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HomeMy WebLinkAbout041-640-001t r 041-640-001 05-2649 RUARK,DONALD * j 69:33 CONNIE LN, PA DIS� Cont: OWNER NSF (GAR, COV) 4J Ji - t "t fr .•� J �It rr i ! •rif�i y r.. 1 - 1 :� t tr, y:. a• r• WIN a 1 ' j� � 111". �+'t�� r„itl'_`;4 � S i �r,,- i`+tr(��<f,�. e, 4 i'y .r yr •C{�s �lt�bi'i yt EY' M¢� Y„ -'itisJ ati aq t f if. t a� � -' ���' ;;.ot 4 tx lif ix'•S�tkC 'y w��;� k; C'Y. fYFJt� - _ • <t�* '� } � i i.i +1�� tPY'f�•' � ,r 6 . +. r}s,�ti'.� y f . t. '•i•.9' .�t' 'Kf SS'ti .1 } yI �T t f}�Rv , r� iy} R t< ,.' f •� i r Ail: - ti� Fh j y -ff^f` t�yi6Le pF Alz:<_ •!si i v rs1'i' ti �{{{� 3pp���n �:��,tS�99 t U���t?��!{4 tr , ' ! u {; S- ,�f y J �: M`kijli } tr1.a'+l;i�.S�%.4 .. 4.. .. -�t'. � ..l. .. - 1.. 5,..!`.Ye1� �e ��•�tslg��t �F��r i �yi�.r%,;Yt� ri .2 .. .. . , .. _..._ A 041.640'001 r";.• 05-2649 RL'ARK DONALD N O T E SL7NN.E LN; P;1RADISE• y: ' 'C °LL t•. �VNER � S ?Z 2 q•O%' Ld hu 1dr, .'ve&r /e- I NSF (GAR COV) _ ,PA > ...��, �;Wt zi I Lr l'r A L _ APN: Permit No. •J Owner: � • ,r* `%O �� �'r1�'��l� �il1b G� .��-��'i .� Site Address: S' JSP, '-"�y - . - ; " /L Contractor: Type of Permit: ':'._``',. ` •,� y, OFFICE COPY Address i w„ GAS � �%(� ` ` / }, f Meter By , Dat � " " J Vr 3- • V I , i .� ..� tiY li ELECTRIC { Meter By `Cllr Date S2_ . 9 Lf -Mf '0cLJ�6,5x -6 J SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOB FINALED: 'Z 1 �� SIGNATURE: 1' CHECKED BY ALL 1_CTe t CAL (L FACCL I QRC'Cl 1 Ree CtE'8.CEP-TACE LO I T � � C i+ -7t fJAnlftG 6 X U / t SuC A'+10 At n( t Cl U-TC.E TS O til : x' Foe (�6020vyrl 5 SST PEA66-TIERT/C Al UJ I -I f CE /N USE E XTP CCC= C'O U61:leS t '^ Date L 2 3 `07 Inspector -hr -28 tJ06Cl�RPEW 7E2 REV 4/05 Phone # 5 3 R — CO RZ Z N Vi FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 y COUNTY OF BUTTE r BUILDING DIVISION � DEPARTMENT OF DEVELOPMENT SERVICES 4 7 County Center Drive • Oroville, CA • (530) 538-7541 , CORRECTION NOTICE �t �+ 2 K- OWNER PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordi ances exist at the above address and should be corrected. Please call for re -inspection w en correction of work is completed. If you have any questions pertaining to this matter, r need additional _ explanation, contact the Building Inspector as indicated below. Qplease a Aw� I'r? tiUf of CAE (I CEAs-PA(C A-1 \ PAI �. S ChE INS T/OAl NEE t 2 c; P LC Prw-rfed , l0VC IAI ALL 1_CTe t CAL (L FACCL I QRC'Cl 1 Ree CtE'8.CEP-TACE LO I T � � C i+ -7t fJAnlftG 6 X U / t SuC A'+10 At n( t Cl U-TC.E TS O til : x' Foe (�6020vyrl 5 SST PEA66-TIERT/C Al UJ I -I f CE /N USE E XTP CCC= C'O U61:leS t '^ Date L 2 3 `07 Inspector -hr -28 tJ06Cl�RPEW 7E2 REV 4/05 Phone # 5 3 R — CO RZ Z N Vi FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 y £,,..COUNTY OF BUTTE... . BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 "lot CORRECTION NOTICE of n/% n M LSC_ vwrvth 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 explanation, please contact the Building Inspector as indicated below. Date �— _ �J�/2 Inspector_l ii.C.(/�/ - REV 4/05 Phone # FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE UA DAA o 5- - a (0 1_Q 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 call for re -inspection when correction of work is ompleted. If you have any questions pertaining to this matter, or need additional expla tcion, please contact the Building Inspector as indicated below. 1 u _h, i Date f (0 Inspector JOA M01 - REV 4/05 Phone # � U �' (p FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 WESTERNWOODS EWP PAGE 01/01 0:9 ill rei 101191 =I 1.11:4 •�� APA crr�r Certificate -of Conformance Certificate 054086 THIS IS TO CERTIFY that the glued laminated timber products identified with a collective mark of Engineered Wood Systems (EWS) were manufactured in accordance with the applicable standards and associated specifications indicated below: ANSI StandardA190.1-1992, For Wood Products— Structural Glued Laminated Timber .1 NER-486 Glued Laminated Timber Combinations And "GAP" Computer Program For Determining Design Stresses ARC 117-93 —'Manufacturing --Standard Specifications For Structural Glued Laminated Timber Of Softwood Species IT IS HEREBY CERTIFIED that the APA EWS trademarked structural glued laminated timber members were produced in a manufacturing facility subject to regular audits In accordance with the Engineered Wood Systems (EWS) Quality Assurance Program. Routine audits include inspection of the manufacturing process and evaluation of the in -plant QA program with adequate sampling to verify ,onformance to industry standards for lumber grade and glueline bond quality. .�••�.o w ID oo••.,� 0ngr %P Cz SEAL g� WA CO." ��•• YlifN G�� `'� *DOUGLAS FIR 24F -V4 *APA -JEWS Certiified *3,500' Radius (Standard Comber) *1ndividual Wrap *Stock is cut to nearest foot b7 T' AUL ., - Thomas G. Williamson Executive Vice President :NU1NEkffEV. 0V0D SYSTEMS Is a related corporation of APA —THE ENGINEERED WOOD ASSOCIATION 7011 S0%ft 19th Strout • P.O. Box 1 f 700 - Taooma. WA 98411-0700 Telephone; (253) 686-6800 - Fax Numper (253) 5857286 LOMMOMULKno"03LIM LONtJ 1 c. LAtiI e PAQ Immus-IM-WO-W dt I ramI 1 - WNWAUAIM J i. & E9t1Vw" brand _ 11e m mmum 1 13 ernorl� � J 'Z t9 Calk "..`"..�,=��%��". !: i~+�~��a�-•�i!�ci � bu I I I I.VUIV I T DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (630) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (630) 538-7541 t IZKIV11 I IVV. PO52649 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penally 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 Issued Date: 12/12/2005 APN: 041-640-001-000 effect. License Class: License Number: Site Address: 3577 LONNIE LN PAR Dale: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' Stale License Law for the following reason (Sec. 7031.5 Description: NSF(2731)GAR(881)COV(593) p Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a Owner: RUARK DONALD E & LEILA A signed statement that he or she is licensed pursuant to the provisions of 14 CHAMBERS LANE 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 OAKLAND, CA she is exempt therefrom and the basis for the alleged exemption. Any 94611 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally 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' Slate License Law does not apply to an owner of property who builds or Improves thereon, and who does Applicant: RUARK DONALD E & LEILA A such work himself or herself or through his or her own employees, 14 CHAMBERS LANE provided that such improvements are not intended or offered for OAKLAND, CA sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of 94611 proving that he or she did not build or Improve for the purpose of sale.). I, as owner of the properly, 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 or property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: pursuant to the Contractors' Slate License Law.). O 1 am Exempt under Article 3 of the Business and Professions Code Dately"11�17'df Owner WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Policy#: otal Square Ft: 4205 S.F. T I certify that in the performance of the work for which this permit Is Valuation: $208,147.00 Issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Dale:y�G �7yj%ZGb Applicant:/ WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 or the Labor code, interest, and attorney's fees. _CONSTRUCTION LENDING AGENCY _ _ This oo;Llil_is hereb Issued_und1er the. applicable proytslons_of the Butte Countv Code and/or 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.) Resolutio to �rkicate above for which fees have been paid. j� Name: lel BY Dale: I OO I I 61 Address: PERMIT EXPIRES N: (Date) ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & 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 I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County upon the above mentioned properly for inspection purposes. ytooeenter Print Name -z) o1y 7-L-� \ ����1 Signature: �� Dale: ��G - 2_; *Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 +=OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE Lfj PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE D E C K S•C O V E R S -CA R P O R TS •GA R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; SoilsSz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nail ing-VeneerStucco-Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls °3� 10 DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness ! Dead Men -Lining i 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI i 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes -Enclsrs-pnIboards -Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test ' 11 Lt Niche 12 Enclsr; Fencing -Alarms 13 Bonding, Diving board or Slide 0 .