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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
County Impact - SFD
Drainage Fees
Dwelling - Custom, Model
Dwelling - Custom, Model
Fund 10 BLDG
Impact Processing Auditor
Impact Processing DDS
Res Impact Fees - SFD
FEE INFORMATION ,
$2,244.02
$684.00
$1,585.43
$1,056.96
$1,056.96
$50.00
$50.00
$2,005.09
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
WORLD F M CONSTRUCTION 1740981 / B /
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is in full force and effect. /
X / 12/18/2006
Contractor's
Date
I- - WORKERS' COMPENSATION DECLARATION I
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
Section 3700 of the Labor Code, for the performance of the work fcr which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
Carrier: Policy Number: Exp. Date:
(This section need not be completed if the permit is Tor one hundred dollars ($100) oror es�—
I
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
provisions.
WARNING: FAILURE'TO SECURE W RKERS' OMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER—TO—CRIMINAL PENALTIES AND CML FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Lender's Address
City State Zip
SMIP - Residential $12.80
Total Charged: $8,745.26 Fees Paid: $8,745.26
Balance Due: $0.00 Receipt No: B166
OWNER / BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
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
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
❑I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
are not intended or offered for sale. If, however, the building or improvement is sold within one
year of completion, the owner -builder will have the burden of proof that he or she did not build or
improve for the purpose of sale.).
❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
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.).
❑ I AM EXEMPT under Section B. & P.C. for this reason:
LX 12/18/2006
Owner's Signature Date
I 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
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
property owner or_parauthlo air
t -on the property owner's behalf. /1/-3,01„p
Owner Contractor OR. DAgent for Owner Agent for Contractor
FILE COPY
PROJECT INFORMATION
Site Address: 1884 20TH ST
Owner:
Permit No: 06-2205
APN: 030-462-025
CHAI VANG
Permit type: RESIDENTIAL
1906 FEATHER AVE
Issued Date: 12/18/2006 By KCG
Subtype: SFD-Custom/Model
OROVILLE, CA 95965
Expiration Date: 12/18/2007
Description: NSF/GAR/DECK(COV)
(530) 370-1492
Occupancy: R-3 Zoning:
Contractor
Applicant:
Square Footage:
WORLD F M CONSTRUCTION CO
FOUATHYULYSSES MOUA
Building Garage Remdl/Addn
7630 TAMARINDO BAY DR
7630 TAMARINDO BAY DR
1,651 693
SACRAMENTO, CA 95828
SACRAMENTO, CA 95828
'
Other Porch/Patio Total
(916) 870-2344
(916) 870-2344
ane � cin
County Impact - SFD
Drainage Fees
Dwelling - Custom, Model
Dwelling - Custom, Model
Fund 10 BLDG
Impact Processing Auditor
Impact Processing DDS
Res Impact Fees - SFD
FEE INFORMATION ,
$2,244.02
$684.00
$1,585.43
$1,056.96
$1,056.96
$50.00
$50.00
$2,005.09
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
WORLD F M CONSTRUCTION 1740981 / B /
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is in full force and effect. /
X / 12/18/2006
Contractor's
Date
I- - WORKERS' COMPENSATION DECLARATION I
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
Section 3700 of the Labor Code, for the performance of the work fcr which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
Carrier: Policy Number: Exp. Date:
(This section need not be completed if the permit is Tor one hundred dollars ($100) oror es�—
I
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation laws of California, and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
provisions.
WARNING: FAILURE'TO SECURE W RKERS' OMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER—TO—CRIMINAL PENALTIES AND CML FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Lender's Address
City State Zip
SMIP - Residential $12.80
Total Charged: $8,745.26 Fees Paid: $8,745.26
Balance Due: $0.00 Receipt No: B166
OWNER / BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
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
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
❑I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
are not intended or offered for sale. If, however, the building or improvement is sold within one
year of completion, the owner -builder will have the burden of proof that he or she did not build or
improve for the purpose of sale.).
❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code:
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.).
