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COMMERCE SECURITY SANK SM
BORROWER'S REQUEST FOR WAIVER OF FLOOD INSURANCE
Loan Number:
Borrower Name:. /Cf� f� %-f /��.�a4l
Property Address%lo J
Transamerica Flood Services, the largest provider of flood information, has accessed the most recent
flood map, issued by the Army Corps of Engineers, and determined that the above referenced property
is located in a 100 year flood plain. Transamerica does not have access to Letters of Map Revision
(LOMR) issues after the map date.
Commerce Security Bank is requiring you, the borrower, to obtain flood insurance based upon
Transamerica's certification.
If you believe the improvements to the above property are not in a flood zone and therefore, you would
not be required to obtain flood insurance, you may obtain a second verification from the following
government agencies:
-1. Planning Department of the appropriate county / city
2. Army Corps of Engineers from the appropriate county / city
I. Federal Emergency Management Agency (Region IX)
Building 105, Presidio of San Francisco
San Francisco, CA 94129
(415)923-7177
If these agencies provide you with one of the following written sources of documentation and you, in turn,
provide this information to Commerce Security Bank, we will immediately release our requirement of
flood insurance.
1. Letter of Map Revision (LOMR) issued after the most recent map date. These are typically kept
on file with the City / County Planning Department.
2. Letter from the City / County Planning Department verifying that the pad elevation exceeds the
base flood elevation and puts the improvements outside the 100 year flood plain.
ELEVATION CERTIFICATE O.M.B. Expires May
y31, 1077
ay 31, 1993
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to
determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).
Instructions for completing this form can be found on the following pages.
BUILDING OWNER'S NAME
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I
Prater
POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER I COMPANY MAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
030-200-095
CITY STATE ZIP CODE
Oroville CA 95965
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 ❑ Other (describe on back)
8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate
the community's BFE: feet NGVD (or other FIRM datum—see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level 1
2(a). FIRM Zones Al -A30 AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of 11-16157
.0 feet NGVD (or other FIRM datum—see Section B, Item 7).
(b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of I I I I I .0 feet NGVD (or other FIRM datum—see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is I .0 feet above ❑ or
below ❑ (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W .0 feet above ❑ or below ❑ (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
level) elevated in accordance with the community's floodplain management ordinance? El Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:) S NGVD '29 ❑ Other (describe
under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on
the FIRM (see Section 8, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: ❑ Yes 1� No (See Instructions on Page 4)
5. The reference level elevation is based on: Z actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate
will be required once construction is complete.) �.
6. The elevation of the lowest grade immediately adjacent to the building is: I 1 11 166 .0 feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance is: � 1 1 1 11.i 11 feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX 5. FIRM ZONE
6. BASE FLOOD ELEVATION
(in AO Zones, use depth)
060017
0365
B
9/29/89 AE
163'
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑ NGVD '29 ❑ Other (describe on back)
8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate
the community's BFE: feet NGVD (or other FIRM datum—see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level 1
2(a). FIRM Zones Al -A30 AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of 11-16157
.0 feet NGVD (or other FIRM datum—see Section B, Item 7).
(b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of I I I I I .0 feet NGVD (or other FIRM datum—see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is I .0 feet above ❑ or
below ❑ (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W .0 feet above ❑ or below ❑ (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
level) elevated in accordance with the community's floodplain management ordinance? El Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:) S NGVD '29 ❑ Other (describe
under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on
the FIRM (see Section 8, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: ❑ Yes 1� No (See Instructions on Page 4)
5. The reference level elevation is based on: Z actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate
will be required once construction is complete.) �.
6. The elevation of the lowest grade immediately adjacent to the building is: I 1 11 166 .0 feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance is: � 1 1 1 11.i 11 feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available.
-I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Ronald L. Graves P.L.S. 4085
CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal)
Professional Land Surveyor Ron Graves and Associates
I I I Lt COMPANY NAME
P.O. Box 986 Oroville CA 95965
CITY
12/16/92 STATE
ZIP
DATE PHONE
Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A v A A v
ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFERENCE
LEVEL BASE LEVEL
REFERENCE
FLOOD
LEVEL
ELEVATION
L
BASE
FLOOD '•' "" ADJACENT:'.';':?:� REFERENCE
ELEVATION REFERENCE .•ADJACENT GRADE '.y{ LEVEL
BASE
FLOOD
ELEVATION
' LEVEL GRADE
ADJACENT:;.
�:..
.....'r�11''. •'.:............::':'..'.:
GRADE
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
Page 2
THE NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
PURPOSE OF THE ELEVATION CERTIFICATE
The Elevation Certificate is an important administrative tool of the National Flood Insurance Program (NFIP)
As part of the agreement for making flood insurance available in a community, the NFIP requires the community to adopt a floodplain
management ordinance containing certain minimum requirements intended to reduce future flood losses. One such requirement is that
the community "obtain the elevation of the lowest floor (including basement) of all new and substantially improved structures, and maintain
a record of all such information." The Elevation Certificate is one way for a community to comply with this requirement.
The Elevation Certificate is also required to properly rate post -FIRM structures, which are buildings constructed after publication of the
Flood Insurance Rate Map (FIRM), for flood insurance in FIRM Zones Al -A30, AE, AO, AH, A (with Base Flood Elevations [BFE's]),
V1 -V30, VE, and V (with BFE's). In addition, the Elevation Certificate is also needed for pre -FIRM structures being rated under post -FIRM
flood insurance rules.
Use of this certificate does not in any way alter the flood insurance purchase requirement. The Elevation Certificate is only used to provide
information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper flood
insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). Only a LOMA or
LOMR from the Federal Emergency Management Agency (FEMA) can amend the FIRM and remove the Federal requirement for a
lending institution to require the purchase of flood insurance. Note that the lending institution may still require flood insurance.
This certificate is only used to certify the elevation of the reference level of a building. If a non-residential building is being floodproofed,
then a Floodproofing Certificate must be completed in addition to certifying the building's elevation. Floodproofing of a residential building
does not alter a community's floodplain management elevation requirements or affect the insurance rating unless the community has been
issued an exception by FEMA to allow floodproofed residential basements.
