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1 NOTES R RESIDENTIAL 4 PERMIT 10 0-020. _- RICHARD 04-1318 7ZS�COUNTRY CLUB OROVILLE Cont: CD CONSTRUCTION NEW SINGLE FAMILY/GARAGE SPECIAL CONDITIONS t CHECKED c BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER rA OFFICE COPY Address `"'"" ly'd »' GAS ate t Meter BY j ELECT 0�� Meter BY 1 t ;j JOB FINALED (Date) Vr- e-lor Signature t4�. J1 OK 0 Not OK . = NotReadya/e MOBILE HOMES Dute ) 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 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 7. Well Clearance & Disconnect 2. 8. Utility Clearance 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors Date Electric Card B-1 Date Card B-1 Date 9. Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 11. 1. Zoning Requirements -Setbacks -Easements 12. 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 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. , Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card 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 It 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 = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Si 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Pi Fire lace Ft .-Steel ,\,NV.; Fall -Fitting -Test -2 Way C/O -Sewer Test Pas Pipe; Size Anchors -Yard Gas Piping; Size Test Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. & Ventilation Date Vtf Card B-1 L'V Date Card B-1 Date I i Card B-1 Date Card B-1 Date PLUMBING (Permit) O"xcept #'s 1 T,.Mr Htr.; Vent -Access -Combustion Air Baffle 18 r ater Pipe; Test & Anchor -Nail Protection 1 ..: TesLrittinas & 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 Date Card B-1 _/ Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. fixture & Transformer Clearance -Ins. Protection 25. EI c. Receptacles Spacing -Lights & Switches at Doors 26. iz oxes & No. of Conductors Stapled 27. omex Installed Close to Edge of Studs & C.J. 2Q,00rquip. Ground made up w/Mech Fasteners -Bond as & Water 29,/1 Appliance Circuits in Kitchen & Conductor Size GFI tr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection bfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 3 ange Circle/ ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes ❑ No ,5service-Riser Conductors & Ground Main Disconnect Equip. Clearances Panels-Motors-Mech. Equip. 434-0 othes Closet Light -Shower Light -Spa Light IV -Smoke Detector Date and B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MEC ICAL (Permit) OK except #'s 3 . Ducts Insulation & Support 3 ent Fan, Exhaust above insulation 38" Condensate Drain & Overflow, Size & Grade 3VFurnace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet Attic Access & Platform if Furnace in Attic Date M/1, , Card B-1 (.^J Date Card B-1 Date ( Card B-1 Date Card B-1 Date FRA I G (Permit) OK except #'s 4 ills Proper Materials & Anchors 4 alts Studs -Nailing Spacing & Braces -Plates -Sound 43. earing Walls over Girders & Floor Nailing 4V Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46/Fleaders & Beams -Size & Bearing ngle & Duplex) Date F52MING (Continued) 47. Hangers -Post Caps -Anchors- onnectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Tru -Shting.-Rtng. 49,, Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access Size &Romex Protection Draft Stop Ins. Baffles Bdrm. W ndows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing Channel Property Line Firewall & Openings 54,/Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits S. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer :tt.- Gcco Mesh -Drip Screed -Fd. Vents-Underflr. Access 69'falazinq Area- ss Protection -Skylights -Plastic i Wall Panels / 63. Infiltration -Walls- indows Date t 2, / Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINA tans) OK except #'s 6 Fart Steps -Door & Sidelight Protection -Landings 6V Smoke Detector Furnace Vents -clearance -Comb, Air -Connector - I arage; Above Floor-Ducts-Mech. Protection Boroom Exiting 6 . .. & Bath Fixtures & Tub Access -Spa 6 Elec. Trim & Subpanel, Breaker Sizes & Labels ->' Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 7 lec. Outlets at Wood Panel, Int. & Ext. 73. it. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74._,111ec. Outlets & Receptacles at Kit. Counter Garage Fire Door; Swing -Landing -Closure 7 A.C. Duct in Garage -Damper 77 tr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 7 Ib.; Elec. & Mech. Equip. Listed for Location 7,9!-Elec. Receptacles in Garage (FF.I.)-Romex Protection 80,Irfsulation- Foam- Looked in Attic 81. ;ward Rails & Deck Construction -Post Caps 8 Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth earance Looked under Floor ❑ Yes _ 3. Following Instld./Drive ❑ Yes YAo/Walks ❑ Yes q No/Planters O Yes k] No 4. Stucco Brown -Finish 85.�/a.0 Unit Disconnect, Electrical -Plumbing 86 ents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. a r Well, Disconnect, Electrical, Plumbing 88e,fxterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ygritilation Throughout House 9 . Glass Prote n - ,44 91. Previous Inspections 93. 0�orrectioviJrairi. as TgqVQLes-Electric Water & Sewer Connected -C/O to Grade HD Approval 94. Energy Compliance Certificate -Other Certificates 95. A'6dress Posted 6 Fire Sprinkle Date 34i ,- Card B Date Card B-1 Date I Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: ENGJ EERED WOOD SYSTEMS Certificate of Confor-mance Certificate 052662 THIS IS TO CERTIFY that the glued laminated timber products identified with a collective mark of Engineered Wood Systems (EWS) were manufactured in accordance with the applicable standaras and associated specifications indicated below: ANSI Standard Al 90.1.1992, For 'vVcod Products — Structural Glued Laminated Tmber NER-486 Glued Laminated Tmber Combinations And "GAP" Computer Program For Determining Design Stresse' AITC 117-93 — Manufacturing — Standard Specifications For Structural Glued Laminated Timber Of Softwood Species IT IS HEREBY CERTIFIED that the APA EWS trademarked structural glued laminated limber members were produced in a manufacturing facility subject to regular audits in accordance with the Englneero; i Word Systoms (EWS) Quality Assurance' Program. Routine audits inc'ude inspection of the mrnufacturing orocess and evaluation of the in -plant QA program with acequate sampling to verify corifomiance to industry standards for lumber grade and glueline bond quality. ,0pt�uBla�� W004 0 A'OT J'� +moi e t SEU 3a 10 iw y '00 00 o+ by Thomas G. Williamson Executive Vice President ENGINEERED WOOD S'rSTEt4S is a ela:ed conma:ion of APA —THE ENGINEERED V�VOD ASSOa.ArrON 7011 Soutn 19th Serest • P.O. Bcx ! 1700 • Tacoma. WA 98411-0700 Tewhons: (2531 4195.6600 • Fax Nwntw. (253) 535•7265 County Subdivision Name DESCRIPTION OF INSTALLATION 1. ROOF .............. Thickness(inches): ........................................................ 2. CEILING Batt or Blanket Brand : .......... *** .............. ThicknessThermal Resistance (R -Value):,::::::,*-*- .... ..... ........................................................ ............................................. :...............:: .... I . .......... Loose Fill Type:::::fiboigl ass i ; i ii:::Brand .............. Minimum Installed Weight/ft:;::':::, 5W lb ............ Minimum inches Manufacturer's installed weight per square foot to achieve Thermal Resistance Lot Number ....................................................... Brand ..................................................... Thermal Resistance .. ........... ............ 3. EXTERIOR WALL Frame Type: A. Cavity Insulation Material: Thickness (inches): B. Exterior Foam Sheathing Material: Thickness inches :[ ...................................................... 4. RAISED FLOOR Material: ......................................... Thickness (inches): ........ ......................................... 5.- SLAB FLOOR/PERIMETER Material: Thickness (inches): Perimeter Insulation Depth ...................... 6. FOUNDATION WALL ............................... Thickness (inches): ............................................. ........................................... Brand Name::::::::::::::: -::- -::- -::- -::- -::- -::- ........... Thermal Resistance (R -Value)::':::::::::::: Brand Thermal Resistance....................................................... .......... Brand Name: Thermal Resistance ................................ Brand Name: ........... I ............................... Thermal Resistance Brand Thermal Resistance (R -Value):::::::::::::"","*"",***** ... ........... DECLARATION I hireby certify that the above insulation was installed in the building at the above location in conformance with the current Energy Efficiency Standards for residential buildings (Title 24, Part 6, California Code of Regulations) as indicated on the Certificate of Compliance, where applicable. j. 2&3€I..............- — ----- , Si Item Number's qtore aij6 Date / , , t Item Number's Signature and Date Installing Subcontractor (Co. Name) or General Contractor (Co. Name) or Owner BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.netWds PERMIT NO. BP041318 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: 09/02/2004 APN: 027-110-020-000 the Business and Professions Code, and my license is in full force and effect. 1/�✓�� License Class: � License Number:.��� Site Address: 7.=5=- ©a.o 4r,. t,twf77Q�y Date: Contractor. Map Index: G� Description: NSF(1696)GAR(624)COV(602) 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: WHITE RICHARD E permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 3412 TUSCANY VILLAGE DR signed statement that he or she is licensed pursuant to the provisions of LAS VEGAS, NV 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 89129-2121 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: C D CONSTRUCTION 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, 43 EXECUTIVE AVENUE provided that such improvements are not intended or offered for OROVILLE CA 95966 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-589-2220 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: C D CONSTRUCTION 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.). 43 EXECUTIVE AVENUE ❑ 1 am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 530-589-2220 Date: Owner: License #: 685990 WORKERS' COMPENSATION DECLARATION 1 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: Carrier: Total Square Ft: 2922 S.F. Valuation: $134,848.00 Policy #: Census Code: I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one $.� (. 3 p Jr • I O • O ¢ hundred thousand dollars ($100,000), in addition to the cost of 4 O�olo% �C $ / 3 (• I 8. 4 -_ 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 Codp anryor I hereby affirm that there is a construction lending agency for the Resolutions t do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)�_ G? • �•� By: ^`--' �&.�.-•� Data: Name: PERPIRES ON: 4 • ' OS ho Address: Date ❑ 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 enterupon the above mentioned property for inspection purposes. Print Name: ��!'�,�%.� ��'c'� /_✓��,� y -I / Signature: z� � •l Date: 0 Owner •0j Contractor ❑ Agent for Owner ❑ Agent for Contractor AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2100+—�IIa516Ea6 Recorded Official Records I REC FEE 7.00 I COPIES 2.00 CoBUty OfTTE I CANDACE J. BRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Alyce 10:49AN 24 -Aug -2004 I Page 1 of 1 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date__ -- /� t/ % PR WNERS: �TTT State of California County of 1' U-� personally appeared rgUrPi,6Xd L4 -J tL-P f personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my ha and offiglai'sgal./ , Signatu ��� / ��_ Seal: ] HEIDI R. HUKILt. r COMM. 01411254 N � Nota P bli A.P. #0_27 tL ® ry u e-Califomla BUTTE COUNTY + My Comm. Exp. April 15, 2007 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. BP041318 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: 09/02/2004 APN' 027-110-020-000 the Business and Professions Code, and my license is in full force and effect.✓ License Class: _ License Number:& /% Site Address: %'z 5z ©2a Co uN ray O Date:0 Contractor. v- [-f /S Ma P Index: ' ,i�?l.1rf � Description: NSF(1696)GAR(624)COV(602) 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: WHITE RICHARD E permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 3412 TUSCANY VILLAGE DR signed statement that he or she is licensed pursuant to the provisions of LAS VEGAS, NV 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 89129-2121 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: C D CONSTRUCTION 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, 43 EXECUTIVE AVENUE provided that such improvements are not intended or offered for OROVILLE CA 95966 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-589-2220 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: C D CONSTRUCTION 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.). 