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027-240-071
RfacolyFO1y�S- �6SSsL- OY 1 SFRYICFS MAR 20oz �uBOAa wR1 T, -,RS �9 —---t--6-d'--t— I2' IS'-<' 8'— t --g'-8' S'-d'�` 355 30# -CENTERLINE SUPPORT REQUIREMENTS ' THIS SHEET IS TO UE INSERTFO WITH SUPPLEMENT TO FIELD INSTALLATION MANUAL FOR 3f1# ROOFZONE SNOW LOAD. SFE ABOVE PRINT FOR LOAD REQUIREMENTS AND LOCATIONS. Xf ROOF I_tur LOAD 7626- -26-CATH L321 _ VOL 1 _ SEC. ILL 51 PC. 6-69S � Y oxaWq BIL: vaa RAIU Q3/06/Z000 aESm UI1 P227 -CTE _ rr4 ..ya y rte, �' - - ` • • •. . I . . NOTES �}; '; RESIDENTIAL - I ::'.�J-+�7i- 04-3319 - PERMIT NO. _ . _ ' Cf:'HEN. SI'T. RRON 76:3% C:T:i'R.l1S'A�'E, PALERMO dont: RESTENT iJtl'� 111:1 !`!'RM FND o S1-3319 Ga.. THE HCD FORM 433A FOR THIS MH CANNOT BE RECORDED UNTIL ONE OF THE FOLLOWING HAS 1 BEEN TURNED IN TO THE BUILDING DIVISION: s (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). (2) STATEMENT. OF FACTS (ONLY ON NEW MH' S). INSPECTOR TO VERIFY SERIAL & LABEL #'S. c - SPECIAL CONDITIONS k - CHECKED BY SRA 'FLOOD CERTIFICATE REQ. ~ `) FIRE SPRINKL-ERS'REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS - SUB -STANDARD HOUSING LETTER. �v or - 0(/16 — -- . -- — OFFICE COPY a= Address i63 C�r�ss 1 +. y� P(4 p� h✓ + ' er By Date , I LGA_S ECTRI er B' = Da� " .� . vet s -b3 t � f • ; ].,% i JOB FINALED V/ Z`��� ! ' (Date) Signature I L J= OK 0 = Not OK = Not Applicable y. . = Not Ready M ILE'HOMES Date MOBI HOME UTILITIES (Plans) OK except #'s tl oning Requirements -Setbacks -Easements 2. Soils' Special MH Support Sketch ewer; Location -Test -Fall -C/O -Concrete ' QiV�ter; Location -Test -Easement Needed (Sketch) EI ricity; Location-Clearances-Grnd-/ /Amp -Concrete Gas; Location -Test -Wrap;-/ /" L 'ft. / /'Nat. or /W11 L "ft./3 i/' LPG 7. Well Clearance & Disconnec 8. Utilitv Clearance Date`L . Ul I V Card B-1 � � U - Date Card B-1 Date Card B-1/ Date Card B-1 Date MOBILEAfOME INSTALLATION (Plans) OK except #'s 2. Footingsa g- Line 3. G!_% -KH Test -Demand -Valve -Connector ectricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH That=Fall-Flex Connector 6. Water; Test -Regulator -Connector ? 7. W r and Sewer Connected -C/O to Grade -HD Aooroval �'- MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s G 1. Zoning Requirements -Setbacks -Easements k 2. Footinos; Soils -Size -Depth -Spacing -Connectors -Steel . 3. .fie Downs -Type -Installation Cert. 4. t Wood Awn.; Posts-Beams-Rftrs-Connectors - Shthg-Frg-Bracing 10. Exits; Insp.-Sketch 6. Carports; Windows -Doors 11. Cert. of Occupancy 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 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 Card B-1 Date Card B-1 Date Enclosure; Fencing -Alarms - Card B;A Date , Card B-1 Date PERM ENT END SYSTEM (ONLY)s Date Card B-1 Date Card B-1 1 3. K0 ' g Requirements -Setbacks -Easements ootings; Size -Spacing -Marriage Line Blocking 4. Gas; MH Test -Demand -Valve _ 5. Electricity; MH Test 6. Water; MH Test + 7. Water and Sewer Connected -�as and Electricity Tagged Boo"E f. t 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 G 1. Zoning Requirements -Setbacks -Easements k 2. Footinos; Soils -Size -Depth -Spacing -Connectors -Steel . 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. t 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 4 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 - tDate 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.-/ P' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel- Blockouts-Wrapped 6. Stemwalls, Garage; Steel- B lockouts -Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test 72. Elec. Outlets at Wood Panel, Int. & Ext. Date 73. Card B-1 Date Card B-1 Date 74. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Garage Fire Door; Swing -Landing -Closure 24. Fixture & Transformer Clearance -Ins. Protection A.C. Duct in Garage -Damper 25. Elec. Receptacles Spacing -Lights & Switches at Doors Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Size Boxes & No. of Conductors Stapled Plb.; Elec. & Mech. Equip. Listed for Location 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes 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 87. Water Well, Disconnect, Electrical, Plumbing Date 88. Card B-1 Date Card B-1 Date 89. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Glass Protection 36. A.C. Ducts Insulation & Support Corrections from Previous Insoections 37. Vent Fan, Exhaust above insulation Gas Test -Meters Tagged, Gas -Electric 38. Condensate Drain & Overflow, Size & Grade Water & Sewer Connected -C/O to Grade -HD Approval 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Energy Compliance Certificate -Other Certificates 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Fanels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes _ 83. Following Instld./Drive O Yes O No/Walks 0 Yes 0 No/Planters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Insoections 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.net\dds PERMIT NO. BPO43318 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: 12/10/2004 APN: 027-240-071-000 the Business and Professions Code, and my license is in full force and effect. Q License Class: C License Number: 8 2� 340 Site Address: 7637 CITRUS AVE PAL Date: 10 O &--e-2 tkontractor: S1L craL15-r e4-nuIZ • Map Index: Description: new mh new site perm fndn (1976) 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: SHARRYN COHEN permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 4244 MARKLEY RD signed statement that he or she is licensed pursuant to the provisions of YUBA CITY, 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 95993 she is exempt therefrom and the basis for the alleged exemption. Any 530-749-6296 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: SKYCREST ENTERPRISES Code: The Contractors' State License Law does not apply to an COUSIN GARY'S HOMES owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 13468 HWY 99 provided that such improvements are not intended or offered for CHICO, CA 95973 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-342-2694 proving that he or she did not build or improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: SKYCREST ENTERPRISES not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed COUSIN GARY'S HOMES pursuant to the Contractors' State License Law.). 13468 HWY 99 ❑ 1 am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95973 530-342-2694 Date: Owner: License #: 812930 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: W- 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: Carver: 2 d -a j t -T/4 Total Square Ft: 1976 S.F. Valuation: $128,440.00 Census Code: Policy Z0 6to �0 C1 �I ❑ I certify that in the performance of the work for which this permit is issued. 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, h and agree that if I should become subject to the workers' (/ compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: l O ��� �/ 2• �' 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 8 compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is h eby issuedd r e a icab a ovisions of the Bi tte County Coda anrUor I hereby affirm that there is a construction lending agency for the Resolutions do work ind' to bove r hic ees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)/ Z V Q Name: BY Date: PERMIT EXPIRES ON: Address: Date O 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & 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 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. 1 hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes Print Name: i�' �' ��� r^' — Signature: 1 A. Date: 0 Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor 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 REQ UIRED A T TIME OF APPLICA TION APPLICANT NAME • � ' ffi �� i�J►1;711(1�����=�1 Add,-ess Zip C?i� y Fax • o 1 - Map Book Fax APPLICANT NAME CONTRACTOR Name Name Add,-ess Zip C?i� y Fax �s Address Phone Map Book Fax E-mail Stat State License Number Zi Phone Fax 2 71 E-mail E-mail Lic. ! Cas APPLICANT NAME ARCHITECT/ENGINEER Name City Add,-ess Zip C?i� y Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLIrNTSiGNATURE r office use only: Zoning Flood Zone y I SRA I As I No Occ. Tye Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. /? D d P J BIN # LOCATION AP# — 02 Q 7 f Prope d r Cross Street WORKER'S COMPENSATION Policy Number ev Z, Carrier Z, " 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 Descrip 'on or Scop of Work: Iff Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): Page 1 of 2 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. ived by: Amount: '� Bldg a�1 SRA Receipt #: Sheriff ' �(' (�a SMIP Date: 1 1 j � ...7 Other Total REV 4-30-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: - ASSESSOR PARCEL NUMBER G 46 Proposed Building Use: Counter Technici Date: 1 1 Items I /�ms required in order to apply for a permit. " 1 boxes MU$T be checkPPYed OR marked N n ��4 I . � 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.. I �v ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. 