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011-251 -010
05-0('19
MERRELL & ASSOC.
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W0$I-1 ST, OROVILLE
CONT: OWNER
INAL
NEW SINGLE FAMILY
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ENCROACHMENT PERMIT
County of Butte Department of Public Works
7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 5A-4356
Download Forms: www.buttecounty.net/publicworks/forms.html
NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE. Permit Number District
Phone (530) 538-7157 Ext. 2016 2
APPLICATION
I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads
and highways, all in accordance with County ordinances and.general laws. All information except signature must be typed or legibly Tinted.
a omp
1. Applicant's Name: ICany Name: � �PSG�I�/ �' %� G
2. Address: �j�(t��J cJ C �-� S (f—,A -
3. Phone:4. Assessors Parcel Number: U
2c>q-C->0'Z-ZG- `-f 6`31 -ZS l c6
5. Location of Work to be Done
tt2�aCTOR'S
! /— 6.Applicant's Signature 1. . INFORMATION
9. Address
10. Phone:
12. Contractor's License Number.
l4. Contractor's Contractor's Signature
16. Please ChecK:
18. Other Work - D
In compliance with
permission is hereb
20. Conditions e7
CGS
I1. Fax:
13. Certificate of Insurance:
14a. Date Signed:
Yes ❑ No: ❑
TYPE OF WORK TO BE DONED411rLWA
17. If Driveway List Type: 5—,3 _ z
Curb: 11 Gutter F-1 Sidewalk: El✓ ✓
ocribe: 19. Plans Attached:
O Yes
PERMIT GRANTED
he above request, and subject to all terms, conditions (including those on page 2 of this permit form) and special co'
.. -t.A _
Underground Service Alert (USA.) must be notified two working days prior to any excavation. 800-227-2600
21. ❑ All work shall conform to accompanying: Detail ❑ Plans ❑ Special Conditions ❑
22. Date Issued 23. Expiration Date:
25. Date Paid: 26. Amon Paid: _ � 27. Paid By:
7l�
Mike Crump, Director of Public Works By:
29. Final Inspection Date: 30. Inspected B ' ❑ Completed - OK
❑ Additional Comments
For County -
urt only: 31 :Comments:
Note: if permits are faxed to any number besides (530) 538-4356, they can be delayed up to one week.
Bina.
Cl No
ons written below,
24. Surety: t,-
28. Receipt No.:
Completed — Not OK
AND. WHEN RECORVIED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
2005-0029116
Recorded I REC FEE
N.
Official Records I
County of I COPIES
2.50
Butte I
CANDACE J. GRIlBBS I
County Clerk-Recorderl
I
I KL
09:ld9Rp! 2!3 -Nay -2m I Page 1 of 2
IIIII�III"IIII(III"I('I'I'III"I
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:
Date
State of California
County of 3 cam"'
PROPERTY OWNERS:
4
before me
personally appeared 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 by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WIJN.ESSSS my hand and official sp4l.
A.P. # �s \ QS\
ANGELA D. PJ ASTELOTTO
Commission #1381124 n
v Notary Public -California ' 1 Cn
Butte County
my Comm. Exp. OCT. 22, 200 v
the following described property in the unincorporated area of Oroville, County of Butte, State of California:
LOTS 1, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "OLIVE ACRES", WHICH MAP WAS
RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON ]UNE 20, 1949, IN BOOK 17 OF MAPS, AT PAGE(S) 22.
Dated: 03/02/2005
8
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.
BP050619
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: 05/23/2005 APN: 031-251-010-000
the Business and Professions Code, and my license is in full force and
effect. qtr �[
License Class: ( License Number: ( O
Site Address: 1720 12TH ST ORO
Date: Z Contractor: Ino iZ& ,� P,590--. frac-
Map Index:
Description: NSF(1656)GAR{484)COV(24)
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: ROGERS CHARLES E &LINDA K
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
1748 12 ST
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
OROVILLE, CA
she is exempt therefrom and the basis for the alleged exemption. Any
95965
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).):
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' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
Applicant: MERRELL LATHING
pp
such work himself or herself or through his or her own employees,
1309 SAN PEDRO AVE
provided that such improvements are not intended or offered for
CERES, CA
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
95307
proving that he or she did not build or improve for the purpose of
209-602-2654
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 contractor(s) licensed
Contractor: MERRELL LATHING
pursuant to the Contractors' State License Law.).
1309 SAN PEDRO AVE
I am Exempt und�rAr' of a Bu iness and Professions Code
,
CERES, CA
Owner J�Z�
95307
295307 -2654
WORKERS'COMP126SATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #: 694869
❑ I have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ 1 have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Total Square Ft: 2164 S. F.
Valuation: $119,640.00
Policy#:
O 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' compensation coverage is
unlawful, to
and shall subject an employer criminal penalties and one
thousand dollars (5100,000), in addition to the cost of/�compensation,
)hundred
Awahl�dl
damages as provided for in Section 3706 of the Labor
G C J
code, interest, and attorney's fees.
