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027-160-024
.7-164 ;L -ay-W-.Grubbs........ .A......P. .......2.. .. _lw/s Dunstone -Rd.- 2000 ft, no. of Grubbs 0 w� -7 Rd., Wyandotte Permit 845-73 (new sing e famil 0 -024 PERMIT# RY SHEET FOR LAND DIVISIONS{ Q)O 027-160 SUMMA 27 160r dio 95-6655 GRUBBS, Jay & Candace Candace Grubbs '7/2/93 Grubbs Rd., & Duns 420 Dunstone Dr., Oroville Lton Dr., Palermo Cont; Thev'os Const.. AddBedroom & SunrOom/SF L,MAP) 0 2 zv/v"Ovw V- . ti �t � N � !-' � C.fl l y ' NOTES RESIDENTIAL PERMIT N( 027 160-024 EADD BS, 04-0801. CANDACE SNTONE DR; OROVILLE HEVEOS CONST REMODEL r E SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER r JOB FINALED (Date) Signature w } r i t SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER r JOB FINALED (Date) Signature J=OK 0 = Not UK . = NotReadyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; 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-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERF OOR (Plans) OK except #'s 15. onin - etbacks-Easements-Flood-Slope /2. , Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel - Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Pie a lace Ftg.-Steel a e; Test & Anchor -Nail Protection W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crinoies 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 15. Access & Ventilation 48. 16. Insulation Date 50. Card B- Date Card B-1 Date ' Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Property Line Firewall & Openings 17. W r Htr.; Vent -Access -Combustion Air Baffle 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection a e; Test & Anchor -Nail Protection Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. W.V.; Test Fittings & Anchor -Nail Protection 58. 20. Shower Pan; Test, First Floor -Tub Access Glazing Area -Glass Protection -Skylights -Plastic 21. Test Tub & Shower, Second Floor -Tub Access 61. 22. Gas Pipe; Sixe & Anchors Elec. Receptacles in Garage (F.F.I.)-Romex Protection 23. Fire Sprinkler; Test Date Card B-1 Date Card B-1 82. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors Izexes & No. of Conductors Stapled omex Installed Close to Edge of Studs & C.J. 28. ESOp. Ground made up w/Mech Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral ❑ Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date 3 y b C�Card B -1-,0/'J Date Card B-1 Date - 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 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- Purl in -Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 83. Following Instld./Drive ❑ Yes O No/Walks O Yes O No/Planters ❑ Yes ❑ No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netldds PERMIT NO. BP040801 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 04/28/2004 APN: 027-160-024-000 provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. �����d' License Number. Site Address: 420 DUNSTONE DR PAL License Cie s : Map Index: Date: D Contractor. Description: KITCHEN ADDITION (31) 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: GRUBBS JAY W & CANDACE J permit to construct, alter, improve, demolish, or repair any structure, prior 420 DUNSTONE DR to its Issuance, also requires the applicant for such permit to file a OROVILLE, CA signed statement that he or she Is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 95966 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 penally 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 Applicant: GRUBBS JAY W &CANDACE J 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 o1 Improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business Contractor: THEVEOS CONSTRUCTION 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 7090 ORO COUNTRY CLUB ROAD pursuant to the Contractors' State License Law.). OROVILLE, CA 95966 ❑ 1 am Exempt under Article 3 of the Business and Professions Code 530-533-0716 Date: Owner: License #: 319048 WORKERS' COMPENSATION DECLARATION I hereby affirm under penally 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 Architect: Labor Code, for the performance of the work for which this permit Engineer: s Issued. I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is Issued. My workers' compensation Insurance carrier and policy number are: 5'62/ Total Square Ft: 31 S. F. Carrier. "^Valuation: U 14 (0.7 Z — 03 $2,015.00 Policy ff: Census Code: ❑ 1 certify that in the performance of the work for which this permit is Issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of Califomla, _ q,5 and agree that if I should become subject to the workers' J compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. n / 1InG�n���/• / Date: 1 "e�♦°i (LIr 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 performance of the work for which this permit Is issued (Sec 3097 Civ.) Resolution work Indicatedve for whl h fees have been paid. Date: 2 8 Name: BY� PERMIT EXPIRES ON:� 8 ©a5 Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely 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. O 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 d thorized agent of the owner. I agree to comply with all county and slate laws relating to building construction. I acknowledge itis unlawful to alter the substance of any I IF rn o d ant of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes. Print Name: d a,—, Signature: Date: G �� 0 Owner CI Contractor 13 Agent for Owner 0 Agent for Contractor 0COUNTY OF BUTTE -DEPARTMENT O 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 t -La e5 ASSESSOR PARCEL NUMBER 0;27, I &D • n--� •4 - Proposed Building Use: A D O r 7 I p .