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040-640-026
5 NOTES RESIDENTIAL PERMIT NO. _'_04.0-640-026 05-0948 BAUMAN,BOB 11 SEGA, CHICO Cont: PERFECTION POOLS NEW POOLMSW500-01 t, ra-1 X-ay,t SPECIAL CONDITIONS CHECKED BY }t SRA - FLOOD CERTIFICATE REQ. 4. FIRE SPRINKLERS'REQ. ' SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB-STANDARD HOUSING LETTER JOB FINALED (D e) Ns d Signature / J = ;OK 0 =,rNot OK NotApplic. = able Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 3. 2. Soils; Special MH Support Sketch Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 3. Sewer; Location -Test -Fall -C/0 -Concrete 6. 4. Water; Location -Test -Easement Needed (Sketch) Electric 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 9. 6. Gas; Location -Test -Wrap;-,' /" L'ft. / P Nat. or / /" L "ft./ P LPG Roof; Shthg-Roofing 7. Well Clearance & Disconnect 12. 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6: Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged) 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B Date Card B-1 Date POO (P s) OK except #'s ks-Easements s; Compaction -Structure Stability Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacle nd Lighting, Distance-GFI 5. Elec.; Pool Li ing; 15 Volts-GFI 6. Elec.; sures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures-Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. PI .; Cir. Test -Water Supply Test 1 . igXf Niche 12. nclosure; Fencinq-Alarms Date`-tY,915 Card Date Card B-1 Date( jy j Card B-1--,<,// Date Card B-1 �SQUIP A "/* J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel -Wrapped _ 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date FRAMING (Continued)• Date Hangers -Post Caps -Anchors -Connectors Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 50. 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 55. 22. Gas Pipe; Sixe & Anchors 56. 23. Fire Sprinkler; Test 57. Siding -Nailing Veneer 58. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection Insulation -Walls -Ceilings 25. Elec. Receptacles Spacing -Lights & Switches at Doors Infiltration -Walls -Windows 26. Size Boxes & No. of Conductors Stapled Card B-1 Date Card B-1 27. Romex Installed Close to Edge of Studs & C.J. Card B-1 Date Card B-1 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes 0 No 32. Service -Riser Conductors & Ground Main Disconnect 68. 33. Equip. Clearances Panels-Motors-Mech. Equip. 69. 34. Clothes Closet Light -Shower Light -Spa Light 70. 35. Smoke Detector 71. Fireplace or Stove, Clearance -Hearth Date Elec. Outlets at Wood Panel, Int. & Ext. Card B-1 Date Card B-1 Date Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. AC. Ducts Insulation & Support 76. 37. Vent Fan, Exhaust above insulation 77. 38. Condensate Drain & Overflow, Size & Grade 78. 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 40. Attic Access & Platform if Furnace in Attic Date 81. Guard Rails & Deck Construction -Post Caps Card B-1 Date Card B-1 Date Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing 89. Ventilation Throughout House Date FRAMING (Continued)• 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under Floor 0 Yes 83. Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: r ................. '.W!'. ........... COUNTY OF BUTTE BUILDING DIVISION t DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville; CA • (530) 538-7541 CORRECTION NOTICE 0 PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of work is completed. If you have -any questions pertaining to this matter, or need additional f-. explanation, please contact the Building Inspector as indicated below. ,r t. Y Date 7 Inspector1 -. REV 4/05 Phone #� L7 v FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 off COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 I CORRECTION NOTICE 0,-j OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at .ti. the above address and should be corrected. Please call for re -inspection when correction of ;. .:. work is completed. If you have an q estions pertaining to this matter, or need additional 4' explanation, pl selcontact B � din Inspectouas indicated below. 13 -A . Date �' Inspector�� REV 4/05 a'~" ♦ Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 J 1 �N k g f: r � -A . Date �' Inspector�� REV 4/05 a'~" ♦ Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVIL'LE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netldds P/,,—y,��s Jai SC?G -D/ 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 the Business and Professions Code, and my license is in full force and effect. C License Class: 41f-- 55 License Number: Date: Y'IJ) OS Contractor: T=�trZEo., ► od{S 1-5; OWNER -BUILDER DECLARATION 1 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 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 the Contractors Stale License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 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 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.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profossions 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.). ❑ '1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: WORKERS' COMPENSATION DECLARATION I hereby affirm under penally 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 /. issued. tY I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit Is issued. tiny workers' compensation insurance carrier and policy number are: _ p Carrier: Policy #: O 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 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, 1 shall forthwith comply with those provisions. Date: ` if /0—S Applicant: v 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 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.) Address: PERMIT NO. BP050949' Issued Date: 04/26/2005 APN: 040-640-026-000 Site Address: 11 SEGA DR CHI —s' Map Index: Description: NEW POOL MASTER #500-01 Owner: BAUMAN, ROBERT 11 SEGA DRIVE CHICO, CA 95928 (530)624-7887 Applicant: PERFECTION POOL AND SPAS 172 E 20TH ST CHICO, CA 95928 530-895-0437 Contractor: PERFECTION POOL AND SPAS 172 E 20TH ST CHICO, CA 95928 530-895-0437 License #: 566654 Architect: Engineer: Total Square Ft: 0 S. F. Valuation: $0.00 Census Code: Ttv permit Is hereby issued under the applicable provisions of the Buffe Counly Code anrvor elutions to do work Indicated,yo)j for which fees have been paid. PERMIT EXPIRES ON: ❑ 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 & Safely 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'l 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 an official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpp I`v Print Name: �✓✓�1 ��I J Signature: Date: 4 / / C ` S ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor r ` 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 mwsTi sao 1 **PLEASE PRINT CLEARLY** PLICANT SI NATURE x ��s For office use OWNER Last Name GL �, L✓t a� ---; � — �- odlS �-S irst Name �o '✓� Address 5 e-:2 C'— r City f e_0 State �t S 77 Phone_ 7 i6_7 Fax E-mail Lic. # Class PLICANT SI NATURE x ��s For office use CONTRACTOR Name Name ---; � — �- odlS �-S Address /7,2- �� -Z-� T City e) State f Zip q --?22 -Phone� �t S 77 -Fa. $9 S o 5 E-mail Fax Lic. # Class PLICANT SI NATURE x ��s For office use ARCHITECT/ENGINEER Name C� l Subdivision Name Map Address 1-72. .moo TC r S city Address t =f City C_ GO State G)I- I 'jpert SJ7 Phone qZ /3G -3q2 Fax E-mail State License Number I K K DE' PLICANT SI NATURE x ��s For office use APPLICANT NAME Name Type Const. Subdivision Name Map Address 1-72. .moo TC r S city CG, i co State ,/1 /Y- ZjpgS`lzs Phone g�s — 0Y3 7 Fax E -mail PLICANT SI NATURE x ��s For office use Zoning Flood Zone SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS PERMIT NO. BP�� BIN # LOCATION AP# 0 4,a Property Address It .s a. 