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HomeMy WebLinkAbout031-234-026} r s : •,'r 7 t " ' t22�` �� i A -,t -'4 : : 4� i � y ,{ , �i T. ktJ r 3 F- . Y'r•s-K i rP d.4'�r F t• rsrf� t (. �t;.. � r. •f.Y „i„�� .r tl r<� N,�,si4 '` f ��'. ft Y,:.. ts�tt � }'. r �r3C it({jay fjF �t��PJyi�, �J f L r ; y� � � �®J>_ x1;/tt i �' J f a t. { �. 1 I? i - yt f i.^ j��jjg}t•�{y} #3 A 1' i .:. _ �. �.' �y f>ii T i •� Ati r 'tt t 11 05-2237 fDUSTINf • . • 7 v S Al ' sl Jk 1 i t OROVILLE • • • NSF.�'o, Ot i7i /fice • it 4”. S fr if. t ' 1 ! nr Ai �' ' t: `� �• 1 {, • t t i, it ,+" to (fi�r;,� t 1 {, 5. t 47 J' Ji. .i t , t s .,+.,® 9 +"� it 1 l -y1 T F - ' 1 jT FFx= i z iy.rty t F '• +s„¢' � ..: 3 - p x�;.: S�' � •'iH a� y 1W �fi t'y ° ':�; i�Sthdi Ft �.a �' ��. s+ 4 �`, a - � � �f .k� 4.x i,: q �'>� ..,� ., F T ki.�. f ,r�.Y'it �+y,. C'�..n �„ 7 •., 1{ ' ��i !�� i .3 tE t c. v, _ r Fri ,_�"" �� ��'.�ih.. �', }-{i A F_ _x'� ice' � . _ •-K.a '� 1�}�i�jGk �s, _d'�[. ^St `ju ..rAt� � .r� . +ti.f:. �k �ak f ,+�,,-1.:.it�";r NOTES r RESIDENTIAL } PERMIT NO. -_--0512237 *631=234--026. 1" I FORD, DUSTIN -HEMEN, OROVILLE . 1 rt� CONT: TRIMISSION CO NSF OFFICE COPY Address 5`�S fi�/'1'►/i^� " ,*. OAOVILL65 GAS Meter By Date '. ELECTRIC % Meter By C. L— Date r' SPECIAL CONDITIONS ^CHECKED • .)" BY SRA Y FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REO. -.. SPECIAL INSPECTION ITEMS �l 4 VERIFY t USE PERMIT CONDITIONS' SUB -STANDARD HOUSING LETTER nr m A- 45 av ~.OFFICE COPY X - -.e Address 14 !^ GAS r Da rV t s Meter By y ELECTRIC Date Meter By l4 OB FINALED (Date) Signature X 7' r RESIDENTIAL } PERMIT NO. -_--0512237 *631=234--026. 1" I FORD, DUSTIN -HEMEN, OROVILLE . 1 rt� CONT: TRIMISSION CO NSF OFFICE COPY Address 5`�S fi�/'1'►/i^� " ,*. OAOVILL65 GAS Meter By Date '. ELECTRIC % Meter By C. L— Date r' SPECIAL CONDITIONS ^CHECKED • .)" BY SRA Y FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REO. -.. SPECIAL INSPECTION ITEMS �l 4 VERIFY t USE PERMIT CONDITIONS' SUB -STANDARD HOUSING LETTER nr m A- 45 av ~.OFFICE COPY X - -.e Address 14 !^ GAS r Da rV t s Meter By y ELECTRIC Date Meter By l4 OB FINALED (Date) Signature X J = .OK 0= Not OK _ = Not ApplicReady hie MOBILE HOMES . =Not Ready Date MOBILE HOME UTILITIES (Plans) OK except #'s t. 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) S. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete ~ 6. Gas; Location -Test -Wrap;-/ ' L'ft. / P Nat or/ /" L "ftl P LPG 7. Well Clearance & Disconnect 8. 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-Connectot 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged - 9. Tie Downs -Type -Installation Cert 10. Exits; Insp.-Sketch 11. Cert of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 :Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements - 2. Footings; Size -Spacing -Marriage Line 3. Blocking . 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date -DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing . S. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 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, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/S'-Circulating Equip. -Heater 8. Elea; Grounding; Equip.w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 1 = OK = Not OK Not Applicable Not Ready Date RESIDENTIAL (Single & Duplex) OK except #'s 1-tg., Main; Soils-Ft1n+< Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ /" Ftg. Depth 4. Ft orches & Decks; Soils -Steel-/ P' Ftg. Depth i e , Main; Steel-Blockouts-WraDoed I (- ( & ' M /6a. I jKd Downs and Special Anchors .V.; Fall -Fitting -Test -2 Way C/0 -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test '\1 1. Water Pipe; Test -Anchors -Regulator -Service Test '13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date _01U. - Card B-1 . Date Card B-1 Date Card 11Date Card B-1 Date PLU (Permit) OK except #'s 1 er Htr.; Vent -Access -Combustion Air Baffle Y u fib/ •1 /Y D.W.V.; Test Fittings & Anchor -Nail Protection r T0. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 2Y Gas Pipe; Sixe & Anchors 23. Fire Sorinkler. Test Date ILIJ,►1-4' Card 8-1 (,4,yV Date Card B-1 Date I Card -B-Y' / ' Date Card B-1 Date ELECTRTCAC (Permit) OK except #'s 34' Eixfure ansformer Clearance -Ins. Protection EI . eceptacles Spacing -Lights & Switches at Doors Size 52!e! & No. of Conductors Stapled 2 ex Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral ❑ Yes O No 32. Se a -Riser Conductors & Ground Main Disconnect Clearances Panels-Motors-Mech. Equip. lothes Closet Light -Shower light -Spa Light J L i moke Detector Date 11 -It V7+16ard B-1 /y,� Date Card B-1 Date Card B-1 Date Card B-1 Date MECH AL (Permit) OK except #'s 3 . A ucts Insulation & Support 3 -4 -lent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fu a -Vent Access -Comb. Ait-Return Air Vent 115 Outlet Attic Access &Platform if Furnace in Attic Date Card 6=1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAM (Permit) OK except #'s Sills Ppg& Materials & Anchors 42. all tuds-Nailing Spacing & Braces -Plates -Sound 4 earl - Walls over Girders & Floor Nailing 44 raft Stop in Walls (rat proof) ; ti- 45. Fire §jpIng-Furred Ceilings -Stairs -Chasers -Tubs 46. eaders & Beams -Size & Bearing ` Date _4*,Cling._loist-Rftr. Ties-Purlin-Roll Brac: Truss-Shtinn_-Rtnn 49.F I Ties or Type A Flue -Fireplace Throat Clearance . Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5 5drm. Windows or Exiting Doors -Sill H imensions Garage Fire Protection Framing- hannel 53. Property Line Firewall & Ooeninas 54. Ext. Doors -One T -Check Garage 3rd Story, 2 Exits 55. S 'i`s; Width -Headroom -Rise -Run -Landing -Fre Protection 5 . o on Roof Overhang -Attic Vents -Rafter Outriggers ng -Nailing Veneer %ti l 9"_ / Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access �y_1/_/_/ 6,e59. Glazing Area -Glass Protection -Skylights -Plastic / 2.- $ 0. Shear Walls: Nailing -Botts 61. Brace Interior/Exterior Wall Panels L63. nsulation-Walls-Celli s nfiltration-Wal - dows rd B-1 a Card B-1 Date L, t , r)J Card B-1 Date Card B-1 Date FIN (Plan OK except #'s Steps -Door & Sidelight Protection -Landings Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - Garage; Above Floor-Ducts-Mech. Protection edroom Exiting F.I. & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel, Breaker Sizes & Labels • 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. . Outlets at Wood Panel, Int. & Ext. d. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance ec. Outlets & Receptacles at Kit. Counter Garage Fire Door, Swing -Landing -Closure 76. C. Duct in Garage -Damper W. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. _ iy6arage; Above Floor-Mech. Protection 7,�.; Bec. & Mech. Equip. Listed for Location 7T EWc. Receptacles in Garage (F.FQ-Romex Protection 88' Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Cle ance Looked under Floor O Yes 83. F owing InstldJDrive 0 Yes O No/Walks O Yes O No/Planters O Yes O No �•o (i ucco Brown -Finish XC. Unit Disconnect, Electrical -Plumbing Ven Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. VXter Well, Disconnect, Electrical, Plumbing xterior Elec. Trim, G.F.I. Receptacle -Underground V ntilation Throughout House ass Protection Correct9ns from Previous InsVctions & Sewer Connected -C/0 to Grade -HD Ap Certificate -Other Certificates Address Posted - 96. Fre Sprinkler Dat r I (� Card B-1 t - Date Card B-1 Date Card B-1 Date Card B-1 Date. Card B-1 Date Card B-1 Comments at Final: 3.- EXTERIOR WALL Frame Type: ...... ­ ':::: .......... A. Cavity insulation Material: . ........ ..... .......... Thickness B. Exterior Foam Sheathing Material: ....... Thickness (inch"). .................... 4. RAISED FLOOR Material: Thicknessinches 5. 6. Brand Name:::::: ... .............. Thermal Resistance (R -Value): ...... . ................... Brand Name: Thermal Resistance (R -Value): Brand Thermal Resistance (R -Value)::- ............... . ... ...... .......... 0 Brand Name: 777777rr7r..... Thermal Resistance (R-Value)::::�� ........... -:11- Brand Name: Thermal Resistanic DECLARATION .• t I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Energy Efficiency Standards for residential buildings (Title 24,'Part 6, California Code of Regulations) as indicated on the Certificate Of Compliance where ap licable. . . . . . . . . . . . . . . . . . . . . Item Number's Signature and Date .. ..... ..... ........... ................. Item Number's Signature and Date AnstaWmg Subcontractor (Co. Name) or General Contractor (Co. Name) or Owner ..... ... ................. ... Installing Subcontractor (CO. Name) or General Contractor (Co. Name) or Owner BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District j� i V/ arl* i6 t I Building Department No. A.P. Number v / 3 L/'-- 02- 6 Jurisdiction: City County Property Owner Property Location/Address Subdivision Lot No. P)P05-22-7 ........................................................................................ 3 Residential Development Q Q Q Sq. Footage ZD Nc of Living Mobile Home Addition/ 'Supplemental to (Group. R) Units Installation Conversion Permit # '(No foundation inspection) ........................................................................................ Commercial/Industrial Q Building Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Sq. Footage (Including Exterior Roofed Areas) Date District Identification No. 06' o u b U Qi n 1 lA l ` School District certifies that For (Applicant) V�-m Q 3--&� \4 c� (Street Address) s (Phone Number) 0rov. J� C (City) has complied with the requirements of Resolution No. representing 1 1�3 square feet. School District Paid by Check # / Remarks: (State) (Zip Code) JD I::) e? b by payment of $ �13 2926 $ ULL MITIGATION $ 111 as � us Date ` Notice: You may protest the Imposition of the fees Identified above by submitting a written protest to the District, In compliance with Government Code Section 66020(a), within 90 days from the data fees aro paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of the fees In any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is notified by the applicable Local Planning Agency that this project Is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school hes to fully rnMgate Its Impact on tit school districts schools. White (school district), Yellow (building department), Pink (applicant) feefonn.xis (3l05XIMrn . i Note to File: • t 10/12/05 031-234-026 Dustin Ford ' Per Joe Hunter, owner has paid all permit and impact fees, but needs a certificate of compliance. Planning will accept the permit application and process, planning fee payment will be deferred until c of c is completed and building permit is ready to issue. Owner's attorney is preparing letter which will state that planning fees will be paid prior to issuance of building permit. We will not issue until planning clearance is complete and fees paid. ' , C r F -o el 6,V PERMIT FBinqiAPN- :LAST NAME FIRST NAME � • � iCONTRACTOR • • CITY/CTYj� STREET NO_ STREET NAME GARDEN RANCH CITY • ' • USE r ' TYPE IREMARKS NEW MH NEW SITE VALUATION FLOOD _ 'FEES PAID ' ' • 'FEES 2 FEES 3 FEES 4 PLAN CHECK ACTIVITY RECEIPT JAPPLIED 02/10/2005 RECEIPT 2 TISSUED RECEIPT 3 RECEIPT 4 FINALED "'Plan Chk-1: - Chkd By -1: ' : Return -1: Plan Chk-2: Chkd By -2: _ Return -2: Plan Chk-3: Chkd By -3:= Approved: - Comments: _ � 255 char. max Str Chk-1: Str Chk-2: �- Str Appr: _- pg7ME/yT - °�, ®e artment.®f PublicWor�ks, o �� o �'I C o u - n t y o f B u t t e I,I pLAND DEVELOPMENT DIVISION J. ,Michael Crump, Director ` 7 County Center Drive ;\ o o /� c�U Nay %f Shawn H: O'Brien, Assistant Director `' RUTTE A 5 Oroville. CA 95965 \ COUNTY � (530) 538-7266 �Qilc WD�� (FAX) 538-7171 JAN, 0 4 2006 D)EVEL•OPNZNT ' SERVICES January 4, 2006 Jack Dustin Ford 65 Canyon Highlands Drive Oroville, CA 95966 - Re: Certificate of Compliance AP 031=234-026 Dear Mr. Ford: Enclosed. please find the Certificate of Compliance that was issued by the -Butte County. Planning Commission and recorded on November' 16; 2005, under Serial Number 2005-0069439, in the -office of the Butte County Recorder, If you have any questions concerning this matter; please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00.p.m. " Sincerely, Stuart Edell �J w Manager, Land Development Division' SE/kp Enclosure cc: Environmental Health Department uilding Department Planning Division (DET 06-10) GIS, A'TTN: Larry � 1 AFTER RECORDING RETURN TO Butte County Public Works Dept. LAND DEVELOPMENT_ DIVISION 7 County Center Dr. Oroville, CA 95965 CERTIFICATE OF COMPLIANCE Assessor's Parcel Number: Recorded I REC FEE 10.00 Official Records I County of I Butte I CANDACE J. 6RUBBS i County Clerk-Recorderl 