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027-350-168
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM - (One form per Building) School District )' � Building Department W. V � (�a A.P.'Number �- 1 V� Jurisdiction: City j County Property Owner Property Location/Address V J ' Subdivision Lot No. V Residential DevelopmentQ ; 0 Q Sq. Footage No of Living Mo ile Home Addition/ *Supplemental to (Group R) • Units Installation Conversion Permit # \ .. (No foundation Inspection) .........................................»........................ ....................»..., Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) 1 Commercial/Industrial Q 0 Sq. Footage New Addition (Including Exterior Roofed "as) 1 . o 4-, Building Department Representative Date 026 v District Identification No. 4 i (Le- W i i2/1 {r -School District certifies that • /) (Applicant) (Street Address) (Phone. Number) (City) ', (State) (Zip Code) has complied with the requirements of Resolution No. /OS 7 D by payment of $ ' representing 0 square feet. {: AB 2926 ; r % ' FULL MITIGATION_, --'r= So (�(o•9 ��-- School District Representative Date ,.9o-�zo24L2j` lAJA ( lel 1`I fti7um A* r -•.NoBae: You may protest the Imposklon of the fess Identified above by subndMng a vntten protest to the District. In compliance with Government Code Section 66020(a), wltfdn 90 days from the date fees are paid. Failure to submit a timely written protist will'prohlbk you from challenging the Imposition of the fiats In any court action. K, subsequent to the School Dlstrid Representative signing this Butte County Schools Impact Fee Certification Form, the School Dlebld Is no~ by the applicable Local Planning Agency that this project Is being rMew ed under the California Environmental Quality Ad (CEQA) th is prays - maybe subted to additional school fess to futiy mMgde. its Impact on the school disbidti schools. White (applicant), Yellow (building department), Pink (school district) y., feeformads 00/031dmm `�4 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement tLESS THAN 1 ACREI `P � • l' Project Title: 19,51 O�( Q►'l•P � fbUI � /� By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs 1 acre or more of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP), and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more of land. I am aware that submitting false and/or inaccurate. information may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: -�P11J11� � Title: Date: vl AND WHEN RECORDED MAIL TO: BUTTeCOUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 19 -May -2004 2004-0029765 Has not been compared with original BUTTE COUNTY RECORDER 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 hasestablishedagricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience of"O' di�scomfort from normal, necessary farm operations. All that real property situate in -the County of Butte, State of California, described as follows: . L o* 10, aS 4ncc&:fN C-ex--vizo crime ec tied \J0'1ec\e;%Ck_ -rcox \- 'Qw*te Covc1, C.a\t�octl't�� W, Nkdr\ ec�p wc�s c�eevc�ed i r �r.e o{-F�e� c�E e p -�- - Aw, ok Q*Ake-, ers r re? u Qz c\ : kemj ck- , Oen P+ est \\ , kn b K C-\ CD�r "b% Ca Date�y_ b PROPERTY OWNERS:. State of California ) County of ) On 3 . � zf! O �4 before me, personalty appeared Su��t`l S'T0c/<S_ personally !mown 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 signatures) on� the instrument, the person(s) or the entity upon behalf of which the person(s) acted, execut0pe instrument. WITNESS my nd and I seal. Sigrlatnr Seal: NICOLLE MILLER �m Cortmliss Ii 1287764 AkffMK10 C=Nft AP. # N�►OarartvfsDac21.21>dt SUJLDINDIVISIGN_ , CoUkt,., Y.0P � E, "BUITDEPART--1A14TT;L.WELOPME NT SERViCES . 7 COIDNTY CENTER .DRIVE 010VILLE"CALIFORNIAk 46TELEPHONE''(53 (530)'538-75418-7541 13.A LXURAL'pU PERMIT ..PERMIT NO.. Adrjqblturalbulding. is -defne_dasf ollows Ag rcUtural -bb,LilI-ding.i§ wstructurd.-designedM d'.co*nstructed to'house fa ra m 0n qoo�4_Pypgrainpou",, 1vA i "products Thise shallnot: ila�e;6f binn a . qgncW.. Ot M -proce ted, Ar6ated, or Packaged, not thall' 0" habitation be are s A,.pjjkqq of ac use public. ' ASSESSOR ACEL NO.. ZONING OWNER -PHONE NO. OWNERS ADDRESS A v .7 T X—IC7 I M LOCATION o LDN -B 6- -A USE OFBUILDING.4-1 SIZE Q GTU RE X SO. FT. W.: TYPE OF CONSTRUCTION: T ObIJF144M:STEEL , EE OTT jg _R y TYPE OF FLOOR TYPE DlN6' NG", COVR P MO! LUTIOW MAT P'-00 MINI ESTJ ST OF 1, , O as Counter rdirtar�ces AG'BUMI-p rrnmuM FY .7q Mehlsoteapme . ,FRONT_ SIDES `R AG Buildings stall 66 a minimum of five (5) feet from any septic tank or [each fields. -t p AG_BuiTd'%gs_ Ahan4Q� -big, A4 _,e, 1. -rho 1_j WN Rqm_,�- 6ileh6m6;:1;9-i ;3 af $6 : i- --ii, v, ";" 18b, d AG Buildings greci er thanI 066 sqoca#ed, mrrtrmum of 23 mobil* and40redt"fh.'�' U in6rhmetc-MAltjj,� gi " ehornk ? n d' about,am'.purposedJuse. rms,with the . td 1*11...be use ras.: stdt6d-, Date 14 OL y pzs `1 op J - `NOTES RESIDENTIAL 027-350=168 r V 04=1413 _ STOCKS, SUSAN • - !1 1951 COXLANE, OROVILLE , R ' r _�T: OWNER I NEW MH PERM FND 4 r f� TIfE HCD FORM 433A FOR THIS MH CANNOT, BE •R.ECORDED UNTIL ONE OF THE FOLLOWING HAS ' yBEEN TURNED IN TO THE BUILDING DIVISION: Y (1) LICENSE PLATE(S) OR DECAL (THE- THEINSPECTOR INSPECTORMUST RETREIVE). i 1 (2) STATEMENT OF FACTS. ONLY ONS`;. 1 NEW MH'S). ,•: ?. , INSPECTOR TO VERIFY SERIAL `& LABEL #'•S: " SPECIAL CONDITIONS CHECKED BY SRA e FLOOD CERTIFICATE REQ. ' FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS I VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER OFFICE COPY )fi } Address GAS mac; i r Meter,By Date' !1 ,. ELECTRIC Meter By Date y "I JOB FINALED (Date) { 'Signature Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s Card B-1 Date Card B-1 Date Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 V=OK MOBILE HOME INSTALLATION (Plans) OK except #'s 0 = Not OK ` - = Not Applicable MOBILE HOMES = Not Ready . Date MOBILE HOME UTILITIES (Plans) OK except #'s 3. 1. Zoning Requirements -Setbacks -Easements 2. S ' ; Sp cial MH Support Sketch Electricity; MH Test -Crossovers -Breakers -Clearances #'*"Sewd<Location-Test-Fall-C/O-Concrete 5. . Wate at n- est -Easement Needed (Sketch) r lectr' ' ; Location-Clearances-Grnd- mp-Concrete �? Ey�lic 6 as; Location -Test -Wrap;-/ /" L'ft. �a t / P Nat. or / /-L-ft./ PLPG Water and Sewer Connected -C/O to Grade -HD Approval 7. Well Clearance 8 Disconnect 8. 8. Utility Clearance Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s Card B-1 Date Card B-1 Date Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 3. omn uireme b ments -oo 4. Ings¢e-Spac' g -Marriage Line 3. Gas; MH Test -Demand- a v - onnector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector r 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. Cent. of Occupancy Date 12. P@lWanjnt Foun ation Only; License Decal Date 1 - Card BL%.0DaV Card B-1 Date Card B-1 Date Card B-1 i 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- Bea ms- 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 FINAL (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel=Connections-Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 / "I ✓ = OK 0 = Not OK - = Not Applicable = Not Ready Date RESIDENTIAL (; Date Underfloor (Plans) OK except #'s Hangers -Post Caps -Anchors -Connectors 1. Zoning -Setbacks -Easements -Flood -Slope Cling. Joist-Rftr. Ties-Purlin-Roff Brac.-Truss -Shting.-Rfng. 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth Fireplace Ties or Type A Flue -Fireplace Throat Clearance 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Attic Access; Size & Ramex Protection -Draft Stop -Ins. Baffles 4. Ftg., Porches & Decks; Soils -Steel-/ P' Ftg. Depth Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 5. Stemwalls, Main; Steel-Blockouts-Wrapped Garage Fire Protection Framing 6. Stemwalls, Garage; Steel-Blockouts-Wrapped Property Line Firewall & Openings 6a. Hold Downs and Special Anchors Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 7. Slab, Steel -Wrapped Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 8. Piers -Fireplace Ftg.