'e, City C�rcc.J Cross Street 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 -Nam Address Description or Scope of Work: _F�.'%-�I Sq. Footage ❑ 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 K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page t 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: Amount: 4(07-1 `t` Bldg SRA Receipt #: � D I I Sheriff Date: J� SMIP Other Total REV 7-27-04 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 paperl) 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 faxesl ❑ 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). ❑_�_3—S.anitation.a "te pJariapprov_alAom-tbe-EavlronmentaLHealtbDepadment. 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 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 KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 7-27-04 COUNTY OF, BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION =.7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 i PERMIT APPLICATION DATA SHEET OWNER: I ASSESSOR PARCEL NUMB4R �/ l �� 7TY Proposed Building Use: Permit Technician.Wq- Date: 71 Iters -required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1. Site plans, 3 or 4 sets, signed 8y 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) Installation manual, including 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 66" stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form i 0 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Re7iffing,items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 5. anitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable 0 ❑ Fire Sprinklers......................'t..................................................................... ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ 19. Erosion Control Plan Required.I....................................................................... ❑ 20. Fees as shown on the attached! Schedule of Fees Due Sheet .............................. ❑ �r`21. City of Chico Plumbing permit..' ................................. ❑ 22. Site plan and business license approval from the City of Biggs .............................. *�_,*Ccontact alifornia Department of Forest''r��'' an approval ❑ paid. Sent by: lanning approval for (A) Use: U�(B)Parking: (C) Parcel Check:... Land Develo ment:abou Im rp , t _ Improvements, _Drainage ........................ 26. NPDES Form.................:......1.................................................................... ❑ 27. Encroachment Permit for. driveway from the Public Works Dept ..........................., ❑ 28. Contractor's license information (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Carrier'and Policy Number .......................................... ❑ 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... 0 31. Letter of Signature authorization...............................................1.................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement .......... .7. .................... ❑ 33. Existing violations and/or expired permits .................................. `:...................... ❑ 34. Deed Restriction...............................................................r......................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: I ❑ 37. Other: t When issued Telephone S 13 413 ' and hold for pickup. I have been informed of the above items and requirements for obtaining' a building permit. Applicant: �� Date: 1. Index ermit application f r the above items numbered: Plan Check Letter I items required �Onr_a`ct�_`rdesigner, owner, was advised of the above data by phone, ❑ mail, ❑ counter, by Date: 067r, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, own r s advised of the abo data ,y ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: tJ _ Plans approved by: 9 Y� Date: Structural reviewed b : Date: Structural approved by: `-Date: IV Note transfer by: Date: Yellow: Building Division E.H. USE ONLY Pot Man Attached .df Floor Plan Attached Sent to B.D. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for dwelling. Other Hold final for: Final clearance O.K. for: NOTE: Environmental Health Specialist 8/96 PRTMENT ,o `r y Svc w7o DeP'artment C o u n t National Pollutant Discharge Elimination Works LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1 ACRE1 Project Description: w t ►�cy� I 1 Project Location and/or Parcel Number: O U G �f U Gt r`C CA 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. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require 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. I Signed: Title: Date:. i Al w5 Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program I Revised 5/24/04 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION r 7 County' Center Drive Oroville, California 95965 • Telephone (530) 538-75 PERMIT NO. (Rev.12j! 6) , i APPLICATION AND"PERMIT ` 3 7 `? ASSESSOR PARCEL NUMBER 040-640-026 ZONING SR -1 BUILDING PERMIT OWNER Me hdadi. Andrew 624-5189 TELEPHONE SO. Fr, OCC. BUILDING VALUATION . OWNERS "UNG ADDRESS 3110 Shady grove Court Chico CA 95973 U 14 778.00 CONTRACTOR'S NAME owner TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $989.90 Plan Checkin Fee $ BUILDINGADDRESS 11 Spgn Drive Chica CA 99()28$ Energy Plan Checking Fee $ PERMIT FEE $ LAT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK NewAddition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: NSF Master 97-44 t Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ N ELECTRICAL PERMIT Fling Fee 20.00 Main ServicezoOA 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' full force and effect. � License Class Lic. No. 10� -70 2 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, 0 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. ❑ I'am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. BSI 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' o pe satin . sura a carrier and policy number are: Carrier Policy Number —O — Z (The above sections need not be completed .the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X _ Date I, _ Signature of App ant - ❑ dwner ❑ Contractor Tent An OSHA permit is quired for excavations o O" deep and demotion or constructionhad/i of structures over 3 stories in height. 