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028-063-019
I } BONE; J.B. 450-67B* 365-67B 899-67p* 366-67E* jj /c a b'oaz -063ig JC i 1 02S-063-019 06-1293 i W/S Ahart Rd. app. 1100, no. of School St., MEDINA, PRANK Honaut-� 1 10056 AHART RD, OROVILLE (add front porch) -�?�- S-/6- Cone OWNER \ \SLI Ow (#convert part of bedroom to bath) -`k -"-0-C-) 1 NSP(L1V, COV) - � ^}� 9-6 � 3 i 1 3I BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 10086 AHART RD Owner: Permit No: 06-1293 APN: 028-063-019 FRANK MEDINA Issued Date: 01/04/2007 By TMP Permit type: RESIDENTIAL 10096 AHART ROAD Subtype: SFD-Custom/Model OROVILLE, CA 95966 Expiration Date: 01/04/2008 Description: NSF(LIV, COV) (530) 743-0744 Occupancy: R-3 Zoning: Contractor Applicant: Square Footage: OWNER FRANK MEDINA Building Garage Remdl/Addn 10096 AHART ROAD 1,196 OROVILLE, CA 95966 Other Porch/Patio Total (530) 743-0744 253 1,449 FEE INFORMATION Dwelling - Custom, Model $19373.12 Fund 10 BLDG $19025.40 SMIP - Residential $8.18 SRA Fees $95.00 Total Charged: $29501.70 Fees Paid: $2,501.70 Balance Due: $0.00 Receipt No: B1399 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License OWNER / / Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that 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 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 Pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 01/04/2007 penalty [$500); Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE XCOMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of :he following declarations: HAVE AND WILL the work himself or herself or through his or her own employees, provided that such improvements MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR E]I are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ section ❑ 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Cartier. Policy Number: Exp. Date: (This section need not be comp eted if the permit is or once Hun r�llars ($100) or less.) RI AM EXEMPT under Section B. & P.C. for this reason: ❑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'X Ql/04/200'� compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisions. X 01/04/2007 1 hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. 1 agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuarce of this permit. I hereby acknowledge thatt is issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on the property owner's behalf. 01/04/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner Contractor OR:Agent for Owner Agent for Contractor FILE C PY Lender's Address City State zip Name M << BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION "PLEASE PRINT CLEARLY" 00. OWNER Address 1 C -)D q �0 Psh0.� k 9 a City -,CoSte Zip Phone 530-7130%-1 A Fax 530--7g3—Q3$Z E-mail rn tcl i hcc, ACS CONTRACTOR Nam _— Address City ' -_� - - r State Phone, _%5'� Fax �`— E-mail APPLICANT NAME Name F�CA�ly� Cv". Address 10 Qq LD %C --V- QLA City o `COV 1 wk, State Zap /)5q r„ f„ uh1ti Phone 3� Fax 7 X43 -07 4 E-mail'-1,5 5 mailrot( ci Y►NLXVq_0d CD M ro)( APPLICAN)i SIGNATURE X 7-,�4 i For office use only: Zoning Flood Zone SRA No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. . Q�_� WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footagex!l V - f f! 16,; i _` _ 9 1 " l -C ❑ Structure Buiu vn 11UULrCnnnD" — - ❑ 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 required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who �X 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. OVER FOR SUBMITTAL REQUIREMEN 15 L Receive by: Amount ` T- SRA Sheriff 7 -,F '— -(� 1 SMIP %j � Othe Date: SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. :��I. ential, New, Remodels, Additions, and Accessory Structures: 3 Site Plans, signed by the preparer. NO GRAPHPAPER! 2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑/ 4. Letter from Engineer or Architect for truss design review. 