09:25AM 16 -Nov -2005 I Pane 1 of 2 031-234-026 This Certificate of Compliance is hereby issued by the County of Butte to certify that the land division that created the parcel of property identified below, complies with the applicable provisions of the Subdivision Map, Act and of Chapter 20 of the Butte County Code. Issued to: Jack Dustin Ford 65 Canyon Highlands Drive, Oroville, CA 95966 Property Location: south side of Hemen Way, approximately 150 feet east from its intersection with Sixth Street. Thermalito area. Description: All that certain property located in the Countyof Butte, State of California, more particularly described in attached EXHIBIT "A". This certificate relates only to issues of compliance or noncompliance with the Subdivision Map Act and local ordinances enacted pursuant. thereto. The parcel described herein may be sold, leased,, or financed' without further compliance with the Subdivision Map Act or any local ordinance enacted pursuant thereto. Development of the. parcel may require issuance of a permit or permits, or other grant or grants of approval. Issuance of this Certificate is conditional upon the following conditions) which have been imposed pursuant to the Butte County Code Chapter 20-166 and Government Code, Section 66499.35 (b), to protect the public health and public safety: ,NONE State of California, County of Butte, on November 15; 2005 , before me, Thomas L. Blixt, Notary Public, personally appeared, Stuart Edell, personally known to me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his, authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. THOMAS L. BLIXT, NOTARY PUBLIC THOMAS L BLIXT Commission 9 1371740 z Notary Public - California Butte County Aly Comm. E -*ms Ate 25, 6 County of Butte STUART EDELL, DEPUTY COUNTY SURVEYOR AAI r -v CERTIFICATE OF COMPLIANCE - Page 2 , Jack Dustin Ford .'AP 031-234-026 ,• , "EXHIBIT: "A" r All that certain real property situate in the County of Butte,- State of, California, described., as follows: Lot 9, of Block 25, as shown on that certain map entitled, ."Map of Thermalito, Butte'• County, .Cala", Which map- was recorded in.the Office of the Recorder of the County of Butte,. State of California, -on June '8, 1887, together with the south half of Tehama Avenue, abandoned, joining said Lot 9 on the north. TOGETHER,WITH a non-exclusive easement'for road -and public utility. purposes over the north 60 feet of the following described parcels of land; Lots 5, 6, 7,. 8, 10 and. 11, of Block 25, as shown 'on that certain map entitled, "Map'of Thermalito, Butte County, Cala", which map was recorded in the Office of the Recorder of , the County of Butte, State of California, on June 8,--.1887, together with the south- half of Tehama Avenue, abandoned, joining said lots- 5 through 8 inclusive, and ,lots,,10 and 11 '. on the north. , NOTE: All new structures must meet Fire Safe Regulations of the Butte.' County Code and Public Resources Code 4290 and 4291. END OF DOCUMENT r TME PPR NT °Z 0 �T,TF0\ Department ®f Public Works C o u m y o•f B u t t e IIO""^ O �1 J. Michael Crump, Director LAND DEVELOPMENT DIVISION A O O %j 7 County Center Drive cOU Nay ���Oroville, CA 95965 Shawn H. O'Brien, Assistant Director. A�eCIC Wo��9 (( X))55 8-7171 7 . BUTTE COUNTY January 4, 2006 JAN 0 4 2005 ` DEVELOPMENT SERVICES 'lack Dustin Ford 65 Canyon Highlands Drive Ciroville, CA 95966 , Re: Certificate of Compliance AP 031-234=026 Dear Mr. Ford: Enclosed please find the Certificate of Compliance that was issued by the Butte.County Planning Commission and recorded on November 16, 2005, under Serial Number 2005-0069439, in the office of the Butte County Recorder. i If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, s V Stuart Edell Manager, Land Development Division SE/kp Enclosure cc: • Environmental Health Department VBuilding Department Planning Division (DET 06-10) GIS, ATTN: Larry N A', ' TER RECORDING RETURN TO Butte County Public Works Dept. LAND DEVELOPMENT DIVISION 7 County Center Dr. Oroville, CA 95965 CERTIFICATE OF COMPLIANCE. Assessor's Parcel Number: Recorded I Official Records I County of i Butte I CROACE J. 6RUBB5 I County Clerk-Recorderl I. 09:25AM 16-Nov-R005.I 031-234-026 REC EEE 10.1@ W Page 1 of 2 This Certificate of Compliance is hereby issued by the County of Butte to certify that the land division that created the parcel of property identified below, complies with the applicable provisions of the Subdivision Map Act and of Chapter 20 of the Butte County Code. Issued to: Jack Dustin Ford 65 Canyon Highlands Drive, Oroville, CA 95966 Property Location: south side of Hemen Way, approximately 150 feet east from its intersection with Sixth Street. Thermalito area. Description: All that certain property located in the County of Butte, State of California, more particularly described in attached EXHIBIT "A". This certificate relates only to issues of compliance or noncompliance with the Subdivision Map Act and local ordinances enacted pursuant thereto. The parcel described herein may be sold, leased, or financed without further compliance with the Subdivision Map Act or any local ordinance enacted pursuant thereto. Development of the parcel -.may require issuance of a permit or permits, or other grant or grants of approval. Issuance of this Certificate is conditional upon the following condition(s) which have been imposed pursuant to the Butte County Code Chapter 20-166 and Government Code, Section 66499.35 (b), to protect the public health and public safety: -N O N E State of California, County of Butte, on November 15, 2005 , before me, Thomas L. Blixt, Notary Public, personally appeared, Stuart Edell, personally known to, me to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. THOMAS L. BLIXT, NOTARY PUBLIC THOd�lA.S L BLOCT Comni"on 91371740 1 . Notary Public - California yi Butte County W Comm. Extras Aug 25, 2006 County of Butte STUART EDELL, DEPUTY COUNTY SURVEYOR CERTIFICATE OF COMPLIANCE Page 2 lack Dustin Ford . AP 031-234-026 "EXHIBIT "A" All that certain real properly situate in the County of Butte, State of California, described as follows: ' Lot 9, of Block 25, as shown on that certain map entitled, "Map of Thermalito, Butte County, Cala", which map was recorded in the Office of the Recorder of the County of Butte, State of California, on- June 8,-1887, together with the south half of Tehama Avenue, abandoned, joining said Lot 9 on the north.. ; TOGETHER WITH a non-exclusive easement for road andpublic utility purposes over the . north 60'feet of the following described parcels of land; '.Lots 5, 6, 7, . 