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040-100-075
1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP041920 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 10/15/2004 APN: 040-100-075-000 the Business and Professions Code, and my license is in full force and effect. / 9 W /Mt License Class: License Number: Site Ad 4 Date: Contractor. P Ma Index: T�ly� 1 l d Description: NSF(589)COV(1674) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 e Business and Professions Code: Any city or county which requires a Owner: HENRY AND KIMBERLY YOUNG permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of P,O.BOX 7$72 the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or CHICO CA she is exempt therefrom and the basis for the alleged exemption. Any 95927 violation of Section 7031.5 by any applicant for a permit subjects the 530 893-2999 ( ) applicant to a civil penalty of not more than five hundred dollars ($500).): as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an Applicant: HENRY AND KIMBERLY YOUNG pP owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). O 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). Contractor: ❑ 1 amExemptunder Article 3 of the Business and Professions Code Date: `�ys Owner: ' . WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: •❑ 1 have and will maintain a certificate of consent to self -insure for License #- - workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as Architect' required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Engineer: insurance carrier and policy number are: Carrier: Total Square Ft: 2263 S.F. Policy #• gLIT"certify that in the performance of the work for which this permit is Valuation: $65,069.00 issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' +� / compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ��/ Date: n _% rYA /� C1 / 2 I " `'` CJ Applicant:% WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code andlor 1 hereby affirm that there is a construction lending agency for the Resolutionto do work in 'cated ove for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) /�� Name: By: Date: / PERMIT EXPIRES �O Address: ON: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance witti Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: �l Signature: Date: wrier ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor 4cPJ4_7-00 �--PP* BUTTE COUNTY /1%�( c� • 50 , DEPARTMENT OF DEVELOPMENT SERVICES �j BUILDING PERMIT APPLICATION 0 601 AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" OWNER Name -,? qqq I Fax CONTRACTOR Name Address City State Phone Fax E-mail Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name e- hz✓�vr � Address Zip City Fax State Zip Phone Page Fax E-mail Date Approved: State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X I j For office use only: Zoning -16 Flood Zone Cross Street &(An s w r c�_ 41- 1^WORKER'S SRA o Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT 001 q BP BIN # LOCATION �1 AN 0 4Q — lV 0 ? S Property Address C' Cross Street &(An s w r c�_ 41- 1^WORKER'S WORKER'SCOMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or Scope of Work: Sq. Footage � w ❑ Structure Built without Permil:971 ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR SUBMITTAL REQUIREMENTS L K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 f —7 i. - -- -- 'e- �} Received by: 7P Amount l�� LJ3 ,.mcg SRA Receipt #:q65gQ� Sheriff (, / g— SMIP /i tel/ / v� Other �y "tJ"7 ___ /e �� S r 6gTotal REV 6-16-04 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN IN% Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! OR 3 Sets Engineered plans (if required) with wet signature on plan's AND 2 sets of stampe&and'signed calculations. , ❑ 3. - 2 Engineered truss details and layouts'(if required) (NO FAXES!). ❑ 4. Letter from Engineer�or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. ❑ 7. o 8. ❑ 9. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Detached Accessory Building Form, filled out by the property owner (if required). Sanitation and site plan approval from the Environmental Health Department. Metal Buildings: (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. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2 Floor plans. , ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. o 7. 2 Flood Elevation Certificate, -wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FABS!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (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. ❑ 9. Letter of intent. ❑ 10. Hazardous Material'Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (53 0) 538-7541.,E . -- . OVER FOR BUILDING PERMIT APPLICATION KAFORMSMILDING FORMSOdgApplSubRgmts.doc Page 2 of 2 REV 6-16-04 J COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION I ingAleps needed to issue the permit. (May require• additional plan review upon receipt of the following items.) . � ire Sprinklers .............................................. "`........................, ",...... ..... . 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by . ❑ 19. -Soils Report and/or Engineered Foundation required...,., ....................................... ........ ❑ Erosion Control Plan Required.........`.................:................................................ 21. ees as shown on the attached Schedule of Fees Due Sheet .............................. CQl1218 �/ Lf6 t ❑ 2. City of Chico Plumbing permit................:...................................................... ' 77 23. California Department of Fore try plan approval ❑paid. Sent by: 24. tanning approval (A) Use: Q,� B)Parking (C) Parcel Check: 0 � n l; ❑ 25. Contact Land Development about _Improvements, _ Drainage ......................... 26. NPDES Form..........................................`!................................................. 27. Encroachment Permit for driveway from the Public Works De"p"t'.' ept........................... O 28. Pre -Inspection for required....... + ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation CarrieVnd Policy Number .......................................... :R" 31. Owner -Builder Verification ( rGiven to owner, _Mailed to owner)._ ................... ❑ 32. Letter of Signature authorization .................................:....:........................ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. O' 34. Manufactured home utility clearance ...................... "`................ -f.................. ❑ -35. Existing violations and/or expired permits ................ .................. y.................. ❑ 36. Deed Restriction........................................................ .................. t ❑ 37. ❑ Grant Deed, ❑ M.H. . Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ,OP 38. Other: ❑ 39. Other: _3 When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: (P Date: -del 1. Index permit application for the bove ites`numbered: Plan Check Letter 2. Additional items required Contractor, designer o e was advised of the a ove data by phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by ' Date: Plans reviewed by: Date: Plans approved by: Date Structural reviewed b : Date: Structural approved by: Date:Cl 1i Note transfer by: Date: RJ WM , Yellow: Building Division 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 1 PERMIT APPLICATION DATA SHEET %� G fia �DOr OWNER: / ASSESSOR PARCEL NUMBER V Gs ` Proposed Building Use: N I- Counter Technician: /-f__1 Date: YO 30 -.. Ater► s 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. . ❑ ` 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4. Engineered truss details and layouts in duplicate. No faxesl 5. Letter from Engineer or Architect for truss design review. ; 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 V.'O duplicate. 9. Metal bldgs: (A,)\Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate O 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 &ti� 14. Hazardous Material Form 15. Sanitation from the Environmental and site plan approval Health Department in t hlco ❑ Oroville, as applicable. ❑ 16. Other I ingAleps needed to issue the permit. (May require• additional plan review upon receipt of the following items.) . � ire Sprinklers .............................................. "`........................, ",...... ..... . 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by . ❑ 19. -Soils Report and/or Engineered Foundation required...,., ....................................... ........ ❑ Erosion Control Plan Required.........`.................:................................................ 21. ees as shown on the attached Schedule of Fees Due Sheet .............................. CQl1218 �/ Lf6 t ❑ 2. City of Chico Plumbing permit................:...................................................... ' 77 23. California Department of Fore try plan approval ❑paid. Sent by: 24. tanning approval (A) Use: Q,� B)Parking (C) Parcel Check: 0 � n l; ❑ 25. Contact Land Development about _Improvements, _ Drainage ......................... 26. NPDES Form..........................................`!................................................. 27. Encroachment Permit for driveway from the Public Works De"p"t'.' ept........................... O 28. Pre -Inspection for required....... + ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation CarrieVnd Policy Number .......................................... :R" 31. Owner -Builder Verification ( rGiven to owner, _Mailed to owner)._ ................... ❑ 32. Letter of Signature authorization .................................:....:........................ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. O' 34. Manufactured home utility clearance ...................... "`................ -f.................. ❑ -35. Existing violations and/or expired permits ................ .................. y.................. ❑ 36. Deed Restriction........................................................ .................. t ❑ 37. ❑ Grant Deed, ❑ M.H. . Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ,OP 38. Other: ❑ 39. Other: _3 When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: (P Date: -del 1. Index permit application for the bove ites`numbered: Plan Check Letter 2. Additional items required Contractor, designer o e was advised of the a ove data by phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by ' Date: Plans reviewed by: Date: Plans approved by: Date Structural reviewed b : Date: Structural approved by: Date:Cl 1i Note transfer by: Date: RJ WM , Yellow: Building Division TO: g epartment FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Plan Approved for: Sewage Disposal Clearance for dwelling. Other r R/P -2:�// TI41 A/. Hold final for C7n-ml rinnrnnno r) K fnr- E.H. USE ONLY Sint Pian Anachod Floor Man Attachad Saw to G.D. Location AP# Water Supply: Public Private Well S, 11 1,,2 AQ Environmental Health Specialist 6� 3o Date 8/96 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 L l� PROSED BUILDING USE ' y 1. BUILDING PERMIT FEES --- Balance Due ..................... $ zo 6_0 Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES a(I g I l (paid at School District Office) (f availablp after Plan Check) �i 3. SHERIFF FEES (paid at Building Division Residential............ , X. 66 =$ Units Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. URBAN AREA FEES Residential (per unit)..... X # Units Amt. Commercial (Sq. Ftg.).... X A.P. # C �0 MI��� DATE /0 -30 - /I RECEIPT # DATE REC. (paid at Building Division) oy.' L& nuu. 5. RECREATION DISTRICT FEES afh6m&lf JQ'oe q-2+.04- (paid .2¢•O9- (paid at Recreation District Office) (form avava ab• lgafterPly a k) 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 # 3 $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone ..... ' X Zone # Units Amt. Commercial (sq. ftg.) ......... V- / Sq. F�tryg. !! 10. OTHER 'W rri 2-o 1 0 At timetit• application; I was aaVrOT-the at may be changed during the, plan checking process. APPLICANT -16 X =$ Amt. 6 fees are required to be paid prior to issuahc�e of the permit. These fees DATE Pursuant to Government Code Section 66020 'you a 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 ct 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) COPY of Document Recorded 10 -Sep -2004 2004-0055738 AND WHEN RE 5 °ORD1rD MAIL TO: Has not been compared with BUTTE COUNTY BUILDING DIVISION original 7 COUNTY CENTER DRIVE BUTTE COUNTY RECORDER OROVILLE, CA 95965 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_ o PROPERTY OWNERS: State of California County of 5LL)tt < before me, personally appeared i '1 cP ersona y �aewn-te-me-(br proved to me on the "sis of s tisfactoryevidence) to be the pers n(s) who a nam s k/are subscribed to the within instrument and acknowledged to me that hekWthey executed the same in ,his4W/their authorized capacity(ies), and that by hisRrwAheir signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my and and official seal. Signature (�/� Sea]:P TWIIA DELMAR 0 COMM. # 1369973 ® •® o NOTARY PUBLIC -CALIFORNIA A.P. # CSO " VV— O�7s COMM. EXP. AUG. 13,2006'A h 'Preliminary Report Order No. BU -202097 KO Description The land referred to herein is situated in the State of California, County of Butte, and is described as follows: PARCEL I: LOT 6, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "DOMON SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE . OF CALIFORNIA, ON JUNE 19, 2002, IN BOOK 154 OF MAPS, AT PAGE(S) 38, 39 AND 40. RESERVING THEREFROM AN EASEMENTFOR INGRESS, EGRESS, STORM DRAINAGE AND PUBLIC SERVICE PURPOSES OVER BRUNSWICK LANE, AS SHOWN ON SAID MAP. ALSO RESERVING THEREFROM PRIVATE STORM DRAINAGE EASEMENTS FOR INSTALLATION AND MAINTENANCE OF PRIVATE .STORM DRAINAGE FACILITIES, AS SHOWN ON SAID MAP, FOR THE BENEFIT OF LOTS 1 THROUGH 5. THIS DEED IS MADE AND ACCEPTED UPON THE COVENANTS, CONDITIONS AND RESTRICTIONS AS SET FORTH IN THAT CERTAIN DECLARATION OF RESTRICTIONS RECORDED AUGUST 5, 2002, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 2002-39827, BUTTE COUNTY, CALIFORNIA; ALL OF WHICH ARE INCORPORATED HEREIN BY REFERENCE THERETO WITH THE SAME FORCE AND EFFECT AS THOUGH FULLY SET FORTH HEREIN AT LENGTH AND GRANTEES BY ACCEPTANCE OF THIS DEED APPROVE, ADOPT, RATIFY AND AGREE TO THE TERMS OF SAID DECLARATION. APNS 040-080-029-000; 040-080-030-000; 040-100-011-000 AND 046-100-012-000 PARCEL II: AN EASEMENT FOR INGRESS, EGRESS, STORM DRAINAGE AND PUBLIC SERVICE PURPOSES OVER BRUNSWICK LANE, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "DOMON SUBDMSION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JUNE 19, 2002, IN BOOK 154 OF MAPS, AT PAGE(S) 38, 39 AND 40. EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL I, DESCRIBED HEREIN. PARCEL III: PRIVATE STORM DRAINAGE EASEMENTS FOR INSTALLATION AND MAINTENANCE OF PRIVATE STORM DRAINAGE FACILITIES, OVER LOTS 3, 4 AND 5, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "DOMON SUBDMSION", WHICH. MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JUNE 19, 2002, IN BOOK 154 OF MAPS, AT PAGE(S) 38, 39 AND 40. O.B.-1 OWNER -]BUILDER VERTFICATTO N 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. I personally plan to provide the major labor and materials for construction of the proposed property ' rovement :YES O O '2. I HAVE HAVE NOT �sigcned"an application for a building permit for the proposed work. 3. I have o6ntracted with the following person (firm) 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 n4or work NANM: 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 O.F. WORK �tCi`p /0a.v s -0 5dw�e 04- ✓-fie CL,& -^L SIGNED: i PROPERTYO DATE:_ NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification trust be completed and returned to our office before we are permitted to issue the permit: �i • OWNER SUEELDER INFORMATION � Dear Property Owner. An application for a building pmait 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 of record on such a permit Building permits are not required to 6e signed by property owners unless they are personally performing their own work If your work is being perfoanad by someone other than yourself; you may protect yourself from possible liability if that person applies for flee 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 womk with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ♦ 1f you employ or otherwise engage any persons other than your immediate family, and the wodc (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 as employer. ♦ 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 wit hholdbW, federal social security taxes, workm compensation insurance, disability insurance costs, and mmemployment compensation conlnbubions. ♦ 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 mon about your obligations under Federal Law, contract the Intemal Revenue Service (and, ifyou 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, properly owners who are not licensed contractors are allowed to perfohm their work personally or dmigh 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 build=' building permikenmecously imps that the property owner is providing his or her own labor and material personally. Building permits are not requ Trod to be signed by property owners unless they are pm* mining their own work personally. Infh>a nbon about licensed ow actor may be obtained by contracting tine Contractors State. License Board in your commhmity or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner BuWea Verification" on the reverse side of this form so that we can confirm that you are aware of dim matters. The building permit wh71 not be issued until the verification is retmhmad. t. I ,C. Vi na, CB.0 Building Inspection NOTE: Tkt Owner-BuffderWomunion is required by Seddon 19830 of &e CaWornk Health mid Safety Code OVER Department C o u n t s J. Michael Crump, Director Public f B u t Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530) 538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACREI - Project Description: Z 4- �� _`• �, Project Location and/or Parcel Number: fO - Z " a By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I, therefore, do not need to apply for a Construction Storm Water Permit . from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: ' Title: Date: —349 —0 ` C Less than I Acre NPDES & SWPPP Compliance Certification Butte County,Storm Water Management Program Revised 5/12/04 BUTTE COUNTY PARK FACILITY FEE PAYMENT CERTIFICATION FORM DURHAM RECREATION & PARK DISTRICT Assessor Parcel Number: 0�0_ ✓1 D V - 0_7 Property Owner(s): `t _V) r Yo (,L, VU?I- v Project Location/Address: A(UVISW, Subdivision Name: Assessable Square Footage: Type.of Residential Development (check one): t . New Development ' FJ Alteration/Addition U Mobile Home ❑ Non -Residential to Residential Comments: A Buil,di ,.,u...n.g 4i'vision R esentat`ive Date Durham Recreation and Park District (DRPD) certifies that t- bin C4X93 --2999 Appli ant N me Phone Number Mailing Address Has complied with the requirements of the Butte County Board of Supervisors , Resolution No. 04-107 by payment foe —� square feet at $1.41 per ft. fora total payment of $ &5b. H ell ---1) 0 AQar 9123 L bR-PD epresentative Date Paid by Check No.: _� Remarks: Bank No.: Paid by Cash: Receipt No.: 20 38 7 DISTRIBUTION: WHITE - APPLICANT PINK - DRPD YELLOW - BUTTE CO. BLDG. DIVISION a + , 1 •� -rs .�. • ♦ ! L i r ver } .i 'I" 1 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM. ' (One form per Building) ; School District - ( ' , r Building DepartmentNo. o4_► f a 0 A.P. Number (140— nn — 071- Jurisdiction: City =izfcaunty Property Owner Property Location/A Subdivision Lot No. Residential Development Q Q Q Q Sq. Footage No of Living Mobile Home Addition/ *Supplemental to (G up R) r Units Installation Conversion Permit # :............................................................................................... •(No`foundation Inspection) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Addition District Identificatiori No. w x(,007 e�o D L(e glot-m U N / F/F77 School District certifies that Sq. Footage (Including Exterior oofed Areas) Date / (Applicant) &RuN5cv/C_ g L? — a-9 y 9 (Street Address) (Phone Number), 7Ju2u->�•� C'>q 9 s y3 �' - • (City) (State)) (Zip Code) / has complied with the requirements of Resolution No. 0 T " 2 by payment of $ I 3/'?,,3 Y� . representing - square feet. 2926 $ <, FULL MITIGATION $ School District Representative Date Paid by Check # (/ / Remarks: { `' No You may protest the Imposition of the fess knlsntlfled stove by sub6 tting a written protest to the District, in compliance with Government Cods Section 66020(a), within 90 days from the data Hes are. paid. Failure to submit a timely written protest wlil'prohlbk you from challenging the Imposition of the fess In any court action. If, subsequent to the School District Representative signing this Bulb County Schools Impact Fee Certification Forth, the School Distild Is OU by by the applicable Local Planning Agency that this project Is being reviewed under the.Califortda Environmental Quality Act (CEQA) ) ibis project hey bi subject to additional school fess to fully midgab.its Impact on tie school dlsbict's schools. ,'White (applicant), Yellow (building department), Pink (school district) feeform.xls 410/031dmm utte County Department of Development Services )NNE CHRISTOPHER, DIRECTOR O 7 County Center Drive Oroville, CA 95965 N (530) 538-7601 Telephone (530) 538-7785 Facsimile �. TO: ' FROM: 1 SUBJECT: O � DATE: LP2A Scott Rutherford (530) 538-7160 srutherford a buttecountv.net Plans Transmittal For Review Per Contract 7/1/2004 Applicant: IYoung, HenryPermit 04-1920 Project Type: NSF/Deck APN: 040-100-075 100% 70% Plan Check Fees $ 858.80 $ 601.16 $ 858.80 $ 601.16 LP2A Fee $ 601.16 Copies Attached: Qty Chk Application Site Plan Review ' FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other September 2, 2004 Mr. Michael Vieira County of Butte 7 County Center Drive Oroville, CA 95965-3397 Phone: (530) 538-7541 Fax: (530) 538-2140 Re: Plan Review: Address: Dear Mr. Vieira: Young SFD Brunswick Lane County of Butte- FINAL REVIEW Jurisdiction Application No.: 04-1820 . LP2A Job No. 2040015-094 Linhart Petersen Powers Associates (LP2A) has completed a final review of the following documents: 1. Plans: 'Two (2) revised copies Plan Sheets C1 through E1 (7 total sheets) Title/Cover Sheet dated June 29, 2004 (rev. date Aug. 20, 2004) by Evergreen Development. 