❑ I AM EXEMPT under Section B. & P.C. for this reason:
LX 12/18/2006
Owner's Signature Date
I 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
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
property owner or_parauthlo air
t -on the property owner's behalf. /1/-3,01„p
Owner Contractor OR. DAgent for Owner Agent for Contractor
FILE COPY
Z.Gq2
� 12.E sfm p
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 OFAPPLICA TION
Website: www.buffecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER INFORMATION
Last Name VANG
Address 7630 TAMARINDO BAY DR.
irst'bfiAI
(;
Address
1906 FEATHER AVE.
City ORQVILLE
State CA
Zip 95965
Phone ( 530) 370-149
Fax
E-mail
SACRAMENTO
CONTRACTOR
Name FOUATHYULYSSES MOUA
Address 7630 TAMARINDO BAY DR.
City SACRAMENTO State CA
Zip 95828
Phone ( 916) 870-234 Fax (916)682-2913
E-mail Lic.#740981
C�
APPLICANT SIGNAT E
X `
For office use only:
ARCHITECT/ENGINEER
Name
EJ RINCHAR & ASSOCIATE
Address
7419 MYTILE VISTA AVE.
City
SACRAMENTO
State
Zip
Phone
SACRAMENTO
CA
95831
Phone
Planner
Fax
(916)428-2076
E-mail
State License Number
tAFTING
APPLICANT SIGNAT E
X `
For office use only:
APPLICANT INFORMATION
Name
FOUATHYULYSSES MOUA
Address
7630 TAMARINDO BAY DR.
City
SACRAMENTO
State CA
Tip 95828
Phone
(916)870-2344
Fax(916)682-2913
E-mail
Lot #
APPLICANT SIGNAT E
X `
For office use only:
AP#
Zoning
—
Flood Zone
SRA
I Yes C No
Occ.
Carrier N/A
Type Const.
Subdivision Name
Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
PROJECT LOCATION
AP#
Property Address 1884 20TH ST.
0AVILLE
Cross Street 20TH ST & GRAND AVE.
WORKER'S COMPENSATION
Policy Number NxA
Carrier N/A
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of pennit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
.
Nev HO BUILT ON SITE.
Sq FT- Living 1 Garage 693 Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy /
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
rr
I I Received by K V. Amount: y 10 — .9 G Bldg I I
Page 1 of 2
Ar -
Receipt #: 1W I�•C.(J
Sheriff
SMIP
Other
Date: t c��
Total
REV 8-12-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxesl
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.. ok ,
❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans,
all in duplicate
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Building Permit Application Without Required Clearances Form
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3. California Department of Forestry plan approval (if required).
❑ 4. NPDES Form.
❑ 5. , Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6. Contractor's license information. (Number, Name Style, Classification).
❑ 7.' Worker's Compensation Carrier and Policy Number.
❑ 8. Owner -Builder Verification (if required). -
❑ 9. Letter of Signature, authorization (if required).
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO.
❑ 12. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530) 538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05
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
App Date:
YANG
oil di,:)nna
APN No: 030-462-025 Permit Type: Subtype:
Permit No: BP 062205 Permit Desc: I New
1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION
Plan Check portion of Permit Fee
2 FEMA RYes Flood Elevation Review $109.98
3 SRA* Yes Fire Plan Check - Non -Refundable $95.00
(State Responsibility Area) Building Inspection $109.98
NON-RFFUNDARI F nnrfinn of fePc rtup at annlicatinn
$2,642.39
$1,056.96 $1,585.43 Balance of Building Permit Fee
0
0 _ $204.98
C4 nsa or
- ---- - --- --- -- -----
FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION ,$1,056.9.6.
FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT $6,631.
$1,585.43
$12.80 61 •+
LL:J
RECEIPT DATE Tech/Asst
9/14/06 Kourtni
4
5
6
7
7a
8
Balance of Building Permit Fees (from No. 1 above)
SMTP* - Strong Motion Instrumentation Program (Enter amount from permit system)
Additional Plan Check Fees (NON-REFUNDABLE)
Other*:
Other*:
MPACT FEES - RESIDENTIAL*
Applications After 04115/06
,>
Per Dwelling
SFD ,c
Per Dwellinc
MFD
County
1 4249.11
1
3183.
Chico Urban Area
6146.23
4538.
EI Medio Fire District
3249.97
2385.
North Chico Specific Plan
0 SR -1, SR -3, SR-1/PD
8801.09
7395.
coo R-1
do R-2
8897.09
1 8390.091
7491.
6984.