INSTRUCTIONS FOR COMPLETING THE ELEVATION CERTIFICATE
The Elevation Certificate is to be completed by a land surveyor, engineer, or architect who is authorized by state or local law to certify
elevation information when the elevation information for Zones Al -A30, AE, AH, A (with BFE's), V1 430, VE, and V (with BFE's) is
required. Community officials who are authorized by local law or ordinance to provide floodplain management information may also
complete this form. For Zones AO and A (without BFE's), a building official, a property owner, or an owner's representative may also
provide the information on this certification.
SECTION A ° Property Information
The Elevation Certificate identifies the building, its owner and its location. Provide the building owner's name(s), the building's complete
street address, and lot and block number. If the property address is a rural route or PO box number, provide a legal description or an
abbreviated location description based on distance from a reference point.
SECTION B Flood Insurance Rate Map Information
In order to properly complete the Elevation Certificate, it is necessary to locate the building on the appropriate FIRM, and record the
appropriate information. To obtain a FIRM, contact the community or call 1-800-333-1363.
The Elevation rCertificate may be completed based on either the FIRM in effect at the time of the certification or the FIRM in effect when
construction of the building was started.
Items 1 - 6. Using the FIRM Index and the appropriate FIRM panel for the community, record the community number, panel (or page)
number, suffix, and Index date. From the appropriate FIRM panel, locate the property and record the zone and the BFE (or flood depth
number) at the building site. BFE's are shown on a FIRM for Zones Al -A30, AE, AH, V1 -V30, and VE; flood depth numbers are shown
for Zone AO.
Item 7. Record the vertical datum system to which the elevations on the applicable FIRM are referenced. The datum is specified in the
upper right corner of the title block of the FIRM.
Item 8. In A or V Zones where BFE's are not provided on the FIRM, the community may have established BFE's based on data from other
sources. For subdivisions and other development greater than 50 lots or 5 acres, establishment of BFE's is required by community
floodplain management ordinance. When this is the case, complete this item.
Page 3
SECTION C Building Elevation Information
Item 1. The Elevation Certificate uses a building's reference level as the point for measuring its elevation. Pages 5 and 6 of this Elevation
Certificate package contain a series of eight diagrams of various building types that are to be used to help determine the reference level.
Choose the diagram that best represents this building, record the diagram number, and use the indicated reference level to measure the
elevation as requested in Items 2a -d.
Item 2. Depending on the property location's FIRM Zone, complete Item 2a, 2b, 2c, or 2d. Use the reference level shown in the
appropriate building diagram as the point of measurement. As shown in the diagram on the back of the Certificate, for all A Zones, the
elevation should be measured at the top of the reference level floor. For all V Zones, the elevation should be measured at the bottom of
the lowest horizontal structural member of the reference level floor. Reporting of elevations in Items 2a and 2b should be to the nearest
tenth of a foot, or alternatively, unless prohibited by state or local ordinance, the reference level elevation may be "rounded down" to the
nearest whole foot ("rounding up" is prohibited).
Item 2(a). For structures located in FIRM Zones Al -A30, AE, AH, and A (with BFE's), record the elevation (to the nearest tenth of a foot)
of the top of the floor identified as the reference level in the applicable diagram.
Item 2(b). For structures located in FIRM Zones V1 -V30, VE, and V (with BFE's), record the elevation (to the nearest tenth of a foot) of the
bottom of the lowest horizontal structural member of the floor identified as the reference level in the applicable diagram .
Item 2(c). For structures located in FIRM Zone A (without SFE's), record the height (to the nearest tenth of a foot) of the top of the floor
indicated as the reference level (from the applicable diagram) above or below the highest adjacent grade immediately next to the building.
Item 2(d). For structures located in FIRM Zone AO, the FIRM will show the base flood depth. For locations in FIRM Zone AO record the
height (to the nearest tenth of a foot) of the top of the floor identified as the reference level (from the applicable diagram) above or below
the highest adjacent grade immediately next to the building. For post -FIRM buildings, the community's floodplain management ordinance
requires that this value equal or exceed the base flood depth provided on the FIRM. For those few communities where this base flood
depth is not available, the community will need to determine if the lowest floor is elevated in accordance with their floodplain management
ordinance.
Item 3. Record the vertical datum system used in identifying the reference level elevations for all buildings. If the datum used in measuring
the elevations is different than that used on the FIRM, then convert the elevations in Items 2a -d to the datum used on the FIRM, and show
the conversion equation under the Comments section on Page 2.
Item 4. Indicate if the elevation reference mark used appears on the FIRM. Reference marks other than those shown on the FIRM may be
used for elevation determinations. In areas experiencing ground subsidence, the most recently adjusted reference mark elevations must
be used for reference level elevation determinations.
Item 5. Indicate if the reference level used in making the elevation measurement is based on actual construction or construction drawings.
Construction drawings should only be used if the building does not yet have the reference level floor in place, in which case the Elevation
Certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be needed once
construction is complete.
Item 6. Record the elevation measurement of the lowest grade adjacent to the building (to the nearest tenth of a foot). Adjacent grade is
defined as the elevation of the ground, sidewalk, patio, deck support, or basement entryway immediately next to the structure. This
measurement should be to the nearest tenth of a foot if this Certificate is being used to support a request for a LOMA/LOMR.
SECTION D Community Information
Completion of this section may be required by the community in order to meet the minimum floodplain management requirements of the
NFIP. Otherwise, completion of this section is not required.
Item 1. The community's floodplain management ordinance requires elevation of the building's "lowest floor" above the BFE. For the vast
majority of building types, the reference level and the lowest floor will be the same. If the community determines that there is a
discrepancy, record the elevation of the lowest floor.
Item 2. Enter date. These terms are defined by local ordinance.
SECTION E Certification
Complete as indicated. The Elevation Certificate may only be signed by a land surveyor, engineer, or architect who is authorized by state
or local law to certify elevation information when the elevation information for Zones Al -A30, AE, AH, A (with BFE's), V1 -V30, VE, and V
(with BFE's) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information
may also sign this certification. In the case of Zones AO and A (without BFE's), a building official, a property owner, or an owner's
representative may sign this certification.