2-3.00 Main Service 200A TO 1000A 46.00 NEW CONST. DWEwNG OCCUP. s0 OR ADDNS. ( a ACC. BLDS. 3.50 Fr. 44.34 NEW CONST. MULTI.OUTLET NON-RESID. @7.50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES BAL @' 0 Ex. Occup. oF"LUTiETs(R�D.oEEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation 3 4.50 13. -50 PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ H D. Es H ISSUE 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. -. M 3�/03 Date / PERMIT EXPIRES ON 3 Dafe Receipt No. WHITE-D.D.S.-B. CANARY -ASSESS PINK -INSPECTOR O D- 7T J% -o UNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - B ILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone ( 30) 538-75 1 PER�NC APPLICATION AND PERMIT �3 �� ? ,bE„ r BUILDINGPERMIT i b -• �O�f o r D� TEtFP3a7ME SQ. FT. OCC. BUILDING VALUATION toe _ !� _7` �'� c 9 3 a 7 TELEPHONE l � � _ DOAE56 jNSTRUCTIOII Lt:r+37tX NDER3 W&P-4 —w -- ,CtWEcr OR E1MMUM CH,TEM OR EHO IM" MAJUM ADORE= -3)b-1"�LUSEOFSTRUCTURE .F ❑ Duplex' ❑ M oblshome ❑' Other TYPE OF WORK .I_ -w ❑ Addi6on ❑ Remodel ❑ 13Uu jSes ❑ Installation ❑ Other - Describe Work: K11�/� F"L &-L:>:D a �,� O -S 18 C, lace Valuation Permit Fee Plan Checku Enamv Plan Each Trap — - ----s-- /- ---7- - 6( Solar or haat pump water heater 1 23.00 $ 2D.00 Each gas water heater or vent s •S?� 15.00 S .0 ng Fee S s PERMIT FEE S.OD 'ERMIT Firing Feel 20.00 Each Trap — - ----s-- /- ---7- - 6( Solar or haat pump water heater 1 23.00 Water piping 1 15.00 /,s 0 [I Each gas water heater or vent 'oI- 15.00 -50,0(-,) Gas piping systerr� 1 - 5 outlets 15.00 sulft sewer 15.00 .Moble Home IS I G I W 1 20.00 PERMIT FEE S 06 - 0c) ELECTRICAL PERMIT Firing Fee 1 0.00 l...t_ r eotry OR lE ± t 71 nn i a 0V Mair Service god► TO IDWA 46.00 NEW ORR�Dm`�w^ ( ° s�J°�ce. °etns`�'. ' 3.5¢N �y • 3 FUM w►t R 145 ""viaE°unEr @7.50 F4SN6i APPAR/lM s sD+r�.E ourtET wR Ex. Occup. mm r OR Fxnstm Ex Occup. FC® A34LM5. . OR F ov= mA S.OD Temporary Service 23.00 Moble Home Facilities 20.00 W=. Wiring 23.00 PERMIT FEE S /1? 7 MECHANICAL PERMIT Firing Fee 20.00 Heating ir% — Q Coorm .-- Hood Ventilation3 Y SZ7 / 3 , 3-0 PERMIT FEt S / S' "d d Mobile Home Installation Fee S Energy Inspection Fee S DK � ' TYPE TOTAL FEE $ d MAZ. I D. FEES I OVI I FjQOA I CDF I P . E --1 -5 This permit is hereby issued under the applicable provisions of the Butle County Code and/or Resolutions to do work indicated above for which fees have been paid. By PERMIT EXPIRES ON Dale �_ r- .r. r.�. -M —�r+c�r+^^ yr Fx '.r--•^*� 'c M' ►�t��t F. rxh. 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: �QC.CiC� ASSESSOR PARCEL NUMBER 4( 0 _ &A0 Proposed Building Use: Counter Technician: \l=J Date: Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. ip. -Plot plans, 3 or 4 sets, signedAy 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. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in duplicate. ❑ 7.1 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 engineer. 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 By ❑ 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............................................................................... ❑ 13. Other 714 aining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) . Fees as shown on the attached Schedule of Fees Due Sheet ....................................... ❑ 15. Statement of Intent for Non -heated and A/C Buildings ............................................. N16. Sanitation and plot plan approval from the Environmental Health Department in ❑ 17. City of Chico Plumbing permit......................................................................... r ❑ 18. California Department of Forestry plan approval ❑ paid. Sent- by: !t w, ❑ 19. Planning approval for (A) Use: (7 K (B)Parking: (C) Parcel Check: O 20. Contact Land Development about ❑Improvements, ❑Drainage .............................. :*:�21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... ❑ 24. Worker's Compensation Carrier and Policy Number ..............:.............................. ❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization ..................................... :.............................. -Z�27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28.. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits ................. :....................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone u7 - 5 i g `j and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: J,�'d Date 1. Index permit application Or the abov items numbered: 2. Additional items required Contractor, designer, owner, was advised cf the above 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 by: Date: Structural approved by: Date: �o Note transfer by: Date: Yellow: Building Division 6-1-03 Plan Check Letter J` y, J Y -76 %.1T0: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H. US ONLY Plot Plain Attached ' Floor Plain Attached Sena to B.D. 1Zi,�� O tae -0/ 2z Owner / Location AP# Plan Approved for: Sewage Disposal ✓ Water Supply: Public Private Well Clearance for / dwelling. Other. Hoffa in - � - ' al clearance O.K. or: NOTE: r 8/96 ',2-2 -Z73 Date :f COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVELLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 SCHEDULE OF FEES DUE OWNER A.P. # %� C�C� f PROP D BUILDING USE I DATE 611 i REC IPT # DATE REC UILDING PERMIT FEES Balance Due ........ ............. $ Additional Fees Due ... .............. $ Additional Fees Due .. ............. $ Revised Plan Checking Fee .............$ 2. SCHOOL DISTRICT FEES ICAC D �j (paid at District Office) (Available after Plan Check) D ✓ 3. SHERIFF FEES (paid at Building Division) Residential ...................... x $360.00 = $ 360- iUnits Commercial (sq. ft.) ......�......... x $0.03 = $ Sq. ft. 4. URBAN AREA FEES (paid at Building Division) Residential ............ x = $� # Units Amt. Commercial (sq. ft.) ...... r ..... x = $ Sq. ft. Amt. 15. RECREATIONAL DISTRICT FEES (paid at District Office) (Available after Plan Check) i 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 1 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE1 $2500.00 (paid at Building Division) 10. OTHER At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APF ICANT rsuant to Government CoOe Section 5020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 88,, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original - Buiding Div. 2nd Copy - Applicant I 3rd Copy - Owner (Rev. 6/00) .'