Test Tub & hower, Second Floor -Tub Access
Z /22. a Sixe & Anchors
23. Fire Sprinkler; Test
Date 14:4%1jKj Card B-1 Date Card B-1
Date C B-1 Date Card B-1
Date E TRICAL(Permit) OK except #'s
24. bre & Transformer Clearance -Ins. Protection
& Switches at Doors
27.iRomex Installed Close to_Sdge of Studs & C.J.
28. ip. Ground mage<p w/Mech Fasteners nd Gas er
28!2 UpJ hce Circuits in Kitchen & Conductor Size GFI
3�ytlfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
3 - Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
ul Neutral Cl Yes ❑ No
rvi =Riser Conductors & Ground Main Disconnect
ui ..Clearances Panels-Motors-Mech. Equip.
34. C es Closet Light -Shower Light -Spa Light
35.. -Smoke Detector
Date it SCard B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ME ANICAL (Permit) OK except #'s
36. A.G-Ducts Insulation & Support
3.V f Fan, Exhaust above insulation
3'C-ensate Drain & Overflow, Size & Grade
3 urnace- ent Access -Comb. Ait-Return Air Vent 115 Outlet
ttic Access & Platform if Furnace in Attic
Date J�, �� rj Card B-1 U Date Card B-1
Date Card B-1 Date Card B-1
Date FRA G (Permit) OK except #'s
4 . Sil Proper Materials & Anchors
4 a ds -Nailing Spacing & Braces -Plates -Sound
4 . ring Walls over Girders & Floor Nailing
4r Dra top in Walls (rat proof)
4 tre Stops, Furredilin ta' -Chas s -Tu s
Headers & Beavs-Size Bearin
Date FR
G (Continued)
0.
JVaigers-Post Caps -Anchors -Connectors
Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Tr hting.-Rtng.
fireplace Ties o pe_Q Flue Fireplace Throat Clearance
.
Attic Acces 2 -Size & Romex rotection-Draft Stop -Ins. Baffles
51.
Bd tndkwspr�iting D Ht. oJwneKsions
)'L-1 -p f, 2.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
51�rPlywood
on Roof Overhang -Attic Vents -Rafter Outriggers
5y.f
ing-Nailing Veneer
58.
Stucco Mesh -Drib Screed -Fd. Vents-Underflr. Access
5 . zing Area -Glass Protection -Skylights -Plastic
fbo',�Shear Walls; Nailing -Bolt
21Or W. BraGe Interior/Exteri all Panels h%. t 1.10 if' -„M r2
63. Infiltration -Walls -Windows
Date10-til-N'Card B-1 / Q Date / o Card B-1
Date - 0,57 CardpeT U9 Date Card B-1
Date F Plans) OK except #'s
. Steps -Door & Sidelight Protection -Landings
Smoke Detector
Furnace Vents -clearance -Comb, Air-Connector-
IlyGaraoe: Above Floor-Ducts-Mech. Protection
W. CvM. & Bath Fixtures & Tub Access -Spa
P599 EIsC. Tf t & Suboanel. Breaker Sizes & Labels
& Rails
C7 F,eplace or Stove, Clearance -Hearth
1� c. Oaflets at Wood Panel, Int. & Ext.
Clearance
Outlets & Receptacles at Kit. Counter
ige Fire Door; Swing -Landing -Closure
Duct in Garage -Damper
Htr.; Vents -Clearance -Comb. Air Conn
in G ge; Above Floor-Mech. Protection
78. P . & Mech. Equip. Listed for Location
Receptacles in Garage (F.FI.)-Romex Protection
In - lation-Foam-Looked in Attic
94 ln -ard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
_ Clearance Looked under Flo • ❑ Yes
83. Followi g Instld./Drive ❑ Yes o/Walks O Yes o/Planters O Yes No
8 co Brown -Finish
A.C. Unit Disconnect, Electrical -Plumbing
8 ents Wove Roof, Plbg-Appliance-Fireplace-Clearance to Openings
er Well, Disconnect, Electrical, Plumbing
1��r Elec. Trim, G.F.I. Receptacle -Underground
89' rtilation Throughout House
Glad's'Protection
L 6S t)C--92. Gas -Meters TagqA,Gas-Electric
93. ater & Sewer Connected -C/O to Grade -HD Approval
(931' . ergy Compliance Certificate -Other Certificates
Address Posted'
96. Fire Sprinkler
Date 'L ) and B-1 Card B-1
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
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;-/ P' L 'ft.
/ P Nat. or/ P' 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.; Posts- Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5.
Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6.
Carports; Windows -Doors
7.
Electric
8.
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9.
Siding; Nailing -Veneer -Stucco -Mesh
10.
Roof; Shthg-Roofing
11.
Ext.; Steps -Doors -Landings
12.
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1.
Setbacks -Easements
2.
Soils; Compaction -Structure Stability
3.
Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4.
Elec.; Receptacles and Lighting, Distance-GFI
5.
Elec.; Pool Lighting; 15 Volts-GFI
6.
Elec.; Enclosures; Conduit Entries -Terminals -Listed
7.
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- 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
DATE:02-3
+ l
PERMIT: 04;),9F?
ASSESSOR PARCEL #: r — 0 o"- 0
OWNER'S NAME:
FEES: (Amount and Purpose): '
BALANCE OF FEES: $
ADDITIONAL FEES: $
REVISED PLAN CHECK
SHERIFF FEE: $
SRA $
COPIES $
URBAN AREA FEES $
CSA 87 (North Chico Spec.) $
WATER TENDER FEE $ BATTALION # .