�� +�- ^ t< �T +Q Et�O C�un�echnician: k- Date: -5 D • ?-D Q AC3ms required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plansor 4 sets, signed by the preparer of the plans. 2. Complete plansoor 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. # ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico g'Oroville, as applicable. 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ -17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ......... ❑ 20. Erosion Control Plan Required........................................................................ ........ I421. Fees as shown on the attached Schedule of Fees Due Sheet ............................. ❑ 22. City of Chico Plumbing permit ............................... 23. California Department of Fores�try plan approval O'paid. Sent by� 4 ... - 24. Planning approval A Use: D K B Parkin C Parcel Check: 7 -21- 0 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:.....::'...................... ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. = ❑ 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36. Deed'Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ �� ❑ 38. Other: ❑ 39. Other: When issued Telephone /� and hold for pickup. I have beeVinform deo". e- b.ove ReAs and requirements for obtaining a building permit. Applicant: Date:1. Index pero or the above items numbered: Plan Chec etter 2. Additional items required Contractor, 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, byDate: Plans reviewed by: Date: Plans approved by: zz Z Date Structural reviewed by: Date:. Structural approved by: Date: Note transfer by: Date: Yellow: Building Division TO:. Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H. USE ONLY Plot Plan AnncMd veyy //�� SentMan At7ssAod an4Ya R D. l � 7 ��LIL C�7i�c.ZB�S 7 v2® ,�clit/3 ?0�1� /GOC • © -00A Owner Location AP# Plan Approved for: Sewage Disposal ✓ Water Supply: Public Private Well Clearance for dwelling. Otheri7-e-6Z4 > 194.6 /7'/0 Hold final for: Final clearance O.K. for: NOTE: Environmental Healt pecialist Date 8/96 i COUNTY OF BUTTE , DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 CHEDULE OF RECEIPT OF FEES //�� [� OWNER A.P. # (/� PROPROSED BUILDING USE DATE ' 4 1. BUILDING PERMIT FEES --- Balance Due ..................... --- Additional Fees Due........ RECEIPT # DATE REC. --- Revised Plan Checking Fee.... $ 2. C OOL DISTRICT �C- '30'1'"rRIFFOFEES S D' ct f (fo a i Plajp V`l (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X # Units Amt. Commercial (Sq. Ftg.).... X Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES /510.00 (paid at Building Division) V 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) O¢ 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. Fig. Amt. 4 lO.OTHER _ � At time of permit application was advised the abo ees are required to be paid prior to issuance of the permit. These fees may be changed during a ch cki pr cess. APPLICANT DATE. t7 Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been i/posedyour project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) National. Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACREI Project Title: By signing below, I, the project owner/owner's agent,- certify that I am aware that a construction project that disturbs I acre or more of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution .Prevention Plan (SWPPP), and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading andotherp,,ermyts or other sanctions provided by law. Signed: Title: Date: Owner Addre�_ Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX ADDITIONS TO RESIDENTIAL BUILDINGS it Number Floor Area The following data showing mandatory and it&fe"ura�5pa11tbA stalled for additions to dwellings. Additions shall not include conversion of non -conditioned space to conditioned space. Remodeling of existing conditioned space is not included. COMPONENT -I 101-499SQ.FT 500-999SQ.FT Ceiling Insulation R-19 R-38 R-38 Wall Insulation R-13 R-13 R-13 Floor Insulation R-19 R-19 R-19 Radiant Barrier Required Required Required Glass U -factor .75 .75 .65 Max.area of glass 50 sq.ft 16% plus removed 16% plus removed Solar heat gain NSEW: .40 .40 .40 Heat, Electric resistance Not allowed Not allowed Not allowed Heat, Gas AFUE 78% AFUE 78% AFUE 78% Heat Pump -Split HSPF 6.8 HSPF 6.8 HSPF 6.8 . Heat Pump Package HSPF 6.6 HSPF 6.6 HSPF 6.6 Cooling - Split SEER 10 SEER 10 SEER 10 Cooling Package SEER 9.7 SEER 9.7 SEER 9.7 Thermostatic . expansion valve* Required on new split A/C systems Required on new split A/C systems Required on new split AIC systems Duct Insulation Duct Sealing' R-4.2 Required R-4.2 Required R-4.2 