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031-243-028
i 31-243-s� 02� RAY 'J SPRAGUE 650 �olusa Ave.,nermalito Permit $#466-76B, ,E,M(new single `f a m`) I . - -> _ _ . 031-243=028 05-0660 KII`NAMONT, KENT - 650 COLUSA AVE, OROVI. 1" CONT: OWNER INALE ADD BDRIM& OFFICE "1 AGI a 031-243,028 06-0760 KINNAMONT, KENT 650 COLUSA AVE, O-ROVILLE Cont: OWNER`\V��� ADDITION Jg, ,- 0/ 0 28 CWD . +mrr..� , Bio '-cam' Ads r° t Av _..._.. _ emit vo Mum - - PUBM =W -IM . • MQLtri111191� �D N[1LldHn ARM r4jV Cu- t .V, Butte c106-0760 031'243.028` �f coy"ti `KINNAMONT; KENT / (530) sal 650 COLUSA AVE,,jOROVILLE `/ 1 Cont: OWNER i ADDITION " F APN: Permit No- Owner- Site o-OwnerSite Address: 1 Contractor. Type of Permit —s SPECIAL CONDITIONS'.- CHECKED BY ❑ SRA Q FLOOD CERTIFICATE EQUIRED Q FIRE SPRINKLERS REQUIRED Q SPECIAL INSPECTION ITEMS Q VERIFY Q USE PERMIT CONDITIONS ❑ SUBSTANDARD HOUSING LETTER Q ENCROACHMENT PERMIT Q REINSPECTION FEE PAID 0 EMV HLTH CLEARANCE Y' A r Cp DATE JOB FINALED: \ ai SIGNATURE: v 60e�y /a�sq�a�r� - :, . = OK o = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION Lj SOFT -SET DATE ID E C K S -C O V E R S -C A R P O R T S `G A R A G E S i Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-DpthSpacing-Cnnctrs-Steel 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FalUC/O-Concrete 3 Decks, Girders/Joists-Dcking-Brcing 4 Wtr; Loctn-Test-Easement Needed-Re6ulator 5 Elec LOctnitrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap . Nat 0 or LPQ Inch Sz Ft Lngth Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng + 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 7 Blckng; Sz-Spacing-Marriage Line 6 Carports; Wndws-Doors 8 Gas; MH Test-Demand-Valve-Cnnctr 7 Electric 9 Elec MH Cntnty Test -Crossovers -Breakers -CI rncs 8 Frmg; S ills-Anchrs -Studs -Rftrs-Trusses 10 Drain; MH Test -Fall -Flex Cnnctr 9 Siding; Nailing -Veneer -Stucco -Lath 11 Wtr & Sewer Connected -GO to Grade' 10, Roof, Shthg-Roofing 12 Gas and Electricity Tagged 13 Tie Downs Q Foundation Q 11 Ext; Steps -Doors -landings 12 Braced Wall pnls 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers s tea` °'� ° °�• o DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 4 0'6 0 0' - 0 5 Elec Pool Lting; 15 volts-GF1 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Egp-Htr ' 8 Elec Grndng; Eqp w/S' Crcltng Eqp-Pool Ightg Bones-EnclsrsTnlboardsdnsultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test Wtr Supply Test 11 Lt Niche 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide _ 40, 0 c' 0� Pool Drawing j, r OK = Ho[ OK // RESIDENTIAL (Single& Dup(ex)-: OOR rLo g -s tbacks-Easements-Flood-Scope g in; Soils-Elec Grnd Ftg Dpth 3 F Garage; Soils-Steel-Elec Grnd Ftg Opth. Ftg Porc %Decks; Soils -Steel Ftg Dpth 5 Stem Its Main; Steel-Blockouts-Wrapped 6 S walls Garage; Steel-Blockouts-Wrapped 6� old Downs and Special Anchrs rrSlab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test tt Wtr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd 13 Plenums & Ducts; Cirnc-MaterialSupport4nsultn 14 Girders-Sills-Anchr Bolts Joists-Vnts-Cripples 15 Acc & Vntltn 16 Insulation .�` o. • � m o'er DATE F R M I N G � //Sills Proper Materials & Anchrs 1�Walls Studs -Nailing Spacing & Braces-PlatesSound 19 Bearing Walls over Girders & fir Nailing 20 Draft Stop in Walls (rat proof) 21%F- a Stops, Furred Ceilings -Stairs -Chasers -Tubs Fc.ili ders & Beams-Sz & Bearing gers-Post Caps-Anchrs-Dnnctns ng Joist-Rftr Ties-Purlin-Roof Brac TrussShthg 25F c Ties or Type A Flue-Frpic Throat Cimc 26 c Acc; Sz & Rmx Prtctn-Draft Stop4ns Baffles - Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions A& Garage Fire Prtctn Framing -RC Channel 29 Prprty Line Firewall & Opngs 30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs iding-Nailing Veneer 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Glazing Area -Glass Prtctn-Skylts-Plastic 36 Shear ails; Nail' 9 -Bolts Q 37 BIS Int/EAVVaIl pnls ,V 38 Insultn-Walls-Ceilings 39 Infiltration-Walls-Wndws DATE JELECTRICAL 40.,Fxtr & Tmsfrmr Clmc4ns Prtctn 1 c Rcptcls Spacing-Lts & Switches at Doors 4 Boxes & No Of Cndctrs Stapled ex Installed Close to Edge of Studs & CJ y4 Eqp Grnd made up w/Mech Fstnrs 45 Gmdng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ga ❑ CU or ❑ AL AC Wire Sz ga ❑ CU or ❑ AL 48 Range Circ ga ❑ CU or ❑ AL Oven Circ 9a ❑ CU or ❑ AL Insulated Neutral ❑ Yes ❑ No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp CImcs pnls-Motors-Mech Eqp 51 Clothes Closet LI-Shvrr Lt -Spa Lt 52 Smoke Detector ugit IPL UJVIBING 5'3'Wtr Htr; Vent-Acc-Cmbstn Air Baffle 5417tr Pipe -.'Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr Nail Prtctn 56 Shwr Pan; Test, First fir -Tub Acc 57 Test Tub & Shwr, 2nd fir - Tub-Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas Piping 40\ 0 owe DATE MECHANICAL 61 AC Ducts Insultn & Support 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air RtrnIVent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic r \c DATE JFI Steps -Door & SideLt Prtctn-Landings Smoke Detector 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr In Garage; abv-fir-Ducts-Mech Prtctn 69 Bedroom Exiting 70 GFI & Bath Fxtrs & Tub Acc-Spa 71 GF1 Arc Fault 72 Elec Trim & Subpnl, Breaker Sts & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Cimc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Cimc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door, Swing -Landing -Closure 79 AC Duct in Garage -Damper 80 Wtr Htr; Vnts-Cimc-Com Air Cnnctr-PRV; abv fir Mech Prtctn- LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Lottn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑Yes ❑No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Pimb 89 Vnts abv Roof, Plmb-Appinc-Frplc-CImc to Opngs 90 W ell, Dscnnct, Elec, Pimb Elec Trim, GFI Rcptcl-Undrgrnd to thru House Glass Prtctn 94 Corrections from previous lnspctns 95 Gas Test -Meters Tagged, Gas-Elec peW96 &Sewer Cnnctd-O/O to grade -HD Apprvl