8. Manufactured homes § Data sheets and installation inst Marriage line info,e(p) Floor Plan�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 elft 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. -;6 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................. J 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ 0 20. Erosion Control Plan Required........................................................................ ..... ........ 'r 21. Fees as shown on the attached Schedule of Fees Due Sheet ......................... ❑ 22. City of Chico Plumbing permit ............................. ...........:...rck-.' 23. California Department of Forestry plan approva paid. Sen 24. Plannin a royal A Use: U� B Parkin : C Parcel C9 PP () () 9 () ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form ........................................................ Ofd 27. Encroachment Permit for driveway from the Public Works Dept�j01��/.q ...... /2 -i!2 o ❑ 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 ................................. iti R i 6'/ Gcsn. ❑ 34. Manufactured home utility clearance............................................................... ❑ '35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37..�Grant Deed;�,M.H. Title/Statemo it of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑/ 38. Other: _ g 39. Other: When issued Telephone and hold for pickup. I have been informed of a above items and requirements for obtaining a building permit. Applicant: Date: n1M j 200 ( 1. Index permit application for the above items numbered: Plan Check Letter 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, b Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: X 1VJ Date: Note transfer by: Date: Yellow: Building Division = COUNTY OF BUTTE, DEPARTMENT OF DEVELOPMENPT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES Z� OWNER A.P. it PROPROSED BUILDING USE Ts) DATE RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ OZ2.SSCHOOL Revised Plan Checking Fee.... $ e DISTRICT FEES I �j(paid at School District Office) (form available after Pl eck) ' /2, _/ /0 3. SHERIFF FEES (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. Fig. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 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. 10. OTHER 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 tanhecking process. APPLICANT K Ar�2 DATES_ Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) ` „n1 •� �P P� BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM V . (One form per, Building) 1 ' 1/"�/ _ School District 11 , Building Department No. A.P. Number ba //� Dy • /�' -�!� Jurisdiction: O City County Property Owner Property Location/A4 Subdivision �` c Lot No. .......................... ».................................. :............ ................... ...... / � Residential Development 0 Q Q Sq. Footage ( `0 No'of Living Mo¢ile ome Addition) 'Supplemental to (Group R) Units �i�istallation Conversion Permit # r `(Nofoundation Inspection) :........................................_..........................._...� Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercia findustrial 0 New Addition a Building Department Representative District Identification No. 0!5 0 19.4 bta—VII ' JA11-10f) 1 I Q� School District certifies that (Street Address) ' Fc� 1e� V (City), has complied with the requirements of Resolution No. representing square feet. ` f--11 A r District Remarks: J Sq. Footage (Including Exterior Roofed Areas) Date / (Applicant) (Phone Number) M— Ft (State) / (Zip Code) by payment of $ I AB 2926 $ FULL MITIGATION $ Date A b'n Notice: You may protest fhs Imposklon of the fess iderkifled above: by submitting a written protest to the District, In compliance with y, . Govern Codi eicdon 66020(a), within 00 days from the date fees aro paid. Failure to submit a timely written protest will'prohibit you from challenging the Imposition of the has In any court actlorL N, subsequent to the Sctrool DNstrfet Representative signing this Butte County Schools Impact Fee Corti atlon Form, the School District Is notllled by the applicable Local Planning Agency that this project Is being reviewed under the California Environments! Quality Act (CEQA), this project may be subject to addMonai school hes to fully nftab.Its Impact on the school district's schools. White (applicant), Yellow (building department), feefwm.x(s 00/03)dmm r p�gPg*rMENT Do OVTrF ° 1 O \ O O c� U t4l C VWV Department .0 o u n t J. Michael Crump, Director of Y ; t� O Public Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1 Project Description: Project Location and/or Parcel Number: ( (D 2900_3 Z 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: 12' 4 Title: Date: Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 STATE OF CALIFORNIA i DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF c00ES AND STANDARDS • REGISTRATION AND TITLING SECTION STATEMENT OF*FACTS This unit is.a: Mobilehome El Commercial Coach El Floating Nome Truck Camper Decal (License) No.(s) Trade Name Serial No.(s) I/We, the undersigned, hereby state that the unit described above: I y b � )a_c_ e -d © r) a-, e r m0_n'0 vv+ P 0 V\-" Affiant further agrees to indemnify and save harmless the Director of Housing and Community Development, State of California, and subsequent purchasers of said unit,.for any loss they may suffer resulting from registration of the above-described unit in California, or from issuance of a California certificate of title covering the same. I/We certify under penalty of perjury that the foregoing is true and correct.,' WlExecuted on at C C'0 rjT Oa a (City) i (State) I , Si mature of each 'ffiant Printed .name of each affiant j �ous` n Cay140me•S Ad es W V C i ty State HCO 476.6 (Rev 11/86) AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION T 7 COUNTY CENTER DRIVE Recorded RE I REC FEE 10.00 OROVILLE,CA 95965 Official Records County Of I CONFORM 1,00 I EGRUBBS CANDACEUJ I ' Recorder 1 ROSEMARY DICKSON I Assistant I Alyce 12:52PM 10—Dec-2004 I Page 1 of 2 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code requires 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 situated in the County of Butte, State of California, described as follows: SEE ATTACHED LEGAL DESCRIPTION Date PROPERTY OWNERS: X X A -A& V Ryan . Mahon Juliet. Mahon State of California County of Butte On 10` ?Z'0before me, t2 JS't�/ L. t`I a vlk" Y�D+0-4 /i lawb l i c-, personally appeared 1?1 a CAVI • 1` IO- OyL O�3v CA IJ LAJ I -C- I--- J�_k6.,VLtSlA___j 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 APN: 027-240-071 CHRISTY L. HINKLE COMM. *1493928 NOTARY PUBLIC-CAUFORNN COUNTY OF BUTTE Comm. Expires June 7, 2008 08/30/2004 08:10 FAX 530 899 9531 FIDELITY NATIONAL TITLE i COUSIN-'GARYS IM004/004 Mo MEN Ca I® "L Taa6 DIED arra. MUM CUME SE a NOM GGLOW, "LTAX 9TATEtm- tf 10; Homo F— Sharryn Cohen AWr= 2010 Margot Circle Cop Reno, Nevada, 89509 em acus 07ded Na. P=0W tai. 9®cortcd I IIS IM 7.i9 OfFicial Cl i .ice ®Posd9 1 I J. Mus I DICM I kzigtaybt I Vickie 83e as-juta-& .I Dego A o9 I WAC E ABOVE TWE WE FM M=MDER Eo UGE THE UNDERS104Wet) GMA-MM(s) DECLAr.W4) 130CM4ENTAAY TRAMM TAX BS 6 -- -0- [a—' Mn9=rFWM aero ❑ C48Y Of Feacol Wo. 0 enantt nod all 6'telt vela o1 it tmM m FMgerly tta:tvegeA W ❑ em�A � til v88l6ai lees vdt� of Ie>ffie a: ac�nbrene® rotrt�initt® ea rims a1 tak. ert9 FOR A VALUABLE CONSIDERATION. rewipt of which is hemby ficknowlefted, KhRCIA F. COSEN, TRUSTEE OF THE i! CIA FAN CONEN LIVING TRUST(I-12-84) hereby GRANT(5) to SKARRYN COHEMv A MARRIED WOW, "Grantee", for and its consideration of the love and affection which Grantor has and bears unto Sharryn Cohen and also for the better support, maintenance, protection and the follming &acrid xW proparay in the livelihood of her and her HEIRS. mum Of BUTTE . Csttataasrwiomia: CALIFORNIA ONE HALF OF ONE HALF UNDIVIDED INTEREST IN Lot 1, in Block 122 of Subdivisions No. 2 of the Palermo Citrus Tract, according to the Official Maga, thereof, recorded in the office of the Recorder of the County of Butte, State ®f California an the 2nd day -of January , 1889 . I Excepting therefrom tete Mortis 315 feet. THIS IS A SOI IDE GIFV AM TEE CPAM70R RECEIVED NOTHING IN RETURN, REVENUE AND TAXATION CODE SECTION 11911 Dated RM= i 1993 STATE OF CALIFOE1tttA g COUNTY OF LOS b 9.3. On Juam 70t 1999 t�Paro me. M. Elmnda a NMBFb Public In ON 10P Dal6 County and State, oe��apip ®pp.M13B89 psattarnalty known, to me dor pmvad to me on the but& of 98Isd=1ory gwdunce) to be the pmeon(s) whom ftwwje) halere ®at wrlheA to no vat In Insrumm end at:tutnvatledgd to me that hefth0toy =taettta® t6ets awn in hIRMST/ftr etas Mp=R&OL and 0= by hleftrrlftir iftnourar(6) on thee insiroentent the partaoMa). or tvim a3ntity tdt9 M Doe" at whtdh 6193 pwwn(e) a stud, onecuted ft inalturna m. VATAIESS my hand ofil:l41 =I —,1) _ 11 Signature F. , qtwtza KML 'r&X ffr&7ZIYE4U°I1Z W PAM SH tww ON M&QW0Z p IV No 1p&MT r St".OWW. r dAIL A3 D PW &@VVM ftme Q;= Acari Cigy A Sts: 009criptioae: sdSfte'M �a zae-4ocvag.99eBD �999.