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040-260-079
_ 7L 40-26-=&, ` ROBERT J. CANNON`S NIS Laura Lane, 450'W Lott Rd, a1 Durham AGRICULTURAL BUILDING -EXEMPT ON4 il'o�(�meta 1-•.s•tora-ge• -bldg) � 9/3/81 4D-26-23` n I Robert Cannon _ N/S Laura Ln.,app.600'W.of Lott Rd. �. Durham 3��� . contra Western Sierra o s`t.""�Chico Permit #283-82B,P,E,M(neasingle family) 040-260-079 04-2632 SIMIC, BRETT 1836 LAURA LN, DURHA Cont: OWNER RE -ROOF _ r k o � l l r 1 ab111 IL IYM1111N9 1 YV Q11a4 %0 54ayv WP -1077 Find Go To J Recent Step by Permit -no Type IWELLLOG SubType IN Lg -Name and Address Information Site Address 11836 LAURA LN Owner ISimic & Weber Applicant Parcel Number f040-260-079 I -A A -.._.moi P9.._: _t ..-1 11_1 n_.._._& r% ---:L DURHAM �w� 1 a1 rr11a 1 1 v��w a11a,1 tl,r! 1 a1 �i1 n 1 c1 nna - (a) Find Go (b) Show Sub -Permits CIAIAAI^IAI 1K11 ^r%RAAT1^K1 Valuation Details Fee Details Fee Payment Details I -Permit Dates Applied 11/0112004 J? Pw Approved NIA J Issued 1116812004 TL Finaled1013112005 CRW - Expiration NIA J - Undefined NIA Status IFINALED This Permit is LOCKED More Info Site Info Contacts (1) Chronology Description ( Plan Reviews (2) Imaging Link I Inspections Internet Link I Print CLOSE BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.neAdds ERMIT NO. BP042632 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: 09/08/2004 APN: 040-260-079-000 the Business and Professions Code, and my license is in full force and effect. License Class : License Number: Site Address: 1836 LAURA LN DUR Date: Contractor. Map Index: Description: REROOF W/COMP p OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjurythat 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: SIMIC & WEBER TRUST to its issuance, also requires the applicant for such permit to file a SIMIC BRETT S & MARY B WEBER signed statement that he or she is licensed pursuant to the provisions of TRUSTEES 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 895 BRUCE LANE she is exempt therefrom and the basis for the alleged exemption. Any CHICO, CA 95928 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 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: SIMIC & WEBER TRUST 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.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: pursuant to the Contractors' State License Law.). ❑ 1 am Tetpt under Articl 3 of the Businpss and P essions Code Owner: Date: WO KERS' COMPENS TION 15ECARAI)ON\ I hereby affirm under penalty of perjury one of the fbIlowing declarations: License #: L4 ❑ 1 have and will maintain a certificate of consent to self -insure for n 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 n: Valuation: $0.00 1 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 Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' / / I compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply wi th se provisi ns. Date: Applicant: WARNING: Failure to secure workers ompensation 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 ENCY I hereby affirm that there is a construction le mg agency for the This permit is hereby issued under the qpplicable provisions of the Butte County CoAp anchor Resolutio t o tyork indic dab for ich fees have been paid. performance of the work for which this pe it is issued (Sec 3097 Civ.)Q Name: By: Date: VV PERMIT EXPIRES ON: Address: Da ❑ 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 f the owne . I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of a official form or docum t of Butte o nty. 1 hereby authorize representatives of ButteeCCounty to enter upon the above mentioned property for inspection purposes. `c'� %'�`'t Print Name: /Z ✓ r Signature: Date: se,O p 0 gmn r ❑ Contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT . 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE All: (530) 538-7541 FAM (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP042632 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: 09/08/2004 APN: 040-260-079-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 1836 LAURA LN DUR Date: Contractor: Map Index: Description: REROOF W/COMP p 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: SIMIC & WEBER TRUST to its issuance, also requires the applicant for such permit to file a SIMIC BRETT S & MARY B WEBER signed statement that he or she is licensed pursuant to the provisions of TRUSTEES the Contractor's Stale License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 895 BRUCE LANE she is exempt therefrom and the basis for the alleged exemption. Any CHICO, CA 95928 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).): 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: SIMIC & WEBER TRUST 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.