Processing Fee is automatically added to impact fee total
9 WATER TENDER FEE (Not collected when impact Fees Applicabie) Enter Bat.#
DRAINAGE FEES*
10
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
Per
xc
3238.72
5648.44
2422.68
8486.40
8582.40
8075.40
7289.40 RECEIPT DATE Tech]/Asst
1 $100.00 $4,349.11 •
$200.00
341
088
211
275 RECEIPT DATE Tech/Asst
893 C�
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 1 $694 Maximum $684.00
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 ISSUANCE OF PERMIT. Forms will be prepared after plan check
is completed for applicant to take to respective district office.
12 SCHOOL DISTRICT FEES* Oroville High/Thermalito 104
12a RECREATION DISTRICT FEES* I Oroville
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: Date:
Pursuant to Government code Se 66020, you a he by notified those Items followed by an "* may have been imposed on your project. You have 90 days
from the date of approval of the ject or from the im stion 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
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET 802205
OWNER: VQng (' ASSESSOR PARCEL NUMBER 030- 162 -V
Proposed Building Use: ��}j' Permit Technician: K.� Date: "� ' 6� ' ®(b
I_ telns required in order to apply for a permit All boxes MUST be checked OR marked NA in order to apply.
°9tXN 1. Site pians,(Dr D r 4 sets, signed by the preparer of the plans.
❑ 2. Complete plans, 3A4 sets, signed by the preparer of the plans
3. Engineered plans 3&r 4 sets, with wet signature on plans AND ets of stamped and signed calculations.
4. Engineered truss details and layouts in duplicate. No faxesl
❑ 5. Letter from Engineer or Architect for truss design review.
`t /=N 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 find 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.
❑L 11. Hazardous Material Form
,K1 12. Acknowledgement of building permit application without required clearances.
❑ 13. Other
IVRemaining items needed to issue the permit (May require additional plan review upon receipt of the following items.)
14. Sanitatioft-a site, wa pmval*om4he.Enxit,4nmentaWdeaI"epfaftmerA*EreMeoIE�eroville;-as gplimbte TIYtT -r ova
❑ 15. Fire Sprinklers ............................................................................................ 14Z 71.
❑ 16. Agricultural Buffer dr and site plan apr from the Ag Commissioner Sent by
❑ 17. Soils Report and/or Engineered Foundation required ...........................................
18. Erosion Control Plan Required........................................................................
19. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
❑ 20. City of Chico Plumbing permit........................................................................
0 21. Site plan and business license approval from the City of Biggs ..............................
❑ 22. California Department of Forestry plan approval ❑ paid. Sent by:
�l 23. Planning approval for (A) Use: l� (B) Parking: (C) Parcel Check:..... ✓ .. l Q �o
❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................
❑/_ , 25. Fire Marshall Review (commercial projects only). Sent by: ......................
�� 26. NPDES Form.............................................................................................
IN 27. Encroachment Permit for driveway from the Public Works Dept ........................... Dro
0 28. Contractor's license information. (Number, Name Style, Classification) ...................
❑ 29. Worker's Compensation Carrier and Policy Number.. ........................................
❑ 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .....................
31. Letter of Signature authorization....................................................................
0/
32. Recorded copy of Agricultural Acknowledgment Statement .................................
El 33. Existing violations and/or expired permits.........................................................
❑ 34. Deed Restriction..........................................................................................
❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO .........................
❑ 36. Other.
❑ 37. Other.
When issued Telephone (g10�70` 2N U I.i SSSS and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant: i Date:
1. Index permit application for the ve items nymbe ,red: Plan Check Letter
2. Additional items required �/
Contractor, designer, owner, was advised of the above data by O mail, ❑ counter, by Date:
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, owner, w advised of the above at by ❑ phone, ❑ mail, ❑ counter by Date:
Plans reviewed by Date: Plans approved by: _ Date: 1
Structural reviewed by: Date: Structural approved by: Date:
Note transfer by: Date:
Yellow: Building Division
.da:s'jx€4
� HFIRREMITO
A Public Agency
410 Grand Avenue
Oroville, California 95965
(530) 533-0740
FAX (530) 533-9243
DIRECTORS
Brad Taggart
Division 1
Gary Allen
Division 2
Edgar C. Thompson
Division 3
Stanley J. Huston
Division 4
Ernest L. Reynolds
Division 5
Gary Alt
Manager/Secretary
John Jeffrey Carter
Legal Counsel
...stabiis^ed 1922
August 1, 2006
Chai Vang..