��5g� �e�: Y of Y Order: fium C®maesazt:: CDF FIRE SAFE REQUIREMENTS AP# 027-240-071 PERMIT # 04-3318-3319 NAME: COHEN, Sharren Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and made a part of this permit. These requirements are minimums and may be superseded by Butte. County local regulations that exceed these standards. Field inspections for compliance will be made by the Butte County Building Department. [X] 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail -ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provided for by the land owner. Drivewav Standards [X] 1273.02 Surface. All driveway surfaces and structures 1273.07 (bridges, culverts and other appurtenant structures which supplement the roadway bed or shoulders) shall provided unobstructed access to conventional drive vehicles, including sedans and fire apparatus weighing up to 40,000 pounds. [Xj 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius [X] 1. No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional surface width of 4 feet shall be added to curves of 50-100 feet radius; 2 feet to those from 100-200 feet. [X] 2. the length of vertical curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. [X] 1273.05 Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. [X] 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. [X] 1270.10 Width. All driveways shall provide a minimum 10 foot traffic lane and_ unobstructed vertical clearance of 15 feet along its entire length. [X] 1273.10 Turnouts. Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, tumouts shall be provided no more than 400 feet apart. 1273.11 Gates [Xj 1. Gate entrances shall be at least two feet wider than the roadway it serves. 2. The gates must be located at least 30 feet from the roadway and shall open to allow a vehicle to stop without obstructing traffic on the roadway. 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. 1 A CDF FIRE SAFE REQUIREMENTS 1� AP# 027-240-071 PERMIT # 04-3318-3319 NAME: COHEN, Sharren Fuel Modification 1276.01 Setback.for Structure Defensible Space [X ] 1. All parcels 1 acre and larger shall provide a minimum 30 foot setback for buildings and accessory buildings from all property lines and/or the center of the road. [ ] 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See other requirements below. [X] 1276.02 Disposal of Vegetation and Fuels. Disposal, including chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification shall be completed prior to completion of road construction or final inspection of a building permit. Other Requirements [ J If Building Setback is 15 to 30 Feet: Class A or B roof Enclosed Eaves [ ] If Building Setback is Less Than 15 Feet Choose any 3 of the following: - Metal or no doors on side toward property line with insufficient setback - Class A or B roof with enclosed eaves - Interior automatic sprinkler system per NFPA 13D - Glass area not to exceed 10% of wall area toward property line with insufficient setback - Siding from the following list: Stucco — 3 coat Hardi-Board or Plank Masonry Masonry Veneer Metal Other Butte county Fire Department approved materials [l 11/23/04 Steven J. Fowler Date Signature N E.H. USE ONLY Piot Poen Attachod_ Floor Plan Attached Santo G.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance SAwWt! &46L, <, AIL Owner. Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwelling. Other �� �- o lub-I JUIICLA 0 aX-) Hold final for: Final clearance O.K. for: NOTE: mental Health Specialist 8/96 Date - _ t IS - RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 2005-0004654B Recorded I REC FEE 10.00 Official Records I CONFORM 1.00 County_Of BUT I I CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Myles 09:37AM 25 -Jan -2005 I Gage i of 2 SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. SHARRYN COHEN REAL PROPERTY OWNER/LESSOR 4244 MARKLEY RD. MAILING ADDRESS YUBA CITY YUBA CA 95993 CITY COUNTY STATE ZIP 7637 CITRUS AVE. INSTALLATION MAILING ADDRESS, IF DIFFERENT PALERMO BUTTE CA 95968 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME") SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION BUTTE COUNTY BUILDING DIVISION LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7 COUNTY CENTER DRIVE MAILING ADDRESS OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP 04-3318 530 538-7541 n E&M]TN TELEPHONE MBE I i Ds- _ NATURE OF LOCAL AGE Y OfOCIAL DAVE COUSIN GAR)PS DEALER NAME (if not a dealer sale, write "NONE") 91265 DEALER LICENSE NO. SKYLINE HOMES INC 2004 2227 -CTE MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER 17-70-0363-T-A/B 76'X 26' ULI563194/5 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIAILABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER 027-240-071 HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept. Pf 09/30/2004 09:10 FAX 530 899 9531 R&CORL Ip RECWESTED BY MND WHEN RECORDED MAIL TMIS DEED AND, JJNUM OTHEOMBE BROWN BitAW, MNL TAX dTATZw NT M. memo t— Sharryn Cohen Sar,Am0 2010 Margot Circle clha Reno, Nevada, 89509 VP L.� J INC OrdeN No. Pxrav tate. FIDELITY NATIONAL TITLE 4 COUSIN_GARYS 004/004 � 999-0024526 Recorded I AEC FEE 7.W Official Records IC3IFORMI .M C9011tv Df BUTTE I CAN= J. 6Rt= I Recorder t 009ENM DID 90N 1 assistant I Vickie 03:43PP 99 -Jun -3999 1 Page I of ) SPACE ABOVE TIME UIE FOUR RECORDER'S USE 3pthwe"d ..f 2Trrn ( THE UNDERSIGNED GRAWM(s) DECLARE(s) OOCUINENTARY TRAN&RM TAX IS S --_-0- I unim pwaio f am ❑ City of Pncd Ne. ❑ tnmpuled oD Ndt value of iaeereel or pmpeny cor yed, or 119 1 1 -e I as fW vdn ku vdae of Iia" or tacumbranom nmr awro w Bmc of =It, old FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, MARCIA F. COHEN, TRUSTEE OF THE MARCIA FAN COHEN LIVING TRUST(1-12-84) hereby GRANT(S) to SHARRYN COHEN, A MARRIED WOMAN, "Grantee", for and in consideration of the love and affection which Grantor has and bears unto Sharryn Cohen and also for the better support, maintenance, protection and the following described real property in the livelihood of her and her HEIRS. county of BUTTE . store of Wfomia, CALIFORNIA ONE HALF OF ONE HALF UNDIVIDED INTEREST IN Lot 1, in Block 122 of Subdivision No. 2 of the Palermo Citrus Tract, according to the Official Map, thereof, recorded in the office of the Recorder of the County of Butte, State of California on the 2nd day -of January , 1889 Excepting therefrom the Horth 315 feet. THIS IS A BONAFIDE GIFT AND TSE GRANTOR RECEIVED NOTHING IN RETURN, REVENUE AND TAXATION CODE SECTION 11911 . Dated JUM 7, 1999 STATE OF CALIFORNIA COUNTY OF LOS AncieleS )B.S. on June 7, 1999 befbra me, Margaret M. Edritorids a Notary Pudic M am for Bald County and State, 0&aottelly appeared personally known to me (or proved to me on the beds of datidociary VAdence) to be the pereon(a) whose name(o) ialera subscribed to the wlthla Instrument and aCb+owledped to Nne that heleheRlxry executed tlto same in hldherAheir aultudzed capowV(imo, and 00 by hWWfti( dlpnstura(S) On the instrument the pomon(s), or Mae entity upon Da im of which the Pofw*) acted, executed the inauumem. WITNESS my hand_Angotiicfal txa61 _,Z) _ 11 Signature is F. Cohen, Trustee MARGAW M. EDMONDS S Comrraagon 4 11116M ¢ Notary RMC -• t,4dom10 Ljm AnWes Ccnstly My Comm. Ext ies Seo 17, 2(M MAIL TAX srATENENTs To P,Uti'y 6HOWN ON FOLLO'W12% I.