Required 1 Additional water heater: AS AN ALTERNATIVE Any which meets budget 1-_1 AZ Any which meets budget Any which meets / budget t 1000>SQ.FT R-38 R-19 R-19 Required .65 16% .40 Not allowed AFUE 78% HSPF 6.8 HSPF 6.6 SEER 10 SEER 9.7 Required on new split A/C systems R-4.2 Required 4ny which meets )udget ING WITH A MAXIMUM 0.40 U -FACTOR AND A MAXIMUM 0.35 YOUR HEAT GAIN COEFFICIENT, AND A 11.0 SEER SPACE COOLING SYSTEM CAN BE SUBSTITUTED FOR DUCT SEALING AND THERMOSTIC EXPANSION VALVE. SEALED DUCTS AND THERMOSTATIC VALVE REQUIRES SPECIAL INSPECTION BY HERS RATER. PROVIDE INFILTRATION CONTROL - WEATHERSTRIP DOORS, CERTIFIED WINDOWS, CAULKING. LIGHTING KITCHEN AND BATH NOT LESS THAN 40 LUMENSIWATT DUCTS TO MEET REQUIREMENTS OF UNIF M MECHANICAL CODE -CHAPTER 6. DESIGN COMPLIANCE STATEMENT: TH OVE B I DESIGN MEETS THE REQUIREMENTS OF TITLE 24, PARTS 1 AND 6 OF THE CALIFORNIA CODE OF REGULATIONS. PROPERTY OWNER OR CONTRATOR -' (6/1101 School, District ' A.P. Number Property Owner BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) r , Building Department No. 6le,0409'cl) ME Jurisdiction- Q City w County Property Location/Address Subdivision Lot No. Residential Development Q Q Q Sq. Footage 3/ No of Living Mobile Home Addition/ *Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation Inspection) ........................................................................ ! ....................... . ... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q Sq. Footage New Addition (including Exterior Roofed Areap P Building Department Representative Date District Identification No. School District certifies that A.- (Applicant) (Street Address) (Phone Number) (City) Istate) (Zip Code) has complied with the requirements of Resolution No. representing 31 square feet. U-01 School District ID 1-t) :t --k 11 by payment of $ . KI / Cr 2926 _ FULL N $ Paid by Check # Remarks: u Date 01 Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the Dh&Ict. In compliance with Government Code Section 66020(a), wftMn 90 days from the date fen are paid. Failure to submit a timely, wrllbnprotestwin'prohlbIt you from challenging the Imposition of the fan In any court action. K. subsequent to the School Dhdrict Representative signing this p Butte County Schools Impact Fee Certification Form, the School. District Is nodfied by the applleaI I Local Planning Agency that this pro)eet Is being r*vW&vd under the California Environmental Quality Act (CEQAh this; o)rimay bewitifectto additional school fess to fully mitigate. its Impact on the school dletftrs schools. White (applicant), Yellow (building department), Pink (school district) feeform.)ds 1 0/03)dmrn J 130 M 4 BASIS OF BEARING 33 D ------------------------------------------------------------------------------------------- RETE N 8754'23" E (R6) 2685.60' W/ NAIL N 8924'57 E (R3,R4,R5) 2884.93' Z5,R6) N 8951'05 E (R) 2848.98' N 89'41'51" E (R2,M) 2684.86'(M) 85.31' (R2 22.92' (R2) 922.85' (M) 1 787.00' 9 -�SET RR SP — LS 4208 ------------ 7 —------ --- A � IEE NOTE #3 A = 41'50'33" ----------------------------------- R = 205.00' L 149.71' N 04'33'15 W (M) 87.23' PARCEL 4 33.99 AC. 0 = 18'35'04" R = 530.00' L = 153.41' N 21'08'20" W (M) 284.51' DUNSfONE DRIVE DEEDED TO BUTTE COUNTY PER SER. # 9.#L--5 I" ----N 04 33' 15" W (M) E A = 16'35'04 ��— R = 500.00' L = 144.73' N 21'08' N 8' N 8 FD. t LS 4 FD 3/4" OIP PER (D2)----. � — N ' N 0 = 30`12'33" / 18 R = 500.00' �_ FD 3/o i L = 263.62' r N N / r / 1 % r � 1 -� t, N r N 0910. EAST M 934.25' �N 094; � 15 121 o ; ; FD 1/2' r ----NO TAG PARCEL 3N ` r _ ` 691d 9.77 AC. �y c ; N 89-;A 0 z o PC] `\\EAST 10 (M) 858.42' r r N 07'26 2 ` ' 1 105 \�`,, PARCEL 2 �� 1 RESIDENTIAL __ y _ 027-160-024- PERMIT#95-0655 GRUBBS, Jay & Candace .420 Dunstone Dr., Oroville Cont; Theveos Const. Add Bedroom & Sunroom/SF a. JOB FINALED (Dat)(— Signature i J V= OK O = Not OK Not = Not Ready Applicable MOBILE HOMES Date/Initials MOBILE HOME UTILITIES (Plana) OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch _ 3. Sewer; Location -Test -Fell -C/O Concrete 4. Water; Location -Teat -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Teat -Wrap: / /" L" ft. / /"Net. or/ P L" ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date/Initials 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 -Fell -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. Exits; Insp.-Sketch 10. Cert. of Occupancy MISCELLANEOUS Date/Initial DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posta-Beams-Rftrs: Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Lendings Date/Initials POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel-Connections-Thickneas Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-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-Pine lboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test e V=OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date/Initials UNDERFLOOR Plans OK except #'s . Zo ing-Setbacks-Easements-Flood-Slope tg., Main; Soils-Elec. ,:.nd--/ Fig. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd. / /" Ftg. Depth 4. Ftp.,, Porches & Decks; Sol ls-Steel-/ /Ftp. Depth temwalls, Main; Steel-Blockouts-Wrapped 8. Stemwails, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs end Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. E,9ctric; Underground ums & Ducts; Clearance -Material -Support -Ina. gird'em-Sills-Anchor Bolts -Joists -Vents -Cripples Access & Ventilation 16, Insulation OK except #'s Htr.; Vent -Access -Combustion Air -Baffle / 17. Wat ipe; Test & Anchor -Neil Protection 11 W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date/initials ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection J S E_Ac. Receptacles Spacing -Lights & Switches at Doors �r . Si xes & No. of Conductors -Stapled . Roma. Installed Close to Edge of Studs & C.J. e6. Equip. de up w/Meeh. Fastners-Bond Gas & Water 7. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or6PA.C. Wire Size/ / ga. Cu or Al 29. . / / ga. Cu or Al. Insulated Neutral Yes 13 No I -n Owuia�onductors & Ground -Main Disconnect 31. Equip. Clearances Panels -Motors -Mach. Equip. 32. Clothes Closet Light -Shower Light -Spa Light Smoke Detector Date/Initials MECHANICAL (Permit) OK except #'s lation & Support AIO-Vent Fan; Exhaust above insulation rain &_Overflow; Size & Grade 37 - ss -Comb. Air -Return Air Vent -115 outlet rm if Furnance in Attic Dat /Initials FRA G Plans OK except #'s ZKIWL C19. Silsflro-Der Material & Anchors LO -Searing Walls over Girders & Floor Nailing D tt Stop in Walls (ret proof) Ftops; Furred Ceilings -Stairs -Chases -Tub r Headers & Beam -Size & Bearing Date/Initials FRAMING (Continued) ps-Anchors-Connectors Ong. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 4?. ype A Flue -Fireplace Throat clearance & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing irewall & Openings t. Doors -One 3' -Check Garage -3rd Story, 2 Exits room -Rise -Run -Landing -Fire Protection ywood on Roof Overhang -Attic Vents -Rafter Outriggers g -Nailing Veneer 5 Screed -Fd. Vents-Underflr. Access L*7-13razing,Area-Glass Protection -Skylights -Plastic 58. Stie r Walls; Nailing -Bolts VVE42 W.'Insulation-walls-Ceilings T 60. Infiltration -Walls -Windows Date/Initials FINAL Plans OK except #'s 61_.F,t.- Steps -Door & Sidelight Protection -Landings L--�_62. Smoke Detector 63. Fuer ace; Vents -Clearance -Comb. Air -Connector- -In Garage; Above Floor -Ducts -Meeh. Protection C room Exiting ` 5. G.F.I. & Bath Fixtures & Tub Access -Spa _V- -El# Trim & Subpanel; Breaker Sizes & Labels 67. PWi:s._&RaiIs_. 68. FirenlaeeorStove; Clearances -Hearth `___fi9_5tec-Outlets at Wood Panel; Int. & Ext. 70. Kit.Fi ...& Appliance; Grnd: Air Gap -Cooking Clearance 71. Elec_Outlets & Receptacles at Kit. Counter 72. Garage Fire Door, Swing -Landing -Closer 73._4.C -Duct in Garage -Damper 74. Wtr. Htr Vents -Clearance -Comb. Air-Connector-P.R.V. err are -Above Floor -Meth. Protection Ib., Elec. & Mach. Equip. Listed for Location __--8. FR�ptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic O Yes erd & Deck Construction -Post Caps ants & Crawl Hole Door -Drainage & Wood -Earth Clearance Lookgo under Floor ❑ Yes 80. mg instld.; Drive ❑ Yes O No; Walks ❑ Yes O No; Planters ❑ Yes ❑ No 81_ SLuoeo; Brown -Finish 8. Unit; Disconnect, Electrical, Plumbing 83,. ents-Above Roof; Pibg.-Appliance-Fireplace.-Clearance to Openings - Wet ell; Disconnect, Elec al, Plumbing tenor Elec. Trim; Receptacle -Underground 86-..Ferffilation Throughout House Comments at CorreqUong from Previous Inspections 89 s Test -Maters Tagged; Gas -Electric 90. Wa Sewer Connected -C/O to Grade -HD ADDroval CEILING BATT OR BLANKET TYPE .:FIBERGLASS BRAND NAME CERTAINTEED THICKNESS (INCHES)_ THERMAL RESISTANCE (R -VALUE)_ LOOSE FILL TYPE -INSULSAFE III CONTRACTOR'S. ABOVE LOCATION IN CONFORMANCE WITH THE CURRENT BUILDING :ENERGY EFFICIENCY MINIMUM THICKNESS JNCHES EXTERIOR WALL BATT OR BLANKET TYPE FIBERGLASS THICKNESS.(INCHES) /� '. BIB SYSTEM INSULSAFE I11 LICENSE NUMBER CONTRACTOR'S MINIMUM THICKNESS BRAND NAME CERTAINTEED ? THERMAL RESISTANCE (R -VALUE) BRAND NAME : CERTAINTEED THERMAL RESISTANCE (R -VALUE) BRAND NAME._URTAINTEED 22 THERMAL RESISTANCE (R -VALUE) �J BRAND NAME cERTAiNTEEb THERMAL RESISTANCE (R -VALUE) RAISED FLOOR MATERIAL FIBERGLASS BRAND NAME CERTAINTEED THICKNESS ,/INCHES THERMAL RESISTANCE (R -VALUE)_ DECLARATION I HEREBY CERTIFY THAT THE ABOVE INSULATION WAS INSTALLED IN THE BUILDING AT THE ABOVE LOCATION IN CONFORMANCE WITH THE CURRENT BUILDING :ENERGY EFFICIENCY . STANDARDS FOR NEW, RESIDENTIAL BUILDINGS. CONTAINED IN TITLE 24 OF THE CALIFORNIA.. ADMINISTRATIVE CODE. p� GENE CONTRACTOR UILDER) LICENSE NUMBER SlI GNATUR 8 TITLE DATE SHASTA INSULATION 27.2941 SUB -CONTRACTOR (INS TION INSTALLER) LICENSE NUMBER PRODUCTION SUPERVISOR SIGAAIURE TITLE DATE COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PER IT NO. APPLICATION AND PERMIT s -D ASSESSOR PARCEL LIMBER 027-1�0-024 ZONING a5 BUILDING PERMIT OWNER Jay & Candace Grubbs TELEPHONE SQ. FT. OCC. BUILDING VALUATION 7 r 95,596- OWN 5 HANG ADDRESS x+20RIDunston e Dr., Oroville, CA 95966 336 sunrocm 17,136, CONTRACTOR'S NAME Theveos Const. TELEPHONE 533-0716 CONTRACTORS MAILING ADDRESS 7070 Oro Country Club Rd., oroville, CA 95966 Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation Is 9 719 Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 369 On ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 23985 Energy Plan Checking Fee $ 91 0 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 420 Dunstone Dr. Oroville PERMITFEE $ 651.85 PLUMBING PERMIT Filing Fee 20.00 Each Trap 91 7.