THERM DRAINAGE FEE $ c
OTHER
OTHER $
VALUATION - IFBALANCE OF FEES OR ADDITIONAL FEES:
TOTAL VALUATION: $
ADDITIONAL VAL: $
(Check one) COUNTY
CITY OF BIGGS
(Check one) RESIDENTIAL
COMMERCIAL.
RECEIPT NUMBERS:
- `� .-,-'��� .- : 11111111lllillllllllillllllilillli
—22
AND WHEN RECORDED MAIL TO: 2ioio a+ioioE668
t-
Recorded I REC FEE 16.00
BUTTE COUNTY BUILDING DIVISION Official Records I CONFORM 1.00
7 COUNTY CENTER. DRIVE CountTE f
OROVILLE, CA 95965 BUT
CANDACE J. GRUBBS I
:Recorder
/ROSEMARY DICKSON I
Assistant I Jason '
09:14AM 01 -Nov -2004 I Page 1 of 4
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County, Code required this acknowledgment to be recorded prior to` issuance of a building
permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, J—
and residents of this property may be subject to inconveriiences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in, tlhe County of Butte, State of California, described as follows:
JL
Date l�% - O PROPERTY OWNERS:
'
Dcty A E • PCA
CA 1P
• V01'1'Vll(� � �lJ�G'� D .
State of California )
County of��� )
On (+a'- _ ��J , D00 before me,
person ly appeared ner4oftatly
.lunaww-fume (or proved to me on the basis of satis actory evidence) to be the person(whose name(�,� is/subscribed
to the within instrument and acknowledged tome that he/shek4my executed the same in his/ authorized
capacityNQ1 and that by his/heAWw4r signatureXon the instrument, the personN or the entity upon behalf of which
the personxacted, executed the instrument.
WITNESS my handprd official seal.
' _ St1am SIMOES
Signature Seal: Cornmigslon #4455271
hlofcay Public - Catlfoinla:
# MV Comm. Diego
i go County
A.P.
)fres Dec 26; 2007
y1fluoo Oggici mna
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ALL-PURPOSE ACKNOWLEDGMENT
State of California •
County of San Diego ss.
�crV P1'41(�
On &Jhbelr- 2.3 before me,
'T /Ul?-
(DATE) IQ (NOTARY) O
• personally appeared <a fie Q Q f:
S NER(S)
e ❑ personally known to me - OR- QVvroved to me on the basis of satisfactory •
evidence to be the P erson(4 whose nameW)
e
is/ate subscribed to the within instrument and
acknowledged to me that hkshe/tbi6y executed •
. ,••• �, OFFICIAL SEAL the same in IVs/her/thjir authorized 4
R. OVENS
• �y' NOTARY PUBLIC- CALIFORNIAw' capacity(ip,. , and that by hji/her/tWr •
' COMM. NO. 1449235
° SA14 DIEGO COUNTY signature(/ on the instrument the
• MY COMM. EXP. NOV. 4, 2007 or the entity upon behalf of
person(?�acted, executed the instr
•
WITNESS my hand and official si
4
•
® NOTARY'S SIGNATURE
• OPTIONAL INFORMATION
The information below is not required by law. However, it could prevent fraudulent attachment of
o edgment to an unauthorized document.
q® -CAPACITY CLAIMED BY SIGNER (PRINCIPAL) DESCRIPTION OF ATTACHED D(
o ❑ INDIVIDUAL
s
❑ CORPORATE OFFICER
TITLE OR TYPE OF DOCUMEN'
TITLE(S)
0
❑ PARTNER(S)
Ae ❑ . ATTORNEY-IN-FACT
® ❑
TRUSTEE(S) NUMBER OF PAGES
o ❑ GUARDIAN/CONSERVATOR
❑ OTHER:
•
e
DATE OF DOCUMENT
SIGNER IS REPRESENTING:
O NAME OF PERSON(S) OR ENTrrY(IES)
® OTHER
•®•0•®•�0®•®•®o®•®•�•s• ®e®e®e-•
APA 1/94 VALLEY -SIERRA, 8007362-3369
person(.e,
which the
Iment.
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;al.
•
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his aclamowl-
•
CUMENT
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ORDER NO. BU -187134-3
DESCRIPTION
THE LAND REFERRED, T.O HEREIN IS. SITUATED IN THE STATE OF CALIFORNIA;
COUNTY OF BUTTE,' AND IS.DESCRIBED.AS.FOLLOWS:
PARCEL I:
PARCEL 2.AS'SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE
OFFICE OF THE RE CORDER
R OF THE
BOOK COUNTY FCALIFORNIA,F
OF MAPS, AT PAGE (S) 98A
8
ON SEPTEMBER ,
APN 027-060=065-000
PARCEL II•
A NON -EXCLUSIVE -EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES, OVER
A STRIP OF LAND 60.0 FEET IN WIDTH, LYING 30.0 FEET ON EACH .SIDE OF
THE FOLLOWING DESCRIBED LINE: _
BEGINNING -AT THE SOUTHWEST CORNER OF LOT 3, OF SUBDIVISION NO. 2,
AS SHOWN ON THAT CERTAIN MAP. ENTITLED,;"MAP OF THE SUBDIVISION NOS.