=; W No PARTY =OWN. MAD. A3 IDIRFit:= ABOVE Nome SWO Aeons Ciry R Star tsscripticn: Butt:e,CA Docuesent- Year. VOCID 1999.24526 Page: 1 of 1 Order: nm conmu at: � u BUILDING PERMIT NUMBER: 04-3318 Address or location of unit: 7637 CITRUS AVE., PALERMO, CA 95968 Legal Description of Real Property: AP#: 027-240-071 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: SHARRYN COHEN Owner's address: 4244 MARKLEY RD., YUBA CITY, CA 95993 INSIGNIA OR HUD NUMBER: ULI563194/5 SERIAL NUMBER OR V.I.N.: 17-79-0363-T-A/B MANUFACTURER'S NAME: SKYLINE HOMES YEAR: 2004 OFFICIAL PPR . VING INSTALLATION ����CC_ V DATE: j l PHONE: (530) 538-7541 H.C.D. 513C 12/22/2004 16:25 5303429174 CHICO BLDG SYSTEMS PAGE 02 GUTS 00 CALWOMA Aulwwm TwaMroMTA"m A►O w1dm AGucv • WWRATMEW1OrM JSMNOCOMMU'"°�"'�' 0r 8723184 �A�6r 0NI 04mr ll NOYYMIO "Ammo MANUFACTURER CERTIFICATE OF ORIGIN lammoo E =lrL PMIQ "M M TD TWO WVEkTWVCA•AROL NIaOM TWM I: NONE IMM fORMau1D 70 THE P1/1CIMifN O1EMfJ1 OI1 TMMe/GAE�1 et►.Tq Mf+OMO/oTOTMORPOIDOWATP.O.ONfM%44CRAVOMC&aEel-10LTInIMIfTrt(somolwan w. corradeuew► �a�A�aTeT►sTIUIN�rdnlraroAaalrlenTreuwrTonso►xlsuTlaa NOpIRiO�lr1-pam ��TO�AK�IIOMsyTIlEMMNIC7INlle.. •.. O CHEM IP Ms I@ A GWICA1f 4100e1RM OHIO RM MCO NO. 7MAANFACTWEM Now OR MUInA a!T MJMLaGrnM= JQW" GI 3FD (SINM E FAMILY DNIELLING) ❑ MIMI 0"T144AW K~ACTrINID Holism NUMlM OF TMNIPORTAM SECTIONS Z COMMERCIAL e� acewANCY OR" MI►MII . SKTLIKE HU14ES IWC 90002 MA ERADORM: valvae 1720 ;UST SFr1M STREET WOODLAND CA 957?6 8 113.,ZE1.7$ of AOODFIFILM 7227–CTE i 2 / 14/ N04 l v on OA Eli: SYYCRTST E! TEPYR13ESiC0i1SI:i GARY'S ROKES IIIAN Tom 12/22/2004 91265 HwY 99 C CF.:OA CA 95971 WVlXVORVVReOlW. TEXTRON Fl j.A�'1CXAL COU r P.O. HuX 16520 ST LOUIS MO 63io3 agwo Ism 70CNON MMIIKACTjo= WJWAL mumMA MCD MI MA CM MIA LARK NUM M LOMOTN VANN . llllANf !n 1 17-70-03fil-T-D 1i►2 5631!'4 912 156 30,666 2 17 -70 -0363 -T -A DLI 563195 912 1St 31,646 TgAM®OMTp NIMH @EN. -TT; TRUCK TRA.vSPORT TwwreAeeal,eeness: ?.0. SIX 179D>rk1W.�: CA 95938 E QElTaalAttOMagllulMlalElaaa+�ow�ovE; QGVs:N GARY'S 8?1lPS; 13468 WY 99 9 CHICO CA 95971 lam*~ aae� h r..am. Jtlard0w.i •a,aw.a�y Ir,a...rr wawa iMDLAXV TOW CA lcl,t2/20L+6 eawroM .• {. i 1 .lID►N1UIMaaiAlaltgp�pAQERC_ � �/ •- �-.—.r lammoo E =lrL PMIQ "M M TD TWO WVEkTWVCA•AROL NIaOM TWM I: NONE IMM fORMau1D 70 THE P1/1CIMifN O1EMfJ1 OI1 TMMe/GAE�1 et►.Tq Mf+OMO/oTOTMORPOIDOWATP.O.ONfM%44CRAVOMC&aEel-10LTInIMIfTrt(somolwan w. corradeuew► �a�A�aTeT►sTIUIN�rdnlraroAaalrlenTreuwrTonso►xlsuTlaa NOpIRiO�lr1-pam ��TO�AK�IIOMsyTIlEMMNIC7INlle.. •.. 01/17/2005 09:37 5303429174 CHICO BLDG SYSTEMS PAGE 02 STATE OF C-%WORMA .dUbINE9b, TRANSPORTATION AND "CUOMO AOGY NUM ER: � EN OEIPARTMENT OF 14OUSINO AND COWAUNFTY' DEVELOPMENT vn A Wvo o OMSMOF COMOOWD•DYANWOb V f Z�� S '7 AtANUPAGTUREp MOUSNO PROGRAM MANUFACTURER CERTIFICATE. OF ORIGIN Fo CNECN IF TMIS 19 A DUPLICATE MCC eMTER ORIOINAI MCO NO. MANLEACT7� U HOME OR MULTIUNIT�- CJ SFD (SINGLE FAMILY Q►NELLING) ❑ MUMN (MULTWNIT MANUFACTURED HOUSING NUMBER OF TRANSPORTABLE SECTIONS 2 OCCUPANCY QROUP MANUFACTURER NAME: SKYLINE. HOMES INC MANUFACTURER LICENSE NUMBER: ' MANIACA Inc . - 90002 S 720 .EAST BEAMER STREET AANUFA TURER TRADE NAME: WOODFIELD WOODLAND CA 95776 SKYCREST ENTERPRISES/COUSIN GARY'S HOMES 3 68 Hwy 99 E WEN TOR 7 CREDITO NAME: TEXTRON FINANCIAL CORP P.O. BOX 16520 se.a SED. MANUFACTURER 98RML NUMBER 1e 1 17-70-0363—T—B 2 17-70-0363—T—A TRANSPORTER NAME: BENNETT TRUCK TRANSPORT P.O. BB% 179 P227—CTE _f CALIF. DEALER NUMBER OR TRANSFEREE DESIGNATION: 91265 CHICO(C) CA 9.5963 ST LOUIS MO (cnT) HCDJMOQNIA OR MUD IASeL NUMBER ULI 56.3194 ULI 563195 DURHAM CA tiN .�H UNIT DESCR19ED A@GVE: MAWCOUSIN GAP.Y'S HOMES 9lnr 13468 HWY 99 E CHICO c ow"V w1dw ow -RT a Prwn ~ 9r w" of ve slw d C.Ndnu 81r I m soft* trn @M au..ro amnat ,ems an r WOODLAND YOLO (o JONATURE OF A1lTHOR12ED AGENT: 63105 $ 113,281.75 E OF MANUFACTURE 12i 14/7.006 12/22/2004 LENGTH IL� WIDTH INCHES WEIGHT POUNDS 912 156 30.666 912 '. 156 31,646 95938 CA 95973 CA IEIlliiIIQ(C ORIGINAL (PMK) FORWARD TO THE INVENTORY CREDITOR UNLESS THERE If NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (YMIRE) fORVyNlD TO TME OCPMTMENT AT P.O_ �{ I x, SACRAMENTO. CA 8!812-1928. WITHIN FIVE (S) OATS OF RELEASE. COPY Z (YEIIOVv► DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION, . �- _ -COPY 3 (GOLDENROD) TO SE RETAINED 9Y THE MANUFACTURER, Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538.7601 Telephone (530) 538.7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING November 17, 2004 Sharron Cohen 4244 Markley Road Yuba City, CA 95993 Skycrest Enterprises 13468 Highway 99 Chico, CA 95973 Subject: APN — 027-240-071 Dear Mr. Cohen, The Butte County Department of Development Services, Planning Department has reviewed the building permit 04-3318 and 04-3319 for a manufactured home and a garage. The property is located in an A-5 (Agricultural 5 acre minimum), which was sent to the Agricultural Commissioner to review for agricultural setbacks. I have attached a copy of the response from the Agricultural Commissioner which states that the western property must have a 125' setback. I also made a note when I reviewed the septic clearance and conditionally approved it with a'note that the setback had to be 125' from the western property line (the septic site plan had a setback of 120' feet). I cannot approve your site plan at this time, as it does not meet the minimum setback required by the Agricultural Commissioner. Please revise your site plan to show that your residential structure will be at a minimum of 125' feet from the western property line. Should you have any questions please feel free to call Lana Adler, Assistant Planner, between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday. at (53.0) 538-7601. Sincerely, ���Cx.c-til D'1 tephen Streeter Planning Manager. ... .. `.fir .. SITE PLAN REVIEW APPLICATION Date: 2� AP# Permit Number (if applicable) 1 . APPLICANT INFORMATION Parcel Size: J. faf/� j C' Owners Name: 31 -yo— 'r'yn o, t Address: �U } � .� l/� a fyew gy C Telephone No.: V 13 ga ' a 9 Y Situs Address: Proposed Use: Residential RSew Single Family Residential ingle 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 ❑ New Industrial ❑ Industrial Addition Other Septic Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Commercial Remodel ❑ Industrial Remodel MOM 0 DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) COUNTY OCT 21' 2004 ' DEVELOPMNT SERVICES Approved ConditionallylA Approved n ❑ Resolve Problems Prior to Approval chzt Site Plan Stamped Approved' ✓lk ,� By ZL,, al r Date t( 1r a ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑Land Conservation Act Minimum Acreage: ❑Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) o Flood Zone: Flood Panel No.: Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ El Administrative Permit Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment -Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: - LDA -I- ( 4--m 0 Applicable Building Setbacks: Zoning Code Streets & Highways Fire Prevention Front Side , Side Street Rear 5-1 Height Waterway N/A N/A N/A Subdivision Map ❑ Setbacks drawn on site Plan, ❑ CDF approval needed for encroachments into SRA setbacks. Applicable Development Fees: Standard Fees ❑ Fire ❑ 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 Deeds: Date of Creation: 7 Legal Access Provided: ❑ No Yes Deed of Reference: / 16 73 Legal Access Required ❑ No Yes Parcel Frontage on Publicly Maintained Road: ❑ NoYes; Road Name: Complies with County Standards for Deed Creation:❑ No M Yes Comments: &)aj A& 6�% —.,2 L10d (., 9'. IN 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 Q 7-240-O(a?" 5psej Zy dad i/ 00 5-570 //lfl-�G Subdivision Map/Parcel Map: PVA� d C S 3 Map Date of Recording: Lot: X� % Z ❑ Use Permit/Minor Use Permit Permit Number: Book: Date of Approval: Page:_�j c Parcel Map/Subdivision Map[Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.RC. 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 Fundmay 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 10, NO LTJ W 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. CM-arrysSuilding Permit Site Plan Reviewl.doc 11/18/2004 07:46 5303429174 CHICO BLDG SYSTEMS PAGE 01 Cousin Gary's Homes 13466 Highway 99 Chico, CIS 96973-9479 dba Chaco Building Systems �-A-Mr"-� To: Phone: Fax: CC: ®ate: Number of pages including cover sheet: From: Phone: (530) 343-2694 Fax: (53®)342-9174 Remarks Urgent () For Your Review () Reply ASAP () Please Comment M 11/18/2004 07:46 5303429174 CHICO BLDG SYSTEMS PAGE 02 BUTTE COUNTY U00DUNI-4 AGRICULTURAL BUFFER NOTIFICATION AND/ORUNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (5301536-7601 Name: 1 IMZtnan Phone: S -10 -6,75 -7 - Mailing Address: X �-� M e sS c� v� . ��� z,�-yv,p c� �c� L E -Mail address Assessor's Parcel Number: 6Z"1 - -?