� s °a 0g °0 °c Pool Drawing ,r r o=OK 0 = Not OK RESIDENTIAL (Single. & Duplex) DATE JUN E FLOOR UAIL I P L Ujk-EKNG ingSetbacks-Easem -Flood-Slope Htr; V -Ac bstn Air Baffle t� Main; Soils-Elec Ciff d CA4P L Ag Dpth 54� e; T & Anchr-Nai h to 3t Garage; Soils-Steel-Elec Grnd- jeJ Ftg Dpth. W V; r Nail MSG Porches/Decks; Soils -Steel � Ftg Dpth ' Test, First fir -Tub Acc(3 5 Fold walls Main; Steel-Blockouts-Wrapped 57 Test Tub & Shwr, 2nd fir - Tub Acc walls Garage; Steel-Blockouts-Wrapped 58 Gas Pipe; Sz & Anchrs 6a'Downs and Special Anchrs 59 r,.Irs; 7 Slab, Steel Wrapped f ar�ing 8 Frplc Ftg-Steel WV; Fall -Fitting -Test -2 -way CIO -Sewer Test o' I�� �.`-5..1 0 �s• s Pipe; Sz Anchrs-Sz Test 1 tr Pipe; Test-Anchrs-Rgltr-Service Test 12 Elec Undrgrnd DATE IMECHANICAL � ms & Ducts; Clrnc-MaterialSupport-Support61 AC Ducts Insultn & Support Gir -Sills-Anchr BoltsJoists-Vnts-Cripples 62 Vent Fan, Exhaust abv Insultn cc & Vntitn 63 Condensate Drain & Ovrflw, Sz & Grade 16 Insulation 64 Furnace -Vent Acc-Comb Air Rtrn1Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic Cj"L' O• !LV o' 09 O` C• �y. DATE IF R N G Sills Proper Materials & Anchrs DATE IFINAL S a uds-Nailing Spacing &es- IatesSound 66-Ezt Steps -Door & SideLt Prtctn-Landings earl�"Walls over Girders & fir Nailing 6VSmoke Detector ZQ,I?f�A.Gtop in Walls (rat roof) ,§,$furnace Vnts-Clrnc-Comb, Air-Cnnctr ire Stops, Furredl5iling tairs-Chasers-Tubs In Garage; abv-flr-Ducts-Meth P n 22 Headers & Beams-Sz & Bearing 66✓edroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns .l6' & Bath Fxtrs T ccSpa 24 Ceiling Joist ftr ies-Purlin-Roof rac-Truss hthg GFI Arc Fault 25 Frplc Ties or ype A ue- rp Throa Clrnc NZ2_0ec Trim & Subpnl, Breaker Szs & Labels 26 Atti cc; Sz 8 x c -Draft St -Ins Ba es 3 tairs, Guard/Handrails rm Wndws or ExitDoors. Ht & Dsions ��Ftplc or Stove, Clrnc-Hearth Garage Fire Prtctn Framing -RC Channel J-R-Mec Outlets at Wood Pnl, Int & Ext 29 Pri)rtv Line Firewall & Opngs Uiivldchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 3 t Doors -One 3' -Check Garage 3rd Story, 2 Exits L77.Eiec Outlets & Rcptcls at Ktchn Counter 3 tairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn _V8,Garage Fire Door; Swing -Landing -Closure 32 Plywd of Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 S' g -Nailing Veneer 8Uf){tfHtr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir 5peco-Cath-Weep Screed�F,rtdtn Vnts-Un r Acc Mech Prtctn; LPG Appince Undr House 3" drain A'GIpKg Area -Glass Prtc4ii SkyLK--Pl w l Ptmb; Elec & Mech Eqp Listed for Loctn ear Walls; Nailing -Bolts t82_FIec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 3 tn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings rd Rails & Deck Cnst ctn-Post Caps 39 Infiltration -Walls -Wndws n Vnts & Crawl a Door Drnge & Wood -Earth 86 'c Drn r. ❑ Yes ❑ No s/Lft8 Stucco o Finish 8P Unit Dscnnct, Elec-Plmb 8&-V.wts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs , DATE JELECTRICAL 90 -Mr Well, Dscnnct, Elec, Plmb - x�Trnsfrmr Clrnc-Ins Prtctn 64-ESd Elec Trim, GFI Rcptcl-Undrgrnd 44'€l>tcls Spacing-Lts & Switches at Doors 2_Vntltn thru House 1 z B es & No Of Cndctrs Stapled l9T Glass Prtct omsx Installed Close to Edge of Studs & CJ "rrecti s from previous Inspctns �� q/p Grnd made up w ech Fs nrs a r -t- 95 Gas t -Meters Tagged, Gas-Elec- �(J �Grndng ElectroCe Bond Ges & & Sewer Cnnctd-C/O to grade -HD Apprvl 45:tApBJnc Cires in chn & Cndc r Sz GFI ffnergy Cmpinc Cert -Other Certs 47-Sr6E'ifeed Wire Sz ga ❑ CU or ❑ AL less Posted AC ire Sz ga ❑ CU or ❑ AL 99 Fire Sprinkler 43, ange Circ ga ❑CU or DAL Oven Circ ga ❑ CU or ❑ AL � � C_ I/nated Neutral ❑ Yes ❑ No cece-o`�� Riser Cndctrs & Grnd Main Dscnnct 5vFq r cs pnls-Motors-Mech Eqp 5 es Closet Lt-Shwr Lt -Spa Lt - moke Detector o'er a o9e D BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. 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 REO UIRED AT TIME OFAPPLICATION BIN # Website: www.buttecounty.net/dds PRINT CLEARLY"* \ OWNER INFORMATION Last Name Fame lsj-�O�G/� Address /� City � SiateC,l City Phone/�) 2�9 d�66 Fax E-mail '35 CONTRACTOR Name City Address City City State,,-. State Zip Phone Fax - Fax E-mail State License Number G' c Lic. # Class '35 APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address City State,,-. Zip Phone Subdivision Name Fax - E-mail Lot # State License Number G' c APPLICANT INFORMATION Name Address /�i City State,,,�;,, Zip��/ Phon Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning P ()p I Flood Zone Cross Street SRA Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: - OVER FOR SUBMITTAL REQUIREMENTS PROJECT LOCATION AP# 6>Zf/—o—Ov/ P operty Address Gore« Goi7t� City , �i�Se 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 Name r Address Description or Scope of Work: Sq FT- Living — Garage Qper?'' Coa/ ❑ Proposed Change of Occupancy (Note previous use): E (AOO "dVrD). 9SN t will expire one 'd9NMO :1uoD -w action on an gSIQV'dyd `NI gINNOD EZ 10-1 s and fee will be i 6b9ZCI_1V IOG `XWVf12I U__. - I00-0b9-Ib0 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. ( A : by: Amount: Bldg 2�y98sRA Receipt�� ?b / L( / Sheriff SMIP Other Date: Total SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order.to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3.or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (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. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). 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. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit 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 8-12-05 Applicant: Ruark, Donald Permit No: OUT TFo Project Type: NSF/Gar o 0 0 041-640-001 o o 7 County Center Drive o •�: _ - o o o 70% Oroville, CA 95965 $ 1,324.41 $ (530) 538-7601 Telephone (530) 538-7785 Facsimile 927.09 WILLDAN Fee N 927.09 TO: WILLDAN ' FROM: Scott Rutherford (530) 538-7160 Chk srutherford@buttecounty.net 0 Tom SUBJECT: Plans Transmittal For Review Per Contract O < DATE: 09/30/2005 Applicant: Ruark, Donald Permit No: 05-2649 Project Type: NSF/Gar 041-640-001 100% 70% Plan Check Fees $ 1,324.41 $ 927.09 $ 927.09 WILLDAN Fee $ 927.09 Copies Attached: Qty Chk 0 Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVIS/0111' 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER: 12 IIA -Y?