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the ens?irieer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! , ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval 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 by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 COUNTY OF BUTTE-DEPARTMENt OF D.EViFLOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965, Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ASSESSORNUMBER Proposed Building Use: N \ Permit 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 A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including 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 calks 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. Hazardous Material Form } J� 12. Acknowledgement of building permit application without required clearances. ! ❑ 13. Other R dining ' s needed to issue the permit (May require additional plan review upon receipt of the following items.) jA�nitation and site plan approval from the Environmental Health Department in ❑ Ch Orovil e, as livable 15. Fire Sprinklers............................................................................................ V ❑ 16. Agricultural Buffer dr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑/ Erosion Control Plan Required........................................................................ [B� 19 Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 0. City of Chico Plumbing permit........................................................................ ❑ 21. bite plan and b0siness license approval from the Ci .1 of Biggs...... .......5� F�// �. C lifomia Depahment of Forestry Ian approval [paid. Sent tA'26. Planning approval for (A) Use: (B) Parking: (C) I ar�celCIfeck . .... • i✓B ❑ 24. Contact Land Development about _ Improvements, _ Drainage ....................... 0 25. Fire Marshall Review (commercial projects only). Sent by: ' ...................... :n 26. NPDES Form ..............................,:»"`:.. ..................................................... ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑, 28. Contractor's license information. (Number, Name Style, Classification) ................... r (3 29. Worker's Compensation Cam 'rand Policy Number.. ...............:........................ �. 30. Owner -Builder Verification (7- Given to owner, _Mailed to owner) ..................... 0___ / 3 etter of Signature authorization.................................................................... W , 32.,-, ecorded copy of Agricultural Acknowledgment Statement ................................. El Existing violations and/or expired permits......................................................... ❑ 34'r Deed Restriction.............................:............................................................ ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other. pt '' ❑ 37. Other. When issued Telephone `-C Q1 q+ and hold for pickup. I have been informed of the aboveitemsand requirements for obtaining a building permit. Applicant � r^-� _ Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional itemmras Contractor, desigas advised of the above data by ❑ phone, sail, ❑counter, by Date: S' Contractor, desig advised of the above data by ,phone, ❑ mail, ❑ counter, b Dater Contractor, designer, owner, was advised of the above at by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: 6 Plans approved by: Date: Structural reviewed b . Date: Stfuctural approved by: Date: Note transfer by: 9v Date: Yellow: Building Division TO: Building Division = Development Services JE.H. USE ONLY Plot Plan Attached Floor Plan Atfached� Sent to BD/DS FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal: Clearance for dwelling. Other Hold final for: 'IMF' :12RIM MARK O.K. NOTE: Environmental Health 7Specialist Building Clearance 9/2005 Water SuFRly: Pubic Private Well -s -6� Date BUTTPUNTY DEVELOPMENT FEE CERTIFICATION FORM FEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ (PARADISE R',C'R!