2:. Structural Calculations: Two (2) copies dated March 17, 2004 by Robert D. McGhie. 3. Title 24: Energy. Compliance Documentation: Two (2) copies dated June 30, 2004,by Evergreen Development 4. Prefabricated Roof Truss Calculations: Two (2) copies dated Feb. 10, 2004 by Longfellow Lumber. The 2001 California Building, Mechanical, Electrical, Plumbing' and Energy Codes were used as the basis of our review. Please note there are no further comments. Therefore, we are recommending approval of the above noted items with the added redlines. Enclosed for your use are the above referenced documents bearing the LP2A plan review stamps along with the applicant's. response letter. Please let us know if you have any questions. Thank you. SincJPT LINHSEN'POWERS ASSOCIATES Rog E. Struer PK:ag Enclosures: Bin 66 fAbutte county 015\butte county 2004\2040015-094-pcf.doc isLINHART PETERSEN POWERS ASSOCIATES 7610 Auburn Boulevard • Citrus Heights, CA 95610 (916) 725-4200 • FAX (916) 725=8242 • Toll Free (877) 235-0653 LAND OF NATURAL WEALTH AND BEAUTY PLANNING DIVISION ,y.t9ok 3�T1�tKtie .t%'�-%� �J�,�5`v�t�f ,.� N A� DEPARTMENT OF DEVELOPMENT SERVICES Nlarc. h`'19,2004 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538 7601 FAX: (530) 538-7785 Henry Young P.O. Box 7872 Chico, CA 95927 RE: Site Plan Review for APN 040-100-075 (Lot #6, Doinon Subdivision) For Your Information. Exhibit "A": (Site Plan Review) Exhibit `B": is a list of conditions related to this parcel and are site specific. Exhibit "C": are conditions related to approval of your parcel. Exhibit "D": (Agricultural Commissioner's statement and recommendation for placement of the dwelling). Please re -submit new plot plans showing the location as recommended by the Agricultural Commissioner. Please review all enclosures to be sure that the information is correct, and that you have incorporated these requirements & conditions into the design of your project. Should you have any questions please feel free to call me between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538-6572. Sincerely, Joseph Bake Planning r nning Manager Attachments. TO LARRY PAINTER tcZ 1 UrUN 1 v SITE PLAN REVIEW APPLICATION Date: .3 %-0 AP# Permit Number (if applicable) Bin Number APPLICANT INFORMATION Parcel Size: O �- Owners Name: K Or �j LAILI=Q Owners Address: 100 %3 o k 7'97 oZ GAiu_� L Telephone No.: -3- a �/ `� Email: Situs Address: %o f ' (, ( c, rr4 -e m PC Proposed Use: Residential 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 Other Septic Agricultural Exempt Building . ❑ Other: Brief Explanation (if necessary): r ❑ Single Family Remodel Cf C) D c �F�I: ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well Agricultural Buffer Form ❑ Applicable ❑ N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) ❑ Approved ❑ Conditionally Approved ❑ Site Plan Stamped Approved By Date Page 1 of 5 ❑ Resolve Problems Prior to Approval �l ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) 100 -Year Flood Plain: (See attached) • Flood Zone: A • Flood Panel No.: . O S 2D C— Index Date: 9 ❑ 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) ❑ Oroville Enterprise Zone 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: - A-1 Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front .5c> c I— Side d Side Street �O L Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 -------------------------------------- Subdivision Map Special Fees Formula 0 in Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel - ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice 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 r Applicable Development Fees: Standard Fees Amount ❑ Fire ❑' School* ❑ Parks/Recreation ❑ Roads ® Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other -------------------------------------- Subdivision Map Special Fees Formula 0 in Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel - ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice 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 r Subdivision Map/Parcel Map: -ba Map Date of Recording Lot: (.0 ❑ Use Permit/Minor Use Permit Permit Number: Book: I H Page: 3 4 C> Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ® Comply with the following Conditions of Approval: 0 Attached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. Page 4 of 5 Nabs THIS ADDITIONAL. MAP SHEET IS FOR INFORMATIONAL PURPOSED ONLY, DESCRIBING CONDITIONS AS OF THE DATE OF FILING AND IS NOT INTENDED TO AFFECT RECORD TITLE INTEREST. A DEVELOPMENT IMPACT FEE FOR SHERIFF'S FACILITIES SHALL BE PAID PURSUANT TO THE PROVISIONS OF CHAPTER 3, ARTICLE II OF THE BUTTE COUNTY CODE, PRIOR TO THE ISSUANCE OF BUILDING PERMITS OR USE PERMIT IN THE CASE OF A MOBILE HOME PARK. SAID FEE AMOUNT WILL BE DETERMINED AND CALCULATED AS OF THE DATE OF APPLICATION FOR THE BUILDING PERMIT OR USE PERMIT. THE HEALTH DEPARTMENT MAY DESIGNATE SEWAGE DISPOSAL AREAS SO AS TO EXCLUDE GRAVEL AND SEASONAL HIGH GROUNDWATER AREAS. DEVELOPMENT OF THESE PARCELS MAY REQUIRE PAYMENT OF WATER TENDER FEES. AUTOMATIC FIRE SUPPRESSION SPRINKLER SYSTEMS SHALL BE INSTALLED IN ALL NEW 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 13'D. ALL NEW RESIDENTIAL SITES SHALL HAVE A MINIMUM LOWEST FLOOR ELEVATION LOCATED ONE FOOT ABOVE THE BASE FLOOD ELEVATION. FLOOD PLAIN CONTOURS SHOWN HEREON WERE DETERMINED FROM THE FLOOD INSURANCE RATE MAP DATED JUNE 8, 1998, PANEL 06007CO520C. HOMESITE LOCATION ON ALL PARCELS SHALL BE APPROVED BY THE DEPARTMENT OF DEVELOPMENT SERVICES AND AGRICULTURE COMMISSIONER"S OFFICE. A RECLAMATION BOARD PERMIT IS REQUIRED PRIOR TO START OF ANY WORK .WITHIN THE BUTTE CREEK PROJECT FLOODWAY, ITS LEVEES & WITHIN 10 FEET LANDWARD OF THE LANDSIDE LEVEE TOES PER SECTION 8710 OF THE CALIFORNIA WATER CODE 6 0 George bomon, Tentative Subdivision Map, AP 40-08-29 and 30 and AP 40-10-11 and 12, 6 lots located on the 'east side of Butte Creek between Ackerman Avenue and Garden Road. Durham area. Engineer: Sierra West Surveying Land Development Division conditions: � Provide 20 feet radius pr,�operty line returns at all street intersections. ok 2 Indicate a 50 ft. building setback line from the centerline "^ of all streets.. 4. •ala ns + 31 ;01��� + 3.� yy,iW.Construct full street section on interior streets and Ackerman rok�,Pccc. .avenue and Garden Road frontage to RS -7A geometric standard. z •fZoAV,� Gror P fi boundary 4 Improve Ackerman Avenue and Garden a from project Usc� a 5-40 to Lott Road to RS -7A road standard. Submit design to County bj�9 orks for approval. "R" value Department of Public Wl IO W determinations and other data may be required to support section desin. dwsree&r S-r���v iuiw j1vizruc-crioll Ar &fere7% r9 A-, ,0 ,+cxge_A4A-A/ Ava C1r�( Provide monumentation as required by the Department of Public Works in accordance with accepted standards. ✓6 Street grades and other features shall comply with the Butte y 'engineering County ordinances, design resolution and other accepted dsl standards. ok Provide permanent solution for drainage. ,V'�7 P,,, 1110 D C All easements of record to be shown on the final map. (9/ Meet requirements of the .Butte County Fire De ap rtment or other 06 responsible agency. Alor,-- vh! A; 17P On Comply with F.E.M.A. requirements and establish 100 year flood X plain elevation. Note flood plain and minimum fwd floor 3.0 ��( elevation on final map. Gv��sT JC� t �h\J 4',2� the requirements of the utility companies (i.e.,, PG&E, a az .,,,Meet Pacific Telephone, water, sewer.) v 0 any delinquent taxes or current taxes as required. 0TV Verify legal access to parcels 1 and 2. �. ..--�- Health Dept. conditions: C11 bProvide a 100 ft. leachfree setback around existing wells either within the property or within 100 ft. of the property 6 boundaries. n� � to + rc, Show a 100 ft. leachfield setback from the highwater line of the creek on parcels 1, 3 and 5. Prove that the required usable sewage disposal area exists on parcels 1-6. Combine with any adjacent parcel any parcel not proven to contain the usable sewage disposal area required by Subdivision ordinance. Comply with the winter groundwater mitigation measure. Meet the provisions of Butte County Code, Chapter 26, Section 26, relative to sewage disposal in flood plains. If applicable, verification that this property is above the ten- year flood elevation will provide compliance. Planning Dept. condition: #, •"11 A development impact fee. for Sheriff's Facilities shall be �1d CX/X14 paid pursuant to the provisions of Chapter 3, Article II of the Butte County Code, prior to issuance of building permits or use permit in the case of a mobile home park. Said fee amount will be determined and calculated as of the date of application for the building permit or use permit. P iaCP_ i be o-aCpr 4 ., r n (}� �tigation measures: s<-;�-N�,.Sft� c ate. �n „Jr rC,. C�'�_. rl ft (af tf'� �!". L:F tet, Sfin �� ,: - 'l b� �i� 5 %�' .�v N,O�i.:-iL� �'�7. `T Ve! )e 0�')rvlPlt iN /IC�*j e/'.f1ei�s-t�t+�f . vC CCw^:"fBS Kihc S {%f•T{C (� Place a note on the additional map of the final map stating: "Automatic fire suppression sprinkler systems shall be installed in all new 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. The purpose of the installation of sprinkler systems is for additional safety and property protection in the event of residential fires. This installation will reduce the demand for structural fire protection services in those instances where they are installed. �2 Place a note on the final map stating that all new residential AoV, sites shall have a finished floor elevation located one foot above the base flood elevation. NOTE: "Minor changes may be approved administratively by the Directors of Environmental Health, Planning or Public Works upon receipt of a substantiated written request by the applicant and only as to those conditions or requirements recommended by their respective departments. Prior to -such approval, verification shall be made by each Department or Division that the modification is consistent with the application, fees paid and environmental determination as conditionally approved. Changes deemed to be major or significant in nature shall require a formal application for amendment. LAJ 00 to ------ ay II PSE 301 -OT 5 1.14 AC ;' ELLi' K Ll NE i' 270' PSDE ---- ------- 5/4-4.13' TT---- '!