rgy Cmpinc Cert -Other Certs ST Address Posted 99 Fire Sprinkler BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530)'538-7541 - LICENSED CONTRACTORS DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class:. License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the following ieason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to rile a signed statement that he or she is licensed *pursuant to the provisions of the Contractor's Stale 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.lhe basis for the alleged exemption. Any violation of Section 7031.5 -by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500).): j9 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). O 1, 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 not apply to an owner of properly who builds or improves thereon, and who contracts for such projects with a contraclgp(s) licensed pursuant to the Contractors' State License Law.). 1 � r� ❑ lam Exempt under Article 3 of the Bysinq�,� and PrA esslons Code rarmyn I Ivv. BPO 60760 Issued Date: 04/18/2006 APN: 031-243-028-000 Site Address: 650 COLUSA AVE ORO Map Index: Description: addition ( 340 ) Owner: KINNAMONT KENT V & MAMI T 650 COLUSA AVE OROVILLE, CA 95965 Applicant: KINNAMONT KENT V & MAMI T 650 COLUSA AVE OROVILLE, CA 95965 Contractor: Date:Owner. LL WORKERS' COMPEbtATI N OECLARATION License #: I hereby affirm under penally of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for. the performance of the work for which this permit . is issued. Architect: ❑ 1 have and will maintain workers' compensation insurance, as Engineer: 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: 340 S.F. Policy Valuation: $22,100.00 J I certify that In the performance of the work for which this permit Is Census Code: 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' I( compensation provisions of Section 3700 of the La r Code, I shall V forthwith comply with those provisions. r2,- Date: Applicant: WARNING: Failure to s ! e work compeation coverage Is unlawful, and shall subject an employer to.crimina penalties and one hundred thousand dollars. (8100,000), In additi to the cost of compensation, damages as 'provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit I ereby is' ed un r the ap able provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the Resolutio to do w6 j tlicate above f which fees have been paid. performance of the work for which this permit Is Issued (Sec 3097 Civ.) V Name: BY Date: Address: PERMIT EXPIRES ON: (Date) Z 6 _ ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information Is correct, and that I am the owner or the duly author' d agent yyf a owner. I agree to comply with all county and stale laws relating to building construction. I acknowledge it Is unlawful to alter the substance of any official jot ordocu �n of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for Inspection purposes. i Print Name: (� s V t ✓t '^ c r'"` J'� _ Signature:�j Date: ������ ll Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor o B. C. Building Permit 01-16-04 pg 1 BUTTE COUNTY PERMIT NO. DEPARTMENT OF DEVELOPMENT SERVICES ve BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) BP060760 OFFICE #: (530) 538-7541 LICENSED CONTRACTORS DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class :. ' License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following season (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's Slate License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and,the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than rive hundred dollars ($500).): JZf I. as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered.for sale (Sec. 7044, Business and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, 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 not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractof(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Bysi696,s and Pr#essions Code � .�Iryi1OII/�� WORKERS' COMPVSATION DECLARATION I hereby affirm under. penally of perjury one of the following declarations: O 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 .of the Labor Code, for the performance of the work for which this permit is issued. ❑ 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: Policy 1 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 .6-ecome subject to the workers' compensation laws of California, and agree that if 1 should become subject to the workers' compensation provisions of Section 3700 of the La r Code, I shall forthwith comply with those provisions. Date: •e �!/ �� WARNING: Failure to soffi worker comperfsation coverage is unlawful, and shall subject an employer to.criminat penalties and one hundred thousand dollars ($100,000), in additi to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. Issued Date: 04/18/2006 APN: 031-243-028-000 Site Address: 650 COLUSA AVE ORO Map Index: Description: addition ( 340 ) Owner: KINNAMONT KENT V & MAMI T 650 COLUSA AVE OROVILLE, CA 95965 Applicant: KINNAMONT KENT V & MAMI T 650 COLUSA AVE OROVILLE, CA 95965 Contractor: License M Architect: Engineer: Total Square Ft: 340 S.F. Valuation: $22,100.00 Census Code: I l �2 CONSTRUCTION LENDING AGENCY This permit i ereby I hereby affirm that there is a construction lending agency for the Resolulio to do wd performance of the work for which this permit Is issued (Sec 3097 Civ.) Name: By: PERMIT EXPIRES O Address: fable provisions of the Built! County Code and/or which a been paid. Date:_ (r— ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials, ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information Is correct, and that I am the owner or the duly author' d agent a owner. I agree to comply with all count and state laws relating to building construction I acknowledge it Is unlawful to alter the substance of any official- o or docu n of Butte County. I hereby authorize representati ves of Butte County toenterupon the above mentioned