Certification is normally to the information provided in Sections B and C. If the certifier is unable to certify to the selection of reference level
diagram 6, 7 or 8 (Section C, Item 1), e.g., because of difficulty in obtaining construction or building use information needed to determine
the Distinguishing Feature(s), the certifier must list the Feature(s) excluded from the certification under Comments on Page 2. The
diagram number used for the Reference level must still be entered in Section C, Item 1.
Page 4
INSTRUCTIONS
The following 8 diagrams contain descriptions of various types of buildings. Compare the features of your building with those shown in
the diagrams and select the diagram most applicable. Indicate the diagram number on the Elevation Certificate (Section C, Item 1) and
complete the Certificate. The reference level floor is that level of the building used for underwriting purposes.
NOTE: In all A Zones, the reference level is the top of the lowest floor; In V Zones the reference level is the bottom of the lowest horizontal
structural member (see diagram on page 2). Agents should refer to the Flood Insurance Manual for instruction on lowest floor definition.
DIAGRAM NUMBER 1
ALL SINGLE AND MULTIPLE FLOOR BUILDINGS (OTHER
THAN SPLIT LEVEL), INCLUDING MANUFACTURED (MOBILE)
HOUSING AND HIGH RISE BUILDINGS, EITHER DETACHED OR
ROW TYPE (E.G., TOWNHOUSE, ETC.); WITH OR WITHOUT
ATTACHED GARAGE.
Distinguishing Feature - The first floor is not below ground level (grade) on
all sides'. This includes "walkout" basements, where at least one side is at or
above grade. (Not illustrated)
' HIGHER FLOORS
' (IF ANY) i
' I
' ' 1
' ' I
' ' I
I ,
GRADE
FIRST FLOOR
All
REFERENCE
LEVEL
(TOP OF FLOOR)
DIAGRAM NUMBER 3
ALL SPLIT LEVEL BUILDINGS, EITHER DETACHED OR ROW
TYPE (E.G., TOWNHOUSES, ETC.); WITH OR WITHOUT
ATTACHED GARAGE.
Distinguishing Feature - The lower level is not below ground level (grade) on
all sides'. This includes "walkout" basements, where at least one side is at or
above grade.
HIGHER FLOORS HIGHER FLOORS
(IFANY) (IFANY)
I 1 1
I 1 1
I i 1
1
• I
I
UPPER LEVEL
GRADE
GRADE INTERMEDIATE
LEVEL
LOWER LEVEL
,WWI
REFERENCE
LEVEL
TOP OF FLOOR)
DIAGRAM NUMBER 2
ALL SINGLE AND MULTIPLE FLOOR BUILDINGS (OTHER THAN
SPLIT LEVEL), INCLUDING MANUFACTURED (MOBILE)
HOUSING AND HIGH RISE BUILDINGS, EITHER DETACHED OR
ROW TYPE (E.G., TOWNHOUSES, ETC.); WITH OR WITHOUT
ATTACHED GARAGE.
Distinguishing Feature - The first floor or basement (including an
underground garage') is below ground level (grade) on all sides'.
HIGHER FLOORS
(IFANY) i
i
i
FIRST FLOOR GRADE
BASEMENT (INCLUDING
UNDERGROUNDGARAGE) FP
REFERENCE
LEVEL
(TOP OF BASEMENT FLOOR')
DIAGRAM NUMBER 4
ALL SPLIT LEVEL BUILDINGS, EITHER DETACHED OR ROW
TYPE (E.G., TOWNHOUSES, ETC.); WITH OR WITHOUT
ATTACHED GARAGE.
Distinguishing Feature - The lower level (or intermediate level) is below
ground level (grade) on all sides'.
HIGHER FLOORS HIGHER FLOORS
(IF ANY) (IF ANY)
I I 1
I I 1
I I I
I 1 t
I 1 1
1
1
UPPER LEVEL GRADE
GRADE INTERMEDIATE
LEVEL
LOWER LEVEL
REFERENCE
LEVEL
(TOP OF BASEMENT FLOOR')
Under the National Flood Insurance Program's risk classification and insurance coverage, a floor that is below ground level
(grade) on all sides is considered a basement even though the floor is used for living purposes, or as an office, garage,
workshop, etc.
Page 5
Note: In all A Zones, the reference level is the top of the lowest floor; in V Zones the reference level is the bottom of the lowest
horizontal structural member (see diagram on page 2). Agents should refer to the Flood Insurance Manual for instruction on lowest
floor definition.
DIAGRAM NUMBER 5
ALL BUILDINGS, INCLUDING MANUFACTURED (MOBILE)
HOMES ELEVATED ON PIERS, POSTS, COLUMNS, SHEAR
WALLS, WITH OR WITHOUT PARKING AREA BELOW
ELEVATED FLOOR.
Distinguishing Feature - For all zones, the area below the elevated floor
is open, with no obstruction to the flow of flood waters (open wood lattice
work or readily removable insect screening is permissible).
HIGHER FLOORS
(IF ANY)
DIAGRAM NUMBER 7
ALL BUILDINGS, INCLUDING MANUFACTURED (MOBILE)
HOMES ELEVATED ON PIERS, POSTS, COLUMNS, SHEAR
WALLS, SOLID NON -BREAKAWAY WALLS, WITH OR
_WITHOUT PARKING AREA BELOW ELEVATED FLOOR.
Distinguishing Feature - For all zones, the area below the elevated floor is
enclosed, either partially or fully, by solid non -breakaway walls, gr contains
equipment servicing the building. For V Zones only, the area is enclosed,
either partially or fully, by solid breakaway walls" having an enclosed area
greater than 300 square feet. For A Zones only, with an area enclosed by
solid walls having proper openings,"' and used only for parking, building
access, or limited storage, use Diagram Number 8 to determine the
reference level.