- /` ASSESSOR PARCEL NUMBER 69 71- 1- yV - e!5�O Proposed Building Use: N-51-- 5/G Permit Technician: � -52 Date: q- 2 S7 Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1 o 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. \ � ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. \� f rJ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. / n/ 4. Engineered truss details and layouts in duplicate. No faxesl \t� /0 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 AIC 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. must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent fog non-residential buildirigs, ❑ 12. Hazardous Material Form /N 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other maininitems needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15. Sahitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable FireSprinklers............................................................................................ ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... ❑ Erosion Control Plan Required........................................................................ !es as shown on the attached Schedule of Fees Due Sheet .............................. ❑ :. City of Chico Plumbing permit........................................................................ o .2. Site plan and business license approval from the City of B' . . .......r....To* 23. California Department of Forest plan approval Id. Sent by!�� • 24. Planning approval for (A) Use: b�(B)Parking: (C) Parcel Check:.- ... - ❑ 25. Contact Land Development about _ Improvements, _ Drainage ........................ /0 26. NPDES Form............................................................................................. ❑ 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 .......................................... N 30. Owner -Builder Verification (_ Given to owner, _Mailed to owner) ..................... 3j_ Letter of Signature authorization.................................................................... - --�, . 32. ecorded copy of Agricultural Acknowledgment Statement ................................. 3. Existing violations and/or expired permits....................:.................................... 34. Deed Restriction.......................................................................................... O 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: 1-766 When issued Telephone �a iy�`L �� %ZVA-2 /< and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Applicant: F�T-c. c/ _() Date: %ADT Z -7 , 5 1. Index permit application for the above items numbered: Plan Check Letter 2. Additional items required Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mailq, 01 counter, by Date: Contractor, designer, owner, was advised of 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 y: Date: Structural approved by: V I L U12 Date: Note transfer by: Date: Yellow: Building Division E.k. USE OTdiY . . •'� �', Pi02 BSen Attechod Floor Man Attached r Sent to G.D. I TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Qom',5 Z4A,1A-,?1e— l/ /J � O//—&✓O -.00 _ Owner Location AP# Plan Approved for: Sewage Disposal ✓ Clearance for /dwelling. Other Hold final for: Final clear nce O.K. for: NOTE: vironmental Health 8/96 list Water Supply: Public ✓ Private Well a Date COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE (530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buffecounty.net/dds OWNER 10yA-1Z�< PROPROSED BUILDING USE 1. BUILDING PERMIT FEES --- Balance Due ..................... --- FEMA Flood elevation review ... $ --- Additional plan checking Fee.... $ 2. SCHOOL DISTRICT FEES 01W VII -LE H-1 6 (paid at School District Office) (form available after Plan Check) SHERIFF FEES (paid at Building Division) Commercial (sq. ftg.)..... X $0.03 = $ Sq.rtg. A.P. # 01 /'W VO �_O0/ DATE 9--2 / `0 5 - RECEIPT # DATE DATE C. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) RESIDENTIAL DEVELOPMENT IMPACT FEESo COUNTY WIDE (per dwelling) $ g v CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per dwelling) Zoning $ 6. SRA FIRE INSPECTION AND PLAN CHECK FEE $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 Vid at Buildiingl Division) ' I 8. SMIP_ aD ,, U 1 9. DRAINAGE FEE nI , 10. OTHER �Nv 11. OTHER V� i ` ' At time of permit application, I was advised the above fees are required to be paid prior to issuance of the permit. These fees may be changed during the plan checking process. APPLICANT' 114_1_-Ia(�l� DATE �jeOT Z /, ?00,j r Pursuant to Government Code Section 66020, you are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the 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 -Building Division Yellow -Applicant Pink -Owner (rev. 7/05) Butte County Department of -Development ServlCeS `'T?'�o 7 County Center Drive.' oroville, CA 95965 ; �o (530) 538-7601 Telephone (530) 538-7785 Facsimile BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: e I need to submit applications for septic and/or well to Butte County Environmental Health immediately. I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained e I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not .limited to, verification the parcel was legally created, adherence.to.all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones) and habitat/species). Please print: Applicant Name: /ZtIA-914 4 p6Y�'//-Z4-) APN: 0 y/ r G yO —toy/ Building site address: L6^VN/'C-- LN',. PWZW/s� Permit No.: I have read, understood and accept the terms and conditions as expressed herein as indicated by my submission of the above -referenced building permit application and my signature below: SIGNATURE OF APPLICANT DATE y Copy to Applicant/EH/File K Forms/BidePermitwithoutClearances 020705 ;±'..�•v„E�F: _: �r. ;:Y. :f•`^:: ' i; ;w:,.. rr,` �.��._.}'�n5•:: V �_ ' El0 Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. �l. I personally plan to provide the major labor and material for construction of this proposed property improvement: 'YES [ j�] NO [ ]. 2- I HAVE [ X ] HAVE NOT [ . ] signed an application for a building permit for thero osed work. p p 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: S. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER DATE: NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the 'Permit. Butte County Department of Development Services ADMINISTRATION t BUILDING ` GIS ° PLANNING 7 County Center Drive Droville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile �N�� 'xc� Y.Cv.��j�a •O1;y1.�? F, '`j- � S�.�•"'" ^F F' i• 6 .. f""i�.`[ L —y cr..'k vss. E..e—��.e••+.�y—-Iu���_w N/.sa`:�.•va�.:�:ii: Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they .are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of Califomia and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. *Micel ei C..ding Inspection NOTE: This Owner -Builder Tnfnrsnatinn is rPnnirpA by CPr-tion I QRZn of the rmlifnrniu Wo%lth unA c%fPty r nriP JYi Department of Public Works ..0 o u n t y o f 6 U t t e ® LAND DEVELOPMENT DIVISION J. Michael Crump, Director Storm Water Management Program ®/ 7 County Center Drive 1 Oroville, CA 95965 - 8 7266 - UC w((oF (FAQ 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase 11 Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement jLESS THAN ACRE Project Description: Project Location and/or Parcel Number: o c/ / -- 6 1/0 - DO/ By signing below, I, the project owner/owner' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that L 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. Signed:— Title:— Date: SITE PLAIN REVIEW APPLICATION Date: �% ti - Permit Number (if applicable) INFORMA TION Owners Name: Owners Address: AP# -,// - tlo Y6-.0 Ol Bin Number 01 Parcel Size: v �l ( ac's Telephone No.: 0/� if76 �o Email: Situs Address: 62 Proposed Use: Residential ❑ New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other Septic ❑ Agricultural Exempt Building ❑ Other: Brief