.1884 20" Street
Oroville, CA 95965
RE: AP 030-462-025
Mr. Vang,
Thermalito Irrigation District is willing and able to provide water and sewer
service for AP 030-462-025 located'between the address of 1880 and 1900 at 20`"
Street in the Thermalito community, California, on satisfaction of the following
conditions:
1. The District shall approve, in advance and in writing, the plans and
specifications for the water and sewer installation to the new dwelling unit.
All plans will be submitted in accordance with TID Improvement Standards
for Water and Sewer Facilities.
2. The water and sewer installation shall be completed in a good and
workmanlike manner, and shall be subject to TID Improvement Standards,
inspections and acceptance;'in writing, by TID's inspector. All sewer and
water lines will have a horizontal separation of ten feet.
3. Thermalito Irrigation District has no sewer or water easements on. the
property.
This letter shall expire one year from and after the date hereof. At which time it
will be. null and void, and of no further force or effect. Connection fees for water
and sewer service shall be assessed at the current rate of the District at such time
they are requested. You, or your successor in interest, shall pay water and sewer
connection fees in advance prior to connection to the water and sewer system of
the District.
Sincerely,
C
Gary Alt
ager
71
BUTTE COUNTY SCHOOLS IMPACTTEE CERTIFICATION FORM
(One form per Building)
School District Building Departme nt No.
(as
A.P. NumberJurisdiction: city JCounty
4
Property Owner
Property Location/Address
Subdivision Lot No.
Residential Development Sq. Footage
No of Living Mobile Home Addition/ *Supplemental to (Group. R)
Units Installation Conversion Permit #
.(No foundation inspection)
....................................... 0 ................................................
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document),
'Commercial/Industrial
New Addition
Building Department Repre_sentative
J�'70099
District Identification No. k"
6 r i, ft i4LSchool District certifies that 9-0
9 1? V ' .aa T, -
Address) -
Sq. Footage
(including Exterior
Roofed Areas)
=Ar -
Date
IZI 040 to
to
ku-, va*�e,
(Applicant) J
(Phone Number)
A2A-y" /U
(d It;) (State) (Zip Code)
has complied with the requirements; of Resolution No. by paymentof$
representing 43qq -square feet.
UW MITIGATION
So
School.District Representative Date
Paid by Check # / Remarks:
You may protest the Imposition of the fees Identified above by submitting a written protest.to the Dist i rict, In conVUwme with
Govemment Code Section 86020(a), within 90 days from the daft fees are paid. Failure to submit a timely written Protest will proMbit
you *=.challenging the Imposition of the fees In any court aciian.
p
If, subsequent to the School District Representative signing Oft Butte County Schools lirnpect Fee Certification Form the School DlMd Is
notified by the applicable Local Planning Agency that this project Is being rwlswad underthelon-1 Environnmytall Queft Act (CEQA).
MIs project may be subject to additional school fees to fully nrMgab ItsImpact on ft school dW&Ws schools.
White (school district), Yellow (building department), Pink (applicant). feeftmids (3fflifiWam
r-1
BUTTEUNTY DEVELOPMENT FEE CER'T'IFICATION FORM
VIFEATHER RIVER RECREATION AND PARK DISTRICT (FRRPD)
❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD)
❑ PARADISE RECREATION AND PARK DISTRICT (PRPD)
❑ DURHAM RECREATION AND PARK DISTRICT (DRPD)
Assessor Parcel Number (s)���j� ���--n25 Building Pen -nit Number
Property Owner (s)
Project Location /Address
Subdivision Name
New Development
Alteration/Addition(s)
Mobile home
Demo
�Peermit (date iss
.Comments: "/ l &I I x
+h
,
Assessable Sq. Ftge 2 3 %,)1
Type of Residential Development (check one)
Single Family -Detached
Non -Residential to Residential
Mobile home replacement
Single Family -Attached
Multi -Family Dwelling
verified by. Assessor Department
verified by Building Department
0 FRRPD 0 CARD D PRPD ❑ DRPD certifies that:
Applicant Name l Phone Number
C) rnc( r N rr! ?c,,_4 iBr(`,,x Irc, rnepitoI
Mailing Address City State Zip
Has complied with requirements of the Butte County Board of Supervisors Resolution No.
by Payment of: �/ �� ` O G
Dwelling Units @ $
Square Feet @ $
Remarks:
per unit for a total of $
per sq foot for a total of $
Paid by Check No: �S Paid by Cash: Receipt Nd'.
