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HomeMy WebLinkAbout027-340-012OWNER'S NAME: FEES: (Amount and Purpose): BALANCE OF FEES: $ ADDITIONAL FEES: $ REVISED PLAN CHECK: $ SHERIFF FEE: $ SRA $ COPIES $ URBAN AREA FEES $ CSA 87 (North Chico Spec) $ WATER TENDER FEE $ BATTALION # THERM DRAINAGE FEE $ OTHER $_ i 0 Q . q OTHER $ VALUATION - IF BALANCE OF FEES OR ADDITIONAL FEES: TOTAL VALUATION: $ ADDITIONAL VAL: $ (Check one). COUNTY CITY OF BIGGS (Check one)' RESIDEN-TIAL COMMERCLAL kP 'N �905C05 �a ll (!o oy County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Linda Garrett ADDRESS: 820 No. Lincoln Way, Space #3 CITY & STATE: Galt, CA 95632 neT= nc rl AInA- 11 Ifl7/r1A SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN: 027-340-012 Permit No.: 04-2320— PAID RETAINED REFUND Develo ment Services $ 684.88 $ 299.95 $ 384.93 THERM DRNG $ - $ - $ - SMIP $ 7.72 $ $ SHR $ 335.00 $ $ SRA $ 43.00 $ 43.00 TOTAL $ 1,027.60 $ 299.95 $ 384.93 c ::::: :::Bt l IiOVVN ::.:**:::::::::A3'U G: T:::: CCOC. NT::;AMO.UN:T:: 101001 DVLPMNT SVC 440-001 4210500 $ 384.93 1011822 THERM DRNG 1800 280 $ - 1011430 SMIT 1001 280 $ 7.72 1011811 SHR 1800 280 $ 101001 SRA 100 46172401 $ TOTAL 1 $ 392.65 $ 392.65 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, ana that tins claim is true and correct as sta d. / 4 Dated this _ _ day of ltlQ k/ 2004, at Calif.—G I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check onebfort ame. Y Dated this day of r 2004, at Oroville Calif. bV� Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND UU NUI WKl l t t$tLUV11 I Hlb LINt - AUUI I UK -J UJC UNLT DEPT & SUB PROJ I SUB. OBJ I CLAIM NO. I INV N0. I INV. DATE I ENCUMB. GROSS AMT. 1.12/2004 Butte County Department of Development Services www.buttecountv.net/dds 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING Linda Garrett 820 N. Lincoln Way, SP#3 Galt, CA 95632 RE: Permit No. 04-2320 APN#027-340-012 Owner: same On 8/5,2004, a deposit was made in the amount of $1,070.60, of which $677.95 was retained. The remaining fees will be reimbursed to you. Please sign, date, and return the enclosed claim form to this office. Once we receive the claim form, we will then process your refund in the amount of $392.65. Should you have any questions, please contact this office Monday through Friday, 8:00 a.m. to 4:00 p.m., at 538-6869. Sincerely, Diane Lewellen , OA III Administrative Division enclosure 04-2320.1tr County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Linda Garrett ADDRESS: 820 No. Lincoln Way, Space #3 CITY & STATE: Galt, CA 95632 nATF OF CI AIM- 11logInd SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN: 027-340-012 Permit No.: 04-2320 PAID RETAINED REFUND Develo ment Services ' $ 684.88 $ 299.95 $ 384.93 THERM DRNG $ - $ - $• - SMIP $ 7.72 $ $ SHR $ 335.00 $ $ SRA $ 43.00 $ 43.00 TOTAL $ 1,027.60 $ 299.95 $ 384.93 ::::r3RE l DOVv1V :::::::::::::::::$ULi:G:t m:.:ACCOCJ1vi': : 41�I iit�V:i': 101001 DVLPMNT SVC 440-001 4210500 $ 384.93 ..�..... >' 1011822 THERM DRNG 1800 280 $ - 1011430 SMI.P 1001 280 $ 7.72 1011811 SHR 1800 280 $ - 101001 SRAI 100 4617240 $ TOTAL $ 392.65 $ 392.65 1, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as staled. Dated this day of , 2004, at Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this day of 2004, at Oroville Calif. Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY EPT & SUB PROJ SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. REFUND CALCULATION SHEET CLAIMANT: Linda Garrett • ADDRESS: ' 820 No. Lincoln Way, Space #3 CITY & STATE: Gaft, CA 95632 DATE OF CLAIM: 10/06/04 APN: 027-340-012 ' RECEIPT INFORMATION NUMBER: 412012 ' DATE: 08/05/2004 ISSUED TO: Linda Garrett • CHECK #: 1051 ' AMOUNT: $1070.60 PERMIT #: 04-2320 Yes No Yes No Yes No • PRIOR REFUNDS: X r _ FEES VERIFIED X REFUND BREAKDOWN ' Title BLDG THRM DRNG AUD SUSP SHER DEV FEE SRA Fund 0010 1800 001 1800 100 . EIE ' Dept 44D-001 • FHRM DRN (SMTP) • '.(SHR), _ h (SRA): ADDnt 4210500 280 - • 280 '„. 2807, 4617240' ' Cash 101001, „1011822_ : 1011430 (`1011611 = 101001 DETAIL PaD RETAIN 'REFUND - . -,•--$LDG4.' .Time 109.98 r x 4`549.90 Filing from Plan Check _- 0.00 0.00 0.0O .... PlanCheck/Filin _ 0.25 -27.50 219.96 219.96 0.00 0.00' ........ ........ .......•.•.•.•..•...•.•.•.•.•.• _ Ins ection -f'. w'�.-_ -- ...0.00 329.94 329.94 :- 329.94ii:}}}}: }}:i?:}} :::•:•:•:!•: •'"'•"•'•'•'•'•' - ' BLDG FEES A 14 ' i.... , .' • :, s.,.- v ;1 ,- -- - -OTHER OTHER BLDG "".xr. ,.. - •r - -: ,. n+. - r... .. - „ �,.. - ~0.00 SHR 25.00 25.00 0.00 SRA 109.98 109.98 109.98 < }}: ilii} :....... ! y ' (REFUND PROCESS FEE' 54.99 54.99 -54.99 -54.99 :':':':':':'::':':':':':':':' :' " BUILDING;TOTAL W '�._°a i+ , 684.88 ` .299.95 +' _~ 384.93 .384.93. ........ THERM DRNG,,%m .,. _, r ;r `^0.00 ..0.00: SMIP's:r,^"�ia,..L,,- �_.K.ir ,,,. __7.72. - _t, . 7.72. _ - 7.72: - _ - .• . '.:V.. KY-1-we:n335.00 :.. - 335.00 . __:t 0.00 °' �.^... _-3:rt^�- ".+....'""t:: u 0.00- SRA s •n k_. .._:'*sri� Z. 43.00 `x'-.; '. -".?' ..f ?%''0.00. .._YL _ K r 4300 ♦ .:c-;:- v w.tt%'3+`S"• ?' �• F x`0.00 - _ , - - $ 1,070.60 $ 677.95 $ 392.65 $ 384.93 $ e -4-1 i:%7.721 $ w b APPROVAL CHECK: $392.65 Date Reviewed 0/ 0 DIFFERENCE: $0.00 - Michael Vieira (Should be blank) Building Manager '' ` .., Fr, '� ,r ff Developm nt Services! November 02 2004 a Tuesday . T s Biu., ,ts„.r••Y 4I}{ +y` r tia ;r�'' '' OUILDINV!DI.VISION UCI 1.0 Counter Kim Person Fund 10 (Bldg Permits) $714.87 SRA Fees (Fire) $43.00 Payment Date 8/5/2004 ' SHR Fees (Sheriff) $305.01 J Permit Number BP042320 I SMIP $7.72 Receipt Number 412012 I Copies/ Document Sales $0.00 Check Number or Cash CUA (Chico Urban Area) $0.00 Parcel Number 027-340-012 I TUA (Therm. Urban Area) $0.00 Applicant GARY GARRETT ( Water Tender Btln #= $0.00 West Chico Fire Station $0.00 Received From SAME Witness Fees $0.00 Total Received ° $1.,070.60: r I Recorders Fees (N.O.C) $0.00 rt , Thermalito Drainage $0.00 Total Fees To Collect 070.60 �) Oroville Area Traffic � $0.00 Notes:. NSF (Non Sufficient Funds) $0.00 } _ Notice of Violation $0.00 NCSP Trails System $0.00 NCSP Roads/ Bridges $0.00 NCSP Storm Drainage $0.00 NCSP Fire Station $0.00 NCSP Parks Type I� $0.00 Value $0.00 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET BUILDING DIVISION DEPOSIT # 265 BAG # 328 PERMIT# RECEIPT# ACCOUNT# F-10 ACCOUNT# (SRA) 0100 ACCOUNT# (SHR) 1800 AVA COURT ACCOUNT# F-10 (CUA) 1800 ACCOUNT# (SMTP) 1001 ACCOUNT# (COPIES) 0010 040856 412011 $ 54.99 8. 