Explanation (if necessary):_ ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval % Site Plan Stamped Approved By Av. Date ALL ITEMS CHECKED APPLY TO THE PROPERTY Parcel Is In: ❑ Snow Load Area: ❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: i( • Flood Panel No.: 577 5-C Index Date: 61,0k ❑ 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: fu D Py Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. Applicable Development Fees: Standard Fees Amount ❑ Fire ❑ School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other -------------------------------------- Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) I T::a"F1 * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit. Parcel Created By ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance/Notice of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Subdivision Map/Parcel Map: 17"'� OV(— C� yam' 54 S Map Date of Recording:-�% t Lot: ✓2 ❑ Use Permit/Minor Use Permit Permit Number: Book: 35 Page:60 4'4f Date of Approval: Parcel Map/Subdivision Map/Use Permit Conditions ❑ Comply with the following Conditions of Approval: ❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Plan must be prepared by a registered civil engineer or other qualified professional and be submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development.. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible'for roa Fol Summary of Specific Requirements: This information provided in this summary is based on the application information and on the best available data at the time of review. CALarrys\Building Permit Site Plan Reviewl .doc r oiYNER S STATEMENT We, M.O.P.S.. INC., A Cliff ... 1, Carporallon doing bu.i.e,e as M.O.R. Co.. a of the land Included .$thin MOUNTAIN OAKS ESTATES, a, .been within the borderline of Ihv en sed map, do hereby elate thol re a lbs only pare... whose c and I, ........ y to p,..ec leer Iltle la Paid land and .. an. .1 to In. prop... tion and reeordallon al ,aid mop ,..barn ruhhn me boundary n., w. also o 1.r for eediastkn to me eoanly of aorto l,. specific papmm the lalmwing: I. INGRESS. EGRESS. SUPPORT, STORM DRAIN AND LIME SAOULE COMMUNITY SERVICES DISTRICT; An .... enl for Ingres.. earn,., ,,pp,H. ,term dram and Lima Saddle Cammunfly Service, 0le1r1c1 ova cand ander SUNVIEW ROAD, CHASITY COURT and LONNIE LANE m-beenhera.n, for me by alt Public Utilities, Law Enlorcameni Fbe Pralecllan, Wallare end other ,stated Public and Coanly Agencies, that- veMelvs and persormel, and la all Lal Oenera rllhm this SubdWlaion and made appurtenant to said Iola 2. UTILITY EASEMENT: E.aemenls to Pacific 8e11, Pacific Gas 8 Electric, Lim. Saddle Commmily S ... Ices District and Vtacom Cabtevislo. for Inatallolim, maNle,orea and r,pol, of all ulililles 13 sheen halloo. Easement. to Pecific B,IL Pacific Go, 8 Electric, Uma Saddle Co""'ly Service, District and VT..om Cabl-10- ter, m,lall.Dal, m,mlmanco and repair of it amore, c ... lr.cted w.r on. across and under Ine Public Utility E ... mml. (P.U.E.) shown here., together with the right I. Iran and re often ., nnce..cry. tree,, Ibnb, and A ... h. 3. COMMON AREA: Lot A a, Sheen hereon H hereby dedicated la the Mountain Oak Estates He.....eis Association le, ,..:tory a ,form drainage. pubtk amui., and oIn.. mss as d0.rmbad to be ellorable by ,aid Homsoe a ', 1,11on. 4, ,The sanitary ,e manta far plpelMe., pond,. Ud,.Ik, apparlmanc... inure.. and eprm. Showa on Shallwar of S hereon A a hereby dedicated to the Moanlahn Oak Estates Homeowner: A„ocialion and County of 8,11, Coanly Mbylae A— No, 141. S. A, smemant far mare.., .Va....opparL r.P.h oad m.I.Im.c. at a.r.a, dispoSet facilities across and m4,r Lot A Is hereby dedicated to Comfy of Bane C—ly Sank. Ar., No. 141, O.C. ENGOOL , Chief E.ecalt a Office, M.O.P.S. INCA, A Calif"nil poralion ' doing business as M.O.R. Co. ACKNOWLEDGEMENT STATE OF CA F NIA SS COUNTY OF 0.4•---./ rm Kr9A b.l„em,. the and ... !,.ad. p.rsanaly .1p. -.d par. -ally known to my lar pf&.d on rhe baei, of aalkteclay avbenevl Io be the pertly -ho,. a -WI-/ser aub.cabed to In. within in,t—1 and ednewladaad to me that Ae/MY]Il,ey a,a- caled In. same In Ma/her/Ikeb aulhori.ed cap,cily(ie,) and that by Na /ber7lbeF,Ipnataefal on the hn,lr—I the p..... Wo, the -lily upon behalf al wMcl, Iha paxe,nl,) .,led. exemtad Ine m,i—.I. WITNESS my hand and official ...I. J P,I,l Name M:Y/tJ5 G % aTe'JO J1tV Co.PuM C i tla,ion .no CCount' s T�ww�ae m A e STgTE OF CALIFORNIA COUNTY OF On— ... all... ma, the and ... igoed, personally pp—d _ pane. ondly kneto me lar p,wad an In, basis of satisfactory avid -0 to be the per,m(Sl wnaaa ,ame(e) la/era s,Aecribad to the .till. hn.lrvnenl and anknoeledgad la me that he /,he/they ..e- ,.d the same In Na/h.r/m.b wmerls.d aApa,llyti..) and 'hot by nH/her /Ih.a S1,0 ale an the mel,rrn.rI the peasants) or the .only apen behalf of rhkh In, potents) acne. executed me mekamenf. WITNESS my hand and official Seal, P,Int Noma Matory P.NIa Comml.,k...vire• Co." =At 9Y- S2/z3 /2.-A,*-9jC SZWPF WS SWEWNT 1, JAMES M. HERRICK, do hereby at le Ihel I am ESa Ilcen,ed lend surveyor of the Stale of Cliff ... Is. that the map of MOUNTAIN OAKS TATES Subdlvision r.p—..f. a s. ley mod, under my direction on October 15. 1985, that It I, Irv, and —pill, as shown, that the enla ,horn will ba eel In Ihalr corrocl poaillon rllhtn 90 days of the data this mop Is rocoraee ane .m b..a+nelanl to enable Ine ,.r,.y Io be a (raced. J ES M. HERRICK Es . ENa L93616 ap.9/39/30/98 C � u Gi7WY SLG kE',1 WS STATEMENT I hereby .lata that 1 have emndnee the final map of MOUNTAIN OAKS ESTATES SubdivisIm that N 1, ,ubalantially the „ .pp.,.d , me ImloNve Inco an file. and any appra.ed :11. 11... thereof. Ihol all Dmvtsiam of Ine SIAdl,lalm Map Act of the Stole of California old ony local *,dkmnro applicable al the Irma of apprwM of Sala Ianf.live mvp have been camalled wilh and I am . 11 INd that the mea b technically corrocl. Data: R D. M,ELR R E15170 Dap,iy Ceany Savyar Ep. 3/31/97 C—ly of BUN. NOTES,•no/ /n/mood /o o/%c/ record /i/% in/eies/ L Each building fol snag provide lNee oil -,treat pakhna ,pace.. 2. Flammable .eq<lana. to be ,S,w,d .Ilhhn 30 fall of al 0-1— M accordance wIlh the ore of, ,.gammon, a1 BIle County and PRC 4290. 3. An mal .alocmg shall be mnslruded of Cl.,. B or bell., ractilg maleNale. AD bolding projeclims,,uch as may eaves, and eaM,d a1Mer Hoar ilgs ,,.ch A. decks, shall be encbsee raita Bath. 4. I.0.110on of an approved pxessaraaa sale, hyd,ml system ,hall be completed Fria 1. hebuollon .1 the Ibsl "citing It. 5. P.rlmele. lancing shall be restricted to barbed wfr, of 11w strand, or lean, the bottom .trend to be a mYnum of 16" abwa grounq Iha lop air to be a madmum of 60' above ground. With Ino .,tap - lion of Ine 26.16 are eanilary se o pond and irrigation <memcol. 6. An mnetradm, ,hen maintain , mhnim.m distance of 50 feel from the ro,de,y ,anlar ire and 5 last Irom my properly line. CLERK ar 7w "1w Ac SUIrRN.SYWS' STd7L1wNr I dohereby .1.1. me that an be, ... 6e-- .a7 , 199,Y, the B.N. C-ly Board at Saps.. I.— ofllci.11y app rove dthe Subdivision Map of MOUNTAIN OAKS ESTATES. E......1. and right-ol-ray, as da.cNbed In Items 1,2,3,4 05 al the On r', Slalemenl .orae. and .tiered for dedicalian to ..Datil to agancles, a,saclelian, and v.buc Mune, ora o, cc".d an beb.1 of h... muuea ..y. Data: 12- h,-r2- L^;ycr _rtler. JOAN S. BLACKLOCK Clerk .1 1n. Boast of Sap.,W—I RMWERN ChRXIFIC41 Flied m the office of the Record., of In. Coanl,r f U.N.. State of C.