Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
027-120-015
111WI 027-120-01 Ii;RK11O1 7 ROBE;, T 31 L t I ETCHER RD. PALERMO Cunt: OW''11.R +,. NSI',GARAGE r �' ' r + "' I 1 • 027-120-015 Sdt1i1ttS't i.a°�1b�Ki'�+t >T r h'.< .fitt�. ,1r,.'`<.'.'f'.{t f j t1 u9++J1t t _ if t..h�'.)J- aL'+^•j_-`'.t�ri �1'.vf,(J .s'lt `'i i7nb�,`:'�T�ti f��itt.'aJa�`Jd�7{`.yjy}71`J+Ss '��7I�tc�iI�s}c�+1S�emiti. �.d". �t'Yi. '?tt,i,iK:.i.J �1 �tYTiJppt f?ii � !�s{,}., eliHF�.,.Hr Y., � �t�b. iskatlF h 1 �3e.' i°L.Gt jJ� �SA Y �r :`y`�Y'e*S;�ttri <�t,t� ys/tjiJt�1, '���+a�'c�tti#�A„�i4t,7 !.��a4!�rz.,'+._t,%...y�"�ii.t,`�'!t,• " i t F 1 a r rt( - r , 05-3206 Y 5,-3,1Y��{1�.,2:0h5�� t 6 RKHOLZ, ALLEN 3472 FLETCHER. OOVILC Cont: BLUE HAVEN POOL-GUNITE low, fill zj w y.i.t.if,Ff114 71 �;t,,�i-f)4 A—, ffr1 r t i•1'! bt r - }+ n ,;crr lnr-s'rr'r'.•;.�'.'., ,dd'�Nu�4i{It11 S�kf1�nrt I{4�'l.,. 41 . { ..3$iIr•.p�I�:�}.{�t1IF� i. � .::. ? - .< '*,tA}i)i �i�i ire 1 �t lr 1'' ItIt1' ;•1 I: i t {111 i 41,It q+3 st' s.ea r e,j+s 1j1 K t r_. t.2i s ,ji .t!'. I ..f, t .•;i,!! 1 , L„ `:� NOTES f n . RESIDENTIAL ' Y '�• CO2 -01- 1 o5 -053 i „< PE NO! ,BIRK i0LZ. ` gq 7Z F LET.:;:-[F:,R RD, PALE? RMO ` a . Coiit: OWNER.' NSF/G1ARAG 10.1-� X01,. uw C1,111....J _ 09 J — 5 u Rr1, SPECIAL CONDITIONS CHECKED BY - SRA - - FLOOD CERTIFICATE REQ. - FIRE.SPRINKLERS REQ. . - r • `�{} 'SPECIAL INSPECTION ITEMS - , VERIFY USE PERMIT CONDITIONS _ - c t `- "SUB -STANDARD HOUSING LETTER r OFFICE COPY a - =Address �,t• GAS .. �. Meter By Date K, `< ELECTRIC Metes By Date JOB FINALED (Da - v -`Signature p: J=OK 0 = Not OK . = NotReadyable 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 Date Card B-1 Date Card 6-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -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 r 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 r 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 POOL$,(Plans) OK except #'s ,29'etbaoks-Easements 1_06h; Eompaction-Structure Stability is --Pool Structure; Steel -Connections -Thickness Dead Men -Lining ked Receptacles and Lighting, Distance-GFI e 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 R Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 v r V' J=OK 0 = Not - =Not AAppplicable + = Not Ready RESIDENTIAL-(. Date UNDERFLOOR (Plans) OK except #'s 1. ning-Setbacks-Easements-Flood-Slope VlwlfFan, Exhaust above insulation ndensate Drain & Overflow, Size & Grade t 5tg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth F /nace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet j Ft Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth /r 1g!Porches & Decks; Soils -Steel-/ /" Ftg. Depth /i St walls, Main; Steel-Blockouts-Wrapped //S walls, Garage; Steel-Blockouts-Wrapped 8• . Hold Downs and Special Anchors 7. Steel -Wrapped - . Pi -Fire lace Ftg.-Steel j"_W-.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test fl 1 OF as Pipe; Size A ors -Yard Gas Piping; Size Test 12.is ater Pipe; T - nchors-Regulator-Service Test - U roun % 1 PI s& p—Clear a MatrAffr u ort - j/ 1 Girders-Sil s -Anchor B -Joi s(Vents- . ies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date P 1 BING ermit) OK except #'s t tr.; Vent -Access -Combustion Air Baffle Pi e; Test & ehor-Nail a to n 84104:0.W.V.; Test F gs & AnowlPNairProtection 20. Show Pan; Test, First Floor -Tub Access 21. Toeftub & Shower, Second Floor -Tub Access s 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'- 14. 4. F' re & Transformer Clearance -Ins. Protection c. Receptacles Spacing -Lights & Switches at Doors oxes & No. of Conductors Stapled Tk_ZAppliance me Installed Close to Edge of Studs & C.J. - Eq . Ground made up w/Mech Fasteners -Bond Gas & Water . Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ !A Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ 4rga r AI -Oven Circ. / /ga Cu or Al , Insulated Neutral ❑ Yes O No 32. i -e-Riser Conductors & Ground Main Disconnect I i . Clearances Panels-Motors-Mech. Equip. 3g0thes Closet Light -Shower Light -Spa Light Smoke Detector q_'} -ns 14 — Waft hat reaoty i Date .. Card B-1 IV Date If Card B-1 Date !jbA c-,%, • Card B-1 Date Card B-1 Date ' MEC ICAL (Permit) OK except #'s aCA Ducts Insulation & Support VlwlfFan, Exhaust above insulation ndensate Drain & Overflow, Size & Grade t F /nace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet j ` Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ' FRA ING (Permit) OK except #'s Is Proper Materials & Anchors alls Studs -Nailing Spacing & Braces -Plates -Sound Baring Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) 4 Fi Stops, Furred Ceilings -Stairs -Chasers -Tubs Headers & Beams -Size & Bearing ti 'ingle & Duplex) Date FRA G (Continued) an ers-Post Caps -Anchors -Connectors ing. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. Ir • lace Ties or Type A Flue -Fireplace Throat Clearance is Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions Garage Fire Protection Framing -RC Channel 53 roperty Line Firewall & Openings Ext. Doors -One 3' -Check Garage 3rd Story, 2 Stairs; Width- Head room- Rise- Run- Land in ire Pr tection Plywood on Roof Overhang -Attic Vents -Rafter -Mu riggers 57. 5Win -Nailing V er cco Me rip Screed -Fd. Vents-Underflr. Access azing Area -Glass Protection -Skylights -Plastic �' rJ . Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Vol Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 - Date V010- ti Card 13-1 Date Card B-1 Date Card 13�.1 Date' FINAL -(Pans) OK except #'s / 64. Ext!Steps-Door&Sidelight Pr6tection-LandUigs 65!�Smoke Detddtor 66rPGnace Vents -clearance -Comb, Air -Connector - In Garage; Aboye Floor-Ducts-Mech. Protection 67 -Bedroom Exiting 68=G -F.1. & Bath Fixt res & Tub Access -Spa 69.,Elec. Trim & Sub -panel, Breakef S&zes & Labels 70�-Stairs & Rails` i 71. -Fireplace or Stove; Clearance -Hearth 72-1Eley. Outlets at Wood_ Panel, Int-.-& Ext" 73 -Kit. Fixt. & Appl anc Ground=AlrvGap`-Cooking- earance 75. Garage Fire Door; SwipgFtanding-Closul=e 76tA:C. Duct in Garage -Damper 7A—WtEHtr.; Vents -Clearance -Comb. Air Connector-P.R.V'• in Garage; Above Floor-Mech. Protection 7&-P1b.; Elec. & Mech. Equip. Listed for Location 79.LE1e6-ReceptacW9 in Garage (F.H4)=Romex Protection 80. Insulation -Foam -Looked iwAttic,- 81t�.G6rd Rails & Deck Construction -Post -,Caps 82' Fdn. VBents & Crawl FtoW06or Drainage & Wood -Earth _ QearandeLo9ked under Floor ❑ Yes 83- Following Instl, Drive O Yes R No/Walks O Yes O No/Planters O Yes Cl No r•j '�°� 84 -Stucco Atn-Finish Va N� 85tA'C Unit Disconnect`Electrical-Plumbing, 86tV ne is Aboye Roof; Plbg-Appliance-Firepld�co'e-Clearance to Openings 8Z -Water Well, Disconnect, Electrica Plumbing 88f- xterior Elec. Trim, G:F(-Receptacle- Underground 89elation Throughout House 90,, ass Protection 91 -!-Corrections Previous Inspections i2. Gas T • meters Tagged, Gas -Electric 93. Water 8 Sewer Connected -C/O to Grade -HD Approval (-94)rtnergy=C6mpliance Certificate -Other Certificates 9�4ddress Posted 96-.Eire-Sprinkler— Date 6-. Eire -Sprinkler Date I -JR-0 Card B-1 (j' Date Card B-1 DaTII - a Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: .J.. �., r !f• h . 