Flo ��SS<r. �•S
CONSTRUCTION LENDING AGENCY
This permit's hereby issued under e plicable provisions of the Butte County Code and/or --
R`fesolutio�
I hereby affirm that there is a construction lending agency for the
to do work indicated above or which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
Name:
g1 Date:
y
PERMIT EXPIRES ON:
Address:
Date
O 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 1'0627.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
O 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 to enter upon the above mentioned property for inspection ses.
/County
Print NamehR - l,(�.-iJ r ' `l»�� OLS Signature•
t
Date: y
0 `/
A.Owner Contractor 13 Agent for Owner 0 Agent for Contractor
�ll
.1
NOTES RESIDENTIAL
i
i
t PERMIT NO. _031-251:-010 _ - _ ____,05 OC 19 _
/MERRELL h ASSOC,
a� s� �' Jr•�c G Gz_ �C�-/ ��'Z,�' 12TH ST, OIcOViL_LE
I CONT: OWNER
fi � �--- �� O ► NEW SINGLE FAMILY
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
CE t
OFFICE COPY +
l
Address
t
GAS l
Meter By Date:v/
4' ELECTRIC
19 %
Meter By �"�� Date
• Y
F
JOB FINALED (Date) 5?—Z-06
•Signature Oc z!!��
r,
J=OK
0 = Not OK
. = Not Ready Applicable MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
2.
Soils; Special. MH Support Sketch
Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
3.
Sewer; Location -Test -Fall -C/O -Concrete
5.
4.
Water; Location -Test -Easement Needed (Sketch)
Carports; Windows -Doors
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
8.
6.
Gas; Location -Test -Wrap;-/ P' L'ft.
/ P Nat. or/ P' L "ft./ P LPG
Siding; Nailing -Veneer -Stucco -Mesh
7.
Well Clearance & Disconnect
11.
8.
Utility Clearance
Braced Wall Panels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Gas; MH Test -Demand -Valve -Connector
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
5.
Drain; MH Test -Fall -Flex Connector
6.
Water; MH Test -Regulator -Connector
7.'
Water and Sewer Connected -C/O to Grade -HD Approval
8.
Gas and Electricity Tagged
9.
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
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
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/5'-Circ.ulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures-Panel boards- 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
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
5.
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/5'-Circ.ulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures-Panel boards- 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
= OK
= NotOK
Applicable
= Not Applicable RESIDENTIAL (Single & Duplex)
= Not Ready
Dated
Date
Card B-1 W Date Card B-1
Card B-1 Date Card B-1
Date UN
RFLOOR (Plans) OK except #'s
oning-Setbacks-Easements-Flood-Slope
tg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ -/" Ftg. Depth
4.
F g., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
Date r
Stemwalls, Main; Steel-Blockouts-Wrapped
Date
Stemwalls, Garage; Steel-Blockouts-Wrapped
Date
Hold Downs and Special Anchors
7.
Slab, Steel -Wrapped
8.
P' rs-Fire lace Ftg.-Steel
W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10.
Fi Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
1 .
Water Pipe; Test -Anchors -Regulator -Service Test
12.
Electric Underground
13.
PWums & Ducts; Clearance -Material -Support -Ins.
1611
' ders-Sills-Anchor Bolts-Joists-Vents-Crippies
1 Access & Ventilation
16.
Insulation
Dated
Date
Card B-1 W Date Card B-1
Card B-1 Date Card B-1
Date
PLU ING (Permit) OK except #'s
1 er Htr.; Vent -Access -Combustion Air Baffle
1 er Pipe; Test & Anchor -Nail Protection
W.V.; Test Fittings & Anchor -Nail Protection
QG-Shower Pan; Test, First Floor -Tub Access
Date r
2t.--Te,st Tub & Shower, Second Floor -Tub Access
Date
as Pipe; Sixe & Anchors
Date
73 -Fire Sprinkler; Test
Date
Date T—
_ Card B-1 _ • Date Card B-1
Card B-1 Date Card B-1
Date
ELEC CAL (Permit) OK except #'s
2wo",FWfure & Transformer Clearance -Ins. Protection
E . Receptacles Spacing -Lights & Switches at Doors
Lj��.olre Boxes & No. of Conductors Stapled
Pemex Installed Close to Edge of Studs & C.J.
E ip. Ground made up w/Mech Fasteners -Bond Gas & Water
2 A„ppliance Circuits in Kitchen & Conductor Size GFI
98. bfeed Wire Size/ /g@. Cu or AI-A.C. Wire Size/ /ga Cu or Al
W. Range Circl/g or AI -Oven Circ. / /ga Cu or Al
Insulated N utr I O Yes 0 No
32. Service -Riser Conductors & Ground Main Disconnect
3allEguip. Clearances Panels-Motors-Mech. Equip.
