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038-180-033
NOTES PERMIT NO. _ 038-180-033 � ! SCOTT, SHANE D2 04-0356 WHITE DURHAM ! CONT: OWNER NEW SINGLE FAMILY I r , PERMIT^ YWAL DATE: JI I v =,,'^^ f BP#���CJ 40 �I EXPIRES: C/ SPECIAL CONDITIONS J � SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY CHECKED BY USE PERMIT CONDITIONS. f SUB -STANDARD HOUSING LETTER OFFICE COPY 1 1 Address GAS o� By ELECTRIC Date y Meter By r JOB FINALED (Date)c[ Signature () PAWKX COUNTY OF BUTTE ' ' ' 'BUILDING DIVISION ' DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 53877541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this office immediately. COUNTY OF BUTTE P BUILDING DIVISION e DEPARTMENT OF DEVELOPMENT SERVICES' 7 County Center Drive. Oroville; CA . (530) 53&7541 • h CORRECTION NOTICE �d OWNER PERMIT NO. A routine in spection indi t/ t file following violations of Butte County Ordinances exist at the above address a should be corrected. Please call for re -inspection when correction of work is complet If you have any questions pertaining to this matter, or need additional explanation, cal contact the Building Inspector as indicated below. x' �� G� /� ✓l� D Ic 7 /tel J T` aka 01 f-7 21-3 T G t//gkZ /1,Iii A/ GIt "UI/ 4)rad�� / �/ l ° Vl j y.►� ?3 �U �3 L P �� 457 t- � a l i sib— T -A -Ar/ W {. Date �% / G Inspector ..4 REV 2/ Phone # %-3 3 i'/1 ` r COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street;,* Chico, CA • (530) 891-2751 7 County Center. Dave •,Oroville, CA • (5.30) 538-7541 , CORRECTION NOTICE ' 02 7/ /1)1� 03 41 OWNER PERMIT NO. A routine inspection indicates that. the following �violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, -< please contact this office immediately. Date �` 7 — y T `-Inspector REV 10/92 A . . i let } COUNTY OF BUTTE BUILDING DIVISION � I DEPARTMENT OF DEVELOPMENT SERVICES ` 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates hat the following violations of Butte County Ordinances exist at the above address and uld be corrected. Please call for re -inspection when correction of work is complet . f you have any questions pertaining to this matter, or need additional exxplanatio ea1se contact the Building Inspector as indicated below. Date Inspector REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 ,�/.Gl-lam August 3, 2004 S� Z)Av I f COUNTY Butte County Building Dept. 7 County Center Dr. Oroville, CA 95965 Re: Permit No. 04-0356, Shane Scott, Jr. Ladies and Gentlemen: L/ 11 TOM, AUG - 5 2004 DEVELOPMENT SERVICES In response to an inspection correction item resulting from a foundation inspection for the above referenced house located on White Drive in Durham, I was asked to inspect a footing in question and make a determination as to its adequacy. The footing in question is the 30 inch wide grade beam footing at the rear of the house on the right side. And, based on a conversation With Lee Mayer, who is constructing the forms, and from reading the inspectors correction notice, it is my understanding that the question is; can the 30" wide horizontal footing be slightly offset from the stem wall? The answer to this is yes, this is acceptable. Based on my inspection, and a review of the structural calculations, the 30" wide grade beam footing at the rear of the house on the right side, as formed, is adequate for the calculated loads. If you have any questions or would like to discuss this further please feel free to call me at 894-3500. Sincerely, G� Eric L. Robertson, P.E. Principal/Civil Engineer Y 1q4pFESSIa�q � C3 W Z NO. 37105 7k Exp. 6-30-M s}, C VVtI �Q. ,`�0F CALIE�C~ Chico Red Bluff Redding I 888 Manzanita Court, Suite A Chico, CA 95926 530-894-3500 894-8955 fax V FEDERAL ERERGENCY MANAGEMENT AGENCY O.A*B: No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM -r ;,,•- -_ r;� Expires December 31, 200: �ELEVATiON CERTIFICATE. I mportant Read the instructions on pages 1.7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number SHANE SCOTT I i BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number P.O. BOX 1102 CITY STATE ZIP CODE DURHAM CA 95938 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) APN: 038-180-033 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) New Residential Structure LATrrUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( ##'- ##' - ##.## or ##.#####) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME B3. STATE BUTTE COUNTY, & INCORP. AREAS 060017 BUTTE COUNTY CA B4. MAP AND PANEL B1 0. B5. SUFFIX B6. FIRM INDEX DATE 137. FIRM PANEL B8. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) NUMBER EFFECTIVEREVISED DATE (Zone AO, use depth of flooding) 0600700735 C SEPT. 29,1989 JUNE 8, 1998 AE .135.3_ —4.135.3- B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ AS Profile ❑ FIRM ❑ Community Determined ❑ Other (Desaibe): SEE C3 BELOW. B11. Indicate the elevation datum used for the BFE in B9: Z NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): 1312. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?❑ Yes ® No Designation Date PWA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ® Construction Drawings' ❑ Building Under ConstrucW ❑ Finished Construction C2. Building Diagram Number 8 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch of photogralrh.) C3. Elevations — Zones All -A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, ARIAE, ARIA1-A30, ARIAH, ARIAO Complete Items C3. -a -i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements'arrd datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 29 Conversion/Comments BUTTE COUNTY BENCH MARK #88 WHICH IS NGVD 29 DATA Elevation reference mark used Does the elevation reference mark used appear on the FIRM?Ajd Yes ❑ No Q�OF . 10�w o a) Top of bottom floor (including basement or enclosure) 136. 3 it(m) M•G. AGF • c�,y o b) Top of next higher floor 136.3 ft(m) �' ��••i�� F �'•G' o C) Bottom of lowest horizontal structural member (V zones only) NIA. _it(m) H ca 90 00 /�•� o d) Attached garage (top of slab) Y m 132. 9 it(m) 1 o e) Lowest elevation of machinery ardor equipment W`° servicing the building (Describe in a Comments area) WA. fL(m) *•. 4o.27647 o f) Lowest adjacent (finished) grade (LAG) 132.3 R(m) z' m/�>>�6•�Q o g) Highest adjacent (finished) grade (HAG) 132 3 ft(m) s'l4 0 . • CN��; . • Q� o h) No. of permanent openings (flood vents) within 1 it above a4acent grade 8 OF CAS -SFO o ) Total area of all permanent openings (flood vents) in C3.h 2500 sq. in. (sq. am) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code Section 1001. CERTIFIER'S NAME LICENSE NUMBER ROBERT G. AGEE. JR RCE 27647 TITLE COMPANY NAME Civil Engineer SIERRA WEST SURVEYING. ADDRESS CITY STATE ZIP CODE 5437 BLACK OLIVE DRIVE 1 PARADISE CA 96969 SIGNATURE DATE TELEPHONE 2118103 (530)877-0253 IMPORTANT: In these spaces, copy the corresponding infomifion from Section A For Insurance Company Use: BUILDING PTREET ADDRESS (Including Apt., Unit, Suile, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. DO: BOX 1 102 Policy Number CITY STATE ZIP CODE DURHAM CA 95938 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS BENCH MARK on site, the nail in 12" Oak, S.E. comer of the property. Elevation =133.25' ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number_(Select the building diagram most similarto the building forwhich this certificate is being completed –seepages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the builf'mg is_ fL(m) _in.(crn) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6$ with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ ft(m) _in.(cm) above the highest adjacent grade. Complete items C3.h and C3.t on front of forth. E4. The top of the pladiomh of machinery and/or equipment servicing the building is fL(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. For Zone AO only: If aro flood depth number is available, is the top of the bottom f m elevated in accordance with the khommunity's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properly owner orowner's authorized representative who completes Sections A, B, C (New C3.h and C3.i only), and E forZone A (with uta FEMA4ssued orcommunity- issued BFE) or Zone AO must sign here. The statements in Sections A, 8, C, and E are coned to time best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordnance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized bystahe or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA4ssued or communityissued BFE) or Zone A0. G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes. DATE TE CERTIFICA G7. This permit has been issued far.❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: — Jt(m) Datum: Gg. BFE or (n Zone AO) depth of flooding at the building site is: _ . _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE TUBE DATE COMMENTS A` APPLIED TESTING CONSULTANTS 4., MATERIALS ENGINEERING TESTING AND INSPECTION ASTM 15.57 Moisture/Density Curve Sample No: T-1 Client: Shane Scott Date: 4 -Aug -04 Address: P.O. Box 1102 Tech: B. Carter City, State zip: Durham, CA 95938 Attn: Shane Scott Project: Scott Residence Soil Description: Brown Clayey Sandy Silt Sample location: Jobslte Sample depth: N/A Trial No: Water Added Gross compacted wt: Container Tare: Net compacted wt: Wet density, pcf: Dry density, pcf; Pan No: Gross wet wt: Gross dry wt: Pan tare: Net dry wt: Moisture loss: % Moisture Content: 116.0 CL a 115.0 d v N. - 114.04- 9.0% 14.04 - 9.0% 1 2 3 4 200 300 400 7215 7345 7363 2863 2863 2863 4352 4482 4500 127.9 131.8 132.3 114.7 115.8 114.4 1 2 3 4 783.9 1006.7 868.0 711.3 894.7 762.1 81.4 81.7 86.7 629.9 813.0 675.4 72.6112.0 105.9 11.5% 13.8% 15.7% Sample Weight: 15,000 grams Rock Correction' ASTM D4718 Total sample wt: +314 rock wt: % of +314 rock: Specific Gravity of +314: Rock adj. density: Y =-2997.5x2806.85x + 61.55 + R21 = 10.0% 11.0% 12.0% 13.0% 14.0% 15.0% 16.0% 17.0% 18.0% Moisture Content (% of dry weight) Max density from curve: 115.8 Max adjusted density: 115.8 pcf This test was performed per ASTM 1557 Optimum moisture: N J3*4% Reviewed by: 3060 Thorntree Drive, Suite 10 9 Chico, CA 95973 • Telephone: (530) 891-6625 • Facsimile: (530) 891-4243 APPLIED TESTING CONSULTANTS MATERIALS ENGINEERING TESTING AND INSPECTION Nuclear Density Testing Report Per ASTM 1557 Client: Shane Scott Address: P.O. Box 1102 City, State: Durham, CA 95938 Attn: Shane Scott Project: Scott Residence Son Description: Brown Clayey Sandy Silt Report Seq. No. Page: 1 of 1 Dqte: 8/3/2004 Tech: K. Coy Gauge # CALIBRATION DATA: Density Std.: Moisture Std.: I Density Xi : Moisture Xi Compaction Equipment: Req'd % Compaction Curve No.: T-1 Max Dry Density: 115.8 Opt. Moist. Content: 13.4 90% Test # Test Depth Location: Building Pad Elev. Wet Density H2O Density Dry Density Moisture Content % Comp. Results 1 8" House Building Pad, Middle FPG 115.3 11.81 103.5 11.4 90% PASS 218" House Building Pad, Northeast Corner FPG 116.6 11.8 104.8 11.3 91% PASS 3 8" House Building Pad, Southeast Corner FPG 115.8 12.1 103.7 11.7 90% PASS 4 8" House Building Pad, West Side, Middle FPG 116.7 11.31 105.4 10.7 92% PASS REPORT: Arrived at jobsite at 0800 hrs. to perform compaction testing of the House Building Pad. Performed 4 nuclear density tests at random locations, as indicated above. A sample of the material was obtained and returned to the laboratory for a moisture density curve. At the completion of the curve, all 4 test results indicate at least 90% relative compaction. Copies to: Reviewed by: 3060 Thorntree Drive, Suite 10 •Chico, CA 95973 • Telephone: (530) 891-6625 9 Facsimile: (530) 891-4243 INSULATION CERTIFICATE Job Number:::::::::5755:::::" ................................ ............................................................................................... e: Scott . ...... . ............................................................................. ::22-86::V--Vhjj .......................... ................ ........... . ..................................... Contractor/Owner Name Job Address (street, city, state) County Subdivision Name Lot Number DESCRIPTION OF INSTALLATION 1. ROOF 3. EXTERIOR WALL Frame A. Cavity Insulation Material: Thickness (inches):::::::::::::::: .............. .:12....114 .............. B. Exterior Foam Sheathing Material: Thickness .................................................... 4. RAISED FLOOR ........... Thickness (inches): '*"*.*. ...... " ....... ............................... ................................................... Brand Name: . ...... ............. Thermal Resistance (R-Value):::::::::::::::::::::w:::.:::::::::::::::13.&.1'9:::::::::::::::::::::::::::::::::::::::: ..... . ....... ......... Brand Name::::::::::::: ........................ ............... Thermal Resistance ........................................... Brand Thermal Resistance ..... ............ 5. SLAB FLOOR/PERIMETER -Brand .................................. al .......... ....... * ....... Thickness (inches): ThermResistance (R -Value): ......... Perimeter Insulation Depth ...................... 6. FOUNDATION WALL ............................................ ........... Thickness(inches): ........................................................ Brand Name: ............ I ......................................... Thermal Resistance ....................................................... DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Energy Efficiency Standards for residential buildings (Title 24, Part 6, California Code of Regulations) as indicated on the Certificate of Compliance,) where applicable. . I I .. .. ............... *"*** ...... : .................... ...... tb ko 4 ................................................................ Item Number's Sigfatu're ar)dDite Installing Subcontractor (Co. Name) or General Contractor (Co. Name) or Owner Item Number's Signature and Date Installing Subcontractor (Co. Name) or General Contractor (Co. Name) or Owner .`•.;."`COUNTY OF'BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER/) C%. (•� a ZON4 . _ 7 v BUILDING PERMIT OWN•ER"\r)� //1� j /�J TfLF�.. N(Q/�fEv` SO.KT, OCC. BUI DING ,VALUA.,T,ION OW ;V- Ao ;ss " / / U)IJMf 17/1 9551VY �•E► �.-".�' CONfUOE'� TELEPHONE .�J fj CONTRACTORS MAILING ADDRESS X tle CONSTRUCTION LENDER " LENDER'S MAILING ADDRESS Fireplace Total Valuation $ " ARCHITECT OR ENGINEER 1 LICENSE NO. - , Filing Fee $ 20.00 Permit Fee $ 3. 519 ARCHITECT OR ENGINEERS MAILING ADDRESS BUILDING ADORES Plan Checking Fee Energy Plan Checking Fee $ ,> ,,:.;6 7 $ 01 -3C� 1$ PERMIT FEE $ LOT NO. SUBDNLSIOWS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF* Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1/1 7.00 7 -7 Solar or heat pump water heater 23.00 Water piping 15.00 /�— Each gas water heater or vent 15.00 Jx5 TYPE OF WORK 1 del 11Iities 11In Matic ❑ Oth 0 New X, Addition ❑�R'z r Describe Work: 1+' /.i�* A01)fi / Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 45 Mobile Home S G W @20.00 -a PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 50 Main Service . .OV o mss 23.00 i LICENSED CONTRACTOR'S 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 the Business and Professions Code, and my license is in full force and effect: License Class ` Lic. No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: CEJ 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWEwNo occuP. OR ADDNS. ( 8 ACC. BLD S. so 3.5¢FT. NEW SID. MULTI.OUTLET 97.53 POWER APPARATUS 8 SINGLE OUTLET CIR. EX. OCCU OUTLET OR FDRUREs BAL @ 1:50 OFIxxEEOTSAa= oRR. Ex. Occup. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE t WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued., My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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. X �A,&t.,eJ00 �+r Date C>� Signature of A lica - © Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or constructionJin of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling - Hood 6.50 Yentilation .., PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE 71 TOTAL FEE $J g HAZ. p, PEES IMP t`fJ FLOOD //',t��� CDFF V PAR 1"/ V6 �0 ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have x •�, i By / 0' PERMIT EXPIRES ON " the applicable provisions Resolutions to do work been paid. -7 Date fc 7 5 Date Receipt No. (.,k(,44 7//41t ice( > i0S%e WHITE-D.D.S.-B.D. CANARY -ASSESSOR /,PINK -INSPECTOR / GOLDENROD -APPLICANT 2 J=OK 0 = Not OK . = NotReadyable Card B-1 Date Card B-1 MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. 1. Zoning Requirements -Setbacks -Easements Footings; Size -Spacing -Marriage Line 2. Soils; Special MH. Support Sketch 4. 3. Sewer; Location -Test -Fall -C/O -Concrete Drain; MH Test -Fall -Flex Connector 4. Water; Location -Test -Easement Needed (Sketch) 7. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete Gas and Electricity Tagged 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat..or / /" L "ft./ P LPG 10. 7. Well Clearance & Disconnect, Cert. of Occupancy 8. Utility Clearance ` Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -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 7. 4. Date MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Date 2. Card B-1 Date Card B-1 Date 4. Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Carports; Windows -Doors 7. 1. Zoning Requirements -Setbacks -Easements Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. 2. Footings; Size -Spacing -Marriage Line Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 3. Blocking 7. 4. Gas; MH Test -Demand -Valve 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 5. Electricity; MH Test Health Department Approval 6. Water; MH Test 11. 7. Water and Sewer Connected 12. Enclosure; Fencing -Alarms 8. Gas and Electricity Tagged Date 9. Exits Date 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 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' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERkOOR (Plans) OK except #'s 2"'F19., Main; Soils-Elec. Grnd.-/ V" Ftg. Depth g., Garage; Soils-Steel-Elec. Grnd.-/( /" Ftg. Depth . Ftei., Porches & Decks; Soils -Steel-/ P' Ftq. Depth mwalls, Garage; Steel- Blockouts-Wra ed Hold Downs and Special Anchors �Z_ Slab, 8. Piers .V.; Fall -Fitting -Test -2 Way C/O -Sewer Test YQr /1 10. UF, P& P pe; Size Anchors -Yard Gas Piping; Size Test ater P' e: Test -Anchors -Regulator -Service Test 12. Ele is Underground 13. grenums & Ducts; Clearance -Material -Support -Ins. 1K Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 9$. Insulation Date Date -_ Card B-1 Date Card B-1 Card B Date Card B-1 Date PLU (Permit) OK except #'s jf�gteQ±r.; Vent -Access -Combustion Air Baffle 1` . er Pipe; Test &Anchor -Nail Protection 1 D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Te Tub & Shower Second Floor -Tub Access as Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELEC CAL (Permit) OK except #'s 2 F�e�& Transformer Clearance -Ins. Protection I . Receptacles Spacinq-Liqhts & Switches at Doors 26!Siz ox & No. of Conductors Stapled 27. x Installed Close to Edge of Studs & C.J. irdround made up w/Mech Fasteners -Bond Gas & Water 2 ApKance Circuits in Kitchen & Conductor Size GFI ubfeed Wire Size/ /x Cu or AI-A.C. Wire Size/ /ga Cu or Al 1. Range Circle/ C'/q B'or AI -Oven Circ. / /aa Cu or Al Insulated Neutral ❑ Yes ❑ No 31-S.%roice-Riser Conductors & Ground Main Disconnect 33. E, di . Clearances Panels-Motors-Mech. Equip. 3 .C o es Closet Light -Shower Light -Spa Light Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MEC JCAL (Permit) OK except #'s 96. fi C. Dugts Insulation & Support Ve an. Exhaust above insulation Condens rain & OverfloykSize & Grade 39. F ce-Vent Access b. Ait-Return Air Vent 115 Outlet Attic Access rm i urnace in Attic Date Card B-1 Date Card B-1 Date Card B- Date Card B-1 Date FRA G (Permit) OK except #'s ITIJSilis.Pfoper Materials & Anchors 42,1V5lls Studs -Nailing Spacing & Braces -Plates -Sound Bring Walls over Girders & Floor Nailing Dr top in Walls (rat proof) ire ops. Furred Ceilings -Stairs -Chasers -Tubs 4B/Headers & Beams -Size & Bearing Date FRAMING (Continued) 4 gers-Post Caps -Anchors -Connectors 4 I' . Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. Oawd—place Ties or Type A Flue -Fireplace Throat Clearance A 'c Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. P perty Lire Firewall & Openings �Y9oors-One 3'-C eck Garage 3rd Story, 2 Exits . STairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56-IPlywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Sidi -Nailing Veneer 58. cco Mesh -Drip Screed -Fd. Vents-Underflr. Access ing Area -Glass Protection -Skylights -Plastic aagff Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Wal s -Windows Date 13/C/Card B-1 . Date Card B-1 Date Card B-1 Date Card B-1 Date FINA ex ept #'s 6 . Ext ps- q oor & Sidelight Protecti - mo a Detector urnace Ve-c earanc omb, Air -Connector - In Ga e; Above F r- Ducts-Mech. Protection room xi 6 at fixture ub Ac lec. Trim & Subpart r er izess 0. Stairs &•RAils� 71e'5ireplace or StQvee`Clearance-HeaFK 72rEfec. Outlets at WoVdIF-anel, Int. & Ext. 73. Kit. Fixt. &,4pJ5fiance nd-Air-Gap-Cooking C rance 74. Elec. Outletbr eptacles at Kit. Counter Gara Fire oor; Swing -Landing -Closure 76 -A.C. uct in Garage -Damper 77 r. Htr.; Vents -Clearance -Comb. Air Connector -P. . in Garage; Above Floor-Mech. Protection ,Z8 -10`f6.; Elec. & Mech. Equip. Listed for on 72—Pec-Receptacles in Garage (F... omex Protection Insulation -Foam -Looked in Attic 84.�aMs& Deck Cons ction-Pos aps dn. VBents & Cr ole Door Drainage 4 Wood -Earth _ Clearance Looked under Floor es / o lowing Instld./Drive D ❑ No/Walks O Yes Planters O Yes Cab 84. 8 . . . Unit Disconnect, Electrcal-Plumbing ent bove Roof, PI ppliance-Firepl -Clearance to Openings a Well, Disconnect, Elec , Plumbing Exterior Elec. Trim, G... eceptacle-Underground 8 . entilation Throughout House 9 lass Protection 9 rrectio rom Previous Inspections 92. st-Meters Tagged, Gas -Electric 93. W Sewer Connected -C/O to Grade -HD Approval n y Compliance Certificate -Other Certificates ddress Posted r. Date -1(0 _5 -Card B-1 C% Date Card B-1 Date(, jCH)'jCard B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE O.M.B. No. 3067-0077 Expires December 31, 200,r- C2. 00: Important Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance COWM Use: SHANE SCOTT BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number P.O. BOX 1102 CITY STATE ZIP CODE DURHAM CA 96938 PROPERTY DESCRIPTION (Lot and Block Numbers, Tau Parcel Number, Legal Description, etc.) APN: 038-180-033 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, tf necessary.) New Residential Structure LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS (Type): ( #9 - #9 - ##.W or ##.#####) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP BUTTE COC UN Y & MCORP. AREAS NRY NUMBER I BUTTE COUNTY 163 STATE B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX DATE B7. FIRM PANEL B8. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) NUMBER 132.. 9 t(m) O e) Lowest elevation of machinery ardor equipment EFFECTIVEIREMSED DATE servicing the building (Describe in a Comments area) (Zone AO, use depth offlood'ng) 06007CO735 C SEPT. 29,1989 JUNE 8,1996 AE 135.3 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined ❑ Other (Describe): SEE C3 BELOW. 611. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Omer (Describe): T 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date PWA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) — C1. Building elevations are based on: ❑ Consbuclion Drawings' ❑ Building UnderConstruction' ❑ Finished Constnnlion C2. Building Diagram Number 8 (Select the building diagram most similar to the buikfing for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevators –Zones Al -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, ARIA, ARAE, ARIA1-M, ARIAH, ARIAO Co T plete Items C3.-ari below according to the buidng diagram specified in Item C2. State ft datum used. t the datum is drfferent frorn the datum used for the BFE in Section B, convert the datum to Mused for the BFE. Show field measurements and datum conversion calculation. Use the space provided orthe Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 29 Conversion/Comments BUTTE COUNTY BENCH MARK #88, WHICH IS NGVD 29 DATA Elevation reference mark used Does the elevation reference mark used appear on the FIRM? []Wes ❑ No o a) Top of bottom floor (induding basement or enclosure) 136. ft(m) o b) Top ot nerd higherfloor 136.3 ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) N/A. _t(m) O d) Attached garage (top of slab) 132.. 9 t(m) O e) Lowest elevation of machinery ardor equipment servicing the building (Describe in a Comments area) NIA. ft.(m) o f) Lowest adjacent (finished) grade (LAG) 132.3 fL(m) o g) Highest adjaoent (finished) grade (HAG) 132. 3 ft.(m) o h) No. of permanent openings (flood vents) within 1 t above adjacent grade 8 o i) Total area of all permanent openings (flood vents) in C3.h 2500 sq. in. (sq. cm) L i2 E m -g E Z. QV'OFESS/p G .4 A No. 27647 70 EXP. 3/31/06 �. 9TF OF CAt-�E�� SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the date available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001, CERTIFIERS NAME LICENSE NUMBER ROBERT G. AGEE. JR RCE 27647 TITLE COMPANY NAME Civil Engineer SIERRA WEST SURVEYING. ADDRESS CITY STATE ZIPCODE 5437 BLACK OLIVE DRIVE A PARADISE CA 96969 2118103 (530)8776253 FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. I For Insurance Company use: I ,UILDINGSTREET ADDRESS (Indud'ag Apt, Unit, Suite, andlor Bldg. No.) OR P.O. ROUTE AND BOX NO.I Poky Number I P.O. BI 1102 CITY STATE ZIP CODE I Co Mmy NAIC Number DURHAM CA 95938 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy loth sides of this Elevation Certificate for (1) community official, (2) insurance agentloompany, and (3) building owner. BENCH MARK on site, the nail in 12" Oak S.E. comer of the property. Elevation =133.25' ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zane AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number _(Select the building diagram most similar to the building for whidn this certificate is being completed — see pages 6 and 7. If no diagram aoanatety represents the building, provide a sketch or photograph.) E2. The bop of the bottom floor (mduding basement or enclosure) of the building is _ t(m) _in.(cm) ❑ above or ❑ below (deck ane) the highest adiaoent grade. (Use natural grade, if available). E3. For Bwlding Diagrams 68 with openings (seepage 7), the neA higher floor or elevated floor (elevation b) of the building is _ t(m) _in.(c m) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery ardorequipment ser idng the building is _ ft.(m) _in,(crn) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, ti available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in aoomlarce with the communitys floodplain management ordnance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this iftmiatioxn in Section G, SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION r The property awrner or owrner's authoraed repiesentafive who competes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community - issued BFE) a Zone AO must sign here. The statements in Sees A, Q C, and E are correct to the best ofmy krrowfedge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL.) The local official who is affiorized by law or aifnance to administer the a mumtys floodplain management ordinance can complete Sections A, B, C (a E), and G of this Elevation Certificate. Complete the applicable items) and sign below. G1. ❑ The Information in Section C was taken from adw doixurentatiat that has been signed and embossed by a licensed surveys, engineer, or architect who is authorized by state or local law to oertify elevation information. (Indicate the now and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E fa a building located in Zone A (without a FEMA4ssued or oommunity-Issued BFE) or Zone A0. G3. ❑ The fdlowing iribmation (ftems G4 -G9) is provided fox oommunity floodplain management purposes. G4. PERMIT NUMBER I G5. DATE PERMIT ISSUED • I G6. DATE CERTIFICATE OF CONIPUANCE1000UPANCY ISSUED G7. This pem>it has been issued fox. ❑ New Construction ❑ Substantial Improvement Gil. Elevation of as -built lowest floor (including basement) of the building is: --ft(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: _ . -R(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS FEMA Form 81-31, January 2003 Replaces all previous editions DROP BOX COVER SKEET All of the following information must be completed. Writing must be legible. Date: [.47 ) , 0. S�-- Assessor's Parcel Number: 0— C) - Owner and/or A S O Applicant: Permit/Application Number: E -Mail Address: Contact Phone Number: V 2-6 _ SI3 Directed to (Staff Person): COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PER o. (Rev. 12/96) APPLICATION AND PERMIT ��4"e`� ASSESSOR PARCEL NUMBER •� _ S . O Z J V,' =DNI _ -� /'� BUILDING PERMIT OWNE TCOE /V SO. O NG A ON .OWN AD S / V /� CONE 'S TELEPHONE � CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuatlon $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ , BUILDING ADDRES Energy Plan Checking Fee $ $ PERMIT FEE $ , LOT NO. SUBDIVISIONS NAME PAkGzL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 77 Solar or heat pump water heater 23.00 Water piping 15.00 0 Each as water heater or vent 15.00 TYPE OF WORK _ New Addition ❑ el ❑ ire ❑ In ❑09 4-ckBuilding Describe Work: Gas piping system 1 - 5 outlets 15.00 sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service zaOA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencingwith Section 7000 of Division 3 of the Business and Professions Code, ) and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: M 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. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I� I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to 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 forthw' h comply with those provisions. `� X Date 01300 7 Si nature of App icant - IA Owner ❑ Contractor ❑ Agent — I An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in he' ht. Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUR. SO OR ADDNS. ( & ACC. BLDS. 3.5¢,. NEW CONST. MULTI.OUTLET NON-R61D. C @7.50 PowER APPARATus 6 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FD(TURES aA@'; 0 Ex. Occup. o TS A llo ERA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 , Ventilation PERMIT FEI= $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTL FEE $ HA2. . F ES IMP FWOD IISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have M By P EXPIRES ON the applicable provisions Resolutions to do work been paid. to 7 6.05 Date Receiptlqo. WHITE -D. NAR ASS SS R NK- NSPECTO GOLDENROD -APPLICANT 9 ,.,'...y�. :1.