-Steel Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test Siding -Nailing Veneer 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 11. Water Pipe; Test -Anchors -Regulator -Service Test Glazing Area -Glass Protection -Skylights -Plastic 12. Electric Underground Shear Walls; Nailing -Bolts 13. Plenums & Ducts; Clearance -Material -Support -Ins. Brace Interior/Exterior Wall Panels 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies Insulation -Walls -Ceilings 15. Access & Ventilation Infiltration -Walls -Windows 16. Insulation Date Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card 8-1 Date PLUMBING (Permit) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings 17. Water Htr.; Vent -Access -Combustion Air Baffle Smoke Detector 18. Water Pipe; Test & Anchor -Nail Protection Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 19 D.W.V.; Test Fittings & Anchor -Nail Protection Bedroom Exiting 20. Shower Pan; Test, First Floor -Tub Access G.F.I. & Bath Fixtures & Tub Access -Spa 21. Test Tub & Shower, Second Floor -Tub Access Elec. Trim & Subpanel, Breaker Sizes & Labels 22. Gas Pipe; Sixe & Anchors Stairs & Rails 70. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Elec. Outlets & Receptacles at Kit. Counter 23. Fixture & Transformer Clearance -Ins. Protection Garage Fire Door; Swing -Landing -Closure 24. Elec. Receptacles Spacing -Lights & Switches at Doors A.C. Duct in Garage -Damper 25. Size Boxes & No. of Conductors Stapled Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Romex Installed Close to Edge of Studs & C.J. Plb., Elec. & Mech. Equip. Listed for Location 27. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water Elec. Receptacles in Garage (F.F.I.)-Romex Protection 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI Insulation -Foam -Looked in Attic 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI Guard Rails & Deck Construction -Post Caps 30. Range Circle / / ga Cu or AI -Oven Circ. / / ga Cu or Al Insulated Neutral ❑ Yes U No Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Service -Riser Conductors & Ground Main Disconnect Clearance Looked under Floor O Yes 32. Equip. Clearances Panels-Motors-Mech. Equip. Following Instld./Drive J Yes J No/Walks J Yes J No/Planters J Yes J No 33. Clothes Closet Light -Shower Light -Spa Light Stucco Brown -Finish 34. Smoke Detector A.C. Unit Disconnect, Electrical -Plumbing 85. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s Ventilation Throughout House 35. A.C. Ducts Insulation & Support Glass Protection 36. Vent Fan, Exhaust above insulation Corrections from Previous Inspections 37. Condensate Drain & Overflow, Size & Grade Gas Test -Meters Tagged, Gas -Electric 38. Furnace -Vent Access -Comb. Air -Return Air Vent 115 outlet Water & Sewer Connected -C/O to Grade -HD Approval 39. Attic Access & Platform if Furnace in Attic Energy Compliance Certificate -Other Certificates 94. Address Posted Date Date Card B-1 Date Card B-1 Date Date Card B-1 Date Card B-1 Date Date FRAMING (Permit) OK except #'s Card B-1 Date Card B-1 40. Sills Proper Materials & Anchors 41. Walls Studs -Nailing Spacing & Braces -Plates -Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 45. Headers & Beams -Size & Bearing jingle & Duplex),, Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties-Purlin-Roff Brac.-Truss -Shting.-Rfng. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Ramex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 6'.. Insulation -Walls -Ceilings 62. 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 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 82. Following Instld./Drive J Yes J No/Walks J Yes J No/Planters J Yes J No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted 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: COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 == CORRECTION NOTICE n s� OWNER PERMIT NO. h .w A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. 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.netWds PERMIT NO. BP041413 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: 06/29/2004 APN: 027-350-168-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1951 COX LN ORO Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NEW MH PERM FND NEW SITE(1608)ATT Contractors' State License Law for the following reason (Sec. 7031.5 DECK(221) Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner' STOCKS, SUSAN ' signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 576 PALMS DR 7000) of Division 3 of the Business and Professions Code) or that he or MARTINEZ, CA she is exempt therefrom and the basis for the alleged exemption. Any 94553 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: STOCKS, SUSAN such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Architect: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of Engineer: RICHELIEU, JEFFREY - NORTH STAR the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 1608 S.F. Policy #: 21, 1 certify that in the performance of the work for which this permit is Valuation: $104 520.00 issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Census Code: 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. Wd� 4W Date:e�C�,l��' A, ' a I I'Re e el (') ed '\��� Applicant: vic. 1 �f cc Z WARNING: Failure to secure workers' compensation coverage is ' ' rhe (p l 4 46(0-5 O3 unlawful, and shall subject an employer to criminal penalties and one t ��l q S hundred thousand dollars ($100,000), in addition to the cost of / I ,eeR�ed . • compensation, damages as provided for in Section 3706 of the Labor _code, interest, and-attomey-s.fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County CodR anrvor I hereby affirm that there is a construction lending agency for the Resolutions to do ork indicated abr which fees have been paid. performance of the work for whit this permit is issued (Sec 3097 Civ.) ` / By: Jo ��r!� ,a Date: Name: " Address: PERMIT EXPIRES ON: D ! - Date ❑ 1 hereby certify that the us 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 haz dous 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 enter upon the above mentioned property for inspection purposes. authorize repres)e�tatives of Butte Coungc= J Print Name: /-T(LInc) Lz X � �% Signature: /(/L�f�fi1/ Date: t r, ' a5 —0(-4 ❑ Owner ❑ Contractor C34,Agent for Owner 0 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 REQUIRED AT TIME OF APPLICATION OWNER Name ls' sa h s4 l< Address 1 9 S i C o L h City ©(Z O.V i LLC— Stat Zip9S9 Phone 3 t� j l cjb Fax E-mail Phone APPLICANT NAME CONTRACTOR Name V� 2 Address Zi 5 City Fax State Zip Phone Map Book 7156 Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name h JJ Address Zi 5 City Fax State Zip Phone Map Book 7156 Fax E mail Planner State License Number APPLICANT NAME Name v c� 6 Address C' JS 0 3 y -7 City rtb lev ✓v_d Stat Zi 5 Phones3C-/— l O Fax E-mail APPLICANT SIGNATURE X &2tz�t i For office use nl : Zoning AP# Flood Zone Property Address SRA Cross Street No Occ. IType Const. Subdivision Name Map Book 7156 Pae Lit # �6 Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP BIN # K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Description or Scope of Work: .o r ,,0 Sq. Footage / 6 Q _ 9 -2, \ I o rc h ❑ 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. i Received b Amount: a� �f ` - (� Bldg P �SRA Receipt� Date: �5 I it 16 Sheriff SMIP a REV 4-30-04 %6G LOCATION AP# Property Address Cp h.0 0buiaCCAi Cross Street .o 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 K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 Description or Scope of Work: .o r ,,0 Sq. Footage / 6 Q _ 9 -2, \ I o rc h ❑ 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. i Received b Amount: a� �f ` - (� Bldg P �SRA Receipt� Date: �5 I it 16 Sheriff SMIP a REV 4-30-04 %6G SUBMITTAL REQUIREMENTS ` -1 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 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 (if required) (NO FAXES!). ❑ 5. Letter from Engineer or Architect for truss design review. ❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to mobile or modular homes.) ❑ 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: ❑ 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. ❑ 5: N:'2 Engineered" Tie Downs•or Foundation plans. ❑ 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 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, All of these must be stamped and wet -signed b, the he en in�eer. ❑ 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 MT Y A• TN'v' P '"'!i'� M..yl'.'