4 / / /7 n <
°��TM ENT
vTrFok- Department ®f Public Works
C o u n t y. o f B u t t e
0
O 7 County Center Drive
' Oroville, CA 95965
0 y 0 J. Michael Crump, Director (530)538-7681
C0 U N-� / (FAX) 538-7171
p�L1c w�a Shawn H. O'Brien, Assistant Director
Assessors Parcel Number:474. Building permit # O6 Z Z.O
Owners Name: 1/
Owners Mailing Address:
Property Address: 2 S�
ENCROACHMENT PERMIT ACCEPTED:
PERMIT NUMBER:
ENCROACHMENT PERMIT' EXEMPTION:
Reason for exemption:
F] Not a County maintained road
Existing driveway conforms to County S-31 standard
Other
Approved by
Printed Name
Title
Date
BUTTE
COUN'T'Y
SEP 1 4
I' i,'%TEe.0P'-V1LN'd
SERVICES
CONDITIONS FOR EXEMPTING A DRIVEWAY PERMIT
An existing home with a driveway 10 years or older and doesn't cause any problems with
the county road or drainage.
2. An existing home with only minor remodeling or repairs.
00
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Michael Parrish, a married man
as his sole and separate property
hereby GRANT(S) to Chai Vang and Blia E. Lee, husband and wife as joint tenants
the following described real property in the City of unincorporated area of Oroville, County of Butte, State of
California:
SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF -
DATED: January 3, 2006
STATE OF CA
COUNTY OF
ON 1---T-
'before me,
ly appeared
personally known to me (or pro d to me on the basis of
satisfactory evidence) to bet person(s) whose name(s) TERRI GEROY
is/are subscribed to a within instrument and
acknowledged to me tha a/she/they executed the same in
his/her/their author' ed capacity(ies), and that by
his/her/their signa re(s) on the instrument the person(s),
or the entity u n behalf of which the person(s) acted,
executed the instrument.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
UCommission #5442021 0
Notary Ptiblie - Calitomla �
Butte. County
My Comm. Exp. CICT. 24, 2D07
Witness A% -hind and official seal.
FD -213 (Rev 7/96) GRANT DEED
(grant)(12-05)
2006-0000673
RECORDING REQUESTED BY:
Recorded 1 REC FEE 13.00
Official Records I TAX 93.58County
Fidelity National Title Company of California
of I
Escrow No.: 05 -108127 -TG
Butte I
Locate No.: CAFUT0958-0958-0001-0000108127
CANDACE J. GRUBBS I
Title No.: 05 -108127 -BD
County Clerk—Recorderl
When Recorded Mail Document
I NZ
and Tax Statement To:
09:00AN 06 -Jan -2006 I Page 1 of 3
Mr: and Mrs. C Vang
1906 Feather Avenue nue
. INIIIIIIIIIIIIIIIIIIIII IIIIIIIII
Oroville, CA 95965
APN: 030-462-025
SPACE ABOVE THIS LINE FOR RECORDER'S USE
`
GRANT DEED
The undersigned grantor(s) declare(s)
Documentary transfer tax is $93.50
[ x ] computed on full value of property conveyed, or
[ ] computed on full value less value of liens or encumbrances remaining at time of sale,
[ x ] Unincorporated Area City of unincorporated area of Oroville,
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Michael Parrish, a married man
as his sole and separate property
hereby GRANT(S) to Chai Vang and Blia E. Lee, husband and wife as joint tenants
the following described real property in the City of unincorporated area of Oroville, County of Butte, State of
California:
SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF -
DATED: January 3, 2006
STATE OF CA
COUNTY OF
ON 1---T-
'before me,
ly appeared
personally known to me (or pro d to me on the basis of
satisfactory evidence) to bet person(s) whose name(s) TERRI GEROY
is/are subscribed to a within instrument and
acknowledged to me tha a/she/they executed the same in
his/her/their author' ed capacity(ies), and that by
his/her/their signa re(s) on the instrument the person(s),
or the entity u n behalf of which the person(s) acted,
executed the instrument.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
UCommission #5442021 0
Notary Ptiblie - Calitomla �
Butte. County
My Comm. Exp. CICT. 24, 2D07
Witness A% -hind and official seal.