322.0 ..... . ......... . . . ......... ..... W .................... $ 305.01 041657 412013 $ 900.50 $ 12.00 042321 412014 $ 2,948.90 $ 43.00 $ 305.01 $ 13.08 412015 $ - $ 1.22 042322 412016 $ 549.90 $ 18.20 1412017 1 $ - $ 1.22 BP042321412018 $ 137.50 BP041780412019 $ 54.05 BP041070 412020 $ 1,115.65 BP042324 412020 $ 55.00 042325 412021 $ 1,113.55 $ 43.00 BP041478 412022 $ 274.95 AVA 412024 $ - $ 125.00 042326 412025 $ 110.00 $ 8,029.86 1 $ 129.00 1$ 622.02 1$ 125.00 1 $ 1$ 39.00 $ 2.44 GRAND TOTAL TO BE DEPOSITED MONEY COLLECTED: COMPILED BY: audftor:yellow DIANE LEWELLEN extn 6869 DATE o�UTrFo Butte County Department of Development Services C Building Division OO - "0 7 County Center Drive cOUOroville, CA 95965 (530) 538-7541 REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on the receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees Daid to other Countv Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the Check those fees which you wish to have considered for refund: " [Building Permit Fees E41theriff Fees =SRA Fees (CDF Fire Planning) Other (specify): Plans for cancelled permits will be disposed of within 10 working days upon submission of a Reauest for Refund. If you want the plans, you may pick them up prior to that time. _ x/13 j6 gn ture Date K:/Forms/Refund Application 082203 r i r y 1 • i 1- � � t � t 1 ! �. {. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541. A FEE WILL BE REQ UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Last Name6, irst Narr�e /r Address City State Zip , � 2 Ph aie�y Fax �� E-maiCX r ol 1,'7e_ �/et7A APPLICANT NAME CONTRACTOR Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT NAME Name /I/' Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE 1-21" wr.2111- For office use only: Zoning I A—cam I Flood Zone )C SRA es No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BPcx4-35j,0 BIN # LOCATION AP# 4 -- 0/2 - Property Address City Cross Street95 9 Sheriff WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: 9W M H r.( Eve/ 5 1 TV C It 80 Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be OVER FOR SUBMITTAL REQUIREMENTS U K:\FORMSMILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: "'1 Receipt #: 4_1Z01 -% Date: j3 -6 -e:,4 - OVER •5.04 Amount: 549.90 Bldg 152.413 SRA B&O.— Sheriff 7' 71 SMTP Other (070. �00 Total REV 6-16-04 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 GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! OR 3 Sets Engineered plans (if required) wilth wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 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. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. 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-signned by the engineer. Mobile, Manufactured, or Modular Homes: 9r'_ 1. 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._ 13' 5. 2 Engineered Tie Downs or Foundation plans. 4;�' 6. Sanitation and site plan approval from 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 GRAPHPAPER! ❑ 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, All 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. 1 OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 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: �A pe R E7T- ASSESSOR PARCEL NUMBER e> a7. 34-e' ® r �- Proposed Building Use: h4 E W Nt N Counter Technician: l�� Date: Items required in ord� to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 4 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 2. Complete p ans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered 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. 16 8. Manufactured homes: �M'Data sheets and installation inst, Marriage line info, (t) Floor PlanTie down or fnd plaall 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 ❑ X12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner 14. Hazardous Material Form 14 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico � t3'Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) If❑, 17. Fire Sprinklers............................................................................................. / 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ t� 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 dpaid. Sent by: +Z I. ............. • s��o-l- �ik� 24. Planning approval (A) Use: 4-L (B) (C) Parcel Check: _. q I ❑� 25. Contact Land Development about _ Improvements, _ Drainage ......................... �j 26. NPDES Form............................................................................................. �t5 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification ( /Given to owner, _Mailed to owner) ..................... 32. Letter of Signature authorization......................................:...................... ....... 33. Recorded copy of Agricultural Acknowledgment Statement ................................. �5 34. Manufactured home utility clearance....... . ...................... : ............................. ❑ -35. Existing violations and/or expired permits....................................................•.... ❑ 36. D e Restriction .. ........................................... ❑ 37. rant Deed, 4_ A, Title/Statement of Facts, geetter from Legal Owner, ❑ Check to H. . . 38. Other: MAnitiF,Ac7��ra��'� cerarrr-tc.