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: pursuant to the Contractors' State License Law.). ❑ I amxe pt under Articl 3 of the Businpss and Aessions Code Owner: Dater WO KERS' COMPENSATION EC ARA ON I hereby affirm under penalty of perjury one of the fbllowing declarations: License #: ❑ 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. 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 issued, 1 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 se provisi ns. Date: Q �9 Applicant: WARNING: Failure to secure workers mpensation 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 ENCY I hereby affirm that there is a construction le rng agency for the This permit is hereby issued under the ipplicable provisions of the Butte County Co anrVpr Resolutio t o Work in di dab for ich fees have been paid. performance of the work for which this pe it is issued (Sec 3097 Civ.) O Name: BY Date: o PERMIT EXPIRES ON: Da Address: ❑ 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 f the owne . I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of a o7f,. docum t of Butte o7. 1 hereby authorize representatives of ButteCountyto enter upon the above mentioned property for inspection purposes. Print Name: ✓ %'i`'r r Signature: Date: a pin r 0 Contractor ❑ Agent for Owner 0 Agent for Contractor r• O.B.-1 OWNER -BUILDER VERIFICATION Attention Property Owner. An "owner-buildee' building permit has been applied for in your name and bearing your signature. Please complete and retum 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 I personally plan to provide the major labor and materials for construction of the proposed Pr operty improvement : YES NO E32 I HAVT1- HAVE NOT ❑ signed an application for a building permit for the proposed work I have contracted with the following person (Pim.) to provide the proposed const mcdon: NAME: . ADDRESS: CITY: CONTRACTOR'S LICENS1j NO. 4. I plan to provi&portions of this work, but I have hired the following person to coordinate, supervise, and pmvide the major NAMM • : 1 01 - CITY: CONTRACTOR'S LICENSE N.O. the work indicated: NAME ADDRESS PHONZ TYPE OR WORK PROPERTYOVniER: NOTE: T7cis Owner -Builder Yerifuadon is required by Section 19831 and 19532 of the California Health and Safety Code. T7sis verification must be completed and returned to our offwe before we are permitted to isri a the mv!i i Av OWNER BUILDER INFORMATION IO Dear Propeaty Owner. 1 ; _ An application Ara buiWM9 pence has been sabmiilad in yarn name Iistmg Ym=1f as the bM der of pmPeriY impmveme� specified. For yOu Pm ec(fOn, you should be aware awt as ffowner4 mildee you• are the re PMOIle party ofrecord on such a P=3k BmWftp=2h are not required to be signed by property owners unless they are own work. If your work is being performed by sameona other thea po' POg weir liability if that person applies for the y�rsel YOU �' P yourself kom possible P� P� is his or her name. licensefivm m are by law to be licensed and bonded by the State of Califim nia and to have a business apply * or 1y They are also requir-ad by l w to Put their license number Oa aII pe—its for which they be aware of the fDllowingyom n fgr � pfian of various trades that you plan to subs you should Your benefit and protecnn: Tfyon employ or otheaengage SayPen= and other costs) is $30030D otl= than your inmme�te hmib,, and the: work (makding Mals or more for the entire prOject. Sod such persons are not licensed as contractors or then you may be an employer. ♦ If you are an emPlaM you mast rester vii. the State and Federal subject to several obligations mclndmg state and GOvemnnents as as employer and you are warl�eas comp m�e � ���& feral social sec�ty �, a Terre be ensati= ice, disability msuramce costs, and unemployment compensalioa conft,,M ons. mai' fima=W tisb for yam ifyou do not CwY nut these ob ' with respect to worlir's btu was6 and these risks are especially serious ♦ Far more specific mon SbOUt XYM W. the U.S. Small Bm� obiigatioas tmdea Federal , cauh-act the iniemal Ravest�nmae Service (and, State Law, contact the D • • )' Far mom spec mon about your obligations undea eP � ofBe�efit Payer and the Division, Ofb&stxial Accidents, If the 3ftUZt= is Winded for sale, FvPerly owners who are not licensed contra ctars are allowed to co�nd 'a=L im their �Pl°3' ' wiii�out a licensed =&Wtyr or subcontractor, only � limited A frequent pmctice