43 EXECUTIVE AVENUE ❑ I am Exempt under Article 3 of the Business and Professions Code OROVILLE, CA 95966 530-589-2220 Date: Owner: License #: 685990 WORKERS' COMPENSATION DECLARATION 1 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 perfornance 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: 2922 S.F. Policy#: Valuation: $134,848.00 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: /-2 4/1 Applicant: tPi.,ii r,/)/(/_� i4'/ ('i/i 42/i/ WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one rJ 8 3Q 3.� (, 1 OJr • (0 • O ¢ hundred thousand dollars ($100,000), in addition to the cost of 4Oro�%� 4 /3 3 14 4 - 0.4 compensafion, 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 Code anrvor I hereby affirm that there is a construction lending agency for the Resolutions taido work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)t- Q , Name: By: Date: PER PIRES ON: 4 D • OS Address: Date ❑ 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 of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. t'- Print Name: , --C �q 1- Al J - 4 4,- f,1,Y1/ Signature: �� ��� _•�i�„�-.� Date: Y /--:1_ /a t-2 / ❑ Owner -d Contractor 0 Agent for Owner ❑ Agent for Contractor BUTTE COUNTY PERMIT NO. {�,iTTF0 DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION BPO4 13 IS C ° 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) c = : ' c OFFICE M (530) 538-7541 ckU YIN DATE: APN: ZONING: ✓ _ -/ PHONE OWAER'9 LAST NAME: OWNER'S FIRST NAME: STREET ADDRESS: FAX: el E-MAIL: SITE ADDRESS: e ^ CITY. ZIP. i D , 42 A Q - NEAREST CROSS STREET: TRACT/LOT P. APPLICANT NAME: PHONE STREET ADDRESS: FAX. CITY, ZIP: E CONTRACTOR NAME: , PHONE jv STREET ADDRESS: FAX CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE l f /, _ _ _ STREET ADDRESS: V/ FAX: � CITY, ZIP: .9 l ✓ . 6 LICENSE NUMBER: E-MAIL' DESCRIPTION OP. SCOPE OF WORK: ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) =L-z�"X 7 ®985 S2 EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. For office use only: 15 P 1.3 L 1. Zz Notes: r SRA 1 SZ • JX Application Received by: K''i` Date: Amount Received: 4'1 � Receipt number: 4-pS836 4..•.�h :�y,� - '' �a.J,'Y.�liw.,;..?�'�v.[++w,'�.-%...' ti.r�,y...r'rt"ti..r.::�r-:"-r•;-�....�""1.' ... �' &U, NTY 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:, vv t4 I -r E ASSESSOR PARCEL NUMBER e>3 %' t t =4D Proposed Building Use: �j S F Counter Technician: Date: tops required in ord" 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 plans, 3 or 4 sets, signed by the preparer of the plans. -:rr 3. Engineered plan , 33 r 4 sets, with wet signature on plans AND 2 sets of stamped and. signed calculations. 4. Engineered truss&etails 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. C] 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst. (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ,E 13. Detached Accessory Building Form filled out by the owner C 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico eOroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 17. Fire Sprinklers............................................................................................ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ................................................... 20. Erosion Control Plan Required........................................................................ ........ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit'.. ..................................................... ermit...................................................... 23. California Department of Forest plan approval paid'. Sent by: ............. 15-2 q- 24. Planning approval (A) Use: (>P-(B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage... ...................... 26. NPDES Form ............................... 27. Encroachment Permit for driveway from the Public Works Dept ........................... Q •2-c4- ' %❑' ' 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ;!