•w BUTTE COUNTY PARRS DEVELOPMENT FEE CERTIFICATION FORM CHICO AREA RECREATION AND PARR DISTRICT Assessor Parcel Number(s) 04 0 Property Owner Project Location/Address Subdivision r4tz_111 !' Lot Number(s) 4 4 Residential Development: (check one) ' New Development Alteration/Addition Mobilehome(s) Total Number of Dwelling Units Comment: Non -Residential to to Residential 7 /3 �uiling Department RepresentativeDate wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww�rww�r*w Chico Area Recreation and Park District(CARD) certifies that abdIP16) P ti u�3-yklto (Applicant Nam6 (Phone Number 31/b Sh(Ad�. %rwe C - (Street Address) �Cy (City) (State) 14ip uoae has complied with the requirements of'Butte Co. Resolution No. 90-140 by y �o payment for dwelling units @:$1,189 for total payment of $ CARD Representative PAID BY CHECK NO. REMARKS: BANK NO. 3 O Date I PAID BY CASH RECEIPT NO. 07/30/03 09612 8:217Rti XXXTOTPL $1189.00 Distribution: White --Applicant Yellow;,, -.Butte Co. Building Dept. Pink --CARD Goldenrod --City of Chico Building Dept. park.fec (form revised 11/90) F. + �. �. 4 1 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District A [' : , 1 ! Building Department No. �' "�� % %J� byo 6 yo - t A.P. Number � � Jurisdiction: � City County Property Owner f-nta4da ne-e' Property Location/Address Subdivision Lot No. .................................................................................................................. Residential Development Sq. Footage Q Nog Mobile Home Addition/ 'Supplemental to a (Group R)t Units Installation Conversion Permit # € '(No foundation inspection): ; .......................................................................... . Commercial/Industrial New Addition (Floor Plans reviewed by School District / "' 'District Identification No. 17 School District certifies that (Street Address) Sq. Footage (Including Exterior Roofed Areas) Date (Applicant) (Phone Number) 1 r <"6-0 e (City) (State) (Zip Code) has complied with & requirements of Resolution No. 57� by payment of $ Q �• representing 13� 0%:?::� square feet. AB 2926 $ FULL MITIGATION $ 1 School District Representative Date Paid by Check # Remarks: 4 Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.x1s•(10/98)dmm Sent By: BUTTE CO ENVIRONMENTALHEALTH; 530'895 6512; Jun -26-03 11:58AM;- Ate ' QtA1JC,'T'U M AND EQUIPMENT INCLUDING 0VEpVjANQS SHALL SEiCLEAR OF All EASEMENTS. A ,BET BACK O=kc -. FROM IME SIDE AND A5 MK%F. FROM THE REAR PROPERTY LIVES AND S1� Ff. FROM THE ROAD CENTERLINE SHALL BE ry CAM fNV'ffMl 11CM. IRFS AND EQUIPMENT EXOEAT rage ele I LCT 4S12R �sq ft. ®UILPINO 4441 ;eq. ft. WYERJCIE GREGORY A. PEITIZ I ARCHITECT wlw&uft&& mkaal. am wq M K SIM PLAN LOT 4 - lVW PALMS SUBDIVISION hr I —1775 BUTI-E COUNTY BUILDING DIVISION TPROVED LOT 4 PLANNING DIVISION- BUILDING PLAN APPROVAL Use: D K Date: 6-2b- Parking: Landscaping: COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 1 7 County''Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) ,4 ,• • V APPLICATION AND PERMIT �� ►'� ASSESSOR PARCEL Nb&ERYZONING 04V-640-026 5R-1 BUILDING PERMIT OWNER #KiA. , Aridrew 624-51891 TELEPHONE Sp. FT. OCC. BUILDING VALUATION OWNERS MAILING 3110 Shad Wave Court Chico CA 95973 R 17k//6.W 6 14'3303 /6 W CONTRACTOR'S NAME owner TELEPHONE �f 498 CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ 103q.614.W ARCHITECT OR ENGINEER UCENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee $989.50 Plan Checking Fee $ BUILDING ADDRESS 11 Sega Drive Qiir-o CA 95928 Energy Plan Checking Fee $ $ PERMIT FEE $10'49 MLOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF` Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 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 ❑ Unities ❑ Installation ❑ Other ❑ Describe Work: NSF Master 97-44 Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 1-5-00 Mobile Home I S I G W 920.00 PERMIT FEE $ ?M M ELECTRICAL PERMIT Fling Fee 20.00 Main Service 000V OR LESS 2OOA OR LESS 23.00 n LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 commencin with Secti7000 of Division 3 of the Busid ProfessiCode, ( g on ) ness anons and my license is 'l full force and effect. ^� License Class Lic. No. n OWNER -BUILDER DECLARATION I 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. 0-- as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service YOGA TO 1000A 46,00NEW CONST. °WELLING OCCUP. OR ADONIS. a ACC. BLDS. .4/- 7 SO 44. 3•50FT. 4.34 NEW CONS . I.ONON•RESID. MULTUT f @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 1 X20 0' o Ex. Occup. ouTiDrsAa o.°ea 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 187.34 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. 911 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' corr[��pe1 sation.insura^� a carrier and policy number are: Carrier ,,,T(� �P t_ (,4r - Policy Number -71-71 0 10 1 U - (/ 1_, (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 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 become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X �r� Date 9 0 3 Signature of Applicant - ❑ ,owner ❑ Contractor Q,.Agent An OSHA permit isQquired for excavations over,60" deep and demotion or constructionL of structures over 3 stories in height. �+ n MECHANICAL PERMIT Fling Fee 20.00 Heating 2 20.00 40.00 Cooling Hood 6.50 6.50 Ventilation 15.00 15.00 PERMIT FEE $145 00 Mobile Home Installation Fee $ Energy Inspection Fee $ 46.00 Occ CONST. TYPE TOTAL FEE $ 1610.94 HAZ ..r- D. FEES JM 0 ` ISSUE This permit is hereby issued under the of the Butte County Code and/or Resolutions indicated above for which fees have / By, PERMIT EXPIRES ON I applicable provisions to do work been paid. Date 13, - Dete' Receipt NoIi/Q VI 7 WHITE-D.D.S.-B.D' CANARY -ASSESSOR PINK-INSPECTOR,GOL;; ROD-APPNCANTr T / - ENCROACHMENT PERMIT County of Butte Department of Public Works 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 538-4356 Download Forms: www.buttecounty.net/pubhcworks/fomis.html NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Phone 530 538-7157 Ext. 2016 __T Permit Number District APPLICATION I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County roads and highways, all in accordance with County ordinances and general laws. All information except signature must be typed or legibly ted. 1. Applicant's ame , u la. Company name: ,Sro'�C - 2. Address: � d � ���� ��e-o✓� �-- Gc�-• � c_.o 9 SCJ '7 3 3. Phone: 3 _ l 0 4. Assessors Parcel Number:n 5. Location of Work to be Done 1- t.Vt N (i�)A—N 6. Applicant's ' atu7. Date: CONTRACTOR'S INFORMATION 8. Contractor's Name� 9. Address 10. Phone:S� Q eLT I L 1�_ 11. Fax:. 3t f 3 12. Contractor's L(p S' License 14umbe . / v 13. Certificate of Insurance: Y6ElNo: ❑ 14. Contractor's Sign 14a. Date Signed: 15. Authorized Agent: TYPE OF WORK TO BE DONE 16. Please Check: Curb: ❑ Gutter: ❑ Sidewalk: ❑ - 17. Driveway (List Type): 18. Other: PERMIT GRANTED In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) and special conditions written below, permission is hereby granted. 19. Conditions Fle4 et c4 17 Fx p24 m o irit ; e Undetground Service Alert .S.A. must be notified two working days prior to any excavation. 