.!,y.r. .wr c _ .+F +_ .i Y '• -'17 wR •; - COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS�N 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET[/' l,^� �n Oi�VNER:`-��� ASSESSOR PARCEL NUMBER Vl�r Proposed Building Use: 1121V4 Y 1 COY \Counter Technician: Date: Items required in order o apply for a permit. II boxes MII T be checked OR marked NA in order apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. . ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 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/ ntial Buildings. ' 8. Manufactured homes Data sheets an instal ation ins Marriage lineZinf, Floor Plan, . Tie down orf pl ns, all in ! duplicate. •/ ❑ 9. Metal Bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in tripAfe,((C))levations In tri c . D) Floor p� i ip;i te. 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 ❑ 1.2. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ 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............................................................................................ 0 18. Agricultural Buffer cir and site plan apr from the Ag Commissioner Sent by ®IL ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ 2�. Erosion Control Plan Required........................................................................ ........ 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,Jr�p Sent by ❑ 24. Planning approval (A) UsO� B)Parking: (C) ar -7 0>� ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form..............................:............................................................... 27. Encroachment Permit for driveway from the Public Works Dept ........................... 28. Pre -Inspection for required....... - .. JJJ Cl 29. Contractor's license information. (Number, Name Style, Classification)- ................. ❑ 30. Worker's Compensation Carriey and Policy Number .......................................... 31. Owner -Builder Verification (iven to owner, _Mailed to owner) ..................... i/ 32. Letter of Signature authorization ....................................... I ........................ ....A. 33. Recorded copy of Agricultural Acknowledgment Statement ................................. 34. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction.............................................�... 9 ............... ... �' -� --� ❑ 37. Grant Deed, M.H. Title/Statement of Facts, flett'er from Le al Owner heck�to H.C.D. $' ❑ 38. Other: ' 39. Other: -R3-0 When issued Telephone 51- /-- / and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. 1. Index permit application for the above items numbered: I Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ephone, `❑ mail, ❑ counter, b Date: Contractor, designer, owne was advised of theov to by phone, ❑ mail, 01y counte Date: ' Plans reviewed by: Date: Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division E.H. USE ONLY ° r___ "• ;� Plot ilea Aneched Roos Plan Aneched Sent to B.D. `. TO:W.„ Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for -oll dwelling. Other o2 2ocr7, f ���-�-a �. Hold final for: Final clearance O.K. for: NOTE: rl Environmental He 8/96 COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95.965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER PROPROSED BUILDING USE n " T `O►'T` XR� 1. BUILDING PERMIT FEES�� � 9 --- Balance Due ..................... $ --- Additional Fees Due........... '=- Revised Plan Checking Fee.... $ L L-42. SCHOOL DISTRICT FEES (W% (paid at School District Offi(x) (f availfte �i k VY 3. SHERIFF FEESaid atildin U g Division) Residential............ X $360.00 Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. A.P. # DATE RECEIPT # DATE REC. 4 0 (eG98 _6�q-04� &._0'-L'qL0 )np - M FW R-07MR, ! 'n � o =irp 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) 0—J17. SRA FIRE INSPECTION AND PLAN CHECK FEE f SO W(paid at Building Division) _ 1 4 i '� 1 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X =$ Gone # units Amt. Commercial (sq. ftg.) ......... X $ Sq. Ftg. 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 plancchec1king process. APPLICANT `.C�/ DATES' '–D C4 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) r� RECORDING REQU,k&1 Edi; a3Y: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 lIIIIIl111IIIIII111i111ii111111111 • �'��4-0067598 7 COUNTY CENTER DRIVE Recorded Official Records I REC FEE 10.00 I CONFORM 1.00 County Of I BUTTE I CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Jason 10:15AM 03 -Nov -2004 I Page 1 of 2, SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, _4' 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. SUSAN E. STOCKS REAL PROPERTY OWNER/LESSOR 1570 COX LN. MAILING ADDRESS OROVILLE BUTTE CA 95966 CITY COUNTY STATE ZIP 1951 COX LN. INSTALLATION MAILING ADDRESS, IF DIFFERENT OROVILLE BUTTE CA 95966 CITY COUNTY STATE ZIP SAME UNIT OWNER (if also property owner, write "SAME') SAME MAILING ADDRESS SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION REDMAN HOMES INC. 2004 MANUFACTURER'S NAME 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 04-1413- 530 538-7541 BUILDIN PERMIT N0. TELEPHONE NUMBER s� -o%S q--17'- SA URE OF LOCAL GENCY OF CIAL WERTIME DATE (if not a dealer sale, write "NONE") NONE DEALER LICENSE NO. DATE OF MANUFACTURE SILVERCREST CLASSIC MODELNAMF/NUMBER 11830034A/B 60'X 268" ORE455957/8 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIA/LABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER AP# 027-350-168 HCD FORM 433(A) REV. 8/91 WHITE -County Recorder CANARY - HCD PINK - Applicant GOLDENROD -Building Dept. ORDER NO.: OD211686-041 -GW SCHEDULE C , THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE. OF CALIFORNIA, DESCRIBED AS FOLLOWS: LOT 10, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "VALENCIA TRACT, SUBDIVISION NO. 1, BUTTE COUNTY, CALIFORNIA", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 11, 1913, IN BOOK 7 OF MAPS, AT PAGE 58. AP NO. 027-350,-168 S' 11� RECORDING REQUESTED BY: V AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 CCP'Y of Document Recorded 03 -Nov -2004 2004-0067598 Has not been compared with original BUTTE COUNTY RECORDER 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. SUSAN E. STOCKS REAL PROPERTY OWNER/LESSOR 1570 COX LN. MAILING ADDRESS OROVILLE BUTTE CA 95966 CITY COUNTY STATE ZIP 1951 COX IN. INSTALLATION MAILING ADDRESS, IF DIFFERENT OROVILLE BUTTE CA 95966 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 04-1413 530 538-7541 BUILDINPERMIT NO. TELEPHONE NUbffiER S A OF LOCAL ENCY OF CIAL DATE NAME (if not a dealer sale, write "NONE') NONE DEALER LICENSE NO REDMAN HOMES INC. 2004 SILVERCREST CLASSIC MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAMUNUMBER 11830034A/B 60'X 26'8" ORE455957/8 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNIAILABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION SEE ATTACHED ASSESSOR'S PARCEL NUMBER AP# 027-350-168 HCD FORM 433(A) REV. 8/91 •' o ORDER NO.: OD211686-001 -GW SCHEDULE C THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: TAT 10, AS SHOWN ON THAT CERTAINI MAP ENTITLED, "VALENCIA 'TRACT, SUBDIVISION NO. 1, BUTTE COUNTY, CALIFORNIA", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 11, 1913, IN BOOK 7 OF'NMYS, AT PAGE 58. AP NO. 027-350-168 • H.C.D. ATTACH CHECK NAME: AP#: DATE: �Y- r 1 A 1 A ;, .�(i � o _.h 11lIIIIlIII�IIIllllllllllli�ll�l I • ' RECORDING REQUESTED BY t dwe I I I laki 2��4--a/Lt�r0Ea224 Recorded I REC FEE 13.00 Escrow Number: 1201-10897- . Official Records I '�}• a County Of I TSE AND WHEN RECORDED MAIL T.0 ; - CANOACE J. 6RUB65� I Recorder I SUSAN E. STOCKS ROSEMARY DICKSON IAssistant i Mark 1570 Cox Lane, 09:00AM 0446-2W4 I Page 1 of 3 " ;;. _Oroville, CA 95966, t,Jar, SPACE ABOVE THIS LINE FOR RECORDER'S USE GRANT DEED y The undersigned grantors) declare(s): Documentary transfer tax is $0.00 -.=City Transfer Tax: $0.00 f I (�) computed on full value of -property conveyed,, {^) computed, on full value less,value of.lieni ^rn encumbrances remaining at time of sale. FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, SUSAN E. STOCKS AN UNMARRIED WOMAN WHO ACQUIRED TITLE AS SUSAN JOHNSON, AN UNMARRIED WOMAN Hereby GRANT(S) to SUSAN E. STOCKS, A MARRIED WOMAN, AS HER SOLE AND SEPARATE,• PROPERTY all that certain real property situate in the County of Butte,.State of California, more particularly described_ as follows: SEE SCHEDULE C -ATTACHED Dated: January 22, 2004 HERETO AND MADE A PART HEREOF 4. a MAIL TAX STATEMENTS .TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE SAME AS ABOVE ' Name Street_ Address City &_ State Page 1 of 2 - 1/22/2004 ` 0,.10=D=&ao<(7n0o ) y.