��� of ®►2��.0 39. Other: When issued Telephone 745 • S9 t f Sos • 3 ►g and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: Date: 1. Index permit a plication for the above items numbered: Plan Check Le 2. Additional items re Contractor, desianeWwn6r.was advised of the above data by • phone, ❑ mail, ❑ counter, by Date:Contractor, designerwas advised of theove ata by ❑ phone, ❑ mail, ❑ coy n r by Date: Plans reviewed by: Date: 8 • • © Plans approved by: Date: 1K 61.0 Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division E.H. USE ONLY .. Piot Plan Attached Rear Plan Atte seem to B.D. It / TO: Building Department FROM:' Environmental Health SUBJECT: Sanitation Clearance Owner ' > Location AP# Plan Approved for: Sewage Disposal Water Sup ly: P blic Private Well Clearance for dwelling. Other - v Hold final for: Final clearance O.K. for: NOTE: Environmental Health 8/96 alist Dat COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER PROPROSED BUILDING USE 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ A.P. #. &)a7 • 34--0- DATE 4�•DATE 5 04– RECEIPT 4RECEIPT # DATE REC. / --- Revised Plan Checking Fee.... $ ✓ 2. SCHOOL DISTRICT FEES O02 -c, (paid at School District Office) (form available after Plan Check) G r v E-4 d w -167119- 3. .tErg3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$-36,0 4-t.2 Units Commercial (sq. ftg.)..... X $0.03 = $ 4. URBAN AREA FEES Residential (per unit)..... . (paid at Building Division) X =$ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $899 (paid at Building Division) 15:2.990 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. $11012 0.5.c4- Commercial .5.84 Commercial (sq. ftg.) ......... X = $ Sq. Ftg. Amt. 10. OTHER P �' % 1 412012 5 04 At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. A' , APPLICANTr DATE Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the projector 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) NOTES RESIDENTIAL PERMIT NO. _ '027-340-012_ : 04-2320 GARRETT, LINDA & GARY`S`""'-T REGINALD WY, OROVILLE Cont: N/A NEW MH NEW SITE PERM FND THE HCD FORM 433A FOR THIS MH CANNOT BE RECORDED UNTIL ONE OF THE FOLLOWING HAS t BEEN TURNED IN TO,THE BUILDING DIVISION: (1) LICENSE PLATE(S) OR DECAL (THE INSPECTOR MUST RETREIVE). t (2) STATEMENT OF FACTS (ONLY ON NEW MH' S). , INSPECTOR TO VERIFY SERIAL & LABEL'#'S. SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS - SUB -STANDARD HOUSING LETTER r i f JOB FINALED (Date) Signature OK 0 = Not OK ' s = Not Ready NotApplicable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s " MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures -Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" 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 Date 16. Insulation 24. Fixture & Transformer Clearance -Ins. Protection Date Elec. Receptacles Spacing -Lights & Switches at Doors Card B-1 Date Card B-1 Date Size Boxes & No. of Conductors Stapled 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 Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or All Insulated Neutral O Yes O No 21. Test Tub & Shower, Second Floor -Tub Access Service -Riser Conductors & Ground Main Disconnect 22. Gas Pipe; Sixe & Anchors Equip. Clearances Panels-Motors-Mech. Equip. 23. Fire Sprinkler; Test Clothes Closet Light -Shower Light -Spa Light 35. Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 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 All 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 59. Glazing Area -Glass Protection -Skylights -Plastic Date 60. Card B-1 Date Card B-1 Date 61. Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Insulation -Walls -Ceilings 36. A.C. Ducts Insulation & Support Infiltration -Walls -Windows 37. Vent Fan, Exhaust above insulation Card B-1 Date Card B-1 38. Condensate Drain & Overflow, Size & Grade Card B-1 Date Card B-1 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date 65. Card B-1 Date Card B-1 Date 66. Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Bedroom Exiting 41. Sills Proper Materials & Anchors G.F.I. & Bath Fixtures & Tub Access -Spa 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Elec. Trim & Subpanel, Breaker Sizes & Labels 43. Bearing Walls over Girders & Floor Nailing Stairs & Rails 44. Draft Stop in Walls (rat proof) Fireplace or Stove, Clearance -Hearth 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs Elec. Outlets at Wood Panel, Int. & Ext. 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-CookingElearance 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.FI.)-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 0 No/Walks 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 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042809 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under / Z �/ provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Dat PN: 027-340-012-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: �,� Site Address: /G dlN/fiLl� &AIAy Date: Contractor. Map Index: Description: NSF(1008)COV(48) OWNER43UILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: GARRETT, GARY 8 LINDA permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to .file a PO BOX 921 signed statement that he or she is licensed pursuant to the provisions of PALERMO, CA the Contractor's State License Law (Chapter 9 commencing with Section 95968 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 209-745-8919 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).): W/1,1, 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• GARRETf, GARY 8r LINDA Code: The Contractors' State License Law does not apply to an PO BOX 921 owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, PALERMO, CA provided that such improvements are not intended or offered for 95968 sale. If however, the building or improvements are sold within one 209-745-8919 year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 0 e B siness and Professions Code Date: %� _O wn License #: WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Architect: Labor Code, for the performance of the work for which this permit is issued. Engineer: ❑ 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: Carver. Tota( Square Ft: 1056 S.F. Valuation: $66,288.00 Policy a: l" a I certify that in the performance of the work for which this permit is Census Code: issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, 77 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. ,QT/ ly.