800-227-2600 20. LCAll work shall conform to accompanying: Detai . Plans ❑ Special Conditions ❑ 21. Date Issued /G 3 02 22. Expiration Date: /U s CSP 23 Surety: . es. Mike Crump, Director of Public Works By: **.Note: If permits are faxed to any number besides (530) 5384356, they can be delayed up to one 10eek. Page 1 of 2 General Conditions — See Page 2 GENERAL CONDITIONS 1. It is understood and agreed that the County has prior right to the use of its rights of way. It is further understood and agreed by the Permittee that the doing of any work under this permit shall constitute an acceptance of all the provisions contained herein and failure on the Permittee's part to comply with any provision will be cause for revocation of this permit. Except as otherwise provided for public agencies and franchise holders, this permit is revocable at any time. This permit is to be on job at all times while the work is being done. 2. Al work shall be done subject to the supervision of and to the satisfaction of the Public Works Department of the County of Butte. The Permittee shall, at all times, during the progress of the work, keep the County Highway in as neat and dean a condition as is possible and upon completion of the work granted herein, shall leave the County Highway in a thoroughly neat, dean, and usable condition. 3. The Permittee agrees by the acceptance of this permit to property maintain any encroachment placed by the Permittee on any pad of the County Highway and to immediately repair any injury to any portion of the highway, which occurs as a result of the encroachment, until such time as the Permittee may be relieved of the responsibility of such encroachment by the County Department of Public Works. 4. It is further agreed by the Permittee that whenever construction, reconstruction, or maintenance work upon the highway may require the installation provided herein shall, upon request of the County Department of Public Works, be immediately moved by and at the sole expense of the Permittee. 5. No material used for fill or backfill in the construction of the encroachment shall be borrowed or taken from within the County right of way. 6. At least one lane of any public road, under the jurisdiction of the Board of Supervisors of Butte County, and other public roads junctioning or intersecting therewith, shall be kept open for travel by the general public at all times. No public road under the jurisdiction of the Board shall be dosed to travel by the general public without special permission, in writing, from the Board of Supervisors. 7. The Permittee, by the acceptance of this permit, shall assume full responsibility for all liability for personal injury or damage to property which may arise out of the work herein permitted or which may arise out of the failure on the part of the Permittee to do the work provided for under this permit In the event any claim of such liability is made against the County of Butte or any department, official, or employee thereof, the Permittee shall defend, indemnify, and hold them and each of them harmless for such claim, 8. Al excavations shall be backfilled and compacted immediately after work therein has been completed. Trenches shall not be left open farther than 300 feet in advance of pipe laying operations or 200 feet to the rear thereof, unless otherwise permitted by the Engineer. Unless otherwise permitted under the Special Conditions, backfill shall be place and mechanically compacted in such a manner that the relative compaction throughout the entire fill within the County road right of way shall conform to the percentage of compaction as stated below. Permittee shall notify foreman 24 hours before backfilling and/or paving. a. The relative compaction from the bottom of excavation to a plane five feet (6) below finish surface grades shall be no less than ninety percent (90%) as determined by Test Method No. Calif. 216-0 of the Materials and Research department, State of California, Transportation Department, Division of Highways, or other approved test method. b. The relative compaction from a plane five feet (6) below the finish surface grade to said finish surface grad shall be no less than ninety-five percent (95%) as determined by the above testing method. Permittee shall bear all costs and responsibility for compaction tests. c The relative compaction from a plane five feet (5) below the finish surface grade to said finish surface grad shall be no less than ninety-five percent (95%) as determined by the above testing method. Permittee shall bear all costs and responsibility for compaction tests. Material for use as trench backfill in any existing or proposed roadway section shall be sand, shall be place in 8" lifts, and be compacted to a relative compaction of not less than 95%. Material for use as backfill in roadside gutter excavations shall be the native material and be compacted to a relative compaction of not less than 90%. Any pavement cutting shall be scored, or saw cut before trenching. Minimum depth of cover over all underground facilities shall be 30 inches, except drainage culverts. All installations, parallel with roadway, shall be placed as dose to the right-of-way line as possible. No portion of the backfill(s) shall be compacted by ponding or jetting. All pavements, curbs, gutters, sidewalks, borrow ditches, pipes, headwalls, road signs, trees, shrubbery, and/or other permanent road facilities impaired by or as a result of construction operations at the construction site(s), or at other ground(s) occupied by materials and/or equipment, shall be restored immediately upon backfilling or the excavation to the original grades and cross sections, and to a condition as good as, or better than, existed prior to the construction. All surfacing materials of roadways and driveway approaches cut or damaged by or as a result of construction operations, shall be replaced within ONE WEEK following the backfilling of excavation, weather permitting, with compacted layers of surfacing materials at least as thick as the existing, and no less than two Inches (2') of asphalt concrete over eight inches (8") of aggregate base, according to`current California State Specifications. 9. Whenever necessary to secure permission from abutting property owners, such authority must be secured by the Permittee prior to starting work. 10. The future safety and convenience of the traveling public shall be given every oonsideration in the location and type of construction. Permittee shall cause to be placed, erected, and maintained all warning signals, rights, barricades, signs, and other devices or measures essential to safeguard travel by the general public over and at the site of work authorized herein. 11. If the construction work covered by this permit is to be done by a private contractor hired by the applicant, applicant shall notify contractor as to the special conditions and requirements contained herein. Page 2 of 2 r3 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 I "Hi 1 11,11 M101111.111001 _ Recorded I IJYf'iciati Records i 'Gunty Via► iT E l liecorder ; RC)SErARY [)ICFSdt� ! Assistant ; AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County C I . de 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: *''THIS DOCUMENT IS PEING RECORDED TO CORRECT THE .LEGAL DESCRIPTION FOR DOCUMENT SERIAL NO. 2002.