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Home My WebLink About040-214-010040-21-4-010 16-1934 THOMPSON, ROBERT COHrR: PHILIP ELECTRIC 2340 OORHAM Si., DOWN T ELE SBR CH/SP /� 04-3271 040-214-010 S'I'LPf L•N, TI IOM AS 2390 DURHAM ST, DURI-WA Cont: oN'NER f.PLC SIDING RGROol MISC �D N F39010 96-1934 ROBERTILIP ELECTRIC AM ST., DURHAM H/SF 1- OFFICE COPY Address GAS Meter Date ELECTRIC Meter By Date ,�UNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, Cali,kirnia X5965 -Telephone (916) 538-75419 ` /��IT O• APPLICATION AND PERMIT �-TT ASSESSOR PARCEL NUMBER 040— ZONING R1 BUILDING PERMIT OWNER ROB TELEPHONE 2 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS N BOX 1131, WMARS 95988 CONTRACTOR'S NAME PHILP ELECTRIC TELEPHONE 934-4809 CONTRACTORS MAILING ADDRESS 1116 TITNTPFR DR, MUM 95988 Fireplace CONSTRUCTION LENDER UNMOWN Total Valuation Is Filing Fee $ 20,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS 2390 DURHAM ST DURHAM PERMITFEE S PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23,00 Water piping 15.00 USEOFSTRUCTURE SF 5 Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: LWRW ELECT SERVICE TO 200 AMP Mobile Home I S I GI W @20.00 PERMITFEE s Contractor ELECTRICAL PERMIT FilinQ Fee 20:00 Main ServiceeoaV OR LESS ( 200A OR LESS ) fM 23.00 23.00 23 •00 Main Service ( 200A TO I000A ) 46.00 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 c' 0Lic. No. / ///� OWNER -BUILDER DECLARATION , 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ 1, 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 NEW CONST. DWELLING OCCUP.SD. OR ( d ACC. BLDS- ) 3.5Q FT. CNS- NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 POWER APPARATUS ( d SINGLE OUTLET CIR. ) Ex. Occup. ( OUTLET OR FIXTURES 6AL .) 2U @ 1.5000 Ex. Occup. FIXOED RESID.°EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE TNSP 23.00 PERMITFEE i 66.00 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor 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.) O I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. ' I _ X_ ant i Date ' (--ij�— Signature of Applic- t\,Qner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height.. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ HAZ. D. FEES I IMP I FLOOD I CDF PARCEL PO HD IS This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have %��Z�"✓ By �_- PERMITEXPIRESON the applicable provisions Resolutions to do work been paid. Date �y J k / (Date) Receipt No. 202369 WHITE-D.D.S.-E.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroviae,» CaPifornia 95965 - Telephone (916) 538-7541/-1/ERMIT o. APPLICATION AND PERMITT� ASSESSOR PARCEL NUMBER - 040-214-010 ZONING R1 BUILDING PERMIT OWNER R TELEPHONE 934-5112 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS PO T� WILLOWS CONTRACTOR'S NAME ELECTRICPHILP TELEPHONE — CONTRACTOR'S MAILING ADDRESS 1116 IIINTPF.R DR, WITJOWS 95988 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHTTECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDINGADDRESS 2390 DURHAM ST DURHAM PERMITFEE $ PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 LAT NO. SUBDIVISIONS NAME PARCEL MAP Solar Or heat pump water heater 23.00 USEOFSTRUCTURE SF IN Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: UPGRADE ELECT SERVICE TO 200 AIMP — Mobile Home ISI GI W1 1 920.00 PERMITFEE 1$ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service ( 2000A AoOR LE Main ESSSS ) 20 23.00 23.00 Main Service ( 200A TO 1000A ) 46.00 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 `—/0 Lic. No. �i/zoo OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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. ❑ 1, 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 NEW CONST. DWELLING OCCUP. OR ( 8 ACC. BLAS. ) SO. 3.5Q FT. CNS. NEW CONST. MULTI.OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET us Ex. Occup. (OUTLET OR FIXTURES 20 Q 1.00 �L Ex. Occup. ( OUTEiETS RESD.)EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PRE INSP 6_00 PERMITFEE $ 66.00 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as 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 MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE S Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall fo ith comply with Those provisions. _ X _�y+y Date �� Signature of ' p icant T30ner 10 Contractor ❑ Agent An OSHA permit is re ire Or excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HAZ. I D. FEES I IMP I FLOOD I CDF PARCEL PD HD ISS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By D to —4;1;; PERMITEXPIRESON V 2 7 (Date) rReceiptNo. 202369 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT M .. , .-.. �vV+�wr•SFwF�Ai7uT r3'R'o,�_�.�4,IXy"`�'+P'fd'�^;'e'iTM'+q"S'„'rirA'^s-�.^.a-'-^�v�y�p-+•q�pr.'..-_..;."7: Y'T'4 4.r�'-J'tX- •�";:..