8, 10 and 11, of Block 25, as -shown on. that certain map entitled, "Map. of Thermalito, Butte County, Cala", which map was recorded in the Office of the Recorder of the County of Butte, State of California, on June 8, 1887, together with the south half-of Tehama Avenue, abandoned, joining said lots 5 through 8 inclusive, and lots 10 and 11 on the north. NOTE: All new structures must meet Fire Safe Regulations of the Butte County Code and Public Resources Code 4290 and 4291.. r ` END..OF DOCUMENT Y T BUTTE -COUNTY DEVELOPMENT" FEE CERTIFICATION FORM FEATHER 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) 51-2—,>- ` � Assessor Parcel Number (s) `/ �2 Building Permit Number�2 Property Owner (s) Project Location /Address Subdivision Name ' y Assessable Sq. Ftge_ Type offRR idential Development (check one) 'i/ ' New Development, V Single Family -Detached Single. -Family -Attached P , Alteration/Addition(s) Non -Residential to Residential Multi -Family Dwelling Mobile home Mobile home replacement verified by Assessor Department Demo Permit (date issued ) verified by Building Department .Comments: ,q�-z� was • Buildh4gVepaptment Rtpresenixiive ua�c RRPD ' ❑ CARD ❑ PRPD ❑ DRPD certifies that: pplicant Name Phone Number Mailing Address City State Zip, Has complied with requirements of the'Butte County Board of Supervisors Resolution No. by Payment of:.� Dwelling Units @ $ per unit fora total of $lJ— Square Feet @ $ per sq foot for a total of $ Remarks: Paid by Check No: Paid by Cash: Receipt No: Recreation and Park District Representative D6te 0-1-1 fnr rev 1.doC - PON WRIT PEL9 WS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved r ❑ Resolve Problems Prior to Approval Site an Stam Approved ` By Date Page 1 of 5 SITE PLAN REVIEW APPLICATION Date: 0S" AN, Permit Number (if applicable) QS',2�-�j �. APPLICANT INFORMATION Parcel Size: . Owners Name: �^ Owners Address: rIVI/1- •/v 1 �%C��/ Telephone No.: ID l 3 g Situs Address: �i�E?/Y✓� ®/�o'1i�X-z Proposed Use: Residential New Single Family. Residential ` ❑ Single Family Addition' ❑ Single Family Remodel ❑ Mobile Home . ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ' ❑ Temporary Travel Trailer , ❑ Multi -family ` Non=residential a _ ❑ New Commercial t ❑ Commercial Addition ❑ Commercial Remodel .. ❑ New Industrial ❑ Industrial Addition ❑ Industrial Remodel Other : ❑ Septic ❑ Well ❑ Agricultural Exempt Building � /� _ - L Other: d Brie/f� Explanation (if n cess ):Q Y f n/1 /�0 D - <P. nn PON WRIT PEL9 WS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved r ❑ Resolve Problems Prior to Approval Site an Stam Approved ` By Date Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservatioa Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) H Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: • Flood Panel No.: 7 E Index Date:b E]Sacramento River Reclamation District (Approval must be obtained from t4Cifo4ffila Reclamation Board) ❑ Feather River Reclamation District (Approvalmust be obtained from the California Reclamation Board) E] North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit El Minor Variance El Administrative Permit ❑ Variance ❑ Detached Building Use Form ❑ Encroachment -Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: A 4- 4-10-L04 Applicable Building Setbacks: Front Zoning Code � � Streets & Highways Fire Prevention Subdivision Map Side i Side Street Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 ❑ Parcel Deemed to be legal _ ❑ Verify Legal Parcel*.' ❑ Verify Legal Access. ❑Provide Deed of Creation ❑ Obtain a. Certificate of Compliance ❑. Obtain a Merger ❑ Obtain a_Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 Applicable Development Fees: Standard Fees Amount Formula ❑ Fire ❑ School* " ❑ Parks/Recreation - ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area —Road. ❑ Thermalito Impact ❑ Other ----------------------------------------------------------------------------------------------------------------- Subdivision Map Special Fees -- ❑ Water Tender . ❑ Road Improvement ` ❑ North'Oroville Area ❑ Other'(per map) . * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of .. the building permit Parcel Created By Deeds; , Date of Creation- Legal Access Provided: ❑ No ❑ Yes Deed of Reference: / . ' � O 3 ��-3 Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: 0a,C' C ❑ Parcel Deemed to be legal _ ❑ Verify Legal Parcel*.' ❑ Verify Legal Access. ❑Provide Deed of Creation ❑ Obtain a. Certificate of Compliance ❑. Obtain a Merger ❑ Obtain a_Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Page 3 of 5 ❑ Subdivision Map/Parcel Map: Map Date of Recording: Lot: Book: ❑ Use Permit(Minor Use Permit Permit Number: Date of Approval: Page: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall- be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development.. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for roa IN Page 4of5 r RF.COROiNC REQIIF.'TED. F.• (RnN .COM'ANY r o'%. 11!;67'4: 9 1 -03823 Loan No. 91—OC3823 Rec.Fee 5.00 WHEN RECORDED MAIL TO: DOC 11.00 JOHNFAP:iNI Recorded,:. Checl. 16:00 12640 LONE STAR ROAD Of f i c i a l Records : - AUBURN, CA 95603 (;ounty of Butte Canda_e T. Grubbs r Recorder 80 1 _ Oam 31 -Ja n- 3 JJ 1 . MALI. TAX S•iATEMENrTS TO: DO. a.) AENTARY TRANSFER TAX $ I .00 " ConrAAW on the atderaaon ,x pare of reoporh c«,bra4 OR .. . 