of =licensed Pmmw F¢a g to be contact= is to secure an P� e�aeausty kPb* tfiat the grDpMty OwrW is providing his Or h� own labor and �� b buiidm' g permit are nat to be signers mat aial personally. Bm7dmg ln£oa about licensed ° �' � P � Ova work personally mW be Obtmad by watr� the C=ftwU= y ar at 1020 N Street SacramgatN CA. 95814. State F icense Board is yam Please complete the "Owner B-Hw Venficahoe on the reverse side Of this farm sO the we cm confhm that are aware of gess matters, The bml&g P� will not be issued tm n the va fimg. is reT�, 3'°II �T �• T7cit O�vr=er-S for art is required by Seaton -ung of tfie CaFforafa SeafBr ar�d Safely Code e1"T raves, BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 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" APPLICANT NAME OWNER Last Na e� hi G d�/j` .fS first Name 9th9f Addre F //3rHCC_ city G r `c o StiJ t zip Zip $Z 6 Fax E-mail E-mail APPLICANT NAME CONTRACTOR Name Cityr4 , � o Address Zip City Fax State Zip Phone Book Fax E-mail Planner Uc. # Class APPLICANT NAME ARCHITECT/ENGINEER Name Cityr4 , � o Address Zip City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT NAME Namee r3,�lfi ,14,E - s Addresses� i3r y" G Cityr4 , � o Std- Zip Phon �_3 0> Sg Z - o ZCo Fax E-mail APPLI AN IGNATURE X For office use only: Zoning Prop Address 36 4 k A-ve Flood Zone I I SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BIN # LOCATION 4J 61 Prop Address 36 4 k A-ve Cjtq� / •- k �-. Cross,BtrDe-rr o� .� Bldg WORKER'S COMPENSATION Policy Number Carrier If hiring anyeeother than license contractors, a certificate of worker's cowponsation must be shown at the time of permit issuance. LENDING AGENCY Name Address De sc iption o Scope of Work: O4n Sq. F otage - ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. M r� KAFORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc Page 1 of 2 RCv !-L/-v% R eived by: Amount: `� Bldg SRA Receipt #: Sheriff SMIP Dat r ' D Other Total KAFORMS\BUILDING F0RMS\131dgApp1SubRgmts.doc Page 1 of 2 RCv !-L/-v% 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 paperl ❑ 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. ❑ 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 on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Ketunos can oniy 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 KAFORMSWILDING FORMS\BIdgAPplSubRgmts.doc Page 2 of 2 REV 7-27-04 Butte County Department of Development ,Services 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile ADMINISTRATION * BUILDING * GIS * PLANNING 12/26/2004 Simic Trust 895 Bruce Lane Chico, CA 95928 Re: Permit Number: 04-2632 APN: 040-260-079 Upon review of the above -referenced permit file by the County Building Official, it has been determined that a refund cannot be processed for the following reason(s): ❑ Refunds can only be made upon written request by the person who paid the fees, whose name is on the receipt issued for the fees paid. ❑ The request is over two years from the date of the fee payments on this non -issued permit. ❑ The request is over two years from the date of permit issuance and construction work has been done. ❑ Filing fees and plan check fees for work plans checked are not refundable. The above determinations have been made in accordance with Butte County Code 3-41(t). You may view Butte County Code online at http://municipalcodes.lexisnexis.com/codes/butteco/. ® Other reason: Due to the processing regarding your permit, application, there are no remaining fees to be reimbursed to you. Should you have further questions about this matter, please contact this office between 8:00 am and 4:00 pm, Monday through Friday. Sincerely, Diane Lewellen, OAIII , Administrative Division enclosure 04-0341.1tr County of Butte Oroville, California GENERAL CLAIM CLAIMANT: Simic Trust - NO REFUND DUE ADDRESS: 895 Bruce Lane CITY & STATE: Chico, CA 95928 DATE OF CLAIM: 12/26/04 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY AMOUNT Refund Claim - See attached calculation sheet APN: 040-260-079 Permit No.: 04-2706 PAID RETAINED REFUND Develo ment Services $ 192.50 $ 219.99 $ 27.49 THERM DRNG $ - $ - $ SMTP $ $ - $ SHR $ $ $ SRA $ $ TOTAL $ 192.50$ 219.99 $ (27.49) ;:;:;:;:; ...........•.•.• :R 11 110 !1V :::'::::::::::>BYlbQ. `C :1 -ACCOUNT: : Alv>EUtJ1V: i :: 101001 DVLPMNT SVC 440-001 4210500 $ (27.49) 1011822 THERM DRNG 1800 280 $ - :::::::: 1011430 SMIP 1001 280 $ - 1011811 SHR 1800 280 $ - 101001 SRA 0100 4617240 $ - TOTAL $ (27.49)1$ (27.49) I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this day of , 2004, at Calif. Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or delivered and that there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this day of , 2004, at Oroville Calif. Department Head or Authorized Deputy Dept. SEE Exp. Code BREAKDOWN Code PAYABLE FROM - FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT & SUB PROD SUB. OBJ CLAIM NO. INV NO. INV. DATE ENCUMB. GROSS AMT. I REFUND CALCULATION SHEET CLAIMANT: Simic Trust - NO REFUND DUE ADDRESS: 895 Bruce Lane CITY & STATE: Chico, CA 95928 DATE OF CLAIM: 12/26/04 APN: 040-260-079 RECEIPT INFORMATION' NUMBER: DATE: ISSUED TO: CHECK M AMOUNT: PERMIT #: PRIOR REFUNDS: FEES VERIFIED 412386 9/8/2004 Simic Trust Title $192.50 04-2706 Yes SHER DEV FEE SRA REFUND BREAKDOWN 0.0 Title BLDG THRM DRNG AUD SUSP SHER DEV FEE SRA 0.00::-*.* Inspectio 0.00 1 0.001 Fund 0010 1800 1001 Applied for 33 Squares 192.50 192.50 Job completed per applicant at 29 sq. 165.00 -165.00 Overcharge 54.99 -54.99 . 192.50 -54.99 Dept 440-001 THRM DRNC (SMTP) (SHR) (SRA)-: Accnt 4210500 280 280 280 4617240 Cash 101001 1011822 1011430 :1011811 1 101001 DETAIL PAID RETAIN REFUND BLDG Time 109.9 .......... .................... .................... ............ .... . Filinfrom Plan Check g () 0 0.0 ........................................ . ................. .. . ...,..*..,., ...,..,.,..,..,.." .. .................... .......... .................... .......... .................... .. .................... .......... .................... .......... ... ........ *".*,,. ...* .............. .................... .................... .................... ......... ..... .. .................... .................... .............. .... .......... ................ .................... ....... .................... .................... .................... . ... ....... .......... .......... .......... .. .......... ......... ....... ** ....... .......... .......... .......... .......... .. ................. . ........ ......... .......... ......... . ......... .......... ......... .......... ...... Plan Check/Filing 0.25 27!256 0.00 0.001 0.00::-*.* Inspectio 0.00 1 0.001 0.00 BLDG FEES OTHER BLDG Applied for 33 Squares 192.50 192.50 Job completed per applicant at 29 sq. 165.00 -165.00 Overcharge 54.99 -54.99 . 192.50 -54.99 BUILDING TOTAL 192.50 219.99 -27.49 -27.49 THERM DRNG 0.00 . 0.00'. SMIP 0.00 0.00 SHR 0.00 0.001 .......... SRA 0.00 APPROVAL Date Reviewed Michael Vieira Building Manager 192.50 $ 12/27/2004 219.99 $ (27.49) $ CHECK: -$27.49 DIFFERENCE: $0.00 (Should be blank) (27.49) $ 4 I CLAIMANT: Simic Trust - NO REFUND DUE ADDRESS: 895 Bruce Lane CITY 8 STATE: Chico, CA 95928 DATE OF CLAIM: 10/05/04 APN: 040-260-079 RECEIPT INFORMATION NUMBER: 412386 DATE: 09/08/2004 ISSUED TO: Simic Trust CHECK #: AMOUNT: $192.50 lo� PERMIT#: 0 - - Yes No Yes No Yes No PRIOR REFUNDS: X FEES VERIFIED xREFUND BREAKDOWN Title SLOG THRM DRNG AUD SUSP SHER DEV FEE SRA Fund 0010 1800 1001 1800 0100 Dept 440-001 rHRM DRN (SMTP) (SHR) (SRA) Accnt 4210500 280 280 - 280 " 4617240 Cash REFUND 101001 1011822 1011430 10.11811 101001 I DETAIL PAID RETAIN BLDG Time 109.98 ::: .. . Filing from Plan Check 0.00 0.00 O.00:i?:ii:•i:?????::: PlanCheck/Filin 0.25 27.50 0.00 0.00 0.00 Inspection 0.00 0.00 1 0.00 0.00 BLDG FEES - OTHER BLDG - Applied for 33 Squares 192.50 192.50 192.50:•iiiiiiiii}iii}:: Job completed per applicant at 29 sq. 165.00 -165.00 -165.00 ; •: : : :::: :....... . Overcharge 54.99 -54.99 -54.99'. <':':': °:':':::<•iiii:• :::::::: ::..... . ii7.:. i- %i ................. iiii}}}. BUILDING TOTAL .192.50 - 219.99 27.49 27.49 THERM DRNG 0.00 0.00 SMTP_ - - 0.00 _. . 0.00 SHR 0.001 0.001--............ SRA x • .. .r _. _. .. - 0.00 .y.. ,..r; .. -, 0.00 $ 192.50 $ 219.99 $ (27.49) $ (27.49) $ I $ . - $ '$ f APPROVAL CHECK: -$27.49 Date Reviewed 10/07/2004 DIFFERENCE: $0.00 Michael Vietra (Should be blank) Building Manager la����a 4 PERMIT - Bin APN - • LAST NAME FIRST NAME CONTRACTOR • CITY/CTY STREET NO STREET NAME CITY m ' USE • TYPE REMARKS ' • • 25 char. max B M P � E � M - VALUATION FLOOD _ FEES PAID RECEIPT : • APPLIED • FEES 2 RECEIPT 2 ISSUED • FEES 3 __ RECEIPT 3 FEES 4 RECEIPT 4 ' FINALED PLAN CHECK ACTIVITY Plan Chk-1: Chkd By-7 _ Return-7: Plan Chk-2: —� Chkd By-Z— Return-2: Str Chk-Z: Plan Chk-3: Chkd By-3: _ Approved: Sfr Appr: Comments: 255 char. max Do sqs - (10 �&M 5,51 ?;- -CEP o�UTTFo Butte County Department of Development Services C Building Division -1 =_ s. - � 7 County Center Drive ._._ •.r ..