•'ww :r�:,=,.'h-,.;.;.::,'�.. ..q, ,,..;,A-� •;.bf.€i�kc'x:� x;..s�.�,Sn#�'.:j:.-.�1'.3.:i;,-.:rt' _n ... _. __ • _.. .. COUNTY OF BUTTE -DEPARTMENT QF D 'O' MENS SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: ,SD4A✓C ASSESSOR PARCEL NUMBER Proposed Building Use: r JCounter Technician: Date: Iters required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1., Site plans, 3 or 4 sets, signed by the preparer of the plans. 0 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 faxes! ❑ 5. Letter from Engineer or Architect for truss design review. OR" 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 du licate. ❑ 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 I� 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 D4 )t ' 19. Soils Report and/or Engineered Foundation required ............................................ ........ 20. Erosion Control Plan Required......................................................................... ........ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. 22. City of Chico Plumbing permit........................................................................ ❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: ❑ 24. Planning approval (A) Use: C3 K (B)Parking:(C) Parcel Check: ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form....................................................................... 27. Encroachment Permit for driveway from the Public Works Dept..... 1 ... 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.H. Title/Statement of Facts, ❑ Letter from Legal Owner, 1:1Check to H.C.D. $ ❑ 38. Other: O ❑ 39. Other: When issued Telephone and hold for pickup. GL�� I have been informed o the above items and requirements for obtaining a ui lAg, p ell- f, v Applican . 7:) 1e: 1. Index permit application for the above items num a YLv Plan Check Letter 2. Additional items required ^� Contractor, designer ne was advised of the ab p o mai counter, Date Contractor, design er, was advised of the abo data by ❑ phone, ❑ mail, ❑ counter, i7-Date: Date: Plans reviewed by: Date: Plans approved by: Structural reviewed by: -Date:,4 j6tructural approvedby' Date: 11 M6if Note transfer by: Date: re, C Y� I r 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 PROPROSED BUILDING USE 1. BUILDING PERMIT FEES --- Balance Due ..................... --- Additional Fees Due........ --- Revised Plan Checking Fee...$ 2. SCHOOL DISTRICT FEES D, I (paid at School District Office) (fog a lable after Plan Check) 3. SHERIFF FEES (paid at Building Division) 2 Residential........... X $360.00 =$ 3 Units Commercial (sq. ftg.)..... Sq.Ftg. 4. URBAN AREA FEES X $0.03 = $ A.P. # DATE 13 V RECEIPT # DATE C. Lu -1W" - %QL3 7b3ky (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. Amt. 5. RECREATION DISTRICT FEE /1d (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. Commercial (sq. ftg.) ......... X = $ Sq. Fig. Amt. 10. 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 plof checking process. DATE Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 2/2003) �K Cii y i fi' School District A.P. Number Property Owner BUTTE COUNTY SCHOOLS IMPACI`tFE CERTIFICATION FORM (One form per Bullding) (JA Building Departmentd o�3S� Property LocatiordAddress Subdivision Lot No. ..........................._.................................. :..... ...................... Residential Development Q '0 Q Sq. Footage 5� NWfLiving Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation Inspection) ..........................................................................._........................i Deed Restricted Sq. Footage _(Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q District Identification No. 41.Z Sty Sq. Footage (Including Exterior Roof Areas) -7l6 V a Date ,?,)L/R,qR'»'7 &ARF/E a School District certifies that ,-V-/AtJE 5,707% (Applicant) 34 -3 2 4.5 - (Street Address) (Phone Number) J�tr R�/�� CSA 953 S (City) (State) (Zip Code) has complied with the requirements of Resolution No. Ocie - 0.2 by payment of $ S5 3 8, 32, .representing cP.5 F g square feet. 2926 $ FULL MmGATIOM $ School District Representative Date Paid by Check # Remarks: NoBee: You may protest the Imposition of the fess identifled above by submitting a written protest to the District, In complianoa with Government Code Section 66020(a), within 90 days from the data fees are paid. Failure to submit a timely wfitsn protest wlll'prohlblt you from challenging the Imposition of the fees In any court aetlen N, subsequent to the school MOW Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notllled by the applicable Local Planning Agency that this project Is being reviewed under On California Environmental Quality Act (CEQA), this project may be subject to additional school fees to hdly ndtigsteAs Impact on On school dlstr1c t schools. White (applicant), Yellow (building department), Pink (school district) feeform.)ds (10/03)dmm -t.T C� t'.,'t �'y"'-r`.•trya:ry,n,,,,,t�,�,w«�„r^-f'1;.yj••-L,r.�Nkl�1v�'���`fYi�+`'�'� i<ii7V'"�'1.`i�'til.n' _ �, r-� •^ t- y,.r •. et „ f }•lbw;. � .� ..�. •, �h'� '- Sa`�`:'%:`y!i h BUTTE COUNTYPARK FACILITY FEE PAYMENT CERTIFICATION FORM ..; ' DURHAM RECREATION AND PARK DISTRICT t ' Assessor Parcel Number,( s): I � O 07_�> � % Property Owner (s): Project Location/Address: r Subdivison Name: Type of Residential Development (check one): Assessable Square Footage: 025 0 ew Development Alteration/Addition Mobile Home (s) Comments: Non -Residential to Residential Durham Recreation and Park District (DRPD) certifies that �h(A Y\1 Applicant Name s3o) S' -J3 - Z.L+S9 Applicant Phone Numlger .. F0. 30,E I I vZ Street Address C 9 City State Zip Code ;has complied with the requirements of the Butte County p Board of Su ervisors Resolution No. � . J a ' 93 -.114 by payment for 2'5-9E square feet at $ 1.04 per square foot for a total payment of $ '2' 9 ( SZ y. / (4, G DRPD Representative PAID BY CHECK No.: . BANK No.: ,_ Gib 31o,dyl PAID BY CASH: RECEIPT No.: ( cn -� Remarks. Date i t DISTRIBUTION: WHITE - APPLICANT PINK - DRPD YELLOW - BUTTE CO. BUILDING DIVISION A, A TRANSM ITTAL From: 4 Robertson & Dominick, Inc. Civil Engineers and Surveyors & 888 Manzanita Court, Suite A inc■ Chico, CA 95926 530-894-3500 894-8955 fax robertson-dom i nick.com Chico o Red Bluff o Redding 4/29/2004 To: Shane Scott From: Jonathan Edwards Of: Re: Structural Calculations CC: ❑ Urgent ❑ Please Reply ❑ Per Your Request • Comments: Shane: Included are three sets of structural calculations, plans with our revisions drawn on them, and truss calcs. If you need anything else or have any questions, please contact me at any, time. t Thank you, Jonathan Edwards Robertson and Dominick, Inc. I �s� �� � � ..__- . , � -- - PLAN REVISION Owner's Name: SLOT AP#: C63- 190 03� BP#:�- V���� Received By: Date: Q 7 ®Z(pq Time: Contact Person & Phone Number: 5?j0 ()Z4 - t4 k g(o PURPOSE OF RE -SUBMITTAL OR REVISION ❑ Permit Application Data Sheet Item )Z *Engineering C] *Plan Revision ae (,JAII-e 0-)( hf-) ryl ❑ *Requested by Building Inspector's Correction Notice - Inspector's Name: ❑ Requested by Plan's Examiner - Plan Examiner's Name: ❑ Other: *If revising a plan which has already been issued, submit two (2) drawings reflecting the revision for plan review along with your approved plans. If engineering is involved in this revision, the engineer must put his requirements on these drawings and wet stamp and sign two sets of engineered drawings. Revised drawings must clearly show changes proposed and locations involved. WHEN APPROVED, PROCESS AS FOLLOWS: Mail to Owner/Contractor at this address: ?\0, fox 1 k O 2 1�jp2 u !kms C UA, fir' S-q?,s tj Call (p?•L-( - L-( k'g (p and hold for pick-up. ❑ Deliver with next inspection. Minimum revised plan check fee to be collected at time of submission of revision, plans examiner will determine if additional plan checking fees are needed: ❑ Minimum $54.99 Receipt #: ❑ Fee not required for revisions requested by plans examiner prior to issuance of permit. ,/ ❑ Additional Fee Amount: Receipt #: Revised 2/04 11 LONGFELLow UMBER CO.INC* Quality Truss Design • Roof & Floor Systems 89 Loren Avenue • Chico, CA 95928-7434 Phone (530) 893-0112 • (800) 678-0112 Fax (530) 893-0140 E -Mail: trusses@longfellowlumber.com Customer: Shane Scott Job No: Whilit0122 ENGINEER Scott Res. Mitek Industries, Inc. Address: Redong (Ray) Yu 7777 Greenback Lane, Suite 109 White Dr. - Durham Citrus Heights, CA 95610 (916) 676-1900 APPROVED INSPECTION AGENCY Timber Products Inspection, Inc. AP#: P.O. Box 20455 Portland, OR 97220 (503) 254-0204 C•20E (Rev. 3/03) r� 25-0-0 • 19-0-0 X � G E G E w a o M U U U'I U U U U' 0III 11T� 0 N N W) U m iv o N N G E N N U - � LONGFELLOW LUMBER CO., INC. 89 Oren Avenue Shane Scott Scottes. Chico CA 95928 Name:. Scott Res. Address: White Dr. r� IT^ IQQL eng V Telephone: ( 530) 893-0112 P City: DurhamJob:�N State: Fax: (530) 893-0140 Phone: m. i—d: n:�Naravamovxrtaun Scale: Not to scale Date: 1/22/04 Drawn By: DMH Job cuss cuss type DEFL in y Scott Res./ While Dr.- Durham TCLL 16.0 Plates Increase 1.25 TC 0.66 Vert(LL) 0.14 20-21 >999 240 811231607 WHIT0122 C1-SWS DROP TC HIP 1 1 M1120H 165/146 BCLL 0.0 Rep Stress Incr NO WB 0.89 Horz(TL) 0.07 17 n/a n/a Job Reference (optional) ^aL;," . •-G., • Co. uluu s uec 2 2003 Mi I ex m6ustnes, mc. I ue reiJ03 08:[6:[0 2004 rage i 20-0-0 35-0-0 I 55-0-0 �7-0-p i 2-0-0 20-0-0 15-0-0 20-" 2-0-0 8x12 M1120 = Scale = 1:143.9 6x12 M1120 \\ 10x12 MI 120H i 3x6 M1120 // 3x10 M1120 402 M1120 // NO TOP CHORD NOTCHING IS ALLOWED 3x10 M1120 3x6 M1120 _ WITHIN 24" OF THE HEEL JOINTS. 