�''ATION AND PARK DISTRICT (PRPD) 0 DURHAM RECREATION AND PARK DIS'T'RICT (DRPD) Assessor Parcel Number (s) 02Z. 0(6- O 4q Building Permit Number ���— Property Owner (s) frna& Mtdin(�, Project Location /Address _AA-FaK (A �- Subdivision Name Assessable Sq. Ftge 1�Y Typ, of Residential Development (check one) New Development Single Family -Detached Single Family -Attached Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) verified by Building Department 'Comments: X1 note jCIM11V d1Q in Building Tpartment Represen a Date . �D ❑ CARD 0 PRPD ❑ DRPD certifies that: c4 I' V1 53(on Applicant Name Phone Number IOC) `1 (v �} �q.v }- 2yoG( oY0��11p C;n 9S� �o�o Mailing Address City State Zip Has*complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of:i Dwelling Units @ $ per unit for a total of $ Square Feet @ $ per sq foot for a total of $ Remarks: A- VNyMe 444 �itrnec�l Paid by Check No: Recreation and Park District Representative PAd by Cash: UFORMSWILDING FORMS\Dark-rec standard form rev Ldoe Receipt No: /- 1-/-�40-7 Date iJ School District I A.P. Number BUTTE COUNTY SCHOOLS I.MPACT,FEE CERTIFICATION FORM Oq 2,- 013 (One form per Building) —aovl lit hi 0� Building 7t No. QV .0co-IN - oftg- oig Jurisdiction: -city County Property Owner r OnK Property Location/Address Ml� Subdivision Lot No. ....................................................................................... • Residential Dev e lopmentI q :Sq. Footage. No of Living Mobile Home Addition/ *Supplemental to '(Gioyp. R) Units Installation Conversion Permit # Cow '(No foundation inspection) ...................... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document), Commercial industrial New Addition District Identification No. ty- Im School District certifies that U Address) �" if,- / Lelf (City) (State) has complied with the requirements of Resolution No. 6 S--9 -square feet. ,'So Q -Z-�.,.- / School District Representative Paid by Check#,Remarks: Sq. Footage (Including Exterior Roofed Areas) �2.2Cn-OCA Date (Applicant) -7113 0-7c/q (Phone Number) '-p4rwo (, (Zip Code) - � by payment of $ - / 0 8 3, -56 _J 11AB 2926 $ kULL MITIGATION $ Date o W Y. You may protest the Imposition of the fen identified above by submitting a written protest -to the District, In compliance with Government Code Section 68020(a), within 90 days from the date fees are paid. Failure to subs* a dww#y written protest will prohibit you *om challenging the Imposition of the fees In any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form the School 01amcl is notified by &.a applicable Local Planning Agency that this project Is baling ►awl under the California Environnw4al Quaft Act (CEQA), this project may be "ad to additional school fins to fully rnitigate Its impact an the school diseWs'schoolls. White (school district), Yellow (building department), Pink (applicant). feelonnift (305*w 1 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR i PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.net/dds ADMINISTRATION " BUILDING " PLANNING Due to the school and/or recreation district offices being closed for an extended time during the holiday season placing a hardship on the project for which this building permit is requested, the school and/or recreation district and the Butte County Department of Development Services have agreed to issue said permit provided that the fees are paid to the school and/or recreation district no later than January 8, 2007. The undersigned agrees to pay the school and/or recreation district by this time and to provide proof of payment by the required date to the Department of Development Services. Failure to do so will result in the immediate cancellation of the building permit. ' APN and street address 0 Co 12193 Building Permit Number Owner's name Print and Signature of Applicant Date 11/21/06 I6 r i. t' BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION • 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner MEDINA, FFL EVEN APN No: 28-063-019 Permit Type: I I'—] Subtype: App Date: 5/31/2006 Permit No: BP 06-1293 Permit Desc: 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $2,288.54 Plan Check portion of Permit Fee $915.42 $1,373.12 Balance of Building Permit Fee 2 FEMA Res Flood Elevation Review $109.98 0 3 SRA* Yes Fire Plan Check - Non -Refundable $95.00 $95.00 $204.98 (State Responsibility Area) Building Inspection $109.98 $109.98 1 NON-REFUNDABLE portion of tees due at application $1,010.42 FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION $1,120.40 FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT "$1,381:30 $1,373.12. $8.18 RECEIPT ,q ATE Tech Asst q5 s5� '/51 4 Balance of Building Permit Fees (from No. 1 above) 5 SMIP* - Strong Motion Instrumentation Program (Enter amount from permit system) 6 Additional Plan Check Fees (NON-REFUNDABLE) 7 7a 8 9 10 Other*: Other*: IMPACT FEES - RESIDENTIAL* Alolications After 04/15/06 a JPerDwelling I SFD ,> I Per Dwelling MFD # Per 7289.40 County 4249.11 3183.54 Chico Urban Area 6146.231 4538.82 EI Medio Fire District 3249.971 2385.76 North Chico Specific Plan A SR -1, SR -3, SR-1/PD R-1 °c R-2 R-3 8801.091 8897.09 8390.09 7604.09 7395.04 7491.04 6984.04 6198.04 Processing Fee is automatically added to impact fee total 0 WATER TENDER FEE (Not collected when impact Fees Applicable) Enter Bat.# DRAINAGE FEES* CHICO STORM DRAINAGE MASTER PLAN New construction, vacant land, on 1 acre or less - Enter 1 or less acre value 770 Butte Creek 771 Comanche Creek 772 Little Chico Creek 773 Big Chico Creek 774 Lindo Channel 775 SUDAD Ditch 776 Mud -Sycamore Creek 777 PV Ditch MH 3238.72 5648.44 2422.68 8486.40 RECEIPT DATE Tech/Asst 8582.40 8075.40 7289.40 $100.00 $200.00 $6,275 RECEIPT DATE Tech/Asst $8,893 10a More than 1 acre, existing buildings - fees to be assessed by Public Works Fee Determination Sheet Needed - Enter amount determined by PW 11 THERMALITO DRAINAGE AREA 1 $684 Maximum Per each new living unit on existing lots where full drainage fees have not been paid 11a Temporary Dwelling 1 $136 At time of building permit $136 annual renewal fee for first 4 renewals. Not to exceed $684. PROOF OF PAYMENT OF FEES (BELOW) MUST BE RECEIVED PRIOR TO I; is completed for applicant to take to respective district office. ma offinnME . OF PERMIT. Forms will be prepared after plan check 12 SCHOOL DISTRICT FEES* Palermo Union High School 092 0, ^o 12a RECREATION DISTRICT FEES* Oroville , N g n1 _ At the time of permit application, I was advised the above fees are required to be paid prior to issuance of the.permit. These fees may be changed during the plan checking process. Applicant: �.�C-�-- Date: 5-- 31 0A Pursuant to Government code Section 66020, you are hereby notified those Items followed by an "*" may have been imposed on your project. You have 90 days from the date of approval of the porject or from the impostion of the above referenced items during which you may protest. The requirements for a protest are specified in Goverment Code Section 66020(a). K:/Building/Forms/Schedule of Receipt Fees Residential 041506 ENCROACHMENT PERMIT County of Butte Department of Public Works 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 538-4356 Download Forms: www.buttecounty.net/publicworks/forms.htmi NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Phone (530) 538-7157 Ext. 2016 Permit Number �/ S� 5� L%� District . APPLICATION I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads and highways, all in accordance with County ordinances and general laws. All information except signature must be typed or legibly rinted. 1. Applicant's Name: " la. Company Name: 2. Address: j e 3. Phone:.� , 4. Assessor's arcel Num er: S. Location of Work to be Done Aid % l�DnC�\— Adrt0 8 6 6. Applicant's Signature 7. Date: ,ct CONTRACTOR'S INFORMATION 8. Contractor's Name t, ne E Co ALt� .. 9. Address 4 R a 10. Phone: -, 11. Fax: 113 12. Contractor's License Number: 13. Certificate of Insurance: Yes No: ❑ 14. Contractor's Signature: A I 14a. Dale Signed 15. Authorized Agent: TYPE OF WORK TO BE DONE 16. Please Check: 17 If Driveway List Type: Curb: El Gutter: ❑ Sidewalk: El 18. Other Work - Describe: 19. Plans Attached: ❑ Yes JX No PERMIT GRANTED In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) and special conditions written below, ermission is h ebygranted. 20. Conditions - .i a '11 4r It Underground Service Alert U.S.A. must be notified two working days prior to any excavation. 