1 AND 2 OF THE P. C. DRESCHER TRACT", WHICH MAP WAS RECORDED IN THE
OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, _ STATE OF CALIFORNIA,
IN BOOK 1 OF MAPS, AT PAGE(S). 25; .THENCE FOLLOWING ALONG THE
WESTERLY BOUNDARY LINE OF SAID' LOT 3, NORTH 0 DEG 17'. 00.'! EAST
89.58 FEET TO A .POINT LOCATED IN`THE CENTERLINE OF AN EXISTING
ROADWAY AND BEING ALSO THE TRUE POINT 'OF BEGINNING' FOR THE
CENTERLINE HEREIN ,DESCRIBED;,, THENCE FROM SAID TRUE POINT OF
BEGINNING, AND FOLLOWING. ALONG THE .CENTERLINE OF SAID ROADWAY,
SOUTH 30 DEG. 44' 40" WEST 432.63' FEET; THENCE SOUTH 35 DEG. -.16'
10" WEST, 496.53 FEET; '`THENCE SOUTH 65 DEG. 27' 00" WEST, "713.80
FEET;'THENCE SOUTH 41 DEG: 021:.00." WEST, 228.54 -FEET;' THENCE NORTH
75 DEG. 30' 35" WEST,. 106.02 FEET; .THENCE NORTH -.3 DEG. 04' 55"
EAST, 225.42 FEET; THENCE NORTH 13 DEG: 29' 35" WEST, 367.16 FEET;
THENCE NORTH 66 * DEG. 11' `05" WEST, 558.40 .FEET; THENCE NORTH 53
DEG. 07' 05" WEST, 186..77 FEET;• THENCE SOUTH 7.8 DEG. 04' 25" WEST,
285.73 FEET;, THENCE NORTH 75 DEG. 36' 115 1WEST, 245.53 FEET; THENCE
NORTH 54 DEG. 19' 45". WEST, -283.57 FEET; Tb'ENCE NORTH .51 DEC'. 31'
•05" WEST, 255.29 FEET; THENCE~NORTH 73'DEG. 35' 45" WEST TO A POINT
THAT BEARS' SOUTH 60. 0., FEET,YROM, THE CENTERLINE .OF THE EASTERLY
EXTENSION OF BOHEMIA AVENUE;. .THENCE WEST. AND' PARALLEL• WITH THE. r
CENTERLINE OF THE EASTERLY EXTENSION OF BOHEMIA AVENUE; TO A POINT
ON THE EASTERLY BOUNDARY OF CITRUS AVENUE AND THE END OF. THE HEREIN
DESCRIBED LINE.
EXCEPTING THEREFROM THOSE PORTIONS LYING WITHIN THE BOUNDS OF
PARCELS 1, 3 AND 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED
IN THE OFFICE OF THE' RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON SEPTEMBER 1, {14981, IN BOOK 83 OF MAPS, AT PAGE (S)
98. '
.CONTINUED
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.netWds
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number: -
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
7000) of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of tg Business and ProfeSOpns Code
Date: LU:: L�`Owner: a/ Z
r�
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ 1 have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Policy #:
I certify that in the performance of the work for which this per 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:—// /(/�7 q
Applicant:�;�1'e�
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.)
Address:
PERMIT NO.
BP042887
Issued Date: 11/29/2004/ APN: 027 -060 -065q -,0,0x0,, )
Site Address: y �(/ "9V l/
Map Index: � /I
Description: NSF(1672)GAR(504)COV(165)
Owner: PAAP DAVID E & CATHY J
4212 60TH ST N
SAN DIEGO, CA
92115-5438
Applicant: PAAP DAVID E & CATHY J
4212 60TH ST N
SAN DIEGO, CA
92115-5438
Contractor:
License #:
Architect:
Engineer: FLT
Total Square Ft: 2341 S. F.
Valuation: $123,416.00
Census Code:
�l1Z-7Z3
s hereby issued under the applicable provisions of the Butte County Code am
Yo do work indi ed a for hich.fees_have been paid.
Y _ / nate. //1
PERMIT EXPIRES
lZ
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and.25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials. , ''
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: IdLl (,/ J b a i?,+4? Signature:
&M
❑ Contractor
❑ Agent for Owner
13 Agent for Contractor
4sIh 4teL
lv; Ilda..
APPLICANT NAME
Name K OS 14
1
ARCHITECT/ENGINEER
Name FL
-7L
Zip <�5<N
Address
Q
-
o col
City &LQ`
Map Book
State
Z
Phone
P
Fax
E-mail
State License Number
APPLICANT NAME
Name K OS 14
1
C fi
Address L4 b td"04000
CityafL O
Statce�.p
Zip <�5<N
—j-
Phone 53b-1A'-U'l
Fax -70-1
E-mail
hkoShebim dro,.w►#ter , czek
APPLICANT SIGNATURE
X U--�
For office use only:
Zoning
Flood Zone
SRAes
No
Occ.