�32. Letter of Signature authorization ....................................... ............................. 33. Recorded copy of Agricultural Acknowledgment Statement ................................. C134. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H, Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other. When issued Telephone 5► a 7 V d and hold for pickup. , I have been4Mormed.of the abov4fitems and requireme-Wf6ir obtaining a Applicant: l A Date: ell 1. Index permit application for the above items nurrfered. rrCtre et r --� dditional items required Conlractor,Agsigner, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, own r, advised of the abgve deta by ❑ phone, ❑ mail, ❑ counter, by Date: Ze Plans reviewed by: - Date: / Plans approved by: ate &e WZ1 Structural reviewed by Date: Structural approved by: Date: Z Note transfer by: Date: Yellow: Building Division TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H. USE ONLY Fiat Pian Anachad Roar Man Attachad .t Siam to G.D. . TTiu'Y�CJ� ,u T, p�CQM� Zb Owner Location APf Plan Approved for: Sewage Dispo--s-a�^ Water Su Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: Public Private 1dVel A MA 2-�--� Environmental Health Specialist Date E��Z� COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT *SERVICES -BUILDING DIVISION ' 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 Y SCHEDULE OF RECEIPT OF FEES OWNER \/V ( R 17-E PROPROSED BUILDING USE &JS F 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ �Jz A.P.# 4527. 116.0zv DATE RECEIPT # DATE REC. 4-66, 2-4 a 4- 2. SCHOOL DISTRICT FEES a ^_ (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ 40U,74, 612-_-+164- Units 64Units Commercial (sq. ftg.)..... ay.r%. 4. URBAN AREA FEES X $0.03 = $ (paid at Building Division) Residential (per unit)..... X = $ 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 689.00 (paid at Building Division) 152-A0 8. WATER, TENDER FEES BATTALION # $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Commercial (sq. ftg.) ......... X = $ Sq. Ftg. Amt. -0 10. OTHER 51 P 13A 14, 912-4-164-- At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT 6���, DATE �J Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). , Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) ENCROACIDIENT PERMIT County of Butte Department of Public Warks 7 Count Center Drive Oroville, CA 95965..Phonr: 04)) 5384157 Ext 2016 Fax: (530) 539-4356 Download Fomis: www.buttecounty.neVpubhcworks/.forms.html NOTIFY COUNTY ". ; H077AS BEFORE WORK IS TO BE DONT, PcmtitNumber District Pb '! ':7 538-7157 Ext. 2016 f APPLICATION I/WE, the undersigned, ht -:bv a.a. ly to the County of Butte for an enefoachment pcm-it to do the following works order or over the County roads and hi hwa all in actor: -aec s h County ordinances and &eneral laws All infomlation except signature must,)e typed or I 'bl ted. 1. Applicant's Name: 1 a. Company Name: s 2. Address: 3. Phone _ 4. As s Parcel Nutuba S. Cocadct of Work u, b 6.pptitant's Signahre .s 7. Date. _ ''CONTRACTOR'S INFORMATION. — 9. Contractor's Name 2— t121�! >AlJ isi1J 9. Address -" 10. Phone:�1 �,•� 11. Fax: g I2 Contrtictar s Licettoe Num 13. Ceftince ra=: Yes' ❑ No: ❑ 14. Contractor's Signature: 14a. Date. Signod: �,i�--?. /-� % i -es' l5. Authorized Agcnt: TYPE OF WORK TO BE BONE 16. Please Check: Curb: ❑ Gutter: ❑ Sidewalk: ❑ i 7. Driveway (Litt Type): IS. Other: PERMIT GRANTED In compliance with the above request, and subject to all terms, conditions (including mme on page 2 of this pcm it form) and special conditions written below, permission is be tygranted. 19. Conditions Underground SeMee Alert .SA must be notified two workin 3a r' tp an excavation. 900-227-2600 2o,' All work shall conform to accompanying: Detail ❑ Plans ❑ Special Conditions ❑ 21. Date Is�s�ued�Q 22. Expirada 23 Sure I Mike Grump, Director of Public Works y: -e " Note: If permits are, raxcd to any numbcr bcgidcs (330) 538-4356, they can be delayed up to one week. Page 1 or 2 Gcneral Conditions — See Page 2 Tz� I.IJTC'TT nrnrn.? TA -dacz 99Ct7-92S-022 S�,I_iori oxlGnd 64uno-) a-41.rlE 4.10 ter. -FaA BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District _ /� (A b `S Building Department No. A.P. Number �� % 0 VXurisdiction: City County Property Owner Property Location/Address ro /'v It Subdivision Lot No. ...................._........._............................ :.................................... Residential Development I ! I Q Q Q Sq. Footage 6 Q No"ofi��Livi+ng Mobile Home Addition/ *Supplemental to (Group'R) Units Installation Conversion Permit # '(No foundation Inspection) Restn ed Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industry Q Q Sq. Footage L° New Addition �` (Including Exterior t Roofed Areas) Buildi4parlment Representative/ Date District Identification No. 050034 - i V�h \ lbC1 �a School District certifies that A -C R Cit' a i f~ V (Applicant) (Streat:Address) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. / WS --,q representing p VL square feet. hoot District Reoresentati. e_ Paid by Check # Remarks: by payment of $ 1 i JAB 2926 $ 1 FULL MMGATION ; $.� Date � Noriko: You may protest the Imposition of the fess Identtiied above by submitting a written protest to the District, in compliai ce with Government Cods section 66020(a), within 90 days from the date hes are paid:lailure to submit a timely wrftten protest wiil'prohfl* you from challenging the Imposition of the toss in any court action. If, subsequent to the School District Representative signing thle';ilutte County Schools Impact Fee Certification Form, the school District Is notMed by the applicable Loaf Warning Agency that this projethle being revivred under** CslBornta Enviromantal QwiHy'Aat (CEQ4 @Ile pr mi ri may be subject to additional school toes to fuliy`Aitigete. its impact on the school dlstrleft schools. White (applicant), Yellow (building department), Pink (school district) feefonn.xe 110/031dmm �VT7' ° RESIDENTIAL PLAN REVIEW GUIDE °° c:'"�- i►:: o SINGLE FAMIL Y, D UPLEX AAID c MISCELLANEOUS ONLY OU Owner. Au �,_ Building Permit Number: (2 l� Plans Exa;niner: 1_;4da 54.mrsor► A. P. Number: 6o8 7- //d r GENE &A,L: Zoning requirements — (number of permitted living units). Plans signed by the designer. Proper description of work on the application. xisting violations on the property. Recorded nonce of violation. Building permit valuation. PLOT PLAN: 6. Complete parcel size and dimensions. Setbacks. side yard, easements, etc. Other buildings or structures. t. Grading. fills andior drainage. Flood hazard Special conditions on Parcel Map: Noise ❑ SR -.k ❑ Fire Sprinklers ❑ Water Tender ❑ Traffic and Drainage fees ❑ Federal Aid Route and/or Federal Aid Secondary Route setback requirement. Building or utilities across lot lines (Lot merger approval by Butte County Land Development) FLOOR PLA`: Plans and specifications drawn to scale with dimensions and of sufficient clarity (UBC section 106.3.3). 1011'0 of natural light and 5% of ventilation (Uniform Building Code section 1203). Escape or rescue windows shall have a minimum net clear operable area of 5.7 square feet The miaimtnta net clear openable height dimension shall be 24". The minimum net clear openable width dimension shall be 20". When «indo%%s are provided as a means of escape or rescue, they shall have a finished sill height not more than 44" above the flcor (Uniform Building Code section 310.4). Skti•lights (Uniform Building Code section 2409 dt 2603.7). Glaring in Hazardous locations (Uniform Building Code section 2406). Habitable space shall have a ailing height of not less than 7 feet 6 inches except as otherwise permitted in this section. Kitchens. halls, bathrooms and toilet compartments may have a ailing height of not Less tion 7 feet measured to the lowest aroiection from the ceiling (Uniform Building Code section 310.6.11 All habitable rooms except kitchens shall have an area of not less than 70 square feet and not less than 7 ffett is any dimension (Uniform Building Code section 310.6.2 dt 310.6.3). GFCI in baths. prage, kitchen, wet bar, and exterior receptacles (NEC 210). Water heaters %% hick depend on the combustion of fuel shall not be installed in a room used or designed to be used for sleeping purposes, bathroom. clothes closets or in a closet or other confined space opening