- O C0- Oroville, CA 95965 (530) 538-754 I� I REFUND REQUEST APPLICATION REFUND POLICY - Butte County Code 3-41(t) 1. Refunds can only be made upon written request by the person who paid the fees, whose name is on the receipt issued for the fees paid. Any refund checks will be made payable to the name on the receipt. 2. The request must be made within two years from the date of fee payments on permits not issued, and two years from the date of permit issuance for permits issued -if no construction work has been done. 3. Filing fees and plan check fees for work plans checked are not refundable. 4. Fees paid to other County Departments are not covered by this claim. INSTRUCTIONS: Submit this application to Development Services for determination of refundable fees. A claim will be generated for any fees to be refunded and sent to the address below for signature (by the person whose name is on the receipt) and return to Development Services fora nt r in . CLAIMANT'S NAME: j MAILING ADDRESS: Qs 3r..k.� c. PHONE: . .... ...... ... ... RECEIPT DATE: _. RECEIPT AMOUNT: REASON FOR REFUND REQUEST: 0,j l n c� j%v ra c !" f� r� /'G = a2 0 t1. 2. jeb Q ,. D 33 S� G vcJ r GIL�u r oma.. / Ac Check those fees which you wish to"have considered for refund: [Building Permit Fees =Other (specify): _ =Sheriff Fees =SRA Fees (CDF Fire Planning) Plans for cancelled permits will be disposed of within 10 working days upon submission of a Request for Refund. If you want the plans, you may ick them up prior to that time. nck's ��o+ss=ins Signature'- Date K:/Forms/Refund Applica ion 82203 A IN rr SIV PERMIT NO. 283-82ByP,E,M v PERMIT EXPIRES OWNER Robert -'Cannon CONTR. Western Sierra Const -,Chico ASSESSOR PARCEL 40-26-23 LOCATION NIS Laura Ln.,app.600'W.of Lott d., Durham r 3' Zklr` 1. 9 Temp. Power Pole E, C Iled G&E emp Elec. Servicer Called PG&E 'Gas Servi Called PG&E J �t JOB FINALED (Date) i Signature ��� J = OK O = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Depth -Spacing -Connectors 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L"ft./ P'Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements Card -BI Date _ Date Card -BI Date _ POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. Elec.; Receptacles and Lighting; Distances-GFI S. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval 7• Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip.-Pool.Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B-1 Date Card -BI Date Card -BI Date Card -BI Date LAK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) , Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements—Setbacks—Easements W—Property Line Firewall & Openings 2. Ftg., Main; Soils—Steel—Elec. Grnd.— / /" Ftg. Depth 49--Fxt. Doors—One 3'—Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils—Steel— / /" Ftg. Depth 4. Ftg., Porches & Decks; Soils—Steel— / /'' Ftg. Depth th—Headroom—Rise—Run— Land ing—Fire Protection Plywood on Roof Overhang—Attic Vents—Rafter Outriggers 5. Stemwalls, Main; Steel—Blockouts—Wrapped—Slab to walls, Garage; Steel—Blockouts—Wrapped—SI iers—F' — teel s— 54. ailing—Veneer Stucco Mesh—Drip Screed—Fdn. Vents—Underflr. Access Glazing Area—Glass Protection—Skylights—Plastic —Fitt —T —2 way C/ Sewer Test i —Bolts as , 'pe; Size—Anchors `---'C jOe"Water Pipe; Test—Anchors—Regulator—Service Test 11. Electric; Underground 1 e" s & Ducts; Clearance—Material—Support—Ins. 1 irders—Sills—Anchor Bolts—Joists—Vents—Cripples Card -BI Date 0 Card -BI Date Card -BI Date Card -BI Date Card -BI Dat Card -BI Date Card -BI Date Card -BI Date Date FINAL,(Plans) OK except k's Card -BI i Date rd -BI Date Date {PLUMBING (Permit) OK except #LL 5 xs. Steps—Door & Sidelight Protection—Landings S moke Detector Water Ht.; Vent—Access bustion A' 5 rnace; Vents—Clearance—Comb. Air—Connector— In.Garage; Above Floor—Ducts—Mech. Protection Water Pipe; Test & Anchors—Nail Protection w—b.W.V.; Test—Fttngs & Anchors—Nail Protection edroom Exiting -0h- Shower Pan; Test, First Floor—Tub Access F.I. &Bath Fixtures &Tub Access T1s Test Tub & Shower, 2nd Floor—Tub Access 641—Elec. Trim & Subpanel; Breaker Sizes—Labels S—erBs Pipe; Size & Anchors ails . Fireplace or Stove; Clearances -Hearth i Elec. Outlets at Wood Panel; Int. & Ext. Card=B1 Dat Card -BI Date 6 j,4. Fixt. & Appliance; Grnd.—Air Gap—Cooking Clearance Card -BI Date Date Card -BI Date ELECTRICAL Permit OK except k's I G. Outlets & Receptacles at Kit. Counter 6 a ge Fire Door; Swing—Landing—Closer , . Duct i d' a—Dam er L-24_-Fix_WTe & Transformer Clearance—Ins. Protection 68. tr. Htr.; ent Clearance—Comb. Air—Connector—P.R.V.