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USE OF STRUCTURE SF IR Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 15 oo TYPE OF WORK New ❑ Addition IR Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Master Bedroom & Sunroom Mobile Home I S I G W 1 920.00 PERMITFEE $ 64 00 Contractor ELECTRICAL PERMIT Filinq Fee 20.'00 Main Service600v OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A To 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in II force and effect. `�/ License Class Lic. No. �� � " OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ADDNS. ( & ACC. BLDS. ) so' 3.5¢ FT. 28 35 NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APOUPARATUSIR. Ex. Occup. (OUTLET OR FIXTURES) BAS a 1.50 Ex. Occup. — oFTiEDrs PLNS. OR ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE _ 49-15 Contractor 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 is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' co ensa n insurance carrier and policy number are: Carrier Q1 � Q MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ 15 00 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the worker ' ompensatio provisions of section 3700 of the Labor Code, I shall fort owit ose provisions. X ,; 0____1, Date _ G� Sign re of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excava ions over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 46.00 gJ COVPE TOTAL FEE $ 849.20 HAZ. _ D. FEE MP FLOOD .� X CDF PARCEL PD HD -� X ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. BY ate PER MITEXPIRESON (Date) Receipt No. 175$32/342.85// 0, WHITE-D.D.S.-B.D. CANARY -ASSESSOR PIN •INSP OR GOLDENROD -APPLICANT - SAF,`y'"y':"�r.r'w.4.iu-•-n�.��+ntr+-; "TK"iti f �Pyv; .-.:Y ,a'�I:eis7�r Ltir "'[±vaR�w V',y., COUNTYOF BUTTE - DEPARTMENT OF VELOPMENT SERVICES - BUILDING DIVISION, r / 7 COUNTY CENTER DRIVE - OROVILLE, CALwI OMNIA 95965 -TELEPHONE (916) 538-7541 v 1 PERMIT APPLICATION DATA SHEET OWNER I Ah Q C P. o. Proposed Building Use - Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted . ......................................... 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3. Complete plans, 3/4 sets, signed by preparer of plans . ..................... . 4. Engineered plans and calcs, 3/4 setslwith wet signature on plans . ............. 5. Hazardous Material Form. ........ su . ...... mentat .................... . 6. Energy Design Compliance and supporting documentation.* ocumentation. . 7. Statement of Intent for Non -Heated an'd A/C Buildings . ..................... . 8. Engineered truss details and layout in duplicate (required prior to plan check). .... 9. Mobilehome data an manufacturer's installation instructions, 2 sets. ........... 10. Fees of $ 5 ©� • . ................. . ,/ 11. Impact fees . (.... ��'! .. ..... . California Department of Forestry plan approva f es. �( ..... . 13. Flood elevation letter (100 year floo by Cali goineer. 14. Sanitation and plot plan approval D I/ ealth Department. .......... r 15. City of Chico plumbing permit. ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). . . Preanspedion requ� 20. Pre -inspection for required. .. to Building inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _). .......... . 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... �± 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. When you issue the permit, process as follows: Mail t owner. Mail to contractor. Telephone and hold for pickup at /� D L _ ffice. Deliver with inspector. / Other , Parcel Creation Acreage Applicant Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. - Other Date By The following data must be submitted priorkyermit issuance: (Circle new item not checked above). 1. Index permit for above items No. �� 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counte _ Date Plans checked by Date Plans approved by Date ets of plans on hold in File cabinet AP folder } Copy - Department of Public Works 94^41tIX�/� {/ \-T _Z© -as TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance H.H. USE ONLZf Plot Plan Attached Fla" Plan Atte a Scat to B.D. / 0/0,1� Owner Location AP// Plan Approved for: Sewage Disposal Water S pply: Public Private Well Clearance for bedroom �mobile rhome. Other Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Date 8/92 , P0 �; �.-'i5�1. 7,ra.r .^t BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Per Building) School District �' D r l M e n o N` Building Department No, A.P. Number Ud Jurisdiction City County Propertycl— Owner CJ /ay u r Gr ��' �. Property Location/Address Subdivison Residential Development No. of. Living MHI Units Commercial/Industrial 0 Lot No. EX Sq. Footage Addition (Group R) ~ (Floor Plans reviewed by School District Personnel) Sq. Footage >n (Including Exterior Roofed Areas) 9,5 - Date District' Identification No. 9S� School District certifies that (Applicant) (Street Address) (Phone Number) (City) .