Type Const
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
cription or Scope of Work:
Lo
Sq. Footage WF��%--�
EStructure Built Wthout 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: IG -4 Amount: Bldg I I
SRA
Receipt #: 4-17 % 2-3 3 o Sheriff
t 34 SMIP
Date: 1 o1414 4 Other
3 s 19 • Total
SUBMITTAL & PERMIT REQUIREMENTS
�Tbpfollowing drawings and specifications must be submitted to the Building Division in order to apply for a
•W MPLETE SUBMITTALS WILL NOT BE ACCEPTED ALL PLANS MUST BE LEGIBLE AND IN INK
�1., 7 Site, plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl
'r4a42., 4omplete plans, 3 or 4 sets, signed b the preparer of the plans No rah paper!) OR
9 Y PP P ( gPPP )
Cr40 '`'E Igineered 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 faxesl
C� 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 insf, (B) Marriage line info, (C) Floor Plan, (D) Tie down
or fid 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 buil ings.
❑ 11. Detached Accessory Building Form'f�ledDaut by the owner (if required).
❑ / 12. Hazardous Material Form (for CommAl F3Ll�dln s only).
l� 13. Sanitation and site plan approval from the n*"q mental Health epartment.
Remaining items needed to issue the permit. Additional iterffs be required after Plan Check and Planning
��YtF.,q
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. Contractors 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).
ate.`
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
meTunos can oniy 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
ssued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
;heck fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
:AFORMSWILDING F0RMS0dgApp1SubRgmts.doc Page 2 of 2 ct;=\i 7_,7s,,
iF .`..:��.-..•-.'..�.,..;.ir•"'a�.r�..A•r-.r..,,�.r=,._-�:.,+-��s.-F L;h4-�..•-.•....'--.�^'s..r.r.--•-�y'�s�-•....:.-......-.•1^�."�-"'`'"y""'-.n"""''ti}..t^�i�y.��.,jy-•yti--,... ... �%'�. ... .. -
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
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
O 19.. Soils Report and/or Engineered Foundation required ........................................... ........
20. Erosion Control Plan Required........................................................................ ........
21. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
22. City of Chico Plumbing permit........................................................................
J 23. California Department of Forestry plan approval Maid. Sent by:K,r 04- �
24. Planning approval (A) Use: �(B)Parking: (C) Parcel Check: It
❑ 25. Contact Land Development about _ Improvements, _ Drainage .........................
-,O� 26. NPDES Form.............................................................................................
27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Pre -Inspection for required.......
❑ 29. Contractor's license information. (Number, Name Style, Classification) ...................
❑ 30. Worker's Compensation Carrier and Policy Number ..........................................
31. Owner -Builder Verification (_ZGiven to owner, _Mailed to owner) .....................
32. Letter of Signature authorization... ...�.ra.,n....?„` .... r'o"..= /...I ..........................
33. Recorded copy of Agricultural Acknowledgment Statement .................................
❑ 34. Manufactured home utility clearance...............................................................
❑ -35. Existing violations and/or expired permits.........................................................
❑ 36. Deed Restriction.........................................................................................
❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
O 38. Other:
❑ 39. Other:
When issued Telephone F3 4 le:, . 4 9�4- / and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit
Applicant:'-�-=
Date:
OWNER:
u
ASSESSOR PARCEL NUMBER Q7�• oho �hS
Proposed
Building
Use: t-1 S F Counter Technician: A.�M �' Date: t o/A Ao ¢
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
1. Site plans, 3 or 4 sets, signed by the preparer of the plans. .
2.
Complete p ans, 3 or 4 sets, signed by the preparer of the plans.
3.
Engineered planso or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
IP4.
Engineered truss a tails and layouts in duplicate. No faxes!
advised of the above data by ❑ phone, ❑ mail, ❑ counter, by
5.
Letter from Engineer or Architect for truss design review.
Plans reviewed by:
6.
Energy compliance design and supporting documentation in duplicate.
7.
Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑
8.
Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
Date
duplicate.
❑
9.
Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed• by the engineer.
O
10.
Flood Elevation Certificate, wet -stamped and signed, in duplicate
❑
11.
Site plan and business license approval from the City of Biggs
❑
12.
Letter of intent for non-residential buildings
❑
13.
Detached Accessory Building Form filled out by the owner
❑
14.
Hazardous Material Form
15.
Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.
❑
16.
Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 17. Fire Sprinklers............................................................................................
❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
O 19.. Soils Report and/or Engineered Foundation required ........................................... ........
20. Erosion Control Plan Required........................................................................ ........
21. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
22. City of Chico Plumbing permit........................................................................
J 23. California Department of Forestry plan approval Maid. Sent by:K,r 04- �
24. Planning approval (A) Use: �(B)Parking: (C) Parcel Check: It
❑ 25. Contact Land Development about _ Improvements, _ Drainage .........................
-,O� 26. NPDES Form.............................................................................................
27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Pre -Inspection for required.......
❑ 29. Contractor's license information. (Number, Name Style, Classification) ...................
❑ 30. Worker's Compensation Carrier and Policy Number ..........................................
31. Owner -Builder Verification (_ZGiven to owner, _Mailed to owner) .....................
32. Letter of Signature authorization... ...�.ra.,n....?„` .... r'o"..= /...I ..........................
33. Recorded copy of Agricultural Acknowledgment Statement .................................
❑ 34. Manufactured home utility clearance...............................................................
❑ -35. Existing violations and/or expired permits.........................................................
❑ 36. Deed Restriction.........................................................................................
❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
O 38. Other:
❑ 39. Other:
When issued Telephone F3 4 le:, . 4 9�4- / and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit
Applicant:'-�-=
Date:
/ () --4-
u
1. Index prm application for
ems numbe�e
Plan Check Letter
2. Additional items required
Contractor, desig r, ow
ised of the above data by phone, ❑ mail, ❑ counter, by
Date:
Contractor, designer, owner, was
advised of the above data by ❑ phone, ❑ mail, ❑ counter, by
Date:
Plans reviewed by:
Date: Plans approved by:
Date:
Structural reviewed by:
Date: Structural approved .