� -/7 Date: l! 4125`�i3�/ �ao� 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. �/ 2 t / ,C 7 CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County CodR ?nrUnr I hereby affirm that there is a construction lending agency for the Resolutio sMdowork in ' ated ve for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) By: Date: a Name: / PERMIT EXPIRES ON: l D� Address: ate ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection pu os t i Print Name: Date: Owner ❑ Contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY PERAUT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 BP 64;YI OFFICE #: (530) 538-7541 B A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" APPLICANT NAME CONTRACTOR OWNER Last Name Address Zip City t Name Address Po Z a 1,.- C "1 City Fax State p G� Phone QQ�b-7+S--S9140)FO.-L3817 Class E-mail APPLICANT NAME CONTRACTOR Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner Uc. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APRLICAIVT SIGNATURE X For office use only: Zoning Property Address Flood Zone Cross Street SRA I Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS LOCATION AP# Property Address city lomil� Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Des •ption or cope of W S o% Cav My Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. II Received by., Amount ;�)L F / • Bldg I I Receipt #: �I _ ,/tom„1.3o Sheriff " SMTP Jj Other Date:g v '4c ' ' 3 Total SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) . ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. , ❑ 6. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor• plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). El 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). — ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regard►ng this process,rc, ntact a Permit Application Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS merunas can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION �K:\FORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DTVI O 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ 1 Q� 20. Erosion Control Plan Required........................................................................ ........ �j 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 g,paid. Sent by: ............. in oil, 24. Planning approval (A) Use: 01!L: (B)Parking: (C) Parcel Check:tt 25. Contact Land Development about _ Improvements, _ Drainage ......................... ®- 26. NPDES Form `❑t 27. Encroachment Permit for driveway from the Public Works Dept ....................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... r 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......................................................................................... O 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued TelephoneGI L ��GG�� and hold for pickup. I have been informed oflheilb/6J,-e it-eernWri regdirdmnts for obtaining a building permit. Applicant: 117A Date: �� --a� �" 0T. ' 1. Index permit application for the t numbered: Plan Check Let r 2. Additional items re=ui I/Contractor, designerwas • ed of the above data by phone, ❑ mail, C3 counter by Date: 2 Y a_P,-) Contractor, designer, owner, was advi d of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: C Date Structural reviewed Date: I Structural approved by: 'Date: Note transfer by: Date: Yellow: Building Division L.//_)69A__6&1'T �• O�� OWNER: ASSESSOR PARCEL NUMBER Proposed Building Use: �.� i,-�. Counter Technician: C�"!�` Date: lo 4 Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. g/ 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. �j 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. t ❑ 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 t t 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 ❑ : s; 12. Letter of intent for non-residential buildings ❑ : ?, =:13.: Detached Accessory Building Form filled out by the owner ❑, -_ 14, Hazardous Material Form 15...5anitation and site plan approval from the Environmental Health Department in ❑ Chico l' Oroville, as applicable. 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ 1 Q� 20. Erosion Control Plan Required........................................................................ ........ �j 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 g,paid. Sent by: ............. in oil, 24. Planning approval (A) Use: 01!L: (B)Parking: (C) Parcel Check:tt 25. Contact Land Development about _ Improvements, _ Drainage ......................... ®- 26. NPDES Form `❑t 27. Encroachment Permit for driveway from the Public Works Dept ....................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... r 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......................................................................................... O 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued TelephoneGI L ��GG�� and hold for pickup. I have been informed oflheilb/6J,-e it-eernWri regdirdmnts for obtaining a building permit. Applicant: 117A Date: �� --a� �" 0T. ' 1. Index permit application for the t numbered: Plan Check Let r 2. Additional items re=ui I/Contractor, designerwas • ed of the above data by phone, ❑ mail, C3 counter by Date: 2 Y a_P,-) Contractor, designer, owner, was advi d of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: C Date Structural reviewed Date: I Structural approved by: 'Date: Note transfer by: Date: Yellow: Building Division E.H. USE ONLY Piot Pian Attachod�'*'- Flow Plan Attacttad N Sent to S.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Q14-ff 4 ""1 1 rIQJ 0 ner Location AP# Plan Approved for: Sewage Disposal Water Supply: P blic Private Well Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist Date 8/96 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES +- OWNER A.P. # PROPROSED BUILDING USE r DATE a RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........... $ Revised Plan Checking Fee.... $ r'I �V_2_._SCHOOL DISTRICT FEES i (paid at School District Office) (form available after Plan h ) 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 trait)..... 