property for inspection purposes. Print Name: "l(�aG a V +` L ti ✓L c H" fl''t Signature: Date:�/* 111V ❑ Owner ❑ Contractor Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16.04 pg 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIRENIENTS 24 HOUR MSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 591-2834 OFFICE 9: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" - For ce use on OWNER INFORMATION OWNER Last Name • 1l first Narr�e� SRA i �a No Address .0 Co \ LASc-t Ave City O \1e State C Zig 1161. "I v Utj ` Phone &.d Fax E-mail Kehl @ v.c�oc co &I For ce use on CONTRACTOR Name Flood Zone Address SRA City No State Zip Phone'" Book Fax E-mail Planner Lic. # Class For ce use on ARCHITECT/ENGINEER Name Flood Zone Address SRA City No State Zip Phone Book Fax E-mail Planner State License Number For ce use on APPLICANT INFORMATION Name Flood Zone Address SRA City No State Zip Phone Book Fax E-mail Planner For ce use on ing Property Address 14/5A- &.370 Flood Zone Cross Street SRA Yes No Occ. I Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP0661-16 BIN / 2 PROJECTLOCATION AP# 6731 —� > —0 G E7 Property Address 14/5A- &.370 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 Address Description or Scope of Work: �Dli 1� s 3 LIU Sq FT- Living Garage 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. Received by: Receipt #: .L�i4 Date:. A o v Amount: l t - Bldg Total 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 A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, 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 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 bV 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 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA .95965 Phone (530)538-7541 Fax (530)538-2140 - - -�, PERMIT APPLICATION DATA SHEET OWNER: A / /UM A -M 0-" 1 ASSESSOR PARCEL NUMBER y Proposed Buildin Use: / TI 0 � J G�� G� L/ 4- '06 p g Permit Technician: Date: \Mems required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. p) 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. ❑ t /J 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. ❑ 3. Engineered. plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxesl ❑ 5. Letter from Engineer or Architect for truss design review. r 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) Find plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Hazardous Material Form ❑ 12. Acknowledgement of building permit application without required clearances. ❑ 13. Other All of these Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 14. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable ❑ 15. Fire Sprinklers............................................................................................ ❑ 16. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 17. Soils Report and/or Engineered Foundation required ........................................... ❑1 Erosion Control Plan Required........................................................................ ��(29,;Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 20. City of Chico Plumbing permit........................................................................ \❑ 21. Site plan and business license approval from the City of Biggs .............................. O 22. California Department of Forestry plan approval ❑ paid. Sent by: 23. Planning approval for (A) Use: (B) Parking: (C) Parcel Check :............ Co ❑ 24. Contact Land Development about _ Improvements, _ Drainage ........................ �O 25. Fire Marshall Review (commercial projects only). Sent by: /� 26. NPDES Form............................................................................................. IN 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 .......................................... j Pi 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 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 AC -74T and hold for pickup. I have been informed of the-abovi terns aqdrequirements for obtaining a building permit. Applicant:'"' Date: '/- '/- 0C-:, , 1. Index t ap4,e'r., rr%tl�above items numbered: Plan Check Letter 2. Ad itid` onal items Contractor, designwas a vised of the above data by phone, ❑mail, ❑counter, by Date: (0 Contractor, designwas advised of the abovedata by O phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: I Z I Plans approved by: 49 14a Date: Structural reviewed by: Date: Structural approved by: 42AC2 Date: Note transfer by: Date: Yellow: Building Division K/Building/Plan Check/Data Sheets/data sheet page 2 9.27.05 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 t t www.buttecounty.net/dds PHONE (530) 538-7541 FAX 538-2140 RECEIPT OF FEES SCHEDULE - RESIDENTIAL Owner kinnamont APN No: 031-243-028 Application Date 4/4/2006 Permit No: BP 06 0760 Permit Type: addition 1 BUILDING PERMIT FEES ESTIMATED AT APPLICATION $852.35 Plan Check portion of Permit Fee $340.94 $511.41 Balance of Building Permit Fee 2 FEMA BYes Flood Elevation Review $109.98 0 3 SRA* Yes Fire Plan Check - Non -Refundable $95.00 0 _ (State Responsibility Area) Building Inspection $109.98 0 - $204.98 NON-REFUNDABLE portion of fees due at application $340.94 4 5 6 7 7a 8 9 10 FEES DUE AND PAYABLE AT TIME OF PERMIT APPLICATION FEES (BELOW) DUE PRIOR TO ISSUANCE OF PERMIT Balance of Building Permit Fees (from No. 1 above) SMIP* - Strong Motion Instrumentation Program (Enter amount from permit system) Additional Plan Check Fees (NON-REFUNDABLE) Other*: Other*: MPAGT FEES - RESIDENTIAL* 4pplications After 2114/05 u Per Dwelling SFD ,c Per Dwelling MFD ,, Per Dwelling MH County 4096.871 3071.14 3117.43 Chico Urban Area 5372.091 3995.45 4889.56 EI Medio Fire District 3128.311 2297.77 2326.36 North Chico Specific Plan 0 SR -1, SR -3, SR-1/PD R-1 7938.531 8031.53 6757.081 6850.08 7633.49 7726.49 'leo R-2 7541 5'i I sssn ns 1 79364q R-3 1 6780.531 5599.08 Processing Fee is automatically added to impact fee total 0 WATER TENDER FEE (Not collected when impact Fees Applicable) Enter Bat.