FD -213 (Rev 7/96) GRANT DEED
(grant)(12-05)
�QppLWEr
� T T®
°1-��, De artment of Public Works
�.
C o u n t y o f B u t t e
=: a
LAND DEVELOPMENT DIVISION
J. Michael Crump, Storm Water Management Program
0
1 Director 7 County Center Drive
Oroville, CA 95965
a `•� 5 (53D) 5313-7266
GQLIC WOVIF (FAX) 53B-7171
National Pollutant Discharge Elimination System (NPDES) Phase II
Construction Storm Water Permit and Storm. Water Pollution Prevention
Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1
Project Description:
Project Location and/or Parcel Number: c010 —
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water
Permit from the State of California Regional Water Quality Control Board. 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 California Regional Water Quality Control Board for a project
that disturbs one.acre or more of land may result in revocation of grading and/or other permits or other,
sanctions provided by law.
Signed:
Title:
--
Butte County Department ol'Developinent Serwces °$OT,TF°
7 County Center Drive °
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES
I request and authorize the Building Division to process this building permit 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:
I need to submit applications for septic and/or well to Butte County Environmental Health
immediately.
I ani required to bring the approved Environmental Health site plan and approved sanitation
clearance to the Building Division as soon as clearance is obtained
a 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 r wire
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: IF�7_ APN: 6'0 0' ZO a..20357_
Building site address: ;9gtIr 20 5-E. aX..O triCl� C4 Permit No.: 06 ZZ0�
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:
SIGNATURE OF APPLIC DATE
F
Butte County Department of Development. Services
TIM SNELLINOS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
ADMINISTRATION * BUILDING * PLANNING
October 11, 2006
Fouathyulysses Moua
7630 Tamarindo Bay Dr.
Sacramento, Ca. 95828 -
Assessor Parcel Number: 030462-025
Building Permit Number: 06-2205 (Vans Residence)
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.
CONPV S:
Provide full bearing under roof girder truss B-1 that has a reaction load of 2,353 lbs and 3,095
�b's
/2. Roof truss member C-1 has reaction loads of 10,286 lbs and 9,055 lbs. Provide calculations for
sizing the supporting columns and concrete pads. Revise the plans to show the 'locations of the
concrete pads and columns.
3. Please submit 2 new sets of plans that are wet stamp and signed by the engineer.
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.
Jim Peterson
j epeterson@buttecounty. net
Plans Examiner
Cc; EJ Rinchak- & Associates, Designer
PLAN REVIEW RESPONSE FORM
In order to expedite the review of you plans, please complete the following information and return this form with your re -submittal.. I
this form is not complete, as to all correction items, we will not be able to accept your re -submittal for review. There must be a valic
response to.every item requested in our plan correction Ietter. "By others" is not considered a valid response. Please indicate yow
response to each item and the location where the information can be found on the plaaVcalcs.
ATTACH THIS FORM TO A COPY OF YOUR PLAN REVIEW LEITER AND RETURN WITH REVISED AND ORIGINAL PLANS.
OWNERS NAME DATE:
��►NC� o -2�0co
ASSESSORS PARCEL NUMBER PERMIT NUMBER
030 — 4 -OZ — 0 7, 0Co--Z2,0 5
RESPONSE FOR
PLAN CHECK ITEM # p
I
RESPONSE BY:
�n iC (L) PCt+At,
LOCATION ON PLANS/CALCS
t
COWENTS:
CAtcs A'O W ,
I
PLAN CHECK ITEM #
RES
BCI Y:
LOCATIDN ON PLANS/CALCS:
DOIY1NENTS-
�PAO`NSE
,
I
COMMENTS.
�tO IJC9� ori
1 -
,V D1 t
PLAN CHICK ITEM 9 �
RESPONSE BY:
2iAJC
LOCATION ON PLANS/CALCS..
DOIY1NENTS-
c w• _ a
v V Yr �+1 •'V U G
'LAN Cid n -EM # IRESPONSE BY: ILOCATION ON PLANWCALCS:
PLAN REVIEW RESPONSE FORM
liz order to expedite the review of your plans, please complete the following information and return this form with your re -submittal, I
this form is not complete, as to alt correction items, we will not be able to accept your re -submittal for review. There must be a valic
response to every item requested in our plan correction letter_ `By others" is not considered a valid response. Please indicate youw
response to each item and the location where the information can be found on the planstcalcs.