-�; . ... .,. x��.:.e. a.. COUNTY'OF B'OTTE - DEPARTMENTOF D�FVELOPMENTSERVICES -BUILDING DIVISION 01 .� 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 A OWNER I r �-W/ Proposed Building Use PERMIT APPLICATION DATA SHEET 0_412r� I P_� Building Inspector No. 040 - 21 (4_()10 c--% Date 8.2,(,o- 9(o At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 22. 23. 24. 25. 26. 27. 28. 29. 30. IN All items have been submitted . .......................................... Plot plans, 3/4 sets, signed by preparer of plans. ....:.................... . Complete plans, 3/4 sets, signed by preparer of plans . ...................... Engineered plans and calcs, 3/4 sets, with wet signature on plans. .............. Hazardous Material Form . ............................................ Energy Design Compliance and supporting documentation . .................. Statement of Intent for Non -Heated and A/C Buildings . ...................... Engineered truss details and layout in duplicate (required prior to plan check). .... Mobilehome data and manufacturer's installation instructions, 2 sets. ........... Feesof $ .......................................... Impact fees as shown on attached schedule . .............................. California Department of Forestry plan approval/fees. ....................... . Flood elevation letter (100 year flood) by California Engineer .................. . Sanitation and plot plan approval Health Department . ............ City of Chico plumbing permit . ........................................ . Plot plan and business license approval from City of Biggs/Gridley. ............. Planning approval for (A) Use: (B) Parking: . ......... Contact Land Development about (A) Improvements (B) Drainage. .......... . Driveway permit (construction approval required prior to occupancy). ...P '4� 'e*o;,r6gd�- Pre -inspection for required. .. to Buf�ding 1naPedor (Date) Contractor's license information. (No., Name Style, Classification) . ............... Certificate of Workmans Compensation Insurance . .......................... Owner -Builder Verification (Given to owner . , Mail to owner _ ) ............ Recorded copy of Agricultural Acknowledgement Statement . .................. Letter of signature authorization . ........................................ Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . Letter of intent on building use ........................ 1 .......... ;....... Mobilehome utility clearance . ......................................... . Documentation of legal access . ..................:.:.:................. . Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . ............... Existing violations/expired permits. Plan phecklist........................................... ( r, When you issue the permit, process as follows: Mail to owner. Mail to conr. Telephon a and h Id for pickupat office. tra oDeliver with inspector. Other OvOi., Parcel Creation Q Acreage XApplicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issiiarice: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date ' Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works OWNER: I DATE: 8— 2 (o -?(;o LOCATION: CONTRACTOR: r PRE -INSPECTION FOR: LLD G�,7 � Q son A.P.#: q0 - 71 y -O l b ZONING: IZ - DnA/T/E/ TO INSPECTOR.-ZG,-�% PERMIT HISTORY: [ JNONE [)AS FOLLOWS: 3 n 2 t TYPE OF OCCUPANCY: BUILDING INS-PECTOR'S REPORT uilding Description: [ ] Commercial/Usage: [ J Residential/# of Units: [ ] Currently Occupied. j J AbandonedNacant. Electric: [ ] Yes [ ] No i Electric is currently : [ ] On [ ] Off Condition of electrical? _ Gas: j Natural[ ] Propane[ ] Obvious problems: Panitation: Mobile Home: Yes[ ] No[ ] 1 None[ ] Currently On[ ] Off[ ] Plumbing working Yes[ ] No[ ] Well: Yes[ ] No('] Obvious Sewage Problems: ction Recommended: Potable water: Yes[ ] No[ ] [ ]Hold for: ector: K I a Date: . j 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.neAdds PERMIT NO. BP043271 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: 11/12/2004 APN: 040-214-010-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 2390 DURHAM ST DUR Date: Contractor. Map Index: Description: RPLC SIDING, RE -ROOF, MISC ELEC, MAIN OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the HSE &GAR AP. 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 to its issuance, also requires the applicant for such permit to file a Owner: THOMAS & CINDY STEFFEN signed statement that he or she is licensed pursuant to the provisions of 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 8960 GOODSPEED ST she is exempt therefrom and the basis for the alleged exemption. Any DURHAM, CA 95938 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 Code: The Contractors' State License Law does not apply to an Applicant: THOMAS &CINDY STEEPEN owner of property who builds or improves thereon, and who does PP such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 8960 GOODSPEED ST sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of DURHAM, CA 95938 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: and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code 12. Date: Owner: _ WORKERS' COMFtNSATIONECLA#AYION I hereby affirm under penalty o ury one o the following declarations: License #: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Architect: ❑ 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. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: , `2 • D4 Applicant: PV WARNING: Failure to secu 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. y CONSTRUCTION LENDING AGENCY This permit is r y issued under the applicable provisions of the Butte County Code ?nrUor affirm I hereby arm that there is a construction lending agency for the Resolutions to do ork indicated above for which fges have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) - v- (� , ' •Z • l Name: By: ru Date: PERMIT ±R ON: t I z Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 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 purpop",,, nn CA�1_ Print Name: `l a �"?�E'T� Signature: Date: ' `Z u Owner ❑ Contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY 0 DEPARTMENT OF DEVELOPMENT SERVICES O BUILDING PERMIT APPLICATION 0 AND SUBMITTAL REQUIREMENTS O 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 O OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER Last Name __5, T / + n�e' First, Name Address co City a h u State C/� Zjp 3 Y Phone Sia-3y3-oo t;8 Fax E-mail APPLICANT SIGNATURE X For office y: VV CONTRACTOR Name 9 e_ AILv-' Address S City State cjk State Zip Phone E-mail Fax E-mail Planner Lic. # Class APPLICANT SIGNATURE X For office y: VV ARCHITECT/ENGINEER Name 9 e_ AILv-' Address S City State cjk State Zip Phone E-mail Fax E mail Planner State License Number APPLICANT SIGNATURE X For office y: VV APPLICANT NAME Name Flood Zone Addre S City State cjk Zp, �53� `1 Phone343 �O Fax E-mail Page APPLICANT SIGNATURE X For office y: VV Zoning Prer�y ddress ^ _:5; Flood Zone Cross Street GoodJae_ z SRA Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BPo43 z BIN # LOCATION AP# QYO L/_ Prer�y ddress ^ _:5; Cj' Cross Street GoodJae_ z WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name � Itlo t—, Address De criptionor Acope of Work: e_ -e I q- ��fi �a Sq. Footage ! yea ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and, no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: K1 Amount: 1154--761 Bldg SRA Receipt #: 4-1 S 50 y Sheriff Date: 0. • t -� • e�,¢ SMIP Other 1154.767 Total REV 7-27-04 yC_ SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet.signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. (Note: Not required for additions to mobile or modular homes.) ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6.' Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. O 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). ❑ 13. Sanitation and site plan approval from the Environmental Health Department. Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3.' California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner (for 433A's). If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action oria application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION K1FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 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 material for construction of this proposed property improvement: YES [ ] NO [ ]. x 2. I HAVE [ ] HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: j DATE: -RZ- NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit.. Rev'd 11/4/2004 Butte County Department of Development Services ADMINISTRATION * BUILDING * GIS * PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your. obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The b6ilding permit will not be 'issued until the ve41cation is returned. Mic el C. Vieir4 C.B.O. Manager, Building Inspection i NOTE: This Owner -Builder IT lrmation is required by Section 19830 of the California Health and Safety Code. 1 RECORDING REQUESTED BY: ffffllfffllffflfllfllffllflflf lflf .