1 SAME AS ABOVE oa NSI:� - C41MOLli on M ooatderatton of vMre tow bra or encu b6ncer remalrbp of tkrre of ram. - a ThA-mdBISie Q�anfnr rinrl;; R AP NCI. '1 •-2-I_e_3o LOT 9 Sipnaturo of De darent or Apart delcnnMhp W - Firm Name ' .. GRANT DEED FOR A `,rALUADLE CONSIDERATION, receipt of"which Is hereby acknowledged; MICHAEL V. PIERCE and DIANE D. MONSON, husband send wife hereby GRNJ7(S) to JOHN FANINI, AN UNMARRIED MA14 the root property In the County of BUTTE State of carrfomia, des«ibed as - LOT 9, OF BLOCK 25, AS SHOWN ON THAT CERTAIN ASAP E'TITLED,"MAP OF THERMALITO, BUTTE COUNTY, CALA",W+YHICH 'MAP WAS RECORDED IN THE OFFI(, i OF THE RECORDER OF THE COUNTY OF.BUTTE, STATE OF CALIFORNIA, ON JUNE 8, 1887, TOGETHER WITH THE SOUTH HALF OF TEHAMA AVENUE, ABANDONED, JOINING SAID LOTS 9 THROUGH 11 INCLUSiVF CN THE NORTH. f r Datod"—lanaary2.5._1.99L_ STATE OF GV IFORNtA )py / n, /✓Y �� COUNTY OFIsMUNSUN_ -- On JANUARY 25, -1991 bd>o. ANGELA D. MAS'runT ---- Pf"enllby appnarod NICIlGEI. V_? E'CE AND' DIANE D. MONSON porsonalty, known to me (or proved to me on the basis of satisfactory - -ldonco) to be the persons) whose name(a) Ware subscribed to the • ' vAINn Instrumont andacknowtodgod to me that ho/she/they oxonnod the 5 same to h:s/twrAholr authorized capacity(Ios), and that by hWlwrAhoir - +• slpnatum(s) on the Instamnonl the porson(s) or the entity upon bohAn of SIT which the porson(s) acted, executed Uw Instrument.. OFFrA L SEALIMTNESS my hand acrd official east. G A D, iMASTEWTTOOARY PUBLICcAuFORNqmmhabaeftb h'MIRF rerry o r+OFPI. SI - 1 END OF DOCUMENT • C`�h-C!LR TEL�JgMJ4 _<ll/E.. , _ _ Fn • /. P. 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OF AeS, Q /1/G'O,P/�ORTEO J /rV.T/[/6 CN/ GZWWYOQ S 5747EMENT COCNTY Q1,P!/EYO,P�; 5T,4TEMENT RECORDERSS STATEMENT 110n TN/t MOP CO??EC7L r R!P?f4ENTS A SURVEY MOO! 9Y MF OR 7L/S MOP Ndf BfIN CYOM/N!D ./N /CCOandAKL R'/TN f/L!G fN/1 1 7dr _ _ UNDER MV D/RECT/ON JN CONEOaMdNCE LV/TN /!/C aCQU/¢EMlNT! SfCT/ON "A7Gle Of TMC LAND 1L/RVIYO?B /CT.7N/4 - /N ROOK [[2��0 OF ML1PS. OT POGp , OT TN! OCOVE4T LE - Y Of Tr/f LOND ecrIFY049 OCT OT THE c, wm70i M.CW/t OdY Of F6Q. /0 _, RoN • 6(WR AMUMPS CE J. RG SLNLC rim. C/NAIJ J O b AefaADEa p. 0. 90X 996 0/I0l//LLE, CAL. 95965 i r W/LL/OM'fMEFF lf. MTfS SEP/OL Nt ph.(9(6) 534- 9f97 V.097. AYJNALD [. f,RAVE4 ,rLf. OOA5 REG/STadTR7A/ E7P/aEF /-9F 9i COUNTY lL NYEYPR o POTr n`isdiuvo/a AP 3rz34-iz ' Butte County Department of Development Services3 o T " PAUL MCINTOSH, INTERIM DIRECTOR 0 0 7 County Center Drive 0 - - 0 Oroville, CA 95965 0 y`=-" o (530) 53877601 Telephone, c)U N'�y (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * PLANNING September 22, 2005 J. Dustin Ford 65 Canyon Highlands Oroville, CA 95966 Subject: Building Permit 05-2237 (APN 031-234-026);.New Single Family Dear Mr. Ford, The Butte County Department of Development Services, Planning Division, hasreviewed the submitted permit application, and requires .the following . revisions to you site plan, or ' information in order to continue the review: , * Fire sprinklers, and the SRA setback are. not requirements for the Planning Division approval, and this notification is for informational purposes. The requested information, or notification, is described on the included hand-outs. You will also be, given some brief direction, on the • following page, of how the information should be' submitted or returned to the County. Should• "you have further questions please: contact me between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538-7601. Sincerely, F ;Lana Adler Assistant Planner Cc: Building File �%7' !'1L4'IVra J� inn J( ! G .CAMll 1.f X 5 azv CreatontDeed ' ❑Site Plan Resubmit —Follow Requirements ❑ Erosion Control Plan ❑ Setback Conformance ❑ Watershed Protection Zone ❑ Front Yard ❑ Cohasset S ecific•Plan ❑ Side Yard . ❑ Subdivision Map Note ❑ Rear Yard ❑ Off -Street Parking; Development Standards ❑ Special Setback or Parcel Limitation ❑ Parking for S 'ecified Use ' ❑ Federal Aid Road/Arterial ❑ Lot & Landscaping Requirements' ❑ Easement ' ❑ Oak Tree Plan. ❑ Subdivision Map Condition/Note` ❑ SRA Setback* ❑ Agricultural Buffer ❑ Fire Sprinklers* ❑North Chico Specific Plan — Erosion Control ❑ Other: * Fire sprinklers, and the SRA setback are. not requirements for the Planning Division approval, and this notification is for informational purposes. The requested information, or notification, is described on the included hand-outs. You will also be, given some brief direction, on the • following page, of how the information should be' submitted or returned to the County. Should• "you have further questions please: contact me between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538-7601. Sincerely, F ;Lana Adler Assistant Planner Cc: Building File �%7' !'1L4'IVra J� inn J( ! G .CAMll 1.f X 5 azv Parcel "Creation Deed A creation deed is the deed that created a piece of•land, dividing a larger piece.', This process is commonly called a subdivision. Prior to M h 4`h of .1972, a parcel of land ; could be. divided by a grant deed, and, gift deeds wer recognized until February 9`h of 1993. Staff is required to review each division to ens a that it was created in compliance with the State Subdivision Map Act, and Butte Co ty Code. A creation deed is required to determine that the legal description matches he current configuration, and that the parcel has the appropriate access to a publicly m %ntained road. The, exact date of creation and type of deed will also be verified. Please ocate the documents and subinit it to the Planning Division at: Department of Development Services Planning Division 7 County Center Drive. Oroville, CA 95926 Note: You can obtain t is document at the Office of the Recorder (25 County" Center Drive, O oville), or work with a title company to locate the appropriate d d. e s THERMALITO IRRIGATION DISTRICT �-- 410 Grand Avenue Oroville, CA 95965 WORK -ORDER ID. New Water Service Installation Novi 7.2005 Amount Paid `00 Date S i Contractor:` Customer Name: Service Address: A.P.- No.. 5k " 7 _7�4-- 0 Z-�v ' Meter Size 4 Account No. Meter Make Sequence No. ID No. Sewer Permit No. Reading .s -1nr. c ".:: .. '.. ..a i �. .1 .�'r. •tee'.-. � 'f' _...: �-3'Y4s: ,_. ,:;..^*..,,:. -• ild�l,.:�3:*<�.u.'�.e.'u�'1C:...ti.'.:+�5.w.'s."i:J:.'"�' ..�'n..;a:51.ti]S.:s.'A:t.. _-e_.v-s.l�> > .� ____ .u�r :,�..-..a�7rrs.►-�>....'a•a•V'ni"YPl..'•�'ir�•s+ra.Em'. .>v r";i":ii'�' .�..�i��-. .. .. THERMALITO IRRIGATION DISTRICT - s� 410 GRAND AVENUE 23Q: OROVILLE, CALIFORNIA 95965 TELEPHONE: (916),533-.0740 ".FAX: '(916) 533-9243 SEWER SERVICE APPLICATION AND CONNECTION PERMIT Service Address: . No .address yet - -on Heman Way Owner's Name: Dustin Ford" 'Date: .11-57=2005 Address: PO BoX. ,5842 Acct.No.. Or:ovhle, CA 95.965 A. P. No:: 031-23.4-026 i Phone:. .693.-0,848 New:Unit: ' 1 Applicant/Agent: Adding Units: Address: " Fees: Phone.. Permit: $ 50 r 0 ., .. Permit valid fo"r. one-year :�;� TID.:. 