- SIGNATURIr PAGE FOR GRANT DEED r SUSAN E. STOCKS STATE OF CALIFORNIA COUNTY OF On before me, _ �� U V 1) 60, personally appeared e (or proved to me on the basis of satisfactory idence) to be the person(s) whose name(s�are subscribed to the within instru nt an acknowledged to me that he they executed the same in his#re /their authorized capacity(ies), and that by his�te�r their signature(s) on the instrument a person(s), or the entity upon be`fialf of which the person(s) acted, executed the instrument WITNESS my hand air d 1. 7- Signature: n Oao V NOTARY Pu9uC-CAUFORNIAO SUTTER COUNTY Q COMM. EXP. OCT. 15, 2001'" MAIL TAX STATEMENTS TO PARTY SHOWN ON FOLLOWING LINE; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE Name SAME AS ABOVE Street Address Page 2 of 2 - 1/22/2004 City & State BUILDING PERMIT NUMBER: 04-1413 Address or location of unit: 1951 COX LN. OROVILLE, CA. 95966 Legal Description of Real Property: 027-350-168 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: SUSAN E. STOCKS Owner's address: 1570.COX LN. OROVILLE, CA. 95966 INSIGNIA OR HUD NUMBER: ORE455957/8 SERIAL NUMBER OR V.I.N.: 118-30034A/B MANUFACTURER'S NAME: REDMAN HOMES INC. YEAR: 2004 r OFFICIAL APPROVING INSTALLATION:-- DATE: 64- PHONE: 4PHONE: (530) 538-7541 H.C.D. 513C r r„ STATE OF CALIFORNIA BUSINESS, TRANSPORTATION AND HOUSING AGENCY`4 DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT e� DIVISION OF CODES AND STANDARDS n REGISTRATION AND TITLING PROGRAM STATEMENT OF FACTS This unit is a: �obilehome 0 Commercial Coach 0 Floating Home 0 Truck Camper Decal (License) No.(s) Trade Name Serial No.(s) I/We, the undersigned, hereby state: I/We further agree 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. Executed on . % O �[at 2dy i L L � (Date) (City) (State) Signature(s) Printed name(s) Address 60 0 State C / Citye ��/ Jun•23. 2004 12:52PM SHOWCASE HOMES No -2307 P. 2 STATE OF CALIFORNIA ' •.. .: i'' , NUMBER: BUSINESS, TRANSPORTATION AND MOUSING AGENCY DEPARTMENT of HOVSING AID d6MIdlINRY'DEVEEOPMENT• 86238 -36 •: a. .. _ DMSION OF COOES'AND STANbAKD§,:-: :: .; .. •-5;.: .. MANUFACTUREOMOUSINGPROGQAM . . . >t. -MANUFACTURER CERTIFICATE' aPOR1SIN Fo CHECK IF THIS IS OUPLLCA MCQ"TER ORIGINAL MCO NO. mANUFACTl1gFn HOME Oft MMTI- JNIT AIANUFACTA)REO HOUSING SFASy)AtG�E�FAMILYLDYVWI) MANU,FACTUREO,NOUSING: TRANSPORTABLESECTIONS NU Z- .;JgIU�Ati(MULTI .UNIT _ 0OCtlPAi11CIV GROl1P: r-� wi'. :'MMUFACTMERNME........ ........• _:.....:. ............. .........:..... .........:........... .............-. .._. . MAN UFACTURER•LICENSFNUMBER: L� �M A 00 44 O I'bt N� r� c� O FACTURER ADDRESS: � -' p I. i t'a' i i L �...Sr . c�)E e �� SUGGESTED RETAIL PRICE: Palo) MANUFACTURER TRADE NAME: MODEL NAME ANDJOR NUMBER: DATE OF MANUFACTURE: ('4AImftw hOME5 6F zc7vX) �Vt' fS T 11'1 -Ass ie• NSZZL �l --13 — G NAMSIDF:WALER OR•TRANSFEREE-(OWMERSHIPTRANSFERRED'T.0): • - . CALIF. OEALER NUMBER- OR ' ' . ; ' • - DATE- OF TRANSFER ": o Dpi , y AJ- L' �tY.�;s,�ir TRANSFEREE DESIGNATION: DEALER OR TRANSFEREE ADDRESS: C'A 5 o (Zip) INVENTORY CREDITOR NAME: INVENTORY CREDITORADDRESS;' I'• i r.S(Ciry �vc.��s lvl v l-, 310-5 SECTION / MANUFACTURER SERIAL NUMBER NCO INSIGNIA OR /IUD LABEL NUMBER LENGTH cws) WIDTH (INCHES WEIGHT POUNDS l O 3•v.03116 O!. 41 c 220 6- U 30,00C TRANSPORT TRANSPORTER ADDRESS: 4 �l r6 6 fi C Sl�eel Will) is., DE9T9W7101,1 FOA UNir oESCR®ED A6OVE: I ON*ualac praky d mr "urAw 01a ba" 01,90.SlAs d CaNemo tl+a11M above lads as eta .ue owea Emadeden &1z-1 o�l' 5w J Ee-m� 124UA1 - /J �� C i—�0� (City) •!- -' � � late) SIGNATURE OF AUTHORIZED AGENT: 7" OISTRgU t ORIGINAL. (PIM() . '-fORVOM TO THE INVENTORY CREO114d. UMLE33 •THERZ IS NONE, •THEN.F.OR%%W TO TNE.PURCHASER (DEALER OR TRANSFEREE). COPY I (YIMITE) FORVIIARD TO THE OEPAA tKMT AT P.O. BOX /525, SACRAMENTO, CA VNI2•I525. WITNBI FNA (3) DAYS OF RELEASE. COPY 2 (YELLOW) OEUVER TO THE TRANSPORTER TO ACCOMPANY TINE UNIT TO ITS DESTINATION. COPY 3 (GOLDENROD) TO BE RETAINED Or THE MANUFACTURER. MCD 483.0 _ Shia T - (7/97) LEGAL DESCRIPTION A.P. #: 027-350-168 All that certain real property situate'in the County of Butte, State of California, described as follows: BUTTE COUNTY ,DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT, 24 HOUR INSPECTION #: (530) 538-7636 (OROWLLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.neAdds J h PERMIT NO. BP042716 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under r provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 10/04/2004 APN• 027-350-168-000 the Business and Professions Code, and my license is in full force and effect. ' License Class: License Number: Site Address: 1951 COX LN ORO Date: Contractor. Map Index: Description: CARPORT(480) & COV(160) 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: JOHNSON SUSAN permit to construct, alter, improve, demolish, or repair any structure, prior. to its issuance, also requires the applicant for such permit to file a 576 PALMS DR signed statement that he or she is licensed pursuant to the provisions of 'MARTINEZ 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 94553 ' she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the " applicant to a civil penalty of not more than five hundred dollars ($500).): y ❑ 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: BALAZ, HAROLD Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, PO BOX 347 provided that such improvements are not intended or offered for PALERMO, CA 95968-0347 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). j I, as owner of the property, am exclusively contracting with —� licensed contractors construct the project (Sec. 7044, Business and Professions Code.e. 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.). O 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: License #: 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. ❑ I have and will maintain workers' compensation insurance, as Engineer:•.-..-•- required by Section 3700 the Labor Code, for the performance of - the work for which this permit is issued. My workers' compensation e. insurance carrier and policy number are: Carrier: Total Square Ft: 640 S. F. , Valuation: $10,240.00 Census Code: Policy#: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, / and agree that if I should become subject to the workers' / compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. v Date: Applicant: + WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. ' CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code ?nrvor I hereby affirm that there is a construction lending agency for the Resoluti s doawork indicat d ab for w ich fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) A O Name: B Date: Address: PERMIT EXPIRES ON: (D*e) ❑ 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 apy official form or document of Butte County. I hereby authorize representa 'ves County to ter upon the above mentioned property for inspection purpose Ztte Print Name: Signature: ��nn Date: r 6 'Agent Owner ❑ Contractor 11 for Owner 13 Agent for Contractor r BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTIONM OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Last Name irst Name Address 5 l CityI ► `aA�\a.Z State Zp /1 LT `tom Phone Fax E-mail APPLICANT NAME O TRACTO Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner Lic. 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 WaAa-,4af :za� Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Property Address 1!15--1 04� Flood Zone Cross Street SRA I Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERA IRT NO. :'off P -W1111 LOCATION Property Address 1!15--1 04� City Cross Street WORKER'S COMPENSATION Policy Number , Carrier h`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 De cripti n or Scope of Wo k: Sq. Footage C D ❑ Structure Built Ivithout 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 IL K:\FORMSIBUILDING FORMS\BldpApplSubRgmts.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. ReceivedQW___ Amount: 1X 10 . dD Bldg (�JJ�� SRA Receipt #: 4Irr)4�TV'' Sheriff SMIP Date: 1 v ` ctl 1 s O ( Other � r - t- Total REV 7-27-04 r 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 /N INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paperl ❑ 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 bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). — ❑ 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 regarding this process, contact a Permit Application Assistant at (530)538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Ketunos 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 KAFORMSSUILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 • COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES-BUILDING-DIVI.SI /N 7 County renter Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. PERMIT APPLICATION DATA SHEET OWNER: 21. ' ) ASSESSOR PARCEL NUMBER Proposed Building Use: Counter Technician: Date: / U L+/ Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. '111 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. . �-- 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 0 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 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... 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 33. Recorded copy of Agricultural Acknowledgment Statement ................................. 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 1 ❑ 13. Detached Accessory Building Form filled out by the owner 38. 14. Hazardous Material Form ",���po•,. 39. 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............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ ❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Fore try plan approval ❑ paid. Sent by: C/ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: oE�L CO- -ay C ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... ❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization ...................................... :............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ 35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone S _ and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: A Date: 47-)-- k `5 C) 1. Index permit al pli`oafion for the above items numbereb: Plan Check Letter 2. Additional items required %,0,U_d ! • Contractor, designer, owner, was advised of the above data by phone, ❑ mail, ❑ counter, by Date: 2 -FVX .0 " Contractor, designer, owner Was,.advised of the above data b ❑phone, ❑ mail, ❑ count r by Date: Plans reviewed by: Date: Plans approved by: l Date: (0 • I - 0, Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division E. Uki SE CAi4Y 9iot Plan dttechod Floor Ma Attachad�" --,fyp,-�, • ti^ 3on:to ®.D. / TO: Building Department FROM: Environmental Health - SUBJECT: Sanitation Clearance ' Owner Location AP#\ Plan Approved for: Sewage Disposal--- Water pply: Public PrivaI el� Clearance for dwelling. Other , Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist 8/96 Zal< q D to Department J. Michael Crump, Director of 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 ILESS THAN 1 ACRE Project Description: Project Location and/or Parcel Number: 1 �Z�l C-cw,) 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. Signed: % &'1I Title: Date: Less than 1 Acre NPDES & SWPPP Compliance Certification Butte County storm Water Management Program r Butte County Department of Development Services www.buttecounty.netldds 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538.7785 Facsimile October 21, 2004 Harold J. Balaz Dorothy J. Balaz PO Box 347 ' Palermo CA 95968 RE: HCD 433A (mobile home on a permanent foundation) Susan Stocks, 1570 Cox Lane; Oroville CA Ap# 027-35.0-168 Dear Harold Balaz; The County of Butte, Department of Development Services, Building Division, is returning your check, payable to HCD due to incomplete permit process. Due to the incomplete information on your permit we are unable to finalize the 433A (mobile home on a permanent foundation) process. You will need to come in to our office, at the address above, and talk to one of our Permit Application Assistants, who will assist you in determining what you will need to finish the 433A permit process. The recorded 433A, check, and supporting documentation must be mailed to the State of California, Housing and' Community Development, Manufactured Housing Department before the mobile home can be removed from state license rolls and the Butte County Assessor treating the mobile as real property. If you have any questions regarding this'process, please call (530) 538-7541, and ask for a Plan Application Assistant. Thank you, Gwyn Benedict Office Assistant II H.C.D. ATTACH CHECK '. r)"CA1 l NAME: AP#: DATE: H.C.D. ATTACH CHECK 1j LVEWC07EA5F Classic Optional 3rd Bedroom Model 4522L 26-8x52 - 2 Bedroom, 2 Bath - I-Wsq.ft. Proudly Produced by cHampion HOMES OF OREGON www.championoregon.com O.B.- I OWNER=BUILDER VERIFICATION 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. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES ❑ NO ❑ 2. I HAVE 0 � HAVE NOT 'gned 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: may. 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 SIGNED: PROPERTYOWNE)Et:k,-_" DATE: NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the ,California Health and Safety Codes This verification must be' completed and returned to our offue before we are permitted•to issue the permit OVER O.B.- I I OWNER BUILDER INFORMATION � 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 ofrecord 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 seveial 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, iLU� CI 1 C. Vi ira, C.B.O. M ger, Building Inspection NOTE. This Owner-Builderlnformadon is required by Section 19830 of the California Health and Safety Code OVER Untitled. February 21, 2004 1 give my permission for Harold Balaz to sign on my behalf for the construction of my home at 1951 Cox Lane, Oroville,, CA. Signed: Date: a -� I C) f ENVIRONMENTAL HEALTH S I T EE PLAN :.....:............._....._......:.. .. :r..::......_.....:......:......_............:......_....._.... ... ...........---......... 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I�:. ..:. .. .. .... .. .:.. .. t.. ..:.. ..:.. ..:... ............. .. ... .. ... .. .. ... .. .. ... .. .. ... .t.. 3 � . .. ... .. .. .. .. .. ... .. .. .. .. .. ... .. .. .. .. .. .. .. ............ = .................. .. .. ... .. .. .. ................._.... .. .. .. .. .. .. ... .. .. .. .. ... .. ..................... -4• bb / ... .. .. 4 .. ... .. .. .. .. .. _ ... .. .............. .. .. .. .. ... .. .�.... .. .. .. .. ............. .. .. .. .. .. .......... .. .. ... .. .. .. .. .. .. .. ... .. .. .. .. ... .. .. ... .. .. ... .. .. ... .. .. ... .. .. ... ..... .... .. ... .. .. _ .. .. ... _ .. .. .. .. .. .. .. ... .. .. .. .. .. .. .. .. ......,_ .. .. .. ... .. .. .. .. .. .. .. .. .. ... ................... .. ... .. .. ............. .. ... .. ............ .i♦YWt!M.�Na Assessor's Parcel Number. ® ®1Z — RISI ® — PU=Scale: 1" _ ( 6\3 T TF Owner Name ��a _°°- Address/ Phone No. Site Location - E Contact: Name 10' Phone 7 %)w fz, Oct, 23, =13 Zoning: General Plan Desig: Size, Acres A — - - 4.00" PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING:" GEN PLAN: USES: 027-350-168 01-1 19AG JOHNSON, Susan Cox Ln., Oroville AG Ex Permit -Hay, Livestock & equip AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DMSION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2000-0037709 Recorded I REC FEE 7.00 Official Records I CONFORM .00 County Of I BUTTE I CANDACE J. GRUBBS I Recorder I ROSEMARY DICKSON I Assistant I Cindy 03:21PM 28 -Sep -2000 I Page 1 of 1 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: ORDER NO. BU -177461-3 DESCRIPTION THE LAND REFERRED TO IN THIS REPORT IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS: LOT 10, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "VALENCIA TRACT, SUBDIVISION NO. 1, BUTTE COUNTY, CALIFORNIA", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON AUGUST 11, 1913, IN BOOK 7 OF MAPS, AT PAGES) 58. /, APN 027-350-168-000 Date PROPERTY OWNERS: State of California County of Butte On 9/28/00 before me, C. Cramer, Notary Public personally appeared Susan E. Johnson 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 hetshetthey executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal Signature Seal: U. Uramer A.P.