37r -Clothes Closet Light -Shower Light -Spa Light
Smoke Detector
Date Card B Date Card B-1
Date Card B-1 Date Card B-1
Date
MEC NICAL (Permit) OK except #'s
./KC. Ducts Insulation & Support
37. Vet Fan, Exhaust above insulation
ondensate Drain & Overflow, Size & Grade
31T F nace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet
Attic Access ttorm if Furnace in Attic
Date r
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRA NG (Permit) OK except #'s
Silts Proper Materials & Anchors
4Y.' IIs Studs -Nailing Spacing & Braces -Plates -Sound
. wring Walls over Girders & Floor Nailing
4Y qtaStop in Walls (rat proof)
4r/F64r/F6 Stops, Furred Ceilings -Stairs -Chasers -Tubs
46 Headers & Beams -Size & Bearing
Date FRA p (Continued)
ngers-Post Caps -Anchors -Connectors
Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng.
49 --Fireplace Ties or Type A Flue -Fireplace Throat Clearance
6Q Access; Size & Romex Protection -Draft Stop -Ins. Baffles
9+1 drm. Windows or Exiting Doors -Sill Ht. & Diwignsions
1 (� GLrage Fire Protection Framing -RC Ch el
erty Line Firewall & ODeninas
$4. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
-55r vs; Width-Headroom-Rise-Run-Landin -Fire Protection
Plywood on Roof Overhanq-Attic Vents -Rafter Outriqqers
-”- Sjding-Nailing Veneer
W'Slixco Mesh -Drip Screed -Fd. Vents-Underflr. Access
Glazing Area -Glass Protecti kylights-P stic
-G&- Shear Walls; ailing -Bo
f 61. Brace I or/Ext Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date Card B-1 ate olo ICard B 1
Date . and B-1Date Card B-1
Date FINAL (Plans) OK except #'s
64. teps-Door & Sidelight Protection -Landings
ST2tUetector
QQ_<' r _ Vents -clearance -Comb, Air-Connector-
lp arage; Above Floor-Ducts-Mech. Protection
Be om Exiting
& Bath Fixtures & Tub Access -Spa
69' Elec. rim & Subpanel, Breaker Sizes & Labels
Melgt_a' & Rails
Elec. Outlets at Wood Panel, Int. & Ext.
7 Fixt. & Appliance; ound-Air-G - coking Clearance
74-'Elec. Outlets & R tacles alit. Counte,
75.-6-j-Hige Fire Doe , Swing- nding-CI re
7 .C. Duct in Garage -Damper
tr. Htr; Vents -Clearance -Comb. Air Connector -P. . .
in G ge; Above Floor-Mech. Protection
74,-1015.; Elec. & Mech. Equip. Listed for Location
79. c. Receptacles in Garage (F.F.I.)-Romex Protection
8 sulation-Foam-Looked ig_80ie-�
84�C a Rails & Deck Constr 'on -Post Caps
8 dn. VBents & Cra a Door Drainage*OVood-Earth
Clearance Looked under Floor Ceres
83-41lowinq Instld./DdYOU Yes O No/Walks O Yes Cl No/Planters O Yes O No
861A.0 Unit Disconnect, Electrical -Plumbing
8 - ents bove Roof, Plbg-Appliance-Fireplace-Clearance to Openings
8 . a ell, Disconnect, Electrical, Plumbing
8 . xt r Elec. Trim, G.F.I. Receptacle -Underground
8 . Venjilation Throughout House
90. -Glass Protection
9 orrections from Previous Inspections
92. Gas Test- eters Tagged, Gas-Electri
9 a- Sewer Connected -C/ o Grade -HD Approval
9 r�gr§y Compliance Certificate -Other Certificates
Address Posted
56-F48 tT=_Z
Date % ! Or -Card 13-1 Date Card B-1
Date Card B- Date Card B-1
Dat -Q Card B- < V8 Date Card B-1,,
Comments at Final:
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.
BPO50619
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 penally of perjury that I am licensed under
=
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 05/23/2005 APN: 031-251-010-000
the Business and Professions Code, and my license is in full force and
effect. 1�
License Class: License Number. 6a'1,90
Site Address: 1720 12TH ST ORO
Date: • Z {%_5' Contractor: j%9f;`72%ZL��`jSUC •
Map Index:
Description: NSF(1656)GAR(484)COV(24)
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
Owner: ROGERS CHARLES E &LINDA K
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
1748 12 ST
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
OROVILLE, CA
she is exempt therefrom and the basis for the alleged exemption. Any
95965
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).):
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
Applicant: MERRELL LATHING
pP
such work himself or herself or through his or her own employees,
1309 SAN PEDRO AVE
provided that such improvements are not, intended or offered for
CERES, CA
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
95307
proving that he or she did not build or Improve for the purpose of
209-602-2654
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 property who builds or Improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor: MERRELL LATHING
pursuant to the Contractors' State License Law.).
1309 SAN PEDRO AVE
I am Exempt u,dprAr(i of ae B iness and Professions Code
CERES, CA
Dat �2 -p,/Owner\ JdBtJ
95307
2009-609-60 2-2654
WORKERS'COMPe6SATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
License #: 694869
❑ 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.