Date:
Note transfer by:
Date
Yellow: Building Division
' E.10 Wit: CAiiY
Plot Pian Attached
i t Roar Plan Atuct-i-
Sant to S.D. !
TO: ,T Building Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance '
�— Owner !_ovation AP#
Plan Approved for: Sewage Disposall� Water Sup Pu I c Private Well
Clearance for dwelling. Other,
Hold final for:
Final clearance O.K. for:
NOTE:
Environmental Health Specialist Date
8/96
COUNTY OF BUTTE t -
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION ,
•7 COUNTY CENTER DRIVE, OROVILLE, CA -95965 TELEPHONE (530)538-7541
SCHEDULE OF RECEIPT OF FEES
OWNER P '
PROPROSED BUILDING USE
1. BUILDING PERMIT FEES
--- Balance Due ..................... $ Z-� • 39
--- Additional Fees Due........... $
A.P.# 027. cmc •b�5
DATE
RECEIPT # DATE REC.
�1 Z723 to AF -16.4-
f
--- Revised Plan Checking Fee.... $
2. SCHOOL DISTRICT FEES '(2!�:)t2�v► L-I✓E e- P+
(paid at School District Office) (form available after Plan Check)
SG–iJ O To AP Pu 614* -IT 40" -A P cu c ck -rt d
3. SHERIFF FEES (paid at Building Division)-124
Residential............ I X $360.00 =$
Units
Commercial (sq. ftg.)..... X $0.03 = $
Sq.Ftg.
4. URBAN AREA FEES (paid at Building Division) .
Residential (per unit)..... X $
# Units Amt.
Commercial (Sq. Ftg.).... X = $
Sq. Ftg. Amt.
5. RECREATION DISTRICT FEES
(paid at Recreation District Office) (form available after Plan Check)
6.•THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at Building Division)
7. SRA FIRE INSPECTION AND PLAN CHECK FEE
489:60 (paid at Building Division)
8. WATER TENDER FEES BATTALION #
$200.00 (paid at Building Division)
9. NORTH CHICO SPECIFIC PLAN (paid at Building Division)
a
Residential Zone X = $
Zone # Units Amt. +
qommercial (sq. ft t
Sq. Ftg. Amt.
•
10. OTHER&.11 A 41?.34
T
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees
may be changed during the plan checking process'
F
APPLICANT. DATE /---(`
Pursuant to Government Code Section 66020, you are hereby notified that items, 2,3,4 5, 6, 8, 9, and 10 above may have been imposed on your project. You ;
have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a .1 I
protest are specified in Government Code Section 66020(a). l�j
Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) 3y
IRK D,
o BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District Building Department No.
A.P. Number U�� • (�(r� lj (� U i Jurisdiction: City County
Property Owner l
Property Location/Address C1."t 1 V^10 l -Y -�
Subdivision Lot No.
Residential Development ® Q Q Q € Sq. Footage )
No ofiving Mobile Home Addition/ Supplemental to (Group R)
Units Installation Conversion Permit p
F
*(No foundation inspection)
.................................................................... .........................i
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Commercial/Industrial Q Q
New Addition
Building Department Representative
Sq. Footage
(Including Exterior
Roofed as)
Date
District Identification No. 0501 _5 6
n �-LV i 16 UK,.. Ci School District certifies that �)Jq V 1 q( A A D '
i
`� J (Applicant)
to `q A t ^% - 3 34
(Street `Address) (Phone Number)
PC\ 1.g Mo C
(City) (State) (Zip Code) 2
has complied with the requirements of Resolution No. by payment of $ J�. Lk
J
representing square feet. 2926 $
FULL MMGATION $
{ tg 6D D
Srhne istriet RanrAgantahvA Date
Paid by Check Remarks:
NoBw: You may protest the Imposition of tiro fess identified above by submitting a wrRten protest to the District, in compliance with
Government Code Section 66020(a), within 90 days from the date flees are paid. Failure to submit a timely written protest witi'prohibit
you from challenging the imposition of the fess In any court action.
N. subsequent to the School District Representative signing this Butte County Schools Impact Fee Certlflptlon Form, the School Distrlr t Is
nod by the applicable Local Planning Agency that this project Is being reviewed under the California Environments! mental Quality Act (CEQA),
this pr al r may be subject to additional school fees to fully mltigale.its impact on the school dlsMd`s schools.
White (applicant), Yellow (building department), Pink (school district) feeformads 00/03)dmm
a f..
....... ...
J�
cl 69aS t,6S OES SOWOH JDAeOPU3 clgE::a"o to i'l das
a-4
692S tES 06S
saWOH Jone6pu3
d:9E ZO �b0 tT daS
OWNE12-BUII.I)ER VERIFICATION
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 materials for construction of the proposed s =
property improvement: YES I NO ❑
*2. I °HAVE A' HAVE NOT ❑ signed an application for a building permit for the proposed work..
I have contracted with the following person (firm) to provide the proposed construction:
NAME: ,
ADDRESS: CITY: ,
PHONE: CONTRACTOR'S LICENSE NO.