3x8 M1120 i 3x6 M1120 3x6 M1120 NO NOTCHIN _ 3x6 M1120 3x8 M1120 i 6.00 M112 12 0 3x6 M1120 3x8 M1120 i 5x8 M1120 = 3 6 M1120 � 3x6 121120 3x6 M1120 7 3x6 12 8 9 3x6 1211200 4x12 M1120 \\ 78 3x6 M1120 5 6 10 4x12 M1120 M1120 4 11 3x6 M1120 3 12 13 0 33 32313029 28726252423 2221 20 1918 17 16 5x8 M112U 3x8 M1120 I 151 0 4x6 M1120 = 4x6 M1120 = 3x6 M1120 = 3x10 MII20 = 4x6 MI120 = 3x8 M1120 11 3x8 M1120 = 3x6 M1120 = 3x8 M1120 11 1941-10 35-7-6 44-1-0 55-0-0 19-4-10 16-2-12 8.5-10 10-11-0 Plate Offsets (X,Y): (2:0-0-14,0-11-6], [2:0-3-7,0-1-4], [7:0-6-0,0-0-15], [9:0-6-0,0-0-15], [14:0-2-11,0-5-10], [14:0-4-0,0-3-1], [48:0-1-12,0-1-0], [50:0-1-12 ,0-1-0],[54:0-1-12,0-1-0],[57:0-1-11,0-1-8],[59:0-1-120-1-0] [61:0-1-12,0-1-01 LOADING (psf) SPACING 2-0-0 CSI DEFL in (loc) VdeFl L/d PLATES GRIP TCLL 16.0 Plates Increase 1.25 TC 0.66 Vert(LL) 0.14 20-21 >999 240 M1120 220/195 TCDL 10.0 Lumber Increase 1.25 BC 0.51 Vert(TL) -0.25 20-21 >999 180 M1120H 165/146 BCLL 0.0 Rep Stress Incr NO WB 0.89 Horz(TL) 0.07 17 n/a n/a BCDL 7.0 Code UBC97/ANSI95 (Matrix) Weight: 545 lb LUMBER BRACING TOP CHORD 2 X 4 DF No.1 &Btr G 'Except' TOP CHORD Sheathed or 5-6-13 oc purlins, except 7-9 2 X 6 DF SS -G 2-0-0 oc purlins (5-4-2 max.): 7-9. BOT CHORD 2 X 4 DF No.1&Btr G BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing, Except: WEBS 2 X 4 DF Std G 6-0-0 oc bracing: 16-17,14-16. OTHERS 2 X 4 OF Std G WEBS 1 Row at midpt 7-21, 8-21,10-17 2 Rows at 1/3 pts 8-19,6-28 REACTIONS (Ib/size) 2=508/16-5-8, 17=2908/0-5-8, 28=4280/16-5-8, 33=140/16-5-8, 32=-41/16-5-8, 31=35/16-5-8, 30=12/16-5-8, 29=26/16-5-8, 27=15/16-5-8, 26=7/16-5-8, 25=65/16-5-8, 24=-155/16-5-8, 23=215/16-5-8, 14=268/0-5-8 Max Horz 2=-59(load case 3) , Max Uplift 2=-12(load case 5), 32=41(load case 6), 24=-155(load case 1), 14=40(load case 3) Max Grav 2=513(load case 6), 17=2908(load case 1), 28=4280(load case 1), 33=157(load case 2), 32=8(load case 4), 31=61(load case 2), 30=37(load case 2), 29=61 (load case 2), 27=28(load case 2), 26=40(load case 2), 25=77(load case 2), 24=18(load case 4), 23=215(load case 1), 14=275(load case 7) FORCES (lb) - Maximum Compression/Maximum TensionQF ESS/ TOP CHORD 1-2=0/45, 2-3=-357/97, 3-4=0/482, 4-5=0/690, 5-6=0/942, 6-78=-2633/78, 7-78=-2103/103, 7-8=-2107/99, �pQ� C ANONq� 13/105, BOT CHORD 2-33=0/177, 32-33=011 8 , 31-32=0/177, 30-31 0/177, 29-30=0/177, 28-29=0/177, 27-2860/1121 0/46 �Q ��� 26-27=0/1121, 25-26=0/1121, 24-25=0/1121, 23-24=0/1121, 22-23=0/1121, 21-22=0/1121, 20-21=0/2591 , 19-20=0/2591, 18-19=0/322, 17-18=0/322, 16-17=-185/51, 14-16=-185/51 C 17180 z WEBS 7-21=-389/0, 9-19=-55/204, 8-20=-20/289, 8-19=-1629/11, 8-21=-820/15,,10-19=0/1778, 10-17=-2650/0, 13-16=-10/160, 13-17=453/18, 6-21=0/1393, 6-28=-3938/0, 3-28=-1068/8 * EXP. 06/30/05 NOTES rS) CIVIt 1) Unbalanced roof live loads have been considered for this design. qT FOF CA1-\F�� Continued on page 2 February 3,2004 © Warning - Verify design parameters and READ NOTES ON THIS AND INCLUDED MITEK REFERENCE PAGE MII.7473 BEFORE USE Design valid for use only with MTek connectors. This design is based only upon parameters shown, and is for an individual building component to be Installed and loaded vertically. Applicability of design paramenters and proper incorporation of component is responsibility of building designer - not truss designer. Bracing shown is for lateral support of individual web members onty. Additional temporary bracing to insure stability during construction is the responsibillity of the erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding fabrication. Quality control• storage, delivery• erection and bracing, consult OST -88 Quality Standard, DSB-89 Bracing Specification. and HIB -91 Handling Installing and Bracing Recommendation available from Truss Plate Institute, 583 D'Onofrio Drive, Madison. WI 53719 I Te , I Job russ russ ype y Scott Res.! White Dr.- Durh WHIT0122 C1-SWS DROP TC HIP i 1 R11231607am Job Reference (optional) Longreuow Lumber Co., inc., Chico, CA yoyzo-rasa 5.200 s Dec 2 2003 MiTek Industries, Inc. Tue Feb 03 08:26:20 2004 Page 2 NOTES 2) This truss has been designed for the wind loads generated by -75 mph winds at 25 ft above ground level, using 10.0 psf top chord dead load and 7.0 psf bottom chord dead load, 100 mi from hurricane oceanline, on an occupancy category I, condition I enclosed building, of dimensions 45 ft by 24 ft with exposure B ASCE 7-93 per UBC97/ANS195 If end, verticals or cantilevers exist, they are exposed to wind. If porches exist, they are exposed to wind. The lumber DOL increase is 1.33, and the plate grip increase is 1.33 3) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind (normal to the face), see MiTek "Standard Gable End Detail" 4) Provide adequate drainage to prevent water ponding. 5) All plates are MT20 plates unless otherwise indicated. 6) All plates are 2x4 M1120 unless otherwise indicated. 7) Gable studs spaced at 1-4-0 oc. 8) This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads per Table No. 16-B, UBC -97. 9) A plate rating reduction of 20% has been applied for the green lumber members. 10) Design assumes 4x2 (Flat orientation) purlins at oc spacing indicated, fastened to truss TC w/ 2-10d nails. 11) In the LOAD CASE(S) section, loads applied to the face of the truss are noted as front (F) or back (B). LOAD CASE(S) Standard 1) Regular: Lumber Increase=1.25, Plate Increase=1.25 Uniform Loads (plf) Vert: 1-2=-52, 7-78=-204(F=-152), 7-8=-204(F=-152), 9-15=-52, 2-14=-14 Trapezoidal Loads (plf) Vert: 2= -124(F= -72) -to -78=-204(F=-152), 8=-204(F=-152}to-9=-124(F=-72) © Warning -Verify design parameters and READ NOTES ON THIS AND INCLUDED MITEK REFERENCE PAGE Mil-7473.13EFORE USE Design valid for use only with MiTek connectors. This design is based only upon parameters shown, and is for an individual building component to be p Installed and loaded vertically. Applicability of design paramenters and proper incorporation of component is responsibility of building designer - not truss designer. Bracing shown is for lateral support of individual web members only. Additional temporary bracing to insure stability during construction is the responsibillity of the erector. Additional permanent bracing of the overall structure is the responsibility of the building designer. For general guidance regarding fabrication, quality control, storage, delivery, erection and bracing, consult OST -88 Quality Standard. DSB-89 Bracing Specification, and HIB -91 7.{ Handling Installing and Bracing Recommendation available from Truss Plate Institute, 583 D'Onofrio Drive, Madison, WI 53719 01,dr F,,47( -C- FEDERAL EMI'RGENC-Y MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200; ELEVATION CERTIFICATE Importait Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number SHANE SCOTT BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number P.O. BOX 1102 CITY STATE ZIP CODE DURHAM CA 95938 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) APN: 038-180-033 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) New Residential Structure LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( ##- ##' - ##.#la?' or ##.#####') ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE BUTTE COUNTY, & INCORP. AREAS 060017 BUTTE COUNTY CA B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX DATE B7. FIRM PANEL B8. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) NUMBER Elevation reference mark used Does the elevation reference mark used appear on the FIRM?XKYes ❑ No o a To of bottom floor (including basement or enclosure)136. 3 ft m P f 9 () EFFECTNEIREVISED DATE o b) Top of next higher floor (Zone A0, use depth of floodng) 0600700735 C SEPT. 28,1989 JUNE 8, 1998 AE 135.3 81 U. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ AS Profile ❑ FIRM ❑ Community Determined ❑ Other (Describe): SEE C3 BELOW. B11. Indicate the elevation datum used for the BFE in B9: O NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?❑ Yes ® No Designation Date PWA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ® Construction Drawings* ❑ Building Under ConstructiW ❑ Finished Construction C2. Building Diagram Number 8 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones All -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AIR, ARIA, ARAE, ARIA1,A30, ARIAH, ARIAO Complete Items C3. -a4 below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Commends area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 29 Conversion/Comments BUTTE COUNTY BENCH MARK #88. WHICH IS NGVD 29 DATA Elevation reference mark used Does the elevation reference mark used appear on the FIRM?XKYes ❑ No o a To of bottom floor (including basement or enclosure)136. 3 ft m P f 9 () P • • - ��� G• AG, o b) Top of next higher floor 136.3 ft. N - •Fy Bottom lowest horizontal c 0 o c) of structural member (V zones only) N/A. _ft(m) o o d) Attached garage (top of slab) 132. UL $ o e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) NIA. fL(m) cc E cc * : No. 27647 ••,�j„ f 3�j�/dam o f) Lowest adjacent (finished) grade (LAG) Highest 132.3 ft(m) = in d'l,9 • CIVIL • • • ' • o g) adjacent (finished) grade (HAG) 132. 3 fL(m) W • • • CF CA��F p o h) No. of permanent openings (flood vents) within 1 ft above a*cent grade 8 o ) Total area of all permanent openings (flood vents) in C3.h 2500 sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any Use statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIERS NAME LICENSE NUMBER ROBERT G. AGEE. JR ' RCE 27647 TITLE COMPANY NAME Civil Engineer SIERRA WEST SURVEYING. ADDRESS CITY STATE ZIP CODE 5437 BLACK OUVA DRIVE PARADISE CA 96969 SIGNATURE I't t DATE TELEPHONE 2118103 (530)877-6253 IMPO TANT: In these spaces, copy the corresponding inforrRadon from Section A. • For Insurance Company Use: BUILDING STREET ADDRESS (Indudng Apt., Unil, Suite, andlor Bldg. No.) OR P.O. ROUTE AND BOX NO. P.O. BOX 1102 Policy Number CITY STATE ZIP CODE DURHAM CA 95938 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS BENCH MARK on site, the nail in 12" Oak, S.E. comer of the property. Elevation =133.25' ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zane AO and Zone A (without BFE), complete Hems E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Budding Diagram Number_(Select the building diagram most simlarto the building for which this certificate is being completed –seepages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) F2 The top of the bottom floor (including basement or enclosure) of the building is_ k(m) _m.