❑ 1 have and will maintain workers' compensation insurance, as
Architect:
required by Section 3700 the Labor Code, for the performance of
Engineer:
the work for which this.permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier:
Total Square Ft: 2164 S. F.
Policy #:
Valuation: $119,640.00
❑ 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' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), In addition to the cost of
// )
�=e /�30&,,114mt/bi�4/ I) �� 43
compensation, damages as provided for in Section 3706 of the Labor
`t
code, interest, and attorney's fees.
n
.. _ CONSTRUCTION LENDING AGENCY-
pe mi(s hereby issued under t e plicable provisions of the Butte County Code and/or
4 _ .
1 hereby affirm that there is a construction lending. agency for the
ZThixs
esoluuufl to d0 woik indicated ove or wiiich`fees'nave been—fiato ° �•. wsr - �x �' -
performance of the work for which this permit is Issued (Sec 3097 Civ.)
I ///� ; {•, •� / )�^
/
Name:
B ; •'!6 Date
PERMIT EXPIRES ON: "
Address:
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 11)627.5 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 stale 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 mentioned property for inspection ses.
� l � � � �—
Print Name:r Signature _---------'
Date:
a
0wner Contractor 0 Agent for Owner 0 Agent for Contractor
R_x O•ate/Time 5EP-01-2005(THU) 14:10 P. 001
SEP -01-2005 TNU 02:25 PM WESTERN INSULATION FAX N0. 9164194027 P. 01
INSULATION CERTIFICATE
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE
WITH THE CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATION CODE,
TITLE 24, STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT:
SITE ADDRESS 1720 12TH ST OROVILLE CA
NUMBER CITY STATE
CEILINGS:
BLOW: MANUFACTURER GREEN FIBER THICKNESS N/A R/VALUE N/A
BATTS: MANUFACTURER KNAUF
EXTERIOR WALLS:
MANUFACTURER
KNAUF
THICKNESS 13"
KNAUF THICKNESS 3.5" RNALUE
KNAUF
38
13
FLOOR INSULATION:
MANUFACTURER KNAUF THICKNESS 6.5" RNALUE 19
KNAUF
AIR INFILTRATION: (TITLE 24) .
YES XXX NO
OTHER:
GENERAL CONTRACTOR: MERRELL & ASSOCIATES LICENSE #
BY: TITLE' DATE
INSULATION CONTRACT WESTERN INSULATION LP LICENSE 0 '794484
BY: TITLE RUTH. AGENT DATE 7/8/2005
I
r
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 01
OFFICE #: (530) 538-7541 9
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY** `p
OWNER
LastN,67 � e- ac, � e�5�,Iv`
irst Name
Address 5"4`_`'C—
City S
StateC
Zip9530
PhonZ o?)G0Z—Z65y
Fax
E-mail
APPLICANT NAME
CONTRACTOR
Name
City
Address
�.�0 % Sr�'���D2o �✓�
City
Fax
State C
Zip g�
Phone
Fax
E-mail
E-mail
Lic.#^moo
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Property Address
C7 2744
Flood Zone
Cross Street
SRA
Yes
N
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
PERMIT
OS "(j&/ q
BP
BIN #
LOCATION
AP# 031 'o-1,O/O
Property Address
C7 2744
City
0rov'4
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
UVtK t=UK SUBMITTAL REQUIREMENTS II
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2
Descr' tion or Scope of Work:
liJ� v ,YI �vtr' eS ece-
Sq, Footag El Structure Structure Built vAthout 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.
rB J
Received by: Amount: / 5%. �SBldg
/ SRA
Receipt #: ` / Sheriff
SMIP
Date: Other
�y (/ C� 1�LJs (D_ `�� Total
REV 7-27-04
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTIONC OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE {I: (530) 538-7541
A FEE WILL BE REO UIRED AT TIME OF APPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER
Last Name
First Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT NAME
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
Lic. #
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip'
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Received by: Amount:
Flood Zone
SRA
Yes
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldaAoolSubRamts.doc
PERMIT
NO.
BIN #
LENDING AGENCY
Name
Address
Description or Scope of Work:
Sq: Footage -
❑ 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.