I plan to provide portions of this work, but I have hired the following person to coordinate,
supervise, and provide the major work:
NAME: °
ADDRESS: CITY. r
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 PHONE TYPE -OF WORK ,
SIGNED:
*PROPERTYOWNER: �s
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.
OVER ;
F
O.B.- I
I OWNER BUILDER INFORMATION
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of 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 A;
apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should
be aware of the following information for your benefit and protection:
♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
♦ If you are an employer, you must register with the State and Federal Governments 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.
♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to worker's compensation insurance.
♦ For more specific information about your obligations under Federal Law, contract 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 contracting the Contractors State License Board in your
community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you
are aware of these matters. The building permit will not be issued until the verification is returned.
qrely,
McelC. Vi ira, C.B.O.
ger, Building Inspection
NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
` itJl
Tartment of Public Works
D
�a p C o u n t. Y-
.0 o f B u t t e
0
o LAND DEVELOPMENT DIVISION _
o q -): Michael Crump, Director Storm Water Management Program
0 0 7 County Center Drive
L' Oroville. CA 95965
OU (530) 538-7266
A LIC �9 (FAX) 538-7171
National Pollutant 'Discharge Elimination -System (NPDES) Phase II
Construction Storm Water Permit and Storm Water PCREtion Prevention
Plan (SWPPP) Acknowledgement TLESS THAN 7 A
iz
Project Description:
Project Location and/or Parcel Number: �� /-9 r 0
P ]
in below I the project owner/owner's agent, certify that this project WILL NOT DISTURB
By signing
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. w ,
I- am aware that submitting false and/or inaccurate information or ' failure ;to apply for a Construction
Stone Water Permit from the State of California Regional Water Quality Control Board for a project
n revocation of grading and/or other permits or other,
that disturbs one acre or more of ]and may result,i
sanctions provided by law. `
Signed:
Title:
Date: %
}
Less than I Acre NPDES & sWPPP Compliance Certification
_ .. .....__ vr..... Rfewevnm►nt Pro Pram •�
W I LLDAN
5 Serving Public Agencies
November 24, 2004
Scott Rutherford
Butte County Building Department
7 County Center Drive
Oroville, CA 95965
(530) 538-7169
(530) 538-2140 FAX
SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL
117 C Street '
Marysville, California 95901
530/749.2373 fax 530/749.2199
www.wilidan.com
Willdan Project No:
f
k.
04-2887
Assessor's Parcel No:
027-060-065
SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL
117 C Street '
Marysville, California 95901
530/749.2373 fax 530/749.2199
www.wilidan.com
Willdan Project No:
14353-1193
Jurisdiction Job No:
04-2887
Assessor's Parcel No:
027-060-065
Description:
Paap Residence .
Dear Mr. Rutherford:
Willdan has completed a plan review of submitted plans and documents for the above referenced project
and recommends your approval with the conditions noted on the 2nd page W this letter. The plans.. and
documents provided for this review that have been found in compliance with the applicable codes are:
* Plans: Two (2) copies sheets Covei through 3 dated 07-12-04, by Endeavor Homes -Frank
Tyukos, P.E., two (2) copies sheet 4 not dated, not signed, two (2) copies sheet 5 dated 08-12-
04, by Endeavor Homes, two (2) copies sheet 6 of 6 dated 07-12-04, by Endeavor Homes.
k . Structural Calculations: Two (2) copies not dated, by FLT Engineering -Frank Tyukos.
k Energy Calculations: Two (2) copies dated 08-16-04, by Barry Rubanoff.
# Truss Calculations: Two (2) copies dated 08-17-04, by MiTek Engineering -James Bourez.
The plans have been stamped with. the Willdan approval stamp and dated the date of this letter.
On the pages to follow is the identification of the codes and standards applicable to the project, a code
analysis, conditions -of -approval and identification of any deferred submittals.
APPLICABLE CODES
Unless noted otherwise, all comments are based on requirements of the 2001 California Building
Standards Code found in the California Code of Regulations, Title 24:
• Part 2, known as the California Building Code and abbreviated herein as "CBC".
• Part 3, known as the California Electrical Code and abbreviated herein as "CEC".
• Part 4, known as the California Mechanical Code and abbreviated herein as "CMC".
• Part 5, known.as the California Plumbing Code and abbreviated herein as "CPC".
• Part 6, known as the California Energy Code, and Energy Commission Standards, and
abbreviated herein as "CECS".
r
1
M
WILLDSWI
AN Public Agencies
CODE ANALYSIS .
Type of
Type of
1s' Floor
2" Floor
Sprinklers
Stories
Total Sq Ft
Occupancy
Construction
—Sq Ft
Sq Ft
Q
R-3
V -N
No
1
1672
NA
1672
U-1
V -N
No
1
504
NA
504
Covered
V -N
No
1
224*
NA
224*
Porch(s)
CONDITIONS OF APPROVAL
1. Approval is contingent upon the review, requirements and approval of other departments
.and/or agencies that have jurisdiction over this project.
2. Revisions and/or notes as red -lined on the plans.
3.. *Permit application building areas specified in the scope -of -work shall be reconciled with plans
to Butte County's satisfaction. Permit application lists covered porch square footage as only
165 square,feet.
DEFERRED SUBMITTALS
Our plan review reveals no deferred submittals noted at this time
SPECIAL INSPECTION NEEDS
.Our plan review reveals no special inspection needs pursuant to CBC 1701.
Sincerely,
Isaac Kuster Gordon Wright, P.E.