800-227-2600 21.- El All work shall conform to accompanying: Detail 04 Plans ❑ Special Conditions (� 22. Date Issued , U 23. Expiration Date: / Q G.�J 24. Surety: 25. Date Paid: S o6�0 5� 26. Amount Paid: O C 27. ; y '-- Paid B• : C A S 1� 28. Receipt No.: y0O;t &'3 Mike Crump, Director of Public Works By: For County 29. Final Inspection Date: 30. Inspected By: ❑ Completed - OK ❑ Completed — Not OK ❑ Additional Comments Attached Use only: 31. Comments: ' Note: If permits are faxed to any number besides (530) 538-4356, they can be delayed up to one week. Page I of 2 Nc 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 material for construction of this proposed property improvement: YES [X] NO [ ]. 2. I HAVE HAVE NOT [ ] signed an application for a building permit for the proposed work. / 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to, provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: 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 3 SIGNED: PROPERTY OWNER: DATE: S-_ S-- 'NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/48004 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.netldds OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has.been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than .your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers'" compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.- - o For more specific information about your obligations under federal law, contact 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 contractor is to secure an "owner-builder"=1uilding 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 contacting the Contractors' State License Board's automated telephone information system at 1-800-321-CSLB (2752) or by accessing their website at www.CSLB.'ca.gov. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, ko—i°, ez Scott -Rutherford Manager, Building Divi ion NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. QpgTMENr O� TT� . 0 o �, 9 0 o c0[1N� o ��; Department of Public Works C o u n t y o f B u t t e o 0 /) J. Michael Crump, LAND DEVELOPMENT DIVISION o �/ Storm Water Management Program 14' Director 7 County Center Drive Oroville, CA 95965 'OCie7� W p (530) 5384266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE] Project Description: /V C AO/Lie Project Location and/or Parcel Number: liAlir,L % AIn( By signing below, I, the project owner/owner's agent, certify that this project WELL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board.. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of Califomia 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: Title: 0 L/,) /z✓ r L. Date: S — 3t — r— K Less than I Acre NPDES & SWPPP Compliance Certification Butte County Stone Water Management Program Revised 5/24/04 Butte CoutityDepartment of 1Developinel2t l-wces 0 1. 0 7 County Center Drive o.. u o <. Oroville, CA 95965 o' -,.tea •,c . c o (530) 538-7601 Telephone c0 (530) 538-7785 Facsimile IUJ I BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building pen -nit application through the plans examination process WITHOUT ' first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to,, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: a I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the,Building Division as soon as clearance is obtained • I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or re uire submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to. all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: iii /�-:��� 1-7 e �i APN: if- ©A, ~% Building site address: A.A#I z- %~ R cl Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: _- Z_ ®"6 SIGNATURE OF APPLICANT - DATE K: Forms/BldePerrtnitwithoutClearances 020705 SITE PLAN REVIEW APPLICATION Date: AP#-�-�Z q Permit Number (if applicable) Bin Number APPLICANT INFORMATION Parcel Size:71 Owners Name: Owners Address: Telephone No.: Site Address: Proposed Use: Residential ^L J& New Single Family Resfdential -- ( t✓��D ❑ Single Family Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling. ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer, i ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other [t] Septic ❑ Agricultural Exempt Building ❑ Other: I •k ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form Zone: GP:� DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Resolve Problems Prior to Approval ❑ Resolved s, w Date 1 2006 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Williamson Act Minimum Acreage: ❑ Residence can be built per contract ❑ Watershed Protection Overlay Zone SRA - (CDF to determine specific requirements) 100 -Year Flood Plain: • Flood Zone: • Flood Panel No.: Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather Rivet Reclamation District (Approval must be obtained from the California Reclamation Board) , ❑ North Chico Specific Plan ❑ Chapman/Mulberry ❑ Cohasset Area Use Requires: ❑ Use Permit ❑ Variance ❑ Agricultural Worker Affidavit ❑ Administrative Permit ❑ Minor Use Permit ❑ Minor Variance Zoning: k` General Plan: Applicable Building Setbacks: Setbacks identified on site Plan. ❑CDF approval needed for encroachments into SRA setbacks. ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 2 2006 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front F r Side Side Street Rear Height Waterway N/A N/A N/A Setbacks identified on site Plan. ❑CDF approval needed for encroachments into SRA setbacks. ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 2 2006 Parcel Created By: ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation: El No ❑ Yes Comments: 15Parcel Deemed to be legal Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements ❑ Subdivision Ma /Parcel Map: Map Date of Recording: 028-050-034-000 028-063-012-000 6 028-063-013-000 028-063-022-000 028-063-017-000 028-063-020-000 r L 028-063-021-000 028-063-01 028-0 028-063-019-000 I 1 1 028-063-018-000 I 1 028-063-004-000 028-063-024-000 100 60-001 100 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * PLANNING July 7, 2006 Frank Medina 10096 Ahart Road Oroville, CA 95966 Assessor Parcel Number: 0028-063-019 Building Permit Number: 06-1293 Thank you for submitting the plans for your building project. The plans have been reviewed and comments are listed below. Please respond in writing to each item by completing and returning the enclosed PLAN REVIEW RESPONSE FORM. Your complete and clear response will expedite the re- check and approval of this project. COMMENTS: li!"rrovide load and footing calculations from a California licensed engineer for glue -lam beams. 2. Provide lateral design on patio walls and at front comer of the house from a Califorpia licensed engineer or comply with CBC 2320 requirements for braced walls. W "r ?'o 9 n / l - -f AO L 3. If lateral design is used, the engineer will need to review the trusses and provide letter to the �'' building department with their calculations. tJo r- Q a QJi",<,t �► ✓I'7 4. Submit two sets of the above items to the building department. "7/14"u /nu If you wish to discuss any of these requirements, please call (530) 538-7541 between the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday. Please refer to your Data Sheet for remaining non -plan check items. (You received this form when you applied for your permit.) The counter staff will answer any questions concerning the Data Sheet. Carl Nelson Plans Examiner 07/07/2006 15:33 5307439352 FRANK MEDINA S�1V�f5Md7dlfO NOLI . � j 7n.40 a*"-^ PAGE 01 I 610-�:Oo-8-eoc envw nrA:jiQVVIlvuq:Zla=arwmnsalwa%armv -salp/mgd OT Qo Vano; Qq tea aot in vl or -Nm uopmol Zql PO Wt W22 asuods� )d W2.tpm ase;qd •asnodsm pneA a pmopism We st JLNTIO 6g„ a2U21 noR=uoa ueld mo m p2pabu tit LrW of asvodsal ,m,t aq wnm 223q j,-esatnai io3 igMn9l"a ALGA ld=e a0 oIgg aq wa Mm smIIor iiE oa se `atajda IOU St ml e�ql 'M=grs-oj mcf, ipm mio3 sM UmP, pm aogmga! �ut�oiin3 C'I�Q' 'id 'su¢ld moi ;o Matnos *Vadxo vI szPso QI waw asmoaSau roman Muria S��IA2I�S , r'.I\IatAl..OolaA9(1 Booz z 11nr A.I.urloa kSPloe,A 1,4Qe�'IJ5 67N-1�61 0 ,r Ir tFS PC, � F -I lio 4 .,i r- C'At16 ,r, loi II E 'I. { SII S Assessment Year 19 7 19 �� RESIDENTIAL PROPERTY APPRAISAL RECORD uOek , P 9r y PARCEL z.