Paoe 1 of 2
RFV 7_27_nd
Received by: Amount:
Bldg
SRA
Receipt #:
Sheriff
SMIP
Other
ther
Total
Paoe 1 of 2
RFV 7_27_nd
Butte County Department of Development Services
YVONNE CHRISTOPHER, DIRECTOR
WILLDAN
Scott Rutherford
(530) 538-7160
ogUTrFo
o I � o
0 0
cOU N'�y
srutherfordo)buttecounty.net
Plans Transmittal For Review Per Contract
3/9/2005
Applicant: IMerrell & Associates Permit No: 05-0619
Project Type: NSF/Gar/Cov APN: 031-251-010
100% 70%
Plan Check Fees $ 1,056.96 $ 739.87
$ 1,056.96 $ 739.87
WILLDAN Fee $ 739.87
Copies Attached: Qty
Chk
Application
Site Plan Review
FEMA Elevation Certificate
Building Plans
Truss Calculations
Energy Calculations
Structural Calculations
Residential Plan Review Guide
Residential Construction Requirements
Other
Other
7 County Center Drive
Oroville, CA 95965
�—
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
O
TO:
'
FROM:
LO
00
1
SUBJECT:
®
M
DATE:
WILLDAN
Scott Rutherford
(530) 538-7160
ogUTrFo
o I � o
0 0
cOU N'�y
srutherfordo)buttecounty.net
Plans Transmittal For Review Per Contract
3/9/2005
Applicant: IMerrell & Associates Permit No: 05-0619
Project Type: NSF/Gar/Cov APN: 031-251-010
100% 70%
Plan Check Fees $ 1,056.96 $ 739.87
$ 1,056.96 $ 739.87
WILLDAN Fee $ 739.87
Copies Attached: Qty
Chk
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 DIV S ON
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: Mocelj o�ASSESSOR PARCEL NUMBER
Proposed Building Use: k of Counter Technician: Date: (JS
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
112 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
5202. Complete plans, 3 or 4 sets, signec 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.
9 4. Engineered truss details and layout in duplicate. No faxes!
❑ 5. Letter from Engineer or Architect for truss design review.
k 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) 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, iB) 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 ouildings
❑ 13. Detached Accessory Building Form filled out by the owner
❑ 1L Hazardous Material Form .�/
1 1 5. Sanitation and site plan approval irom the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ' -77
6. 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 play apr from the Ag Commissioner Sent by
❑ 19. Soils Report and/or Engineered FDundation required ........................................... ........
❑ 20. Erosion Control Plan Required....................................................................... ........
21 Fees as shown on the attached S:hedule of Fees Due Sheet ..............................
❑ 22. City of Chico Plumbing permit.......................................................................
23. California Department of Forestry plan approval ❑paid. Sent by: ...........
-Planning approval (A) Use: QC(B)Parking: (C) Parcel Check: a�
❑ 25. Contact Land Development about _ Improvements, _ Drainage ................ I ......
..
f' NPDES Form.............................................................................................
' Encroachment Permit for driveway from the Public Works Dept ...........................
❑ Pre -Inspection for required.......
❑ 29. Contractor's license information. dumber, Name Style, Classification) ...................
❑ 30. Worker's Compensation Carrier and Policy Number ..........................................
❑ 31. Owner -Builder Verification (_ Gi-en to owner, _Mailed to owner) .....................
❑ 32. Letter of Signature authorization._...................................:.............................
V,33. Recorded copy of Agricultural Acknowledgment Statement.
❑ 4. Manufactured home utility clearance...............................................................
❑ 35. Existing violations and/or expired permits.. .......................................................
❑ 36. Deed Restriction........................................................................................
❑ ❑ Grant Deed, ❑ MA Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
Other:
Other: 011 M p 4M 9 0 N
Wen iss ed Telephone : � and ho for pickup. l )
�. /%/ r911 x-11
I have been informed of the above items and requirements for obtaining a building permit.
Applicant: � 8 'O
1. Inde >permit application for the above items numbered: Ian Check Lett r
2. Additi na to sWrequired
ontractor, esign ow was advised of the above data by .hone, ❑ mail, ❑ counter, by ate:
C esigne , er, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Structural reviewed y: Date: Structural approved by. Date:
Note transfer b Date:
Yellow: Building Division
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541
SC EDULE OF FEES DUE
OWNER. I SGS -S A.P. #
PROPOSED BUILDING USE DATE �U
RECEIPT # DATE REC.
1. BUILDING PERMIT FEES ` 7
--Balance Due ..........................................:............. $
--Additional Fees Due ............................................ $ _
(P --Additional Fees Due ............................................ $
--Revised Plan Ch king Fee ................................. $ N
1G
hem-
2. SCHOOL DISTRICT FEES
(paid at District Office)
3. SHERIFF FEES (paid at Building Division)
Residential .................................... -
Units
Commercial (sq. ft.) .................... x $0.03 = $
to ✓lf97rrlmc�+-cS�ft. 1-/096 � o _ 5
�4.-I�R�BAN AREA FEES � ��G�
Residential ............................ / x = $
# Units Amt.
Commercial (Sq. ft.) ............. x = $
Sq. ft�2�
5. RECREATION DISTRICT FEES
6. THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at Building Division)
SRA FIRE INSPECTION AND PLAN CHECK
$89.00 (paid at Building Division)
8. WATER TENDER FEES (Battalion # )
$200.00 (paid at Building Division)
9. CSA 87 TRAFFIC FEE
$2500.00 (paid at Building Division)
P 10. OTHER 1 �b�
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees
may be changpddU-r-in-g the plan checking process.
APPLICANT
DATE 4--1
Pursuant to Government Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 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 Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 6/00)
LIC W;k4p
.Department ®f Public Works
J. Michael Crump,
LAND DEVELOPMENT DIVISION
Storm Water Management Program
7 County Center Drive
Oroville, CA 95965
(5.30) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase ll
Construction Storm Water Permit and Storm Water Pollution Prevention
Plan (SWPPP) Acknowledgement jLESS THAN 1 ACRE
Project Description: /1%6� s/� � A'" ,z -z Ka/P
Project Location and/or Parcel Number: (-- f— 2 5 -
By
By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB
1 acre -or more.of land and that I, therefore, do not need to apply for a Construction Storm Water Permit
from the State of California Regional Water Quality Control Board. Phased projects that contain
multiple site build -outs of less than one acre but when combined with subsequent phases total more
than one acre of disturbed soil will require a Construction Storm Water Permit from the State of
California Regional Water Quality Control Board.
I am aware that, submitting false and/or inaccurate information or failure to apply for a Construction
Storm Water Permit from the State of California Regional Water Quality Control Board for a project
that disturbs one acre or more of land may result in revocation of grading and/or other permits or other
sanctions provided by law.
Signed:
Title: /—
Date:
Less than 1 Acre NPDES & SWPPP Compliance Certification
Butte County Storm Water Management Program
Revised 5/24/04
ENCROACHMENT PERMIT
County of Butte Department of Public Works
7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 538-4356
Download Forms: www.buttecounty.net/publicworks/forms.html
NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE
Permit Number
District
Phone (530) 538-7157 Ext. 2016
2
APPLICATION
I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads
and highways, all in accordance with County ordinances and general laws. (All information except signature must be typed or legibly rinted.
1. Applicant's Name: �� y'SG�lA—ice 1-Z G
7
la Company Name:
2. Address:
CeA1r S Cry
3. Phone:
4. Assessor's Parcel Number. (571 C
5. Location of Work to be Done S-- pL t'
!
6. Applicant's Signature
7. Date:
CONTRACTOR'S INFORMATION
8. Contractor's Name�C'��
9. Address
10. Phone:
Co`1 �S�i GtG�
I L Fax:
12. Contractor's License Number.
13. Certificate of Insurance: Yes ❑ NO: ❑
14. Contractor's Signature.
14a. Date Signed:
15. Authorized Agent
TYPE OF WORK TO DE DONE941�-Cwt> . ,
16. Please C Sidewalk:
eck Curb: Gutter.
❑ ❑ ❑
17. If Driveway List Type:.
18. Other Work - Describe:
19. Plans Attached:
❑ Yes ❑ No
PERMIT GRANTED
In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) and special conditions written below,
permission is hereby granted.
20. Conditions
e WA l•eu�2
Underground Service Alert (U.SA) must be notified two working days prior to any excavation. 800-227-2600
21. ❑ All work shall conform to accompanying: Detail ❑ Plans ❑ Special Conditions ❑
22. Date Issued
23. Fapiration Date:
24. Surety:
25. Date Paid: U 2 o Paid: _ /`� �Q �` Ped >f i .4 y` 28. Receipt No.: / 1 G_
C
Mike Crump,' Director of Public Works By:
29. Final. Inspection Date: 30. Inspected By: ❑ Completed - OK 7QY Completed — Not OK
❑ Additional Comments Attached
For County
use only: 31. Comments:
Note: if permits are faxed to any number besides (»ut 5sa-4356, racy wn V..—y— .l
Page I of 2
BUTTE COUNTY, SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District Building Department No. ()(.0
A.P. Number J'u'risdiction: city r]County
Property Owner
Property Location/A
Subdivision
Lot No.
Residential Development
..................................... ......................
Sq. Footage
No oTfving
Mobile Home
Addition/ *Supplemental to (Group R)
Un
Installation
Conversion Permit #
*(No foundation Inspection)
........................................................................ ! .................... ... ...
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document)
Commercial/industrial Q
Q
Sq. Footage
New
Addrdon
(Including Exterior
Roofed Area,)
T1 � 4 C)
Building Department Representative'
Date I
I
District Identification No. 05(J2 V J
r,
'chool District certifies that rr S 0C
��(Applicanpo.
R-,
I - Street Address) (Phone Number)
o r ou
(City)
has complied with the requirements of Resolution No.
representing square feet.
Ily - I
Paid by Check # ' Remarks:
(State) (Zip Code)
0S -4D by payment of $
1" 2926 $
PFULL MMGATION $
6- S -
Date
Nbftir: 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 On date fees; are Pahl. Failure to submit a timely written protest will'prohlbIt
you from challonglng the Imposition of the fan In any court action.
K, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District Is
MR bythe 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 fen to fully mitigate.ft Impact on the school districtle schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xis (10/03)dm.m
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)
0 DURHAM RECREATION AND PARK DISTRICT (DRPD)
Assessor Parcel Number (s)y'5� ' )'s I - (2� ) 0 Building Permit Number (�-) G ' 0�4 19
Property Owner (s)
Project Location /Address
Subdivision Name
xy e11 /) s
I)U--"
Assessable Sq. Ftge Ko
/ Type of Residential Development (check one)
r/ New Development Single Family -Detached \ Single Family -Attached
Alteration/Addition(s)
Mobile home
Demo Permit (date issued
Comments:
�J'5
Non -Residential to Residential
Mobile home replacement
Multi -Family. Dwelling
verified by Assessor Department
Building Department Rek*entative Date \
verified by Building Department
0 FRRPD 0 CARD ❑ PRPD ❑ DRPD certifies that:
G ii 0 Litt C,
Applicant 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 @ $
Square Feet @ $
Remarks:
Paid by Check No: `�( Paid by Cash:
per unit fora total of $ 1066.0-0
per sq foot for a total of $
Receipt No: Kay 9 7
Recreation and Park District Representative Date
vdcnLMQ%AI itr nrklr, FnRMC\narlr_rPr. ztanrlard firm rev IAA
A
SITE PLAN REVIEW APPLICATION
Date: /���� AP# 63 / —257— 0/0
Permit Number (if applicable) Q 5 6(P/
APPLICANT INFORMATION Parcel Size: `:20 (2 C4—eS
Owners Name: M�-�-& �SSOe . iL/�C .
d�Owners Address: 70 �lvi't lZd. . 6,VS ' - IFS - 5O 7
Telephone No.:.'
Situs Address:
Proposed Use:
;meq )Go.�2-
11 -'_14 � t
WE M
Residential
W 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
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
❑ Commercial Remodel
❑ Industrial Remodel
❑ Septic ❑ Well
❑ Agricultural Exempt Building
❑ Other:
-r
ti
Brief Explanation (if necessary): _7/l
06,n as, oo) � lye/j/V s
5 0&1a -
DO NOT WRITE BELOW PIIS LINE
�01/e R$ o�1Gr
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
N Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
In Site Plan Stamped Approved
By Date 4�
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:
Flood Panel No.: 06 �M C 0 1W Index Date:$/ ��
El Sacramento River Reclamation District (Approval must be obtained from the Cali ornia Reclamation Board)
❑ Feather River Reclamation District (Approval must 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:'
Applicable Building Setbacks:
Front
Zoning Code
,
Streets & Highways
Fire Prevention
Subdivision Map
Side
5 -
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
c 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 •
Date of Creation: ;j,?dC17 t/ ! %Z Legal Access Provided: ❑ No Yes
Deed of Reference: l 3 g 3 — Z(D3 Legal Access Required ❑ No ® Yes
Parcel Frontage on Publicly Maintained Road: ❑ NoYes, Road Name:
Complies with County Standards for Deed Creation:❑ No a Yes
Comments:
LN Parcel Deemed to be legal
Verify Legal Parcel 71 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: 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 roa
u
Page 4of5
r,
x
x
Summary of Specific Requirements:
This information provided in this summary is based on the application information and on the best available data at the time
of review.
C:\L,arrys\Building Permit Site Plan Reviewl.doc
Page 5 of 5
i
RECORDING REQUESTED BY
First American Title Company
AND WHEN RECORDED MAIL TO:
Merrell and Associates, Inc.
1309 San Pablo Ave
Ceres, Ca. 95307
A.P.N.: 031-251-010-000 (ptn)
CE TO BE A TRUE AND EXACT COPY
OF TN IA ORIENT RECORDED
IN COUNTY OFFICIAL
RECO R R�CO�pERS INSTR01 NO•
Space Above This Line for Recorder's Use Only
GRANT DEED
File No.: 0301-1773023 (RK)
The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $55.00; CITY TRANSFER TAX $0.00;
SURVEY MONUMENT FEE $10.00
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 Oroville, and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Charles E. Rogers and Linda K.
Rogers, husband and wife r
hereby GRANTS to Merrell and Associates, Inc. a California Corporation
the following described property in the unincorporated area of Oroville, County of Butte, State of California:
LOTS 1, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "OLIVE ACRES", WHICH MAP WAS
RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON ]UNE 20, 1949, IN BOOK 17 OF MAPS, AT PAGE(S) 22.
Dated: 03/02/2005
Charles E. Rogers fLinda Rogers <..`
Mail Tax Statements To: SAME AS ABOVE
VY
A.P.N.: 031-251-010-000
STATE OF CA
COUNTY OF BUTTE
Grant Deed - continued
File No.:0301-1773023
(RK)
Date: 03/02/2005
On J�, 1 before
me, _ Notary Public, personally appeared
Charles 0 Rogers and Linda K. Rogers , 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 signature(s) on the instrument the person(s) or the entity upon behalf of which the person(s) acted,
executed the instrument.