(cm) ❑ above or ❑ below (check one) the highest a4aoent grade. (Use natural grade, if available). E3. For Building Diagram 6.8 with openings (seepage 7), the next higher flax or elevated floor (elevation b) of the buil ft is _ IL(m) _in.(cm) above the highest adjacent grade. Complete items C3.h and C3.i on frau of form. E4. The top of the platform of machinery and/or equipment servicing the building is_ ft(m) _in.(c m) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom fioor elevated in accordance with the community's floodplain management ordnanoe? ❑ Yes ❑ No ❑ Unknown. The local official must certirfy this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authored representative who completes Sections A, B, C (Item C3.h and C3.i any), and E forZo neA *thorn a FEMAmued orcommunity- issued BFE) or Zane AO must sign here. The statements in Sections A, B, Q and E are correct to the best of my knowfedge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZJP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communiy's floodplain management ordinance can complete Sed ions A, B, C (or E), and G of this ElOvatian Certificate. Complete the applicable items) and so below. G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, orarchitect who is auUrorized bystai3e or local law to certify elevation information. (Indicate the source and date of the elevation data in the Commends area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA4ssued or eormmunityissued BFE) or Zone A0. G3. ❑ The following information Oterms G4 -G9) is provided for community floodplain management purposes. 11 1,T) G7. This permit Inas been issued for.❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: — –ft(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: _ . _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS IiTT Inter-Departemorandum \0 0 un TO: FROM: SUBJECT: DATE: -S E PLAN REVIEW APPLICATION Date: �- �..x_-(, `-�AN �. • Permit Number (if auplicablel Bin Number APPLICANT INFORMA TION ' Parcel Size: Owners Name: +/j ` I Owners Address: P D� x, LA 5 S 8 Telephone No.: �-� ; H 1 alp Situs Address: Ly 71' q z-!7 %L.. Proposed Use: R idential New Single Family Residential ❑ Single Family Addition ❑ 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 O er . Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ ell [TAgricultural Buffer Form ❑ Applicable ® N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ❑ .Site Plan Stamped Approved B Date 1 ~ 27 — C" LI Y —T Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: 0 ❑ 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: A • Flood Panel No.: 07 3 S' Index Date: ' ( – Gi D ❑ 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 Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: Applicable Building Setbacks: n U ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. C: Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front b 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. C: Page 2 of 5 Applicable Development Fees: Standard Fees • ❑Fire . ❑ School* ❑ Parks/Recreation ❑ Roads - ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other Amount Formula ----------------=------------------------------------------------------------------------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. • Parcel Created By Deeds: Date of Creation: Deed of Reference: Parcel Frontage on Publicly Maintained Road: Complies with County Standards for Deed Cre Comments: L'a—I GP'6_7 t G Parcel Deemed to be legal Legal Access Provided: ❑ No 11 Yes Legal Access Required ❑ No ❑ Yes ❑ No N Yes, Road Name: WH I-rG fZ D No ❑ Yes ❑ Verify Legal Parcel ' ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger , ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements •-------------------------------------------------------=-------------------------------------------------------------------- Page 3 of 5 II Subdivision ME/Parcel Map: Map Date of Recording: Lot: A ❑ Use Permit/Minor Use Permit Permit Number: Page: Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Attached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 n ❑ 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 PI -0 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. • Page 4 of 5 • P x Summary of Specific Requirements: This inform_ ation provided in this summary is based on the application information and on the best available data at the time of review. C V arrys\Building Permit Site Plan Reviewl.doc Page 5 of 5 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement rLESS THAN 1 ACRE XProject Title: Oc3g /80 0�3 By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs .1 acre or more of land requires a Construction Storm Water Permit from the State Water Resources Control Board and -that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP), and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading anor other permits or other sanctions provided by law. Signed: Title: Date: e9 / 310 O.B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder' 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. (3'I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES'',O NO ❑ 2. I HAVE_ HAVE NOT 13signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: CITY.. J • e! CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this 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 (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIG D: DATE: NOTE. This Ownei-Builder Peri,flcation is required by Section 19531 and 19532 of the California Health and Safety Codes This verification must be completed and returned to our office before we are permitted to issue the permit. OVER r) OWNER BUILDER INFORMATION Dear Property Owner. QB• -1 An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party ofrecord 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 you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to seveial obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract 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 contactors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. 4er,iBuild Mic ira, C.B.O. ing Inspection NOTE. 77, is Owner-BuUderinformadon is required by Secdon 19830 of the California Health and Safety Code. OVER O.B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" 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. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YE§ 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 (Srm) to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: �. NAME• ADDRESS: CITY. PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: ED SOCIAL SECURITY N MEBER: DATE: 1,91-3D C� f NOTE. This Owner -Builder Verijkation is required by Section 19531 and 19832 of the California Health and Safety Coda This verification must be completed and returned to our office before we are permitted to issue the permit. OVER I OWNER BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party ofrecord on such a permit. Building permits are not required to lie 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 you plan to subcontract; you should be aware of the following information for your benefit and protection: ♦ If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300' or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments 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. ♦ There may be financial risks for you if you do not cant' out these obligations, and these risks are especially serious with respect to worker's compensation insurance. l For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your .obligations under State Lave, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the st=ur a 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 contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form 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 ly, C. Vi ira, C.B.O. r, Building Inspection NOTE. This Own er-Builderinfonnation is required by Section 19830 of the California Health and Safety Code OVER FPoEMPERGY CALCULATION SERVICESuditing, Analysis and Documentation. A L L Y CEC Certified Energy Plans Examiner - RES91-1006 / NR -91 -1002 -C -HERS Analysts - RD/FmHa Auditors - Member of RRHA of Texas Reference: Title 24 energy calculations :for your RESIDENTIAL project. To whom it may concern; Provided in this package, are- three sets of energy calculations. Two of these sets are for submittal to the building department. One set, the paper clipped original, is your file copy. Please be sure to sign these energy calculations on page 3 of the CF -1r forms where indicated. Read the signature requirements and determine who is most qualified, or willing to accept responsibility for the installation of energy measures required to meet the California energy code. A "Mandatory Measures" checklist is contained within the energy documents. These requirements pertain to all construction and should be considered minimum code requirements. Any specific increases in efficiencies noted in the Title -24 Energy Documentation supercede "Mandatory Measures". Energy features that must be incorporated into this structure are indicated on the summary sheet attached, by paper clip, to one set of the energy calculations. This information should be copied and presented to all sub -contractors to ensure proper installation of these energy features per Title -24 requirements. You may be eligible to receive State, Federal or Privately funded incentives for upgrading your projects energy efficiency. Please feel free to call with any questions that you might have regarding current programs in affect for residential new construction. The sooner you do this the better. Any questions will be gladly answered. If I may be of any assistance, now, or in the future, please don't hesitate to -call. , Thank you for your business. Marty Runnells, C.E.A Energy Calculation Services 574 Manzanita Avenue, Suite 9 ecs@energyguru.com 877 /530.894.8466 tel. Chico, California 95926 Est. 1989 530.894.3422 fax. January 30, 2004 Butte County Building Dept. 7 County Center Dr. Oroville, Ca 95965 Re: Shane Scott, White Dr., Durham, CA (038-180-033) Ladies and Gentlemen: This is to state that I have reviewed the truss calculations prepared by Longfellow Lumber Co. (their job # Whit0122) for the