(State) (Zip Code) . has complied with the requirements of Resolution No. by payment of $ representing % square feet. F� Check here if fee received represents "Full Mitigation". School District Representative Paid by Check # Bank Number Paid by Cash Date Remarks: a�T If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeformmki (4/94) 7i, Gf1�{c9-T is �aoM �DJA�T -r0 SN � P-OOM CST. SIDE� 7 69. �M . r APR ? t'a5 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION Apt? 17 1925 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT .__ S<Z�- ASSESSORPARCEl UMBER 027-1�0-024 ZONING a5 BUILDING PERMIT OWNEJay &Candace Grubbs TELEPHONE SO. Fr, OCC. BUILDING VALUATION OWN 5 20 MAILING ADDRESS Dunston e Dr., Oroville, CA 95966 474 r99,396- 336 M 17,136 CONTRACTOR'S NAMETELEPHONE Theveos Const. 5,33-0716 - CONTRACTORS MAWNG ADDRESS 7070 Oro Country Club Rd. oroville CA 95966 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is 719 LENDER'S MAILING ADDRESS - Fling Fee $ 20,00 Permit Fee $ 169 On ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDINGADDRESs 420 Dunstone Dr. oroville PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 91 7.00 LOT NO. SUBONroN_S NAME PARCEL MAP ,Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF IR Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 is nn - Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 15 nn TYPE OF WORK New ❑ Addition IR Remodel O Utilities ❑ Installation O Other O Describe Work: ) ast B d oom & 4 Tn oom Mobile Home I S I G1 W 1 @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filinq Fee 20.00 Main Service000V OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in -boll force and effect. License Class Lic. No. G ice OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, as owner of the property, army employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason 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 is issued. O 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' corllpensa n nsurance carrier and policy number are: Carrier & n � I Q� NEW CONST. DWELLING OCCUR OR ADONS. ( 8 ACC. BLDS. ) SO. 3.5¢ F7. NEW CONST. MULTI.OUTLET NON•RESID ( BRANCH CIRCUITS ) @7.50 / POWER APPARATUS ) 1 6 NGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) zo o 1.00 BAL w Ex. Occup.FIXED APPLNS. OR (OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 48,351 Contractor MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ 15-00 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the worke�ompensation. provisions of section 3700 of the Labor Code, I shall fortKw cc wit ose provisions. X Date Sign re of Applicant - ❑ Owner KContractor O Agent An OSHA permit is required for excava(ons over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is 46-00 OCC CONST. TYPE TOTAL FEE $ i HA2. D. FEES IMP FLOOD COF PARCEL PD HD ISSUE X I X This permit is hereby issued under me of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON applicable provisions Resolutions to do work been paid. Date (Gare) J ReceiptNo. 175832/342.85// WHITE-D.D.S.-B.D. CANARY- ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT Certificate of Compliance: Residential (Page 1 of 2) CF -1 R Project ilia ����� _el� I Li,nate Prof 901 Add��rress /�, l/ I I� ��� `" J f.�41 Bwk4ny Permit it Documentation Author Telephone Plan Check/ Date 4G1�i �, � � � Field Check /Date Compliance Method (Package, Point System or Compu r) Climate Zone Enforcement Agency Use Only GENERAL INFORMATION Total Conditioned Floor Are 414 ft2 ; Building Type: Single Family Addition (check one or more) Mufti -Family Existing -Plus -Addition Front Orientation: North / East / South / West / All Orientations (Input orientation in degrees and circle one.) Number of Dwelling Units: Floor. Construction Type: Slab /!raised r1rcle one or both) BUILDING SHELL INSULATION Construction Component Insulation Assembly FENESTRATION Fenestration Area Orientation (sfl Front..... ( ) Front..... ( ) L ft Location/Comments Shading Devices Fenestration Interior Exterior 0 Left ....... ( )bo Rear..... Rear..... ( ) Right..... ( ) Right..... ( ) Skylight ....... Skylight ....... THERMAL MASS etc.) Revised December 1992 Area etc. 0 Overhang 'Framing s o� BUTTE COUNTY Thickness - ���GJ ►.��auuivut�scn ons IEcf���Batfa',�fck \KI MEi�lr COMY OF SUVIi BUILDING DEPT APR 0 6 1995 U Certificate of Compliance: Residential (Page 2 of 2) CF -1 R HVAC SYSTEMS Note: Input hydronic or combined hydronic data under Water Heating Systems, except Design Heating Load. Distribution Heating Equipment Minimum Type and Duct or Heat Pump Type (furnace, heat Efficiency Location Piping Thermostat Configuration Pu Al etc.) (AFUE/HSPF) (ducts/attic, etc.) R -Value _ Tvna fenl;..,...n„L.....� Cooling Equipment Minimum Duct Type (air conditioner, Efficiency Location Duct Thermostat Configuration heat um , eva , coolln SEER attic, etc. R -Value--• Type (split or package) WATER HEATING SYSTEMS Energy' External Rated' Tank Factor or Tank Water Heater Distribution Number Input (kW Capacity . Recovery Standby' Insulation TXpe Type in System or Btu/hr1 rnaunncl G I _-_ MIt — .,_. 