HIGHER FLOORS
(IFANY)
DIAGRAM NUMBER 6
ALL BUILDINGS, INCLUDING MANUFACTURED (MOBILE)
HOMES ELEVATED ON PIERS, POSTS, COLUMNS, SHEAR
WALLS, WITH OR WITHOUT PARKING AREA BELOW
ELEVATED FLOOR.
Distinguishing Feature - For V Zones only, the area below the elevated
floor is enclosed, either partially or fully, by solid breakaway walls." When
enclosed area is greater than 300 square feet or contains equipment
servicing the building, use Diagram Number 7; this will result in a higher
insurance rate. The enclosed area can be used for parking, building access
or limited storage.
HIGHER FLOORS
(IF ANY)
DIAGRAM NUMBER 8
ALL BUILDINGS CONSTRUCTED ABOVE AN UNFINISHED
SPACE, INCLUDING CRAWL SPACE.
Distinguishing Feature - For A Zones only, the area below the first floor is
enclosed by solid or partial perimeter walls, is unfinished, and contains no
equipment servicing the structure. The area can be used for parking,
building access, or limited storage.
HIGHER FLOORS
(IF ANY)
Under the National Flood Insurance Program's risk classification and insurance coverage, a floor that is below ground level (grade) on
all sides is considered a basement even though the floor is used for living purposes, or as an office, garage, workshop, etc.
Solid breakaway walls are walls that are not an integral part of the structural support of a building and are intended through their design
and construction to collapse under specific lateral loading forces, without causing damage to the elevated portion of the building or
supporting foundation. An area so enclosed is not secure against forceable entry.
If the area below the lowest floor is fully enclosed, then a minimum of two openings are required with a total net area of at least one
square inch for every square foot of area enclosed with the bottom of the openings no more than one foot above grade. Alternatively,
certification may be provided by a registered professional engineer or architect that the design will allow equalization of hydrostatic
flood forces on exterior walls. If neither of these criteria are met, then the reference level is the lowest grade adjacent to the structure.
: 7,21-003/202f..()
� U. S. GOVERNMENT PRINTING OFFICE: 1990 Page 6
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3D-20-95 3237-90B,P,E,M 4
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Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: / P L" ft.
/ /"Nat. or/ /"L"ft./ P'LPG
7. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
N
\5
ti
�✓ ti
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; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1 `
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards- Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK ,.
O = Not OKs
-=Nodable
NorReaReadyy RESIDENTIAL (Single,& Duplex)
' =
Date DERFLOOR (Plans) OK except #'s
1 oning-Setbacks-Easements-flood-Slope
2. Ftg., Main; Soils-Elec. Grnd.- tg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ . Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel -Bloc kouts-Wrapped
6. Stemwalls, Garage; Steel -Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
L,4.'Pie rs-Fireplace Ftg.-Steel
D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
as Pipe; Size -Anchors
ater Pipe;iT-dS Anchor -R ulator-Service Test
12. Electric; Underground
ienums & Ducts; Clearance -Material -Support -Ins.
,VA -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Insulation
Date - ,�, Lf .Card B-1 Date Card B-1
Dat Card B-1 yqCe Date Card B-1
Date PLUMDWG- (Permit) OK except #'s
Water tr.; Vent -Access -Combustion Air -Baffle
Water P'pe' Test & Anchor -Nail Protection
V.; Test -Fittings & Anchor -Nail Protection
first Floor -Tub Access
Second Floor -Tub Access
as Pipe; Size & Anchors
Date -ZCard B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
2T7-,_3Ee ransformer Clearance -Ins. Protection
EIec,Receptacles Spacing -Lights & Switches at Doors
Size Boxes & No. of Conductors -Stapled
o -Installed Close to Edge of Studs & C.J.
Equip. Ground made up w/Mech. Fastners-Bond Gas & Water
Appliance Circuts in Kitchen & Conductor Size/GFI
e ire i e / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insylaled Neutral O Yes ❑ No
Service -Riser Conductors & Ground -Main Disconnect
Clearances Panels-Motors-Mech. Equip.
32. fight -Shower Light -Spa Light
moke Detector
Date- Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except #'s
34--A.C. Ducts Insulation & Support
ent Fan; Exhaust above insulation
n ensate Drain & Overflow; Size & Grade
3i -Vent; Access -Comb. Air -Return Air Vent -115 outlet
Attic Access & Platform if Furnance in Attic
P 19
Date - and B 1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except #'s
Sils. Proper Material & Anchors
4 a -lis S ds -Nailing, Spacing & Bracing -Plates -Sound
Baring W lsover Girders & Floor Nailing
412, raft Stop in.Walls (rat proof)
ga-ST6`ps: Furred Ceilings -Stairs -Chases -Tub
4. Headers & Beam -Size & Bearing
Date FRAMING (Continued)
45-`Ha[�gers-pos't Caps -Anchors -Connectors
_467-Cing. Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Rfng.