*-- X 10,0' WELL SETBACK LINE LOT 6 10.00 AC ---- ------ 50' BLDG SUM K U 10 ------ ------------- -- ------------- - - - - - - - - - - - - - - - - - - - - - - - - - 1358.70' CARDEN low,% I N Ir 75.3.0'(M B.47'(C) iE Mo -ENT R,'C E L 1011IE 11 -279 �R. �6312DIE lit V) U 7-1 liz I If co rt ""W —,44.1,3 30.14 (C) II SEE DETAIL FD 3/405 01P .0 LOT 6 10.00 AC 7 . A . . . . . . . . eIf 17. 71.1 ad, L=54.43' 4M I► I 20-' EX. R/W - PER (R2) If II F0. KA[L & TIN 251' L.S. 3334 Lj Lj 347.44'0`8) ,47.44',81) LJ J 1358.70 1 (M, R 2, rz 0 S-8,8-39'37"W(M) Ll 1T 5 14 AC FD 3/4 S89*52'5i II POS ON. rr 1'05" II 11 -279 �R. �6312DIE lit V) U 7-1 liz I If co rt ""W —,44.1,3 30.14 (C) II SEE DETAIL FD 3/405 01P .0 LOT 6 10.00 AC 7 . A . . . . . . . . eIf 17. 71.1 ad, L=54.43' 4M I► I 20-' EX. R/W - PER (R2) If II F0. KA[L & TIN 251' L.S. 3334 Lj Lj 347.44'0`8) ,47.44',81) LJ J 1358.70 1 (M, R 2, rz 0 S-8,8-39'37"W(M) Ll FD 3/4 S89*52'5i FROM CA FROM POS ON. o o FD. 3/4 1 7L.S. 3346 BUTTE COUNTY AGRICULTURAL BUFFER NOTIFICATION AND/OR UNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring adricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on.existing -parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538.7601 1J'��1 ri Ov Phone: t Name: , Mailing Address: E -Mail address Assessor's Parcel Number. 4to - 10 0 -0-75- - ©d Q Reason you believe you qualify for the unusual circumstances exception: �s .Co ac r-v- �:.1 Owner or Auth ized g rat' signat re Date UNUSUAL CIRCUMSTA S DEFINITION: �ei'V �,�a r lot an exis Aq%' Wel_ nenfi�:AL1'H An exceptional or extraordinary condition where the existing size or shape or (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot br�ff r�z o12005 ne. P� form- SITE PLAN REQUIREMENT: submit 4 copies with this handout fors ec�c re uirements CHICO Refer to the Site Plan Submittal ;: ��1 :?l'l: .......................................................P...........................................................:::.:.: internal Dept. Contact lnf : e ❑ Env. Health Drplanning - ❑ BuAdlng ❑ Other Contact Person: Phone: FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING For Agricultural Commissioner office use only: (to be completed after submittal ) .mop DISCRETIONARY PERMITS (Planning) MINISTERIAL PERMITS (Building) ❑ Exception Recommended Exception Granted with the F ] Exception NOT Recommended following conditions: Reason/Conditions/Specific setbacks from adjacent agricultural operations: 14ueke� aqL�J VIASNP d �. .�:n Clf�.t7lr�G Ann (7r?SOn�e.-tipo r6�1;4e 91,9. 41,SJka_ Agricultural Department Signature: �_ Date: 3&1'3/0-4 C12PIA &'--x IMC 7/1103 'FEDERAL EMERGENCY MANAGEMENT AGENCY " °"' 'd:tROW-. V067 -00 - NATIONAL FLOOD INSURANCE PROGRAMs July 31, 30C ELEVATION CERTIFICATE A� Important: Read the Instructions on pages 1 --PHIC01 � L 1 0 a . SECTION A - PROPERTY OWNER INFORMATION .For Insurance Company Use BUILDING OWNE 'S NAME Policy Number BUILDING STREET ADDRESS (including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number -A-(L P Mrti J72tv�' CZip I C� 9 r938E A- IZl NAD 1927 I.1 NAD 1983 L�kUSGS Quad Map " Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM),INFORMATION bi t Nrlr WAAMUNITY NAME S COMMUNITY NUMBER B2. COUNTY NAME I B3. STATE I Du"iTe C-OJrJ> l7�oot-i I' ljUT[- C14, NUMBER DATE FREVISED DATE ZONE(S) go (Zone.AO, use depth of floo 610..'Indic6te the source of the Base Flood.Elevatlon (BFE) data.or base flood depth entered in 89. LJ FIS Profile ISI FIRM L Community Determined LJ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: W NGVD 1929 I_I NAVD 1988. LJ Other (Describe): B12. Is the building -located in a Coastal. Barrier Resources System (CBRS) area or Otherwise Protected Area (OPAJ? "Yes. {.I Ni Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: J_XJConstruction Drawings' LJBuilding Under Construction* LJFinished Constructioi 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number __I__ (Select the building diagram most similar to the building for which this certificate is being completed 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 C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different fro the datum usedfor the BFE in Section B, convert'the datum to that used.for4he BFE. Show field measurements and datum conversio calculation. Use the space provided or the Comments area of Section D or -Section G, as appropriate, to document the -datum conver Datum !k(/� fZ 9 Conversion/Comments Elevation reference mark used StAe o FPD 207 Does the elevation reference mark used a ? LJ.Yes ppear on the FIRM? ❑ a) Top of bottom floor .(including basement or enclosure) % %S 7 ft. (m) W ❑ b) Top of next higher floor ❑ c) Bottom of lowest horizontal structural member (V zones only) --- ft.(m) ( ) n i':' ,.�. sic: e.•. �'.;�• ❑ d) Attached garage (top of slab) ❑ e) Lowest elevation of machinery and/or equipment w' servicing the building 9 -4t .(m) ❑ 0 Lowest adjacent grade (LAG) / 7 r E c .11;r G 12 -31 -OS ❑ g) Highest adjacent grade (HAG.) / 7 5' urns ❑ h) No. of permanent openings (flood vents), within 1 ft. above adjacent grade /v w ( ) 3 ❑ ) Total area of all permanent openings flood vents In C3h ICV,4 p( ) 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 Con this certificate represents my best efforts to Interpret the data available. 1 understand that any false statement may be Punishable by fine orim risonment under 18 U. S. Code, Section 1001. CERTjF rfvTE �� 'Z, Ss� ICENS NUMBER e___1 X JDE � Z lOS`- / COMPANY NAME l l fir/ .S STATEo`t9 �� - c9A 9 �g/°-D7,_? 2�9 Form R1-31. 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' : _ , ° } � •�.�" �+ I UtCiV 1 V L,nit.lJ Ltt �. c= TO LARRY PAINTER SITE PLAN REVIEW APPLICATION Date: ��- %�—D �i AP# Permit Number (if applicable) Bin Number APPLICANTINFORMATION Parcel Size: I_oAc- Owners Name: �J 'e Owners Address: e O A o X 7 97 a GAA_,e� ZSR/ 2.7 5c7) 1- 28 L)Gj Telephone No.: �,G -3- Cr `T Email: Situs Address: Proposed Use: Residential 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 Other Septic Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary): ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well Agricultural 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 By 1 UC Date O Page 1 of 5 Z 0• ALL ITEMS CHECKED XIDPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) ❑ SRA - (CDF to determine specific requirements) 100 -Year Flood Plain: (See attached) • Flood Zone: A • Flood Panel No.: . O S 20 C— Index Date: �— 8 —9 S ❑ 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) ❑ Oroville Enterprise Zone 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: - A-10 Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 AI Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Jr 0 c Side Side Street -S0 L Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2 of 5 AI 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 is Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By Deeds: Date of Creation: Legal Access Provided: Deed of Reference: Legal Access Required Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ No ❑ Yes ❑ No ❑ Yes ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice 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 0 Subdivision May/Parcel Man: E,„j So t3 Map Date of Recording: b' 11 rr Lot: l0 ❑ Use Permit/Minor Use Permit Permit Number: Book: I Jr' Date of Approval: Page: 3 ti Parcel Map/Subdivision Map/Use Permit Conditions is Comply with the following Conditions of Approval: Z Attached ❑ None ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. D V Page 4 of 5 NOI.ES: THIS ADDITIONAL MAP SHEET IS FOR INFORMATIONAL PURPOSED ONLY, DESCRIBING CONDITIONS AS OF THE DATE OF FILING AND IS NOT INTENDED TO AFFECT RECORD TITLE INTEREST. A DEVELOPMENT IMPACT FEE FOR SHERIFF'S FACILITIES SHALL BE PAID PURSUANT TO THE PROVISIONS OF CHAPTER 3, ARTICLE II OF THE BUTTE `COUNTY CODE, PRIOR TO THE ISSUANCE OF BUILDING PERMITS OR USE PERMIT IN THE CASE OF A MOBILE HOME PARK. SAID FEE AMOUNT WILL BE DETERMINED AND CALCULATED AS OF THE DATE OF APPLICATION FOR THE BUILDING PERMIT OR USE PERMIT. THE HEALTH DEPARTMENT MAY DESIGNATE SEWAGE DISPOSAL AREAS SO AS TO EXCLUDE GRAVEL AND SEASONAL HIGH GROUNDWATER AREAS. DEVELOPMENT OF THESE PARCELS MAY REQUIRE PAYMENT OF WATER TENDER FEES. AUTOMATIC FIRE SUPPRESSION SPRINKLER SYSTEMS SHALL BE INSTALLED IN ALL NEW 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 130. ALL NEW RESIDENTIAL SITES SHALL HAVE A MINIMUM LOWEST FLOOR ELEVATION LOCATED ONE FOOT ABOVE THE BASE FLOOD ELEVATION. FLOOD PLAIN CONTOURS SHOWN HEREON WERE DETERMINED FROM THE FLOOD INSURANCE RATE MAP DATED JUNE 8, 1998, PANEL 06007CO520C. HOMESITE LOCATION . ON ALL PARCELS SHALL BE APPROVED BY THE DEPARTMENT OF DEVELOPMENT SERVICES AND AGRICULTURE COMMISSIONER"S OFFICE. A RECLAMATION BOARD PERMIT IS REQUIRED PRIOR TO START OF ANY WORK .WITHIN THE BUTTE CREEK PROJECT FLOODWAY, ITS LEVEES & WITHIN 10 FEET LANDWARD OF THE LANDSIDE LEVEE TOES PER SECTION 8710 OF THE CALIFORNIA WATER CODE. I!� %w v George Domon, Tentative Subdivision Map, AP 40-08-29 and 30 and AP 40-10-11 and 12, 6 lots located on the east side of Butte Creek between Ackerman Avenue and Garden Road. Durham area. Engineer: Sierra West Surveying Land Development Division conditions: 6?90 Provide 20 feet radius p'rpperty line returns at all street intersections.` ok 2Indicate a 50 ft. building setback line from the centerline of of all streets . �, plans 3l'01 /---.�kei ct• �3 �cConstruct full street section on interior -streets and Ackerman 11 0,c avenue and Garden Road frontage to RS -7A geometric standard. r'0 fZoAV 4 Improve Ackerman Avenue and Garden - +_ye from project boundary 40 to Lott Road to RS -7A road standard. Submit design to County Department of Public Works for approval. "R" value determinations and other data may be required to support section desZger-MA-Al . dwsrf c- r ,rrlwp�'b lurul jlj7 rueer/9l-/ 4.r eDDparvW �® Avg. Provide monumentation as required by the Department of Public Works in accordance with accepted standards. ✓6 Street grades and other features shall comply with the Butte y County Ordinances, design resolution and other accepted OSI engineering•standards. Ok 7 Provide permanent solution for drainage. 