1. For small gas storage (rated input S 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input 2 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For Instantaneous gas water heaters, list Rated Input and Recovery Efficiency. ,SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) 1 k A . Ii . COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6, of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple Designer or Owner (per Buslneas a Professions code) Documentation Author Name: Name: Tite/Firm: Address: Tite/Firm: (� Address:, I k" j Y .tom iii_ Telephone: Lic. #: (signature) Enforcement Agency Name: Title: Agency: Telephone: (date) (signature/stamp) (date) Revised December 1992 Telephone: IjV'%7yj , L°7r-;7 (date) Mandatory Measures Checklist: Residential MF -1 R NOTE: Low.rise residential buildings subject to the Standards must contain these measures regardless of the complianc approach used. Items marked with an asterisk (') may be superseded by more stringent compliance requiremenets lit;ted on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION DESIGNER ENFORCEMENTI Building Envelope Measures * §150(a): Minimum R-19 ceiling insulation. §150(b): Loose fill insulation manufacturer's labeled R -Value. *§150(c): Minimum R-13 wall insulation in framed walls' (does not apply to exterior mass walls). * §150(d): Minimum R-13 raised floor insulation in framed floors; minimum R-8 in concrete raised floors. §150(1): Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 perm/inch. §118: Insulation specified or installed meets California Energy Commission quality standards. Indicate type and form.. §116.17: Fenestration Products, Exterior Doors and Infiltration/Exfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. / b. Manufactured fenestration products have label.with certified U -value, and infiltration certification. V c. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. §150(8): Vapor barriers mandatory in Climate Zones 14 and 16 only. §150(f): Special infiltration barrier installed to comply with §151 meets Commission quality standards. §150(e): Installation of Fireplaces, Decorative Gas Appliances and Gas Logs 1. Masonry and factory -built fireplaces have: a Closeable metal or glass door b. Outside air'intake with damper and control c. Flue.damper and control 2. No continuous burning gas pilots allowed. Space -conditioning, Water Heating and Plumbing System Measures §110-13: HVAC equipment, water heaters, showerheads and faucets certified by the Commission. §150(i): Setback thermostat on all applicable heating systems. §1500): Pipe and Tank Insulation 1. Indirect hot water tanks (e.g., unfired storage tanks or backup solar hot water tanks) have insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater). 2. First 5 feet of pipes closest to water heater tank; non -recirculating systems, insulated (R-4 or greater). 3. All buried or exposed piping insulated in recirculating sections of hot water system. 4. Cooling system piping below 55'F insulated. 5. Piping insulated between heating source and indirect hot water tank. * §I50(m): Ducts and Fans 1: Ducts constructed, installed and sealed to comply with UMC Sections 1002 and 1004; ducts insulated to a minimum installed value of R-4.2 or ducts enclosed entirely within conditioned space. 2. Exhaust fan systems have backdraft or automatic dampers 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers.. §114: Pool and Spa Heating Systems and Equipment 1. System is certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating and no pilot light. 2. System is installed with: a. At least 36' pipe between filter and heater for, future solar heating. b. Cover for outdoor pools or outdoor spa. 3. Pool system has directional inlets and a circulation pump time switch. §115: Gas-fired central furnace, pool heater., spa heater or household cooking appliance have no continuously buring.pilot light. (Exception: Non -electrical cooking appliance with pilot < 150 Btu/hr.) Lighting Measures §150(k): 40 lumens/watt or greater for general lighting in kitchens and rooms with water closets; and recessed ceiling fixtures IC (insulation cover) approved. Revised January 1992 • 845_73: B,P,V",M PERMIT NUMBER - B P . E PERMIT EXPIRES Jay W. Grubbs ?OWNER owner CONTR 27-16-4 'LOCATION (A.P. w/s Dunstone Rd. 2000 ft. north of Grubbs Rd., Wyandotte r i, 1 COUNTY -. OF BUTTE DATE �/// <f� � J, &4 `, REMARKS OR CORRECTIONS ki T Department of 'Public Works c BUILDING INSPECTION-- RECORD Zoning Setback Forms _ Foundation Piers & Girders Fireplace — Rgh. Plumbing ` 7 Bond Beam Lath & Plaster Rein. Steel Gas Piping & Test Found. VentsoZ Framing - Plmg. Topout '-Rough Elec. Wtr. Htr. I �.- % �".' Furnace rcfP�—! '�py — Kitchen Vent��.�—.