e A Flue -Fireplace Throat clearance
0,'Access; Size &Romex Protection -Draft Stop -Ins. Baffles
Windows or Exiting Doors -Sill Hgt. &Dimensions
Garage Fire Protection Framing
SldpertdLine Firewall & Openings
Doors -One T -Check Garage -3rd Story, 2 Exits
Stairs; Width-Headroom-Rise-Run-Landing-Fire.Protection
ywood on Roof Overhang -Attic Vents -Rafter Outriggers
iding-Nailing Veneer
Sf SWsso Mosh Brp Crraori-Fri vrants-Underflr. Access
azin Area -Glass Protection -Skylights -Plastic
8 r Walls; Nailing -Bolts
5 . Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
Date —,! a' 4Card B- Date Card B-1
Date �L - and B-1 Date Card B-1
Date- . FINAL (Plans) OK except #'s
Steps -Door & Sidel
ke Detector
- Furnace; Vents -Clearance -Comb. Air -Connector -
Garage; Above Floor-Ducts-Mech. Protection
6 Bedroom Exiting
65.4.17.1. & Bath Fixtures & Tub Access -Spa
6. lec. Trim & Subpanel; Breaker Sizes & Labels
67. Stairs & Rails
66?Ficeplace or Stove; Clearances -Hearth
9. Elec. Outlets at Wood Panel; Int. & Ext.
t, K Kit ixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
lec. Outlets & Receptacles at Kit. Counter
Garage Fire Door; Swing -Landing -Closer
A.C. Duct in Garage -Damper
tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor-Mech. Protection
75. Pl_ lec. & Mech. Equip. Listed for Location
c. Receptacles in Garage; (G.F.I.)-Romex Protection
7. In tion -Foam -Looked in Attic Yes
Gu rd Rails & Deck Construction -Post Caps
Fdn. Vents & Crawl Hole Door -Drain e & Wo -Earth
arance Looked under Flo v es
0. Following instld.; Dr've 0 No; Walks es 13 No;
Planters 0 Yes o
��co; Brown -Finish
82. A., -Unit; Disconnect, Electrical, Plumbing
Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Openings
A4 : e r'Well; Disconnect, Electrical, Plumbing
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Vqr Throughout House
Glass ection
orrectipnsfrom Previous Inspections,
L,,189. }C' P -est -Meters Wged; gAs-EleeTric 15 _/ Z --v t cs%�_—
90.. Water & Sewer Connected -C/O to Grade -HD Approval
1. Energy Compliance Certificate -Other Certificates
Card B-'; f Date Card B -1 -
Date Card B-1�� Date Card B-1
Date �S- -3 `i/ Card B-1 " L� Date Card B-1
Comments at Final:
(NOTE: An entry must be made each time you visit job site)
� � '4'.' <�`' 1�wY'v` � t .moi~ Z:`. . <, •v.. 'l. ♦ -. F .y � .. .�1. ... 4
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751 S
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
�fZ 2 Ad
O N1=R PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or ed additional explanation, please contact this office immediately.
7 Fkz tA)00
r
6,F/ w /v ' o 4f JIA;
c 0 U l y Ards ovi
31A �-1 Ta ok 5w /TtA K F -c4 -T W
Date ✓" !�/ Inspec r
r
r . t'«' 1Lr " �-+ir` i6 ��r. �7R�+ wmw
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541'
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
ffmi�
Date Inspector/l T�i�il'
f
ENERGY CERTIFICATION
LOCATIO
A. P. NO.
ROOF
Material _
Brand Name
Thickness
EXTERIOR WALL -
'Thermal Resistance_ lue)
(R Va-
Material FIBERGLASS
Thickness (Inches) - d�
Brand Name CERTAINTEED_ __
Thermal Resistance
CEILING
(R Value)
-",
Batt or Blanket Type FIBERGLASS -
Thickness-(I-nched�) -
Brand Name CERTAINTEED - __ __
'Thermal
.
Loose Fill Type.__FIBERGLASS_ _
Resistance (R Value)—_-_
Brand Name CERTAINTEED
Minimum Thickness ( Inches)/4-
No. of flags 3o Weight/Dag 25
Area Covered (Sq. Ft.) /
FLOOR,ELEVATED
.1bs
_ Thermal Resistance (R Value) 3Q
Material -____FIBERGLASS
Thickness Inches)__ (�
Brand Name CERTAINTEED_
-4?
_
FLOOR, SLAB
Thermal Resistance (R Value)]/
Material_
Brand Name
Thickness (Inches)
Thermal Resistance (R Value)_
FOUNDATION WALL
Material—
Brand Name.
Thickness(inches)
( )—__-TTkxermal
- --
Resistance (R Value)_
f
I HEREBY CERTIFY,THAT THE ABOVE INSULATION WAS INSTALLPI) IN THE
ABOVE BUILDING IN CONFORMANCE WITH THE STATE OF CALIFORNIA ENERGY
REQUIREMENTS.
HAu1K.IN.S�.N�US�R��S�.IVC 379407 __ _
Firm Name/Owner - State Contractor's License No.
�- ----Ll I (0
Signature
Date
I HEREBY CERTIFY THE ABOVE INSULATION AND ALL REQUIRED ITFtIS AS
SHOWN ON THE BUILDING DEPARTMENT APPROVED PLANS AND ATTACHMENTS
HAVE BEEN INSTALLED AS REQUIRED BY THE STATE OF CALIFORNIA ENERGY
REQUIREMENTS.
Owner
Sig riate Genontractor/Owner
Date
-/�- - .ate -= -
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION'AND PERMIT
PERMIT NO.
Z 0
ASSESSOR PARCEL NUMBER
ZO ING
AP
BUILDING PERMIT,
OWNP'ra ERe� Enterprises •
534-7673 TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
1257 50280
OWNER'S MAILING ADDRESS
6368 Lincoln Blvd #72, Oroville 95966
440 6160
CONTRACTOR'S NAME
Prater Construction
TELEPHONE
534-9230
'
CONTRACTOR'S MAILING ADDRESS
PO Box 336, Palermo 95968
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $5 0
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$334.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$167.00
Energy Plan Checking Fee
$ 15.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS -
"arc'ty /41 -a c
$ 151O
BUILDING ADDRESS
1166 Rudd Creek Court Thermalito
Permit fee
$�e
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
8 2.00 16.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
ARCEL MAP
f43
Water piping
5,00 5,00
Each qas water heater or vent
5.00 5.00
USE OF STRUCTURE
SF ® Duplex❑ Mobilehome❑ Other
• SPECIFY
Gas piping system 1 - 5 outlets
5.00 5.00
Building sewer
5.00 5.00
Mobile Home Is G W
10.00e
TYPE OF WORK
New la Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: 3 BR _
Permit Fee
$46.00
Contractor
ELECTRICAL PERMIT
FilingFee 10.00
00V OR LESS
Main service 100 AMP OR LESS
1
10.00 10-00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
11-1
am licensed under provisions of Chapt. 9, Div. 3 of the BuSIneSS
and Profess i s Code and my license is in f I force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.&
OR ADDNS. ACC, BLDGS.
21/POsgft 42.40
NEW CONSTR. MULTI -OUTLET
NON-RESID BRANCH CIRC ITS
2.50 ea
POWER APPARATUS e
SINGLE OUTLET CIR. )
Ex. OCcup(OUTLETS OR FIXTURES
aA 020 @90
FIXED APPLNS.