✓ Fidelity National Title Company of California 2P1Q)4-42XQ E 659la Escrow No.: 04-215624-]H Locate No.: CAFNT0958-0958-0002-0000215624 Recorded I REC FEE 15.00 Title No.: 04-215624 Officiatyf Records I TAX 117.70 CounWhen Recorded Mail Document BUTTE and Tax Statement To: CANi1ACE J. GRUBBS Recorder I I Mr. and Mrs. Thomas Steffen ROSEMARY DICKSON i 2390 Durham Street I Kathy Durham, CA 95938 02:aAssistant -20@4 9 of 4 APN: SPACE ABOVE THIS LINE FOR RECORDERS USE DEED This deed is being signed -inT counterpart The undersigned grantor(s) declare(s) Documentary transfer tax is $117.70 [ X ] computed on full value of property conveyed, or [ ) computed on full value less value of liens or encumbrances remaining at time of sale, [ ] Unincorporated Area purham, FOR A VALUABLE CONSIDERATION, receipt of whichis hereby acknowledged, Robert B. Thompson, an unmarried man, as to an undivided 1/3 interest, and Dorene M. Pierce and Richard V. Pierce, as Trustees of The Richard V. Pierce and Dorene M. Pierce Revocable Trust dtd 2-23-98, as to an undivided 1/3 interest: and Valerie D. Thompson, Trustee of The Janet N. Gilbert and Valerie D. Thompson Revocable Trust dtd 8-28-01, as to an undivided 1/3 interest hereby GRANT(S) to Thomas Steffen and Cindy Steffen, husband and wife as joint tenants the following described real property in the `Durham, County of Butte, State of California: SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF. _ . , rA g4�� JANET R. HERBERT COMM. # 1351382 NOTARY PUBUC-CDATED: October 25, 2004 COUNTY OF BUTTEComm. Expires Apri4 i?', 2 t STATE OF CALIFORNIA COUNTY OF�'t ON I Q.ZQ L0!:A before me, the undersigned Notary Public personally appeared personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. hand and official sea[. B. Thompson The Richard V. Pierce and Dorene M. Pierce Revocable Trust dtd 2-23-98 Dorene M. Pierce, Trustee By: Richard V. Pierce, Trustee The Janet N. Gilbert and Valerie D. Thompson Revocable Trust dtd 8-28-01 By: Valerie D. Thompson, Trustee MAIL TAX STATEMENTS AS DIRECTED ABOVE FD -213 (RtN,7/96) / GRANT DEED STATE OF CA COUNTY OF Butte__ On October 26. 2004 before me, Janet R. Herbert Notary Public (Name of Notary Public) personally appeared Robert B. Thompson personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seat. JANET Ft. BERBERT Gomm # 1351382 WCYaRY PUBUC-C&IFORNIA --- ....... a p C(3UNTY OF Burr 9006 re 0 ry Public) a p Comm. ExPiros APIR V. - s (This area for notarial seal) (noary)(07-02) RECORDING REQUESTED BY: Fidelity National Title Company of California f° Escrow No.: 04215624 -JH Locate No.: CAFNT0958-0958-0002-0000215624 Title No.: 04215624 When Recorded Mail Document and Tax Statement To: Mr. and Mrs. Thomas Steffen 2390 Durham Street Durham, CA 95938 APN: This deed is being Signed in A TpWD SPACE ABOVE THIS UNE FOR RECORDER'S USE The undersigned grantor(s) declare(s) Documentary transfer tax is $117.70 [ X ] computed on full value of property conveyed, or [ ] computed on full value less value of liens or encumbrances remaining at time of sale, [ ] Unincorporated Area Durham, FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Robert B. Thompson, an unmarried man, as to an undivided 1/3 interest, and Dorene M. Pierce and Richard V. Pierce, as Trustees of The Richard V. Pierce and Dorene M. Pierce Revocable Trust dtd 2-23-98, as to an undivided 1/3 interest and Valerie D. Thompson, Trustee of The Janet N. Gilbert and Valerie D. Thompson Revocable Trust dtd 8-28-01, as to an undivided 1/3 interest hereby GRANT(S) to Thomas Steffen and Cindy Steffen, husband and wife as joint tenants the following described real property in the Ourham, County of Butte, State of California: SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF DATED: October 26, 2004 STATE OF CALIFORNIA COUNTY OF S AcN TU ON -*0 ..Z 6 • e 4.f( before me, the undersigned Notary Public, personally appeared V A L F— 2::G T') . m4 e) M r- S o N (or proved to .me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Witness my an and official seal. Signature Robert B. Thompson The Richard V. Pierce and Dorene M. Pierce Revocable Trust dtd 2-23-98 By: Dorene M. Pierce, Trustee By: Richard V. Pierce, Trustee The Janet N. Gilbert and Valerie D. Thompson Revocable Trust dtd 8-28-01 .L Valerie D. Thom n, Trustee MAIL TAX STATEMENTS AS DIRECTED ABOVE FD -213 (Rev 7/96) GRANT DEED (grant)(09-04) R. m1mJ Comm""'on * 1471052 •a Notary Public • Collfomla EI Dorado County MyComm. Expl= Mar 17, 20 Escrow No.: 04215624-]H Locate No.: CAFNf0958-0958-0002-0000215624 Title No.: 04-215624 EXHIBIT "A" THE LAND REFERRED TO HEREIN BELOW IS SITUATED UNINCORPORATED AREA , COUNTY OF BUTTE, STATE OF CALIFORNIA, AND IS DESCRIBED AS FOLLOWS: THE SOUTH 140 FEET OF THE EAST 50 FEET OF LOT 9 OF THE SMITH TRACT, DURHAM, BUTTE COUNTY, CALIFORNIA, WHICH MAP WAS FILED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, February 14, 1916 IN VOLUME "8" OF MAPS, AT PAGE 6, DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTHEAST CORNER OF SAID LOT 9 ON THE NORTH LINE OF DURHAM STREET; THENCE.S. 74.25' WEST ALONG SAID NORTH LINE 50 FEET; THENCE ATA RIGHT ANGLE NORTH PARALLEL WITH THE EAST LINE OF SAID LOT 9, 140 FEET; THENCE AT A RIGHT ANGLE EAST PARALLEL WITH THE SOUTH LINE OF SAID LOT 9, 50 FEET TO THE EAST LINE OF SAID LOT; THENCE SOUTH ALONG SAID EAST LINE, 140 FEET TO THE POINT OF BEGINNING. Tnitialc: