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Home My WebLink About028-063-004 .028-06=3-004.. SABRINA, CURRENT' . ORovl'1e ' 10124'Ahart Road; . MEDINA, FRANK •PERMIT RENEWAL 10096 AHART.RD, OROVILL.F. BP # n14 - Cont: OWNER Date' COMPLETE REMODEL BP Expires: O 28 -0(0 3 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.neUdds 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 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Date: Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish; or repair any structure, prior to, its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9. commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or Improvements are sold within one year of completion, .the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). , ❑ 1, as owner of the propeiiy, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profdssions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ '1 am Exempt under Article 3 of the Business and Professions Code Date: 117/05 Owner: WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code,.for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: PERMIT NO. BP043250• Issued Date: 01/07/2005 APN: 028-063-004-000 Site Address: 10124 AHART RD HON Map Index: Description: SHEETROCK, SIDING, RE -ROOF, RPLC WINDOWS, DOORS Owner: FRANK A & ROXANNE MEDINA 10096 AHART ROAD OROVILLE, CA 95966 Applicant: TONI MEDINA Contractor: License #: Architect: Engineer: 10096 AHART ROAD OROVILLE, CA 95966 Carrier: �Policy # Total Square Ft: 0 S. F. I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, I shall not employ any person in any manner so as to Census Code: 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. '� CS Date: I 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 --2-1 code, interest, and attorney's fees.U / CONSTRUCTION LENDING AGENCY This permit is hereb issued under the applicable provisions of the Butte County Cnda enrt/nr a I hereby affirm that there is a construction lending agency for the Resolutions to d o c dlc tad above for which fees have been paid. performance of the work for which this permit Is issued'(Sec 3097 Civ.) I Name: BY Date: PERMIT EXPIRES ON: _ 6 Address: !Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that'I am the owner or the duly authorized agent of the owner. I agree to comply with all county and stale laws relating to building construction. •1 acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes; Print Name: \ P -t C1 \ \ \ \T C\t N'\ 6\ ' Signature Date: -=/ ❑ `Owner 13 Contractor �Agenl for Owner ❑ Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REO UIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" APPLI CANT NAME OWNER Last Name Crry ust Name Addr \ bockQ, `�hwck \- c\, City State State i1 Zp 15%* Phone -j 3_ �-� y y Fax -14-3 _ 9 3 5Z E -marl r6 Q8\ o C..o `n� APPLI CANT NAME CONTRACTOR Name - Crry Address zip City Fax L- 0) 7y3 - 935Z State Zip Phone Book Fax E-mail Planner Lia # Class APPLI CANT NAME ARCHITECT/ENGINEER Name Crry Address zip City Fax L- 0) 7y3 - 935Z State Zip Phone Book Fax E-mail Planner State License Number APPLI CANT NAME Name �O�C1 \ �`n,Ls�•\ Address Crry state n ,o zip Phone (530) -7H3-0-7yq Fax L- 0) 7y3 - 935Z E-mail r0 o- 0 0.0\ - Cor \ APPLICANT SIGNATURE X Gam_ M"� — __� - :1 For office use only - Zoning Property Address \C)\.Ar Flood Zone Cross Street S tea\ SRA Yes No Occ. Type Const Subdivision Name Map Book Page, Lot # Planner Date Approved: PERMIT NO. BP n43 BIN # LOCATION oar-oc��-oo� Property Address \C)\.Ar City Cross Street S tea\ WORKER'S COMPENSATION Policy Number Carrier if hiring anyone other than license contractors, a certificate of worker's compensation must be shown attire time of permit issuance. . LENDING AGENCY Name Address Descriptiop or Scope of Work: r lc i4ob sf sidina. r121c 13 wtt�d®, I - 1c 2 do"s Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. 013 II Received by: Amount % 14-.87 Bldg I 1 ri Receipt P + 131150 Date: 11 -,9 - 04 - Sheriff ,9.04 - SRA Sheriff SMIP Other -714--67 T-4-1 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 BEACCEPTED. ALL PLANS MUST BE LEGIBLEAND ININIG ❑ . 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. 7 3. Engineered truss details and layouts in duplicate (if required). No faxesl :1 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) 7 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. 7 6. Manufactured homes: (A) Data sheets and installation insi, (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). 1 9. Site plan and business license approval from the City of Biggs. 10. Letter of intent for non-residential buildings. 1 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. 'emaining items needed to issue the permit. Additional items may be required after Plan Check and Planning :view (May require additional plan review upon receipt of the following items.) I 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). I 2. Impact Fees. 1 3. California Department of Forestry plan approval (if required). 1 4. NPDES Form. I 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. Titre/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). you have questions or would like additional information regarding this process, contact a Permit )plication Assistant at (530)538-7541. EXPIRATION OF APPLICATION plicafions for which a permit has not been issued will expire one year after date of application. In order to renew action an apprication after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS funds can only be made upon written request by the person who paid the fee. The request must be made within two irs from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits jed; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan .ck fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION JRMSSUILDING FOR MS1BIdeAnnl..QitkP, 1, d.._ .,___ COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ASSESSOR PARCEL NUMBER 6 V G e.:. Qo 4 - Proposed Building Use: Counter Technician: Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 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 AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ 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 Forestry plan approval ❑ paid. Sent by: ............. ❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... ❑ 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... 0 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... q�-- A 31. 32. Owner -Builder Verification (_ Given to owner, Wgiiled to owner) ..................... 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 °�<4 . a�y�¢. and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: -T-Z.Date: I I- �/-- Q 1. Index permit application for the above items numbered: AICV r,�Plan Check Letter 2. Additional items required Contractor, designe was advised of the above data by one, ❑mail, '❑ counter, by Date: Contractor, designe o n , a advised of the above ata phone, ❑ mail, ❑ count r, y Date: Plans reviewed by: Date: / 2_ 2q/ D Plans approved by: Date Structural reviewed by: Date: Structural approved by: Date: Note transfer by: Date: Yellow: Building Division O+ �CC�� y 7�r K '�' iii BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL. REQUIREMENTS 24 HOURINSPECTION#: OROVI LE: (530) 538-7636 - CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION **PLEASE PRINT CLEARLY** 'OWNER Last Nameksl lFirst Name Address City �,r0 v\ �� State ZZp Phone -7 x,.1y Fax -143_935Z E-ma1 r 6 c` 04\ - Cz `M ARCHITECT/ENGINEER Address I City I State I Zip Phone I Fax License Number APPLI CANT NAME CONTRACTOR Name City `r C j Address City Fax (53C) -7g3.. -`735Z State Zip Phone Name Fax E-mail Lia # Class ARCHITECT/ENGINEER Address I City I State I Zip Phone I Fax License Number APPLI CANT NAME Name ---- Address City `r C j State CAP\ Phone (53D^) -7q __6-7 yy Fax (53C) -7g3.. -`735Z E -mal i'L G -G\ . C0nN APPLICANT SIGNATURE X::F PERMIT NO. BIN # "f4—EQ-6A TON-- AP9 oar-oc��-bob Property Address City Cross Street 5C W\ 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 ofpermit issuance. LENDING AGENCY Name Address Description or Scope of Work: aV-QV4-'1\-C rq_nAc .\ Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. II Received by. `�, Amount 714-. £'7 Bldg I I Receipt #: 413 i010 Date: 11. c9 • 04 - SRA Sheriff SMIP Other 7/4-. X37 - _ . SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF ry �l MARY LOU DOjfGHTY Document Date: April 13, 2004 State of California } w LYNETTE GARTON Comm. # 1351379 NOTARY PUBLIC CALIFORNIA County of Butte W Comm. Expires April 17, 2006 County of BUTTE SS. On �Q6 s\ \k-\. WA. before me, the undersigned, a Notary Public in and for said County and State, personally appeared MARY LOU DOUGHTY Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature a FOR NOTARY SEAL OR STAMP LYNETTE GARTON Comm. # 1351379 a°! NOTARY PUBLIC -CALIFORNIA p Courtly of Butte gig Comm. Expires April 17, 2006 MAIL TAX STATEMENTS TO: Same as Above BTEC/GRANTDEED � • . �i�� iii �i� � �EE� � is �i cite � �� i f� RECORDING REQUESTED BY Bidwell Title & Escrow Company E" GD GD -4 — 1101 Q!ll 5 3 CS, E3 -¢- Recorded I REE FEE 10.00 Official Records ICounty AND WHEN RECORDED MAIL TO Of I Name FRANK A. MEDINA BUT! E I CAWDACE J. CRUBBS I Street 10124 Ahart Road aaa Recorder I ROSEMARY DICKSON I Assistant I Kathy City, state Oroville, CA 95966 09=00AM 02 -Sep -2004 I Page 1 of 2 zip Order No. 00203174-004 SPACE ABOVE THIS LINE FOR RECORDER'S USE Parcel No. 028-063-004 GRANT DEED THIS FORM FURNISHED BY BIDWELL TITLE & ESCROW COMPANY The Undersigned Grantor(s) Declare(s) Docurnentary'iransfer Tax is $0 . o ❑ City/Town of 21 computed on full value of interest or property conveyed, or d ❑ Unincorporated Area ❑ full value less value of liens or encumbrances remaining at j{ This conveyance confirms title to the Grantees who continue to hold the interest the time of sale FF Acquired on July 31, 2003 Doc #2003-0050360 T -TAX pd $60.50 R&T 11911 ❑ Monument Fee of $10.00 THIS DEED RECONVEYS A SECURITY INTEREST R&T A iq? i FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, MARY LOU DOUGHTY hereby GRANT(s) to FRANK A. MEDINA and ROXANNE MEDINA, husband and wife as Joint Tenants the following real property in the ❑ City of 2 Unincorporated Area County of BUTTE, State of California: SEE EXHIBIT A ATTACHED HERETO AND MADE A PART HEREOF ry �l MARY LOU DOjfGHTY Document Date: April 13, 2004 State of California } w LYNETTE GARTON Comm. # 1351379 NOTARY PUBLIC CALIFORNIA County of Butte W Comm. Expires April 17, 2006 County of BUTTE SS. On �Q6 s\ \k-\. WA. before me, the undersigned, a Notary Public in and for said County and State, personally appeared MARY LOU DOUGHTY Personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Signature a FOR NOTARY SEAL OR STAMP LYNETTE GARTON Comm. # 1351379 a°! NOTARY PUBLIC -CALIFORNIA p Courtly of Butte gig Comm. Expires April 17, 2006 MAIL TAX STATEMENTS TO: Same as Above BTEC/GRANTDEED Order No. 