-0045904, RECORDED SEPTEMBER, 4, 2002, IN BUTTE COUNTY, CA.. 7 Date 10/2.3/02 PROPERTY OWNERS: ANDREW MEGI. )A . I 1 State of California ) County of Butte ) On 1.0/23, 2002 before me, J. TUNISON, NOTARY Barbara Page 1. of personally appeared ANDREW . MEGI- DADI personally known to me (or proved to me on the basis of satisfactory evidence) to be the persons) 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`Mgnature(s) on the instrument, the person(s) or the entity upon behalf of which the persons) acted, executed the instrument. WITNESS my hand and official seal, f Seal: J. ?L_ COMM. it128Asi� A.P. NGiAfil'RU6LI(.- P. C LIFOFIIJIA riUTff COLI 1'1' C� f EXHIBIT "ONE" PARCEL. I: Order No. 202500 - C i Lots 1 thru 24, inclusive and Remainder Land, as shown on that certain Map entitled, "Chambers Subdivision #2", Phase I, filed in the Office of the County Recorder of Butte County, California, on August 4, 1999, in Book 147, of Maps, at Page(s) 86, 87 & 88. I PARCEL II: A Non -Exclusive Easement for ingress, egress, drainage, public utilities and public services over Lot 6, as shown on that certain Map entitled, "Chambers Subdivision #2", Phase I, filed in the Office of the County Recorder of Butte County, California, on August 4, 1999, in Book 147, of Maps, at Pages) 86, 87 & 88. Assessor's Parcel No: 046-640-011 -000 i Date: 1 I SITE PLAN REVIEW L/i Lam- O Permit Number if a�licable • APPLICANT INFO► RMATION Owners Name: t� 1 Owners Address: ' _ ,I Telephone No.: • i L, " s 12dn 61taan ed A By P pproved 1 7_4 Date 6 _'2_0 _ Situs Address: 7" Proa�osed Use• Re ' ential New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑❑ Permanent Second Dwelling ❑Temporary Mobile Home (Aunt Minnie Temporary Travel Trailer ) ❑ Multi -family 1 Non-residential ❑ New Commercial I ❑ ❑ Commercial Addition AP# APPLICATION Parcel Size: ❑ Single Family Remodel New Industrial ❑ Commercial Remodel ❑ Industrial Addition ❑ Industrial Remodel Z. A . Septic I ❑ Aicultural Exempt Building Re -Well ❑ Other: Brief Explanation 'f (1 necessary): N L DO NOT WRITE BELOW THIS LINE Page 1 of 5 solve Problems Prior to Approval i ALL ITEMS CHECKED APPLY TO THE PROPERTYIt 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: X • Flood Panel No.: 0 5 1 U Index Date: ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑ Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: — Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2of5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side p Side Street Rear ' 0 Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Page 2of5 t JJ Applicable Developutent Fees: Standard Fees. Amount Fo_la ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads =--- Sheriff ❑ Drainage -- ❑ NCSP/CSA 87 ❑ Chico Urban Area – Road ❑ ThermalitoImpact --- - — ----------- ❑ Other ---- Subdivision Map,Special Fees--------------------------------------------------------------------------- ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area . ❑ Other (per map) * Check with school district to verify actual fee if pre review. A final determination will be made at the ' the building permit, time of Parcel Created By • ❑ .Deeds: Date of Creation: Deed of Reference: Legal Access Provided: ❑ No Parcel Frontage on Publicly Maintained Road: Legal Access Required ❑Yes ❑ No El Yes No Complies with County Standards for Deed CreatiEJNo 11 Yes, Road Name: on: Comments: ❑ El Yes r ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ElObtain a Certificate of Compliance ❑Provide Deed 'of Creation ❑ Obtain -a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maes recorded prior to Book 17 of Maps Page 23). El Construct road to: ❑ Meet current Environm talne He�th Meet Parcel size required by zone Department requirements ------------------------ Page 3 of 5 40091 Subdivision Mal) arcel Map: 7-, „� 3�J per.Lw, S .IS OT�, Map Date of Recording: ) D 0,11 Lot: ❑ Use Permit/Minor Use Permit Permit Number: Book: 1 S Date of Approval: 41. Page: 34;, 3 S • Parcel Map/Subdivision Map/Use Permit Conditions Comply with the following Conditions of Approval: {1TT Pk e-1 4 e t It 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, Nl~PA 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 P must be prepared by a registered civil engineer or other qualified professional and 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 roa ❑E Page 4 of 5 IM] ) �� `A I TI ON AL G INFORMATION Sv °° SHEFT 10.00' P.S. � 1. BUILDING SETBACK LINES ARE AS SHOWN OF MAP \ , AND AS FOLLOWS: I LOT 6 FRONT/REAR/SIDE YARD - 50' FROM CENTERLINES OF ,0 INTERIOR STREETS, SPEEDWAY,- ENTLER AVENUES, AND THE SOUTHERLY LINE OF THE OLD S.P.R.R RIGHT OF WAY. REAR - 10' FROM PROPERTY LINE (EXCEPT WHERE NOTED) 0.3 SIDE - 10' FROM PROPERTY ILINE �� F �t 2. LEACH FIELD FREE SETBACKS ARE 5' FROM THE EDGE OF f THE STORM DRAIN TRENCH, 5'I FROM THE EDGE OF THE PROPERTY LINE AND 100' FRAM EXISTING AND PROPOSED WELLS. / 3. BUILDING IDENTIFICATION AND/OR ADDRESS SHALL BE INSTALLED IN CONFORMANCE WITH PUBLIC RESOURCES CODE 4290 AND SHALL BE POSTED AT THE BEGINNING OF BUILDING CONSTRUCTION AND \ MAINTAINED CONTINUOUSLY THEREAFTER. <° THE SHERIFF'S FACILITIES IMPACT FEE SHALL BE PAID, PURSUANT TO THE PROVISIONS OF CHAPTER 3, ARTICLE II OF THE BUTTE 20 / COUNTY CODE, PRIOR TO THEI ISSUANCE OF A BUILDING PERMIT, SAID AMOUNT SHALL BE DETERMINED AND CALCULATED AS OF THE DATE `fG� OF APPLICATION FOR BUILDING PERMIT. s 5. THE LEACH FIELD AREA ISS NOT TO EXTEND BEYOND THE 02 / ROADSIDE SETBACKS BUT MAY INTRUDE INTO THE 50' BUILDING SETBACK ALONG THE S.P.R.R'I RIGHT-OF-WAY PER BUTTE COUNTY PUBLIC WORKS 6. PER FLOOD INSURANCE RATE MAP NUMBER 06007C 0510 D, REVISED APRIL 20, 2000, THE PROPERTY SHOWN HEREON LIES WITHIN �y ZONE X AND IS OUTSIDE OF ITHE 100 YEAR FLOOD -PLAIN. co° 0 7. LOWEST FLOOR. ELEVATIONS SHALL BE A MINIMUM OF 12" ABOVE THE HIGHEST ADJACENT GRADE. 8. WELLS ARE TO BE LOCATED OUTSIDE THE ROADSIDE BUILDING SETBACKS PER BUTTE COUNTY CODE SECTION 10-8, WHICH DOES NOT INCLUDE THE 50' BUILDING SETBACK ALONG THE S.P.R.R. RIGHT-OF-WAY. , C\Land Project- P2\MPO IWIN ='LM' ;PDIVl'l0N\dwa\FlNAL MAP 5-2n-02DWG 08.'0?/0? 0808•14 AM P Sent By: BUTTE CO ENVIRONMENTALHEi ALTH; 53 895 6512; Jun -16-03 ENV1R0N :- Ir,! BUTTE COUNTY ' JUS& 17 '2003 AGRICULTURAL BUFFER UNUSUAL CIRCUMSTANCES REQUEST COHICO, CAL 11FOR I 8:10AM; Page 2/2 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 divided or subdivided. Applicant must complete the following and return with the required site plan to: Development Services Department, 7 County Center Drive, Oroville, CA (630) 538-7601 Name: A ,ha YIU rn P� ad r Phone: Assessor's Parcel Number i Reason you believe you qualify for the unusual circumstances exception: Tilt Aie_,E4- A -c; i-t�)P2 vUE7 ZZvi/-) JO,4LM s La/ Applicant's signaturei %-/'-)-03 Date QN9SU„ AL,CIR9UMSTANCE .DEFINITION: An exceptional or extraordinary condition where tate existing lot size or shape or an existing improvement (well, septic systems, structures etc.) does not allow for the standard condition of a 300 -foot buffer zone. SITg PLAN REQMIRgMW. submit 4 copies with this form Refer to the Site Plan Submittal handout for specific requirements :........ .................................... For Agn,c tt" Cotnnilssloeer office�usa only: (to be completed niter submittal) DISCREIP ARY PERMITS (Planning)--- MINISTERIAL P MITE (agildrdinpl V Exception Recommended. 0 Exception Granted with the 0 Exception NOT Recdmmended following conditions: Reason/Conditions/Specific setbacks from adjacent agricultural operations: S Agricultural Department Signature: -�' Date 6 2D� YMC 4a"3 i INTER -DEPARTMENTAL MEMORANDUM I TO: BUILDING DIVISION ROVILLE I / FROM: ENVIR. HEALTH, CFECO DATE: RELEASE ENV. ALTH HOLD ON BUILDING FINAL FOR: 1 OWNER NAME: SEPTIC: `�— WELL: IV AP#:�0 l0 414 Q)6ADDRESS/LOCATION: Comments: GL/memos/releasehold I COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION` NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of butte county Ordinances exist at the above address and should be corrected. Please notice this office when correction of work is completed., If you have any questions pertaining to this matter, or need additional explanation, please c 4tact this office immediately. i %/� �/L7 �% �� i�i/�G�✓ iii %t la /� /lr rYz do , / Vf ,I Date/,/ X 'Inspector REV 10/92 f COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 53877541 ,--' CORRECTION NOTICE OWNER c PERMIT NO. A routine inspection.indicates that the following violations of butte county Ordinances exist at the above address d should be corrected. Please notice this office when correction of work is completed. If ou have questions pertaining to this matter, or need additional explanation, please con ct t ofr immediately. CIO f- yl -,'Ko V o A mY f --tAA- )-cr—l' 'rr1 SS Ve vl �wI L�1 Date —� Inspector ` If REV 10/92 T. APAN —Certificate,of Conformancp-- Certificate 052736 THIS IS TO CERTIFY that the glued laminated timber products identified with a collo..; ve mark of Engineered Wood Systems (EES) were manufactured in accordance with the applicaf;i� standards and associated specifications indicated below ANSI Standard A190.1-1992, For Wood F5roducts - Structural. Glued 12minated Timber i�---�-- -N R--486 Glued Laminated Tmber Cornbinations And "GAp" Cornputer Frog.ram For Determining Design Stresses AITC 117-93 - Manufacturing - Standard Specifications For Structural Glued Laminated Timber Of Softwood Species eA IT IS HERESY CERTIFIED that the APA. EWES trademarked structural glued laminated tirnbel members were g�roduced in a manufacturing facility subject to regular audits in accordance witty the argineered Wood Sys#ems .(fYWS). Quality Assurance Program.. Routine audits include insp.:,otion of the rnanufactu.ring. process and evaluation of the in -plant QA.program with adequate sampd:ng .to verily conformance to industry. standards for lumber grade and giueline bond quality. yr - ,` Q � D Q q,4't .. SEAL by -- ' - z Thomas G. Wiliiamsc„ Executive. Vice Presicic-:tt ENCIIVErRED y»DD SYSTEMS z 8 16187C0 ccupmaiton 01 APA _7 sE ;,�,,,rccAED W000 ASSOCIA710h• 70.11 $OoiT 7961 STC41 - Pfl. 80,x 11700 • Iscomb.. wA 9&411-0700 7oleDhotlt: (253) Sws 5600 • Far wumber. (753) 563.726: GREGORY A. PEITZ ARCHITECT 1907 MANGROVE, SUITE "E" I , CHICO CA 95916 (916) 894-5719 i • i . i PROJECT: 1'ji -c h�1115 3 03 1 Q I �� ��; ` ✓ S'�-g /�! �� N Z" C z. 4� I have reviewed project and all loadingthe. truss submittal the above design criteria have been met. Gregory A. Peitz Architect . C' -�.�f}1' � i '4•� S f a! 6'r j. `i.) ��rI�R •• k ' , � iti �... f Y r Y ' �Y.::}� �h 'v.:- .. {d C ertadnTeedC4 InsulSafe 4 Builders Statement = Fiber Glass Blowing Insulation Homeowndr Name / Jobsite Mame Builder (sign) Company Name Date Inspected By (sign if required) Date R -VALUE BAGS PER 1000 SQ. FT. MAXIMUM SQ. FT. PER BAG MINIMUM WEIGHT POUNDS PER S4 FT. MINIMUM THICKNESS To obtain a Thermal Resistance (R) of: Bags per 1000 sq. fL of net area: Contents of bag should not cover more than: (sq. ft.) Weight per sq. ft. of installed insulation should not be less than: abs.) Should not be less than: Cin.) 60 36.5 27 0.986 22 49 29.6 34 0.800 181h 44 26.4 36 0.712 163/4 38 22.8 44 0.615 143/. 30 18.0 56 0.485 12 26 15.5 65 0.418 101h 22 13.1 76 0.353 9 19 11.1 90 1 0.301 1 73/4 13 7.7 129 0.209 5'h 11 6.6 151 0.179 43/4 THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION • In accordance with the chart above, you must install the minimum number of bags per 1,000 sq. ft of net area for each R -Value listed. • The maximum net coverage must not exceed that specified for each R -Value. • The installed insulation must be at or above the specified minimum thickness for each R -Value. • Failure to install the required minimum weight per sq. ft of insulation at or above the minimum thickness will result in reduced R -Value. • This product should not be mixed with other blown insulations or the thermal claims will become invalid. DANGER: RECESSED LIGHT FIXTURES—TO PREVENT OVERHEATING, DO NOT INSULATE ON TOP OR WITHIN 3" OF SUCH DEVICES. DOES NOT APPLY TO TYPE IC LIGHT FIXTURES OR TO FLUORESCENT FIXTURES WITH THERMALLY PROTECTED BALLASTS. 30-24-233 Builders Statement A Saint-Gobain Company 02002 CertainTeed Corporation 11/02 R -VALUE THICKNESS AREA (SQ. FT.) INSULSAFE 4 ) BAGS USED BATTS/ROLLS (✓) CEILINGS WALLS FLOORS THERMAL PERFORMANCE—ATTIC BLOWING APPLICATION • In accordance with the chart above, you must install the minimum number of bags per 1,000 sq. ft of net area for each R -Value listed. • The maximum net coverage must not exceed that specified for each R -Value. • The installed insulation must be at or above the specified minimum thickness for each R -Value. • Failure to install the required minimum weight per sq. ft of insulation at or above the minimum thickness will result in reduced R -Value. • This product should not be mixed with other blown insulations or the thermal claims will become invalid. DANGER: RECESSED LIGHT FIXTURES—TO PREVENT OVERHEATING, DO NOT INSULATE ON TOP OR WITHIN 3" OF SUCH DEVICES. DOES NOT APPLY TO TYPE IC LIGHT FIXTURES OR TO FLUORESCENT FIXTURES WITH THERMALLY PROTECTED BALLASTS. 30-24-233 Builders Statement A Saint-Gobain Company 02002 CertainTeed Corporation 11/02 V___ NOTES r. T_`__ RESIDENTIAL Eot0-026 PERMIT NO. _EGHDADI, ANDREW ' 11 SEGA, CHICO NEW SINGLE FAMILY -#97-44 K SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY V USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 0311775 CHECKED BY OFFICE COPY ; e Address GAS Y ' ii Meter By Date I ` ELECTRIC Meter By Date - '•JOB FINALED.