�' a� .3 --�_, 9 x!!�z r NJ I Date ,q.._ cl,77 NAME OF PROPE•Rl- - •/ ��r l "_ �—' s'� s�E� a.r7— COMMUNITY SUBDIVISION Q� ---LOT. ' !m P rovement R.C. L. N. D. SMELT G G'T" OF —/U SHEET; l - CHARACTER OF SUBJECT PROPERTY_. CHARAC ,0� OF NEIGHBORHOOD USE TOPOGRAPHY LAND IMPS. BUILDING qp USE TOPOGRAPHY TREND _ Sin le Motel Lev .l Sidewalk Class: esidential Commercial In t� o Level Sloe Developing Double Low Curb Built: 1SihQ1e Retail LAIN_Low Undulating Stationafy _ Duplex Proper High Gutter Stories: Ifficome Wholesale Hea High Marsh Declining Flat Marginal Hill Pavement Area: Area Area Are Hilly Blighted _ Apartment Sub Mar 'l _ Bank _ Prow _ S otted S ottedotted -164 Zoning: Zoning: Sloe Orn. Li hts .`'. TVDic01 IRibbon Ribbon Ribbon (/'lV©0 UTILITIES Fill Park. Strip Over lm onin : • .Land Value �! lView All Installed lUnderaroundRetain. Wall Parhway Under IMD. • 2ooq GENERAL X168 OR: 1 ❑ Z 3.,❑ 4 ❑ 5 ❑ Fbles Rear Park' Tress 6esirhil PIM910a:Utilities: 1169 JCom. Cent rs: T .No.Stories: B/d . Rest Polls Front View t ;f L / s:_Transp.: If.� rovements Date 52O J Assessment Year 19 7 19 �� 19 19 19 ; uOek , P 9r y Prnccl ka�rnisQr x!!�z r NJ I Date ,q.._ cl,77 Im rodemient Re Iocem7t.Cost Q� ' !m P rovement R.C. L. N. D. 7Z l - Land Value qp Total Property R.C•L.N.D. I 5 EET / OF?j Capitalized Eorni ng Ability .160 We Code: X Indicated Sale Price 1161 . Sale; Arc; Code: Listed Price 1167 Approiaer No: �I g 163 Incompicl6, P.U. 19......... -164 Zoning: . p APPRAISAL X165 Zoning Conlormiry: Ycs No ❑ Total Property Value�(�^ (/'lV©0 +166 Use Confo.miry: Yes'q No❑ • .Land Value �! /s OVzAny .167 Bldg. Cinss: 2 V �� Improvement Value • 2ooq X168 OR: 1 ❑ Z 3.,❑ 4 ❑ 5 ❑ ' ASSESS VALUES 1169 9?lhs: 1 Z ❑ 3' ❑ Fj ❑ X*❑ Land Ll 'no 1,171 B—Yco, A,.b: If.� rovements %P 52O J 1177 Lmd Type: Lor I 14—,ire Total Property D 1173 �❑y G—g.. Ycs ❑ 1 No lXl E_ntelrp ed I 1174 1108 P-1: -,.-E] Acraege 1 REMARKS t_ANn Vdl OF - rnMP11TATInM COMPUTATION OF MODIFYING FACTOR /9 19 /9 /9 19 /9 /9" I9- Width Mod. Unit Fr. Ft. Year V®lu® Fair Rent r act. lue V lu /5 a� Land Value 1777. / B (vo Imp. R. C. N. Formula -------- -- ----- ---- C. E. A. COMPUTATION OF MODIFYING FACTOR 73 POTATION SPECIAL FEATURE Book Coses Buil!-/n Beds Shulters Venet/on B//nds Unit Own Z M rM DIN BUIL RECRD 0RESIDENTIA PARC L �` � _. , /,4 —44 ADDRESS" r ^^ // a SHEET —1� OF—1-Z Jsr—. 3 DESCRIPTION. OF BUILDING. . GLASS@ SWAP£ CONSTRUCTION STRUCTURAL EXTERIOR ROOF. LIOHTINO AIR CONDITION NOON AND FINISH .DETAIL M>7 I TO Frome2.yy^2-(• I Stucco on Flat / Pitch I . Wiring Healing Conlin FLOORS FLOOR FINISH fNTERIOR FINISH Sub: Standard Gob/[ fl ROOMS K T. COndU%t Forced /eOm TRIM B l Z Molerio/ Grode Wo//s Cei/in s ARCHITECTURE Standard Sheathing Sidin NO / B X. Coble Grovity Humid. A// b r �,/.! rw- Above -Standard ConcrefeBlock Shed Fixtures )Vo/JUnit - (Stories Specio/ 17 f 9 qa Cut UP Few jyjcheop Ent. No/! USE TYPE Back Shing/es Dormers Av . Medium f/oorUnit I Living / Since/e -__ FOUNDATION Adobe Shakes Mony Special ZoneUn/l. Dining/ Daub/e_ Concrete F/oor.✓oisl: B.BB. T. gG. (igllers Cenfrol Dup/ex Reinforced lit r 2:X��-2 PLUMBING Bed i _ Apartment Brick 2"4: "X . "- .Brick Shin /e Poor I 1600d Bed 1 Floi_ `\ Wood Sub Floor. Slone Shake Oil Burner i Court Piers �jy `% WINDOWS rile Fixfuret Mote/ X I D.H. I lCoselnent Tile Trim oterHeoter M.=B.T.U. Insuloled Ceilin s liteelJosh II Composition Kitchen / _ Units L/oh1 I#eovv Insuloled Noll% IVcreens I Compo. Sh/n le Gas—Elect. I I k yD i Bd Material.. L ih: Ft. Sp/ash: CONSTRUCTION RECORD EFFEC. APPR. NORMAL % .GOOD . RATING (E, G, A, F, P) BATH -DETAIL Permit No. For Amount Dole YEAR YEAR Remain ArcA. FunC. Can- Stora eSpoc 'Work-. Age 9'lob/e '/o Con . Fun F/, No. --FINIS FIXTURES SHOWER Life ttr, for u b'dC�et hshi A P P Floors Wo//s c. Lo. ub Type Grode 1. D. Finish ro 1�_i- �/ t' U 7 _� P4.c' . o e'7 A I 'A / v 73 POTATION SPECIAL FEATURE Book Coses Buil!-/n Beds Shulters Venet/on B//nds Unit Own Z M rM M WOME f #.,; \ r 3 t� .. .