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 SSM (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 the plan checking process. APPLICANT DATE Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) O.B.- I Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. I personally plan to provide the major labor and materials for construction of the 01. proposed property improvement: YES] NO[ O2 I HAVE] HAVE NOT[ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: ` NAME: ADDRESS • CITY: PHONE: CONTRACTOR'S LICENSE NO. 4_ I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work:, NAME: = ADDRESS:CITY: PHONE: CONTRACTOR' S LICENSE NO. 5,. I will provide -some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME . ADDRESS PHONE TYPE OF WORK SI D: PROPERTY OWNER: C UY NUMBER: DATE: o / NOTE_ : This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. May 1995 2.26 Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for -the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned C.- Viei* C.B.O. Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. May 1995 2.27 Department of Public Works J. Michael Crump, Director 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 LLESS THAN 1 ACRE1 Project Description: `G(.l �GC i �I C% 10 0 Project Location and/or Parcel Number: pdA u) -p- #-- 02-`7- 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. 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. r Signed: Title: Date: q- -� 2, V --D � ' Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program 1 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM ; (One form per Building) ' School District O R QV I i. L E E Building Department No. P 45,+ g�Qc� A.P. Number - b �'y • 3 • -e ) • al :)L, Jurisdiction: City �Coun Property Owner R n R C— >T Property Location/Address oG ►�I f�-1-D v Y �� 5/ �� Subdivision Lot No. Residential Development o School District certifies that _ n �✓ ' '�L#: ...............................................................:..................................... (Street Address) No of Living Motiile Home Addition/ 'Supplemental to Units Installation Conversion Permit # (State) (Zip Code) *(No foundation Inspection) ..................................................................... ......................... Commercial/Industrial A._... 1 Department 0 New Addition Sq. Footage r (Group R) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Sq. Footage (Including Exterior Roofed Areas) 9— y eD 4 Date j i District Identification No. t .r �. o School District certifies that _ n �✓ ' '�L#: , j {� , . •s (App)icantf (Street Address) ..J (Phone Number') ® v --d4 w.1 L LG CAN (City) (State) (Zip Code) has complied with the requirements of Resolution No. p 3 --6 `E --1 by payment of $ 1 representing O 0 8 square feet. 2926 $ FULL MMGATION $ School District Representative Date Paid by Check Remarks: b 1^1 '3-.( a ' lost, 135z-- 615 65 3 5 3 Notice: You may protest the Imposition of the hes kler tt abov* by submitting a written protest to the District. In compllance with Govarmnent Code Section 66020(a), within 90 days from the dab hes are pail. Filune to submit a timely written protest will prohibit you from dudWriging the Imposition of the hes In any court aatlorL N, subsequent to it* School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is noflfied by the applicable Local Planning Agency that this project Is being rwlewsd under the Calhhrnla E Mronwrertal Quagty Act (CEQA), this project mq be subject to additional school hes to hdy mlthwe its Impact on the school dWbktls schools. White (applicant), Yellow (building department), Pink (school district) feeform.>ds (10/03)dmm CHECKLIST FOR SHIPPING PLANS TO WILLDAN The following items must be included when shipping plans to Willdan for plan check: ✓Cover Sheet Copy of Permit Copy of Site Plan Review Form with important items highlighted. (i.e. map conditions, site elevations if snow load area, fire sprinklers, flood zone, requirements for engineered foundations, etc.) (2) sets of plans with plot plans (1 plot plan stamped and signed.by CDF if in SRA. Both sets of plans must be signed and stamped by the engineer or architect of record for commercial construction or engineered structures.) (2) sets of structural calculations (Commercial or engineered structures) (2) sets of energy calculations (2) sets of truss calculations (Designed for appropriate snow load) (2) wet stamped flood elevation certificates (If within a flood hazard zone) (2) copies of SRA requirements (If in SRA) Copy of geotechnical report recommendations (If a geotechnical report is referenced on the parcel map .or subdivision map) (2) copies of Residential/Commercial Construction Requirements (Blue Sheets) Residential/Commercial Plan Review Guide Butte County Air Quality Management District Rule 207 Form (Ifa fireplace or wood burning device is shown on the plans.) Code analysis for commercial construction (Must be included on the plans) Permit history for commercial construction (i.e. copy of file jacket) • Enter date shipped to Willdan in Access �'a 7-� • Place assembled plans and documents in shipping bags • Prepare shipping label • Call Willdan for pickup✓ Sent by: Date sent: q' �- O.B.-1 OWNER -BUILDER VERIFICATIiON Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your eailiest opportunity.to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. I personally plan to provide the or labor and materials for construction of the proposed property im ovement : YES NO 112. I HAVE 7HAVE NOT ❑ signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CITY: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK { IGNED: PROPERTYOWNER:� .SOCIAL SECURITY NUMER: DATE: e, NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER x O.B.