1705 0 Preliminary Review.By: Date: Ext. Fees: -1000-)0 Remarks::' = C6nnecti - n fees . will .re those ar)iDl•icable at SC -OR: 1318 0 time of -:connection to the sewer collector, system.. Lateral: 1 M Cleanout up "to grade required at the property ether: line: :Sewer.che.c;k valve. required.. Sewer. permit fee includes .One construction inspection only; TotalfeeS: 8 0 Inspection tees •will: be $50:00 per visit. " Amount Paid: 4198" 00 Collected By: Finaled By: Date:. Signature of Owner/Agent:. " .MONTHLY SERVICE CHARGES WILL COMMENCE AUTOMATICALLY UPON COMPLETION Date Billed: Computer: Paid SC -OR: A.P. File: (R:FC.) Blue Book: Paid SC -OR: Meter Book: ,+ (S/C HG's) Rev. 5/95 Iq-j-P 0 0_2 BUTTE COUNTY PERMIT DEPARTME T OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION AND SUBMITTAL- REQUIREMENTS � 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 �j BP , . LLQ. OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION BIN # Websiteww.buttecounty.net/dds� **PLEASE PRINT CLEARLY** �v OWNER INFORMATION i Last Name O First N e Address City State,, � Zips -9 Phone D ^�o %3 ✓d� lax_l E-mail ,;P? CONTRACTOR Nam Address City State Zi 6 Phone:,3y Fax E-mail Lic.5 66o , Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name , -J City !� Address Zip 57 City Fax Sta :e Zip 9���5, Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address 6-57�� o� l�/• �� City !� State� Zip 57 Phone Fax E-mail APPLICANT SIGNATURE X �i t9 2 For office use only: Zoning ro Address Flood Zone I V I SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PROJECTLOCATION AP#�5J Z� ro Address City Cross Street, WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name l� / Address Description or Scope of Work: ez� -� Sq FT- Living 1243 Garage I 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 required. 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. Received by: Amount c, l ,C_ Bldg SRA Receipt #:I 3� 24 I Sheriff t SMIP Date:— �� �5 �j Other `� hTotal KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 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 faxes! ' ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 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-siqned 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 K:\FORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 . YVONNE CHRISTOPHER, DIRECTOR o�UTTFo o o 7 County Center Drive o 0 Oroville, CA 95965 M• (530) 538.7601 Telephone (530) 538.7785 Facsimile N TO: WILLDAN FROM: Scott Rutherford (530) 538-7160 ' O, • sn.ithertord a buttecountv.net Tom SUBJECT: Plans Transmittal For Review Per, Contract 0 < ]DATE: - 08/22/200.5 Applicant: Ford, Dustin Permit No: 05-2237 Project -Type: Nsf - 03.1-234-026 100% 70%. Plan Check Fees $ .:. - 943:72 $ 660.60 ' • $ 943.72 $ 660.60 ' WILLDAN Fee $- 660.60 Copies Attached: Qty Chk 0 Application ' . Site Plan, Review ' FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations, Residential Plan Review Guide Residential Construction Requirements Other Other COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISrON 6PO5223j 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: [ 1 i yr r 1 ASSESSOR PARCEL NUMBER(`_ oat 1 O _G Proposed Building Use: f mle I' 1y) Permit Technician: .l7 Date: %_ ' `i - or , V It ms required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. �'= N 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑� 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. �2N 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. \ .3 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form 0 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other V?maini cl- DE vj�_Loft- P�T-- items needed to issue the permit. (May require additional plan review upon receipt of the following items. - _ ❑ 16. Fire Sprinklers............................................................................................ 0 17. - Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑,�19 Erosion Control Plan Required........................................................................ Ot Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 217 City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs .............................. ❑/ 23. California Department of Forest Ian approval ❑ paid. Sent by: lanning approval for (A) Use: (B)Parking: (C) Parcel Check:..... Contact Land Development about _ Improvements, Drainage ........................ 2� 26. NPDES Form.............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 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) ..................... q,� 31. Letter of Signature authorization.................................................................... N" 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... q� 35. ❑ Legal description ❑ M.H. Title, title search, registration or MCO ......................... 36 Other: )r - 1� (9 Other: When issued Telephone ln`-1 �) e l l _ !4 1 and hold for pickup. I have been informed of the above items and requit ments for obtaining a building permit. Applicant: � � Date: 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required ontractor, esigner, owner, was advised of the above data by phone, ❑ mail, ❑ 6ounter, y Date: n ractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, byDate:Date: Plans reviewed by: Date: Plans approved by: Date: Structural reviewed byll. Date: 4 4 Structural approved b . Date: Note transfer by: Date: Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER T"t)r'�' A.P.# PROPROSED BUILDING USE c,. DATE RECEIPT # DATE REC. 1. BUILDING PERMIT FEES --`Balance Due ..................... $ +—t -l- •3 q39- 3 --- FEMA Flood elevation review... $ ; --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available afte lan Check) 3. SHERIFF FEES (paid at Building Division) ' Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. RECREATION DISTRICT FEES r�U Tf ryr (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT F S COUNTY WIDEer dwelling) $ { CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning , F $ 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) / 8. SMIP a 1/9' 9. DRAINAGE FEET,J6%33 10. OTHER 11. OTHER At time of permit application, I was advised the above fees are required to be paid prior 'to issuance of the permit. These fees may be changed during the plan checking process., APPLICANT t �' ,. DATE 4 I 6S Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4; 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 7/05) • � t ` AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 �P- 5 Recorded 1 REC FEE 7� Cifficial Records 1 County of • l COPIES 8.00 Butte i `,.CROACE 1 GRUBBS County Clerk-Recorderl I Sri 011:10M21 -Sep -2@05 i Pane I of I NII��IdI��I�IlINIQ�NII�I�IN�N AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT T 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 witliin 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: A-I.t'wa ri' �-ha fi. C rr � n/! -a -p W48- �� �''f�I� • ���-`,�� , : , l�,fa��� �����'�� ��� lot" Date T- 21 ci c PROPERTY OWNERS: State of Cal' ornia ) County of1.