ATTACH THIS FORM TO A COPY OF YOUR PLATY REVIEW LETTER AND RETURN WFTH REVISED AND ORIGINAL pLgNS.:,�r
OWNERS NAME DATE
ASSESSORS PARCEL NUMBER. _ _ _
RESPONSE FOR PLAN CHECK LETTER DATED:
PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALLS:
COMMENTS:
I PLAN
BY:
S:
L7i
LOCATION ON PLANSICALCS:
COPY of Document Recorded
19 -Sep -2006 2006-0048573
Has not been compared with
original
BUTTE COUNTY COUNTY RECORDER
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. The property described herein is adjacent to land or included. within an area zoned for agriculturat purposes,
and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides pesticides, and fertilizers; and from.the pursuit of agricultural. operations
including; but not limited to cultivation, plowing, spraying, pruning; and harvesting which occasionally generate dust,
:smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
Date, `7�00 PROPERTY OWNERS:
�G
County -of
1117
before me,
a
personally appeared C AiAN N ersonally
known to me (or -proved to me on the sis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by hiss/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal. RICHARD FEUERSTEIN
COMM. #1568619 �
Signatur G Seal: C - 0 NO NOTARY PUBLIC -CALIFORNIA
BUTTE COUNTY
My Comm. Expires April 13, 2009
A.P. # 0311- yW�I -499_5� J
Escrow No.: 05 -108127 -TG
Locate No.: CAFNT0958-0958-0001-0000108127
Title No.:. 05 -108127 -BD
EXHIBIT "A"
THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, AND. IS
DESCRIBED AS FOLLOWS:
All that real property situate in the unincorporated are, County of Butte, State of California, being portions of Parcel 1 and 2
on the Parcel Map filed in Book 62 of Maps at Page 80, Butte County Recorders Office described as follows:
Beginning at the Southwest comer of said Parcel 1; thence South 890 59' 31" East along the South line of said Parcel 1 and
2, 330.02 feet to the Southeast comer of said Parcel 2; thence North 000 00' 13" East along the East line of said Parcel 2,
197.54 feet; thence leaving said East line, North 890 59' 03" West, 330.02 feet to a point in the West line of said Parcel 1;
thence South 000 00' 13.'_' West_along-said:West line, 197.59-feet-to-the=pointof beginning.--~ --
'TniN�lc• � �
j
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE .
OROVILLE, CA 95965
2006-0048573
Recorded I REC FEE 10.00
Official Records I
County of I COVURNED COPY 1.00
Butte 1
Mau J. GRUBBS 1
County Clerk-ftecorderl
I
I CP
Ii12:58M 19 -Sep -M i Page 1 of P
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building
permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes,
and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals,
including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations
including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm
operations.
All that real property situate in the County of Butte, State of California, described as follows:
,Sec ,off c�Po�
Date_ _ 9��� 6 PROPERTY OWNERS:
State of California
County of
On
G before me,
personally appeared ' A i 44,W 6114 1-.,—e personally
known to me (or proved to me on the ty6sis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed
to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal. RICHARD FEUERSTEIN
Si natur c Seal: v COMM. #1568619
g NOTARY PUBLIC - CALIFORNIA
° BUTTE COUNTY
w My Comm. Expires April 13, 2009
A.P. # "9150 - �i'�.? -off -- _
2
L
Escrow No.: 05 -108127 -TG
Locate No.: CAFNT0958-0958-0001-0000108127
Title No.:, 05 -108127 -BD
EXHIBIT ..A„
THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, AND, IS
DESCRIBED AS FOLLOWS:
All that real property situate in the unincorporated are, County of Butte, State of California, being portions of Parcel 1 and 2
on the Parcel Map filed in Book 62 of Maps at Page 80, Butte County Recorders Office described as follows:,
Beginning at the Southwest corner of said Parcel 1; thence South 890 59' 31" East along the South line of said Parcel 1 and
2, 330.02 feet to the Southeast corner of said Parcel 2; thence North 000 00' 13" East along the East line of said Parcel 2,
197.54 feet; thence leaving said East line, North 890 59' 03" West, 330.02 feet to a point in the West line of said Parcel 1;
thence South 000 00' 13" West along .said West line, 197.59 feet to the point of beginning.