- I L OWNER BUILDER INFORMATION I Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. _ If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. ♦ If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. rely, s R �w Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER Butte County Department of Development Services YVONNE CHRISTOPHER, DIRECTOR County Center Drive roville, CA 95965 30) 538-7601 Telephone 30) 538-7785 Facsimile TO: FROM: I 1 SUBJECT: M DATE: WILLDAN Scott Rutherford (530) 538-7160 srutherford()buttecounty.net Plans Transmittal For Review Per Contract 9/29/2004 Applicant: JGarrett, ary & Linda Permit 04-2809 Project Type: NSF/Cov APN: 027-340-012 100% 70% Plan Check Fees $ 887.11 $ 620.98 $ 887.11 $ 620.98 WILLDAN Fee $ 620.98 Copies Attached: Qty Chk Application ' Site Plan Review' FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements, Other Other 1�� o� Department of Public Works ° C o u n t y o f B'u t t e o. J. Michael Crump, Director LAND DEVELOPMENT DIVISION' O Storm Water Management Program 7 County Center Drive �y Oroville, CA 95965 (530) 538-7266 (FAX) 538;7171 NationalPollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACREI , Project Description: Project Location and/or Parcel Number: r 0A 7— 2740 — 01 -2 -- 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. 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. n Signed: Title: ©� Date: 0 —�- Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/12/04 9 Opt *rmdow 27'-IY t0 is SITE PLAN REVIEW APPLICATION Date: 7 L1310V AP# Permit Number (if applicable) APPLICANT INFORMATION Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: Parcel Size: 51 ) Q [' a� Residential ❑ New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other Septic ❑ Agricultural Exempt Building ❑ Other: ❑ Single Family Remodel 0 Commercial Remodel ❑ Industrial Remodel -BUTTE C®Uta'TY JUL 19 2004 DE VELOp 'T EN Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) [R, Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval [A\Si e Plan Stamped Approved By ( cj yA Y Date /,n Paye 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: E] Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and -requirements) FA 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) m Flood Zone: x • Flood Panel No.: lo -7 (- i Index Date: co ❑ 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) ElCohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ------------------------- 7 ---------------------------------------------- -------------------------------------- ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: Applicable )Building Setbacks: DlipQA-_i�_ ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways 4 Fire Prevention Subdivision Map Front -Side------ --..-..._... S - --.. ---- -- - -- Side Street I ;3 0 Rear ' S Height Waterway N/A N/A- N/ t DlipQA-_i�_ ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Applicable Development Fees: Standard Fees Amount Formula ❑ 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 thetime of the building permit. Parcel Created By Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required El -No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal. Parcel ❑ Verify Legal Access ❑Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements ----------------------------------- ----------------------------- 3 of 5 n Subdivision Map/Parcel Map: Map Date of Recording: Lot: W— ❑ Use Permit/Minor Use Permit Permit Number: Book: * 0 `4 Page: IJ )� Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated, with residential development.. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department --- of Development -Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible lvr roa Page 4 of 5 t Summary of Specific Requirements: i This inform_ ation'provided in this.summary is based on the application information and on the best available data at the time of review. C:1Larrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 REGINALDTOF`MS 71'ENTAT VE SUBDIVISION MAP AND BOUNDAR'�--Li-�i�:--- -(,�J,-;7FICNTION, 16 parcels on the south of the right-of-way at the eastern eno of McIntosh Avenue, approximately 1200 ft. east of Grier Avenue, Palerino area. Assessor's Parcel Number: 27-18-12 & 14 Engineer: Graves -Barnhart -Brawn All -IP, -7-24 Esc Public Works Department conditions are: ®K1. Indicate a 50 -ft. building setback line from the centerline of all streets. 2. Street signs shall be provided by the developer at all street intersections per,County requirements. LSunmit 5 alternate str es for each street to the County a cress coo ina or c� or approval of street names.) Construct full street section on all streets to RS -7A geometric standard. Minimum structural section to be 4" AB and SC 250 ....prime. Ok'\'4< Provide monumentation as required by the Department of Public Works in'accordance yith accepted standards. &f, G c �' Provide permanent solution for drainage. 6 All easements of record to be shown on the final map, h:!�'' r� '� o `7. Meet the requirements of Butte County Fire Department or other responsible agency. 0K 8. Provide circulation. ig Pay off assessments. O(K 10. Meet the requirements of the utility companies (i.e., PG & E, Pacific Telephone, water, sewer). 11. Pay any delinquent taxes. P12- Comply with requirements of the Mosquito Abatement District, i.e., grade drainage channels to remove potholes to remove water that (;(�u might cause mosquito problems.. Health Dept, conditions are: T!�. 3. Show a 50 ft. leachfield setback from the drainage way on parcels 1, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 15, and 16. 4.Show a 100 ft. leachfield setback from the highwater line of the creek on parcels 1, 2, 3, 4, 5, 13, 14, 15 and 16. 5. Show the usable sewage disposal area proven to meet the requirements of the Subdivision ordinance on parcels 2, 3, 4, 10, 11 and 16. ,see following page) „- MT _ ....... .._.._. - .__....._..._.... _....._.. __...... _.._._... _._ __... _.....__ .. t.._• . _ . . .. Tom. (Reginald Loftus Tentative Subdivision) 16. Place a note on, the map that no water well may be located within 100 ft. of the usable sewage disposal area on parcels 2, 3, 4, 10 11 and 16. . elxr D. Prove that the required quantities of domestic water are available by drilling at least three wells in locations designated by the Health Department. Additional wells may be required if water yield's are not adequate or consistent. Planning Department conditions are: 18. Submit a grading plan to the Department of PublChaktern70 obtain a grading permit, if deemed necessary., per p of the adopted Uniform Building Code. 19. Utilize standard erosion control measures and construction practices to minimize erosion and other construction impacts. 20. Contact a local representative of the Department.of Fish and Game regarding_the..stream bed alteration for the.bridge:crossing of Wyandotte Creek. Obtain a Section 1603 permit, if required, from the Department of Fish and Game. 1 r • t a 4 INSPECTION FEE (I FIDOD INTER WRITTEN I W I LLDAN Ma s Street Marysville, California 95901 Serving Public Agencies 530/749.2373 fax 530/749.2199 www.willdan.com November 22, 2004 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL Willdan Project No: 14353-1174 Jurisdiction Job No: 04-2809 Assessor's Parcel No: 027-340-012 Description: Garrett NSF Applicant: Gary and Linda Garrett Dear Mr. Rutherford: Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2"d page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: * Plans: Two (2) copies sheets 1 through 3, dated 10-18-99, drawn by Jane Aagard * Energy Calculations: Two (2) copies dated 11-08-04, by Designs by Jane -Jane Aagard * Truss Calculations: Two (2) copies dated 09-07-04, by Meek's Lumber and Hardware The plans have been stamped with the Willdan approval stamp and dated the date of this letter. The applicant has requested that all superceded copies of plan sheets and documents be returned to him/her. All superceded copies of plan sheets and documents will be returned to Butte County with stamped approved plan sets. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. WILLDAN Serving Public Agencies APPLICABLE CODES Unless noted otherwise, all comments are based on requirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: 0 Part 2, known as the California Building Code and'abbreviated herein as "CBC" 0 Part 3, known as the California Electrical Code and abbreviated herein as "CEC" 0 Part 4, known as the California Mechanical Code and abbreviated herein as "CMC" 0 Part 5, known as the California Plumbing Code and abbreviated herein as "CPC" 0 Part 6, known as the California Energy Code, and Energy Commission Standards, and abbreviated herein as "CECS" CODE ANALYSIS CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project.. 2. Revisions and/or notes as red -lined on the plans. 3. All plan sheets shall be signed by designer, or person responsible for the plans as required by California Health & Safety Code Section 5536.1. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals noted at this time., - SPECIAL INSPECTION NEEDS, .' Our plan review reveals no special inspection needs pursuant to CBC 1701. Sincerel ncere, saac; Kuster Plans Examiner Cc: E-mail Alice Mefford at: amefford@buttecounty.net Linda and Gary Garrett, 820 North Lincoln Way #3, Gait, CA 95632, FAX (916) 802-3197 Page 2 of 2 t County of Butte Permit Number 04-2809 Willdan Project Number .14353-1174 Type of Type of 1 1" Floor 2°Floor Sprinklers Stories Total Sq Ft Occupangonstruction Sq Ft Sq Ft 777777` R-3 V -N N/A 1 1008 N/a 1008 Porch V -N N/A 1 60 N/a 60 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project.. 2. Revisions and/or notes as red -lined on the plans. 3. All plan sheets shall be signed by designer, or person responsible for the plans as required by California Health & Safety Code Section 5536.1. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals noted at this time., - SPECIAL INSPECTION NEEDS, .' Our plan review reveals no special inspection needs pursuant to CBC 1701. Sincerel ncere, saac; Kuster Plans Examiner Cc: E-mail Alice Mefford at: amefford@buttecounty.net Linda and Gary Garrett, 820 North Lincoln Way #3, Gait, CA 95632, FAX (916) 802-3197 Page 2 of 2 t County of Butte Permit Number 04-2809 Willdan Project Number .14353-1174 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2e121Q0-ea--ioQf48Z�-7>S Recorded Official Records I REC FEE 1,COPIES County Of BUTTE I CANDACE J. GRUBBS I Recorder ROSEMARY DICKSON I Assistant I Jason 11:28AN 09 -Aug -2004 I Page 1 of 2 ;Mgt* AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date ��®D t State of California County of ai ti -W 10.00 2.50 On -Pk:kq ib1r q ,)-G0LJ before me, personally appeared C-; i nn A, L. a c�, Cnct r r• - } personally m known to me (or proved to e 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 rr; MARY A. THOMPSON 70 'n ia�A.P. 4 � , 2006 1 the following described property in the unincorporated area of, County of Butte, State of California: PARCEL I: LOT 12, AS SHOWN ON THAT CERTAIN MAP ENTITLED,-LOFTUS SUBDIVISION MAP", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF.BUTTE, STATE OF CALIFORNIA, ON AUGUST 22, 1986, IN BOOK 1040F MAPS, AT PAGES) 18 AND. 19. PARCEL II: AN EASEMENT 60 FEET IN WIDTH FOR ROAD AND PUBLIC UTILITY PURPOSES, ON OVER AND UNDER A STRIP OF LAND, THE CENTERLINE OF WHICH IS MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTHWEST CORNER OF SECTION 23, TOWNSHIP 18 NORTH,.RANGE 4 EAST, M.D:B. & M.; THENCE SOUTH 6310 15'23" EAST, 419.40 FEET TO A TANGENT CURVE CONCAVE NORTHERLY, HAVING A RADIUS OF 150 FEET, A CENTRAL ANGLE OF 520 30'26", AN ARC LENGTH OF 137.46 FEET; THENCE. NORTH 640 14'. 