Plans Examiner Plan Check Engineer
Cc: Alice Meffora,'E-maiil: ameff6rdg1buttecounty.net
Brad Kosh, 740 Nevada Street Gridley, CA -959.48 FAX (707) 678-8605 Email: bkosh@bicmframing.com
..David Paap, 3639 Shawnee Road, San Diego, CA 95117
Page 2 oft County of Butte Permit Number 04-2887
Willd.an Project Number .14353-1193
,.` SITE -PLAN REVIEW. APPLICATION
Date: 1/ % A' l AP# i '27
Permit Number (if applicable)
APPLICANT INFORMATION
Owners Name:
Owners'Address:
Parcel Size:
cfn .fa�c �Gte4o (A 5.2117 '.
Telephone No.. &I — 9/ 7 335 .. v
SitusAddress:l, .:.64or. n
f. `./
Proposed Use,
Residential
New Single Family Residential
❑ Single Family Addition ❑ Single. Family Remodel
❑ Mobile Home
Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Traver Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ -Industrial Addition
❑ Commercial Remodel
❑ Industrial Remodel
Other
❑ Septic ❑ `Well
;Agricultural Exempt Building
❑ Other:
Brief Explanation (if necessary):
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
-Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
Site Plan Stamped Approved
By Q Date / / 0
Page 1 of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Snow Load Area:
❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)` ^ �
El Watershed Protection Overlay Zone l(See attached standards andrequruements)
® 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: JJCC
• Flood Panel No.: 0 WOO7C- 07r<:9 Index Date: ,;10Bo
❑ 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
El Minor Variance El Administrative Permit
❑ Variance
❑ Detached Building Use Form ❑ Encroachment -Permit — — — —
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning: A4 — 6
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
1 , 1
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
.20
�
Side
/Dr
Side Street
Rear
/D ►
�s r
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
1 , 1
Page 2 of 5
Applicable Development Fees: `
Standard Fees Amount l�� V'%Formula
❑ Fire`
❑ School*
❑ 'Parks/Recreation
❑ Roads
❑ Sheriff 4
❑ Drainage "
❑ NCSP/CSA_87
❑ Chico Urban Area— Road ,
❑ Thermalito Impact
❑ Other
---------------------------
Subdivision Map Special Fees
❑ Water Tender A ..
❑ Road Improvement
❑ North Oroville Area
El Other (per map) '
F
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit.
Parcel Created By
❑ Deeds:
Date of Creation: Legal. Access Provided: El -No ❑ Yes
Deed,of Reference:�= Legal'Access Required ' ❑ No' ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑'Yes, Road Name:
Complies with County Standards for Deed Creation:❑ No ❑ Yes
Comments:
❑ Parcel Deemed to be legal
❑ -Verify Legal Parcel "❑ Verify Legal .Access ❑Provide Deed of Creation
❑ Obtain a Certificate of Compliance
❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
r ❑ . Meet current Environmental Health[ Department requirements
..Page 3 of S
10 Subdivision Map/Parcel Map:
Map Date of Recording: Q /
Lot: a:
❑ Use Permit/Minor Use Permit
Permit Number:
Book: Y 3
Date of Approval:
Page: q k,
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 roa
El
IMI
Page 4 of 5
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2
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
COPY of Document Recorded
01 -Nov -2004 2004-0066822
Has not been compared with
original
BUTTE COUNTY RECORDER
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENT IAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes,
and residents of this property maybe"subject to`inconveniences or'discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including; but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
Date /0 _ t' 0 PROPERTY OWNERS:
ohxo_ P
State of California )
County of �&,7y000—'r', (( )
On n(4t_ - ICJ . DOO `i :before me, n e
.knww fame (or proved to me on the basis of satisfactory evidence) to be the person(s§kwhose nameN is/i1rr subscribed
to the within instrument and acknowledged to me that h_/shWihey executed the same in his/har-kheir authorized
capacity, and that by his/heFA"r signatureKon the instrument, the person( or the entity upon behalf of which
the personK acted, executed the instrument.
WITNESS my hand d official seal.
Signature �ZvSeal•SUZME SlM�S
c Coon 81455271
1Votmy Public - Cditomia
San Diego County
A.P. # My Comm. Evlres Dec 26 2007
ORDER NO. BU -187134-3
DESCRIPTION
THE LAND REFERRED TO' HEREIN IS. SITUATED IN THE STATE OF CALIFORNIA,
COUNTY OF BUTTE, AND IS.DESCRIBED AS FOLLOWS:
PARCEL I•
PARCEL 2, AS SHOWN ON THAT CERTAIN
OFFICE OF THE RECORDER OF THE COUNTY
ON SEPTEMBER.1, 1981, IN BOOK 83 OF
APN 027-060-065-000
PARCEL II•
PARCEL MAP, RECORDED IN THE
OF BUTTE, STATE OF CALIFORNIA,
MAPS, AT PAGE(S) 98.
UTILITY
ES
ER
A STRIPXOFULAND 60.0 FEIvE ETF NRWIDTH,�LD NG 30C 0 FEET ON EACHSSIDEVOF
A S
THE FOLLOWING DESCRIBED LINE:
BEGINNING AT THE SOUTHWEST CORNER OF LOT 3, OF SUBDIVISION NO. 2,
AS SHOWN ON THAT CERTAIN MAP ENTITLED,' "MAP OF THE SUBDIVISION NOS .