--to Oil Reason you believe you qualify for the unusual circumstances exception: C) 4 Owner or Authorize gent's signature Date UNUSUAL CIRCUMSTANCES DEFINITION: An exceptional or extraordinary condition where the existing lot size or shape or an existing Improvement (well, septic systems, structures etc.) does not allow for the standard condition of a 300400t buffer zone. SITE PLAN REQUIREMENT: submit 4 copies with this form Refer to the Site Plan Submittal handout for specific requirements ........................................................................................................................................ I ........... Internal Dept. Contact Info: 0 Env. Health ❑ Planning ❑ Building Other Contact Person: Phone: FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING .................... For l�gricaaffural Cornrssi�eioner o> c® uga only: (to be corrvpleted after submlt4al ) DISCRETION RY PERMITS(Planning) MINISTERIAL PERMITS(Building) Exception Recommended Exception Granted with the ❑ Exception NOT Recommended following conditions: Reason/Conditions/Specific setbacks from adjacent agricultural operations, 6a.,,@ u" I I Agricultural Department Signature:, -;�� Date: 04 �2pC6N�. YMC 7/1/03 11/18/2004 07:46 5303429174 CHICO BLDG SYSTEMS PAGE 03 Butte County. Department of Agriculture Request for Services: PLANNING ! BUILDING PROJECT REVIEW Effective August 24, 2004, Butte County Ordinance No. 3680 section 3-61, k, 4, address the fee schedule for agricultural. related planning project review: "All planning applications that are referred to the Agricultural Commissioner for review or when an individual or business requests review by the Agricultural Commissioner will be charged at an hourly rate of sixty five dollars ($65.00) per hour with a minimum of thirty-two dollars and tifty,cents ($32.50) for one-half hour. Any additional or subsequent review of planning matters by the Agricultural' Commissioner shall also be charged at this same rate;" Name: Phone No. Business name (if applicable); AAddress: City & St.: Name or Scope of planning project (include any documents or maps to facilitate review): Zip: Qe)1 LDB oAus2szk etc Zl.r bu,lclt {ra•� _ &A APN number. 02"1-Z'ij.. Consultation regarding the results of the review and any related documents will be provided by prior arrangement or appointment. The charge(s) for project review and mileage wilt be due at time of service or may be billed if approved by the Agricultural Department. T : totals are as follows: Hr's labor C $65.00/hr $ qa s p Mileage ®.30/mi $_ p Total Charges S !O� " I agree to pay the Butte County Department of Agriculture for Planning/Building services provided in accordance with the Butte County ordinance No. 3680. V -Signature: Date: "!;; � � � 1 : B ,t aP� ^.�.pw►r•. �(r� r L. �t4, � ,raf�w _',1 �.y .rta�.s:a+rr^.A.R.:M "tf ��...w/r��igg•,�e ���� P �t4�. 66 �t . t 1 .r.�a.. 1�`• kolat�. # .. �rK orte' •y�te tf. .9, 1 , r r 4 - t r i•b� i a �.� �s 1 3. r* d +� `'� e it ny I v� T I' 7 � /( '� p ✓,. � f V S f. V,. . t i A. won ------------- 7 •/,..a, y �• r � �" .�a t'��� � d. "gyp. .' J1 ^I • �: ^.'_:1.Z.. u vt� ..1�! rr � - rt r.. { 6 a � �- --� ��"� ��'� j .k. �, 3. �. 'r�yi:�.• %I>< 7 ,i '�"'r 'alp_ r /' _ ! -'� �!. M + ,Fq..t rIrq`�.- i M stB.y. c 44 - '1•'p'.ar.� !1 . `. �•'��dt .. � 'r`; Thy 7I°P 1. ' ,; �.. •:.� w . , 3r16 t'. ♦'mss 1: �6: '1j l }�� O v O BUTTE COUNTY O O O O AGRICULTURAL BUFFER NOTIFICATION AND/OR o"-' �o UNUSUAL CIRCUMSTANCES REQUEST IV Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538-7601 Name: jt�l�� V�labtan Mailing Address: _K 2-r-51 b E -Mail address Assessor's Parcel Number: 5Z-1 - "2-1t0 - 0'1 I Reason you believe you qualify for the unusual circumstances exception: or signature Phone: '6-10- 6-7 Si- Q1�j�L9B Y, a -2g - d�- Date UNUSUAL CIRCUMSTANCES DEFINITION: An exceptional or extraordinary condition where the existing lot size or shape or an existing improvement (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone. SITE PLAN REQUIREMENT: submit 4 copies with this form Refer to the Site Plan Submittal handout for specific requirements ................................................................................................................................................... Internal Dept. Contact Info: ❑ Env. Health ❑ Planning ❑ Building Other Contact Person: Phone: FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING ......................................................................................................................................................................................... For Agricultural Commissioner office use only: (to be completed after submittal) DISCRETIONARY PERMITS (Planning) MINISTERIAL PERMITS(Building) ❑ Exception Recommended Exception Granted with the ❑ Exception NOT Recommended following conditions: Reason/Conditions/Specific setbacks from adjacent agricultural operations: -Parkt: SKe It ;net -'z6agra Fa,4e,, $-fAXrt 1411, v S e r2la-ceJ 7P>1 4-L_o Wg.S �wenclar-fir 2 .tea �' CS S . Agricultural Department Signature: Date: oa 23 b� YMC 7/1/03 Butte County Department of Agriculture Request for Services: PLANNING / BUILDING PROJECT REVIEW Effective August 24, 2004, Butte County Ordinance No. 3880 section 3-61, k, 4, address the fee schedule for agricultural related planning project review: "All planning applications that are referred to the Agricultural Commissioner for review or when an individual or business requests review by the Agricultural Commissioner will be charged at an hourly rate of sixty five dollars ($65.00) per hour with a minimum of thirty-two dollars and fifty cents ($32.50) for one-half hour. Any additional or subsequent review of planning matters by the Agricultural Commissioner shall also be charged at this same rate." Name: Juk-e_ M -3-k d'n Phone No.: (01193"1 Business name (if applicable); Address: '2-S5 ) 1�) City & St.: Pa ja_ J Zip:`J LQ?� Name or Scope of planning project (include any documents or maps to facilitate review): t�nusya- ` etcr�u�Ks�anL� �•�t,.�0 �� , Pf i.?� r- -kt but td i nt, o� ro "O Li A- t, a APN number: OZ-I-Z`to-C-7 Consultation regarding the results of the review and any related documents will be provided by prior arrangement or appointment. The charge(s) for project rev_i:ew and mileage will be due at time of service or may be billed if approved by the Agricultural Department. Tete -totals are as follows: l•S Hr's labor @ $65.00/hr $ Q-I.SD V Mileage @ .30/mi $___2 - 20 Total Charges $ / 0q •?D I agree to pay the Butte County Department of Agriculture for Planning/Building services provided in accordance with the Butte County ordinance No. 3880. Y -Signature: &aL�_) Date: q 2� ' ��I- Ar lid Ar I If*mat 4 2' , .1 Tv low Jo I If*mat 4 2' , .1 Tv NOTES' t a` e` �� "* • PERMIT NO. _ Oas- RESIDENTIAL A4�R ��11 r 04-3319 t SHARRON + il.US AVEN, PALERMO Cant: SKYC RES`f' EN`f Gn.l;AGE G5/-33/8 /y/1// fiVo IP6;'w. SPECIAL CONDITIONS ' SRA FLOOD CERTIFICATE REQ. F FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS ,'. VERIFY L USE PERMIT CONDITIONS +' SUB -STANDARD HOUSING LETTER {{t t r . y { r JOB FINAL"ED + Signature ti CHECKED BY J=OK 0 = Not OK . = No ReadyApplicable DECK2COVERS, CARPORTS(GARAGES (nns) 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 j 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete r 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect gro'Sigling; 8. Utility Clearance 1 oof; Shthg-Roofing 11. Exi.; Steps -Doors -Landings Date raced Wall Panels Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date 1. Zoning Requirements -Setbacks -Easements Date 2. Footings; Size -Spacing -Marriage Line 1. 3. Gas; MH Test -Demand -Valve -Connector 2. 4. Electricity; MH Test -Crossovers -Breakers -Clearances 3. 5. Drain; MH Test -Fall -Flex Connector 4. 6. Water; MH Test -Regulator -Connector 5. 7. Water and Sewer Connected -C/O to Grade -HD Approval 6. 8. Gas and Electricity Tagged 7. 9. Tie Downs -Type -Installation Cert. 8. 10. Exits; Insp.-Sketch 9. 