00203174-004 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: A PORTION OF LOT 83 AS SHOWN ON THE MAP ENTITLED, "TOWN OF HONCUT", WHICH MAP WAS FILLED FOR RECORD IN THE BUTTE COUNTY RECORDER'S OFFICE ON MARCH 13,1899 IN BOOK 7 OF MAPS, AT PAGE 85, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT A POINT 309 FEET SOUTH OF THE NORTHEAST CORNER OF LOT 83 RUNNING THENCE WEST 416 FEET MORE OR LESS TO A POINT 309 FEET SOUTH OF THE NORTHWEST CORNER OF SAID LOT; THENCE RUNNING SOUTH 278 FEET; THENCE EAST 170 FEET; THENCE SOUTH 50 FEET; THENCE EAST 213 FEET; THENCE NORTH 326 FEET MORE OR LESS TO THE POINT OF BEGINNING. AP NO. 028-063-004 DATE: PERMIT: ASSESSOR P2 OWNER'S N1 FEES: (Amount and Purpose): BALANCE OF FEES SHEET -3-50-64 BALANCE OF FEES: $ ADDITIONAL FEES: $ REVISED PLAN CHECK: $ SHERIFF FEE: $ SRA $ COPIES $ URBAN AREA FEES $ CSA 87 (North Chico Spec.) $ WATER TENDER FEE $ BATTALION # THERM DRAINAGE FEE, $ (4 OTHER $ OTHER $ VALUATION - IF BALANCE OF FEES OR ADDITIONAL FEES: TOTAL VALUATION: $ ADDITIONAL VAL. $ (Check one) COUNTY CITY OF BIGGS (Check one) RESIDENTIAL COMMERCIAL RECEIPT NUMBERS: Butte County Department of Development Services ADMINISTRATION' BUILDING • GIS " PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538.7541 Telephone (530) 538-2140 Facsimile August 20, 2003 Gil Smith 460 Rio Lindo Chico, CA 95926 s Re: HAZARDOUS ELECTRICAL CONDITIONS 10124 Ahart Road Honcut, CA. AP# -028-063-004 Dear Mr. Smith This department received a complaint alleging health and safety hazards at the above referenced living unit. On August 19, 2003 an inspection was conducted by this department. The owner (Mary Lou Doughty) and tenants are not currently occupying the structure. The structure at this site has numerous electrical hazards including but not limited to open conductors and conductor splices, unprotected conductors, and a lack of proper grounding and bonding. The structures have been posted for nonhabitation . As the Chief Building Inspector for Butte County, I am requesting that the electrical and gas to the structure referenced above be disconnected until appropriate actions are taken to resolve the hazards. Further, I request that the electrical and gas service not be reconnected until an authorization from this Department is granted to do so. This letter shall also serve as notice to the property owner and tenants that the electrical and gas service is to be disconnected. Should you have any questions concerning this matter, please contact Scott Rutherford or Michael .Vieira at the number above. Sincerely C Scott Rutherford Chief Building Inspector : --------------------------------------- COMPLAINANT: ADDRESS: PHONE NUMBER: OTHER COMMENTS• CC Z loo Sa .. • O . f /.4.',7C o063 j0 91 _ 90 /3 M w . A 61 2.40 0 Q — — 22 017 o 8r s 09 in 117 -�; 1.9 ac p its 430 ___ see iso 219 200 't C116 23 • �w G 57 ieoagro . 4 � 1; 3 14,E 0113 o a�_o• • r--, 178 �,a = 1 -[23 AC 97.. 200 tibIr fn O QLOCAC : F+ �' 4 '. .67 A C ITO 84 12 :._ 340 213 J Q -. f 4 A 1 9 0 CN, 200 10 i0rs�! 60• ' i13 • 0 04 97 .10 Ol to 60 13 11 8 ttt __ o a 200+18 0. ;' 99 O 300 ioSAO fI PSD 0 iso j-: ��- to ' t00 �5 - 10 7< f - •1 �� •0 028 -03 - too. _ -04 PIT. Lo i t 90 PjA cr. 0 3 toc : 2 0 0 W CL 50 100 //''�� 07Cou/111" _ ��i 'J�'kr BALANCE OF FEES SHEET 6 DATE: PERMIT #: ASSESSOR PARCEL #: OWNER'S NAME: FEES (Amount and Purpose): BALANCE OF FEES: $ ADDITIONAL FEES: $ REVISED PLAN CHECK: $ SHERIFF FEE (commercial only): $ SRA: $ COPY FEES (S1 or more) $ DRAINAGE S BASIN BC RESIDENTIAL IMPACT County Wide Chico Urban El Medio North Chico Specific $ WATER TENDER FEES $ BATTALION # FEMA $ SNUP $ OTHER RECEIPT NU BER(S)