into abath or bedroom (Uniform Plumbing Code section 509.0). Fuel burning equipment shall not be installed in a closet, bathroom or a room readily usable as abedroom. or in a root. compartment or alcove opening directly into any of these (Uniform Mechanical Code section 304.5). Garage fire%vall separation - required on garage side including supporting walls and posts (Uniibrtn g Code section 302.4 exception #3). Under no circumstances shall a private garage have any opening into a room used for sleeping purposes (Unifor-n Building Code section 312.;). «Wood stove location - Alcove — UbiC section 205 confined space 8t 223 unconfined space &30.2). Smok_ detectors (Uniform Building Code section 310.9.1). Pagel of 2 Al. -Water closet clearances (Uniform Plumbing Code 408.5). 4t:.z:4$)mwsr compartment minimum 1024 sq. in 8 30" circle (Uniform Plumbing Code 412.7). Bearing walls shall be supported on masonry or concrete foundations that shall be of sufficient size to support all loads (Uniform Building Code section 1806.3). STRUCTURAL DETAILS: 1. Braced wall panels shall start at not mon than 8 feet from each end of a braced wall line. Brand wall panels mm be in line or offset from each other by not more than 4 feet (UBC section 2320.11.3). Spacing shall not exceed 34 feet on anter in both the longitudinal and transverse directions (UBC section 2320.4.1.) Braced wall lines must be continuous throughout the structure. - 2. A California licensed architect or registered enginmr must prepare a lateral analysis for the areas of the building that do not comply with the Uniform Building Code. This must include the designer's `vet" stamp, signature, registration number and expiration date on all sheets of plans depicting the designed elements and covet sheets of calculations. -r— Clerestory requiring balloon framing and/or engineering. X41 Foundation plans complete enough to construct building (Uniform Building Code Table 18-I-C�. -d! Floor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct building. ..?!Roof construction details complete enough to construct building. .-irghtce construction details and calculations if necessary. J3 --Garage door header size(s). -9:—Porch header size(s). typical header size(s). —Stud heights. . High expansive soil — special foundation design required - 0 walls requiring design Cryo. wallboard nailing inspection required. Ifthe area belowthe lowest floor.is fully enclosed, than a minimum of two openings are required with a total net area of at least one square inch for every square foot of area enclosed with the bottom of the openings no more than one foot above grade. Alternatively, certification may be provided by a registered professional engineer or architect that the design will allow equalization of hydrostatic flood forces on exterior walls. Building must be designed and anchored to prevent floatation, collapse or lateral movement. Construction design requirements must be shov-n on the building plans. . Electric, heating, vendlation, plumbing and air conditioning equipment and other ser% ice facilities shall be designed and/or located so as to prevent water from entering or accumulating with the components during conditions of flooding. ML4CELLANEOUS ITEMS: Stairway details — landings, rise and run head clearance, handrails (Uniform Building Code section 1003 ). Guardrails (Uniform Building Code section 509). Brick or stone veneer (Uniform Building Code section 1403). Exterior pIaster— weep screeds (Uniform Building Code section 2506.5). - Roof pitch for roof covering (Uniform Building Code Table 15-B-1& 2, 15-D-1 & 2). Foam insulation — protection. 36" halls and stairways (Uniform Building Code section 1064.3.3.2). Tviv exits on three — story dwellings (Uniform Building Code section 1004.2.3.2). Underfloor access and ventilation (Uniform Building Code section 2306.3 8 2306.7). Attic access and ventilation (Uniform Building Code section 1505). and requirements. eM, design compliance and supporting documentation. . CDF responsible area requirements. ' ING PERMIT REQUIREMENTS: 1. ❑ SRA. 2. ❑ Flood elevation certificate. 3. ❑ Fire Sprinklers required. 4. ❑ Special Inspection requirements. S. ❑ Use Permit conditions. 