� Firewall Garage Vents Sanitation & Water ELECTRIC /3 ..7. GAS BUILDING Temporary — Temporary Cert. of Occup. Final Final Final _Z,2 -,A173 DATE �/// <f� � J, &4 `, REMARKS OR CORRECTIONS ki T COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR 7 County Center Drive — _Qroville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT aueNtt en tauvezi of the County of tilto enter upon the above entioned property f r inspection purposes. X 1,4 U Date 3 2 Sign Lure of Permitee or Agent � Receipt No, !a _<-1 5 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Building permit expires Date___� �.`'"'7"y-` BUILDING Owner SQ. FT. OCC. BUILDING VALUATION O Mailing Address OCi Telephone No. �O Fireplace O Contractor Total Valuation 691s-.06 Mailing Address �.�2_ Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address �/ S PLUMBING No. @ FEE PERMIT FILING FEE $2.00 / L Each Trap 1.50 , _ �•/i Repair drainage or vent piping I1.50 Water piping 1.50 Each gas water heater or vent 1.50 _ / _ A P (� Zoning 8 Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees Ih San ion Fire Dept. Fire Zone Use Permit Building sewer 5.00 El Parking Plans arcel Declaration Parcel Ma P 60' R/W Im provements Lawn sprinkler system 2.00 Bldg. Plans R d Parcel Approval Plans Approval Permit Fee $ NEW ADDITION ❑ UTILITIES ❑ OTHER [:]ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 LNZ Main service incl. 1 meter d Additional meters, ach 1.00 Single Family Duplex ❑ Mobil Home ❑ Others ❑ Sub -panel (12 or less) (more than 12) a Range, Cook -top or Oven 2 1.00 p Water Heater or Space Heater 1.00 ,67 Li ht ix ur bal d10 Re s., swi c & fix outlets S,fAD CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F. A. Furn. Motor 2 1.00 _ Evap.coo Ier, ar.disp.orD.W. 1.00 Air conditioner or heat pump • p Water pump Mobil Home Facilities 5.00 Temp. Power Pole 5.00 License No. Classification Misc. wiring I am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability VIforrkmen's Compensation. have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. I certify that I have read this application and state that the above inform tion is correct. I agree to comply to all County Ordinances and Ste Laws relating to building construction, and hereby MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling ` Ventilation Hood 2.00 Permit Fee $ � /7 TOTAL PERMIT FEE aueNtt en tauvezi of the County of tilto enter upon the above entioned property f r inspection purposes. X 1,4 U Date 3 2 Sign Lure of Permitee or Agent � Receipt No, !a _<-1 5 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Building permit expires Date___� �.`'"'7"y-` AGRICULTURAL BUILDING Exemption from Permits t, owner of the property located at lease print) OF - o s40 k 3 0 s -D Assessor Parcel # intend to construct an agricultural building on this property that is not subject to permits. Agricultural building is defined as follows: 'Agricultural building is a structure designed and constructed to house farm implements,.haY, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation.or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. I understand that if I.change the use `or occupancy of this building in the future, that I will be subject to the necessary permits, inspections, and approvals from the Butte County Building Department. Signature of Property Owner Date 9 AGRICULTURAL BUILDING Exemption from Permits I, /q V L2 P %P S , owner of the property located at (please print) Assessor Parcel # 7 �(� " L'� , intend to construct an agricultural building on this property that is not subject to permits. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. I understand that if I change the use or occupancy of this building in the future,.that I will be subject to the necessary permits, inspections, and approvals from the Butte County Building Depart ent. r S iY nature of Property Owner 1 �'� �� ��✓�� g P t Date '/ — '/y — a SUMMARY SHEET FOR LAND DIVISIONS APPLICANT ADDRESS OWNER Same ,.. PROJECT DESCRIPTION TENTATIVE PARCEL MAP LOCATION 4 parcels located on the northwest corner of Grubbs Road and Dunstone Drive. Palermo area. ASSESSOR'S PARCEL NUMBER(S)27-16-04 & 05 ZONING A-5 GENERAL PLAN AQ.-Resi. PROJECT CONSISTENT? YES GENERAL PLAN CONFORMANCE REPORT June 30, 1993 LAND CONSERVATION ACT CONTRACTS? DATE APPLICATION RECEIVED July 2, 1993 AGENT/SURVEYOR/CIVIL ENGINEER G.D.A. ADDRESS 220 Grand Ave., Oroville, CA 95965 DATE PLANNING DIRECTOR'S REPORT PREPARED ENVIRONMENTAL CATEGORICAL EXEMPTION - DATE FILED_ DETERMINATION AND DATE _ NEGATIVE DECLARATION - DATE ADOPTED MIT.NEG.DECLARATION - DATE ADOPTED ENV.IMPACT REPORT - DATE CERTIFIED STATE CLEARINGHOUSE NO. DEVELOPMENT REVIEW COMMITTEE HEARING DAT APPEALED BOARD ACTI APPEAL HEARING DA COMMENTS FOR PLANNING DIRECTOR'S REPORT ASSIGNED TO RECEIPT NUMB LD 1005 (11/92) DIS ir,41 A r X L Ild , It, -7:7 PRINTED ON CLEARPRINT 1000H 77777"�-`-77- p;W We it'll 7 PIT%? Tw ;w UYAM APPROVED Uawfe ignetur if es [PLANNING DIVISION - BUILDING PLAN APPROVAL ANN Use: Date: Parldng:_ Landscaping: Other. Signature: F_� u b nl ar n V0 r' -w 1,�A, IJ,-_�" Pill,, _j_; 17 _ 1 f--4 -4�1 vz� f lip - "l ` I t � 11 t I 1� i �j Pq lAk 6414 -6or & 1 4 PRINTED ON CLEARPRINT 1000H J��_l lt.�n__ 11.1 eo m A J� -L-LJ � o 7- -7-7,r, K r V4 �::, Tl f lt� tilo, 77 QA 1��: -Z j, ......... ;W