4,a&c,� '1 v-eAx, (-r�em� f On bSr 1110, P"+ 16K s All easements of record to be shown on the final map. 14 Pk S/ Meet requirements of the Butte County Fire Department or other 66 iA_4r responsible agency. ,U0725 aA/ A4;4,P b� Comply with F.E.M.A. requirements and establish 100 year flood X plain elevation. Note flood plain and minimum f-!TA9E*d floor elevation on final map. off. UD •yr;zy`6 llf� Meet the requirements of the utility companies (i.e.,, PG&E, - Pacific Telephone, water, sewer.) v 0 -s'?Y t 12 �r,q Pay any delinquent taxes or current taxes as required. p�j 91 Verify legal access to parcels 1 and 2. Health Dept. conditions: �W 1 lb� Provide a 100 ft. leachfree setback around existing wells either within the property or within 100 ft. of the property 6 boundaries. COt� PCr:. ,M Show a 100 ft. leachfield setback from the highwater line of the creek on parcels 1, 3 and 5. Prove that the required usable sewage disposal area exists on parcels 1-6. Combine with any adjacent parcel any parcel not proven to contain the usable sewage disposal area required by Subdivision Ordinance. Comply with the winter groundwater mitigation measure. Meet the provisions of Butte County Code, Chapter 26, Section 26, relative to sewage disposal in flood plains. If applicable, verification that this property is above the ten- year flood elevation will provide compliance. Planning Dept. condition: n.(ei -D ctf LA '.o. ----- joy 81.4 301 -OT 5 1.14 AC ELL K LINE 11 270' PSDE ► PSDE -5144.13, T 100' WELL \�-SETBACK LINE LOT 6 10.00 AC --------- r - - 50' BLDG SETBACKM L yE -0 ---------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1358.70' CARDEN r v.-- \ B -.47'(C tMAENT 'CEL 1011 a*47'35*"W -9 544.13'(0) 30.14 (C) SEE DETAIL FD ... . .. ... . . ...... LOT 6 10. 0,0 AC R -;V r= , se, 3-8err 15� -3-4.43 rl- I IV 20' EX. R/V - rr PER (R2) FD, NAIL & TIN 251' L.S.L 3334 : - --z - 41. 0 o S,0-8-30'37jqw(m) 1358I.70'(KR2AI� FD ,T 5 4 AC 0M CA POSITION. II C) 1,05 II 11 a*47'35*"W -9 544.13'(0) 30.14 (C) SEE DETAIL FD ... . .. ... . . ...... LOT 6 10. 0,0 AC R -;V r= , se, 3-8err 15� -3-4.43 rl- I IV 20' EX. R/V - rr PER (R2) FD, NAIL & TIN 251' L.S.L 3334 : - --z - 41. 0 o S,0-8-30'37jqw(m) 1358I.70'(KR2AI� FD. 3/4 1 3346 FD 41.s 0M CA POSITION. C) FD. 3/4 1 3346 FEDERAL EMERGENCY MANAGEMENT AGENCY -• '6-' -B'. f�ti '3067-00' NATIONAL FLOOD INSURANCE PROGRAM s July 31, 0 se -,ELEVATION CERTIFICATE A� Important: Read the instructions on pages 1 - 7'. fto C: L1Frjc=j ice. SECTION A —PROPERTY OVVNER INFORMATION For Insurance Company Use BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number C��42�[ry 17i2c�Je' ( ##° - #9 - ##.W or NUMBER• car-- 9 V93s 1111 NAD 1927 JJ NAD 1983 LJUSGS Quad Map L Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM)_INFORMATION DATE REVISED DATE I • ZONE(S) 90 I B3. SC& (Zone.AO, use depth of floo f 610.:Indicate the source of the Base Flood Elevation (BFE) data.or base flood depth entered In 69. LI FIS Profile IXI FIRM LJ Community Determined LJ Other (Describe): B11. Indicate the elevation datum used for the BFE in 69:1)9 NGVD 1929 LI NAVD 1988. LJ Other (Describe): B12. Is the building located in a Coastal. Barrier Resources System (CBRS) area or Otherwise Protected Area (Q PAY? L j Yes. {.J N( Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: LXJConstruction Drawings' LJBuilding Under Construction* LJFinished Constructioi 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number _L_ (Select the building diagram most similar to the building for which this certificate is being completed 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, V1430, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different fro the datum used for the BFE in Section 6, convert'the datum to that used.for:the BFE. Show field measurements and datum conversio calculation. Use the space provided or the Comments area of Section D or. Section G, as appropriate, to document the datum conver Datum N�✓� ConversioniComments Elevation reference mark used SUM -re FD 2¢7 Does the elevation reference mark used a O a) Top of bottom floor (including basement or enclosure) % %ft g PPear on the FIRM? LJ Yes ❑ b) Top of next higher floor (m) O c) Bottom of lowest horizontal structural member (V zones only) _ ft.(m) O d) Attached garage (top of slab) ( ) o o a r! O e) Lowest elevation of machinery and/or equipment ' tt (m) E ` .1 ` / servicing the building q o C f ' O Vo 10 0 Lowest adjacent grade (LAG) ,,Yi r, 12-31-05 / 7 S QZptt.(m) z m ❑ g) Highest adjacent grade (HAG) / 7 S �CR.(m) �' i' ❑ h) No. of permanent openings (flood vents)•within 1 ft. above adjacent grade iv .¢ fl `-'�� OF ;etc` =fes O D Total area of all permanent openings (flood vents) In C3h 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 Con this certiricate represents my best efforts to interpret the data available. l understand that any false statement may beunishable b rine orim risonment under 18 U. S. Code, Section 1001. CERTjF PC NS r/ E 1Z /. SSA ¢ 9 C STATE ZIP CODE "!5/r�iS ' . C'04 9 F96 7..,3 z4z�9 FFMA Fnrm R1-31. AIIC, 99o SFF REVERSE CInF FnP r`nKITIKII BUTTE COUNTY AGRICULTURAL BUFFER NOTIFICATION AND/OR UNUSUAL CIRCUMSTANCES REQUEST Butte County requires a 300 foot buffer between neighboring agricultural operations and a residence. This dimension is based on environmental assessments and studies. The Agricultural Commissioner may identify unusual circumstances where the 300 foot buffer cannot be met on existing -parcels. This exception is not available for lots being created, divided or subdivided. Owner or Authorized Agent must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (530) 538.7601 Name: A%ZOv Phone: get : Al � Mailing Address: 0 e- o Ci `� 0L7 E -Mail address Assessor's Parcel Number. 6 tt0 -160 - 0-? 5'- 0 d 0 Reason you believe you qualify for the unusual circumstances exception: c� c !vac •Co LSC r,�e_ LSI// / iKa, S 7`� � �O� Q�/l CP• 1�F�� � � �iV�-�'\ Owner or Auth ized g .rat' signat re Date UNUSUAL CIRCUM ST S DEFINITION: An exceptional or extraordinary condition where the existing lot size or shape or an exstY ecdnf-irrL7' (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot bg�rzone. A 2 2004 this form `I SITE PLAN REQUIREMENT: submit 4 copies with Refer to the Site Plan Submittal handout forspecific requirements CHICO, CALIF0, ....................................................•................RN lnternal�Dept. Contact Inf�� [3 Env. Health Planning ❑ Bund1mg ❑ Other Contact Person: Phone: • �• FORWARD THIS FORM TO LARRY IN DEVELOPMENT SERVICES FOR PROCESSING :...........-... ........................................................................................................................................................................ For Agricultural Commissioner office use only: (to be completed after submittal ) r DISCRETIONARY PERMITS (Planning) MINISTERIAL PERMITS (Building) [] • Exception Recommended Exception Granted with the Exception NOT Recommended following conditions: Reason/Condidons/Specific setbacks from adjacent agricultural operations: F��2� erS a��a� ►Mai d As, 0�4 -,--- Agricultural Department Signature: CV -1c_ V Date: 3Zr3L,4 It erj� 1MC 7/1/03 I I t u e County vs, k� } �" • 4 L A N D O F NATURAL W E A L T H A N D B E A U T Y PLANNING DIVISION, DEPARTMENT OF DEVELOPMENT SERVICES `:1Vlarch 19;2004 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530) 538-7785 Henry Young P.O. Box 7872 i Chico, CA 95927 RE: Site Plan Review for APN,040-100-075,`(Lot 46, Domon Subdivision) For Your Information. Exhibit "A": (Site Plan Review) 1 Exhibit "B": is a list of conditions related to this parcel and are site specific. Exhibit "C": are conditions related to approval of your parcel. Exhibit "D": (Agricultural Commissioner's statement and recommendation for placement of the dwelling). Please re -submit new plot plans showing the location as recommended by the Agricultural Commissioner. Please review all enclosures to be sure that the information is correct, and that you have incorporated these requirements & conditions into the design of your project. Should you have any questions please feel free to call me between the hours of 8:00 a.m. and 4:00 p.m. Monday through Friday at (530) 538-6572. Sincerely, COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California' 95965 • Telephone (530) 538-7541 PERMIT NO. (,Rqw,:12/96) APPLICATION AND PERMIT 400>, - Z-) ASSESSOR PARCEL NUMBER 040-100-075 ZONING BU I LDI NG P ER M IT OWNER KIMBERLY YOUNG TELEPHONE 895-1910 SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS 1890 CUMMINGS LN DURHAM 95938 CONTRACTOR'S NAME �7�7�� OWN 1\ TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS GARDEN RD DUREAM Energy Plan Checking Fee $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other ELEC FOR WELL SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: ELK FOR IM-1-14JRZIER I D0.4m Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 1@20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 "OOVOR LE Main Service 200A OR LESS 23.00 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 I No. OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law ff r the following reason: Ga' 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 I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit 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 Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCOUP. OR ADDNS. ( a ACC. S. SO 3.50FT. NON N.R SID. MULTI.O RCUTITS @7,50 POWER APPARATUS a SINGLE OUrLET CSI R. Ex, Occup. OUTLET OR FORURES BAL p':s50 Ex. Occup. 0FucFEED R p,OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE_ INSP 00 PERMIT FEE —23 $ MECHANICAL PERMIT Fling Fee 1 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S 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.) LI 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. 01 2 X . Date — �_') ig of ppilcant - Owner ❑ ontractor ❑ Agent An OSHA per itis requl edr excavatio"ver ver 5"VIA-pep and demolition or construction of structures over 3 stori . height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 66.00 H CDF PARCEL I PD HD I G E This permit is hereby issued under the of the Butte County Code and/or Resolutions indicated above for which fees have By lri PERMIT EXPIRES ONCTN11 applicable provisions to do work been paid. at Ll ate Receipt No. a WHITE-D.D.S.-B.D. CANARY-ASSESTO�, INK -INSPECTOR GOLDENROD -APPLICANT M h ti d 4 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET G /l OWNER ASSESSOR PARCEL NUMBE (O -' �V U� 07 Proposed Building Use: (G� Counter Technician.cw" Date: 0 / Items required in order t pply for a permit. All boxes MUST be checked OR marked NA in order er to apply. ❑ L. Plot plans, 3 or 4 sets, signed ty the preparer of the plans. ❑ 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. Energy compliance design and supporting documentation in duplicate. ❑ ti6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the en ineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ }' ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................... 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... r _ '❑ 13. Other - Remaining items needed to issue the permit. (May require additional plan review upon receipt of the followinj items.) ❑ 14. Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ❑ 15. Statement of Intent for Non -heated and A/C Buildings ............................................. ❑ 16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit........................................................................ ❑ 18. California Department of Forestry plan approval ❑ paid. Sent by: ...................... ❑ 19. Planning approval for (A) Use: (B)Parking: , (C) Parcel Check: ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage ............................... 1. Encroachment Permit fir drive ay from the Public Works Dept. construction approval prior to occupancy). 2"'22. Pre -Inspection for U r required ................ ❑ 23. Contractor's license mformat 'n. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number .............................................. t ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Exiting violations and/or expired permits......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. OtAr: i When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit Applicant: Date: F _ ?i,� 3 1. Index permit application for tk�jbove items numbered: 2. Additional items required J Contractor, designer wrier as advised cf the above data by hone, ❑ mail, ❑ counter, by Contractor, designer, wrier, was advised of the above data by phone, ❑ mail, ❑ counter, by Plans reviewed by: Date: Plans approved by: Structural reviewed by: Date: Structural approved by: Note transfer by: Date: Yellow RuildinQ Divicion 'ZA Plan Check Letter _Date: _Date: Date: Date O.B.-1 OWNER-BUII,DER 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: YES M"- NO 11 Q2J I HAVE [ HAVE NOT��gned 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: 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: DATE: 6 — % `1— NOTE. This Owner -Builder Yer07cation is required by Section 19831 and 19832 of the California Health and Safety Coda This vertl7cation must be completed and returned to our office before we are permitted to issue the permit. OVER OWNER BTJIELDER INFORMATION Dear Property Owner. An application for a budding 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 of record on such a permit Building pemmrts 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: ♦ 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. ♦ 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 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 subcont wtor, 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 owned is providing his or her own labor and material personally. Budding 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 budding permit will not be issued until the verification is returned. IMcIC. Vi ira, C.B.O. Building Inspection NOTE: This Owner -Builder Lzforrnadon is required by Section 19830 of the California Health and Safely Code. COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive Oroville, California 95965 • Telephone (530) 538-754 PERMIT NO. (Rev. -V2196) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER AO� ` ZONING BUILDING PERMIT �� J OWNER TE HONE !D SQ. FT. OCC. BUILDING VALUATION OWN 5 'UNG ESS 144, •,� �( I TELEPHONE ONTRACTOR•S MAIUNG ADDRESS NS CTION LENDER DEB'S MAIUNG ADDRESS Fireplace Total Valuation $ RECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ HITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ B ING ADDRESS Energy Plan Checking Fee $ $ PERMIT FEE $ NO. SUBDNISION'SNAME MAI PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE Solar or heat pump water heater 23.00 ❑ Duplex ❑ Mobilehome ❑ Other 9 Water piping 15.00 sPECII Each gas water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.00 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Building sewer 15.00 Mobile Home I S G I W @20.00 Describe Work: PERMIT FEE $ /O ELECTRICAL PERMIT Fling Fee 20.00 •ODV OR LESB 23.00 �•3. Main Service aow oR" Main Service tow TO 1000A 46.00 NEW CONST. DWELLING OCCUP. .3 rJ¢SO• OR ADDNS. ( 8 ACC. BIDS. FT. NEW CONS MULTI.OUTLEi 7.50 .PERMIT FEE PAID $ NONRESID. C � @ FOWER APPARATUS 8 SINGLE OUTLET CSR. 20 OUTLET OR FDCTURES @ '.00 . EX. OCCU BAL @ .50 FIXED APPLNS.R I Ex. Occup. OUTLETS E.SID )EA 5.00 SRA$ Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 SHERIFF $ - 3.w PE MIT FEE $ (OG tu MECHANICAL PERMIT Filing Fee 20.00 OTHER $ Heating Coolin Hood . 6.50 $ Ventilation PERMIT FEE $ Mobile Home Installation Fee $ $ Energy Inspection Fee $ CCC CONST. TYPE TOTAL FEE $ HAZ p. FEES IMP FLOOD CDF PARCEL PD HD ISSUE AMOUNT RECEIVED $ V=e- C`� This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work DATE RECEIVED. �xv/11) indicated above for which fees have been paid. C.� By Date RECEIPT # ��� 1 ��` PERMIT EXPIRES ON Dere .:...:... : PRE -INSPECTION.. REPORT ,:.: OWNER: (M DATE: 0 • • G i� , 1, • It ! s • CONTRACTOR: PRE-INSPETION FOR- WN -0412a DATE TO i • PERMIT HLSTORY. •NE )AS FOLLOWS, BUQ,DING INSPECTOR'S REPORT Building Description: Commercial/Usage: Residential/# of Units: Electric: Gas: Currently Occupied AbandonedNacant Yes No Electric currently On Off Condition of Electric. Natural Propane None _ Currently On Off Obvious Problems: Sanitation: Plumbing Working Well Working Obvious SewageProblems Potable Water Comments: J ACTION RECOMMENDED: ISSUE: HOLD FSR Date— v Sketch buildings on reverse and indicate location on property. I 'e'r .. (Rev.12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive Oroville, Calif&nnia'95965 • Telephone (530) 538-754 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER -_ 0UILDINGPERMII TE NONE SO. FT. OCC. BUILDING VALUATION OWNER /O i pyr 5 LING WtOESS ` CONTRACTOR'S NAME TELEPHONE CONTRACTORS MOILING ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHRECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGNEERS MAILING ADDRESS Plan Checking Fee RUILDINGADORESS Energy Plan Checking Fee $ PERMIT FEE S LOT NO. SUBDN510N'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE Solar or heat pump water heater 23.00 SF ❑ Duplex ❑ Mobilehome ❑ Otherjq Water piping 15.00 SPECIFY Each gas water heater or vent 15.00 TYPE OF WORK Gas piping system 1 - 5 outlets 15.00 New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other Building sewer 15.00 Mobile Home S G1 W1 @20.00 Describe Work: PERMIT FEE $ /O ELECTRICAL PERMIT Fling Fee 20.00 Main Service ioonoaLEss 23.00 73. .PERMIT FEE PAID SRA SHERIFF OTHER :J AMOUNT RECEIVED $ (D(e - C7 � DATE RECEIVED. � U RECEIPT BUTTE COUNTY (DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042828 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 07/27/2005 APN: 040-100-075-000 the Business and Professions Code, and my license is in full force and effect./ — (� -Z?S�Q�b License Class: Number: Site Address: 1956 GARDEN RD DUR 1Licensre Date: �"�� Contractor: W j S �1 e g Map Index: Description: FIRE SPRINKLERS FOR BP03-2641 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: YOUNG, HENRY to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of P O BOX the Contractor's State License Law (Chapter 9 commencing with Section 7872 7000) of Division 3 of the Business and Professions Code) or that he or CHICO, CA 95927 she is exempt therefrom and the basis for the alleged exemption. Any (530) 893-2999 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: YOUNG, HENRY Code: The Contractors' State License Law does not apply to an pp owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, P O BOX 7872 provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one CHICO, CA 95927 year of completion, the owner -builder will have the burden of (530) 893-2999 proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, Contractor: SQUYRES JR, WILLIAM and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). P O BOX 3176 ❑ I am Exempt under Article 3 of the Business and Professions Code CHICO, CA 95927 Date: Owner: License #: 275206 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 Architect: is issued. ❑ I have and will maintain workers' compensation insurance, as Engineer: required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S.F. Policy #: Valuation: $0.00 I certify that in the performance of the work for which this permit is Census Code: issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. hc Date: I © I V r„ \� Applicant:JV �`(') (71 l WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is h by issue nd tJalpzbleprovisions of the Butte Cnunty Coda 2nrVnr I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Resolutions do work ' icated bwhich fees have been paid. Name: By: Date: -?^ 2 7 —D Address: PERMIT EXP ES ON: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ' ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled constructidn of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or docum t Butte County. I hereby authorize representatives ofB tte County to enter upon the above mentioned property for inspection pu ses. Print Name: 1 1 A Yti �; S N ,r Signature: .-�� N Date: I ❑ Owner Contractor 0 Agent for Owner ❑ Agent for Contractor �13T r BUTTE COUNTY 0 o DEPARTMENT OF DEVELOPMENT SERVICES 0 0 BUILDING PERMIT APPLICATION > 0 AND SUBMITTAL REQUIREMENTS - - •-• ° 0 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 _0 OFFICE #: (530) 538-7541 OUR A FEE WILL BE REQUIRED AT TIME OF APPLICA TION "PLEASE PRINT CLEARLY": OWNER Last Name 0 kAn G First N me >, Addres, O 13 '7 Z City G� State ti Zip j Phone -530 $y3 - 2^tqL I Fax V T3 , al E-mail � — Sq t - c1i q CONTRACTOR t(ti Name \-j W In Address , x . G City G Stat V� \�C ►V Zipgt I J / ne �4)CD)-z Faxr3ail Lic. ZO EE- Cless 14 APPLICANT NAME ARCHITECT/ENGINEER Name City �NIC.O Address Phone1 s_ I City State Zip Phone Fax E-mail State License Number APPLICANT NAME Name es Address O 1 0 3 17 / City �NIC.O SStta C �7 1 Phone1 s_ I 1 J b E-mail APPLI T SIG RE X --t M V For office use only: Zoning Flood Zone Sq. Foot3ge SRA Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BP.,3 -z8 BIN # . WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. I LENDING AGENCY Name I Address i I Description or ScopeofWork: s lcr 5iTe Sq. Foot3ge ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note prev'ous use): EXPIRATIO ?OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application aft4lexpiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. •-y�reY request must be made prior to the expiration of the permit and no."onstruction work has been done. Filing fees, plan check fees for ork plan checked and other department costs are not refundable. Received by: j2o Amount: ltoll • 900' Bldg OVER FOR SUBMITTAL REQUIREMENTS It K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 1 of 2 «� �{ SRA Receipt #: Sheriff t� SMIP .' Other Date: 9 . Zg -Jo4- og • 9r�' Total REV 6-165-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION. 