HomeMy WebLinkAbout039-570-034no
White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant
1�J �tlod�
L
n R_- I
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: YES ] NO[ ].
2. ? H &vEf ] mt, an apolicat'n for a building permit for the
proposed work-
3.
ork3. I have contracted with the following person (firm) to provide the proposed
NAi`vIE: YC4 0,,,aC'+1Y-N
ADDRESS: 37-4 k0t, CITY: 450,A -Joz-C-
PHONE: `ic7(3 '1 I -1q I CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to
coordinate, sup 'se and prQvide the ma'o
NA�NI E•
ADDRESS: CITY:
PHONE: tjOhNONINEW 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:
NA';N E ADDRESS PHONE TYPE OF WORK
,,,SIGNED:,,,°
.PROPERTY OWNER:
—
L-,SOCIAL SECURITY NUMBER: -
L, DATE:
NOTE: This owner -Builder Verification is required by Section 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before
we are permitted to issue the permit.
i
1.
`''`� OVER
LAND DEVELOPMENT
BUILDING / ENVIRONMENTAL HEALTH - PERMIT CLEARANCE Building Permit No.
OWNERSp A.P.
NAME: NUMBER: l
PRINT LAST NAME FIRST, '
COUNTY ZONING �r�
DESIGNATION: A I O FLOOD ZONE:: FLOOD MAP: zed ►3
APPROVED: CONDITIONALLY APPROVED: ✓ RESOLVE PROBLEMS PRIOR TO APPROVAL:
PARCEL CREATION BY DEEDS OR MAP �� i S�
M.o2IE-ffiEh19 I2ttiNGkF be6
DEED INFORMATION:
DATE OF CREATION: DEED REFERENCE:
LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO
COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: YES NO
COMMENTS/CONDITION
MAP INFORMATION: Q
DATE OF RECORDING Z 2 LOT 85 BOOK /0 PAGE 8
COMPLIANCE WITH OLD SUBDIPSION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT
PAGE 23): YES a NO . IF YES, MARK APPROPRIATE ITEM(S) BELOW: $ fjL►
A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements.
CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BU/LD/NG DIVISION UNLESS OTHERW/SENOTED.
1. Maintain a 50 ft. building setback from centerline of road.
_ 2. Maintain a ft.building setback from right-of-way/centerline of
3. Comply with Zoning code for building setback from road.
4. Maintain a 100 ft. leachfield setback from all existing. wells.
5. Maintain a ft. leachfield setback from
6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department.
7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290.
8. Connect to a public water supply.
9. Connect to a public sewer. system.
_ 10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National
Fire Protection Association Standard for the 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 Fire Department
specifications, serves the parcel.
11. Pay T.D.D. (Thermalito Drainage District) fee in the amount of $
_ 12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below)
_ 13. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish & Game at 916-355-7010.
j 14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated
in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be made to the Pranning Divrsian! j
15. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic
safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3
requirements of the Uniform Building Code.
_ 16. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors.
X 17. Pay school impact mitigation fees.
X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article II of the Butte
County Code.
_ 19. 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.
20. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find
pending examination of the site by a professional archaeologist. This person would then be able to assess the site
significance and suggest appropriate mitigation measures.
21.
22
23
24
25
26
AIG 31►8 30 ,kiNt100
166a Z ` VW
C13AI333H
LD 7/96
C:\WP51 \F0RMS.K\8LDGPERM.CLR