1+ r _ �"k � � "' max ' 's SACRgMENTO BUILDING:CONTRACTORS' d,.au.rwY,..l'k. .f... rRi • ...�..'iEJ. `{.. l- �. 4 ...f f'k�(+ ' �` ` v NII t.,t`Z�� i .•� r .!»' 4}Zi DATE INSULATION COMPLETED Lo ( square feet) ( .. 1.�, square feet)( square feet) ="'TYPE OF INSULATION"'.; '. ' TYPE OF INSULATION ,' . . r" ?; "TYPE OF INSULATION y ` MATERIAL MATERIAL �4 FIBERGLASS FIBERGLASS FORM BATTS & BLOW MANUFACTURER'S PRODUCT I.D. FIBERGLASS FORM BATTS MANUFACTURER'S PRODUCT I.D. FORM BATTS MANUFACTURER'S PRODUCT I.D. 'LMANUFACTURERz = ":; ! .;; , — MANUr-ACTURER.Y :�'y 'V " -.WANUFACtURERI! ; -CT CT OCF Kf , TCERTIFICATION20F„INSULATION KN - CT OCF . N BAGS 'x y%LUE�4rtQ '" �iAPPLiED� �' ' R;VALUE + APPLIED i 'MIN.+INSTALLED y 7x _ . r W'c1CiHT PEF54 lR VALUE„*� 4P �'wiED i v xr� .iNSfAI EED •CT,�t �w TltlCl(NESS' s sr9 _ TIiiCKNESS '.INSTALL'EP'i. ` , ,INSTALLED I.::,�. Z�,,,�' '--- ""'ADDRESS OR TRACT t- " " •w Azo. _ I 4 +�'-.., �' - _ �"k � � "' max ' 's SACRgMENTO BUILDING:CONTRACTORS' d,.au.rwY,..l'k. .f... rRi • ...�..'iEJ. 1309 MELODY ROAD MARYSVILLE CA 95601 LIC#202026 _ 605 S. AUBURN STREET, GRASS VALLEY, CA 95945 LIC#202026 f'k�(+ ' �` ` v ❑ 3881 BENATAR WAY, SUITE A, CHICO, CA95928 LIC#202026r ❑ 8924 AIRPORT ROAD, REDDING, CA 96002 LIC #202026 ; DATE INSULATION COMPLETED Lo ( square feet) ( .. 1.�, square feet)( square feet) ="'TYPE OF INSULATION"'.; '. ' TYPE OF INSULATION ,' . . r" ?; "TYPE OF INSULATION y ` MATERIAL MATERIAL ;MATERIAL FIBERGLASS FIBERGLASS FORM BATTS & BLOW MANUFACTURER'S PRODUCT I.D. FIBERGLASS FORM BATTS MANUFACTURER'S PRODUCT I.D. FORM BATTS MANUFACTURER'S PRODUCT I.D. 'LMANUFACTURERz = ":; ! .;; , — MANUr-ACTURER.Y :�'y 'V " -.WANUFACtURERI! ; -CT CT OCF Kf , OCF KN - CT OCF . N BAGS 'x y%LUE�4rtQ '" �iAPPLiED� �' ' R;VALUE + APPLIED i 'MIN.+INSTALLED y 7x _ . r W'c1CiHT PEF54 lR VALUE„*� 4P �'wiED i v xr� .iNSfAI EED •CT,�t �w TltlCl(NESS' s sr9 { TIiiCKNESS '.INSTALL'EP'i. ` , ,INSTALLED QUARE FOOT; j,1 F Y,: K , .a tyaTHICKNESS� ` la , A` -a• - 7. Xr w «-. aI.�' Wrw-•M'e- '•�T WALLS IF.R VALUE�IS OTHEKXHAWWALLS f s No ABOVE,,— - •` � .._ _ . 'KNEE MATERIAL r`' FORM " t ` R -VALUE _ ` MANUFACTURER f . FIBERGLASS ; BATTS t r CT�; rx tiOCF..`r }KNg IAlIt1NFILTFtATI0NSEALANT,, MATERIAL,'' ` 'r'FOAM, J. O MANUFACTURER + r ..` { w3 ' } "`" ' f HILTI �' k ' i''`tir .. a zz ,` FOAM` j..HANDY L „4K / ^ �:-.w.+- - '.> a...� .:y� .. -. 3y,,.,,�. .,vs. lth..,. wr. W�v.a,r.-'•4 �: r.. 1THIS�ISTO`CERTIF„YTHATINSFILATION AND/OR'SEALANT;HAS BEEN;IN3 FALLEO'IN;CONFRMANCEyWIT�i APp„LICABL�E,kCOQESfi MATERIAtSTANDARDS�ANDREGt1L�ATIONS KI_" IR Q NIATU E,P INxS` ULTIOt �` • i `YA bf ' $ r DATE SIGNATURE - GENERAL CONTRACTOR 3 r TITLE Kj ' DATE, REMARKS {, !r •-, 51 - ,T r. .�Zwr. i.� W � Sa:-.•.ii!. :)^r .w � +. 1'. aro 4. w e ,r} .WHITE `Builder Copy GREEN Builder Copy YELLOW Customer Copy,'PINK Attic opy, GOLD '.File Copy ,r s t i � * ' < `' w � � •' sr<5 �-� � ,'t iTy�. �`r- �"ftr t..'4::.C't.. '"'' Y S'.t.5!' a k�' t e'��';•�". •.�`rk .r •� -.. S' .1 ..-+ c Zi.. �,+' r '�,.. r!. t< Y:ti 1 i. r f. � `, ,i •'X ... sJ,2•- ti _ "s�"..;., "" .. r -k- --q .,},,.::,•b �.�^'}-,:`iy'+rt..-+ (� t.' 'i.:-.- 4 r �•.i �= al,..s..+,,.... ., r r. •+ c - ,-Z �` ^"S}� "C ..� t •i'�••,' 7" .... OC*T-07-2005 0740 P.02iO3 - Civi1 EASM=ing and :Design . PO. Box 5l IS:Chico, CA 95927 Phonc:'•(S30) 52I.264.9-Fak (530) 343-5320 edag aus ' usenliineeci[ut cord, TRANSMITTAL .Octo 1 b:; 2P05 Ailan:9ir hal : Mr• khoti akesi'd Brice . :i�1. e>aflow'thr's: Ise ter to..¢ va as:agr.¢einent' -or-all .6wing.Allan Birkholz. to,use sl ier pauair i�ig on thdAndide wd'of the-sl�ehrwull:cl�ntniniRg the elertAca{. ' neh See the d #tri : beloi (cciflo4t #1::44��f..qr nailing.requir,.ements for- shear trkihsf o tO--fhe bio :, • :Please see previous- tran.'smi"ttal. pegardigg. the blocking and straping requirements :for the .perf.orei#td .s :theme nre stiff in eff ect. f .,• I n�. I: INtER10R 5WEAWALL IF DE5.*NATEb ON FLOOR PLAN 2. STRAP HOLDOUN AS NO?EO ON t..E " SCHEDULE. EXTr;M10R SWEAR PANP EL H2 —.—_——.._—.._=•.— -- _r_ I E X PLAN �— 4. Ibd NAILS >D 6" STTAO,30ZED FULL HEIGHT:OF STUD S. 2x STUDS 61b'PL. F` . • . '.. • . `. � • : • � `�-J 1. E UL TA • DFf_S9/p . W " No. ones 0 1�*+ pp :Os20 IGP5* . ' = Pant '1 dlfA1 cmb 21/( S!o iV T� �OF C. 'TE-COUNTY' BUILDING DIVISION APPRO FD DQT-07-2005 07 41 �.MMWW TRUM Civil. ineert Des' - OB6x�511.5Chico CA 95927 "' Phope: {530j.S2I-264$ •, I?."x; {5.30) 343'-5320 _'. ,.. •- .eda(a�aiismusengineervig:com'I 7Y P.03/03 r 2X STUDS AT IE" D.G. 2. '2X. DOU6LE TOP PLATES .3. • 2X FLAT BLOCKING. BEHIND 5TRAAP 4. I70UrLE 7X HEP QR 5. 51MP50N G515 GO.:L=D STRAP, U.O.N. 6. 'LENGTH OF, �TfifAP J5: - T6'THE CND OF St4EAR WALL PANEL, OR *60" - BEYOND OPENING' 7. ' EDGE NAIL KING �TUD(s) B. 5ILL PLATE; TOTAL P.03 OCT-07-2005 07:40 HNJ Ci5Ml1S. nnnn nn MM�� nn *Civil Engineering & D . 'n PO Box 5 S ,hie r CA 95927 Phone: (530) 521-2648, fax: (530) 343-5320 eda(ci)aus musengineering.com TRANSMITTAL October 4, 2005 Allan Birkholz MO.. H u w l Orovill.e, CA (�3.� 53ffi -71785 Subject: Birkholz Residence Site Visit Fletcher Road, Oroville, CA Dear Mr. Birkholz, Per your corrections list for the inspection of the subject residence, please provide the following: • Use double 2X headers as blocking at top and bottom of electrical panel. Bore through top header to allow, electrical loom to pass, and per electrical code requirements.. • Provide Simpson CS 18 strap on exterior of wall. See attached detail • Make sure that the edge nailing of the plywood is 4" o.c. and the field nailing is 12" o.c. Let me know i f you have any additional questions or concerns. Eric D. Ausmus, P.E. Ausmus Engineering l E:\Work\Ausmus Engineering\2005_ Projects\Birlcl,olz\Transmittal2.doc P. 01/03 � i NATES RESIDENTIAL' 025'240-083 04-3365 PERMIT NO.-BIRKHOL-TZ; ROBERT------ CONT: OBERT--•--- CONT: WM SQUYRES FIRE SPRINKLERS. -, 01, 1 l SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER .1 _ t y i a JOB FINALED (Date) .,�.1 . t©� ' 1 Signature t ;i E ry i v t SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER .1 _ t y i a JOB FINALED (Date) .,�.1 . t©� ' 1 Signature J=OK 0 = Not OK . = NotReadyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test-Wrap; -/ /" L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 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 Enclosure; Fencing -Alarms Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Date 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures -Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 -- [ J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 58. 11. Water Pipe; Test -Anchors -Regulator -Service Test 59. 12. Electric Underground 60. 13. Plenums & Ducts; Clearance -Material -Support -Ins. 61. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 62. 15. Access & Ventilation 63. 16. Insulation Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Card B-1 Date Card B-1 Date Ext. Steps -Door & Sidelight Protection -Landings Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test 74. Elec. Outlets & Receptacles at Kit. Counter Date 75. Card B-1 Date Card B-1 Date 76. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 24. Fixture & Transformer Clearance -Ins. Protection Plb.; Elec. & Mech. Equip. Listed for Location 25. Elec. Receptacles Spacing -Lights & Switches at Doors Elec. Receptacles in Garage (FF.I.)-Romex Protection 26. Size Boxes & No. of Conductors Stapled Insulation -Foam -Looked in Attic 27. Romex Installed Close to Edge of Studs & C.J. Guard Rails & Deck Construction -Post Caps 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Clearance Looked under Floor 0 Yes 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters O Yes 0 No 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes O No Stucco Brown -Finish 32. Service -Riser Conductors & Ground Main Disconnect A.C. Unit Disconnect, Electrical -Plumbing 33. Equip. Clearances Panels-Motors-Mech. Equip. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector 89. Ventilation Throughout House Date 90. Card B-1 Date Card B-1 Date 91. Corrections from Previous Inspections Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Date 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. I nfi Itration-Wal Is -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. 73. Elec. Outlets at Wood Panel, Int. & Ext. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes _ 83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters O Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP0532016 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date; 12/20/2005 APN: 027-120-015-000 the Business and Professions Code, and my license is in full force and �- �� Site Address: 3472 FLETCHER RD ORO License Class: Li((c��enseNumb++er: Date: ) _% T Contractor: IJ�V� l , c �2 r1 Map Index: Description: POOL MASTER 01-517 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: BIRKHOLZ, ROBERT 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 3472 FELTCHER RD signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95973 she is exempt therefrom and the basis for the alleged exemption. Any 530-533-1119 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: BLUE HAVEN POOLS Code: The Contractors' State License Law does not apply to an DIVING LADY INC. owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 275 FAIRCHILD ST, STE 100 A provided that such improvements are not intended or offered for CHICO, CA 95973 sale. If however, the building or improvements are sold within one 530-899-8445 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: BLUE HAVEN POOLS not apply to an owner of property who builds or improves thereon, DIVING LADY INC. and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). 275 FAIRCHILD ST, STE 100 A CHICO, CA 95973 ❑ I am Exempt under Article 3 of the Business and Professions Code 530-899-8445 Date: Owner: License #: 718849 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: A U T -,CNS Carrier: Total Square Ft: 0 S. F. 3 � � Ci Z Valuation: $0.00 Policy #: Census Code: ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any persons any manner so as 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, 1 shall forthwith comply'with those prbvisions. Date: Applicant: WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated a ove f r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) O1� Name: By: Date: L �1J V PERMIT E PIRES ON: 12-2 O a IJIU 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 enter upon the above mentioned property for inspection purpos s. Print Name: Q r Al�l i -D Signature:li� r I,� 1 Date: ❑ Owner ❑ Contractor ❑ Agent for Owner `,MAgent for Contractor B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER Last Name 1 t Vl O First Name Address 3 Lt /� e,.Y I\ CityO - 1 State Zip X17 'I Phone 533 Fax E-mail -%V) - ., APPLICANT NAME ARCHITECT/ENGINEER CONTRACTOR Name Address JA poen Address a o c I: 5 p� QN--, 0. City - Pho n,1(, State a, I Zip Phone Date Approved: State License Number Fax 39 Z 57 d E-mail Lic. # Class -%V) - ., APPLICANT NAME ARCHITECT/ENGINEER Name 1 -5+ot 1 Address 50 1 Zip City 02 State Zip 6 Pho n,1(, 9 33 3X-7 Fax E-mail Date Approved: State License Number -%V) - ., APPLICANT NAME Zoning Name 1 t II] C t� 6�►6') % a � Address �O City I Stat Zip Phone 0Q9 C)Cq 7� -J l U > Fax E-mail JY' "- : &Wv Z For office use only: Zoning Property Address� / ��G1 1� Flood Zone Cross Street SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS KAFORMSWILDING FORMS\BldgApplSubRgmts.doc PERMIT 05. Jcr" � BIN It LOCATION do or Sc pe of Work: Property Address� / ��G1 1� CityQ �v fQ Cross Street WORKER'S COMPENSATION Policy Number © t 0 Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name A JX 4 Address Decri do or Sc pe of Work: ol1 Sq. Footage S --L O Structure Built without Permits O Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Page 1 of 2 REV 2-24-05 Rec 'ved by: Amount: T Bldg W SRA Receipt #: Sheriff ' + ' SMIP Date: Other Total Page 1 of 2 REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED.. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ . 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A%C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. .-.1 1 ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) . ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS0dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: r `�` G� ASSESSOR PARCEL NUMBER C) 1 y Proposed Building Use: �UV \ J`�lL/� Permit Technician: Date: a U J .1 ms required in order to apply for a permit. All boxes MUST be checked OR marked NA in order tojapply. 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. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including 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. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other maining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑ 18. Erosion Control Plan Required........................................................................ . ❑ 19. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 20. City of Chico Plumbing permit........................................................................ ❑ 21. Site plan and business license approval from the City of Biggs .............................. ❑// 22. California Department of Forestry plan approval ❑ paid. Sent by: 23. Planning approval for (A) Use: �(B) Parking: (C) Parcel Check: ............ 12- i>- os- ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ ❑ 25. Fire Marshall Review (commercial projects only). Sent by: ...................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ .29. Worker's Compensation Carrier and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Telephone �lv\ .