# 027-356-/68-000 C. CRAMER COMIL In ZN t)6 Mk CP31 Nasmmft ilt cm*, C ftlft W Comm hp, JULY 12, 2009 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. ol:� Agricultural building is defined as follows: Agricultural building is a structure designed/shallonot ucted to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structurbe a placeof 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. d ZONING OWNER PHONE NO. OWNER'S ADDRESS °'1 C o � d t q, LOCATION OF BUILDING ^ oo Ff i D n -r4 � Cox az F e� D�lc-/- ds`rN 6 USE OF BUILDING SIZE OF STRUCTURE QQv//,,,, 0� X'= v gSQ.FT. TYPE OF CONSTRUCTION: WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF SIDING' RO F COVERING FLOOR TYPE ESTIMATED COST OF CONS TaCTION .40 AG Buildings shall comply with the minimum front, side, and rear yard setback requirements of the applicable County Ordinances as follows: ` tom✓ 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 about, and the purposed use confirms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date ( o''-�'` _fS23 Permit Fee - $60.00 Receipt No. Signature of Owner The above described AG Building is exempt from a building permit. Manager Building Division 3f��1/ Date White — DPW, Yellow ssessor, Pink- I., G� o{ d nro ka r/ LAND DEVELOPMENT BUILDING /ENVIRONMENTAL HEALTHY PERMIT CLEARANCE Bumng Permit No. ����E13PwM t �El_lE A.P. OWNERS NAME: NUMBER: G—CSG' PRINT LAST NAM T v q COUNTY ZONING DESIGNATION:_A5 /s 5- X FLOOD ZONE: FLOOD MAP: 4 1 B APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS OR MAP "X LANE DEED INFORMATION: DATE OF CREATION: DEED REFERENCE: LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO COMMENTS/CONDITIONS: MAP INFORMATION: DATE OF RECORDING I<--) ) LOT, is 1 %D n -C- V oatL- Eli- c -A,- Tnae r— BOOK "7 PAGE 5 6 COMPLIANCE WITH OLD SUBDIVISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR JO BOOK 17 OF MAPS AT PAGE 23): YES _ NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW: > 5 A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BU/LD/NG DIVISION UNLESS OTHERWISE NOTED. 1. Maintain a 50 ft. building setback from centerline of road. 2. Maintain a ft.building setback from right-of-way/centerline of 3. Maintain a 100 ft. leachfield setback from all existing wells. 4. Maintain a ft. leachfield setback from 5. Pay water tender fees in the amount of S to Battalion Number of the Butte County Fire Department. 6. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. 7. Connect to a public water supply. 8. Connect to a public sewer system. _ 9. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the 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 Fire Department specifications, serves the parcel. 10. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $ _ 11. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) _ 12. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010. USE PYLY Plot Phm Att+ched Now Phm Amehed Seat to B.D. / TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance / � ec, l !.Cly �a�" �- Owner Location Plan Approved for: Sewage Disposal Water Supply: Public Clearance for bedroom 10wwbm. Other Hold /final for: for: It - Environmental Health 4/a) 0 a1 -3s0 -!(�8 APAP Private Well 1 ��l ^i 120' 140' `' 160 E.H. USE ONLY Plot Plan Attached Floor Plan Attached -710 Sent to S.D. TO: Building Department FROM: Environmental Health SUBJECT:. Sanitation Clearance Owner Location AP#. Plan Approved for: Sewage Disposa Clearance for dwelling. Other Water Supply: Public Private Well ' Hold final for: bi t h Final clearance O.K. for: MOTE: c Environmental Health Specialist Date 8/96 200'r;-- �+--•--...� -�--� �T r r i—i-1, . 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Assessors Parcel Number: Owner Name Address / Phone No. Site Location Contact: Name _ ^©M r--3-polM MM. ► J,T.M, 1 af- I i H1 Oct"w 21 M FOR OFFICE USE ONLY Zoning: General Plan Desig: Size, Acres 4.00" _ — i PROVIDE FOR ALL ADJACENT PARCELS SIZE (AC): ZONING: GEN PLAN: USES: CDF FIRE SAFE REQUIREMENTS 027-350-168 BP -04-1413 Susan Stocks APS PERMIT # NAME 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 will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. [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. CDF FIRE SAFE REQUIREMENTS 027-350-169 BP -04-1413 Susan Stocks AP# PERMIT # NAME Fuel Modification 1276.01 Setback for structure Defensible Space Pq 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. pq 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 Bwlding Setback is Less Than 15 Feet Class A or B roof with enclosed Eaves and: Choose any 2 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 Io% 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 6 -1- Q)I, Date 2 U U J H 7 T b r� 0- 00 El 1 011 am LOOM 41'-4' w` 41'-4' 35'-1}• a w+ outer v 14,900 100 =-----------..r_-----------------------------------------------------` ' --------------------------------- �— 42 27'-2#' " r.- LL G) mmoo_ oto a NOTES; I. THIS FRNT 15 TO BE USED FOR LOCAM or WAYN UNE PIER BIOMNO M0 UT1UTiES MD Is SVB M TO flu• 2. SEE THE RM" IMALLA7 0[r 1yWIm FaR sm ma mr-4JP RE4UFI am 3. SMENT WST 6E. MWO U f A KM-MRED UCNM. ' 0" QA� s ---------- --=--- -- - t • t Serial #30??? 4522L-93 72„ -A 241'- 560th - Customer: Stocks ' ata SLVEM - "a SHT I (D Fit ur-am KAT DUCT C !SSM AER BLOOM KmEt ply REV er.,m 4stvwEsT cw sid III C� Sy U. Building Permit Number: d q_ 1413 ' Owner Name: Residential Construction Requirements IMPORTANT This set of plans and specifications MUST be kept on the job site at all times and it is unlawful to make any changes or alterations on same without written permission from the Building Division, County of Butte. All materials and workmanship shall be in accordance with recognized good practices and of a quality prescribed for the specific use in the 2001 California Building Code (2001 U.B.C), 2000 California Plumbing Code ( 2000 U.P.C.), 2000 California Mechanical Code (2000 U.M.C.) and the 1999 California Electrical Code (1999 N.E.C.) COMPLY WITH ITEMS CHECKED BELOW Your parcel lies within a designated 100 -year flood plain. Finish floor, electrical, H.V.A.C. equipment and services shall be a minimum of one foot above the elevation shown on the attached Flood Elevation Certificate. A Post Flood Elevation Certificate ` will also be required ce with the flood elevation Note: We will no accept the following as compliance requirements: ' chored to concrete L Building is an stemwall system with conventional anchor bolts. 2. Building plate on top of stemwall to be one foot or more above the 100 -year flood elevation. (Plate height less than 24" above grade, or engineered design required). 3. Electrical, heating, ventilation, plumbing and air conditioning equipment and facilities located above the plate. 4. At least 2 openings in exterior walls, located on opposite or adjacent walls with a total net area of not less than 1 square inch for every square foot of enclosed area. 5. The bottom of the openings shall be no higher than 1 foot above grade. 6. The openings may be screened or covered with other devices that will permit k automatic entry and exit of floodwater. f h Page 2of 2 Building Permit Number: 0 4 -1 L[ 1 3 Owner Name:G%b Parcel lies within the State Responsibility Area (SRA). Comply with attached requirements. Fire sprinklers are required in this structure. 