Ex. Occup. OUTLETS ((RESID )REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
EL
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
Heating Wall Htr
1 6.00
Cooling Swamp Cooler
6.00
Hood
3,00 3,00
Ventilation
1 3. 3.00
Permit Fee
$28.00
Contractor
I certify that I have read this application and state that the above information
t comply to all County Ordinances and State Laws relating
to bucti n, and hereby authorize representatives of the County or
Butte ton bove-mentioned property for inspection purposes.
is co4itieju
I also'av in emnify and keep harmless the County of Butte against
all Iien s, costs, and expenses which may in any way accrueagainin onsequence of the granting of this per it.
Xate
Signature of Applicant - Owner 510T Contractor 81YAgent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in hei t.
Mobile Home Installation Fee $
Energy Inspection Fee $30.00
occ
_3
CONST TYPE
%
A
TOTAL FEE $ 70ga
HAz
CUA
PARK
F' PAR P�
]=
Ho
ISP
This permit is nereby issued under
sions of the Butte County Code and/or
work indicated • above for which fees
DIRECTO OF PUBLIC
BY
PER EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date /'
oma '`? -S
(.I
f -
Receipt No. ��0�,
WHIrC•D.P.W., 7ELL0 W-ASe!$90 R, P INK•IN3PE+TOR, GOLDENROD-APPLICANTprz; In
-` j, '7P •- s 7lY Tl; s�'�.syyy .{*�"`„n'/� J '� R'4 i1 7 (" -�- - 1-"'1'�'Y\Ip;�. 4- !, ,
„ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE;:CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APwPLIATION DATA SHEET
Permit No.
OWNER PIV`t. 1 TiY�- G �v �. -f Ir-iCj A. P o. -3
Proposed Building Use a' Building Inspector Date_l/% 7 7D
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
-11 All items have been submitted. .... -e"' ..................
2. Plot plans in duplicate/triplicate,sig y=p eplarer of plans ........
3. Complete plans in dupl cate•w _,Ii�ca,fs'gned by preparer. of plans . .
4. Complete engineered • IPs-acrd�calcs, with wet signature on plans . .
5. HazardousMater a Form'' ..................................... .
6. Ener Desi n Comp liance and supporting Energy g p documentation .........
�7. Statement of Intent for Non -Heated and AC Buildings ...............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
i Fees
oti
Fees of ns.. �.. ................. W Id
'
11. Chico Urban Area fees paid .......................................
Park fes paid .....................................
���� Sc ool strict fees paid./0/ 91F0
14. Sanitation approval from Health Department "2 -
j. 15. City of Chico plumbing permit............
.....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval.for (A) Use: (B) Parking: ......
jImprovements may be required. Contact Land Development Section DPW
9. Driveway permit (construction approval required prior to occupancy) P22 ✓1
20. Pre -Inspection for required Pre-Inspec. request to • • • Building Inspector (Date)
" 21. Contractor's license information (No., Name Style, Classifications ...
. Certificate of Workmans Compensation Insurance ..................
. Owner-Bu'Wd' er Verification (Given to owner ❑, Mail to owner ❑) .....
24 W2 4`'
. Recorded copy of Agricultural Acknowledgment Statement .........!7-2-1- 76'
5. Letter of signature authori atio
7: ,A- - p
:V��Iephone,
issue the permit, proce as follows: Mail e . Mail to contractor.
C12-30and hold for pickup at e. Deliver w./inspector.
Other rnrn
Applicant Date /(,/
Copy of Haz-Mat form sent Health Dept. Fire Dept. fir Pollution Date
Copy of plans sent Health Dept. Fire Dept, Other Date By.
The following data must be submitted ri r to er 'it i le new ite not gjjecked above).
1. Index permit for above items,No,
2. Additional items required:
r'
Con or, designer, owner, was advised of above required data by_phone�nail_c unter by..date O—
Contractor, designer, owner, was advised of above required data by—phone —ma ll_counter byv date
Plans checked by Date Plans approved by Date ����✓?'f��
Sets of plans on hold in File cabinet AP folder
Copy—DPW
TO: Building Department
n
FROM: Encroachment Permit Section
RE:- Driveway Clearance
owner location/,'AP #
Driveway permit f2OiZ�yIP���d has been issued for the above property.
si atdate
ure
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
ASSEZSOR'PARCEL NUMB
(�
Z IN
%Z
BUILDING PERMIT
OWNER. /
• 2/L'f�f2 �l lei
TELEPHONE
S3 7107
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
61 3 4 ,�c eL U 13u/D 7a �9S�I�
CONT CT R'S NAME ,A /1 �� /I/ TELEPHONE
e�pl//%K /V
�.
o
a
CONTRACTOR'S MAILING ADDRESS T
-P 0 6 k Pj9 L �deLu D �Sq6
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation S
LENDER'S MAILING ADDRESS
ARCHITECT OR ENGINEER LICENSE NO.
Filing Fee
S 10.00
Permit Fee
Plan Checking Fee
$
vi
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
✓ !J
Penalty
$
BUILD G D RESS �� G
D
Permit fee
$ 5a ,
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2,00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00 O 0
Each qas water heater or vent
Gas piping system 1 - 5 outlets
5,00 l]
1 5.00 Q(�
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
5.00 Q (�
Mobile Home I S I G JW
110.00ea
TYPE OF WORK
NeAddition❑ RemodelUtilitiesInstallation❑' Other ❑
DeschbbD
e work: /��k_�/i/
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service j0OVOR AMP ORSLESS
10.00 Q
/,�
CONTRACTORS LICENSE LAW
I declare under penalty
ena
p y of perjury jur y (check one):
El am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
FlFIXED
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Main service EA. ADD'L 100 AMP
2.50
NEW CONST.// DWELLING OCCUP.tk
OR AODNS. l ACC. BLDGS. )
, /20sgft ,
NE w CONST R. ULTI.OUTLET
NON-RESID BRANCH CIRCUITS
2.50 ea
(POWER
/POWER APPARATUS e
OUTLET CIR. )
Ex. OCCU OUTLETS OR FIXTURES
P
20 @SOe
SALO 30
APPLNS. OR
EX. Occup. OUTLETS (RESID.) EA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for 5100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate 'of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating
1 6,Q
WaL-L/+-r/2--
Cooling
r0
Hood
3.00
Ventilation
p
'
Permit Fee
$ v 61
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County ofocc
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X
Signature of Applicant — Owner ❑ Controctor ❑ Agent ❑
An OSHA permit is required for excavations ove 5' " deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee S
CONST TYPE
TOTAL FEE $ r
HAZ
I CUA I
PARK
I SCHI
FLD
PAR
I PD
I Ho
I ISSUE
Th;s permit is nereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No. -3 :: off -.