% `c+J and hold for pickup. I have been mformeY of the above ' ems and requirements for obtaining a building permit. Applicant: 4�AlJDate: 0 1. Index permit application for the above items numbered: Plan Check etter 2. A act" items required r ontraesigner, owner, _ , was advised of the above data by phone, ❑ mail, ❑ counter, by Date: or, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: 12 Plans approved by: Date: Structural reviewed boDate Structural approved by' Date: J - Note transfer by: Date: iV Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 p �.lbl c Works Department of i HND DEVELOPMENT DIVISION ). Michael ch a e t Crump Director storm Water lytana;ement Program • - e 7 County Center Drive \\� -� Oroville, CA 95965 . U NZ (530) 538-7266 . A `�S AUC WOF' (FAX) 538-7171 National PoltutanL Discharge Elimination System (NPDES) Phase- hase I.t Construction Storm Water Permit and Storni Water Pollution Prevention Pian (SWPPP) Acknowledgement (LESS THAN 1 ACRE Project Description: Project Location andlor Parcel Number: By sipping below, I, the project owner/owner,s agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of .California Regional Water Quality Control Board.. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total S more than one acre of disturbed soil will require a Construction Storm Water Permit California Regional Water Quality Control Board. 1 am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project. that disturbs one acre or more of land may result in revocation of grading and/or ocher permits or other sanctions provided by law. Signed: Title: Date: TO:. Building Division — Development Services FROM: Environmental Health SUBJECT: Sanitation Clearance Owner' - - " Location Plan Approved for: Sewage Disposal: Water Supply: Public Clearance for dwelling. Other Hold final for:. Final clearance O.K. for: NOTE: 9 En`vi_r6me'nti'I_tfe7alth Specialist Date Building Clearance 9/2005 N Y Plot Plan Attached Floor Plan Attached Sent to BD/DS ®Z7—/7— _5 AP# _Private Well SITE PLAN REVIEW APPLICATION Date: AP# Permit Numberlicable if applicable) pp ) � �� � Bin Number r L APPLICANT INFORMATI , Parcel Size: Owners Name: - r/ Owners Address: 0UW Telephone No.: C-7 5 t333 ZZEmail: Situs Address: Proposed Use: esidential 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 4�-Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel -ell ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval Site Plan Stamped Approved By^.��. Date ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: dw ❑ 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 requiredj4p1A SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) Flood Zone: X • Flood Panel No.: /C- 5 y Index Date: G1 4D Ov ❑ Sacramento River Reclamation District (Approval must be obtained from the talleomia 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) ❑ Oroville Enterprise Zone Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance --------------------------------------------------------------------------------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: ,+-6— Applicable "_S Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 FA Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area -Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other -------------------------------------- Subdivision Map Special Fees ❑ Water Tender F-1, 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: Legal -Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑'No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice 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 to Subdivision Map/Parcel Map: Map Date of Recording: /1 1 , Z� % Lot: ❑ Use Permit/Minor Use Permit Permit Number: Book: /0 / Page: V/ Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. IN x Page 4of5 Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CALarrys\BuiWing Permit Site Plan Reviewl.doc Page 5 of 5 OCT -07-2005 07:40 _ Civil- Engineering inn Design . YO'Sox SI15:C.lico, CA'95�27 . P6onc:'(530)'521-2649Taz (534) 343-5320 • ens ' oseiigineerttut.coan " 'MANSMITrAL ' /Eiluri.•'rlkhol�• . $irkholz Resid-Me. Pledsg,atlow :Ais. fetter.to:.00ve as:ogreement for all6wing.A116n Birkholz. to use 4 earpaftfi tg ora the hMai ..wall, -of the shearamit:'aontclniiig the electrical. pane�ir ; See'!he d a tielow tedha0 O 44)•�ft�ir nailing -.0 uirements for shear • 'trchs#ec to•.ti�e hoi�.'• • ..�r .Please see previous-transrt�ittdl. regarding the blocking and straping requirements :liar the •perforattds roil;_as: tFi a are stiH'in eff ect. I: INTERIOR 5WEARWALL iF ' DE5.IGNATED ON FLOOR PLAN `'r' STRAP WOLDOW A5 NOTEO ON j -'� E N. SCNE'DULE — — — — —• _ — imr 3. XTERIOR SWEAR PANEL PER PLAN 4. Ibd NA1L5 W6' STAOiGERcO FULL HEIGHT:OF.STUD F! 5. 2x STUDS Olb' oc. _ DETA, 7. L 6*19" P. 02/03 •Psgb '1 •dlf�d 17�YI UON 7a 05 -70.G73 / .. Fel e E. CGUNTY BUILDING DIVISION 07- 7- 1-w-©�s OCT-07-2005 07:40 P. 01/03 mus M. q+�(���y/�����M �M' �/�/(�j��� �M' M(\/(�j��� yf+ El V�11 1 1\\UVU LJ �LI V � L J� LM� IJV O Qivlil�UE1ngiJJneering & Design PO Box 5115 Chicu. CA 95927 Phone: (530) 521-2648, fax: (530) 343-5320 eda@aus musennineerin g.com L . TRANSMITTAL October 4, 2005 Allan Birkholz Orovil1c, CA _ Subject: Birkholz Residence Site Visit Fletcher Road, Oroville, CA Dear Mr. Birkliolz, Per your corrections list for the inspection of the subject residence, please provide the following: • Use double 2X headers as blocking at top and bottom of electrical panel. Bore through top header to allow electrical loom to pass, and per electrical code requirements. • Provide Simpson CS 18 strap on exterior of wall. Seeattached detail • Make sure that the edge nailing of the plywood is 4" o.e. and the field nailing is 12" o.c. Let me know il' you have any additional questions or concerns. Eric D. Ausmus, P.E. Ausmus Engineering, • , 1 E:\Work\Ausmus'Eiigineering\2005_ Projects\(3ir1<holz\Transmiltal2.doe AND WHEN RITOIJi MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005-0028757 Recorded I REC FEE 10.00 Official Records I County of I COPIES 4.50 Butte I CMACE L GRUBBS 1 County Clerk -Recorder! 1 I SA 09:08A91 20-fty I Page 1 of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date��r State of California County of 3utV2 before me, 7 mm��nn hVn�r�(ts_ personally appeared KOY(2P i? -t- t\-- Ib 1 V -1L !10U?- personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature Seal: MARY A. THOMPSON U Commission #1351470 0 U Notary Public -California ieq Butte County 1 A.P. # (� �2-Z20- �� y My Comm. Exp. APR. 15, 2006 Oar -1 5'o ois Af Order No. 00220919-001 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL A: PARCEL 2 AND 3, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON NOVEMBER 25,1987, IN BOOK 109 OF MAPS, AT PAGE(S) 41 AND 42. ' EXCEPTING THEREFROM THE NORTHERLY 30 FEET OF FLETCHER ROAD. RESERVING THEREFROM A NON-EXCLUSIVE EASEMENT FOR INGRESS, EGRESS AND PUBLIC UTILITIES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED NOVEMBER 25,1987 IN BOOK 109 OF MAPS, AT PAGE(S) 41 AND 42. AP NO. 027-120-014 AP NO. 027-120-015 PARCEL B: A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITIES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JULY 28,198 1, IN BOOK 83 OF MAPS, AT PAGE(S) 34 AND 35. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. IBPO50531 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 05/20/2005 APN: 027-120-015-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 3472 FLETCHER RD PAL 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 the Date: �a=' Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 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: Map Index: Description: NSF (3510), GAR (517), COV (1210) Owner: BIRKHOLZ, ROBERT A. PO BOX 865 PALERMO, CA 95968-0865 (530)533-1119 (530)743-1096 allan@tru-brite.com Applicant: BIRKHOLZ, ROBERT A PO BOX 865 PALERMO, CA 95968-0865 (530)533-1119 (530)743-1096 allan@tru-brite.com Contractor: License #: Architect: Engineer: AUSMUS ENGINEERING Carver. Total Square Ft: 5237 S.F. Policy #:: Valuation: $259,918.00 Census Code: 3�3fI 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 complywi those rovvl1isions. DateV — : Applicant: WARNING: Failure to secure wor r�ompensation coverage is unlawful, and shall subject an employer to criminal penalties and one n addition to the cost of hundred thousand dollars provided for compensation, damages as provided for in Section 3706 of the Labor ee �) / f f7� /►moo J� �, w ")' i / /,Lr/ code, interest, and attorney's fees. q ? L r CONSTRUCTION LENDING AGENCY This permit is her by issued under tha applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutions to work indicated 516ove ff r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: —/ ir� BY Date: (J Address: PERMIT EXPIRES ON; L �lJ CJCQ ❑ 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. 19627.5 of California Health 8 Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby 8uthorize representatives of Butte County to enter upon the above ned prop rty for inspection purposes. Print Name: Signature: Date: V / -k6 wrier 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor 6164 :::7 S_eo St�)_ VYr t BUTTE COUNT 0� �0 DEPARTMENT OF DEVELOPMENT SERVICES O O BUILDING/PERMIT APPLICATION ° ° AND SUBMITTAL REQUIREMENTS O "_.�_ '• = O 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 O OFFICE #: (530) 538-7541 ✓ �, CD ,�y A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Q /I.✓ UN Website: www.buttecounty.netldds "PLEASE PRINT CLEARLY" 1p;/ OWNER La N eKicZ riMAarap Address pa�, c5b/S Citq� St t�a zi �4 8 Stet Zip E-mail APPLICANT NAME CONTRACTOR Name City n�6 Address Address_as City Stet Zip Phone ax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City n�6 Stale Address_as Phone/" �� City i?Ll State Zi Planner Date Approved: E mail State License Number APPLICANT NAME Name'!R,-,, 1 \O Address WX s P101 City n�6 Stale Zip ,/8 Phone/" FaCx. E-mail AP / NT,.&tNATURE X r For office use4ff y: Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BPO -5- 05- BIN sBIN #, 11 LOCATION AP# 0/5 - /SPro ert Address - Property Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address OVER FOR SUBMITTAL REQUIREMENTS 11 KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Description or Scope of Work: � co V l� Sq. F o ❑ Structure Built ithout Per ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received b 7 Receipt #: �Loq �2 ,-2 q Amount: 570 3 '5Bldg 20y'" SRA Sheriff SMIP Other / -70Total REV 7-27-04 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a ,parmit. INCOMPLETE -SUBMITTALS WILL NOT BE ACCEPTED, ALL PLANS MUST BE LEGIBLE AND IN INK. 1. Site plan `, 3 r 4 ets, signed by the preparer of the plans. No graph paper! 2. Complete p an , 3 r 4 sets, signed by the preparer of the plans (No graph paper!) OR ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 3. Engineered truss details and layouts in duplicate (if required). No faxes! 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ Hazardous Material Form (for Commercial Buildings only). ❑ 3. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR �® 7 County Center Drive Oroville, CA 95965 (530) 538.7601 Telephone (530) 538-7785 Facsimile ® TO: ' FROM: LO T' SUBJECT: ® DATE: WILLDAN �UTTF °°J��\\I 0 0 o _ o cOU N'�y Scott Rutherford (530) 538-7160 srutherford ftuttecounty.net Plans Transmittal For Review Per Contract 3/1/2005 Applicant: . Birkholz, Robert Permit No: 05-0531 Project Type: NSF/Gar/Cov APN: 027-120-015 100% 70% Plan Check Fees $ 1,503.33 $ 1,052.33 $ 1,503.33 $ 1,052.33 WILLDAN Fee $ 1,052.33 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other COUNTY OF BUT76AEPARTMENT OF DEVEL PVEkT' SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: 2dff0 f-2g�-L - ,IhM/kSSESSOR PARCEL NUMBER 62 �, d` A Proposed Building Use: /,4 Counter Technician: We Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to 4p0ly:, I N 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.. iV N 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. �O t N 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 01,J 4. Engineered truss details and layouts in duplicate. No faxes! \ ❑ 5. Letter from Engineer or Architect for truss design review. Cpl (1 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 linelnfo, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form 5 Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.)/��� 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers.............................................................. .....:........................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered -Foundation required ........................................... ........ \ ❑ 0. Erosion Control Plan Required........................................................................ ........ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. O 22. City of Chico Plumbing permit........................................................ )�'ls 23. California Department of Forest y plan approval -91- aid. ,$eG0y: -o c OF ,,,2 _,)Planning approval (A) Use: D"B)Parking: (C) Parcel Check:a- dS ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 6. NPDES Form............................................................................................ 7. Encroachment Permit for driveway from the Public Works Dept ........................... q . Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... \❑- 30. Worker's Compensation Carrier and Policy Number..........................I............... �4N 31. Owner -Builder Verificalioii (_ Given to owner -_Mailed to owner) ..................... ❑ 32. Letter of Signature authorizationf'.............. .::.............................................. 3�Recorded copy of Agricultural Acknowledgment Statement ................................. �0 D . 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. $ 66 - ❑ 38' Other: ❑ 39. Other: When issued Telephone ._._ and hold for pickup. F -o - 4-11 I have been informed of the above items.and requirements for obtaining a building permit. ApplicantL- r-.' .� - Date: o 1. Index permit application fo ove ite s numbered: cat) Plan Check Letter 2. Additional items Contractor, designer, wn , was advised of the above data by phone, ❑mail, ❑ counter, b t^ 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 by: b Date: Note transfer by: Date: Yellow: Building Division E.H. USE ONLY , Plot Plan Anschod Floor Plan Anachad Sent to B.D. -rO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Dispo Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: Supply.: Pu Envir nmen Health Specialist Date 8/96 ell COUNTY OF BUTTE ,3 pv'5 d S3 DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER n 01- i Iub-V>ta-r *"b V Am I PROPR SS BUILDING USE I UILDING PERMIT FEES --- Balance Due ..................... --- Additional Fees Due........ Plan Checking Fee.... V:�' A. P. # DATE RECEIPT # DATE REC. 2) SCHOOL DISTRICT FEES oy1.oyIC.C..L— t161f School District Office) (form available after Plan Check) RIFF FEES (paid at Building Division) Residential............ =$ 20Y_ Units �rcial (sq. ftg.)..... X $0.03 = $ _ S Ft "AN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Kpaid ' l (Sq. Ftg.).... X = $ Sq. Ftg. Amt. REATION DISTRICT FEES ren I2tNL� Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES <7. :00 (paid at Building Division) Zg A FIRE INSPECTION AND PLAN CHECKK FEE ' f1S9 aid at Building Division) 20 t f q b 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division), 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X = $ Sq. tg. Amt. 10. THER 5VV\) o �/ q 3 _=,.S�ZqSr 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 proms. APPLICANT DATE C� of O — 6�5 Pursuant to Government Code Secfqo-u are h eby tified 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 a 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) "-.,r.+ti nom..Sa'e. •i l' Y•' •�; lY.S".�riF�4li!,i�..[ ..2 'refit: '��_ {,n 14.414 �:t�.._x��xss=cs 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. I., I personally plan to provide the ma'or labor and material for construction of this proposed property improvement: YES [No [ ]. 2. 1 HAVE HAVE NOT [ ] signed an application, for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: 'PHONE: CONTRACTOR'S LICENSE NO: 4.. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPS DATE: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the' permit. Rev'd 11/4/2004 Butte County- Department of Development Services ADMINISTRATION ` BUILDING t GIS ° PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They, are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o if you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Mica] C. Vieiri C.B.O. M ager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. ■�1C WOp �L�� Department C o u n t, J. Michael Crump, Director Public f B u t Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE] Project Description: N5� Project Location and/or Parcel Number: 027— By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: Date: —�-� Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 Butte County Department ofDevelop hent Sem'ces �uTr� 7 County Center Drive �'"`" �0 Oroville, CA 95965 °fit ° (530) 538-7601 Telephone o 4 o (530) 538-7785 Facsimile UNty BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: • I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained • I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not .limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: I (_ APN: - 0Z7— / '-�O — 0/5— Building i5— Building site address: Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above-referenc building permit application and my signature below: -a�-OS SIGNA l E AP ICANT DATE Copy to Applicant/EH/File K:Forms/BidgPermitwithoutClearances 020705 RECORDING REQUESTED BY Bidwell Title & Escrow Company AND WHEN RECORDED MAIL TO Nome Robert A. Birkholz Street P.O. Box 865 Address ZIP'S'"` Palermo, CA 95968 O^dtrNo• 00220919-001 2005-04J2Q►g2q. Recorded I REC FEE 10.00 Official Records I TAX 129.80 CoBUTTT_ Of CANDACE J. 6RUBBS 1 ROSEMARY DICKSON I Assistant I Travis. 09.00AM 14 -Apr -2005 1 Page 1 of 2 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 027-120-024 027-120-025 GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY The Undersigned Grantor(s) Declare(s) ❑ City/Town of PJ Unincorporated Area Documentary Transfer Tax is $129.80 m computed on full value of interest or property conveyed, or ❑ full value less value of liens or encumbrances remaining at the time of sale ❑ Monument Fee of $10.00 FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Robert A. Nitrio Trustee of the Nitrio Family Trust U.T.D. dated November 22, 1989 hereby GRANT(s) to Robert A. Birkholz, a Married Man as His Sole and Separate Property. the following real property in the'O Unincorporated Area County of Butte, State of California: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF The io F ly Trus U.T.D. dated Nove 2 ,.19 Robert A. Nitrio, Truatel' Document Date: April 7, 2005 State of California Countyof ill_ } SS. On ci - I \ • LYJ , before me, the undersigned, a Notary Public in and for said County and State, personally appeared Robert A. Nitrio Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/shelthey executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on .the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. 1 y Z= FOR NOTARY SEAL OR STAMP Q. N K `"I COMM.# 1433346 NOTARY PUMN-CAU MNIA COUNTY OF BUTTE Co m. EX Tres Au 2 200 jr MAIL TAX STATEMENTS TO: Same as Above aTECIGRANTDEED r� EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: Order No. 00220919-001 ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL A: PARCEL 2 AND 3, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON NOVEMBER 25, 1987, IN BOOK 109 OF MAPS, AT PAGE(S) 41 AND 42. EXCEPTING THEREFROM THE NORTHERLY 30 FEET OF FLETCHER ROAD. RESERVING THEREFROM A NON-EXCLUSIVE EASEMENT FOR INGRESS, EGRESS AND PUBLIC UTILITIES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED NOVEMBER 25, 1987 IN BOOK 109 OF MAPS, AT PAGE(S) 41 AND 42. AP NO. 027-120-014 AP NO. 027-120-015 PARCEL B: A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITIES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JULY 28,198 1, IN BOOK 83 OF MAPS, AT PAGE(S) 34 AND 35. C� W I LLDAN Serving Public Agencies April 21,'2005 Scott Rutherfr,rd Butte County Building Department 7 County Center Drive Oroville, CA 95965 Tel: (530) 538-7169 Fax: (530) 538-2140 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com COUNTY OF BUTTE PLAN REVIEW REPORT Status: APPROVED Willdan Project No: 14353-1452 Jurisdiction Job No: 05-0531 Assessor's Parcel No: 027-120-015 Applicant: Robert Birkhloz Description: Birkholz NSF Dear Mr. Rutherford: Willdan has completed a -plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2nd page of this letter. The revisions were in response to a previous plan review and comments listed in our letter dated March 31, 2005. The plans and documents provided for this review that have been found in compliance with the applicable codes are: • Plans: Two (2) copies sheets 1, 3, 5, 8, 9 & 11, dated 02/24/05; sheets 2, 4 & 6 revision dated 4/7/05; sheets S1 through S4 dated 02/08/05, by Eric Asumus, RE • Energy Calculations: Two (2) copies dated 4/8/05, by Don Freemyers. • Truss Calculations: Three (3) copies dated 02/10/05, by Longfellow Lumber Co. Inc. • Structural Calculations: Two (2) copies dated 02/07/05, by Ausmus Engineering. The plans have been stamped with the Willdan approval stamp and dated the date of this letter. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. 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. y APPLICABLE CODES - Unless noted otherwise, all comments are based on requirements of the 2001 California Building. Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code and abbreviated herein as "CBC." • Part 3, known as the California Electrical Code and abbreviated herein as "CEC." • Part 4, known as the California Mechanical Code and abbreviated herein as "CMC." • Part 5, known as the California Plumbing Code and abbreviated herein as "CPC." • Part 6, known as the California Energy Code, and Energy Commission Standards, and abbreviated herein as "CECS." CODE ANALYSIS Our plan review revealed the following information regarding the occu a-ncY designation, hPa of construction, and other pertinent features. This information is consistent with that shown on the plans. Specific Type of Type of 1" Floor 2" Floor Total Use Occupancy Construction Stories S Ft S Ft S Ft Dwelling R-3 V -N 2 2,344 1,166 3,510 Garage U-1 V -N 1 517 N/A 517 Covered Porch R-3 V -N 1 1210 N/A 1210 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. 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. - bmcerety, Michael LeBeau Plans Examiner Ricardo Guzman, S.E. Structural Plan Check Engineer Cc: E-mail Alice Mefford at: amefford@buttecounty.net ' Robert Birkhloz, P.O. Box 865 Palermo, CA 95968 Fax:(530) 749-1096 Albert Edgar, 2625 Forestview Dr. Oroville, CA 95966 Fax: (530) 534-9153 Page 2 of 2 Wi.11dan .14353-1.452 PC2.17 Butte County 05-053 1. r 5-3 F 2. zA School District A.P. Number Property Owner ri Property Location/Address Subdivision jBUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FOR (One form per Building) Buildingbepartment No. Jurisdiction: city 'county Residential Development No of Living Mobile Home Units Installation Commercial/industrial New T f Building diipartmerit Representative Lot No. ........................................................... ; ...................................... Sq. Footage Addition/ *Supplemental to (Group R) Conversion Permit # *(No foundation Inspection) ....................................... 1, ............... .... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) entification No. 0503 � VI0 D' t I Id 4, 1 U LUI 1111 Plq k School District certifies that Sq. Footage (including Exterior Roofed Areas) Date (Applicant) (Streeddress) (Phone Number) O'eoy, ILL Icity) (State) (Zip Code) has complied with the requirements of Resolution No. by payment of square•fe�et,4 0 School District Representative. Paid by Check # Remarks: 2926 $ FULL MITIGATION $ Y l7- QS - Date Nofte: You may protest the Imposition of the fen klentl%W above by submitting a written protest to the District, In compliance with Govern". Code Section 66020(a), wffldn 90 days from the date fen are paid. Failure to submit a timely written protest wtll'pmMbtt you from challenging the Imposition of the fen In my court sedan. N, subsequei t to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is ntlfld by the aWlcWe Local Planning Agency &.9 this project Is being rsviewed under tie California Environmental Quality Act (CEQA] this project maybe subject to additional school fees to fully mitigate. its Impact on the school dlstiftft schools. White (applicant), Yellow (building department), Pink (school district-) feeform.xls 00/03)dmm I 22 / I c%A 5z 1" 5 -�D A-, � , BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM ,FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (PRPD) ❑ DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel NumberJ t '�(s) �-% —1 �--� _Building Permit Number � / / , A n . n Property Owner (s) Project Location /Address Subdivision Name New Development Assessable Sq. Ftge -35 t 0 Type of Residential Development (check one) Single Family -Detached Single Family -Attached Alteration/Addition(s) . Mobile home Demo Permit (date issued Comments: Non -Residential to Residential Mobile home replacement Multi -Family Dwelling verified by Assessor Department verified by Building Department ❑ FRRPD CARD ❑ PRPD ❑ DRPD certi� t: a _lf_)4-y_- �Da��O!A � 1 :2 I Applicant Name Phone Num % Mailing Address V City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ Square Feet @ $ _ Remarks: Paid by Check No: Paid by Cash: Recreation and Park District KAFORMSWILMNG FORMS\park-rec standard form rev Ldoc per unit for a total of $ /06 . CJZ) per sq foot for a total of $ Receipt No: M-0 W Q AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005®0028757 Recorded I REC FEE 10,00 Official Records I County of I COPIES 4.5® Butte I CAMACE J. GRUBBS I County Clerk-Recorderl I I SA d9:@8AN 20 -May -20M I Page 1 of 2 IIII 111111111111IN III IIIN 1111111 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 State of California ) County of &,kVe ) AIL personally appeared S/�L1O�' O j- (�j 1 ►� i� �1l- personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature A 1 9 ��( !i�c USeal• ,1 MARY /7' . THOWIPSON Commission #1351470 c7 Notary Public - CaliforniaT �t L l Butte County U A.P. #.7 — �� V . / =�l n y Comm. Exp. AF'F;. ':5, 2006�ti_ P EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: Order No. 00220919-001 ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL A: PARCEL 2 AND 3, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON NOVEMBER 25, 1987, IN BOOK 109 OF MAPS, AT PAGE(S) 41 AND 42. EXCEPTING THEREFROM THE NORTHERLY 30 FEET OF FLETCHER ROAD. RESERVING THEREFROM A NON-EXCLUSIVE EASEMENT FOR INGRESS, EGRESS AND PUBLIC UTILITIES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED NOVEMBER 25, 1987 IN BOOK 109 OF MAPS, AT PAGE(S) 41 AND 42. AP NO. 027-120-014 AP NO. 027-120-015 PARCEL B: A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITIES, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JULY 28,198 1, IN BOOK 83 OF MAPS, AT PAGE(S) 34 AND 35. b � SITE •PLAN REVIEW APPLICATION fi .7—/070-'0/5— Date: ���Z�OS� AP# 0.27-/.70--0/5— Permit Number (if applicable) 05--65-31 S: V Permit APPLICANT INFORMATION Parcel Size: �S Owners Name: �- Owners Address: Telephone No.:3 Situs Address: 2 7 7,? - Proposed Proposed Use: Residential New Single Family Residential ' ❑ Single Family Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ Commercial Remodel ❑ New Industrial ❑ Industrial Addition ❑ Industrial Remodel Other ❑ Septic - ❑ Well , ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval i Site Plan tamped Approved By Date -5-1-105- Page -1-O Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) Watershed Protection Overlay Zone (See attached standards and -requirements) Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) 100 -Year Flood Plain: (See atta�Ched) • Flood Zone: _ ?C L • Flood Panel No.: Cv0© % % Index Date: 71-2.& 00 ❑ Sacramento River Reclamation District (Approval must be obtained from the Oalif6rnia 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: # '- Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front � r 20 � Side 3� r Side Street Rear Sr Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 i Applicable Development Fees: Standard Fees Amount Formula ❑ Fire E . ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Impact ❑ Other Subdivision Map Special Fees -------------------------------------- ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify, actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By Q Deeds: Y Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ 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: jO / ❑ Use Permit/Minor Use Permit Permit Number: Book: J J 9 Page: 411 Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development.. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for roa Page 4of5 Cx,. ❑ 1 0 0 Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CAI,arrys13uilding Permit Site Plan Reviewl.doc Page 5 of 5 6- w logm 2 �Oay2'�S` LLr�J �W 2(u Ol� dE y CL orf 'v 2Fa- -0g xr•0$f r WQIV �ClO�CiP8 OOt� �-8kk�� QwV �t3w�bV wuw H. C� �0a lD Lou �W�r34z¢ g o� a 22ZJ� g9 OoWy 0 0C< o W w 0,owLO c rS t �: v. Q' o r c9 3 oC w W�Q12 Oct �£� 3°v ,dl 2 r U�t 2�ta JQZ d Zr a' o o out Zd(Cuu WILL— �OrQ W V&w2Q�� p�0 gv pG,� p�� ow v io�2 W�uJo'Wc�Oaf 3 ?Wa 9®' m�� 0�w d `� a ��" �o w 2h p0 3 0 a�', aw W rl- �h (� to �__0II ? � u-� �� r � ��Z �,v�'�w cr .O2�U Qr Zrc yi11 �° W29 J I uZiocojju eriu� zru LLW ��N W �p � F�� � o Q u 0 .- € oo r oleo �d 3 �_ .2 26 �Zou av 2 oaQdc, Fu vol Og o ll `9�IL * Q�p.. o 10 u W 0 IA 11P 0 EL 0 0 N LOuj J C Q O r "t�o�p�c� Q?4 pWoI�WWW� etlJud c1� U, 2��Op �mg2w o 2F21�u122�f"�o Q, p z 3 4 U L Q O w W 2 U3 MW�� 22.3 us wmLLJ p C O J 41 4t.� vr-- " o O. n �o �Ao,� n, an�'� . •��J a DC�Az r� 4 07 o� b� a H N l a r N a 0 ac �/m 8 Oda°� g Z 8W g�N.0c �h WQ��ti W�Wapfj J3 u � Q J o'Rem iv N �,tl� rLL $W V�y p o �ea m -s � o z wad 24 wdQ J — r-wrd W U�O �2N2� 2� Q r- �. ,e 2too "o 'owd �N LU ado 2 p ~ 006pIz fvot o rte. M J g'-moi"�e W^ u� ti d 00 ao O r 1Cpry� M LNQ v cc W JCN0(CJ Lo �wwY d J va�poc0�u a��a gv J Lij Q k tom otQ 40 L (n ' \by3 g�•6i^. C-) 0� 2 C) 17 y�oOWJ J'32�r W Q7 ui LA 9 UJ Q W I - Vi LU �D4_L� f- o- 3 O cc �,tl� rLL $W V�y p o �ea m -s � o z wad 24 wdQ J — r-wrd W U�O �2N2� 2� Q r- �. ,e 2too "o 'owd �N LU ado 2 p ~ 006pIz fvot o rte. M J g'-moi"�e W^ u� ti d 00 ao O r 1Cpry� M LNQ v cc W JCN0(CJ Lo �wwY d J va�poc0�u a��a gv Q k tom �Q �� �o ii .($ \by3 g�•6i^. do iISO i' N 1 pC 07 Q H— I� n j �,tl� rLL $W V�y p o �ea m -s � o z wad 24 wdQ J — r-wrd W U�O �2N2� 2� Q r- �. ,e 2too "o 'owd �N LU ado 2 p ~ 006pIz fvot o rte. M J g'-moi"�e W^ u� ti d 00 ao O r 1Cpry� M LNQ v cc W JCN0(CJ Lo �wwY d J va�poc0�u a��a gv •- r t�Ti. Ilk Z ... .di" n 7 ,jAo&-idV NYnd ONICIT(l9' NOITAIJ OIC" O Vo 1 d '��y y �4YP - '7 $ •+c�ii�� � Fi"!''fM aZl�.�'7' Y' �;Yf4.. t BLU HNNIEN POOLS rtGa�es to be self-closing and�sef��latchfn�"` ti - - - - - °arrx�^'r.�D ��1Net;down GU�IITEtwi�e daflor seven.days — BLUE HAVEN OFFICE: CC In L UX d: l doh' ab r Q)P4 Ile C GENERAL POOL SPECIFICATIONS: (Temp.# MAXIMUMPERIMETER: SUR. S AREA: S MAXIMUM LENGTH*. POOL CAPACITY: POOL DEPTH TURNOVER RATE: Hrs. EXCAVATION DECKING Access Front r._, - .. _ Type Bob Cat Shuttle . Color Remove Dirt ?"w► eSZ Risers Remove Stump(s) ;+ 0 Footings p Remove Fence _A k Mastic Replace Fence %A Drains Remove Concrete P4 S. F. Sawcut Concrete MFt. EQUIPMENT Filter Type Size SV STEEL Pump HP l 2 Sp 1 S Expansive Soil Steel Pattern B Smart Box Yes PLUMBING Smart Pure Yes RD Filter Run Ftg: Smart Li ht Yes Te Return Lines int" SPA 41 500 W Li ht No P -Trap sh Line NO Smart Vac 11 No Gas Line -—Ftg Heater BTU Nat Drill Drive Div. Board ELECTRICAL Slide Run By Q • Ftg Water Feature . GUNITE Love Seat PLASTER b. Swim Out Ext. 2nd Step Color 1 R.B.B. AA in. X Ft. SPA '1 J U R.B.B.--&L– in. X Ft. Size In Out Plumbing Run Q 5 COPING Dam Wall Length 1-4 Type . ,0 Number of Jets CQ Blower Hp�_Yes-� No TILE D K �� Remote Model # Type Spa Dam AA Spa Side Switch Yes to Accent Tyle R. Smart Light Yes Mia 100 Watt Light Yes do BUYER Initials �� • Approve above specification 7 • Approve location equipment • Understand that decking shown is for illustration purposes only and understand that W/9arer t e v square fe t of deck. r Signature; " ,� Date f i Prepaired Especiall `-For: A l 1Qvi. ���cQ 21 i- kha1� 3 L1 7Z 1` �c,".¢ }. Rd Street City � Zip Hoe Phone 1J 3 3 Home Phone , 510 Work Phone 10 7 � Designer ¢k Job No. LO[ MOCK IrBGI _ Mapsco No. 1. SITE PLAN ............ ............... ..................... .............. ...... ...... ...... ............. ....................i V ................. .............. ...... . ..... .. .......... ...... ...... ....... ....... ............... ...... ...... : ..... ......... ........... ......... ...... ...... ................ .................... ...... ...... ...... ...... ...................... ........... ............... ...... ...... ................ .......... ...... ............ ...... ................ ........ ....... "..: ....... ........ ................ ........ ...... ...... ............ ...... ...... ...... ...... ...... ...... I .................................... ............................... i •...... '0. I I r :: k. ...... ..............:.............................................. r............. ...... ...... ............ ...... ................. ..>......; . . . 1. ..<.... .:;.. ..; ....:. i.. ..>.. ..j.. ..;.. ..j.. . .. : . . ` 6 Min 7 . F? .. ... RVIZE .. .. ., ,. .. .. .. .. ... .. .. .. .. \; '/.. '� .. .. .. .. .. .. .. .. ... ... .. .. .. ............. .............. _....._..... .. ................. ............................................. ..:....:... i-Ro • ..................................... . H ..Itl 0 '. .......... ........ ...... .. 0. . ........ ...... ...... ..:........:. ... .. .. .. .. ... .. .. .. .. .. ......... : .. ..:............:... .. . r.: _.. pati - 0 . . . . . . . . . . : nate .. ` .. .. ... ... ........... .. .. .. .. .: 1S I� t. .. .. .. .. .. .. ... iIT . e. 7. _9 ... . 1 ,� , f ) .. ... .. .. .. .. .F :' ...... .............. ...... ....... ..... . 7 ............. .. ............... .. .............: .......... ..... ............. ...... I ...... .......... ...... ...... .................. ......... ...... ........... ...... ...... ...... ............ ............................ ....... ......... ............. : : : ...... I... .......... ...... ....... .... .. ...... ...... ...... ...... ...... .............. ..... ...... ...... ...... .......... ...... ................... ..... ............... ............ ............. X .,..................... .. ... ... .. .. .. .. .. .. .. .. .. .. .. .. .. ... ........... .. ., ,. .,�. ............... ... .. ,.. .. .. • V N4 W - W ............... ....... ....... ..:....:. ......."..,._............ .....................r .. .. .. .. .. .. .. .. .. .. ... ... .. .,. .. .. .. ,. .. ., .. .. ". •2 :•1 ....... .. .. .. .. .. ............. ., ., ... ... ... .. ,. .. .. ,. .. ,. .. ., .. .. .. ,. .. ... .. .. ... .. .. ... .. .. ...................• .. .. .. .. ., .. .. ., .. ., .. ...................... �. a G P _ t� ZONING: SCALE:' _. Assessor's Parcel P Owner Name Address/Phone No. 2q r, Fca -� C �n e w RJ S33'1$ 6 q Site Locations . Contact Name: Phone: 899 g YUBAZOUNTY COMMUNITY DEVELOPMENT Building Inspection Division 9158th street, Suite 123 Marysville, CA 95901 PH: 530-749-5440 FAX: 530-749-5434 www..yubacomdev.org Assessor's Parcel Numbe/r�:. Fil ®moo ®a = a o 0 Owner Name 1� I e�; J c�, R. h YUBACOUNTY COMMUNITY DEVELOPMENT Address/Phone No. 2q ?J, F—e I f c Rj s3 I i l q Building Inspection Division PH: 530-749-5440 9158th street, Suite 123 FAX: 530-749-5434 Site Location fy) Marysville, CA 95901 www..yubacomdev.org Contact Name:'Phone: 899 +