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Enclosure; Fencing -Alarms Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Date 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECK2COVERS, CARPORTS(GARAGES (nns) OK except #'s Zo ' Requirements -Setbacks asements ttooTootings; 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 j 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors r __Z -A Joatrie Q;e,Frmg.; Sills-Anchors-Studs-Rftrs-Trusses gro'Sigling; Nailing -Veneer -Stucco -Mesh 1 oof; Shthg-Roofing 11. Exi.; Steps -Doors -Landings 1 raced Wall Panels Date - Card B-1 o Date Card B-1 - Date j Card B-1 e Card B-1 Date POOLS (PI s) 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 r = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped _ 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued) Card B-1 Date Card B-1 Date Hangers -Post Caps -Anchors -Connectors 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 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Date 57. Card B-1 Date Card B-1 Date 58. Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Glazing Area -Glass Protection -Skylights -Plastic 24. Fixture & Transformer Clearance -Ins. Protection Shear Walls; Nailing -Bolts 25. Elec. Receptacles Spacing -Lights & Switches at Doors Brace Interior/Exterior Wall Panels 26. Size Boxes & No. of Conductors Stapled Insulation -Walls -Ceilings 27. Romex Installed Close to Edge of Studs & C.J. Infiltration -Walls -Windows 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Card B-1 Date Card B-1 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI Card B-1 Date Card B-1 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes 0 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 69. Elec. Trim & Subpanel, Breaker Sizes & Labels Date 70. Card B-1 Date Card B-1 Date 71. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Elec. Outlets at Wood Panel, Int. & Ext. 36. A.C. Ducts Insulation & Support Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 37. Vent Fan, Exhaust above insulation Elec. Outlets & Receptacles at Kit. Counter 38. Condensate Drain & Overflow, Size & Grade Garage Fire Door; Swing -Landing -Closure 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet A.C. Duct in Garage -Damper 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 80. 41. Sills Proper Materials & Anchors 81. 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 82. 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 83. 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 84. 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr.'Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (FF.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes _ 83. Following Instld./Drive 0 Yes 0 NoMalks 0 Yes 0 No/Planters 0 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 FAM (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP043319 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: 12/10/2004 APN• 027-240-071-000 the Business and Professions Code, and my license is in full force and effect. License Class :C—L4-1 License Number: S k 29 30 Site Address: 7 3 7 e l m V � Date: 101>0'—'2-6+Contractor. coed vT L toL-r f Map Index: Description: det gar (624) 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: SHARRYN COHEN permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 4244 MARKLEY RD signed statement that he or she is licensed pursuant to the provisions of YUBA CITY, 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 95993 she is exempt therefrom and the basis for the alleged exemption. Any 530-749-6296 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).): ❑ 1, 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: SKYCREST ENTERPRISES Code: The Contractors' State License Law does not apply to an COUSIN GARY'S HOMES owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 13468 HWY 99 provided that such improvements are not intended or offered for CHICO, CA 95973 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 530-342-2694 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: SKYCREST ENTERPRISES not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed COUSIN GARY'S HOMES pursuant to the Contractors' State License Law.). 13468 HWY 99 ❑ 1 am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95973 530-342-2694 Date: Owner: License #: 812930 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: issued. Engineer: WI 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: Cartier: Z C'" N 1 • -h( Total Square Ft: 624 S. F. Valuation: $40,560.00 Census Code: Policy#: 2p U le DO C}Go t ❑ 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 California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall /y forthwith comply with those provisions. 7 Date: �s�� �FL Z d 0!J 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 h y iss ed underlhe a icable provisions of the Butte County Coda 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.) Resolutions do work in ' ove r whi fees have been paid. / Z �r� Q V Name: By: Date: PERMIT EXPIRES ON: /O 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 represenn-ta�tives of ButteCountyto enter upon the above mentioned property for inspection purposes. Print Name: �C- `�—� �f ^7 — Signature: 7Z!- A' I� 0 Date: I . b 0 Owner contractor ❑ Agent for Owner ❑ Agent for Contractor I. 1 A4 , -1,-,,;"BUTTP -COUNTY ` DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION v4! AND SUBMITTAL REQUIREMENTS ' 24 HOUR INSPECTION#: OROVILLE: (530),538-7636 • CHICO: (530),891 -2834. - OFFICE #: (530) 538-7541 t ' A FEE WILL BE REQUIRED AT TIME OFAPPLICATION' NO APPLICANT NAME OWNER Name �i� �Q/i►_ii7iiii.��� 5 wlr� l f4 Ii �/�/Iii' City Fax State Zip Phone Book Fax E-mail Planner State License Number .G'rI • _ i Fax jF17L 61 VA Sm NO APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner State License Number NO APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE F 'office use only: , i , , Zoning Flood Zone SRA Yes. No Oce. Type Const. Subdivision Name Map Book Page Lot'# Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS KAFORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc Page 1 of 2 BIN # LOCATION AP# 9 7 -e2- 07/ Property Address rugs �� Cross Street WORKER'SCOMPENSATION Policy Number .1 Carrier Ozell Q I , If hiring anyone other than license contractors, a certificate of worker's compensation must 6e shown at the time of permit Issuance. LENDING AGENCY . Name Address Description or-acope of Work: XLz�✓ Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a pemmit has not leen issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been- done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Receive by: Amount: ✓T,Bldg .� SRA Receipt #: I y Sheriff SMIP I Date: �l *,� ,t �.�/ Other l U I 553 ! i Total REV 4-30-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! ❑ 3. 3 Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. 2 Engineered truss details and layouts (ifrequired) (NO FAXES!). ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not requiredfor additions to mobile or modular homes.) L ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 8. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 9. Sanitation and site plan approval from the Environmental Health Department. ❑ 10. Metal Buildings: (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. Mobile, Manufactured, or Modular Homes: ❑ L 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval fiom the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, .wet -stamped and signed (if required). Commercial, New, Additions -and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C).Elevations in triplicate, (D) Floor plans in triplicate, Afl of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 4-30-04 COUNTY OF BUTTE-DEPARTMENT,,OFDEiVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140( n PERMIT APPLICATION DATA SHEET C --7 J OWNER: �/U ASSESSOR PARCEL NUMBER 09 ( • 24,0 y Proposed Building Usey Counter Technician: Date: (� Items required in order to apply for a p� i it. All boxes MUST be checked OR marked NA in order t pply. 1. Site plans, 3 or 4 sets, slgnedb the preparer of the plans. . 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 1 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 0 14. Hazardous Material Form ��r, 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ; 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers.....................................`............................................I.......... 