6. ❑ Sub -Standard Housing lever. Pzee -- . f = , j Illllillllllllllllllllllllllllllll 2920 920—�a05 a 6'6t� AND WHEN RECORDED -NAIL TO: J BUTTE COUNTY BUILDING DIVISIONRecorded Official Records I REC FEE 7.00 I COPIES 7 COUNTY CENTER DRIVE Count OfBUTTE 2.00 I OROVILLE, CA 95965 CANDACE J. GRUBBS I Recorder ROSEMARY DICKSON j Assistant 10:49AN E4 -Aug -2004 I -Alyce I Page i of i AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date` PR7 OWNERS: State of California County of 1311.E On before me, personally appeared (J 1* r LILLr' personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and offi a al. Signatur Seal: HEIDI R. HUKILL COMM. 01411254 A.P. # C ,4 , 2 . a --0 0 N ? Notary Publle•Callfornla y w BUTTE COUNTY .� My Comm. Exp. ApdI 15, 2007 COUNTY.OF.13UTTE !\ BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES ., 411 Main Street, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. C'A-M ��L� 4� ii / �t� 3O 19,4 VS lei SITE PLAN REVIEW APPLICATION CJ 0 Date: 2 6 __03 AN Permit Number if applicable) n1) 1( APPLICANT INFORMATION Parcel Size: Owners Name: ILAS P\Q^nt I) a h Lie Owners Address: Telephone No.: i L) Situs Address: Proposed Use: 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: 24 -i 1 D — 2.6 I � , t_l I ALA1 __S ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel Well ❑ Agricultural Buffer Form Brief Explanation (if necessary):_.pJi DO NOT WRPTE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Im Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval 10 Site Plan Stamped Approved By Date 6 Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY I \` 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: • Flood Panel No.: C5 $5 Index Date: t-}-2.8 — @� ❑ 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: A — Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Doric+ 7 r%F C C7 0 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front 7t— Side �� 3 Side Street Rear S 77o Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Doric+ 7 r%F C C7 0 Applicable Development Fees: Standard Fees Amount Formula Water Tender Fire •❑ ❑ School* ❑ Parks/Recreation Other (per map) ❑ 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 Deeds: Date of Creation: 12-" 19 — 6_1 � Legal Access Provided: ❑ No Yes Deed of Reference: ) y 5 H — O SO Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No E Yes, Road Name: G4Z U 694S QD 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 ❑ Meet current Environmental Health Department requirements Page 3 of 5 ❑ Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: Page: ❑ Use Permit/Minor Use Permit Number: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions Comply with the following Conditions of Approvah ❑ 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 Pla must be prepared by a registered civil engineer or other qualified professional and b oo 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. EJ Page 4 of 5 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm... Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACREI Project Title: By signing below, I, the project ownerlowner's agent, certify that I am aware that a construction project that disturbs 1 acre or more of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP), and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more of land. I ani aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctions provided by law., ■�■■■■Mil[■■■■r■■■■■■■■■■■■■■■■■■■ ■ ■■■■■■IN■■■illi■■■■■■■■■■■■■■■■■■■ ■E■■■■■■1■tr■■t■■■■ ■■■■■■■■■e rE�■■I■■■■iii ■■■■MINE■ ■■■■■■■■■■ MONIES ■■■ ■■■■■■■N\\�■■'iMM■■■ MIN■■■■■■■■■IE■ iiiiiii■■i MEN aiiMiiiiiiiiii i�i■m■ ■■■■■■■■■1�■■■ ■■■■■■■■■■� ■■■ ■■■■■■■■■■ ■■11■�!■tai\■ �■■■■�■■■ H■ ■ININ■M■■■■■■■��■■►��a►�■■■■MIN■ ■INNH■ ■IN■■MEIN■■■M■�1■■■ecce■■■■■■■■■■M■■ ■ ■■■■■■■E MEN I■E■■■E\\►1w■E■EEE■■ENE t "'T a 0.4 � : 1 K.4 E �• _.R E. -M- PALERMO CITAO 1 O5� 00 488.42 4o�a7 366.48 i 1 650.89 3 3 1 4 3 � 150 6 - o , .•« - ; `- - ��1� '�V 23 3Zz• - t ,9 1 30 / SIw�Q D 4 3 h 38 O s o C SAP,40 oma', 6.33 AC °� 9.46AC 3.79 • / 4 ,�MC§I 48 1n i� < 41.288 �. 1 � At 2 IA _ w V w 5.82 At. _ J 35 r+1j0' 1►j as At. qs I VCD 20.04 AC j� t? 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