(Date) 2 � Signature J=OK 0 = Not OK otReadyable , MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap; -i P' L 'ft. / /'Nat. or/ P' L " ftJ P LPG' 7. Well Clearance & Disconnect 8. Utilitv Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged. 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date --Card B-1 Date _ PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GR 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date LR4DERFILOOR (Plans) OK except #'s '-Z-Ftg., Main; Soils -Elea Grnd.- -U" Ftg. Depth , Garage �Elec. Grnd.-/ ly Ftg. Depth tg., c e s,0,oils-Steel-/ /" Ftg. Depth 5. temwa s, Main; Steel-Blockouts-Wrapped e alts, Garage; Steel-Blockouts-Wrapped iF&PHodr] Downs and Special Anchors 8. Piers -Fireplace Ftg.-Steel .V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test er Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date kr ,/ Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 1 'PLU ING (Permit) OK except #'s tZAVAt6r Htr.: Vent -Access -Combustion Air Baffle .W.V.; Test Fittings & Anchor -Nail Protection 20 Shower Pan; Test, First Floor -Tub Access Test Tub & Shower, Second Floor -Tub Access 22_.6'rs Pipe; SiAnchors 23. _ kA.Sprinkler; Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. EQdp. Ground made up w/Mech Fasteners -Bond Gas & Water 2 Appliance Circuits in Kitchen & Conductor Size GFI 7� _4' 30. eed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 341"Range Circle/ . /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No 32-t-eryice-Riser Conductors & Ground Main Disconnect 33 ui . Clearances Panels-Motors-Mech. Equip. 34rG othes`Closet Light -Shower Light -Spa Light Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHA GAL (Permit) OK except #'s C. Duc s Insulation & Support te4ent 5P, Exhaust above insulation U.,GKdensate Drain & Overflow, Size & Grade 3 urnace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 4Q. is Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date RAMING (Permit) OK except #'s W. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound Baring Walls over Girders & Floor Nailing top in Walls (rat proof) ILA5...Ore Stops, Furred Ceilings -Stairs -Chasers -Tubs 4,&,HI aders & Beams -Size & Bearing Date FRAMING (Continued) 4Q_,Gffl5g, JoisyRftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rtng. epl ce"Ties or Type A Flue -Fireplace Throat Clearance qD,,�, ccess; Size & Romex Protection -Draft Stop -Ins. Baffles 51. rm. Windows or Exitino Doors -Sill Ht-A,15mensions 15 Garage Fire Protection Framing-RCChannel J Z I Q , (' T3e4rrop.e.dy Line Firewall & Openings t. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55-Staii'rs; Width -Headroom -Rise -Run -Landing -Fire Protection .! f41 We -P ywood on Roof Overhang -Attic Vents -Rafter Outriggers ( 57. Siding -Nailing Veneer Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access Glai g Area -Glass Protection -Skylights -Plastic ear Walls; Nailing -Bolts 51. Brace Interior/Exterior Wall Panels' �z • v3 / 2. Insulation -Walls -Ceilings /163. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64 Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 7. Bedroom Exiting 66. G.F.I. & Bath Fixtures & Tub Access -Spa . Elec. Trim & Subpanel, Breaker Sizes & Labels airs & Rails X/ Fireplace or Stove, Clearance -Hearth n. Elec. Outlets at Wood Panel, Int. & Ext. A Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 7d. Elec. Outlets & Receptacles at Kit. Counter 79. Garage Fire Door; Swing -Landing -Closure Z. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 7 . Elec. Receptacles in Garage (F.F.I.)-Romex Protection 9. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under Floor O Yes Following Instld./Drive O Yes O No/Wal O Yes D No/Planters 0 Yes O No ZW Stucco Brown -Finish 8-W.A.C. Unit Disconnect, Electrical -Plumbing B . Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Be Water Well, Disconnect, Electrical, Plumbing 4 Exterior Elec. Trim, G.F.I. Receptacle -Underground 8_9. Ventilation Throughout House 99,, Glass Protection 9y. Correcti ns fro22 Previous Inspections jj &0Y 92. GasMst-Metdrs Tagged, Gas -Electric 9e Water & Sewer Connected -C/O to Grade -HD Approval 9 . Energy Compliance Certificate -Other Certificates Address Posted 'le -Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: v s l� r r, OU PE-RFEICT1111111110N o1 1% 1 -1) �: i 119 Sales, Service, Installation • Lir, #566654 5 1=e. i, e- c. t ` W . >35 150 APPROVED Butte ou Environ nta ea t1. � v I _ Signature m o �_-57� 42 , ZZ Ii. \ \ yt.e7 �r�k I Lf i 5' l=ehcc �. to 7►'t,-;h I , Imo_.. { i v_ afvl 4 F*1\ N� os_ U Assessor's Parcel Number: Fol © ® - © 0 0 - 0 0 C) APPROVED- c ►�-, �� �� I i 5 �- �. «p C 1� 6 -1 ` 7116 7 Owner Name /Address / Phone No. E3 "' — ,� Phone Site Locationt 1 S e C-1./ on t POOL GENERAL`- �� SPA GENERAL __.. SPECIFICATIONS SPECIFICATIONS DIRECTION -- = C TIONS _ r s yn SIZE 14Z X ZZAREA 6wo DEPTH YTO�f 4 SPA TYPE: MDL # SHAPE a l ,� DIMENSION: LINER ltJl.'� C k-sft•- DEPTH. v y / Y.. CAPACITY GALS = COLOR TOTALGALLOt1t5 ! V 5e7� r '7" �( 'TILE/PUMP SPA JETS MOTOR H.P. HEATER: 7 �T�cv FILTER ��� �� SQ FT � ;t PUMP &MOTOR: v pie VACUUM LINE & SKIMMER -7w e, Z' AIR BLOWER: „7 111 ! RETURN LINE I ���E `r%r. GAS UNE:. I MAIN DRAIN PLUMBING FOR SPA: I ..__-..------- ._.._..._._.�. «- ELECTRI AL: CLOCK.N `SKIMMER MODEL BACKWASH LINE �!s EXCA ATiON: OF 1/2 FILL LINE DECKING , ANTI SIPHON VALVE i (MISCELLANEOUS: 3 nlHEATER �- SIZE �- BTU SOLAR GENERAL GASLINEBY: i--VENTEDBY:-— SPECIFICATIONS LIGHT ? A K S'0.-.ET. POOL SQ. FT. PANEL r CLOCK T.^ i PANEL TY PANELSQf ELECTRIC BY; rr�^ NUMBER PANELS LUMB RUN ELECTRICAL BONDING BY: f�e•�/'<7ea.n { AUTOMATIC ANUAL POOL CLEANER THERMO ETERS BOOSTER-PUPP CHLORINATOR �e� r e 42 l NGLE ❑ DOUBLE ❑ ELECTRIC BY: BOARD -SIZE BOARD SUPPORTS JOB N0. JC LADDER - MODEL MAP BOOK NO. ' ' SLIDE # Color— Hookup LEGAL DESCRIPTION GRADING IGt 1 Q`�D"G�fG—ZG STUB PLUMB ❑ YES P-06 r c•_�.,{A 0�.. DECK BY: t(it G NOTES 4 ' SCALE 118" = 1'0" -LOT NO. �• zo � X . _. �- 771c 'R: zs,X TRACT NO. *� O fTl�iTU �r'I� BOOK PAGE BLOCK i 4 !xT•-� ,�/cL. t ESCROW CLOSE j t�ooti Sc� i 1 STc�4 -TENTATIVE DIG DATE 4. x Marx! E PERMIT OFFICE 57 MGR. s i SALESMAN ""7��v� r i iL ---- OWNER TO DETERMINE DWN BY. APPROXIMATE ELEVATION OF i CK'DBY. DATE POOL ON DAY OF EXCAVATION POOL AREA TO BE FENCED, BY OWNER PER COUNTY OR CITY ORDINANCE. GATES TO BE SELF i : NOT TO SCALE CLOSING AND SELF LATCHING. 4 DO NOT TURN ON POOL LIGHT E DEEP 2 WHEN POOL IS EMPTY 2z�g END SHALLOW END :,... POOL OR SPA • UNLESS OTHERWISE SPECIFIED NAME oh 13 x S +A� 27cc t5, !b POOL IS 3 SHALLOW TO 8 DEEP ADDRESS 1( r.: I HAVE RECEIVED A COPY OF THIS PLAN AND HEREBY C L�iGv C r APPROVE POOL AND r� t 114 EOUIPMENT LOCATION ACROSS STREETS 7 ' RES. PHONE G-ll GZ -7U,'7 BUS. PHONE CUSTOMER'S SIGNATURE DATE Gla I E� 17Z ;7 Wff EAST 20T" STREET PERFECTION CHICO, CA 95928 C)s 0= F� U TY i • (916) 895-0437 07 1 A h Bu1iV License #566654 ELLIS A&E SUPPLIES #4OD6c APPROVED - - - Y