���c +) On `l '� t -� before me, ' personally appeared ids Ai of person}}y ' own a (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s)•is/are subscribed • ' to the within instrument and acknowledged to me that he/she/they executed the same in his/her/th-eir.authorized capacity(i`e5j; and that by his/her/Etreir signature(s)-on the instrument, the persons) or the entity upon behalf of which the personfs) acted, executed,the instrument., - WITNESS my ¢ nd and official seal. . OJP JAMES LAMAR KINSER Signatures GLc2,�` Sealc COMM. #1377185 -� NOTARYPUBLIC-CILIFORNiA r BUTTE COUNTY Comm. Expires Sep;. 8, 2006 Z� A. P'. # Y e r i t w R' t. a f' B U t• t o LAND DEVELOPMENT DIVISION - II ;— �—' ® . J Mj/ hael Crump, Director sto n Water Management Program `.'•.\ ® 7 Count' Center Drive �.\\ .CC / " Oroville. CA 95965 5 (530) 538-7266 �ALlC wpF�. (FAX-) 538-7171 �latio.nal °.P®Mutant Discharge Elirriination System (NPDES) Phase Construction Storm Water. Permit and. Storm Water Pollution Prevention Plan (sWPPP) Acknowledgement BLESS THA1\d• 9 ACRE Project Description; 5 �r,cT 2� rat. I Project Location and/or Parcel Number: o � � �/ 3 � By signing below, L 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 frcn the Slate of California Regional Water Quality Control Board. Phased projects that contain multiple site build=ouis of less than one sere but when combined with ubsequent 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: Date: RECORDING REQUESTED BY Mid Valley Title & Escrow Company AND WHEN RECORDED MAIL TO: 'Jack Dustin Ford 65 Canyon Highlands Drive . Oroville, CA 95966 1` Recorded I REC FEE 10.0 Official Records I TAY. 46.75 County of I Butte CMDACE J. GRUBBS .1 County Clerk-Recorderl I ABG @2oC M 26-IIIAugI-20@51 I Plage 1 `of ii2ff + • I�1! ��{ I��' !�" 11I I� �I��Lf �I� I ���I A.P.N.: 031-234-026-000 File No.: 0403-1988699 (MM) GRANT DEED ZA The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $46.75; CITY TRANSFER TAX $0.00; + SURVEY MONUMENT FEE $ , X computed on the consideration or full value of property conveyed, OR computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale, X unincorporated area; [ ] City of , and FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Donald Moore, Sr. and Alda D. Moore, husband and `wife as joint tenants hereby GRANTS to Jack Dustin Ford, a married man as.his sole and separate property ; the following described property in the Unincorporated Area , County of Butte, State of California: _ PARCEL I: • " LOT 9, OF BLOCK 25, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF THERMALTTO, BUTTE COUNTY, CALA"", WHICR MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JUNE 8, 1887, TOGETHER WITH THE SOUTH HALF OF TEHAMA AVENUE, ABANDONED, JOINING. SAID LOT 9 ON THE NORTH. PARCEL II: A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES OVER THE NORTH 60 FEET OF THE FOLLOWING DESCRIBED PARCELS.OF LAND: LOTS 5, 6, 7, 8, 10 AND 11, OF BLOCK 25, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MAP OF THERMALITO, BUTTE COUNTY, CALA""; WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER, OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JUNE 8, 1887, TOGETHER WITH THE SOUTH HALF OF TEHAMA AVENUE, ABANDONED, JOINING SAID • LOT 5 THRU 8 INCLUSIVE, AND LOTS 10 AND 11.ON THE NORTH. x r 4 Dated: 08/16/2005 , Mail Tax Statements To: SAME AS ABOVE A.P.N.:,031=234-026=000 Grant Deed. - continued File N6.:0403-1988699 r . (MM) Date: 08/16/2005 Donald Moore, Sr. Alda D. Moore . ` STATE OF California } , )ss. 4' COUNTY OF -Butte } On ( a �y before me, Le74 VJ4. ZhD224 5 personally appeared Dnia Id Mn S Y. mdq D, 77M d !1e, personally known to me (or proved to me on the basis of satisfactory evidence). to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that his/her/their signatures) on the. instrument the person(s) or the entity upon behalf of which the persons) acted, executed the instrument. WITNESS my hand and of ficial seal. This area for official notarial sea/ Si nature MARY A. THOMPSOfV , RRA Commission #1351470 0 v Notary Public -California Butte County . CD My Com Ission Expires: My Comm. Exp. APR. 15,2006 Notary Name: J 1�i')GQ f �/ /til `f-�6 12 So Notary Phone: Notary Registration Number: County of Principal'Place of Business:, . s Page 2 of 2 _N47 WILLDAN Serving Public Agencies September 16, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX 2399 Gateway Oaks,Drive, Suite 210 Sacramento, California 95833 916/924-7000 fax 916/92473644 www.willdan.com BUTTE COUNTY PLAN REVIEW REPORT Status: Approved Jurisdiction Job No: 05-2237 Assessor's Parcel No: 031-234-026 Description: Ford -NSF Willdan Project No: 14353-1865-M Dear Mr. Rutherford: Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and , documents provided for this review that have been found in compliance with the applicable codes are: # Plans: Two (2) copies, sheets T0.1, A1.0, A3.0, S2.0, S3.0 dated 8/17/05 by Tri Mission Co. # Structural Calculations: Two (2) copies not dated by Frank James Pursell �k Truss Calculations: Two (2) copies dated 7/13/05 by Endeavor Homes E # Energy Calculations: Two (2) copies'dated 8/19/05 by Martin Alvis The plans have been stamped with the Willdan approval stamp and dated. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. r� `A WI LLDAN Serving Pubiic Agencies APPLICABLE CODES Our review was based on requirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code (CBC). • Part 6, known as the California Energy Code, and Energy Commission Standards (CECS). CODF. ANAI,VCiC Specific Use Type of Occupancy Type of Construction . Stories 1" Floor Sq Ft 2 "d Floor Sq Ft Total Sq Ft NSF R-3 V -N 1 1203 N/A 1203 COV PORCH R-3 V -N 1 110 N/A 110 GARAGE U-1 V -N 1 441 N/A 441 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and/or notes as red -lined on the plans. 