# DRAINAGE FEES* CHICO STORM DRAINAGE MASTER PLAN $200.00 770 Butte Creek 771 Comanche Creek New Construction, vacant land, on 1 acre or less - Enter 1 or less acre value 772 Little Chico Creek 773 Big Chico Creek 774 Lindo Channel 775 SUDAD Ditch 776 Mud-Svcamore Creek RECEIPT DATE Tech/Asst $340.94 N H 9V 'f AI -W-06 Cra $513.6211W 1 052— y �'v-fb $511.41 $2.21 6475.49 RECEIPT DATE Tech/Asst $100.00 � $200.00 Kourtni � 736 $6,975 RECEIPT DATE Tech/Asst 777 PV Ditch $8,603 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 $652 Maximum Per each new living unit on existing lots where full drainage fees have not been paid 11a Temporary Dwelling F $130 At time of building permit $130 annual renewal fee for first 4 renewals. Not to exceed $652. 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' H 6 H %2'r4','rz-1 tb y i 6 - 12a RECREATION DISTRICT FEES* ,by At the time of permit application, I was checking process. Applicant: Pursuant to Government code from the date of approval of the specified in Goverment Code Si above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan L IZ - Date: �V �d those Items followed by an " may have been imposed on your project. You have 90 days above referenced items during which you may protest. The requirements for a protest are K:/Building/Forms/Schedule of Receipt Fees Residential 121205 pYtTMEN U T T T °A,\ W ®r D-epartment ®f PU.Ic . �` \�'� • C o u n t y o f B u tj. e I{ a 0 1 c o J. Michael Crump, LAND DEVELOPMENT DIVISION �. Storm Water Management Program //'' Director' • 7County CenterDrive U N Oroville, CA 95965 A�QUC W0 Q�9 r )530) 538-7266 ` (FAX) 538-7171 National Pollutant Discharge.' Elimination System (NPDES) Phase II r Construction Storm. Water Permit and Storm 'Water-Pollution Prevention Plan (SWPPP) Acknowledgement [LESS ;THAN 7 ACRE] Project Description: Project Location and/or Parcel Number: S�' C I a A&e 3-0`3 By sigrung 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 buil&outs of less than one acie,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. Lam aware that submitting false and/or inaccurate information' or failure-to apply,for a Construction Storm Water Permit from the State of Califor is Regional Water Quality Control Board for a.project that disturbs one acre or more of land may ult in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: W Y Qom. . Dater Less than I✓Acre NPDES & SWPPP Compliance Certification ` f Butte County Storrs Water Management Program c ' Revised 5/24/04 OWNER-BUILID]ER VERIFICATION ICA:TION ; Attention Property Owner: An "owner -bull der".building permit has been,applied for in your name and bearing your'. signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. I personally plan to provide the major labor and material for'construction of this proposed' property improvement: YES.[/] NO --2. I HAVE [✓] HAVE'NOT [' ] signed an application fora building permit for the proposed, work. 3. I have -contracted with the following person.(firm) to provide the proposed construction: .NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I•plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and: provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. " I will provide some of the work but I have contracted (hued) the following persons to provide , the work indicated: NAME ADDRESS PHONE. TYPE OF WORK SIGNED: PROPERTY OWNER: DATE: NOTE: This Owner -Builder verification is required by. Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. ' Butte County Department of Development Services 0T ADMINISTRATION `BUILDING t GIS ° PLANNING 7 County Center Drive o Oroville, CA 95965 0 =' (530) 538-7541 Telephone CO (530) 538-2140 Facsimile U OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or. through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, Scott Rutherford Chief Building Inspector NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. UGIT uTT 0 I�e� .artment. '®f Public Wo ks Fp I p p C o u n t y o f B u t t o p p 0 p 7 County Center Drive Orovihe, CA 95965 �p COU ��y J. Michael Crump, Director (530)538-7681 N (FAX) 538-7171 trc �S Shawn H. O'Brien, Assistant Director s Assessors Parcel Number: 3 —ZY 3 - 02' Building permit # Owners Name: ke, t K Owners Mailing Address: Property Address: l� • . • ENCROACHMENT PERMIT ACCEPTED: PERMIT NUMBER: ENCROACHMENT PERMIT EXEMPTION: Reason for exemption: ❑ Not a County maintained road . Existing driveway conforms to County'S-31 standard ❑ Other Approved by ` Printed Name v / Title _ • - Y Date CONDITIONS FOR EXEMPTING A DRIVEWAY PERMIT 1. 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... ion BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) SchoolDistrict (J a,6 vi Qr 1-06 Building Department No. 60760 A.P. Number 0 Z Jurisdiction: City j'/ County Property Owner - ��/ MN�-`�'✓1 a"Y�%�" Property Location/Address Subdivision Lot No. Residential Development = Q No of Living . Mobile Home Units Installation Commercial/Industrial 0 New Addition Building Department Representative :..................................................................................... `. Sq. Footage Addition/ 'Supplemental to (Group. R) Conversion Permit # .(No foundation inspection) E........................................................................................ Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) L'dcldentification No. 06,0223 ' lchool District certifies that A U (Street Address) J (State) Sq. Footage (Including Exterior Roofed Areas) Date f (Applicant) r (Phone Number) (Zip Code) has complied with the requirements of -Resolution No. QS — / v by payment of $ EAf ,� 1'd' � r represents 9 square feet. B 2926 $ School District Representative Paid by Check # /J//+ Remarks: ULL MITIGATION $ Dl t7 D l� 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 date fees are paid. Failure to submit a timely written protest will prohlblt you from challenging the Imposition of the fees In any court action. i M, subsequent to the School District Representative signing this Butt 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 tees to fully mitigate Its Impact on the school dlstrlcrii'schools. White (school district), Yellow (building department), Pink (applicant). %eform.xis (3/05)drhm NOTESRESIDENTIAL . J 031-233-0�8 -' PERMIT N0." � ' 05-0660 ,- KINNAMONT; Ia=NT 650 COLUSA AV , OROVLLLE CONT: OWNER ADD BDRM&, OFFICE r SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS. VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER fy 4f K JOB FINALED (Date) 4 Signature '�. J=OK 0 = Not OK - = Not Applicable . =Not Ready MOBILE HOMES ` MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s . Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails '4. 'Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft./ P LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Well Clearance & Disconnect 7. Electric 8. Utility Clearance 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing Date Card B=1 Date Card B-1 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 12. Braced Wall Panels Date MOBILE HOME INSTALLATION, (Plans) OK except #'s - 1. Zoning Requirements -Setbacks -Easements Date Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line Date Card B-1 Date Card B-1 3. Gas; MH Test -Demand -Valve -Connector Date POOLS (Plans) OK except #'s . 4. Electricity; MH Test -Crossovers -Breakers -Clearances 1. Setbacks -Easements 5. Drain; MH Test -Fall -Flex Connector 2. Soils; Compaction -Structure Stability 6. Water; MH Test -Regulator -Connector 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 4. Elec.; Receptacles and Lighting, Distance-GFI 9. Tie Downs -Type -Installation Cert. 5. Elec.; Pool Lighting; 15 Volts-GFI 10. Exits; Insp.-Sketch - 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 11. Cert. of Occupancy 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures-Panelboards-Ins. to Main Conduit Date Card B-1 Date Card B-1 9. Health Department Approval Date Card B-1 Date Card B-1 10. Plumb.; Cir. Test -Water Supply Test - Date PERMANENT END SYSTEM (ONLY) 11. Light Niche 1. Zoning Requirements -Setbacks -Easements 12. Enclosure; Fencing -Alarms 2. Footings; Size -Spacing -Marriage Line 3. Blocking Date Card B-1 • Date Card B-1 4. Gas; MH Test -Demand -Valve Date Card 13-1 Date Card B-1- 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 = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date UN 9 RFLOOR (Plans) OK except #'s . On ing-Setbacks-Easements-fid-Slope VFtg., Main; Soils-Elec. Grnd.-/!?/" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles tg., Porches & Decks; Soils -Steel -/)Z /" Ftg. Depth Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14, Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s er Htr.; Vent -Access -Combustion Air Baffle 18. W Pipe; Test & Anchor -Nail Protection 9. D.W.V.; Test Fittings & Anchor -Nail Protection 0. 5b wer Pan; Test, First Floor -Tub Access 21.jest-Tub & Shower, Second Floor -Tub Access 21 Gas Pipe; Sixe & Anchors prinkler; Test Date ii Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECT CAL (Permit) OK except #'s 24. 'acture & Transformer Clearance -Ins. Protection 2 . Elep. Receptacles Spacing -Lights & Switches at Doors 2 • . i Boxes & No. of Conductors Stapled 2 . Romex Installed Close to Edge of Studs & C.J. 2 Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 9 2 AppGance Circuits in Kitchen & Conductor Size GFI 0. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al -31-Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes Cl No 32. Se 'ice -Riser Conductors & Ground Main Disconnect ui . Clearances Panels-Motors-Mech. Equip. es Closet Light -Shower Light -Spa Light *-r 3r Smoke Detector Date J% O Card B-1 Date Card B-1 Date 17 p / Card B-1 Date Card B-1 Date MEC NICAL (Permit) OK except #'s 3AeC. Ducts Insulation & Support 37 Vent Fan, Exhaust above insulation -197 Condensate Drain & Overflow, Size & Grade .29 -Furnace -Vent Accgss-Comb. Ait-Return Air Vent 115 Outlet g0: Attic Access & Pi4tform if Furnace in Attic Date f Card B-1 Date Card B-1 Date Card B-1' Date Card B-1 Date FRAMJNG (Permit) OK except #'s 41 s Proper Materials & Anchors 4 . W s Studs -Nailing Spacing & Braces -Plates -Sound 4 Be 'ng Walls over Girders & Floor Nailing 44. raft Stop in Walls (rat proof) 45. Fjra Stops, Furred Ceilings -Stairs -Chasers -Tubs 461" -Headers & Beams -Size & Bearing Date FRAMI G (Continued) 47 �rigers-Post Caps -Anchors -Connectors 4$. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. eplace Ties or Type A Flue -Fireplace Throat Clearance 5 . Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions . arage Fire Protection Framing -RC Channel 51. foperty Line Firewall & Openings 54' Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits airs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Sidinq-Nailinq Veneer 72!:2ucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58' Glazinq Area -Glass Protection -Skylights -Plastic Panels l W.Insulation-Walls-Ceilings 63. Infiltration-Walls-Wi ws Date Card B-1 Date Card B-1 Date and 1 Date Card B-1 Date "FINA lans) OK except #'s Detector Vents -clearance -Comb, Air -Connector - ,ht Garage; Above Floor-Ducts-Mech. Protection Bedroom Exiting & Bath Fixtures & Tub Access -Spa -69-E1ec-Trim & Subpanel, Breaker Sizes & Labels ._ZD. -Stairs & Rails 1— .'replace or Stove, Clearance-Hearth -;2--E,a�. v.,tlets at Wood Panel, Int. & Ext. 7,3-Kii . Fxt. & Appliance; Ground -Air -Gap -Cooking Clearance 74'-EMc. Outlets & Receptacles at Kit. Counter rage Fire Door; Swing -Landing -Closure -%--A-G. Duct in Garage -Damper Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. Garage; Above Floor-Mech. Protection Z8' Plb.; Elec. & Mech. Equip. Listed for Location Receptacles in Garage (F.F.I.)