above referenced project and they have been prepared in accordance with the plans. The trusses are adequately configured for construction of this building. The engineerin,g_andanalysis-of the trusseswas-doneby-Longfellow Lumber Co.'s -engineer Robert�C. Anderson, P -E. (RCE 17180). If you have any questions please feel free to call me at 894-3500. Sincerely, Eric L. ob son, E. FESS10&� ai O LU W Z NO. 37105 Exp. 6-30-04 y: \ Ct s��rF OFCAL�FJ�� ChicoORed BluffORedding 888 Manzanita Court, Suite AO Chico, CA 95926 0530-894-3500 0894-8955 fax LONGFELLOW LUMBER Quality Truss Design • Roof & Floor Systems 89 Loren Avenue • Chico, CA 95928-7434 Phone (530) 893-0112 • (800) 678-0112 Fax (530) 893-0140 E -Mail: trusses@longfellowlumber.com CO. INC. Truss Proposal Date Jan. 27, 2004 Bid good through 2-12 04• for acceptance = Price subject;tachange: iftrusses notl elivered.." within 10.. weeks of acceptance:date. " • All Shipments are C.O.D unless a credit application has been approved: v - Delivery with the aid of the contractor;is plate { line: `Accessibility is;at:dri eves discretion. • An additional charge of $75.00 will.be assessed if, drives has to drop the trailerto access job site. } • Extra crane time for unusual conditions will be i`. billed at a rate of $90.00 pei hour • Inspections. to.determ nejob site accessibilify'will ; be billed at $90.00 _per hour. • Storage of Trusses beyond 30 days of original delivery date will result in a storage charge of 1.5% per month. • Trusses are not returnable for credit. �' RR�• t Mme., �/'�y� =�Ex.�' �ta�+ ialiffic es r3-�n'rhr .i4PJ M nakGwu n n L61 Square edge perimeter blocks ❑ Brace panels Q Hangers for truss to truss connections ❑ Valley trusses (� Backing trusses ❑ Soffited overhang [[� Delivery Notes *wide load delivery. P. lloo- � jillip- 1110- 11loo- J011,- Engineering Total $ 289.57 Street White Dr. City Durham Bldg.Oept Butte Co. Job Name Scott res. A.P.M 4 P TCLL TCDL BCDL C51 16 10 ' 7 25 % `� �µ Sizes&Pitch Try F a rr Name FTC Pitch V1&10/12 Top Chord 2 x 4 Wall 2 x 6 Shane Scott ;Overhang 2411 Street P.o. Box 1102 city State Lp Durham Ca. 95938 Phone Job Key 343-2459 Whit0122 cell Fax 67.4-41 RF �' RR�• t Mme., �/'�y� =�Ex.�' �ta�+ ialiffic es r3-�n'rhr .i4PJ M nakGwu n n L61 Square edge perimeter blocks ❑ Brace panels Q Hangers for truss to truss connections ❑ Valley trusses (� Backing trusses ❑ Soffited overhang [[� Delivery Notes *wide load delivery. P. lloo- � jillip- 1110- 11loo- J011,- Engineering Total $ 289.57 Street White Dr. City Durham Bldg.Oept Butte Co. Job Name Scott res. A.P.M 4 P TCLL TCDL BCDL C51 16 10 ' 7 25 % `� �µ Sizes&Pitch Try F a rr �k ar= t5L FTC Pitch V1&10/12 Top Chord 2 x 4 Wall 2 x 6 BC Pitch ;Overhang 2411 Trusses Total $ 11,910.00 e. ^ ead, Time The required lead-time for truss orders will vary according to construction activity. Current lead-time is $ weeks. 3 For best service, please order trusses as far in advance as possible. Tf1Q11/l You! Sierra West Surveying LICENSED LAND SURVEYING 5437 Black Olive Drive - Paradise, CA 95969 Phone: (530) 877-6253 Fax: (530) 877-6254 January 29, 2004 County of Butte Environmental Health P.O. Box 5364 Chico, California 95927 RE: Shone Scott APN 038-180-033 To Whom It May Concern: The base 100 -year flood plain elevation for the above referenced building site is 135.3 feet, and the elevation of the ground adjacent to this site is 132.3 feet. The 10 -year storm intensity usually is about 30% less than the 100 -year storm intensity. Thus, 10 -year storm waters within the ditches along the adjacent road do not affect building site unless the site is below the road, which is not the case in this matter. The 10 -year flood elevation is below this building site. V QROF ESS q Robert G. Agee, Jr. R.C.E.27647 No. 27647 Registration Expires 3/31/06 EXP. 3/31/06 9TF CF C:Letters\82715cott.1tr AND WHEN RECORDED MAIL T0: BUTTE COUNTY BUILDING DIVISION Recorded I REC FEE 10.00 7 COUNTY CENTER DRIVE Official Records I OROVILLE, CA 95965 County Of I BUTTE CANDACE J. GRUBBS j Recorder ROSEMARY DICKSON j Assistant I Shawnya 03:21PM 26 -Jul -2004 I Page 1 of 2 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 Q� ��� PR ERTY O RS: T c kA—;Lk-.G V2� _ `Sc -c' i State of California ) County of On (\Ak"- i[o 2QO4 before me,. personally appeared nn e, �o-R-= personally known to me to be the person(s) whose name(s) tXare subscribed to the within instrument and acknowledged to me that-he/she/they executed the same in hisAber/their authorized capacity(ies), and that by his4iWtheir signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my ha and official seal. Signature11 Seal: - BRDA MST® COMM. fJ 933'5862 , MARY _ 33 \, • Pu TA.P. #-MiV �F BUTTE Comm $�spta3tt Qo4. 4fi, LOWS JC Order No. 00216130-002 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: A PORTION OF LOT 21 ON THAT CERTAIN MAP ENTITLED, `EMAP OF THE HANLON TRACT SUBDIVISION UNIT NO. 191 , WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 7,1910, IN MAP BOOK 6, AT PAGE 16, MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT THE SOUTHEAST CORNER OF SAID LOT 21, SAID CORNER BEING THE CENTERLINE INTERSECTION OF TAYLOR AVENUE AND WHITE DRIVE; THENCE WEST ALONG THE CENTERLINE OF WHITE DRIVE AND THE SOUTH LINE OF SAID LOT 21, 300.00 FEET TO THE TRUE POINT OF BEGINNING FOR THE PARCEL HEREIN DESCRIBED; THENCE FROM SAID POINT OF BEGINNING AND CONTINUING ALONG SAID CENTERLINE WEST 177.46 FEET; THENCE NORTH 346.00 FEET; THENCE EAST 177.46 FEET; THENCE SOUTH 346.00 FEET TO THE POINT OF BEGINNING. AP NO. 038-180-033 J { j 1 E.14. USE OAKY Plot Plan Attached Flocs RonAtusAed /J Sent to 8.0. 0.crL' TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance . o ))Z e,2i1s�� dam' ld� 033 Owner location AP# Plan Approved'for: Sewage Disposal ✓ Water Supply: Public Private Well Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: I C -s ta�7 Environmental Health Specialist Date 8/96 FEDERAL EMERGENCY MAIIAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200; -, ELEVATION CERTIFICATE Imoortartt: Read the instructions on sages 1- 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Comparry Use: BUILDING OWNER'S NAME Policy Number SHANE SCOTT BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number P.O. BOX 1102 CITY STATE ZIP CODE DURHAM CA 95938 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) APN: 038-180-033 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) New Residential Structure LATITUDE/LONGITUDE (OPTIONAL)HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( W - #9 - ##.#IF or ##.#####� 19 NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE BUTTE COUNTY, & INCORP. AREAS 060017 BUTTE COUNTY CA B4. MAP AND PANEL B5. SUFFIX 66. FIRM INDEX DATE ,x-87. FIRM PANEL 88. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) NUMBER 5 k, v K 'a- " 4r '. EFFECTIVE/REVISED DATE (Zone AO, use depth of flooding) 06007CO735 C ,, 618198. o a) Top of bottom floor (including basement or enclosure) See Comments. _fL(m) M AE 134.3 �� ; °�P� G • ^• o c) Bottom of lowest horizontal structural member (V zones only) NIA. _ft(m) y 00 o �® F o d) Attached garage (top of slab) 132.. 9 ft(m) E LU 0UWJ m o e) Lowest elevation of machinery and/or equipment B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined 54 Other (Describe): SEE C3 BELOW. B11. Indicate the elevation datum used for the BFE in 139: O NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?❑ Yes ® No Designation Date PN/A SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on:;, Construction Drawings* ❑ Building Under Construction' ❑ Finished Construction C2. Building Diagram Number 8 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3. -a4 below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum. used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 29 ConversionfComments BUTTE COUNTY BENCH MARK #88 .WHICH IS NGVD 29 DATA Elevation reference mark used Does the elevation reference mark used appear on the FIRMA X Yes ❑ No Q�flS$/ak o a) Top of bottom floor (including basement or enclosure) See Comments. _fL(m) M �� 1e°000000•° 0 o b) Top of next higher floor 134.3 ft(m) o �� ; °�P� G • ^• o c) Bottom of lowest horizontal structural member (V zones only) NIA. _ft(m) y 00 o �® F o d) Attached garage (top of slab) 132.. 9 ft(m) E LU 0UWJ m o e) Lowest elevation of machinery and/or equipment S27 servicing the building (Describe in a Comments area) 133.4 fL(m) E 7 �• 7 / Z o f) Lowest adjacent (finished) grade (LAG) 132.3 ft(m) z .0 Highest (HAG)132. 3 ft(m) S C V °'••°. •° •• o g) adjacent (finished) grade '1 �1,\Q' o h) No. of permanent openings (flood vents) withinft above adjacent grade 8 o ) Total area of all permanent openings (flood vents) in C3.h 2500 sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER ROBERT G. AGEE. JR. RCE 27647 TITLE COMPANY NAME Civil Engineer SIERRA WEST SURVEYING. ADDRESS _.. CITY STATE ZIP CODE 5437 BLACK O� DRIVE PARADISE CA 96969 SIGNATU� A,�i// 211 03 (530)877&253 IMPORTANT: In these spaces, copy the corresponding information from Sedon A. For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite, ardor Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number P.O. BOX 1102 CITY STATE ZIP CODE Comparry NAIC Number DURHAM CA 95938 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenl/company, and (3) building owner. COMMENTS C3a) The lowest elevation under the crawl space is 132.3 feet NGVD. C3e) The lowest elevation of the machinery and/or equipment servicing the building is the air conditioning compressor unit at 133.4 feet NGVD. The area of the enclosure is 2500 square feet BENCH MARK on site the S E comer of the property. Elevation =133.25' ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 through E4. Ifthe Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Seddon C must be completed. E1. Building Diagram Number _(Select the building diagram most similarto the building for which this certificate is being completed —seepages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is_ fL(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6.8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ ft(m) _ih.