1 AND 2 OF THE P. C. DRESCHER TRACT", WHICH MAP WAS RECORDED IN THE
OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA,
IN BOOK 1 OF MAPS, AT PAGE(S) 25; .THENCE FOLLOWING ALONG THE
WESTERLY BOUNDARY LINE OF SAID LOT 3, NORTH,0 DEG.' 17' 00" EAST
89.58 FEET TO'A POINT LOCATED IN THE CENTERLINE OF AN EXISTING
ROADWAY AND BEING ALSO THE TRUE POINT 'OF - BEGINNING FOR THE
CENTERLINE HEREIN DESCRIBED; THENCE FROM SAID TRUE POINT OF
BEGINNING, AND FOLLOWING ALONG THE CENTERLINE OF SAID ROADWAY,
SOUTH 30 DEG. 44' 40" WEST 432.63 FEET; THENCE SOUTH 35 DEG. -.16
10" CE NORTH
WEST, 496.53 FEET; THENCE SOUTH 65 DEG. 27' 00" WEST,13
FEET; THENCE SOUTH 41 DEG. 02'00" WEST, 228.54 -FEET; THEN
75 DEG. 30' 35" WEST, 1.06.02 FEET; THENCE NORTH -3 DEG. 041 55"
FEET;
EAST, 225.42 FEET; THENCE NORTH 13 DEG.. 29' 35" WEST,
THENCE NORTH 66'DEG. 11' 05" WEST; 558.40 FEET;
THENCE NORTH 53
DEG. 07' 05" WEST, 186.77 FEET; THENCE SOUTH 78 DEG. 04' 25" WEST,
285.73_ FEET; THENCE NORTH 75 DEG. 36' 15" EST, 245.53
.53 FEET; -THENCE
61. THE CE
NORTH 54 DEG. 19' 45". WEST, 283.57 FEET;
05" WEST., 255.29 FEET; THENCE NORTH 73 DEG..35' 45" WEST TO A POINT
THAT BEARS SOUTH 60.0 FEET .FROM THE CENTERLINE OF THE .EASTERLY
EXTENSION OF BOHEMIA AVENUE;. .THENCE WEST.AND'PARALLEL WITH THE
AVENUE; 'TO A POINT
CENTERLINE OF THE EASTERLY O EXTENSION OF BCITRUS AVENUE OHEMIA
AND THE ND OF THE HEREIN
ON THE EASTERLY BOUNDARY
DESCRIBED LINE.
EXCEPTING THEREFROM THOSE PORTIONS LYING WITHIN THE BOUNDS OF
PARCELS 1, 3 AND 4, AS SHOWN ON THAT CERTAIN PARCEL MAP, RE OEDED
IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,
OF
CALIFORNIA, ON SEPTEMBER 1, 1981, IN BOOK 83 OF MAPS, AT PAGES)
98.
CONTINUED
/ ORDER NO. BU -187134-3
v
DESCRIPTION - CONTINUED
PARCEL III:
NON-EXCLUSIVE. EASEMENTS FOR INGRESS, EGRESS AND FOR PUBLIC
UTILITIES OVER CYNTHIAN LANE, BOHEMIA.WAY AND THE NORTH 30 FEET OF
PARCEL 3, ALL AS SHOWN ON THAT CERTAIN PARCEL MAP,
RECORDED IN THE
OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA,
ON'SEPTEMBER 1, 1981, IN PAGE(S)
98.
BOOK 83 OF MAPS, AT PAG
EXCEPTING THEREFROM. ALL THAT PORTION LYING WITHIN THE BOUNDS OF
PARCEL I, DESCRIBED HEREIN.
ALL-PURPOSE ACKNOWLEDGMENT
Y State of California
County of San Diego 1 ss.
0 /^
On &h 6e r- 'c ' �00 before me, %�lf% ��i' ` PiVi/
0 �- /
0 (NOTARY)
personally appeared !D
S NER(S)
VVVO
personally known to me - OR -proved to me on the basis of satisfa
o evidence to be the person(z) whose n,
is/ate subscribed to the within instrume
acknowledged to me that b6she/tja�6y ex
OFFICIAL SEAL the same in IVS/her/their auth(
0
story,
me,(e) O
it and ,
;cuted
rized O
vf R. OVENS
m e NOTARY PUBLIC- CALIFORNI0
COMM. NO. 1449235
° SAN DIEGO COUNTY
MY COMM. EXP. NOV. 4, 2007
capacity(i9s�), and that by 46/her/tlwfr
signature( on the instrument the person(,e,
or the entity upon behalf of which the °
person(?�acted, executed the instrument.
WITNESS my hand and official seal. °
0
NOTARY'S SIGNATURE O
OPTIONAL INFORMATION °
The information below is not required by law. However, it could prevent fraudulent attachment of this acknowl- Q
edgment to an unauthorized document.
CAPACTff CLAIMED BY SIGNER (PRINCIPAL,)
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE(S)
❑ PARTNER(S)
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER: r
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
0
DESCRIPTION OF ATTACHED DOCUMENT
0
0
Leese®c<2=>c.29!=-e�O.0�e. ®®_*--dIE
APA 1/94 VALLEY -SIERRA, 8007362-3369
0
A
TPTLE OR TYPE OF DOCUMENT
0
0
NUMBER OF PAGES O
0
b
0
DATE OF DOCUMENT
0
. d
• o
OTHER o
r