-Romex Protection 8"sulation- Foam -Looked in Attic _-84 - 46wcl Rails & Deck Construction -Post Caps 82'Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under Floor ❑ Yes -83 Fallowing Instld./Drive 0 Yes O No/Walks O Yes 0 No/Planters O Yes 0 No -e4---Stucco Brown -Finish t5-A.C. Unit Disconnect, Electrical -Plumbing Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Steer Well, Disconnect, Electrical, Plumbing Exterior Elec. Trim, G.F.I. Receptacle -Underground Ventilation Throughout House Glass Protection 9 . Corrections from Previous Inspections -9Q. s Test -Meters Tagged, Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval ergy Compliance Certificate -Other Certificates Address Posted +ire Sprinkler Date and B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: Irj,•'�" { ti •• �. r �, inn• � .. •i...•�t MW I �'r- •� • •- . MOW" TherniM ReB 2. CEILING Batt or Typv t Brw d Name Johns Mwwft ''fl cwtess ( ) 13 TMnnd Resisbm (R Valine) �, • �� - I.00se FM Type - Brand Nww Johns Manville Conbndr/s nft inked viraWM sq. w, Mfi#mun�Ttd , Mmi- k aakuw% huftbdwoW per sus fMto TlmwW Ra ma (R Vahm) I EXTERIOR WALL Malum.BsBs Tfdckness (!nchw) b 5 4. RAMM FLOOR Malek Elambn soft . Tt�dc�s 1 & SLAB FLOOR / PEfiiMETER Maberlal Petftew ftb#M ova �RNiIl7 l7 a FOUNDATION WALL Mal�ai Th�e� (ir�es) - • Brow mom .johm mammme - TMmvd R (WVaWL— 8dr8Rd Nana idds mamma TfNMW ROME= (R-Vahm) AwRI Narire: ThWmal RakftM (I�Vakee; Name ThWMd Raddw a (R -V") DE1ChILeA MILAN y v�grrrt � We In bte) es on fhePwoe, w C.L.B498t� �� -65 mg—lFew Dam r--- :Tff f .• . . • • C c. M.' it 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. BP050660 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. 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: 05/02/2005 APN: 031-243-028-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 650 COLUSA AVE ORO Date: Contractor: Map Index: Description: addition bedroom and office 672 cov 136 p OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: KINNAMONT KENT V &MAMI T to its issuance, also requires the applicant for such permit to file a 650 COLUSA AVE 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 95965 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).): Ir`-(- I, as owner of the property, or my employees with wages as their V —sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: KINNAMONT KENT V &MAMI T Code: The Contractors' State License Law.does not apply to an owner of property who builds or improves thereon, and who does 650 COLUSA AVE such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for 95965 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, 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: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Bus' ess Professions Code Date: Owner: License #: WORKERS' COMPENSATION LARATION I hereby affirm under penalty of perjury one of a 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: is issued. ❑ 1 have and will maintain workers' compensation insurance, as Engineer: 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: 808 S.F. Policy#: Valuation: $45,856.00 I certify that in the performance of the work for which this permit is Census Code: 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: WARNING: Failure to secure workers' co ensation coverage is unlawful, and shall subject an employer to criminal penalties and one 31 � hundred thousand dollars ($100,000), in addition to the cost of � compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions to d rk i dicated above for which fees have been paid. �, as Name: By: Date: G Address: PERMIT EXPIRES 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. ❑' Notification in accordance with Section 19827.5 of California Health 8 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 docu nt of Butte County. I hereby authorize representatives of ButteCounty to enter upon the above mentioned property for inspection purposes. Print Name:. Signature: Date: i 91pwner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION. 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 nn PEER�M-IT APPLICATION DATA SHEET d /, OWNER: ASSESSOR PARCEL NUMBER "✓ 1 ���y�� Proposed Building Use: /"1( `-` 1 V tr \ Counter Technician/ Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in orderto apply. 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. O 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. 6. Energy compliance design and supporting documentation in duplicate. 0 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst. (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate ❑ 11. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form t,� ` 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ j 20. Erosion Control Plan Required........................................................................ ........ o/ 0 Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 22. City of Chico Plumbing permit........................................................................ i23. California Department of Fores ry plan approval ❑ paid. Sent by: ............. C4) Planning approval (A) Use: (B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... .IL 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization......................................:............................. ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ -35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... 37. ❑ Grant Deed, ❑ M Title/Stat ent of Facts, ❑ Le ter from Legal Owner, ❑ Check 00ther: k � (^ ❑ 9. Other: i When issued Telephone and hold for pickup. 1 have been informed of the above item/wand requirements for obtaining a building permit. Applicant: �' 1 Date: / 1. Index permi�ap'plica ion ford a oveitems numbered: Plan Check Letter 2. Additional items re 1 Contractor, designe ,own , was bdvised of the above data by phone, ❑mail, ❑counter, by Date:.