�91—(J., m g:c/ .lou �m .Is. an e a9Tif day of DECE"I SeA • I3ti, In Book 335 of Maps, al pagetsl C O, b at Ihv requael of NorlhSlar Enphna.rinq. Serial Na. Serial N' No. CANDACE J. GRUBBS Coanly Recorder Counly at Bull, Dap.ly NOTES, (Cont.) 7. Read eanatruclial oGlivifiea shall be hmiled 1. the dry season of the year,lappraaMatefy April lN..ah Seplemb.,x d Ali faxndalsm, shney be Rldae Eafales n,, o.r knownoalr Mwntoiled in nOak, Eslalesa,bly o er L. R Der dated June)6. 990,cm All o, Lime Saddle .ilh me 8.11. Caamy Pabtic War Depadmenl. 9. If applicable, Den, Head leas will b .mored m be paid of lima of se—img bailding per—ilL 10. Properly owner shall Jahn and pay Imo• or ........Me to A fire prale,Ilon dlarrkl 11 and when ane I. e,tab161h,d m the .ran MOUNTAIN OAKS ESTATES A PLANNED UNIT DEVELOPMENT A PORTION OF SECTIONS 7 8 18 T. 21 K.R.4E.,MD.9.and K BUTTE CO. CALIFORNIA for M.O.P-S., INC., A California Corporation Doing Business As M.O.R. CO. North Star Engineering SO aEaARAYIpx A mm • —. t,lfamee ee92. - Isle) esu- ass CIVIL ENGINEERS - PLANNERS - SURVEYORS. APd 41-08-115, A-1-47-93 Sells IN. N°20 31 E.,99.60 )R•A• fN I6e 261.• IR•,y i M-1 fa 1!e 1< Y:1 /kms 113 1. IS \1 19. s1•u'I9'w.,1o3.5e 1R•A. f� I 6,Op1T'•I� Nf � � � gd CIE. K I m OL D:, 1Y Wje� 6.36 rl 316 ,Ij�pd ° K 2° ' a j6�cE..� 3 a, 'i 1,9p9Dd \ SCALE : r • 100' - '.'. 6�m �R•j K o 1%eM. 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N•O1�l�40•w. 281.69' 3. W. (N.C.- 31'11 •w., T1.001R•Aa C Sa 22-23- rose .zor_ °C 27 8i ♦ N OO.Od "1 \NOYQY•YV • ° w OR9 OC Fp • \ Np9•QY4 sv. 3xo!•QYIz•W. I.q v F$ 51 W �I I�AQ•lIIYW`1 1.1�1�'`,1° � � � F V fj0 4Y °y OR9K Nq oP y YR° TO y O.e9K WC. AIIA $ ti'oD a ' >•_00' � 1 Ir.l000d Qo�w, eY' LOT A 6� v/EW 44 °1- .x {�?a'o` -'' o -x.091.°- I .A` a oa•1Pa4- EE• pO 111R•A LA O>•]d09' 14'E 19.°9p0r°°•! / 11A0.0009 OZ L•55 1; O]']ZJ6-E •r=o-'IPWT�-� � oGAd � \\ R• Ep. PI• D � •L� Y'''b`b. \�\.{/, �� a D•ry'Y �",4Y/ `r / �/ ial / d°. s• swore NeTAL naTE ADDED W ]6l41R.ANT LOT A / j / �f S. - , zE9.I MARIE I 9.20. 02 >A E., I.Oi FROM uIC. P0911ION r4�'/ / c Q4.SYS OE BEAMWS \AMD TW- / �,&.. MHr �i^r '•O t1 0�. t•D.°ty,) L �' M1e s / u \•P� -s / rNt e°[u a eE.- FORTwa NAP a � '�i Q1 .' }•+�. <"' ,�' 0'�2° tt .` y THE NoRFNI- TN CENrvBmE OF- -s[CTldl /4•o ply ZN\ / / •� •9?'S u u sNowN ON NAP eooN n cE x Na L$5616 /NOIYf41 p, •R _ AND E,NDENCED m ,nAmda swWN A, S Io:REoN u FOUND. rARNc OF .uD LNE WRY•!°+Re / 5) a MOO a 00' i.' zP L Pr MOUNTAIN OAKS ESTATES 38 13.33.12r66a9TR \5E/ �a>O' L.18°•°° A PLANNED UNIT DEVELOPMENT Dae K F 3.33 -1746 -FF- OF 86.19' - lyTSz aLea� Faa ioa�ww roe�/ a • SO°ti LOT A �; A PORTION OF SECTIONS 7,8 18 T. 21 N.. R. 4 E., M. D.B. and M. 054AWIN• 1°B.OB'w- saB.T9'(34aTs')R. i BUTTE CO. - CALIFORNIA _ LEOENO REL1 W lIL7oE74E7VCfS for >ET I'M gore PP; TAU4ED tD 361. F0. 2 TOPPER IN IRON PIPE M.O.P.S., INC., A Callfo rnlo. Corporation o .ET SII' ROM roc OR 1/r .,DAR N T MAP., PAGE Be MR 1/4 CORNED ,9EG. 1 pIB T -w LJ 8816 - R. 102 YAPS, PAGE 25 T.EIN.,R.4E.,M.D.8.o.e M. Doing Business As - y. o -11 -. SET 311 maN roe OPw, n NAPS. PA.! 34 PEP a 73 M.PS.PO.34 M.O.R. CO. 1/r REBAR TA°GEOL! XI. - 1ND COUNTY RON PIPE TAGGED La 1.41 R° R MMM fDN'EMi2 F0A. "1- NorthStar Engineering BURE FNDA NO. 4NTFm-2 IPAEAs OTNEmm NOTED FRL M0. Q • 9•a A .MEET ND 1 0 Y Di 8 t0 OECIARATgN OgV[-GNICO,ULIiOPMIA CALCULATED MCNr 9l926.1910189l-I600 . 0 aC.- Gmwu+ u DESEAUED R. IE. oA, FAME 3e0 -!el • � 'CIVIL ENGINEERS -PLANNERS ; SURVEYORS p SET BUTTE COUNTY ANODNDl BT • t9eo OA. P:.".:,* A.E! uo•au . SHEET. 3 OF 5. - CENTERLINE MONVMEUT - R, !D -1. PA4E .1 Je0! i Tr y 46 R° 45 d0..' -ARE METAL 1 --ED RE 2Y90- BEAPa 9.23.38 Z4•W.,I9.]9' FROM CALL. POS. p9a.6fi ' ryOTe 3109:W 594.801R•A• (N.DT°11 09 N' orr4a D 11-0 I 1 LOT A 38.68 At INCLUDIND ROADWAY- i 09'xY W F 9 54 oy • $y o.x9K y8 1. M PPMI 9NN P9ca wfiTC IIE]D r0M M ewnmwr OVDI Tne uV, wa roM M IotLOM'ND MWONs: .. M DwADngr tNu R M vAMrn sNowN Naas cDlmnu rwLar M TR R A IJ1M0E Lcurr MT1 WM AM0.A POMR CIDeT9Ni ALQM M lAiex TIiAC AIIOL! IW11] COwD MOt NM OC[M 1KATV, WawOU! 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M M1wlT - R • WAY Iw1 IDT! .IUUD Yqe CLLCWILD IMOY C0.1RY R OORL ADIIT.R•WY WP MIIM9U A9A11-81-x. FlL MUrDI 6•MA, LILCIe I • x R a, !AD IDOMi-R-WY NAI WU WAM -o0• oo ZT LLOID M NOMTN • ®Ilfll CDTIUOJNC OF' SZ w1 1.,' 21. 0.1E M NWUN lM R YD SCCTW U NFLC U SNOwN aN TN! WP AID M A]0NT-R- WAY U —0 0U0 R. D[AANaa Iw1 A. SNow11 NLMeON ARC IItC°Im 1EDNDa ICII IIS A. 100,1 39 R OFV,J, POOL 109 AND e00. !T R DEWS, PAIS 409 OMAIR WCNENM IoM ODa9ATIDll .Tom . M LOCATIDN R aAD xnuNeNrO AM[ Nor louTselC AND TNFr Wr on wr IIOT Amen iN1 PMRCMrr. 0. 1oaN OA R MM.— 192 D 3 A Y WIDE WL IM A — 1AIC w KCTON Ia, TO OMO WTu,tJDNT a Powu Ia]rulr. M Duct LOCAtIDI R DAD ueeNrNT n NOT otlfil[D Arm Ir Wr m WY NOT AIRR TIC! PMRaaT. 0. BIX]t Tal RIKuI MI—, IA. 101 OMANTA ON EASCIAM To PACOD TacR YID i[LEI;RAPN COMPANY POII P0.! LM AM A!]OCUTV, fACCJTiLx iME C9AR IACATIDxI R !AD [AIFMM U NOT oar A AID a WY aM Wr IDT A M TNU PWWY. n 0!• Ae' zr E Dl O!' AO' aI• E .9032 P1E10 690JTNEG 4YC w 09•! n o9• {� aj- Yxa.NFatylt E 11lA0'IMAN a pJ-M' °°• F. 119.1( a°- Yn10ry 0. W OT MOT. IRE-oo' 0011 a sWL 8�90a�lYT T.21 N., R.4 E., M.D.B. and M. MWA/L W - ALTJ. '. • ]TIaY PI[LD E NtA•14 �Yw1_ JTVJ1ACC fAL ,t tt w•oe•oe-w ✓J n oT• or ao• w: zits. 'ie5 2JIAI TIIARA d'r. W. NCE .00• of J6 0 IULL M N.TA. JFf OET/X T)" TMJ JMFFT K o!• It— W. 111 MEFF1pL. CAIc w. oa• Iw 9s w. P Ao'w. zeisr uya DOT• MLC —13. 00 )]• 0 9CLL[ ]filYa s nTA /3S -6y" . MOUNTAIN OAKS ESTATES WLHep�Fi 171md ct A PLANNED UNIT DEVELOPMENT ' A PORTION OF SECTIONS 7 8 IB a Na MM16 a T.21 N., R.4 E., M.D.B. and M. 9 x -9A BUTTE CO. CALIFORNIA to M.OP.S., INC., A California Corporation Doing Business As M.O.R. CO, NorthStar Engineering 20 0ECLNU oRVE • C1ICo, TLLiOeMA 9°920 • 0ID891 m CIVIL ENGINEERS • PLANNERS • SURVEYORS SHEET 5 OF 5 SITE PLAN REVIEW APPLICATION Date: AP# C?q (' 6 q 0 •06 ( Permit Number (if applicable) () = 2 6 ` Bin Number APPLICANT INFORMATION Parcel Size: Owners Name: Owners Address: Telephone No.: M/ Situs Address: %O t 2 3 Proposed Use: Residential New Single Family Residential ❑ Single Family Addition ❑ Single Family Remodel ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other ❑ Septic ❑ Agricultural Exempt Building Other: Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form DEVELOPMENT SERVICES INFORMATION (For Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval it Site Ian Stam ed Approved By Date 1 ALL ITEMS CHECKED APPLY TO THE PROPERTY W" A Parcel Is In: ❑ Williamson Act Minimum Acreage: ❑ Verify residence can be built per contract ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) • Flood Zone: • Flood Panel No.: 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) Use Requires: ❑ Use Permit ❑ Variance ❑ Agricultural Worker Affidavit ❑ Administrative Permit ❑Minor Use Permit F] Minor Variance Zoning: 10&,0 Applicable Building Setbacks: General Plan A- K ❑ Setbacks drawn on site Plan. Q CDF approval needed for encroachments into SRA setbacks. 2 4 V, Zoning Code Streets & Highways Fire Prevention Subdivision Map Front Side Side Street Rear , Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. Q CDF approval needed for encroachments into SRA setbacks. 2 4 V, Parcel Created By ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation: F1 No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements Subdivision Man/Parcel Map: Map Date of Recording: Lot: 2 3 ❑ Use Permit/Minor Use Permit Permit Number: _ Book: M7 Page: Date of Approval: 3 W I LLDAN Serving Public Agencies December 2, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX 3 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com BUTTE COUNTY PLAN REVIEW REPORT Status: Approved Jurisdiction Job No: 05-2649 Assessor's Parcel No: 041-640-001 Description: Ruark NSF/Gar Willdan Project No: 14353-1899-M Dear Mr. Rutherford: Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2nd page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: * Plans: Two (2) copies, sheets 1 through 8 dated April 2005, revisions not dated, by Gary Hawkins, Architect. i E * Structural Calculations: Two (2) copies dated 06/19/05 by Gary Hawkins, Architect. 