— In rage; ove Floor—Mech. Protection ec. Receptacle acing—Lights & Switches at Doors 7 , b., Elec. & Mech. Equip. Listed for Location Size e4es of Conductors—Stapled 7 le .Receptacles in Garage; (G.F.I.)—Rome Protec. ex I talled Close to Edge of Studs & C.J. E Ground made up w/Mech. Fasteners—Bond Water Ins alienFoamLooked in Attic es and Rails &Deck Construction—Pos s 2 Appliance'Circuits in Kitchen & CondueTUr Size Fdn. Vents & Crawl Hole r—Drainage & Wood -Earth Clearance Looked under Floor es _ --So—Subfeed Wire Size / / ga. Cu or AI—A.C. Wire Size / / ga. Cu or At =Range Circ. / / ga. Cu or AI—Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes 0 N . Following instld.: Drive ❑ Yes Walks Q� [:]No; P ters ❑ 28. Service—Riser Conductors & Ground—Main Disconnect —29s Equip. Clearances; Panels—Motors—Mech. Equip. St cco; Br n—Fi ' on, a, 7 Unit; Disconnect— & Cond./Sig—M1V Outlet —30 --Clothes Closet Light—Shower Light 7&,—Vents Above Roof; Plbg.—Appliance—Firepl.—Clearance to Opngs. 8 Water Well; Disconnect, Electrical, Plumbing erior Elec. Trim; G.F.I. Receptacle—Underground Card B -N Date Card -BI Date o e 'lation throughout House Card B` Date Card -BI Date 8 I Protection Date MECHANICAL (Perrcit) OK except q's orrection rom Previous Inspections —Meters Tagged; G l c Z A.C. Ducts; Insulation & Support 82c Vent Fan; Exhaust above Insulation 8 r & Sewer Connected—C/O to Grade—D Approval CqWEnergy Compliance Certificate—Other Certificates _ 33. Condensate Drain & Overflow; Size & Grade 34. Fuinace—Vent; Access -Comb. Air—Return Air Vent -115V outlet 26 Attic Access & Platform if Furnace in Attic Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Card -BI Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Date FRA ING(Plans) OK except q's Comments at Final: t Sills; Proper Material & Anchors _ F walls; Studs—Nailing, Spacing & Bracing—Plates—Sound X8!8 ing Walls over Girders &Floor Nailing 3 — Dr top in Walls (rat proof) ire Stops; Furred Ceilings—Stairs—ChasesT `7 eader & Beam—_Size_& Bearing angers—Post Caps—Anchors—Connectors , Ing. Joist—Rftr. Ties—Purlin—Roof Brac.—TrJ;—Shthng.—Rfnq. k+i. .Fireplace Ties or Type A Flue—Fireplace Throat _ Attic Access; Size & Romex Protection—Draft Stop—Ins. Baffles . tl��m. drWindows or Exiting Doors—Sill Hgt. & Dimensions _ �7. Garage Fire Protection Framing - (NOTE: Anentry must be made each time you visit jobsite) RES IDENP IAL :.:-ENERGY CONSERVATION STANDARDS CONSTRUCTION COMPLIANCE CERTIFICATE THIS IS TO CERTIFY TRAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS AT Lura Drives tMoibh9, jlpa4AI44-ln CFA. • (location) BUILDING PERMIT NO. A.P. NO. THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS: (Check each item or writs N/A if not -applicable) INSULAT ION : GLAZING Slab Edge NA Single Glazed Fdn. Walls NA Special (Ins'ulated) NA Floors R-11 . •366 0•. •:,•CERT...,&.. LABELED WDS. / Walls R-13 1000 m - & SLID"ING. DRS. Ceiling/Roof, _ WEATHERSTRIPFED DRS. Ducts !/ BACK DAMPERED ••FANSN& Circulating Pipes INTERMITTENT IGNITION DEVICES 9A APPROVED HEATER___ EATER� CERT, dPPLIANCES APPROVED WTR.HTR. I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED. Insulation Applicator Name_ Rawkine Insulation Co Inc Signature of (Pleas print ._ Insulation Applicator State Contractors License No. 378,407 General Contractor/Owner Name "�45f Signature of please pr' t) General Contractor/Owner Date 5/12'18a' State Contractors License No. 3/q 7__; '; THIS CERTIFICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO REQUESTING FINAL INSPECTION AND SHALLBE POSTED IN A CONSPICUOUS LOCATION- WITHIN OCATIONWITHIN THE DWELLING. GA�vNa�l R i` •` .. -�_ 1. \ /3 U5 43, n 22 t7 39 l5Ac. /652.6 40 4 2/ 65' 9 0 y8� 4.14 AC O 167- 1450.1 29, 27. /7Ac. 4 w 4. 32Ac . 590 'x5 \ O N 27.09 AC � 6 77.23 42 13.5. 0 i52,8 20 \ ` w I8 1320 26 ,Q 0 440 55A 34 o �B 59 \ .64Ac i5 _----- ----- �\%5a am 161.5 9 6 D 12, /4 A c. ' 58454- 5. 8454c 19 .I \ 2./4AC � /4.09 AC s 24 3v 475. 4.37AC'' /3 � \ \ 6.63 AC a O 5 • /25.6— ,3 Ac. 35- 44. \ 7.9 ^ � -`- - - - 591,6- - /320 \ A.29 W 507 \ �4 "' S. CAc \� qgo 95 740 41a , • \\. P7N32-3 1 72 7ZZ,/7 3 70 p 29 17i 1 \ a` cv <56 \fJ37pt YT. 49 4 n \ v1 8 3.0 A(.. Ci \ \ 31 -123.56 \\ 4zrs 334.71 3 sse. es co CO j G7 \ _ 477 1-4 (5. 0,4 314. 6@0 11 \\\ 111.27 77. 34�.G�` I• ` 72i ry 0 to J - - • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORK PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/5 -4541 APPLICATION AND PERMIT [�C AS`SES,S�L A'CEL "Utv}�E 4 Y 1([! „�) ZON NG�-� BUILDING PERM OWt#TELEPHONE SQ. FT. OCC. BUILDING VALUATION - OWNER'S MAILING ADDRESS C NTR AC R'S NAME TEL HONE 7/ '1 V CONTRACTOR'S LING ADDRESS Fireplace E) CONSTRUCTION LENDER UNKNOWN Total Valuation$ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ' oo Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDI G ADORES PLUMBING PERMIT Filing Fee 10.00 ©O / r , ^ W Each Trap 2.00 ,� Repair drainage or vent piping 5.00 Water piping .