11" EAST, 249.28 FEET TO THE. CENTER OF A 50 FOOT RADIUS CUL-DE-SAC; THENCE NORTH 75° 33' 38" EAST, 523.62 FEET TO THE END OF THE HEREIN DESCRIBED CENTERLINE. PARCEL III: .N.,� 027-340-012-0 N Grant Deed'- continued File No.:0403-1519276 (MM) Date: 07/08/2004 NON-EXCLUSIVE EASEMENTS FOR ROAD AND PUBLIC UTILITY PURPOSES OVER RAIL BRIDGE ROAD, MEETING PLACE, MACKINTOSH AVENUE, AND REGINALD WAY, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "LOFTUS SUBDIVISION MAP", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE,.STATE OF CALIFORNIA, ON AUGUST 22, 1986, IN BOOK 104 OF MAPS, AT PAGE(S) 18 AND. 19. EXCEPTING THEREFROM ALL THAT. PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED HEREIN. Dated: 07/08/2004 - OFy..... .....:..... . STATE OF CALIFORNIA NUMBER` ' BUSINESS, TRANSPORTATION AND HOUSING AGENCY o DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT. • _. DMSION'OF CODES AND STANDARDS c MANUFACTURED HOUSING PROGRAM. - MANUFACTURER CERTIFICATE OF ORIGIN DISTRIBUTION:ORIGINAL (PINK) FORWARD TO THE INVENTORY CREDITOR, UNLESSirHERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 95812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER. ❑ CHECK IF THIS ISA DUPLICATE.MCO-ENTER ORIGINAL MCO NO.. MANUFACTURED HOME OR MULTI -UNIT MANUFACTURED HOUSING NUMBER OF . SFD_ (SINGLE,FAMILY DWELLING) ❑: MUMH (MULTI -UNIT MANUFACTURED HOUSING , . . TRANSPORTABLE SECTIONS 7 ...COMMERCIAL COACH::.. ... •.. OCCUPANCY GROUP MANUFACTURER NAME: ' ' ' "" "' '" " ' MANUFACTURER LICENSE NUMBER: THE KARSTEN COMPANY 90153 MANUFACTURER ADDRESS: SUGGESTED RETAIL PRICE: 9998 OLD PLACERVILLE ROAD SACRAAgENTO CA 95827 62.,460.00 (Street) (City) (State) (zip) MANUFACTURER TRADE NAME: MODEL NAME AND/OR NUMBER: DATE OF MANUFACTURE: VILLA '44003F 04-1.0-03 NAME OF DEALER OR TRANSFEREE (OWNERSHIP TRANSFERRED TO):" CALIF'. DEALER NUMBER OR DATE OF TRANSFER: TOM'S MOBILE AND MOTOR04-10-03 TRANSFEREE DESIGNATION: 91.09? DEALER OR TRANSFEREE ADDRESS: 6366 LINCOLN BLVD OROVILLE CA 95965 (Street) (City) (State) (zip) INVENTORY CREDITOR NAME: INVENTORY CREDITOR ADDRESS: (Street) (City) (State) (Zip) SECTION MANUFACTURER SERIAL NUMBER HCD INSIGNIA OR HUD LABEL NUMBER LENGTH WIDTH. WEIGHT 1� (INCHES) INCHES) (POUNDS) 1` KC—CA-01—K31339 A RAD 1380750 :_'.528 162 23760 2 KC—CA-01—K31339 B RAD. .1380751 528 162 23760 A TRANSPORTER NAME: D & R TRANSPORT TRANSPORTER ADDRESS: P. O. BOX 179 DURHAK CPQ 95933 (Street) (City) Stale) (zip) DESTINATION FOR UNIT DESCRIBED ABOVE: TOM'S MOBILE AND MOTOR 6366 LINCOLN BLVD OROVILLE CA 95965 (NAME) Street City (State) (Zip) I certify under penalty of Perjury under the .Iaws of the State of California that the above facts are true and correct Executed on 04—"10-0 3 at SACRAMENTO SACRAMENTO CA (Date) (C' (County) (State) SIGNATURE OF AUTHORIZED AGENT: DISTRIBUTION:ORIGINAL (PINK) FORWARD TO THE INVENTORY CREDITOR, UNLESSirHERE IS NONE, THEN FORWARD TO THE PURCHASER (DEALER OR TRANSFEREE). COPY 1 (WHITE) FORWARD TO THE DEPARTMENT AT P.O. BOX 1828, SACRAMENTO, CA 95812-1828, WITHIN FIVE (5) DAYS OF RELEASE. COPY 2 (YELLOW) DELIVER TO THE TRANSPORTER TO ACCOMPANY THE UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED BY THE MANUFACTURER. RYi=CORDING REQUESTED BY Mid Valley Title & Escrow Company AND WHEN RECORDED MAIL TO: Gary G. Garrett and Linda L. Garrett 820 North Lincoln Way, Space 3 Galt, CA 95632 210104—QDjGD4Z043 Recorded Official Records Count TEOf CANDACE J. GRUBBS Recorder ROSEMARY DICKSON Assistant 09:00AM 13 -Jul -2004 I REC FEE 10.00 I TAX 36.30 I Lisa I Page 1 of 2 Space Above This Line for Recorder's Use only A.P.N.: 027-340-012-0 File No.: 0403-1519276 (MM) GRANT DEED � - - -- -- W Undersigred-Gfantor(s) Dedare(s DOCUMENTARY TRANSFER TAX $36.30; CITY TRANSFER TAX $0.00; SURVEY MONUMENT FEE $ computed on the consideration or full value of property conveyed, OR X computed on the consideration or full valueless value of liens and/or encumbrances remaining at time of sale, X unincorporated area; () city of, and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Paul M. Santoni and Dolores L. Santoni, husband and wife hereby GRANTS to Gary G. Garrett and Linda L. Garrett, husband and wife as joint tenants the following described property in the unincorporated area of , County of Butte, State of California: PARCEL I: LOT 12, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "LOFTUS SUBDIVISION MAP", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 22, 1986, IN BOOK 104 OF MAPS, AT PAGE(S) 18 AND. 19. PARCEL II: AN EASEMENT 60 FEET IN WIDTH FOR ROAD AND PUBLIC UTILITY PURPOSES, ON OVER AND UNDER A STRIP OF LAND, THE CENTERLINE.OF WHICH.IS MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTHWEST CORNER OF SECTION 23, TOWNSHIP 18 NORTH, RANGE 4 EAST, M.D.B. & M.; THENCE SOUTH 630 15123" EAST, 419.40 FEET TO A TANGENT CURVE CONCAVE NORTHERLY, HAVING A RADIUS OF 150 FEET, A CENTRAL ANGLE OF 520 30' 26", AN ARC LENGTH OF 137.46 FEET; THENCE NORTH 640 14' 11" EAST, 249.28 FEET TO THE CENTER OF A 50 FOOT RADIUS CUL-DE-SAC; THENCE NORTH 750 33'38" EAST, 523.62 FEET TO THE END OF THE HEREIN DESCRIBED CENTERLINE. PARCEL III: Mail Tax Statements To: SAME AS ABOVE �z- ' A.P.Nj 027-340-012-0 s ti Grant Deed - continued File No.:0403-1519276 (MM) Date: 07/08/2004 NON-EXCLUSIVE EASEMENTS FOR ROAD AND PUBLIC UTILITY PURPOSES OVER RAIL BRIDGE ROAD, MEETING PLACE, MACKINTOSH AVENUE, AND REGINALD WAY, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "LOFTUS SUBDIVISION MAP", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 22, 1986, IN BOOK 104 OF MAPS, AT PAGE(S) 18 AND 19. EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, . DESCRIBED HEREIN. Dated: 07/08/2004 --�-� -Paul-M- ntoii Dolores L. Santoni - _---- _ STATE OF CALIFORNIA } }ss. COUNTY OF BUTTE } On _ JULY 9, 2004 before me, _ MARY A. THOMPSON, NOTARY personally appeared __ PAUL'M. SANTONI AND D0r.0RFR r. cahmnrar 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 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. MARY A. THOMPSON This area for offic/ai Commission #1351470 notarial Sea/ a Notary Public - California 0) , Sig re C::; v Butte county My Comm. Exp. AP 15,2006 My CommisUn Expires: _ APRIL 15, 2006 Notary Name:_ _ MARY A- THOMPgQN Notary Phone: 510-511-668n Notary Registration Number: County of Principal. Place of Business:_pUTTE Page 2 of 2 7 ................... ...... 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