0 The following parcel map requirements shall be met: All structures and equipment including overhangs shall be clear of all easements. A setback of :t feet from the side and �Q feet from the rear property lines and 20 feet (25 feet if Federal Aid Route) from the edge of the right of way shall be clear of structures and equipment except for a 2 foot overhang. Expansive soil may be encountered on this site. This condition may require the foundation to be designed by a California registered engineer or licensed architect. - OCT -29-2003 14:24 CHAMPION—SILVERCREST 5038732389 P.04iO4 SHOWCASE SUSANSTOCKS 452 io9 HKemks 2 P t 110 107 MMJRks pf" tog TYAxks hire 109 Meier Im 110 Hs"P Mary CMNlaf 111 GFI 6/1A 112 JAMES HARDI PANEL EXT W/ ROOF, 12" FDS EAVES, 11" GABLE END OVERHANG A 30# ROOF 113 2X116" OC EXTERIOR WALLS, MOEN FAUCETS, ROCKER SWITCHES. ILS PAD, TILE TUB TRIM I 114 MEDICINE CABINETS RECESSED PER PLAN I 116 CLASSIC PACKAGE PROMOTION (CLINK) 11f TILE ■ACKSPLASH BEHIND RANGE I 117 OAK VENEER SIDE PANEL CABINETS TIO 111 1' STRETCH LIVING ROOM i DINING ROOM 116 ENGINEERING FEES FOR STRETCH 120 GAS PACKAGE INCL GAS WATER HEATER, FURNACE O RANGE 121 UPGRADE HIGH EFFICENCY GAS FURNACE ( REQ. W/ HINGED ROOF SYSTEMS) 122 PLUM FOR GAS DRYER 123 ALL BREAK AXLES FOR CA DELIVERY (DOT REQ) 124 OMIT MBR CLOSET ON STUDY SIDE 125 BR112 TO BE STUDY 129 COMBINE BRM WARDROBE AND MBA WARDROBE SPACE TO CREATE NEW MBR CLOSET PER PRINT 127 CONVERT STUDY TO BR42 W/ WARDROBE, DOUBLE DOORS TO FOYER, OMIT HALL ENTRY 121 9 112'SIDEWALLS, HIGH FLAT CEILINGS,1112 ROOF PITCH i STACKED WINDOWS T/O 129 COTTAGE PORCH OPTION ON 6112 ( PORCH TO BE !0" SIDEWALL HIGH) 130 ADD ADDITIONAL 45X10 WINDOW TO WING ROOM SIDEWALL 131 EXCHANGE LR ENDWALL WINDOW FOR 46X51 HIGH DIVIDE WINDOW 132 ADD ADDITIONAL 46X51 HIGH DIVIDE WINDOW TO LK ENDWALL AND RECENTER BOTH 133 EXCHANGE KITCHEN WINDOW FOR 46XS1 HIGH DIVIDE WINDOW OVER SINK 134 EXCHANGE MBA TUB WINDOW FOR 4SX31 SAFTY HIGH DIVIDE WINDOW 135 ADD CROWN FEATURE MOULDING TO KIT, LIVING ROOM i DINING ROOM 131 GAS COOKTOF i DOUBLE EYE4.EVEL OVENS 137 TIP -OUT STORAGE 0 KITCHEN SINK 131 BREADBOARD IN ADDITIONAL BANK OF DRAWERS LEFT OF RANGE 139 4 CAN LIGHTS EXCHANGE FLOS IN KITCHEN 140 2 WALL SCONCES IN MOR, REPLACING OVERHEAD LIGHT, DDITIONAL SCONCE IN HALL Thank You 1. Owner's Name: 2. Assessor's Parcel Number:-- a a 7 3 SO - 3. O 3. Installer's Name: 4. Is the site currently under permit? Yes[ ] No[�ermit No. 5. Is the site an existing site? Yes[ ] No[ ✓j (If yes, furnish two plot plans). 6. What is the electrical rating of the mobilehome?�, Amperes. 7. What is the mobilehome site circuit breaker rating? 200 Amperes: r E. What is the electrical rating of the mobilehome site? ZD Amperes. 9. Is the main service remote from the mobilehome site? Yes[ ] No[ J If it is, what is the rating? Z-00 Amperes. 10. Is*there any other electric load to be served by the mobilehome site electric service ' (Le. well, garage etc.)? Yes[ ] No[ ] If yes, please identify the load and size: a) The mobile home site: Load- 1� Q _Q_ Amperes- Z� b) The main service: Load- Amperes - 11. Type of gas service at mobilehome site: Natural[ ] Propane[ ] None[ ] - 12. Size of as pipe at the mobilehome site from the meter or tank: inches. 13. What is the gas pipe length from the meter or tank to the mobilehome?�(ft.). 14. What is the mobilehome gas demand? B.T.U.* *(This information is not required if the pipe length is less than'b feet on natural gas or less than 50 feet on propane). THE OTHER SIDE OF THIS FORM MUST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION CGUZ4 1 ' r3 ,NG DEP 6'R 0, P May 1995 =•S -? tm I o' II V ,. Irl = k ei, 0 - MobilehomeManufactorer: 411U.CKCrt-a_L- -Man yfacture Year: 26 0 If other than single wide, furnish Setup Model Number:— If 6 - Width: CP6 V (ft.) Length:_&fTagalong or Expando SizeL' (&) x On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets. FOOTINGS: Wood pressure t7rea,Other: or foundation grade Imer: SUPPORTS: Concrete block[ Provide Tie Down Specifications for all Mobilehomes: Pier.Fobtings SINGLEWME and Location Line I Lime 2 ..................................................... Main Beams Line2— ..................................................... Line I MULTI -WIDE *I Line 2 ....................................... .................................... . 2 TL -.!,.e 3 Line 2 ..................................................... : ........................................... Main Beams ................................................................................................ ....................................... ........... ---Line 5 Tag or Triple ine 4 ................................................. el Line 1 Piers:, Size minimum: Spacing maximum: From ends-maximu Line 2 Piers: V Size minimum: x 1131. Spacing maximum: , C)L From ends -maximum i 1_' 0 Line 3 Roof Loads: Size minimum Location (from front) Line 5 Roof Loads: Size minimum: Location (from fr tlt P Line 2 Line I Line I Openings Size minimum: I 1x[ I Each side of openings with width over: C 4 7.1 Line 4 Piers: Size minimum: ]XI I Spacing maximum: From ends -maximum, I OVER a 2 OR 4 2 2 TYP. is PERIMETER ---------------i r------------------------------------------------- ----------------------------------------- 4-4-- L--J ----------------------------------------�L--J L --J L --J L --J L --J L --J L --J L__J L__J V I I 42'-6 3/411 2OR 2 2T -21/411Q i II A II UNIT TYP. A INTERIOR — — -- -- 191-4 I/2" I Lu I L _J L—_J L _J L__J L__J L__J L__J L__J L__J I I j I < �_--� 11600. V— 3,300 I 18,300 1 ♦ / 114,900 ---T ---� �— ---�, i I� /19,900 I� /111600 1♦�/ 1♦ /I I - - - - - - —i /-�-1— - - - - - - - ��- - - —I - 1--- - - - - - - - - - --1- --- - - -� —F - � -- ---y I/ ♦ I/ ♦� I I � L__J L__J L__J L_ J L__J L__J L__J L__J L__J I < I 2 , j 6' I Q II II b MAXIMUM TYP. FOOTING PAD CENTER UNDER FLOOR GIRDER �— , UNIT ' cn SEE "TABLE II" FOR SIZE _L --J L—_J L --J L --J L --J L --J L --J L --J L --J I I I I ---------- j FOUNDATION PLAN FOR "SILVERCREST CLASSIC" 4522L 93 1/411=1'-O" LEGEND 3,300 MAXIMUM PIER LOAD - SEE SHEET 2 "TABLE i" FOR SIZE I� /I MARRIAGE PIER - NOT SHOWN TO SCALE a+�iT� Co�r�i 1 lU1LDING DEPART[ -,;, APPR0Vrz ch Z: a C-� a 00 E'o � U � N a O H LO 10 O O y— O 2 cc M O U O N H C) U p O c- 0 N N U L O O L. .... C O 5 r�� * V C •lam LIJ V Y Sv V W W a � N � Jazo aQa�- W m J J 0 x< SOU z�vw 04rJ a=�5 0 O z a: :3 0 O LL Design: JMR Checked: JMR Date: MAY, 2004 Job No. Sheet% 1 of 2 Sheets CONSTRUCTION. NOTES: GENERAL CONDITIONS: 1. The Contractor shall verify all dimensions and details prior to construction and notify the Engineer of any discrepancies. 2. All construction and methods shall be in strict conformance with the applicable provisions of the California Building code, 2001 Edition, and the latest edition of the UMC, UPC, NEC, and applicable municipal, state, and Federal regulations 3. All work is subject to building department field inspector's approval. 4. The contractor shall provide all measures necessary to protect the structure, workmen, and all other persons during construction. FOUNDATION: 1. The Contractor shall be responsible for the location of all underground facilities or other buried objects which may be encountered but which are not shown on these plans. Locations and depths of any existing utilities that may or may not be shown on these plans they are approximate and may not be complete. 2. Foundation design is based upon an assumed soil bearing capacity of as determinetd by local Building Department or soils report. 3. All excavations shall be inspected and approved by the Building Official before concrete is poured . Footings shall be at least 12 inches wide, and extend at least 12 inches into the prepared pad, or as directed by the Engineer, whichever is lowest. Engineered fill may be used as existing grade provided tests are presented to the Engineer of a 90% relative compaction. 4. The bottom of all footings shall be level. 5. The Contractor shall be responsible for determining the exact location of all anchor bolts, holdown anchors or straps, and embedments, prior to placement of concrete_ __ 6. Anchor bolts to be 1/2" diameter X 10" -tong with 7" embedment into concrete spaced at 6'-0" o.c. maximum unless otherwise noted on plans, shearwall schedule, or details. Bolts shall be located within 12" of each end of 2x sill plate with a minimum of two anchor bolts per sill plate. 7. Any unusual soil conditions such as organic soils, clay pockets or uncertified fills shall be brought to the attention of the engineer prior to construction. S. Clean footing excavations of debris and loose soil prior to placing concrete. 9. Slope the ground surface away from footings to direct water away from the foundation and prevent water ponding next to the footings. Provide 1, per f dot slope away for 6'. 10. Provide an 18" x 24" under floor access. if. Wall stems may be 8" cmu with all cells grouted with $4 a 24" o.c. horiz. and vert. or Co" wide concrete. 