- LOT NO. SUBDIVISION NAME PARCEL MAP Each Aas water heater or vent 5,00 Gas piping system 1 - 5 outlets r USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New Addition❑ Remodel[] Utilities[] Installation❑ Other ❑ Describe work: Permit Fee $ 70' Q Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6101 OR LESS 100 AMP OR LESS DO O Main service EA. ADD'L 100 AMP 1 2,50 QfD NEW CONST. OWEL I C d OR ADDNS. ( ACC. L S. Q ft CONTRACTORS LICENSE LAW I dear nder penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full rce and effect. License No. �1�72 3�_ Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR. -O LET 2,50 ea NON.RESID BRANCH CIRC TS NEW CONSTR. POWER APPARATUS S\ NON-RESID. SINGLE OUTLET CIR.1 Ex. Occup OUTLETS OR FIXTURES a �� FIXEDCC APP LHS, OR EX. Occup.(OUTLETS (RESID,) EA. 2.00 Temporary service 10.00 ' Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. �. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating T 1 , on Cooling Hood 3.00 31 Ventilation permit Fee S �' Contractor I certify that I have -read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities dgments, costs, and expenses which may in any way accrue against ai o my in conse Bence of the granting of this permit. Z �� �� X DateSignature of Applicant — Owner ❑ Contractor X Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. �1 /V PARC PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or work indicated above for which DI R R OF P LIC By /O PERMIT EXPIRES Date tQ the applicable provisions resolutions to - fees have been paid. WORKS ate tgr_ S D/� Z 3 �iy Receipt No. S� ��� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT �! . 'Y°s"RD"'r,. ,a1. +,.:aawi. Qf+4.++Ry:a�.r+-Tv-�;.wr., �.... _ - _ -as.=•srP!.�.- �-'_:rs+`;� ` :=L=%*'_ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/534-4541 r.. o. r+. PERMIT APPLICATION DATA SHEET OWNER Permit No. A. P. No. Proposed Building Use J Permit Fee Based Upon: Complete Contract Price DPW Valuation n � her (Explain) Building Inspector ` ' \ Date' At time of permit application, I was advised the following data must be submitted prior to permit processing and/or Issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate/triplicate. . . . . . . . . . . 3. Complete plans in duplicate. /triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . ... . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . /9: Letter of signature authorization. , . D� , 10. Sanitation approval from Health Dept.r�- 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . 17. d 8. At -A When you Issue the permit, process as TOIIOWs: - Mall to owner. Telephone t_' and hold for pickup at �ifl) ol Other Applicant Mail to contractor. _Deliver w/irnspector. Date Z -- Copy of plans sent Health Dept., Fire Dept., Other I Date During the plan checking process, the following data must be submitted prior to permit issuance. (For required items not checked above at time of a pli ation, ,'r item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor Designer, Owner) was advised of above required data by By Plans checked by_ Plans approved by Other Copy—DPW elephone Mail Date, _ Date -Date er IFV-2— TO: Building Department FROM: Environmental Health, Chico SUBJECT: Sanitation Clearance � f6- �- 3 T. ,��-��o�- &,, (vim l� a a Owner Location o � A r) i Plan approved for: sewage disposal_ Hold final for: Final clearance O.K. for: Clearance for 2 ---bedroom 11 home. Other Note*** Sanitarian water supply water supply water supply Date Ret stn to DPW OFFIC:AL RECof1 os AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT BUTTE COUNTY- (;ALI : . FOR RESIDENTIAL DEVELOPMENT REM11 5 REQUE;Tzp BY 'Section 26-8.1 of the Butte County Code requires this acknowledgement FEB (0 9 17 AV. 1982 be recorded prior to issuance of a building permit. CLARK A. NELSON The property described herein is adjacent to land or included CLERK-RECORDERI G� 1 '.within an area zoned for agricultural purposes, and residents of �2 FEE this property may be subject to inconveniences or discomfort arising " .3�3 '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 occa- sionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive 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: ieing a portion of Farm Allottment No. 15, as the same is