WITNESS my hand and official sealJAN FAIRLESS
. COMM. 0 1445934 This area for o>fciai
NOTARY PUBUC-CAUFORNIA w notarial seal
COUNTY OF BUTTE
Comm. Expires Nov.15, 2007
Signature
My Commission Expires: `�'� �'l `�. / 5, v2' 7
Notary Name: 41-1� 16�U�A�
Notary Registratio Number1gg5'q3y
Notary Phone: 53o 533-33�,
County of Principal Place of Business: L—
Page 2 of 2
r'
C
THERMALIT® IRRIGATION DISTRICT
A Public Agency
DIRECTORS'
Brad Taggart
Division 1
Gary Allen
Division 2
Edgar C. Thompson
Division 3
Stanley J. Huston
Division 4
Ernest L. Reynolds
Division 5
May 18, 2005
Brian Merrell
1309 San Pedro Avenue
Ceres, CA 95307
RE: AP 031-251010
Mr. Merrell,
410 Grand Avenue
Oroville, California 95965
(530) 533-0740
FAX (530) 533-9243
Gary Alt
Manager/Secretary
John Jeffrey Carter
Legal Counsel
Thermalito Irrigation District is willing to provide water and sewer service for AP
031-251-010 located at the end of Vista Estates Drive in the Thermalito community,
California, on satisfaction of the following conditions:
1. The District shall approve in advance in writing the plans and
specifications for the water and sewer installation to the new dwelling unit. All plans will
be submitted in accordance with TID Improvement Standards for Water and Sewer
Facilities.
2. The dwelling unit has it's own sewer lateral from the TID sewer main to
the house. An independent meter will be required for the dwelling unit.
3. 'The water and sewer installation shall be completed in a good and
workmanlike manner and shall be subject to inspections and acceptance in writing by
District's Manager or Engineer.
Established 1922
•
This letter shall expire one year from and after the date hereof. Connection fees,
which for a dwelling unit presently are $4,655.00 for a three-quarter inch water
connection, and $3,157.00 for a sewer connection, shall be assessed at the then rate of the
District at the time such connection are requested.
Sincerely,
'L
`r AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
2005-0029116
Recorded I REC FEE 1®,N
Official Records I
County of I COPIES 2,53
Butte I
CPATACE J. GRIBBS I
County Clerk-Recorderl
I
1 KI.
09.OM 23 -Play -2W I Page i of 2
Iill III III I ILII I III III I Till II 11111
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:
Date Z3
State of California
County of 3 01(-I
PROPERTY OWNERS:
R. before me
personally appeared 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 by his/her/their signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.,
WITTNES�S my hand and official sggl.
1
A.P. # C��
v;
u� i,oi mission #1`t31 124
C Notal' P'Miic cahform A cn
teew.e:,:�i•:. ,
JeJ -
�T
the following described property in the unincorporated area of Oroville, County of Butte, State of California:
LOTS 1, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "OLIVE ACRES", WHICH MAP WAS
RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF
CALIFORNIA, ON JUNE 20, 1949, IN BOOK 17. OF MAPS, AT PAGE(S) 22.
Dated: 03/02/2005
w
W � LL.DAN Ma s Street
A Marysville, California 95901
Serving Public Agencies 530/749.2373 fax 530/749.2199
www.willdan.com
Aprils 13, 2005
Scott Rutherford
Butte County Building Department
7 County Center Drive
Oroville, CA 95965
Tel: (530) 538-7169
Fax; (530) 538-2140
Subject:
Plan Review Report
Status:
Approved
Willdan Project No:
14353-1478
Jurisdiction Job No:
05-0619
Assessor's Parcel No:
031-251-010
Description:
Merrell & Associates-NSF/Gar/Cov
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 1-6 dated 1/28/05
# Title 24 Report: Two (2) copies dated 1/31/05 by Paul K. Linville
# Truss Calculations: Two (2) copies 2/8/05 by Villa Truss
The plans have been stamped with the Willdan approval stamp and dated the date of this letter
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.
Thank you.
W I LLDAN
Serving Public Agencies
APPLICABLE CODES
Unless noted otherwise, all comments are 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 and abbreviated herein as "CBC".
• Part 3, known as the California Electrical Code and abbreviated herein as "CEC".
• Part 4, known as the California Mechanical Code and abbreviated herein as "CMC".
• Part 5, known as the California Plumbing Code and abbreviated herein as "CPC".
• Part 6, known as the California Energy Code, and Energy Commission Standards, and abbreviated herein
as "CECS".
CODE ANALYSIS
Our plan review revealed the following information regarding the occupancy designation, type of construction, and
other pertinent features. This information is consistent with that shown on the plans and permit application.
Specific Use
of
Oc uppancy ac
Constre uction of
Sprinklers
Stories Total Sq Ft
Dwelling
R-3
V -N
No
1 1656
Gara e
U-1
V -N
No
1 484
Covered Porch
R-3
V -N
No
1 24
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 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. The Title -24 -CF -1R -form shall be signed by a representative of Merrell and Associates. CES 10-
103(a)1 and California Residential Manual 1.4.8
SPECIAL INSPECTION NEEDS
Our plan review reveals no special inspection needs pursuant to CBC 1701.
DEFERRED SUBMITTALS
Our plan review reveals no deferred submittals.
Sincerely,
,VZ
Richard Essenwanger
Plans Examiner H
Cc: Alice Mefford, amefford@buttecounty.net
Merrell & Associates, 1309 San Pedro Avenue, Ceres, CA 95307, Fax (209) 531-1066
.Paye 2 of Butte County 05-0619
Vi%i:lldan 14353-1.478..PC.1..1