` �^ + Contractor, designer, wner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: 1. Plans reviewed by: Date: Plans approved by: Date: Structural reviewed by: Date: Structural approved by: V1 Date: Note transfer by: QQ39fjzf,Date: Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER t '� ni b A. P. # PROPROSED BUILDING USE -A DATE RECEIPT # DATE C. . BUILDING PERMIT FEESj(� --- Balance Due ..................... $ ( 21 --! Additional Fees Due........... $ --- evised Plan Checking Fee.... $ ' CHOOL DISTRICT FEES aid at School District Office) (form available after Plan heck) l o4 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ Units Commercial (sq. ftg.)..... X $0.03 Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. , Commercial (Sq. Ftg.).... X = $ Sq. Ftg. Amt. L 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE ,$89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION # $200.00 (paid. at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X =$ Zone # Units Amt. r Commercial (sq. ftg.) ......... X = $ Sq. Fig. Amt. ) 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 pi n ecki process. APPLICANT DATE Pursuant to Govem nt Code Sec V60, 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 project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Cotion 66020(a). ' Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) -• '• PpftTMEPv2- T,Fo� Depart .e-nf ' f .Pub1.*Ic W arks m �0 C. o -u m y ®-. f B. u t; t o O 0 J o J. Michael Crump, Director LAND DEVELOPMENT DIVISION ® 0 i Storm Water Management Program 7 County Center Drive OU t4l Oroville. CA 95965 �L1C W�R� ' (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge .E.Ilmination System (NPDES) Phase ii Construction Storm Water Permit and Storm -Water Pollution Prevention �" rl Plan (SWPPP) Acknowledgement LLESS THAN -1 ACRE Project Description: a' AA t .l d A f ' Project ]Location and/or Parcel Number: .3 Ou 3 - 0,117 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 Swim Water Permit from the State of California Regional Water Quality. Control Board. - l 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: t Less than 1 Acre NPDES & SWPPP Compliance Certification Butte;County Storm Water Management Program Revised 5/24/04 ,QQ mN, a,=.�.. .x.u..:ati�.•�5e,'z.;r,..>!af�zz.:�r...s.. r_?<Y�zh<....r..>,:. _r.-st,..i :...X.,..a., r - Attention'Property Owner: , " An "owner -builder" building permit has been applied fo'r in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary, delay in processing and issuing your building permit..No building permit will -be issued until this verification is received: , 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: , YES [V'] ' -NO [ ]. 2. I HAVE [ /],HAVE NOT [ ] signed an application for a -building permit for the proposed work. 3. I have contracted with the following person (firm) to.pfovide the proposed construction: 'NAME: b _p ✓► ADDRESS: coso COILCSC. 6 �n Or9,1:1 i'a ` PHONE: 5;_3 c/ CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I,have hired the following personlo coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. 1 will provide some of the,work but I have'coritracted (hired) the* following persons to provide the work indicated: NAME -ADDRESS PHONE TYPE OF WORK w SIGNED: PROPERTY OWNER: „� vt�v►•� DATE: �J NOTE: This Owner -Builder verification is required'by,Section 19831 and I9832,of the California Health and Safety Code: This verification must be completed and returned to our office before 'we -are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department ©f Development Services ADMINISTRATION * BUILDING * GIS * PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538.2140 Facsimile I-ROW'ONE OPER Hsi R. I ISMS NA Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. I C. Vieiri, C.B.O. :r, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) j School District�%(C�'D�' 1 Building Department No. a U Jurisdiction: CI County A.P. Number �' � ��'T3 ' � �+ � city � Property Owner Property Location/Address In l J ��Ti C�� •• i �/'��� 1 ! l� Subdivision Lot No. Residential Development Q No of Living Mobile Home Units Installation Commercial/Industrial _0 New Building"bepartment Representative Addition . ................. _....... _...._........................:...................................... C� / . ®�I Sq. Footage Addition/ 'Supplemental to (Group R) Conversion Permit # *(No foundation Inspection) ..................................................................................._............_..; 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. 0!502 9 I' (_ un I'M' o ►' 4-i2bchool District certifies that { j'1, I ili� U (Applicant) (Street Address) (Phone Number) (City) (State) (zip Code) — has complied with the requirements of Resolution No. l lJ� �Q by payment of $ 5-0-S 2--] representing j/J r? squaee feet. 2926 $ FULL MRIGATION �n l School Paid by Check of ,�, Remarks: Date Nonce: You may protest the Imposition of the fees Identiflad above by submitting a written protest to the Dlstrkt, In compliance with Govemmwd Code Section 66020(a), within 90 days from the data fees aro paid. Failure to submit a timely written protest wllf prohlbit 'you from challenging the Imposition of the face in any court adlon. K, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is nOR ed by tit applicable Local Planning Agency that this project Is being revlewad under the California Environmental Quality Act (CECA) this project may be subject to additional school fees to fully nnkipaleAs Impact on the school dlablct'a schools. White (applicant), Yellow (building department), Pink (school district) feeformads I10/03Mmm z SITE PLAN REVIEW APPLICATION Date: .' Z�'d� AP# 3/' Z`{�'/�2d Permit Number (if applicable) Bin Number S APPLICANT INFORMATION Parcel Size: . Owners Name:w��y�lL`t�I eorn7 Owners Address: Telephone No.:. / Situs Address: 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 - F -1 Multi -family. Non-residential` ❑ New Commercial , ❑ Commercial Addition ❑ Commercial Remodel New Industrial ❑ Industrial Addition ❑ Industrial Remodel Other ❑ Septic ❑ Well ❑ Agricultural Exempt Building ❑ Agricultural Buffer Form ❑ , Applicable ❑ =N/A ❑ Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) W Approved r' ❑ Conditionally Approved ❑ Resolve Problems Prior to, Approval Site P Stampe proved .By' Date Z� G Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation 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) ❑ 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: �C • Flood Panel No.: - Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ 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 ❑ Administrative Permit ❑ Minor Variance ❑ Variance -------=------------------------------------------------------------------------------------------------------- ❑ Detached Building• Use Form ❑ Encroachment Permit- Agricultural ermitAgricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: �fl (LD 0 Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 v. Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Z Side 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 v. Applicable Development Fees: Standard'Fees Amount Formula Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff Drainage - ❑ NCSP/CSA 87 ❑ Chico Urban Area - Road Thermalito Drainage Area ❑ Thermalito Urban Area ❑ 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: j. Date of Creation: , , Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road`: ❑ No M. Yes, Road Name: Complies with Co y t dards r Deed Creation:❑ N ❑ Yes Comments: ❑ 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 'of 5 ❑ Subdivision ME/Parcel Map: Map Date of Recording: Lot: Book: Page: ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: 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 road maintenance, and stop sign maintenance. IS Page 4 of 5 •\ ?;PERMIT NO. 4'66-76B, P,'E,M —77 77 PERMIT EXPIRES/`' .,.",OWNER Ray J. Sprague 'CONTR. owner LOCATION (A.P. 31-243-4 650 Co Ave., Thermalito Y llt COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBINGM2, oe ` Setback 9 Firewall 3� Soil Piping Forms Parapets - 1st Floor Main Bldg. Restroom Finish - 2nd Floor Footings 7— Z v Windows 3rd Floor Stemwal I ' Siding 3®Z To p out % e Slab Z =!z:? Roof SheathingWater Piping Piers Roofing Sewer,;z Garage Fdn. Vents Fixture e4�_X—& Footings 2 7 Garage Vents ater HtdIEW Stemwall Z Z Prov. for physically Heaters Slab handicapped Appliances �f Carport Conformance of exvy._/�� Gas Piping & Tes Footings structure // - Temp. Gas✓X� Slab Final Sanitation Patio FIREPLACE Final d; Footings Footing ELECTRICAL Masonry Walls Throat Rough -17za �r i Reinf. Steel f Final Fixtures S_ Bond Beam FIR SPRINKLERS Motors--- Frming/ . Test Water Htr. Stucco Final Subpanels �J Mesh MECHANICAL Grd. Fault Prot.,�y Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation,] 3 Permanent Door Closer Final �p Final DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN. CONFORMANCE WITH THE CURRENT REGULA- TIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Street Lot Number Tract No. EXTERIOR WALLS �iti9 Manufacturer Thickness/Type R Value CEILINGS Batts: Manufacturer Thickness R Value Blown: Manufacturer Thickness No. Bags Wt./Bag Sq. Ft.'Covered R Valu,- aluFLOORS FLOORS Manufacturer Thickness/Type _ R Value SLAB ON GRADE Manufacturer Thickness/Type R Value Width of Insulation inches IMY SPRAGUt FOUNDATION ALLS Manus er DENERAL CONTRACTOR Thickness/Type R Value P. 0. BOX 1837 GENE O TRACTO gbgbb• LICENSE Na. BY TITLE — DATE _ INSULA CO TRACTOR: HAWKINS INSULATION CO.. LICENSE o. 215-925 BY TLE DA - V COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR ' • 7 County Center Drive — Uroville, California 95965 s_ Telephone: 534-4,41 APPLICATION AND PERMIT .BUILDING Owner SQ. FT. OCC. BUILDING VALUATION 'Mai I i ng Address S" U e Telephone No. Fireplace Contractor Total Valuation Mailing Address LIV Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee $ Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.001:5,00 Each Trap 1,50 ,®() Repair drainage or vent piping 1.50 - Water piping 1.50 r Each gas water heater or vent 1.50 (i A. P. No. �— a `—� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 , v Each additional outlet .30 Feis/ '� ve. Fire Dept. Fire Zone Use Permit Building sewer 5.00 EQA Parking rcel Plans- Declaration Parcel a p 60' R/W Im r p ove ents Lawn sprinkler system 2.00 Bldg. PI4 Rec'd Parcel Approval Plans pproval Permit Fee $ � NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEEPERMIT FILING FEE $3.00 8.00 Main service 100o V OR AMP ORLESS5.00 Main service EA. AOO'L 100 AMP 2.50 - Single Family Duplex ❑ Mobil Home ❑ Others ❑ OVER 600V Main service 100 AMP OR LESS 25.00 Main service EA. ADD•L 100 AMP 1.00 NEW CONST. OR ADDNS. ( ACCLBLDGLING OC P. &) 2�syft 6 , NEW CONSTR. MULTI-OTLE BRANCH CIRCUITS) 2.50ea NON•RESID. ( U NEW CONSTR. ( SIPOWER APPARATUS & NON.RESID. NGLEOUTLET CIR. CONTRACTORS LICENSE LAW I am licensed u the provisi s of Chapter 9, Div. 3, of the State of Cal' rni ess rofessions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES) '°� BAL @ 109 EX. CCU FIXED APP LNS. OR O 2.00 P•(OUTLETS (RESID.) EA) Temporary service 10.00 Mobile Home Facilities 15.00 �o j License No._ C. Classification Classification Mi Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ 'J 60 0 $ -� WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. 12 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 Workmen's Compensation Laws of California. I certify that I have read this application and state that the above information is corrg agree to comply -to all County Ordinances and State La rel Ing to wilding construction, and hereby authorize repr sent Ives of County of Butte to enter upon the above menki'oned o erty r nspection purposes. X � --e D e •�-y ��� MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling GU �.yr!,ti 3 •dU Ventilation Hood J 2.00 �,pp Permit Fee $ 2 $ /2 TOTAL PERMIT FEE $ Q This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOI�,qF PUBLIC WORKS Signatur!cr of errnitee-drAgent By Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date//� i TNERMALITO IRRIGATION DISTRICT