designated and delineated on that certain Map entitled, "Subdivisional Plan of the Durham State Land Settle- ment, being a portion of the Esquon Rancho situated near Durham, Butte County, California", which map was recorded in the office of the Recorder of Butte County, California, September 17, 1918, in Volume 8 of Maps, at pages 16, 17 and 18, and more particularly described as follows: / Beginning -at the Southwesterly corner of said Lot 15, said point being in the centerline of a County Road; thence from said point of beginning, along the West- erly line of said lot, North 320 30' West, 1369.49 feet to the Northwesterly corn- er of said lot; thence along the Northerly line of said lot, North 660 05'East 644.00 feet to the Northeasterly line thereof; thence along the Easterly line of said lot, South 240 25' East, 272.80 feet; thence leaving said"lot line, South 660 05' West 51.15 feet; thence the following courses and distances; South 270 22' East, 250.05 feet; South 70 39' East, 270.57 feet; South 130 42'East, 161.05 feet; South 570 33' West; 65.88 feet; South 330 49' East, 302.15 feet and South 30 57' East, 163.54 feet to a point in the Southerly line of said Lot 15; thence along said Southerly line, being the centerline of said County Road, South 890, 30' West, 105.61 feet and South 6:90 30' West, 135.50 feet to the point of beginning. EXCEPTING THEREFROM the Southerly 20.00 feet lying within said County Road. Date: February 9, 1982 PROPERTY OWNERS: State of California ) On this the 9th day of February , 19 82 ) SS. before me, the undersigned Notary Public, personally County of Butte ) appeared Mary L. Cannon i> KATHLEEN A. PISA�11 known to me to be the person(s) whose name(s) is .n, NOTARY PUBLIC -CALIFORNIA subscribed to the. within• instrument and acknowledged Butte County that she executed the. same for the purposes My Commission Expires Dec, 3, 1985 p p therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. o QJz-�-�„/.4_ 0 Notary Public + Kathleen A. Pisani Present A.P. NO. � '/l.! 'le - a 1 F..f. 4 Yr'\ �i9xSE'Zti� �r f#ro JY'�0 �J Y li%f�+�R��. .., 'i, �.,: ?'..,�C l', `•J"l �YJ�"���^w'J J•t���'fy"(�itr pC?'*i'C {,.� STATE OFC LIFORNIA j � O^ COUNTY OFSI- E ))) 'D• E �(� f3rZu�irv� IO 1C' obefore me, the undersigned, a Notary Public in and for Rr °�•. v said State, personally appeared::::L+ ,QaLL rC— E Q •. known to me to be the person whose name I S anweneeeeEE�oenune��aeto►E�rrrne>fo�omm�woe� wOFFICIAL SEAL o v r .. subscribed to the within instrument and ack wledged to me DANIEL F. HUNT e _ C ' vg74- 'j" NOTARY PULLIC — CALUORNIA 7 that— exec ted the same. ^ F' T ' /f FR -NO'e OFFICE IN THE _ r y ti COUNTY OF BUTTE 3 o WITNESS my hand%p Oficial s al Comm. Exp. Oct. 1, 1982 C m f ., � ~ U T r+ • •e.�- ..;••sre+. `•wr.�r*<+x;wer-wii vrm..f�nw.�y',Cf.{''KPi+:a,s. ykL �.tti,w r.�,.,t.,..'.f rr'.e.v. a ..ti. - .:^rte 6r rr •e" �4r •�. it E.! M � *X cii?. .(`.Y . .:YM `G ..>• �;A'y ,_:;�,"�1�.• ..`y`.� •r'' r"'t: .:.n 1.,, t�•s.�.r. �� � •a:+ �.i ,.:+••*� t"c �.',:A { �7a... _• �, 'ki .� {•.e.J<`.'i'i'Y7'+�r P «`Y N � i •� v r - � - my cp4f )V/s BUTTE COUNTY BUILDING DEPARTMENT 7 County Center Drive Oroville, CA. 95965 PHONE: 916-534-4541 ' AGRICULTURAL BUILDING Exemption Form I, eefOR7- X L9A1,11Q1;-01V , owner of the property located at (please print) Assessor Parcel # yl0 --0216112,3 , intend to construct a �_' 'x A I T, F24MC �Cx'/agricultural building on this property. (specify type of construct • & siding) I declare the building will be used to house (specify se from definition below) which conforms to the Ag. building definition. Agricultural building is defined as follows: Agricultural building:is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public.- -..- I understand if I change the use or occupancy of this building I will be sub- ject to the necessary permits, inspections, and approvals from the Butte County Building Department. , Signature of Property Owner Date Building Inspector receiving form Comments: Duplicate to field inspector - Date a MW r r , A � _ ;: tMrP n. .,'�•,faiWk " u�l}1 4 Y}yy,� K ' ua . n ,• Y;. n d ' , vl .r •, � iMr. inAw k 1�li w«� �+d•w w ww M M'� grAAa4 'Inw ,raia4+t w A�Vn,Mw hr .4fy+M MrM•!M�bw4�*t'A-?,"awfi"+wr ,wp.e�, „ r •, •, w w "..~� k.N�,�r � ,.I r y .6. y, ,� � �"?`M41ty r11��G-.,rMwr�'.w,r�r.�*�Iel�n"1�¢�w,!�r'7"T�',"Md'!p'"".lr.!!IM+�Ye+M!•M!!""�M*"tNw;?4i+hirA"itMj':.�M+e*Y1k,rti,N. rrewM,�r.wn+M�+x T::wa"M+n.ar.M.�.rk`���"�'r !M!��'/j�'.r �w �st .,. tib �a4 t^+°.r1:rr' �r �1wD` A�A441. 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