3. All plan sheets shall be signed by designer or person responsible for the plans as required by California Health & Safety Code Section 5536.1. 4. *Permit application building areas specified in the scope -of -work shall be reconciled with plans to Butte County's satisfaction. 5. The Title -24 -CF -1R -form shall 'be signed by the designer, owner or other person taking* responsibility for the project design and the Title -24 -documentation author (where different). CES 10-103(a)1 and California Residential Manual 1.4.8 6. Field inspector to verify installation of existing or new smoke detectors in all existing bedrooms and hallways leading to bedrooms (may be either battery operated or 110 volt with battery backup) as required when the valuation of any addition made to a Group R -occupancy, exceeds $1000 per CBC 310.9.1.2 through CBC 310.9.1.5 7. Gable -End Truss calculation submittal is deferred to Butte Co.'s review at their discretion. 8. The splice detail attached to plans; and that the PHD2-SD 3 '(at the garage wall) will be installed per manufacturer's recommendation (with SSTB16 for single -pour or SSTB20 for two -pour, ABs). SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals. Page 2 of 3 Butte County 05-2237 Willdan 14353-1865-M.PCI F A V V I LLDAN 2399 Gateway Oaks Drive, Suite 210 Serving Public Agencies Sacramento, California 95833 916/924-7000 fax 916/924-3644 www.willdan.com Sincerely, Tom Trueb Plans Examiner Cc: Alice Mefford amefford@buttecounty.net Jim Pursell Engineering, Email: jpursell@sbcglobal.net Tri Mission Co., Fax: 530-534-0888 ATTACHMENT 300 *AS DETERMINED BY CHORD OR COLLECTOR FORCE CALCULATION, (8)-16d COMMON OR BOX NAILS MINIMUM PER ITEM 10 CBC TABLE 23-II-B-1 (XX)- 16d ON BOTH SIDES OF WALL INTERSECTIONS 9c (XX)-16d ON BOTH SIDES OF DOUBLE TOP PLATE SPLICES 4'-0" MINIMUM 4'-0" MINIMUM 2" MIN TYPICAL TOP PLATE SPLICE DOUBLE TOP , PLATE SPLICE TYPICAL NAILING -16d COMMON OR BOX NAILS AT 16" OC (2)-16d COMMON OR BOX NAILS ON BOTH SIDES OF BUTT SPLICES IN TOP PLATE NOTES: (1) THE NAILING SHOWN ABOVE IS REQUIRED AT ALL EXTERIOR WALLS(DIAPHRAGM BOUNDARIES) AND OVER ENTIRE LENGTH OF ANY WALL CONTAINING A SHEAR WALL . (2) THE ABOVE DETAIL IS BASED ON A TOP PLATE DETAIL DEVELOPED BY NORM SCHEEL, SE 300 TOP PLATE SPLICE DETAIL NO SCALE Page 3 of 3 Butte County 05-2237 Willda.n 1.4353-1865-M.PCIF . BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #. (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP052237 - B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of. Issued Date: 11/17/2005 APN: 031-234-026-000 the Business and Professions Code, and my license Is in full force and effect. r1 License Class : V License Number: Site Address: 545 HEMEN WAY ORO Date: Contractor: Map Index: Description: NSF(1,203)GAR(44 1)COV(1 10) OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: FORD, JACK DUSTIN permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 65 CANYON HIGHLANDS DR signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95966 - she is exempt therefrom -and the basis for the alleged exemption. Any (530)693-0848 (530)534-0888 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: FORD, J. DUSTIN Code: The Contractors' State License Law does not apply to an 65 CANYON HIGHLANDS owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are -not intended or offered for 95966 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of s le.). as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: TRI MISSION COMPANY not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed PO BOX 1842 pursuant to the Contractors' State License Law.). OROVILLE, CA ❑ 1 am Exempt under Article 3 of the Business and Profession s•6 95965 (530) 534-0800 Date: tr 1'0501wner: License #: 856009 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: .s issued. ❑ Engineer: PURSELL, FRANK JAMES I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for.the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 1754 S.F. Policy #: Valuation: $90,539.00 I certify that in the of the work for which this is Census Code: performance permit 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. Date: Applicant:L4 WARNING: Failure to secure workers' compensation coverage is c. unlawful, and shall subject a` employs to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of h /1� / / �(f 7'7~— i� '-`33 compensation, damages as provided for in Section 3706 of the Labor , _. /I l ) code, interest, and attorney's fees. (6// 113 CONSTRUCTION LENDING AGENCY This permit's hereby issued under the pplicabte provisions of the Butte County Code and/or -soluti I hereby affirm that there is a construction lending agency for the R to do work indicatg� 96ov for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name:' BY• Date: f77<25 PERMIT EXPIRES Address: ON: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. Er Notification in accordance with Section 19827.5 of California Health $ Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree•to comply with .all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above me tioned property for inspection purposes. Print Name: i %c � /Q P%t�—+%� Signature: —A Dale: Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 ^i AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 2005-0057119 Recorded I REC FEE 7,00 Official yyRecords I CoButteof i COPIES 2.00 CANACE J. GRUBBS I County Clerk-Recorderl I I SA 011:IMM 21 -Sep -2005 I Page 1 of 1 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Lot- 4 i ®¢ ar 9 cGK- -L5 / o,s tj o vl 4ko-t Cer,�4r, N1,L-p e� MA -P a r- -Me-rA4,00i` to ` 13u t"tze_ G�euvjit' i &/. / lz lh � b A&,o /��:� fig _ Date 9-- 21 —06 PROPERTY OWNERS: �/ �� < State of California ) County of On �- �` _� before me, personally appeared J, UU5-� ti for cA perssf}y _IUown � , e (or proved to me on the basis of satisfactory evidence) to be the person(R) whose name(stis/an subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/tWr authorized capacity(ie , and that by his/hert(tleir signature(s)-on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my pend and official seal. JAMES LAMAR KINSER COMM. #1377185 -' Signatur Seal: (@3 ® NOTARY PUBLIC CALIFORNIA ® BUTTE COUNTY / My:Comm. Expires Sept. 28, 2006 A.P. # f�.3f 2-3�� �� CD