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........................................................................ ........ 434- 21. Fees as shown on the attached Schedule of Fees Due Sheet ....................... /..... ❑ 22. City of Chico Plumbing permit .................................................. . ............ 23. California Department of Forestry plan approval ❑ paid. Sent : ............ g/ 24. Planning approval (A) Use: OIL (B)Parking: (C) Parcel eck: la- •1- ❑ 25. Contact Land Development about _ Improvements, _ Drainage: ........................ 26. NPDES Form............................................................................................. 27. Encroachment Permit for driveway from the Public Works Dept.,?. ...... l� Ufa O4i G�GL ❑ 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 J`i' and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: 2 d� e l <�--�--f ` Date: I P, r,10✓ 2-uoq 1. Index permit application for the above items numbered: Plan Check Letter 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, by Date: Plans reviewed by: Date: Plans approved by: e> I Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division vTr o G 0 `sy_ 1:- o 0 of Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX DETACHED ACCESSORY BUILDING OWNER'S STATEMENT OF USE Plan review will not be started until this form is completed, signed by the property owner, and returned to the Butte County Building Division. Attached Accessory Buildings and Additions will be checked for residential use. Exception: Garages and Carports. Owner: Phone: !Mailing A dress Site address: Assessor's Parcel Number: ®„77'a5,0 —,6�71 Zone: Please answer questions 1-16, and explain any yes answers for questions 2-14 in the space provided on page 2 of this form. GENERAL INFORMATION: I. Is there a primary dwelling on the property? Yes ❑ No '. Is the structure already built, under construction, or under notice of code violation? Yes ❑ No 3. Will items produced in this building be offered for sale? Yes ❑ No 4. Will the public have access to this building? , Yes ❑ No 5. Will any advertising, on or off site, be associated with the use of this building? SITE CONDITIONS: Yes ❑ No 6. Is the structure foundation within 5' of septic tank or 10' of leach tines? Yes ❑ No 7. Is ani- portion of the structure located closer than 20' to your front property line? . Yes [3 No 8. 9. Do you plan to add a driveway or modify existing access to a county maintained road? Will the proposed structure encroach Yes ❑ No EJ within any recorded easement? CONSTRUCTION FEATURES: Yes ❑ No El 10. Will this building have insulated floor, walls, or ceiling? Yes ❑ No 11. Will this building be heated or cooled? Yes ❑ No 12. Will this building have a water closet/toilet? Yes ❑ No 13. Will this building have a sink? Yes ❑ No 14. Will this building have a water heater? Yes ❑ No 15. What npe of floor covering will the building have? t6. What t) -pe of wall covering will the building have? OVER 1 of 2 PROPOSED USE: (check only one box) ❑ Residential Storage Shed — I will be storing in this building and it will of a used for any other purpose (no bathroom and no heating or cooling). 2. rivate Garage _.'A building or. a portion of a building not more that 1,000 square feet (3,000 by xception) in area in which only motor vehicles used by tenants of the building or buildings on the premises are stored or kept" A earetae door is required 3. ❑ Residential Carport — A covered structure intended for parking of vehicles. Two or more sides must be entirely open. 4. ❑ Residential Occupancy — Structures meant to be occupied, as opposed to a storage shed, garage, or carport. 1f you checked #4, please check the uses below which best fit this building. ❑ GuestHouse ❑ Pool House ❑ Studio Apartment ❑ In-lawuarters E] Recreation Room El Game Room q ❑ Bonus Room ❑Study Library ❑ Playroom ❑ Den ❑ Studio ❑ Artist Studio ❑ Hobby Room ❑ Craft Room ❑ Canning Kitchen ❑ Music Room ❑ Sewing Room I ❑Family Room' � ❑Sun Room ❑ Private Office ❑ Workshop ❑ Home Occupancy p cy - El Other —Use = Dcstrib< tvpc or Worbhop Aust be approved by the Buue County planning Division. Explanations: This area is for explanation of any "yes" answers on questions 2-14. Please indicate the question number before the explanation. Additional Information: Plan review will not be started until this form is completed and received. A Plans Examiner will contact the o-,vner with specific requirements per the use indicated. I hearby affirm under penalty of perjury that the above information is true and correct. I understand that any changes to the use, or character of use, of this building will require permits from the permitting authority. I understand that Real Estate Disclosure laws re disclosure of this information if or when the property is offered for sale. Owner's Name: Please Print Owner's Signature: Date: 2 of 2 �Z_ j , t: C®F FIRE SAFE REQUIREMENTS AP# 027-240-071 PERMIT # 04-3318-3319 NAME: COHEN, Sharren Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and made a part of this permit. These requirements are minimums and may be superseded by Butte County local regulations that exceed these standards. Field inspections for compliance will be made by the Butte County Building Department. [X] 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail -ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provided for by the land owner. Driveway Standards [X] 1273.02 Surface. All driveway surfaces and structures 1273.07 (bridges, culverts and other appurtenant structures which supplement the roadway bed or shoulders) shall provided unobstructed access to conventional drive vehicles, including sedans and fire apparatus weighing up to 40,000 pounds. [X] 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius [X] 1. No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional surface width of 4 feet shall be added to curves of 50-100 feet radius; 2 feet to those from 100-200 feet. [X] 2. the length of vertical curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. [X] 1273.05 Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. [X] 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. [X] 1270.10 Width. All driveways shall provide a minimum 10 foot traffic lane and unobstructed vertical clearance of 15 feet along its entire length. [X] 1273.10 Turnouts. Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. 1273.11 Gates [X] 1. Gate entrances shall be at least two feet wider than the roadway it serves. 2. The gates must be located at least 30 feet from the roadway and shall open to allow a vehicle to stop without obstructing traffic on the roadway. 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. :R.. CDF FIRE SAFE REQUIREMENTS AP# 027-240-071 ' PERMIT # 04-3318-3319 NAME: COHEN, Sharren Fuel Modification 1276.01 Setback for Structure Defensible Space V ] 1. All parcels 1 acre and larger shall provide a minimum 30 foot setback for buildings and accessory buildings from all property lines and/or the center of the road. [ ] 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See other requirements below. [X] 1276.02 Disposal of Vegetation and Fuels. Disposal, including chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification shall be completed prior to completion of road construction or final inspection of a building permit. Other Requirements [ ] If Building Setback is 15 to 30 Feet: Class A or B roof Enclosed Eaves [ ] If Building Setback is Less Than 15 Feet Choose any 3 of the following: - Metal or no doors on side toward property line with insufficient setback - Class A or B roof with enclosed eaves - Interior automatic sprinkler system per NFPA 13D - Glass area not to exceed 10% of wall area toward property line with insufficient setback - Siding from the following list: Stucco — 3 coat Hardi-Board or Plank Masonry. Masonry Veneer Metal Other Butte county Fire Department approved materials [l 11/23/04 Steven J. Fowler Date Signature e BUILDING DIVISION COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (530) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT NO. ,P®� t�0o 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. ASSESSOR PARCEL NO.2-7 — 2 t j �ry — 0 7 / `7 ZONING A -5 - OWNER PHONE NO: OWNER'S ADDRESS G 3 S �v er (D e x LOCATION OF BUILDING _ S ko i F�A-� f�-'I'�� il L-1 USE OF BUILDING SIZE OF STRUCTURE I� .X 6 ( .- I lS°1 SO. FT. TYPE OF CONSTRUCTION: WOOD FRAME STEEL _ CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COVERING L'J FLOOR TYPE 0yL C 2&_167- ESTIMATED COST OF CONSTRUCTION $ '-- /-/, ®- (3. ..0 AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: FRONT SIDES REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated ab AG Building definition. If any change in use or occupancy of the building is obtain any necessary permits, inspections, and approvals to comply with th occupancy. Date 03-6?--os� Permit Fee -$109.98 Receipt No. S� Signature of Owner tnd the purpose,0 use confirms with the I will contacythe Building Division and uirements in Oect at that time and before White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod —Applicant Date q -13 -s - -AAA SITE PLAN Yf` 4 i .... ...... ................... ............. :.....:............................ ,...... ......: ....... ... ..... .... .. • • .............. ..............._ . .. ... .. ... .. .. .... ...:......:.....::._......... ................... ........... •• . .... ................. .... ...... ;......._ .. .. ... ._ .. ... ............. .. .. a� x............................ ............ 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Assessoes Parcel -Number O[] 21 Q — 9 Owner Name e Ill Address / Phone No r e Site Location n#%n+fti#• Phone Scale: 1" _ Odabw 23,2= FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acnes 4.00' PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: SITE'PLAN .. .. .. �.; .. .. .. .. .. .. .. .. .. .. .. .. . •• ..ntOHeafti .. .. :.....................:. .. .. .. .. .. .. .. .. ............ .. .. .. .. . .. ... ......_................ ....._....._................. — :.. ., .......... ... ._ .. .. .. .. .. 0. E..C� C. . _,, ..... ..... ......... ............................ : ......... . .. _--• • .. .. _... a� .X .Y. . . . . . . . . . .. e- . . . . .. . . . . . . . N �, .... :v ..:...::...:.. E ...iA ....:: _............. ..:..: .:::::::: ...:........:. ..........: ... _.:.:.. .... .. ... :.. ............. ..i .._... _... • • • ....... .................. .......... .. . . . .. : : : : : ........................ ... i•-•-............... .. �... .. . .. .. ............ . — —...................._ .. _ _ ... • • .. .. .. .. :.� ..... 7 ........... :....:........ ...... ............. ;... :.. :....> is i................ .. .. .. .. .. .. .. ... .. .. .. :.....:......:......:....... ;.....:....... .. .... .. -- .. ..................... ..................... .................... .... .. .. .......................... j. .. _.. .. .. .. .. .. .. .. ... .. .1......i ................ ... .. ... .. .. ... .. .. .. ........... .. ................_ ... .. .. .. .. .. .. ... .. .. ...................... :i h :• i •� {.. .. ... .. .. .. .......... .. ................ .. .. .. .. .. .. .. .. .. ............. .. .. ..i.. .:......:.. r.. .......... ................ .1 .. ............. .. <...... .....:...<...... ... . . .. .. Pt�Nt�NG - F1GPC7aailPPiOVAC a� .. .. .. .. tiex- - ...........�.... .. - . .. .. .. .. .. ... .. • -• _ ... /� �J�}�j� •� ��//n .. .. .. .. ............. ........................... .. .. ... .. .. ...... ............. . .. ......................._... Assessor's Parcel -Number: Owner Name ' e Address/ Phone blo. Site Location f :nntarl- Name ©— © © El Scale: 1 = Phone .- SW- odabw A =3 FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres 4.00" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: t, � 2 Environmental Healtl #12 Cousin Gary Circle OCT 2 6 2004 "The Yuba Classic" 7GouniyCenter®r►ve 3 Bedroom 2 Bath, 1976 Sq. Ft. Plan P227CTB`- APPROVED Butte County BEDROOM - - Environme tale ith FA ILY ROOM BEDROOM No. 3 No. 4 10 8" <~ i i 10, ignature { OPTION 4TH BEDROOM Features in this Model include: ; * Picture Window &Dormer Glamour lamour Master Bath with Corner Tub, Stall Shower and Skylight * Master Bedroom Walk -In Closet * Oak Kitchen Cabinets with Drawer Over Door Construction * Sheetrock . Walls with Rounded Corners 4th Bedroom Option Available * Exclusive Safease Package * Residential Heat *Deluxe GE Kitchen Appliance Package * 6" Exterior Walls *Sliding Glass Door *Skylight in .Kitchen . *Recessed Entry 3 D - SITE PLAN .................3....................;............: _... • - ..................... ..................4... ................... .. .... .. .. .. .. .. .. .............. .. .. • - .. .. .......................... .. .........••.•-•............. .. ....:....:91 o tv 6, dal 1. ............... .. .. .. .. .. .. .................. i t..- ........ ... �TID _ .. .. .....:...... ...... ..................;.: :.. ....:.. :•--................ ..;..- :. ..:.. . ., .... .. .. ..:<. d :U - 1 _ . ..........-••................ .......:... .. • •. • .. .. .. .. .. . ... ._ .. .. .. _.. -.. .. ................... _...... .. .. .. .............. .. .. .. .. .. .. .. ... ._ .. ... ._ .. .. ...... .. .. _ .. _ . _ ...... ............................ .. .. .. .. - - .. ............. ......................... .. .. .. .. .. ............. .. -- APP • .. .. .. .. .. .. .. .. ............ .. .. .. .. .. . -sut� CF+� En iron •.. .. .. .. .. .. .. .. .. .. .. .. .. - . . ..:....:.. ............... .�` l.�.e . u 9 , •F ..:.. ..:.. .lJ 1... n . .. .. .. ........................ .- -• . .. • .. .. •• .. .. .. .. r �. `7 /'_ ....................:.....:......=... .. .. ;.. ..i.. .. ... .............. .. .. .. .. .. .. ............. ._ .. .. .. .. .. .. .. .. ............................i. .. _.... ............... ...._... ... -- .. _ .........�..... .. .. .. .. .. ... • • - . .. .. .. .. .. .. ... .. ............. .. .. ... ................................ : : : : . . . . . Assessors Parcel Number: OO 2 121 —Ufl S OwnerName ' e — Address / Phone No. AI z_VAY'X2f Site Location -f`-nntn&- Name ©— ©© El Scale: v Phone *-� 5W - 0a wam FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres i- 4.00" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: — GEN PLAN: _-- USES: ll f SITE PLAN Y ....... • -- . •. .......... .. ... •• _.. .• • •• .......................... .. :.....:...... .... ...... ........... ........................................... .......... . ..... •• . ..... .- .. .... :................... .. s.. .. ................. .. ............. ............ :......:.....;... <•.... . ..........•................... :..... :...........:....... -. .. .. .. t .. _ . .. ... . :...................... ..:...:....:....:. . � � . . . . . . . . . : a.. :v t :....:......: ..................... .. .. .. .. .. `. . -. .. -- •- ... -- •- .. .. ... .. .. .. .. .. .. .. _ . . .................................. .. .. .. .. - ........ ................... ....................... .. ... �. ...................... .. • • • • . ..... .. .. ;j.. .. .. ...........................-• . .. .. .. .. ... .. . . . . . . . . . . . . . . . . . . .: . . . ....: r... .. .. .. ... .. .. .. .. ........... �.:. .. .. .. .. .. .. .. .. .. .. .. .. .. _ ......... .. _... .. .. .. . . . . .. .. .. .. .. .. .. ....__. . ......:......;.....,......,......;............................... ............. ........... r .. ... .. .. ... .. .. .. .. .. .. .. .:.. ..:.. ..:. .. 1 ....... ............................ . l .:. .. .. •• .. -. .. .. ... .. ... .. .. . .. .. ... .......... .. .. 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Assessor's Parcel Number: UO 0 Q — 4 Owner Name ; / e _ Address / Phone blo. I' Site Location f :nntart Name ///0 © — © ©F/9 Scale: 1" = Phone 35`0'1 - -s 10 oaaobe Z3, 2003 FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres a.0(r I PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: ys K�. #12 Cousin Gary Circle "The Yuba Classic" Bedroom Bath, oft ® .. �. �JLJEms on Mon a ■�I\�LI��1 Wine S _±_+������■ fiN■■■■■■■■.■■■ ■ ■■■ ■■��■■r1 .. DINING ROOM ri=■■■■■�f■■ ■■■N �Illl�i0 NOON ■■■■■■■■■■■■■■D1.■ ---_- fBEDROOM ■■O1. (fill11 NOON ■■ ■, ININ ■■i■ ■■■n■■■■■■■■■■■■■■ ■■■■■■■■fH■NH■■■■■ NOON lg�l■■■■■■■�" ll�i i■■■■ :r ■1.....�� ■■ . ...-�..�. . ■ 1 r ■■■ ■mill N PIPO will dr 7 - BEDROOMNO MASTER skrow •.. BEDROOM FOYERO121 FAMILY OM LIVING .. Plan 1`227CTR cov FA FALY ROOM 14'-8" 190%q0,V,F0- OPTION 4TH BEDROOM Features in this Model include- * Picture Window & Dormer * Glamour Master Bath with Corner Tub, Stall Shower and Skylight * Master Bedroom Walk -In Closet * Oak .Kitchen Cabinets with Drawer Over Door Construction * Sheetrock Walls with .Rounded Corners 41h Bedroom Option Available Exclusive Safease Package * Residential Meat *Deluxe GE Kitchen Appliance Package 6" Exterior Walls * Sliding Glass Door * Skylight in Kitchen *',Recessed Entry