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: a t_, �.i c. ASSESSOR PARCEL NUMBER 54-d'>- t oe�-) • en ->:75 r -- Proposed Building Use: 1:71 ►2 F 2 _1 +L. l.. E- Y-� Counter Technician: 44 ` Date: f 04 - Items 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. ❑ 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. ❑ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (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 ❑ 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 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: (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 ........................... ❑ 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......................................................... El36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone /3G s��tq and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: r Date:�Y%� 1. Index permit ,plication for I e above it s n bered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advise oet e above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advise'd'oI the abov data y ❑ phone, ❑ mail, ❑ counter by Date: Plans reviewed by: _Date: 0 Plans approved by: Date:.D / Structural reviewed by: Date: F Structural approved by: Date: Note transfer by: Date: Yellow: Building Division 5 1. Fire sprinkler installation and supply system shall comply with NFPA 13D-1999 Edition. 2. Where stored water is used as the sole source of supply, a tank float switch must be set to maintain 10 times the minimum quantity of water determined by the listing and calculations. (7 times for exception to section 2.1). Tank float switch must be set to maintain 281 gallons minimum useable water storage in tank. 3. Provide adequate protection against freezing for system components outside or in the unconditioned space. 4. The fire sprinkler system shall be tested for leakage at normal operating pressure. 5. Provide 1 extra sprinkler of each type used and a wrench. 6. Residential sprinkler heads must be at least 8 feet apart. 7. The owner is responsible for the condition of a sprinkler system and shall keep the system in normal operating condition. 8. Sprinklers shall not be painted with the exception of those painted with factory - applied coatings. 9. See plans and specifications for other requirements. 10. Minimum of Um required at si. . DERT" APPROV,'cr" HYDRONICS: RESIDENTIAL FIRE SPRINKLER HYDRAULICS !2.1 SUBMITTAL. CON'.VRAC".V(At: W11A,1AM P. o I? F1101: (5.10) 34') 1 01 2 ADDRESS: PO BOX 3176, CHICO. CA 95927-13170 Date: 9-25-2004 File: YOUNG JOB: YOUNG RESIDENCE, 2 HEADS FLOWING Page I STATIC 50.0 RESIDUAL 40.0 Psi FLOW 35 GPM SPRINKLER MANUF ELIABLE MODEL : Fl/RES/49�; MIN SPR FLOW A.0 GPM MIN SPR PRES 8.�2 Psi_ NODEE TION K PRESSURE DISCHARGE NO.Psi ET FACTOR GPM ------ -------- -------------------------------- ---------------------------- 1 2.0 4.90 8.2 14.1 2 AJ12. 0 4.90 8.2 14.0 3 i912. 0 8.8 4 12.0 12.7 5 3.0 SOURCE 1.9.0 co - SPRINKLERS FLOWING 2 0 AREA PER SPRINKLER 256 Sq.Ft. q, TOTAL DESIGN AREA 512 Sq. F V- W. SO REQUIRED DENSITY .05 GPM/Sq.Ft.on ;", : ,ling )t COMPUTED DENSITY .05 Gpin/Sq. FL. -4c. 275206 TOTAL SPRINKLER FLOW 2 8. -1 GPM TOTAL DOMESTIC FLOW 0.0 GPM TOTAL WATER REQUIRED 28.1 GPM TOTAL SPRINKLER PRESS 19.0 Psi WATER METER LOSS 0.0 Psi C-) SOURCE VALVE FIXED LOSS 0.0 Psi @ SOURCE Copyright(1991) SUPPLY PRESS AVAILABLE 43.4 Psi by DEMAND PRESS REQUIRED 19.0 Psi Hydronics Engineering PRESSURE CUSHION 24.3 Psi 34119 Fremont Bl, Suite 609 Fremont, Ca., 94555 (415) 487-9160 MAXIMUM VELOCITY 9.3 FIS k COUNW**�' )EPAIRTMEIM. IObEO i. HYDRONICS: IJ� �lI0��Dl SJB4I����. Page J C0N118/\CT08: NIJI M y- ", .||<. |'|V/( |'K�r|'|o]' ]U) ]4!)-|0|2 ADDRESS: PO B0�[3l76. COI 8 9SY27-\}76 � Date; 9-25-2004 File: YOUNG JOB: YOUNG RESIDENCE, 2 HEADS FLOWING PIPE BEG FLOW K -FACTOR LENGTH C -FACTOR PRESSURE NO. Qpm FITTING TYPE FTG FR- LOSS poi END DIAMETER TOTAL (Poi/Ft) -------------- l ----------------------------------------------------------- g~ 14.1 lI= 4.90 I,~ 9.0 PL 8.2 Pt 8.2 1 Q= 14.1 F=LR F= 8.0 C= I50 De 0'0 Pv -0'I // \/el = � 7 ' ~ D l I09 ' %,�= I7 O . 8 O342 . �� . D 6 �o 8 I ' 3 Pt 8.8 --------- -------------------------------- --------------------------- J g= 1.4.0 l{= 4.90 I,= O. b PL 8.2 Pt 8.2 2Q= 1-4.0 F=LB F= 12.0 C= 150 De 0.0 Pv -O.l ~ | ^ �el� 4.� D~ l.lO9 TI,� 20 ' 0'0339 Pf 0.7 Po 8.0 3 Pt 8.8 ---------_ ------------------------_----------------------------_------ . ] cI= 0 O ' - ' � U 0O T '~ l6 » '.- �C 8 8 ' �� ^ 8 8 3 (�~ 28.0 F=2IJl F= l5.D C= 150 De 0.0 Pv -0.6 � VeI= 9'3 D= I'109 IL= 31';0 0'I227 Pf 3.8 Pu 8.2 4 ' Pt 12.7 --_------- � . --------------------------------------------------------------- g= 0.0 l(= 0.00 T.� 9.0 pt 1.2.7 PL 1.2.7 4 O~ 28.0 F=4BS F= 11'0 C= ISO De 3'9 Pn -0.6 Vel= 9'3 D~ 1.109 IL= 20'0 0.I227 Pf 2'5 Pu I2'1 S Pt 19.0 ------------------------------------------------------------------------- Metec = 0.0 Valve ~ 0.0 ------------------------------------------------------------------------- S ------------------------------_-----_--------|-_-------------------------- [)= 28.0 ^«< SOURCE >>> Pt 19.0 E=>4S-Elb I,=»90-IIIl» B=>TeeBcb 8~>TeeRnu C~>ConPlg S=>SwgChk G=~QatVln i HYDRONICS FIRE SPRINKLER HYDRAULIC GRAPH PSI 100 + j 90 + 70 + 60 + 50 X Static X X X 40 + X Resid 30 + 20 + 1* Spr Sys 10 + Elev Loss 0 ++--+---+----+----- 0 200 300 400 JOB: YOUNG RESIDE X - Water Supply Cu Static 50.0 P Residual : 40.0 P '� Viz• -+ - - - - - - - - +-- - - - - -- +----------+------------+ 600 700 i .bo 900 1000 1.85 -(GPM) HEADS FLOWING * - Water Demand Curve Avail Press 43.4 Psi @ 28.1 Gpm Req'd Press 19.0 Psi @ 28.1 Gpm Model F1 • Cauti%o,Ihn • • #.W yT Mpb kMWi/3MC!+°r•ff aw�xMtMY&rYI+K� Read Carefully! Installation Instructions & Technical Data (Details in bulletins 035 & 135) • Model F1 Res 49 Pendent • Model F1 Res 49 Recessed Pendent / F1 (F1 escutcheon, adjustment) F1 Res 49 Pendent F1 Res 49 Recessed Pendent/F1 • Model F1 Res 49 Recessed Pendent / FP (FP push-on/thread-off escutcheon) • Model 171 Res 49 CCP Pendent F1 Res 49 Recessed Pendent/FP F1 Res 49 CCP Pendent . Model F1 Res 40 HSW . Model F1 RES 40 Recessed HSW/F2 (F2 escutcheon, adjustment) F1 Res 40 H5w F1 Res 40 Recessed HSW/F2 Max Sprinkler Spacing it (m) 12 x12 (3.6x3.6) 14 x 14 (4.30.3) Technical Data Sprinkler Temp. x Max. Ambient Max. Ambient K Sprinkler Thread Size Rating Max Pressure Tem Length - p' Factor Inch •F •C •F 'C 'F 'C - - /z' NPT 155 68 175 psi 100 38 4.9 2.25 66-(5_Z) (R'/7) _.. 175 79 (12 bar)- -1 -- - - 50 -- Max Sprinkler Flow Pressure Sprinkler Identification cin Spacing gpm (Lpm) psi (bar) Number (SIN) ft 7.0(0.48) 12 x12 (3 6x3 6) - 13 (49�_ 7.0_(018) _ 14 x 14 (4.3x4.3) 13 (49) 7.0 (0,48) 16 x 16 (4.9x4.9) 13 (49) 7.0 (0,48) R3516 18 x 18 (5.5x5.5) 17 (64.3) 12.0 (0.83) 20x20(6.1x6.1) 20(75.7) 16.6(1.14) Technical Data Sprinkler CCPAss embi y Temp. x Max. Ambient Sprinkler K Length Thread Tem . Size Rating p Rating Pressure Temp. Factor Inch (mm) •F •C •F 'C 'F 'C - - /2' NPT r 5 r (R,/,) 15.E 68 13� �7 175 psi 100 38 (12 bar) 150 f�Ei 4.9 2.25 (57) Max Sprinkler Flow Pressure Sprinkler Identification Spacing It (n qpm (Lpm) psi (bar) Number (SIN) 12 x 12 (3.6x3.6) 13 (49) 7.0 (0.48) Rating 14 x 14 (4.3x4.3) 13 (49) 7.0(0.48) 16x 16 (4.9x4.9) 14 (53) 8.2 (0.56) R3516 18 x 18_C5.5x5.5) -18 (68_1) _ ..... 13.5 (0.93) -_ W' NPT (R '/,) 20x20 (6.1x6.1) 20(75.7) - -,-- 16.6(l.14) _---__-. •F g y m psi De ec or C1 pm (bar) Inch (mm) Number (SIN) 155 (68) 175 (79) 155 (68) 175 (79) 13 (49.0) 16x 16(4;9x4.9) 155 (68) 17 (64.3) 16 x 16 (4.9x4.9) _ 175 (79) 18 (68.1) 16 x 18 (4:9X525) 155 (68) 175 (79) 20 (75.7) 18 x 18 (5.5x5 155 (68) 175 (79) 22 (83.3) 16 x 20 4.9x6.1 155 68 175 79 23 87.0 12x 12 (3.6x3.6) 155 (68) 175 (79) 13 (49.0) 14x14 (4.x4.3) 155 (68) 1T5_(79)17 (64.3) 16x16 (4.9x4.9) 1551M] 175 (79) 20 (75.7) 10.6 (0.73) 16.0(1.10) 18.1.(1.24) 20.2(1.39)_ (101 52) 25.0 (1.72) R3538 30.2 (2.08) 6-12 181512 (152-305) 25.0 (1.72) -_ The Reliable Automatic Sprinkler Co., Inc., 525 North MacQuesten Parkway, Mount Vernon, New York10552 135Rev. B Technical - -- - Data -- - - _ --Max. - - - Sprinkler Sprinkler Thread Temp. Max. Ambient K Length Size Rating Pressure Temp. _ Factor Inch 'F 'C .F 'C - (mm) W' NPT (R '/,) 155 68 175 79 175 psi (12 bar) 100 384.0 2.45 150 66 . -_.(62) Sprinkler - Temp. I Flow I Pressure Ceiling -to- Sprinkler it t Identification •F g y m psi De ec or C1 pm (bar) Inch (mm) Number (SIN) 155 (68) 175 (79) 155 (68) 175 (79) 13 (49.0) 16x 16(4;9x4.9) 155 (68) 17 (64.3) 16 x 16 (4.9x4.9) _ 175 (79) 18 (68.1) 16 x 18 (4:9X525) 155 (68) 175 (79) 20 (75.7) 18 x 18 (5.5x5 155 (68) 175 (79) 22 (83.3) 16 x 20 4.9x6.1 155 68 175 79 23 87.0 12x 12 (3.6x3.6) 155 (68) 175 (79) 13 (49.0) 14x14 (4.x4.3) 155 (68) 1T5_(79)17 (64.3) 16x16 (4.9x4.9) 1551M] 175 (79) 20 (75.7) 10.6 (0.73) 16.0(1.10) 18.1.(1.24) 20.2(1.39)_ (101 52) 25.0 (1.72) R3538 30.2 (2.08) 6-12 181512 (152-305) 25.0 (1.72) -_ The Reliable Automatic Sprinkler Co., Inc., 525 North MacQuesten Parkway, Mount Vernon, New York10552 135Rev. B Basic Principles of Solvent Cementing The solvent cemented connection in thermoplastic pipe and fittings is the last vital link in a plastic pipe installation, It can mean the success or failure of the system as a whole. Accordingly, it requires the same professional care and attention that are given to other components of the system. There are many solvent cementing techniques published covering step by step procedures on just how to make solvent cemented joints. However, we feel that if the basic principles involved are explained, known and understood, a better understanding would be gained, as to what techniques are necessary to suit particular applications, temperature conditions, and variations in size and fits of pipe and fittings. Be aware at all times of good safety practices. Solvent cements for pipe and fittings are flammable, so there should be no smoking nor other sources of heat or flame in working or storage areas. Be sure to work only in a well ventilated space and avoid unnecessary skin contact with all solvents. More detailed safety information is available from Harvel or IPS Weld -Ong Corporation. To consistently make good joints, the following should be carefully understood. I The joining surfaces must be softened and made semifluid. 2 Sufficient cement must be applied to fill the gap between pipe and fitting. 3 Assembly of pipe and fittings must be made while the surfaces are still wet and fluid. 4 Joint strength develops as the cement dries. In the tight part of the joint the surfaces will tend to fuse together, in the loose part the cement will bond to both surfaces. These areas must be softened and. penetrated 7Lv,W74_1 jr..., When using the ONE STEP cementing process, penetration and softening can be achieved by the cement itself (read ONE STEP cementing procedures carefully; refer to installation instructions). For certain sizes, under certain conditions, it may be desirable to use the TWO STEP process which utilizes a primer to ensure adequate softening. For example, when working in cold weather with targe diameter pipe, more time and additional applications may be required. Cement coatings of sufficient thickness n..