12. Provide 6" x 14" screened under floor vents per code CONCRETE: I. All concrete shall have a cement factor of 5 sacks per cubic yard, a maximum slump of 4" and a minimum fc=2,500 psi after 28 days curing unless otherwise noted. 2. Vibrate concrete around all bolts, rebars and surfaces. 3. Construction joints shall be clean and wet prior to pouring concrete. 4. Aggregate size shall be a maximum of i-1/2' in foundations and 3/4" at all other locations Curing compound shall be sprayed on all exposed surfaces immediately after final troweling. 5. Ail cement shall conform to ASTM Standard C-150. All aggregates shall conform to ASTM Standard C-33. 6. Unless shown otherwise, the minimum concrete cover for reinforcing shall be 2" except when concrete is to be placed directly against earth where it shall be 311. WOOD: 1. All wood bearing on concrete shall be pressure treated Hem -Fir 2. Holes for bolts shall be bored with a bit 1/32" to 1/16" larger than nominal bolt diameter. 3. All bolt heads and nuts against wood shall bear against 2" x 2" x 3/16" steel washers, unless special washers are called for on plans or details. STEEL: 1. Reinforcing steel shall conform to the provisions of ASTM A-615 Grade 40 for 04 E smaller, ASTM A-615 Grade 60 for *5 bars and larger. All rebar to be deformed and ail splices shall not be less than 50 bar diameters of the larger bar. Horizontal laps in adjacent bars shall be staggered V -O" minimum. 2. Bolts and nuts shall conform to the provisions of ASTM A307, Grade A. TABLE I PIER BASE OR POURED IN-PLACE CONCRETE FOOTING DIMENSIONS MAXIMUM PIER LOADS (LBS) SEE NOTE I ALLOWABLE SOIL BEARING PRESSURE = 1000 PSF 1500 2000 2500 3000 3500 4000 4500 5000 FOOTING SIZE 16" x 14" 16" x 18" 16" x 23" 16" x 27" 24" x 21" 24" x 24" 24" x 27" 24" x 30" MAXIMUM PIER LOADS (LBS) SEE NOTE i 2x4 PONY WALL 6000 7000 8000 9000 10,000 11)000 12,000 13,000 FOOTING SIZE 30" x 29" 30" x 34" 32" x 36" 36" x 36" 36" x 40" 36" x 44" 36" x 48" 36" x 52" 1`t,y00 tv : L�gY x'}8", ec,�t .rnnerr,Je 1'ar (Zi U'� G l cv�� �un� i%1 -10c)4 NOTES: k06 -J- 1. SEE FLOOR PLAN FOR MiNIMUM PiER CAPACITY UNDER RIDGE BEAM SUPPORT POSTS. 2. LARGE SUPPORT POST LOADS MAY REQUIRE DOUBLE PAIR APPLICATION (SEE DETAIL A ON MFG. PLANS) CHECK MAXIMUM PIER CAPACITY WITH METAL PIER MANUFACTURER. TABLE I[ FOOTING SiZE FOR INTERIOR PIERS ALLOWABLE SOiL BEARING PRESSURE = 1000 PSF ON -CENTER PiER SPACING PiER LOAD FOOTING SIZE ro 21320 24" x 13" 8' 28480 24" x 17" 10' 3553 s 24" x 22" 12' 4264 * 24" x 24" TABLE I[[ ANCHOR BOLT SPACING AT PERIMETER STEMWALL LOCATION OF ANCHOR MAXIMUM SPACING WALL LiNE BOLT SiZE OF BOLTS SHORT WALL HEIGHT OF RIDGE (Hridge) = 14.1 FT AT EACH END 1/2" D1AM. 34" ON CENTER LONG WALL AT EACH SIDE 1/2" D1AM. 72" ON CENTER NOTES: I. A MiNIMUM OF 2 BOLTS PER SILL PLATE ARE REQUIRED. 2. BOLTS SHALL BE INSTALLED A MAXIMUM OF 12" FROM END OF SILL PLATE 3. 2" X 2" X 3116" STEEL WASHERS ARE REQUIRED AT EACH BOLT. 4. EACH BOLT SHALL HAVE A MiNiMUM EMBEDMENT OF 7". 5. THE ANCHOR BOLT CALCULATIONS ARE BASED ON A PREMANUFACTURED HOME WITH A MAXIMUM LENGTH OF 70 FEET AND A MAXIMUM WIDTH OF 40' FEET AND A MAXIMUM WEIGHT OF 75,000 POUNDS WITH A MAXIMUM PLATE HEIGHT OF 8' AND A MAXIMUM ROOF PITCH OF 4:12. STRUCTURAL CALCULATIONS FOUNDATION ANCHORAGE FOR SINGLE FAMILY RESIDENCE BASED ON TIS 2001 CAIJFORNIA BUILDING CODE. GRAVITY LOADS: ROOF: COMPOSITION SHINGLES 3.0 PSF 1/2" 055 OR PLYWOOD 1.5 PSF FRAMING 3.0 PSF R-30 INSULATION (OPTIONAL) 2.0 PSF 5/8" GYPSUM WALLBOARD 32 PSF MISCELLANEOUS 13 PSF DEAD LOAD 14.0 PSF LATERAL LOADS: SEISMIC= 25 *036 *W = 0.164 W FOR LiGHT FRAMED SHEARWALLSi 55 WHERE R = 55 SOIL PROFILE = Sd FOR STIFF SOiL PROFILE Ca = 036 PER UBC TABLE 16-Q P = 1.50 E = P * VW 0.245 W (PER UBC EQ. 30-1) NET FORCE = 0.245 W/1.4 = 0.175 W WIND: EXPOSURE = C METHOD 2 WiND SPEED = 80 MPH Cq 13 qs 16A PSF Ce 0-15' = 1.06 Cq*qs*Ce = 0.0226 KSF I WEIGHT OF BUILDING (WT) = 75.0 K LENGTH OF BLDG. (Lbidg) = 70 FT WiDTH OF BLDG_ (Wbtdg) = 40 FT HEIGHT OF BLDG.. (Hbldg) = 8 FT HEIGHT OF RIDGE (Hridge) = 14.1 FT llf"1,4- RIDGE---' FLOOR PLAN SLOPE v 2 Wbldg ELEVATION PLAN .EL MAiN RAIL )D WEDGE SHiM B"x16" MASONRY BLOCK )1STURBED SOIL INTERIOR PIER DETAIL \ / N.T.S. MOBILE HOME BY OTHERS 2x4 TOP PLATE 16d NAiLS A 12" O.C. T l STEEL MAiN RAIL WOOD WEDGE SHIM 6"x8"x16" MASONRY BLOCK 2x12 PRESSURE TREATED MIN. OF 24" LONG OR USE "ABESCO" PADS INSTALLED PER MANUFACTURER'S SPECIFICATIONS UNDISTURBED SOIL ( *7 FOOTING DETAIL LATERAL FORCE PERPENDICULAR ars TO RIDGF WiND FORCE (Vwind) = Pwind * (Lb1dg/2)*(Hridge - Hbldg/2) Vwind = 8.44 K SEISMIC FORCE (Vselsmic) = (WT/2) * k Vselsmic = 6.6 K (WIND GOVERNS) ANCHOR BOLT SPACING (ABspacing) = 0.600K/BOLT * Wbldg/V ABspacing = 341 IN LATERAL FORCE PARALL-L To pinrTF WIND FORCE (Vwind) = Pwind * (Wbldg/2)*(Hridge - Hbldg/2) Vwind = 4.8 K SEISMIC FORCE (Vsetsmic) = (WT/2) * k Vselsmlc = 66 K (SEISMIC GOVERNS) ANCHOR BOLT SPACING (ABspacing) = 0.600K/BOLT * Lbldg/V ABspacing =166A IN USE: 1/2" DIAMETER X 10" ANCHOR BOLT 34 INCHES ON CENTER ALONG THE WIDT OF BUILDING 1/2" DIAMETER X 10" ANCHOR BOLT 72 INCHES ON CENTER ALONG THE LENGTH OF BUILDING x.IIOU` G N.T.S. X z< N N INTERIOR PIER DETAIL 12" N.T.S. MANUFACTURED HOME BY OTHERS 3/8" CDX OR EQUAL W/ 8d A 6"/12" OR 5/16" HARDIEPANEL SiDING WITH 8d HOT DiPPED GALV. NAILS to 6"/12" INSTALL PER MFG. RECOMMENDATIONS PLYWOOD SPLICE 3/8" CDX OR EQUAL W/ 8d to 6"/12" 4x6 RIM WITH VENT PER CODE 2x4 PRESSURE TREATED SiLL UNDISTURBED SOIL 1/2"x10" A.B. WITH SPACING PER TABLE III ON THiS SHEET WITH 2" X 2" X 3/16" THiCK STEEL WASHER F4 REBAR CONTINUOUS rOP E BTM. FOOTING DETAIL N.T.S. 6UTTE CODN I r �IUILDiNG DEPARTf EFt APPROVE FOUNDATION DESIGN CRITERIA THE FOUNDATION AND ANCHOR BOLTS SHALL BE DESIGNED 1N ACCORDANCE WITH THE '98 CBC AND DESIGNED FOR THE FOLLOWING MiNiMUM CRITERIA: WIND SPEED: 80 MPH WIND EXPOSURE: C SEISMIC ZONE: 3 2 co ©E U U_ a o v o o } o� 2 � ci p v o .� o � > W C14 CL_ :E 0 L. Nino Ln0 L Q r�V .._ 0 V ir W Q � N � J Q Z O U. 0 J W mJ Q aOxU ZJO O _V W E'J aQ0 �= z O � � O O U. ©FESSjp 0540 rn C3 C M c� 30 07 Design: JMR Checked: 3/8" CDX OR EQUAL W/ 8d A 6"/12" 2"x6"x8" PRESSURE TREATED Job No. OR 5/16" HARDIEPANEL SiDING WITH 8d1 Sheet - BLOCK WITH SHIMS of 2 Sheets HOT DIPPED GALV. NAiLS A 6"/12" 2x4 PONY WALL INSTALL PER MFG. RECOMMENDATIONS STUDS AT 16" O.C. 6"x8"x16" MASONRY BLOCK Zx4 PRESSURE TREATED SILL Sd GALV. 0 6" O.C. EDGES UNDISTURBED SOIL 2 d 12" FIELD Cq I I I I ((( UNDISTURBED SOIL . Z _ IIII 1/2"x10" A.B. WITH SPACING PER N ------=- TABLE III ON THiS SHEET WITH 2 - *4 REBAR EACH WAY 2" X 2" X 3/16" THICK STEEL WASHER *4 REBAR CONTINUOUS TABLE I 12" TOP E BTM. ( *7 FOOTING DETAIL LATERAL FORCE PERPENDICULAR ars TO RIDGF WiND FORCE (Vwind) = Pwind * (Lb1dg/2)*(Hridge - Hbldg/2) Vwind = 8.44 K SEISMIC FORCE (Vselsmic) = (WT/2) * k Vselsmic = 6.6 K (WIND GOVERNS) ANCHOR BOLT SPACING (ABspacing) = 0.600K/BOLT * Wbldg/V ABspacing = 341 IN LATERAL FORCE PARALL-L To pinrTF WIND FORCE (Vwind) = Pwind * (Wbldg/2)*(Hridge - Hbldg/2) Vwind = 4.8 K SEISMIC FORCE (Vsetsmic) = (WT/2) * k Vselsmlc = 66 K (SEISMIC GOVERNS) ANCHOR BOLT SPACING (ABspacing) = 0.600K/BOLT * Lbldg/V ABspacing =166A IN USE: 1/2" DIAMETER X 10" ANCHOR BOLT 34 INCHES ON CENTER ALONG THE WIDT OF BUILDING 1/2" DIAMETER X 10" ANCHOR BOLT 72 INCHES ON CENTER ALONG THE LENGTH OF BUILDING x.IIOU` G N.T.S. X z< N N INTERIOR PIER DETAIL 12" N.T.S. MANUFACTURED HOME BY OTHERS 3/8" CDX OR EQUAL W/ 8d A 6"/12" OR 5/16" HARDIEPANEL SiDING WITH 8d HOT DiPPED GALV. NAILS to 6"/12" INSTALL PER MFG. RECOMMENDATIONS PLYWOOD SPLICE 3/8" CDX OR EQUAL W/ 8d to 6"/12" 4x6 RIM WITH VENT PER CODE 2x4 PRESSURE TREATED SiLL UNDISTURBED SOIL 1/2"x10" A.B. WITH SPACING PER TABLE III ON THiS SHEET WITH 2" X 2" X 3/16" THiCK STEEL WASHER F4 REBAR CONTINUOUS rOP E BTM. FOOTING DETAIL N.T.S. 6UTTE CODN I r �IUILDiNG DEPARTf EFt APPROVE FOUNDATION DESIGN CRITERIA THE FOUNDATION AND ANCHOR BOLTS SHALL BE DESIGNED 1N ACCORDANCE WITH THE '98 CBC AND DESIGNED FOR THE FOLLOWING MiNiMUM CRITERIA: WIND SPEED: 80 MPH WIND EXPOSURE: C SEISMIC ZONE: 3 2 co ©E U U_ a o v o o } o� 2 � ci p v o .� o � > W C14 CL_ :E 0 L. Nino Ln0 L Q r�V .._ 0 V ir W Q � N � J Q Z O U. 0 J W mJ Q aOxU ZJO O _V W E'J aQ0 �= z O � � O O U. ©FESSjp 0540 rn C3 C M c� 30 07 Design: JMR Checked: JMR Date: MAY, 2004 Job No. Sheet - 2 of 2 Sheets