(cm) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is_ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, 9 available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community s floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (widW a FEMA4ssued or community - issued BFE) or Zone AO must sign here. The staterrents in Sections A, B, C, and E are correct to the best of my krro►Medge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G 1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. F -1A community official completed Section E for a building located in Zone A (without a FEMA -issued or communityissued BFE) or Zone A0. G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management proposes. G7. This permit has been issued for.[:] New Constuction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: ft(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: _ . _ fL(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS k August 3, 2004 CONTY Butte County Building Dept. AUG - 5 2004 7 County Center Dr. DEVE.GtvNd Oroville, CA 95965 SERVICES Re: Permit No. 04-0356, Shane Scott, Jr. Ladies and Gentlemen: In response to an inspection correction item resulting from a foundation inspection for the above referenced house located on White Drive in Durham, I was asked to inspect a footing in question and make a determination as to its adequacy. The footing -in question is the 30 inch wide grade beam footing at the rear of the house on the right side. And, based on a conversation with Lee Mayer, who is constructing the forms, and from reading the inspectors correction notice, it is my understanding that the question is; can the 30" wide horizontal footing be slightly offset from the stem wall? The answer to this is yes, this is acceptable. Based on my inspection, and a review of the structural calculations, the 30" wide grade beam footing at the rear of the house on the right side, as formed, is adequate for the calculated loads. If you have any questions or would like to discuss this further please feel free to call' me at 894-3500. Sincerely, Eric L. Robertson, P.E. Principal/Civil Engineer QQ,pFESSIp�q`\ W �� c NO. 379Q5 EXP. 6-3 �C Lp. C1V1L 9I'F CAL*��~� ChicoORed Bluff ORedding 888 Manzanita Court, Suite A 0 Chico, CA 95926 0 530789473500 0894-8955 fax FROM: DATE: INTER -DEPARTMENTAL MEMORANDUM BUILDING DIVISION, ENVIR. HEALTH, CHICO RELEASE ENV. HEALTH HOLD ON BUILDING FINAL FOR: OWNER NAME: a,� SEPTIC: WELL: AP#: I � ADDRESS/LOCATION: �(%j�j lo�Q' /J,p Comments: GL/memos/releasehold s 0 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Read Ute insbucdons on naaes 1.7. O.M.B. No. 3067-0077 Expires December 31, 200: SECTION A - PROPERTY OWNER INFORMATION I Fa Insuranoe Company Use: I BUILDING OWNER'S NAME Policy Number SHANE SCOTT BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number P.O. BOX 1102 CITY STATE ZIP CODE DURHAM CA 95938 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) APN: 038-180-033 ' BUILDING USE (e.g., Residential, Nonresidential, Addition, Accessory, etc. Use a Commends area, ff necessary.) New Residential Structure LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( f f - #9 - ##.W or ##.##q##) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COWAUNITY NAME 8 COWAJN" NUMBER I BZ COUNTY NAM= 163. STATE COUNTY, BUTTE COY, 81NCORP. AREAS 060017 BUTTE COUNTY B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX DATE B7. FIRM PANEL 68. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) NUMBER NIA. _t(m) EFFECTIVEIREVISED DATE 132.. 9 ft(m) (Zane AO, use depth of Wing) 06007CO735 C SEPT. 2D, 1989 JUNE 8,1998 AE 135.3 1310. Indicate the source of the Base Rood Elevation (BFE) data or base flood depth entered in 89. ❑ AS Profile ❑ FIRM ❑ Community Determined I ❑ 011ier (Describe): SEE 03 BELOW. B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date PNIA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Constr cW Xf Finished Construction C2. Building Diagram Number 8 (Select the building diagrarn most similar to the building for which this certificate is being completed - see pages 6 and 7, ff no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations—Zones Al -A30, AE, AH, A (with WE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, ARIA1-AW , ARIAH, ARIAO Complete Items C3. -a4 below according to the building diagram specified in Item C2. State the datum used. (f the datum is different from the datum used for the BFE in Secfim B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use tine space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 29 ConversbVComrnerits BUTTE COUNTY BENCH MARK #88 WHICH IS NGVD 29 DATA Elevation reference mark used Does the elevation reference mark used appear on the FIRM? es ❑ No o a) Top of bottom floor (including bwernent or enclosure) 136.4 ft.(m) d o b) Top of next higherfloor 136.3 ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) NIA. _t(m) o d) Attached garage (top of slab) 132.. 9 ft(m) w m o e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) NIA. ft(m) E ro o f) Lowest adaoent (finished) grade (LAG) 132.3 ft(m) z' N o g) Highest ad)aoent (finished) grade (HAG) 132. 3 t(m) o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 8 tY o i) Total area of all permanent openings (flood vents) in C3.h 2500 sq. in. (sq. cm) J 00FESSnp X00 lq:� c C t No. 27647 A 1 EXP. 3/31/06 9TF OF CA1-\F�� SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. t certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIERS NAME LICENSE NUMBER ROBERT G. AGEE. JR. RCE 27647 TITLE COMPANY NAME Civil Engineer SIERRA WEST SURVEYING. ADDRESS ' CITY STATE ZIPCODE 5437 BLACK OLIVE DRIVE PARADISE 96969 FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A For Insurance Company Use. BUILDING STREET ADDRESS (Indu ft Apt, Unit, Suite, ardor Bldg. Na) OR P.O. ROUTE AND BOX NO. Pofwy Number P.O. BOX 1102 CITY STATE ZIP CODE Company NAIC Number DURHAM CA 95938 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy, both sides of this Elevation CertfiCate for (1) community official, (2) insurance agenlicompany, and (3) building owner, COMMENTS BENCH MARK on site, the nail in 12" Oak, S.E. comer of the property. Elevation =133.25' 0 Check here if attachments . SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT up For Zone AO and Zone A (without BFE), complete therm E1 through E4. If the Elevation Certificate Is intended for use as supporting infomratim for a LOMA or LOMR-F, Section C must be wripleted. E1. Building Diagram Number _(Select the building diagram most similar to the building for which this cerftate is being completed – see pages 6 and 7. If no diagram accutately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is _ t(m) _in.(am) 0 above or 0 below (check ane) the highest ado W grade. (Use natural grade, if available). E3. For Building Diagrams 6$ with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ t(m) _in.(an) above the highest adaoent grade. Complete iterns C3.h and C31 on front of form. E4. The top of the platform of machinery ardor equipment servicing the building is _ ft(m) _in.(am) 0 above or 0 below (crack one) the highest ac*ent grade. (Use natural grade, I available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom Noor elevated in accordance with the community's floodplain mmagernent ordnance? 0 Yes 0 No 0 Unknown. The local oficlal must certify fhis information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Ithrns C3.h and C3.i only), and E for Zane A (without a FEMA4ssued or corrrrKmity- issued BFE) or Zane AO must sign here. The sta:errents in Sections A, a C, and E are oorW to ma best Amy kmie ge PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIPCODE SIGNATURE DATE TELEPHONE COMMENTS 0 Check here ifattachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the oomm ity's floodplain rnonagernent adinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable items) and sign below. G1.0 The information in Section C was taken from olher doamentation that has been signed and embossed by a licensed surveyor, engineer, or architect who Is authorised by state or local law to certify elevation infomiation. (Indicate the source and date of the elevation data in the Comments area below.) G2.0. A community official completed Section E for a building located in Zone A (without a FEMA4ssued or communitymissued BFE) or Zone AO, G3.0 The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COWUANCEIOCCUPANCY ISSUED G7. This permit has been issued for, 0 New Construction 0 Substantial Improvement . G8. Elevation of as -built lowest floor (including basement) of the building is: — ft,(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: _ . _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE COMMENTS FEMA Form 81-31, January 2003 Replaces all previous editions 91 -dU .._�. l�'o" !d • ••_ t.►' ..... i. -fkI iYX•,�(,•'Y �;.?ik; vq"Ir+•__. Y. .. Y'T}I�'^Y+Mf' ?�,'1Sy, `l .. 111 /y •.r...rr. '4v.•� V jt119 A,`�•P 1(r�,{ 1�.P�O�VE S t Butte Cou r` ' I Environental a th ILIto Signature f ry 3 iO h D111 J lr\ W/O wt\le . - N S 8071Z)M of tkaa , 7 a 1rel �u �- � I IEN'v">^-ONROENTAL HEALTH i } Ci iiwP, CALIFORNIA PgOt 7= b_ c� N . i ••_ t.►' ..... i. -fkI iYX•,�(,•'Y �;.?ik; vq"Ir+•__. Y. .. Y'T}I�'^Y+Mf' ?�,'1Sy, `l .. 111 /y •.r...rr. '4v.•� V jt119 A,`�•P 1(r�,{ 1�.P�O�VE S t Butte Cou r` ' I Environental a th ILIto Signature f ry 3 iO h D111 J lr\ W/O wt\le . - N S 8071Z)M of tkaa , 7 a 1rel �u �- � I IEN'v">^-ONROENTAL HEALTH i } Ci iiwP, CALIFORNIA PgOt 7= q -4q At 'v 1\5.1 V 0- I "lz AG I U v Jq Grp o Piz 7. -r rL 2iao r- T 2.2'3 AC. f -k so k POD II I lu AV I . &.j ON LI I i A'4 ve 0, p Xoc- L L A, AOf-AE APPROVED Butte County nm tat m, Environm tal H Ith L k\ SateZ si at ly— mo 5LOpe- Pvtoperry %AO i IT 'i A p,4/ 03$ 180 0 35 ENVIROW-AENTAL HE ITH to 7— La, O JAN 2 2 2004 LaT 'N3 MAP. CHICO, CALIFORNIA 00 q -4q At 'v 1\5.1 V 0- I "lz AG I U v Jq Grp o Piz 7. -r rL 2iao r- T 2.2'3 AC. f -k so k POD II I lu AV I . &.j ON LI I i A'4 ve 0, p Xoc- L L A, AOf-AE APPROVED Butte County nm tat m, Environm tal H Ith L k\ SateZ si at ly— mo 5LOpe- Pvtoperry %AO i IT 'i A p,4/ 03$ 180 0 35 ENVIROW-AENTAL HE ITH to 7— La, O JAN 2 2 2004 LaT 'N3 MAP. CHICO, CALIFORNIA