+rs.era+Kn..er. More than sufficient cement to fill the loose part of the joint must be applied. Besides filling the gap, adequate cement layers will penetrate the surfaces and also remain wet until the joint is assembled. Prove this yourself. Apply on the top surface of a piece of pipe two separate layers of cement. First flow on a heavy layer of cement, then alongside it a thin brushed out layer. Test the layers every 15 seconds or so by a gentle tap with your finger. You will note that the thin layer becomes tacky and then dries quickly (probably within 15 seconds) The heavy layer will remain wet much longer. Now check for penetration a few minutes after applying these layers. Scrape them with a knife. The thin layer will have achieved little or no penetration. The heavy one, much more penetration. Surfaces must be assembled while they are wet and soft If the cement coatings on the pipe and fittings are wet and fluid when assembly takes place, they will tend to flow together and become one layer Also, if the cement is wet the surfaces beneath them will still be soft, and these softened surfaces in the tight part of the joint will tend to fuse together. Surfaces Non Fusec As the solvent dissipates, the cement layer and the softened surfaces will harden with a corresponding increase in joint strength. A good joint will take the required working pressure long before the joint is fully dry and final strength Is obtained. In the tight (fused) part of the joint, strength will develop more quickly than in the looser (bonded) part of the joint. Information about the development of bond strength of solvent cemented joints is available. The QUALITYLine VSR-SF VANE TYPE WATERFLOW ePOTTER SWITCH WITH RETARD FOR SMALL PIPE Potter Electric Signal Company Potter Electric Signal & Mfg. LTD 2081 Craig Rd.,/P.O. Box 28480 1967 Leslie Street Don Mills, Ontario, Canada M382M3 St. Louts, Mo. 63146 (314)1178-4321 / (800)325-3936 (416)441-1833 UL & ULC LISTED STK. NO. 1113000 U.S. PAT. NO. 3921989, CANADIAN PAT. NO. 1009680 OTHER PATENTS PENDING. The Model VSR-SF is a vane type waterllow switch for use on wet sprinkler systems that use 1", 1 1/4", or 1 1/2" pipe size. The unit may also be used as a sectional waterflow detector on large systems. The unit contains two single pole double throw snap action switches and an adjustable pneumatic retard. The switches are actuated when a clow of 10 gallons per minute or more occurs downstrearn of lire device. The flow condi- tion must exist for a period of time necessary to overcome the selected retard period. INSTALLATION: These devices may be rrlounted in a horizontal or vertical pipe. On horizontal pipe they should be installed on the top sldo of the pipe where they will be ac- cessible. The units should not be Installed within 6" of a valve, drain or fitting which changes the direction of the waterllow. The has a 1 " NPTbushing for throading into. a non corrosive "TEE". Soo figure 2 for propor "TEE" size, type and installation. Service pressure: Up to 250 PSI Mlnllnurn Flow Rale for Alarm: 10 GPM Maximum Surge: 10 FPS Enclosure: Cast Aluminum, red enamal finish. Cover held In place with tamper resistant screws. Contact Ratings: 10 wo Amps@ 2of 5/2250 V. AC C) 2 Amp. @ 0-30V. DC Conduit Entrances: Two openings for 1/2" conduit. Usage: Listed Plastic, Copper and Schedule 40 Iron Pipe. Fits pipe sizes - 1", 1 1/+", & 1 1/2" Note: 0 paddles are furnished with each unit, one for each pipe size of threaded or swoat TEE, one for CPVC, and one for polybutylene. Environmental Limitations: 405• /1204.C/49C Caution: This device Is not Intended for applications In explosive environments. Service Use: NFPA-13 Automatic Sprinkler NEPA-132 One or Two Family Dwelling Residential Occupancy up to 4 Stories NFR PA -71 Central Station NFPA-7 Local NFPA-72B Auxiliary NFPA-720 Remote Station NFPA-72D Proprietary Optional: Cover Tamper Switch , order Stk. No. 0090018 Kit for Outdoor Use: Order Stk. No. 1940036 Screw the dovico into the "TEE" filling as shown in Fig. 2. Care must be taken to properly orient the device for the direction of waterllow. The vane must not rub the inside of the "TEE" or bind in any way. The stem should move freely when operated by hand. The device can also be used in copper or plastic pipe installations with the proper adapters so that the specified "TEE" filling may be installed on the pipe run. TESTING: Check the operation of the unit by opening the "Inspection Test Valve" at the end of the sprinkler line orthe drain and lost connection, it an Inspectors Test Valve is not provided. If there are no provisions for testing the operation of the flow detection device on the system, application of the VSR-SF is not recommended or advisable LCAUTION: There are 8 paddles furnished with each unit. These paddles have raised lettering that shows the pipe nd type of "TEE" that they are to be used with. The proper paddle ID115l be used. The screw that holds the paddle be securely tightened. nEV D BULLETIN 002 PAGE 1 OF 2 PRINTED IN USA P BELLSPOTTER PBA -AC & PBD -DC UL Listed, FM Approved 6" BELL SHOWN Sizes Available: 6" (1 50111m), 8" (200mm) and 10" (250mm) Voltages Available: 24VAC 120VAC 12VDC (10.2 to 15.6) Polarized 24VDC (20.4 to 31.2) Polarized Service Use: Fire Alarm General Signaling Burglar Alarm Environment: Indoor or outdoor use (See Note 1) -40" to 150"F (-40" to 66"C) (Outdoor use requires weatherproof backbox.) Termination: 4 No. 18 AWG stranded wires Finish: Red powder coating Optional: Model BBK-1 weatherproof backbox These vibrating type bells are designed for use as fire, burglar or general signaling devices. They have low power con- ounts on a snard 4" (101 mm) square electrical box for indoor use or on sumption and high decibel ratings. The unit mldoor appl calions1dWeatherproo backbox model BBK-1 Stock No. 1500001.a model BBK-1 weatherproof backbox ALL DC BELLS ARE POLARIZED AND HAVE BUILT-IN TRANSIENT PROTECTION: SIZE INCHES (mm) rn(P(oo) ) u) vw) 6 (Itis) 0 (Pon) 10 (250) VOLTAGE I MODEL NO. I STOCK NO. 12VDG 12VDC 12VIIc 24VUc 24VDC 24VDC 24VAC, 24VAC 24VAC 1 POVAC I70VAC 1 P6VAC PIID 126 Pnm1 'o rnn IP N) PUD246 ruD746 PIID7410 PDA240 PIIA24n VIIA2410 PI IA 1 706 PnAI20n PRA12016 1700012 1700012 1710012 1706024 1700024 1710024 1000024 lnono2n 1010024 1006120 1000170 1010120 CURRENT (MAX.) 12A A 2A .IPA 06A .06A .non .1 7A 17A 'I 7A .05A .05A .05A TYPICAL ala AT 10 FT. (3-)(2) 05 MINIMUM IN AT 10 FT. (3m) (I) 76 76 70 76 7f) 7fl 70 76 7f, 02 02 05 Notes: 1. Minimum dB ratings are calculated from integrated sound pressure measurements made at Underwriters Laboratories as specified in UL Standard 464. UL temperature range is -30" to 150"F (-34" to 66"C). 2. Typical dB ratings are calculated from measurements made with a conventional sound level meter and are indicative of output levels in an actual installation. _ Potter Electric Signal Company • 2061 Craig Road, St. Louis, MO, 63146-4161 • Phone: 800-32.5-3936/Canada 886-882-1833 • wvvw•pottersignal.com PAGE I OF 2 MKT. 98850001 - REV r PRINTED IN USA MFG. H5400776 - 3/99 36 TocC� INConPONATED COnONA. CA • (/Of) 737.6590 . � d -o rte: tir �`'}� wt Y r' , r , � r 1f� pi ,'r Yr"' .riti � F 4 �� row PY Y i w i5 ti r� iyt r r� �. rPt y, r,�M1r W i '.,Kry x ,Wn•Fnr "'� ^ FIG. 23 HANGER FOR C.P.V.C. PLAS77C PiPE DOUBLE FASTENER STRAP TYPE Size Range - 3/4" thru 2" C.P.V.C. pipe. Material- Carbon Steel with galvanized finish G-90 govt. spec. Function- The Fig. 23 and Fig. 24 are intended to perform as a hanger/restrainer to support only C.P.V.C. piping used in automatic fire sprinkler systems. Fig. 23 and Fig. 24 can be installed on the top or on the bottom of a beam. The Fig. 23 can also be installed on the side of a beam. -i he Fig.'23 and Fig. 24 can also function as a restrainer to preveP rt the upward movement of the sprinkler head during activation. Approvals - Underwriters' Laboratories listed to support fire sprinkler piping. Meets and exceeds the requirements of N.F.P.A. 13, 1313, and 13D. Features -'i'hc Fig. 23 and Fig. 21 incorporate features which protect the pipe and ease installation. "ihe flared edge design C.P.V.C. PIPE SIZE 1-1 2 REVISED 3/94 A 1 li FIG. 24 HANGER FOR C.P.V.C. PLASTIC PIPE DOUBLE FASTENER STRAP TYPE – SiDE MOUNT __J_ ==-4— C LK- A _1 protects the C.P.V.C. pipe from any rough surface. The Fig. 23 design incorporates snap retainers allowing easier and faster installation. Tile Fig. 23 and Fig. 24 are easily attached to the building struc- ture using the two Ilex head self threading screws' furnished with the product. It is recommended that rechargeable electric drills fitted with a hex socket attachment be used as installation tools. No Impact tools (such as a harnmer) or impact fasteners (such as drive screws or nails) are allowed. Damage has been known to result from Installations using Impact type tools. No pre drilling of a pilot hole in wood is required. Order By - Figure number and C. P.V.C. pipe size. Patents Pending '-l-lardened hex head self threading screw is furnished with the product and is the rninirnurn fastener size acceptable. C IMAX. IIANGER SPACING FIG. 23 FIG. 24 FIG.23 FIG. _24 FIG. 23 FIG. 24 3 1/8 2 5/16 1-9/16 1-5/32 1-3L16 1-3/16 4-3/16 3 2-3/32 1-1/2 1-3/16 1-3 16 1-5%8 1='3,•1 ' .MTV] 4-7/8 3-11/16 2-7/16 1-27/32_1-3/1-6—A-3/16 5-1 6-1 8____ FAs,rENER _-- FASTENER APPROX. I IEX I IEAD WEIGHT SIZE PER 100 ---5/16 ---- 9-- 6 11 5/16_-- 15 \ N C -,-,-f -e- C SuP� I AC. 11 0I?1;�1� No it, VAI -VL.. Ilrl I11_IJO 11U .I 11V ... I [I I ,1 I ,• I/I I ` l!; 1.11.',' I._....... I:: - - - - -I ca9?UVw Note- 525 and 900 Hellon Wwdmis naive hoth hor,rnntal and vertlrrll molmtlr-r All others are vertical only ®1 '—G —I— u -1 ra I u 1.. c.11�UVYV 'a'3I1.5Vw' QUICK_ Galvanized Tanks -76 psi Max Wkq Pr.ssure ci'lu�V caw Capacity T^ Drawdown Dimension \A t. Order Model Gallons Gallons (2 30-50 Din x Ht.' LE& No. r 142 Tall 42 4.3 1d x 48 72 V42GT 42 Short 42 4 3 20 x 32 74 V42GS !g2 az 8,4 20 x so � 1 • a Va2G 120 West 120 122 24 x 60 161 V120G West 220 22.4 30 x 78 31)3 V220G .220 .315 West 315 32.1 36 x a0 4'6 V315G �� 80 VSOW 480 49 42 x 87 640 V480G f'525 Combo 525 53.6 36 x 128 6115 V525G 900 Combo 900 91.8 42 x 159 1040 V900G Note- 525 and 900 Hellon Wwdmis naive hoth hor,rnntal and vertlrrll molmtlr-r All others are vertical only ®1 '—G —I— u s GL co r 0 r� cv-1 M n ao b N v L 0 v S � � 2 Sur AQ F P- w W J DRAWN r _,CHECKED r DATE SCALE JOB NO. yUVh1E.i SHEET r 0 �v ao i S � � 2 Sur AQ P- W J Y Z DRAWN r _,CHECKED r DATE SCALE JOB NO. yUVh1E.i SHEET