WHITE-D.P.W., TELLOW-ASSE330R;.PINK -INSPEC/. O GOLDENROD -APPLICANT
o
Return to DPW AGRICULTURAL STATEMENT OF ACKNUAXDGEMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8.1 of the Butte County Code
requires this acknowledgement 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 incon-
veniences or discomfort arising 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 agricul-
tural zones which have as a priority use for productive 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:
Parcel 1, as shown on that certain mapfiled in the office of the
Recorder, County -'!of Butte,State of California, on June 6, 1985 in
Book 99 of maps, at page 22.
RESERVING THEREFROM a Non-exclusive Easement for road and public
utility purposes as shown on the parcel map referred to herein.
Said Easement to be for the benefit of and appurtenant to the re-
maining land of the G."rantor herein and shall insure to the benefit of
and may be used by all persons who may hereafter become the owners of
any parts or portions of said appurtenant land.
AP No. 030-200-095
Date: 9/19/90
PROPERTY OWNERS:
PRATER ENTERPRISES FRED W. PRATER
MARGERET L. PRATER RON D. PRATER
State of M01,12( v10 On this the,,�/'5� day of 19 Q before
) SS. unde igned ;�,Z
ry Public, personally appeared`
County of /9 / ) d�7 D
Personally known to me. CJ Proved to me on the basis
of satisfactory evidence.
a:J to be the person(s) whose name(s) %s
I subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN WITNESS
IV. WHEREOF, I hereunto set my hand and official seal.
_y
Present A.P. No.
INotary Public
i
ilA
THERMALITO- IRRIGATION DISTRICT
410 GRAND AVENUE
OROVI LLE, CALIFORNIA 95965
TELEPHONE 533-0740
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
1
Service Address: illm n.�-.1,/ Cr--,:.,,
Owner's Name:
I
Address: .,U., 1°�'.r i' t; i,;,.: ��b
Date:
%wA
Acct. No:
�i;�
A.P. No.:. '
Phone: .:��+
No. Units:
Applicant/Agent: L;
Agents Proof:
Address:
Fees:
Phone:
Application $
Arrearage
Preliminary Review By: Date:
CSA 26
Remarks: C7..:�X,,10., t �L: r:..� �L. '.�t.a;;.� �_'� ,Z%A- L',
SC OR
Iii . i,w. u {Jr;.:�.t 7:1_I., 1;) .SY
n`.,` L '
1st mo. S. C.
Other
/ ell"
Total Fees
Collected By:
�
Date: �r
Field Review By: Date:
Remarks:
r
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON:
❑ Date of TID approval of completed building sewer (early connection).
❑ 30 days after date above, or on date of D.P.W. approval of completed building sewer, which ever comes
first ("existing construction", prior to Mar. 5, 1974).
❑ 180 days after date above, or on date of D.P.W. approval of completed building
sewer, which ever comes
first ("new construction", after Mar. 5, 1974).
DISTRIBUTION: WHITE - TID, YELLOW - APPLICANT, PINK - DPW, GOLDENROD - DPW to TID
-This
set df plans and specifica
ktions MUST be
r�pt on the job ?t all times and it is unlawful to
Make- any chances
r pull' "'On IrOm the Department of Public
oks, Countf 0i, Butte.
�- ._
A setback of 5 ft, trom the
property lines and a setback
' ot fro
_—.m the r W
7v f
centorhm shall be clear of
structures or equipment except
for a 2 ft. eave overhang. 1�
Finish floor, electrical, HVAC
equipment and services above
flood elevation of usm
NOTE:—Alt Materials & Workmanship Shall Be i
Accordance with RecoaniZeCi Ca00d Practices a
of a quality ;prescribed for the Specified use in t ,e
Uniform Building, Plumbing & Mechanical Cod and
the National Electrical Code.
.... _ .... _...............
.-..... _......_...............
............
.... .._.
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t '
i -
i
� zo
1�JG
�j. � "SC•�Da '
U T,5,
1
See WS
plans`
Creek QIL
I
* yo'g
Plan on file for building
1 3 o 37-90
BUTTE COUNTY
ILDING DEPARTMENT
APPR0VEl/ D
. , � •/�/cwt,■/��/,/■� /^'/
Don
ENNEBRS
L
LAND ,
9URVEYOR3 C as sod
7R/�A7JCALIFORNIAQ�CORPO(JR'ATION
September 21, 1990
A.P. #30-20-095
Ron Prater
Ruddy Creek Court
(916)534.9587
P.O. BOX 986 — OROVILLE, CA 95965
100 GOLD DREDGER DRIVE
On September 20, 1990, we set a j inch rebar with L.S. tag 4085 near
the North line of the above referenced parcel.
We established an elevation on this point at 164.36. This was derived
from the Butte County Public Works Bench Mark "V-7", a 2 inch brass
disk in the South side of the bridge over Ruddy Creek at Biggs Avenue.
The County published elevation for this bench mark being 164.30.
Thank you.
Sincerely,
Ronald L. Graves, P.L.S.
Ron Graves and Associates
T4
t
j�
jl.'� g2F
S—
�Gr/2�/� �n Ta
5T;+7 -E /72,oa p l 163 /
div T-t1NEO FR6
1
2 . STYE IcGa IZ 6e�16C /2F-4 p .
AL LAN `
G''•Ql�l
*:a: No. 4085 � '
N>9Expires Q
••��s 3p•g2•�OP��
Finish floor, electrical, HVAC
equipment and services above
flood elevation ofoo � USQS,
SURVEYING SOIL TESTING ENGINEERING
OWNER /LG /514
5189
RESIDENTIAL PLAN CHECKING GUIDE
(S.F.,'DUPVE &•MISC. ONLY)
Bldg. Permit #
A.P. # 36 - ,I_o Z 7S
GENERAL
Y. Zoning requirements: (sideyards
2. Valuation.
ans signed by designer.
Energy Design and Compliance.
Y•
Items on data sheet.
and number. of permitted living units).
PLOT PLAN
plete parcel size and dimensions.
2-. Setbacks, sideyards, easements, etc.
3. � buildings
l rli ngs
f f
Y. Flood hazard.
6n�s��-montes e�—Feation m -a -T =r campc-P-dement.
FLOOR LAN
. complete to scale plan with dimensions.
?!/ uired windows for light and ventilation (Sec. 1205).
Required windows for second exit (Sec. 1204).
--rpeet--gess (Sec. 5406).
. squired room sizesceiling ceiling heights (Sec. 1207).
7/ GFCIs in baths, garage, and exterior outlets (Article 210-8).
1$! Light fixtures, switches, receptacles, and exterior receptacles for maintenance
mechanical equipment.
Y- Locations of water heater, heat' and cooling eaui-pm-effit, other electrical or
equipment, and plumbing fixtures.
1 rage firewall, door size, and closer (Sec. 503(d)(3)).
14. 1 3'0" exterior exit door (Sec. 3304(e)).
1 . tove lbcation, alcoves, and clearance.
. Smoke detectors (Sec. 1210).
STRUCTURAL DETAILS
1/ FF undation plan complete enough to construct building.
2 --'Flo
Flo r construction details complete enough to construct building.
ations and wall construction details complete enough to construct building.
Roof construction details complete enough to construct building.
y.
MISCELLANEOUS ITEMS TO LOOK OUT FOR
'—*��- ^• aQ
1.7 . landings, rise and run, head clearance, handrails (Sec. 3306). 1
e Tas (Sec. 1711 & 3306(j)).
3. apter 30).
RESIDENTIAL PLAVCHECKING GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONY D)
- 706).
A�operroof pitch for roof c ring (Chapter 32).
Roof covering type - (fir azard).
7. R er i rearinR
Garage door or porch header sizes.
Adequate bracing.
e
and • - ).
1 Att' access and ventilation (Sec. 3205).
1erfloor access and ventilation (Sec. 2516).
1 . Combustion air for fuel burning appliances.
1
Flashing at all exterior openings.
lateral design. Z
LV 7;i'15-5 P14 le ( %j S -j
5/89
Q
G1
:-
''
jF,
DATE
RECEIPT.
TOTAL
TENTATIVE
HRIS
CHECK of
STREET
PVBLIC
COMP-
FIRg
NO.
RfiCgIV ED
MAPS
INSPECT
SIGNS
DOCUMENTS
LIANCE
HYDRANT
OTHER
APPLICANT RECEIVED FROM
� D D-
D-qs •
OFFICIAL RECEIPT
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
LAND DEVELOPMENT SECTION
.ti
k
l^(�✓Wuw�."rti "'}.�11`�.A'"-r .,r _.:Tr•--•.��r v . r"n-�`✓l•-'� yr=, ti-.�,y,rrs._.._ -, -... v—cr� ... .q,. -. _,r. .. Y...� ._ ._ �. 1� .
BUTTE COUNTY SCHOOLS DEVEI;OPMENT FEE CERTIFICATION FORM
(One Form;p6r"'.Pu1lding)
a
A.P. Number 30',20'�r7�j ;Building Department No.
School District OP -0 ��i � City = County Jurisdiction
Property Owner_P IV�•t1TTr...�• j�a�
Project Location/Address(,MD�
Subdivision Lot Number
Residential Development:
Sq. Footage
# of Living MHI Addition (Group R
Units
'i'Commercial/Industrial: Sq. Footage
New Addition ( Including Exterior
Roofed Areas)
/BuIlding�D p`aftm9iit Representative Date
(Floor Plans reviewed by School District Personnel)
ict Id No.
Applicant„Name
t Address
School District certifies that
one Number
(City) (State) (Zip Code)
.has complied with the requirements of Resolution
No.
•-
by the payment o • $'�— l� . D6 representing K�(.J square feet.
AVI
School District Representative Date
PAID BY CHFrCK NO. REMARKS:
BANK�1
PAID BY CASH
white-applicantOyeli�bgudinde artment ink -school districtPP g P P
SCHOOL.FEE (8/88)
THERMALITO IRRIAGATION DISTRICT
+� tr a � C
+ 41+0'*GRA ND AVENUE
OROVMLLE. CALIFORNIA 95965
TELEPHONE 533-0740
CSA 26 SEWER SERVICE APPLICATION AND CONNECTION PERMIT
Service Address: �° �' . , _ 1♦
Owner's Name: . _ ,_..s _ .... _ ... _., L „
Date:
Address:
Acct. No:
A. P. o.
Phone:
No. Units:
Applicant/Agent:
'.
Agents Proof: ✓
Address:
Fees:
Phone:
Application $
Arrearage
N
Preliminary Review By: Date: CSA 26
Remarks: SC OR
C.
Other
,f Total Fees..
Collected By:
„ Date:
Field Review By:.. Date:» -
r
Remarks:
J
MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPO,:Health
❑ Date of TID approval of completed building sewer i(early connection). Enviconmen
❑ 30 days after date above, or on date of D.P.W. approval of completed buildinghgg,
�w�r, w Ic ever comes
first ("existing construction", prior to Mar. 5, 19741). .emtomia
❑ 180 days after date above, or on date of D.P.W. approval of completed building s9we�`ewhich ever com
first ("new construction", after Mar. 5, 1974).
DISTRIBUTION: WHITE - TID, YELLOW -APPLICANT, PINK -DPW, GOLDENROD -DPW to TID