1 * Truss Calculations: Two (2) copies dated 07/27/05 by Longfellow Lumber Co. Inc. . .., 1 * Energy Calculations: Two (2) copies dated 06/29/05 by Gary Hawkins, Architect. The plans have been stamped with the Willdan approval stamp and dated. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. i Cc: Alice Mefford amefford@buttecounty.net Hawkins, Fax: 893-0532 ; r i 1 W I LLDAN Serving Public Agencies APPLICABLE CODES 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com Our review was based on requirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code (CBC). • Part 6, known as the California Energy Code, and Energy Commission Standards (CECS). CODE ANALYSIS Our plan review revealed the following information regarding the occupancy designation, type of construction, and other pertinent features. This information is not consistent with that shown on the permit application*. Specific Use Type of Occupancy Type of Construction Stories Total Sq Ft Dwelling R-3 V -N 1 *2,731 Garage U-1 V -N 1 *881 Covered R-3 V -N 1 593 CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and/or notes as red -lined on the plans. 3. All plan sheets shall be signed by designer or person responsible for the plans as required by California Health & Safety Code Section 5536.1. 4. *Permit application building areas specified in the scope -of -work shall be reconciled with plans to Butte County's satisfaction. 5. Field inspector to verify installation of existing or new smoke detectors in all existing bedrooms and hallways leading to bedrooms (may be either battery operated or 110 volt with battery backup) as required when the valuation of any addition made to a Group R -occupancy exceeds $1000 per CBC 310.9.1.2 through CBC 310.9:1.5 6. Gable -End Truss calculation submittal is deferred to Butte Co.'s review at their discretion. SPECIAL INSPECTION NEEDS Our plan review reveals no special inspection needs pursuant to CBC 1701. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals. Si re Clinton McKinley, C. .O. Senior Plans Examiner Page 2 of 2 11 Ricardo Guzman, S.E. Structural Plans Examiner Butte. County 05-2649 Wifldaa 14353-1899-M..Pt'2.F BUTTE COUNTY DEVELOPMENT FEE CERTIFICATION FORM (�EATHER RIVER RECREATION AND PARK DISTRICT (FRRPD) ❑ CHICO AREA RECREATION AND PARK DISTRICT (CARD) ❑ PARADISE RECREATION AND PARK DISTRICT (PRPD) 0 DURHAM RECREATION AND PARK DISTRICT (DRPD) Assessor Parcel Number (s) - -()Q/ Building Permit Number -,2 (o �Zcl Property Owner (s) ,� _ _65 Project Location /Address Subdivision Name A New Development Alteration/Addition(s) Mobile home Demo Permit (date' s Comments: , , - Assessable Sq. Ftge 2 9 13 / Type of Residential Development (check one) Single Family -Detached Single Family -Attached Non -Residential to Residential Mobile home replacement Multi -Family Dwelling verified by Assessor Department verified by Building Department ❑ FRRPD 0 CARD ❑ PRPD 0 DRPD certifies that: Applicant Name Phonel4umber Mailing Address City State Zip Has complied with requirements of the Butte County Board of Supervisors Resolution No. by Payment of: Dwelling Units @ $ _ Square Feet @ $ Remarks: per unit fora total of $ LV:�)(# . 00 per sq foot for a total of $ Paid by Check No: No Chec K Paid by Cash: Receipt No: j S y,2 Recreation and Park District Representative Date' v-- int -•11, -­­ Arn___- ___ _.__-1 -- __.. 1 A-, BUTTE COUNTY SCHOOLS IMPACT,FEE CERTIFICATION FORM (� (One form per Building) School District 43 L6V lQC4 hBuilding Department No.� A.P. Number 041-6/0-&)V Jurisdiction: City County Property Owner ��(j �l 2)tl r C� Property Location/Address L n n i P L,,,1 ✓w ► (af f 12,11.�1?-, 04- Subdivision -4_Subdivision Lot No. Residential Development Q Q . Q Q Sq. Footage % No of Living Mobile Home Addition/ 'Supplemental to (Group, R) Units Installation Conversion Permit # •(No fo :...........................................................undation inspection........................)..... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial 0 0 Sq. Footage - New Addition (Including Exterior Roofed Areas) —��-A5 Building Department Representative ' Date District Identification No. 060140 oy 1 lS� V1 Vwoy\ �� School District certifies that �D r A (Q RVAf (Applicant) - Lor h � .e_ Lt Y, -a— 510 —.3-3q— 0-76c.e (Street Address) (Phone Number) (City) has complied with the requirements of Resolution No. representing ol —7 a square feet. School District Paid by Check # V g l ,) 67- Remarks: (State) `+ B 2926 MITIGATION 3, 951 t, (Zip Code) by payment of $ 13 1 ' I Date 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 fess are paid. Failure to submit a timely written protest will prohibit you from challenging the Imposition of tit 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 mitlgate Its Impact on the school districrii schools. White (school district), Yellow (building department), Pink (applicant) teeionn.xls (3ro5)d�un `a AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 ?5-0059155 Recorded I REC FEE 15.F Official Records i County of i COPIES 3.50 Butte i CAWCE J. GRUBBS I County Clerk-Recorderl i I SA 011:29AM 29 -Sep -20M I Gage 1 of h IIII III III 111111111111111111111111 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides; and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date.PROPERTY OWNERS: State of California ) County of '�-!) ,,.�- ) On[�Zq � (;� before me, personally appeared < ', 1 C2 ; -C personally known to me (or proved to me on the basis of satisfactory evidence) to be the per on(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that4tefs'Mthey executed the same in UisNter/their authorized capacity(ies), and that by-hisAter/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official se Signature Seal: COa118R1t4tFM1 Comm%aon #t 1806160 tJnk'"W Public . C A.P. #0 ComButte county My m. EV*es Jun 18, 204 o t ORDER NO. BU -184090-2 CH DESCRIPTION THE LAND REFERRED TO HEREIN IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS: PARCEL I• LOT 23, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MOUNTAIN OAKS ESTATES, A PLANNED UNIT DEVELOPMENT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 29, 1994, IN BOOK 135 OF MAPS, AT PAGES) 60 THRU 64. THIS DEED IS MADE AND ACCEPTED UPON THE COVENANTS, CONDITIONS AND RESTRICTIONS AS SET FORTH IN THAT CERTAIN DECLARATION OF RESTRICTIONS RECORDED MAY 22, 1995, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 95-16637, BUTTE COUNTY, CALIFORNIA; ALL OF WHICH ARE INCORPORATED HEREIN BY REFERENCE THERETO WITH THE SAME FORCE AND EFFECT AS' THOUGH FULLY SET FORTH HEREIN AT LENGTH AND GRANTEES BY ACCEPTANCE OF THIS DEED APPROVE, ADOPT, RATIFY AND AGREE TO THE TERMS OF SAID DECLARATION. AP#: 041-640-001-000 PARCEL II: A NON—EXCLUSIVE RIGHT AND EASEMENT OF ENJOYMENT IN AND TO THE LOT A, INCLUDING INGRESS AND EGRESS, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MOUNTAIN OAKS ESTATES, A PLANNED UNIT DEVELOPMENT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 29, 1994, IN BOOK 135 OF MAPS, AT PAGES) 60 THRU 64. PARCEL III• AN EASEMENT GRANTED IN PERPETUITY BEING NONREVOCABLE AND ALSO BEING TRANSFERABLE BY THE GRANTEE TO ANY INDIVIDUAL, CORPORATION, PARTNERSHIP, OR PUBLIC BODY OR AGENCY. SAID EASEMENT IS FOR THE INSTALLATION, MAINTENANCE, REPAIR, REPLACEMENT AND OR EXPANSION OF SANITARY SEWER PIPE LINES, STORAGE FACILITIES, IRRIGATION FACILITIES, THE RIGHT TO UTILIZE THE FOLLOWING DESCRIBED EASEMENT TO RECEIVE IRRIGATION WATER FROM SAID FACILITIES AND ALL OTHER APPURTENANCES TO SAID USES INCLUDING INGRESS AND EGRESS, IN, OVER, ACROSS AND UNDER THE FOLLOWING DESCRIBED PARCEL. ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: BEING A PORTION OF SECTION 18 AND SECTION 19, TOWNSHIP 21 NORTH, RANGE 4 EAST, M.D.B. & M.., MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTHWEST CORNER OF SAID SECTION 18, SAID CORNER BEING MARKED BY A STANDARD DEPARTMENT OF WATER RESOURCES MONUMENT CONTINUED ORDER NO. BU -184090-2 CH DESCRIPTION - CONTINUED PARCEL III - CONTINUED AS SHOWN ON THAT CERTAIN MAP RECORDED IN BOOK 42 OF MAPS, AT PAGE(S) 6, BUTTE COUNTY RECORDS; THENCE LEAVING SAID POINT OF BEGINNING ALONG THE WEST LINE OF SAID SECTION 18 NORTH 00 DEG. 05' 47" WEST, 820.00 FEET; THENCE LEAVING SAID WEST LINE SOUTH 90 DEG. 00' 00" EAST, 910.00 FEET; THENCE SOUTH 00 DEG. 00' 00" WEST, 1145.07 FEET TO THE NORTHERLY RIGHT OF WAY LINE OF MESSILLA VALLEY ROAD; THENCE ALONG SAID NORTHERLY LINE SOUTH 33 DEG. 37' 10" WEST, 67.22 FEET TO THE BEGINNING OF A CURVE CONCAVE TO THE NORTHWEST HAVING A RADIUS OF 270.00 FEET; THENCE ALONG SAID CURVE 334.66 FEET THROUGH A CENTRAL ANGLE OF 71 DEG. 00' 00"; THENCE NORTH 75 DEG. 21' S0" WEST, 441.81 FEET TO THE BEGINNING OF A CURVE CONCAVE TO THE SOUTH; THENCE FOLLOWING SAID CURVE ALONG A RADIUS OF 430.00 FEET, THROUGH A CENTRAL ANGLE OF 19 DEG. 43' 17" AN ARC DISTANCE OF 148.01 FEET TO THE WEST LINE OF SAID SECTION 19; THENCE LEAVING SAID NORTHERLY RIGHT OF WAY LINE ALONG SAID WEST LINE OF SECTION 19, NORTH 00 DEG. 38' 14" WEST, 368.93 FEET TO THE POINT OF BEGINNING. PARCEL IV: AN EASEMENT GRANTED IN PERPETUITY BEING NONREVOCABLE AND ALSO BEING TRANSFERABLE BY THE GRANTEE TO ANY INDIVIDUAL, CORPORATION, PARTNERSHIP, OR PUBLIC BODY OR AGENCY. SAID EASEMENT IS FOR THE INSTALLATION, MAINTENANCE, REPAIR, REPLACEMENT, AND OR EXPANSION OF SANITARY SEWER PIPE LINES AND ALL OTHER APPURTENANCES TO SAID USES INCLUDING INGRESS AND EGRESS, IN, OVER, ACROSS AND UNDER THE FOLLOWING DESCRIBED PARCEL. ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: BEING A PORTION OF SECTION 18, TOWNSHIP 21 NORTH, RANGE 4 EAST, M.D.B. & M., MORE PARTICULARLY DESCRIBED AS FOLLOWS: A SANITARY SEWER EASEMENT 30.00 FEET IN WIDTH LYING 15.00 FEET ON EACH SIDE OF THE FOLLOWING DESCRIBED CENTERLINE: COMMENCING AT THE SOUTHWEST CORNER OF SAID SECTION 18, SAID CORNER BEING MARKED BY A STANDARD DEPARTMENT OF WATER RESOURCES MONUMENT AS SHOWN ON THAT CERTAIN MAP RECORDED IN BOOK 42 OF MAPS, AT PAGE(S) 6, BUTTE COUNTY RECORDS; THENCE LEAVING SAID COMMENCEMENT POINT ALONG THE WEST LINE OF SAID SECTION 18 NORTH 00 DEG. 05' 47" WEST, 820.00 FEET; THENCE LEAVING SAID WEST LINE SOUTH 90 DEG. 00' 00" EAST, 704.27 FEET TO THE TRUE POINT OF BEGINNING FOR THE FOLLOWING DESCRIBED CENTERLINE; THENCE LEAVING SAID POINT OF BEGINNING NORTH 09 DEG. 27' 14" EAST, 269.26 FEET; THENCE NORTH 15 CONTINUED ORDER NO. BU -184090-2 CH DESCRIPTION - CONTINUED PARCEL IV - CONTINUED DEG. 00' 04" EAST, 391.45 FEET; THENCE NORTH 05 DEG. 32' 19" EAST, 187.07 FEET; THENCE NORTH 33 DEG. 13' 45" EAST, 143.71 FEET; THENCE NORTH 68 DEG. 49' 57" EAST, 201.63 FEET; THENCE NORTH 75 DEG. 48' 47" EAST, 151.14 FEET; THENCE SOUTH 81 DEG. 37' 06" EAST, 235.74 FEET TO A POINT IN THE NORTHEASTERLY LINE OF PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, IN BOOK 102 OF MAPS, AT PAGES) 25, SAID NORTHEASTERLY LINE BEING LABELED NORTH 34 DEG. 25' 58" WEST, 143.34 FEET ON SAID MAP. SAID POINT BEING THE TERMINUS OF,THE HEREIN DESCRIBED CENTERLINE.' w 2005-0059155 Recorded i RIC FEE 16.00 �^ AND WHEN RECORDED MAIL TO: Official Records 1 County of I COPIESa. ;0 BUTTE COUNTY BUILDING DIVISION Butte i 7 COUNTY CENTER DRIVE GAIdllACi Butt GRUBBS I OROVILLE, CA 95965 County Clerk-Recorderl . I 1 SA 011:29RM 2j9 -Sep -2005 I Page 1 of 4 IIII"III"�IIIIIII'��I�I'I�I'II�I AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: �ee c✓��'�jed Date !;��� 0,-=7 PROPERTY OWNERS: State of California County of 5 ,k - DR before me, personally appeared 1 Ce KnEMgPe 11 personally known to me (or proved to me on th6 basis of satisfactory evidence) to be the pe on(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that4tetslia=/they executed the same in 4is ter/their authorized capacity(ies), and that by-iisAwr/their signature(s) on the instrument, the person(s) or the entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my_ hand and official sell. / � CO0�1 didMNALL Signature Seal: Cin * I5MU180 Notory RAft - cambRMo A.P. #M*90 �Al►Conlln Eltplree,lunl0. 5A ORDER NO. BU -184090-2 CH DESCRIPTION THE LAND REFERRED TO HEREIN IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS: PARCEL I: LOT 23, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MOUNTAIN OAKS ESTATES, A PLANNED UNIT DEVELOPMENT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 29, 1994, IN BOOK 135 OF MAPS, AT PAGES) 60 THRU 64. THIS DEED IS MADE AND ACCEPTED UPON THE COVENANTS, CONDITIONS AND RESTRICTIONS AS SET FORTH IN THAT CERTAIN DECLARATION OF RESTRICTIONS RECORDED MAY 22, 1995, UNDER BUTTE COUNTY RECORDER'S SERIAL NO. 95-16637, BUTTE COUNTY, CALIFORNIA; ALL OF WHICH ARE INCORPORATED HEREIN BY REFERENCE THERETO WITH THE SAME FORCE AND EFFECT AS THOUGH FULLY SET FORTH HEREIN AT LENGTH AND GRANTEES BY ACCEPTANCE OF THIS DEED APPROVE, ADOPT, RATIFY AND AGREE TO THE TERMS OF SAID DECLARATION. AP#: 041-640-001-000 PARCEL II: A NON-EXCLUSIVE RIGHT AND EASEMENT OF ENJOYMENT IN AND TO THE LOT A, INCLUDING INGRESS AND EGRESS, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "MOUNTAIN OAKS ESTATES, A PLANNED UNIT DEVELOPMENT", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE; STATE OF CALIFORNIA, ON DECEMBER 29, 1994, IN BOOK 135 OF MAPS, AT PAGE(S) 60 THRU 64. PARCEL III• AN EASEMENT GRANTED IN PERPETUITY BEING NONREVOCABLE AND ALSO BEING TRANSFERABLE BY THE GRANTEE TO ANY INDIVIDUAL, CORPORATION, PARTNERSHIP, OR PUBLIC BODY OR AGENCY. SAID EASEMENT IS FOR THE INSTALLATION, MAINTENANCE, REPAIR, REPLACEMENT AND OR EXPANSION OF SANITARY SEWER PIPE LINES, STORAGE FACILITIES, IRRIGATION FACILITIES, THE RIGHT TO UTILIZE THE FOLLOWING DESCRIBED EASEMENT TO RECEIVE IRRIGATION WATER FROM SAID FACILITIES AND ALL OTHER APPURTENANCES TO SAID USES INCLUDING INGRESS AND EGRESS, IN, OVER, ACROSS AND UNDER THE FOLLOWING DESCRIBED PARCEL. ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: BEING A PORTION OF SECTION 18 AND SECTION 19, TOWNSHIP 21 NORTH, RANGE 4 EAST, M.D.B. & M., MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE SOUTHWEST CORNER OF SAID SECTION 18, SAID CORNER BEING MARKED BY A STANDARD DEPARTMENT OF WATER RESOURCES MONUMENT CONTINUED ORDER NO. BU -184090-2 CH DESCRIPTION - CONTINUED PARCEL III - CONTINUED AS SHOWN ON THAT CERTAIN MAP RECORDED IN BOOK 42 OF MAPS, AT PAGE(S) 6, BUTTE COUNTY RECORDS; THENCE LEAVING SAID POINT OF BEGINNING ALONG THE WEST LINE OF SAID SECTION 18 NORTH 00 DEG. 05' 47" WEST, 820.00 FEET; THENCE LEAVING SAID WEST LINE SOUTH 90 DEG. 00' 00" EAST, 910.00 FEET; THENCE SOUTH 00 DEG. 00' 00" WEST, 1145.07 FEET TO THE NORTHERLY RIGHT OF WAY LINE OF MESSILLA VALLEY ROAD; THENCE ALONG SAID NORTHERLY LINE SOUTH 33 DEG. 37' 10" WEST, 67.22 FEET TO THE BEGINNING OF A CURVE CONCAVE TO THE NORTHWEST HAVING A RADIUS OF 270.00 FEET; THENCE ALONG SAID CURVE 334.66 FEET THROUGH A CENTRAL ANGLE OF 71 DEG. 00' 00"; THENCE NORTH 75 DEG. 21' 50" WEST, 441.81 FEET TO THE BEGINNING OF A CURVE CONCAVE TO THE SOUTH; THENCE FOLLOWING SAID CURVE ALONG A RADIUS OF 430.00 FEET, THROUGH A CENTRAL ANGLE OF 19 DEG. 43' 17" AN ARC DISTANCE OF 148.01 FEET TO THE WEST LINE OF SAID SECTION 19; THENCE LEAVING SAID NORTHERLY RIGHT OF WAY LINE ALONG SAID WEST LINE OF SECTION 19, NORTH 00 DEG. 38' 14" WEST, 368.93 FEET TO THE POINT OF BEGINNING. PARCEL IV: AN EASEMENT GRANTED IN PERPETUITY BEING NONREVOCABLE AND ALSO BEING TRANSFERABLE BY THE GRANTEE TO ANY INDIVIDUAL, CORPORATION, PARTNERSHIP, OR PUBLIC BODY OR AGENCY. SAID EASEMENT IS FOR THE INSTALLATION, MAINTENANCE, REPAIR, REPLACEMENT, AND OR EXPANSION OF SANITARY SEWER PIPE LINES AND ALL OTHER APPURTENANCES TO SAID USES INCLUDING INGRESS AND EGRESS, IN, OVER, ACROSS AND UNDER THE FOLLOWING DESCRIBED PARCEL. ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: BEING A PORTION OF SECTION 18, TOWNSHIP 21 NORTH, RANGE 4 EAST, M.D.B. & M., MORE PARTICULARLY DESCRIBED AS FOLLOWS: A SANITARY SEWER EASEMENT 30.00 FEET IN WIDTH LYING 15.00 FEET ON EACH SIDE OF THE FOLLOWING DESCRIBED CENTERLINE: COMMENCING AT THE SOUTHWEST CORNER OF SAID SECTION 18, SAID CORNER BEING MARKED BY A STANDARD DEPARTMENT OF WATER RESOURCES MONUMENT AS SHOWN ON THAT CERTAIN MAP RECORDED IN BOOK 42 OF MAPS, AT PAGE(S) 6, BUTTE COUNTY RECORDS; THENCE LEAVING SAID COMMENCEMENT POINT ALONG THE WEST LINE OF SAID SECTION 18 NORTH 00 DEG. 05' 47" WEST, 820.00 FEET; THENCE LEAVING SAID WEST LINE SOUTH 90 DEG. 00' 00" EAST, 704.27 FEET TO THE TRUE POINT OF BEGINNING FOR THE FOLLOWING DESCRIBED CENTERLINE; THENCE LEAVING SAID POINT OF BEGINNING NORTH 09 DEG. 27' 14" EAST, 269.26 FEET; THENCE NORTH 15 CONTINUED ORDER NO. BU -184090-2 CH DESCRIPTION - CONTINUED PARCEL IV CONTINUED DEG. 00' 04" EAST, 391.45 FEET; THENCE NORTH 05 DEG. 32' 19" EAST, 187.07 FEET; THENCE NORTH 33 DEG. 13' 45" EAST, 143.71 FEET; THENCE NORTH 68 DEG.'49' 57" EAST, 201.63 FEET; THENCE NORTH 75 DEG. 48' 47" EAST, 151.14 FEET; THENCE SOUTH 81 DEG. 37' 06" EAST, 235.74 FEET TO A POINT IN THE NORTHEASTERLY LINE OF PARCEL 1, AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, IN BOOK 102 OF MAPS, AT PAGE(S) 25, SAID NORTHEASTERLY LINE BEING LABELED NORTH 34 DEG. 25' 58" WEST, 143.34 FEET ON SAID MAP. SAID POINT BEING THE TERMINUS OF THE HEREIN DESCRIBED CENTERLINE. Status: JISSUED _ _ _ 1 APN: 041 640 00.1;0.00_ _ _ 1 Bin #:A,1_l_-J Site Address:3577 LONNIE LNPAR I Map index: Owner (Title): RLIARK-DONALD E.&_LEILAA j Project Title: _ I Contractor: JGARUQOPEq 1 Applicant: RUARK_DONALD E,& LEILA Contr Phone: 530 877y8080 i Architect: I Contr. Lic. # I Engineer: I Description:NS_F,(2731JGAR(881)COV(593) f Fee Summary Construction Permit Fee: ._ $3,376,32 Misc. Permit Fees: r1i _ __$_0..00 Strong Motion: VF—$20.811 _$20.811 Investigation Fees: Other Agency/Impact: $0.00 Other Fees: —$0.00 TOTAL FEES: .$_3,397.1.3 Fees Paid: $0,00 Balance Due: $_0.00 Planning: I� Fire: PW -Land Dvlmt: Jr' PW Encroach: J Ag buffer: Ag Statement: Pre-Insp: Soils Rpt/Eng. Found: J Other: Key Dates Applied: 09/29/2005 J Approved: 12/05I2005,J BP Renewal: Issued: 12112/2005) Expired: /_!__j Finaled: _! !_J Voided: _/ Census Data Census Class Code: Updates + Exit Back Construction Information Permit Category: BLDG RES___ Construction Type: VN_ J Total Valuation: _$208,1.47._00) Total Square Feet: 4,205�� Permit Type: NEW_ 1 Required to Issue Contractor's Lic.: tj Workers Comp: l Owner/Builder: Sign Authorization: Erosion Control Plan: Chico Plumb: Recreation Dist: Fire Sprinkler: TRA: 110013----i High School District: JNOT.FOLIND.lN TABLE Elem School District: NOT_FO JND IN TABLE_ I Water: 1 Sewer: f Rec Dist: I _ 1 NPDES: r Water: Health: Sewer: School Fee: I'll Deed Restriction: Plan Check: AQMD: MH Docs: (� Grant Deed J MH Title/Statement Ltr-legal owner HCD check $$ Intialized:09/29/2005.] CSCHNURR) SP0S2649 APN8041-640001 OWNER: RUARK TOTAL PERMIT COSTS $7,698.99 $7,698.99 Building Permit Fees $3,486.30 SMIP $20.81 Res Dev Impact $4,096.88 SRA Review $95.00 LIBRARY LIBRARY LIBRARY ROADS SHERIFF SHERIFF FIRE FIRE processing processing $7,698.99 SRA FACILITIES MATERIALS VEH 8 EDP BRIDGES FAC VEH BEOP FACILITIES VEHBEOP auditor dev ser Fund 10 F10 F-1001 F1800 F1808 F1810 F1821 F1825 F1825CWIF F1825CWIF F1831 F1840 F1840 F1851 F1851 F050 F10 Receipt 0439863 Dated 929/05 $1,529.39 $1,434.39 $95.00 $1,529.39 Receipt 0443139 Dated 12/12/05 $6,169.60 $2,051.91 $20.81 $257.00 $599.81 $276.64 $0.00 $217.34 $146.20 $4.36 $1,206.78 $282.39 $137.79 $330.54 $638.03 $0.00 $0.00 $6,169.60 $7,698.99 $3,486.30 Wednesday, September 20, zoos Development Services BUILDING DIVISION Ver. 1.0 Counter Curtis Person Payment Date Permit Number Receipt Number 1 Check Number or Cash Parcel Number Applicant Received From Total Received -$-1,529 39 Total Fees To Collect $1,529.39 Notes: ta Fund 10 (Bldg Permits) SRA Fees (Fire) SHR Fees (Sheriff) SMIP Copies/Document Sales CUA (Chico Urban Area) TUA (Therm. Urban Area) Water Tender Btln #= West Chico Fire Station AVA Restitution Payment Recorders Fees (N.O.C) Thermalito Drainage Oroville Area Traffic NSF (Non Sufficient Funds) Notice of Violation NCSP Trails System NCSP Roads/Bridges NCSP Storm Drainage NCSP Fire Station NCSP Parks Type Value I� $1,434.39' $95.00 $0.00 $0.29j $0.00 I $0.00 $0.22j $0.00 I $0.22J. -$0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 REQUEST FOR AUDITOR'S CERTIFICATE AND TREASURER'S RECEIPT DEPARTMENT: DEVELOPMENT SERVICES - BUILDING DIVISION DATE: 9/30/2005 BAG NUMBER: 328 DEPOSIT NUMBER: 63 RANGE OF RECEIPTS: 439861 - 439892 MONEY COLLECTED: 9/29/2005 DESCRIPTION FUND TITLE FUND CODE DEPT CODE ACCT CODE CASH CODE AMOUNT BLDG PERMITS BLDG INSPCTN0�- 010_^-'"440001`"""4210500 _101001 $-29,879.43] REMOVE NOTICE OF VIOLATION GENERAL FUND 0010 440001 4350903 101001 $ - CHRG ON RET CHECK BLDG INSPCTN 0010 440001 4610105 101001 $ AVA COURT ORD RESTIT REIM AVA CRT ORD 0010 440001 4617252 101001 $ COPIES COPY SALES 0010 440001 4711910 101001 $ 30.25 WITNESS FEES BLDG INSPCTN 0010 440001 4712523 101001 $ - RECORDERS FEES GENERAL FUND 0010 470001 4613701 101001 $ FIRE PLNG APPL FEE (SRA) FIRE PROTECTN (010y__45000:1 ""'""4617240"--- 101001 y$,: ,.y„�,;,,2,477.96 SMIP FEES SMIP FEES 1001 280 1011298 $ 36.34 SHERIFF DEVELOPMENT (SHR) SHER DEVL FEE 1800 280 1011811 $ 3,903.29 CHICO URBAN STREET IMPROVEMENT CHICO URBAN AREA 1800 280 1011815 $ - OROVILLE AREA TRAFFIC OROVILLE TRAFFIC 1800 280 1011817 $ - CHICO VECINO DRAINAGE TRUST CHICO VECINO 1800 280 1011821 $ THERMALITO DRAINAGE THERM. DRAINAGE 1800 280 1011822 $ DRAINAGE DEPOSIT TRUST DRAINAGE DEP. TRUST 1800 280 1011823 $ SUB -DIVISION DRAINAGE TRUST SUB -DIV. DRAINAGE TRUST 1800 280 1011824 $ NCSP - TRAILS SYSTEM NCSP - TRAILS SYSTEM 1800 280 1011888 $ NCSP - ROADS & BRIDGES NCSP - ROADS & BRIDGES 1800 280 1011889 $ NCSP - STORM DRAINAGE NCSP - STORM DRAINAGE 1800 280 1011890 $ NCSP - FIRE STATION NCSP - FIRE STATION 1800 280 1011891 $ NCSP-PARKS NCSP-PARKS 1800 280 1011892 $ - CWIF - GENERAL GOVT. FACILITIES CWIF-GEN. GOVT. FACILITIES 1808 280 101001 $ 1,689.51 CWIF - GENERAL GOVT. EQUIPMENT CWIF-GEN. GOVT. EQUIP 1810 280 101001 $ 779.22 CWIF - LIBRARY - FACILITIES CWIF-LIBR - FACILITIES 1825 280 1011826 $ 612.19 CWIF - LIBRARY - MATERIALS CWIF-LIBR - MATERIALS 1825 280 1011827 $ 411.81 CWIF • LIBRARY - VEHICLE & EQUIPMENT CWIF-LIBR - VEH & EQUIP 1825 280 1011828 $ 12.28 CWIF - ROADS & BRIDGES (NCSP/CUA) CWIF-ROADS & BRIDGES 1831 280 1011001 $ 3,123.43 CWIF - SHERIFF - FACILITIES CWIF-SHR - FACILITIES 1840 280 1011841 $ 795.42 CWIF - SHERIFF - VEHICLE & EQUIPMENT CWIF-SHR - VEH & EQUIP 1840 280 1011842 $ 388.12 CWIF - FIRE - FACILITIES CWIF-FIRE - FACILITIES 1851 280 1011852 $ 931.04 CWIF - FIRE - VEHICLE & EQUIPMENT CWIF-FIRE - VEH & EQUIP 1851 280 1011853 $ 1,797.16 WATER TENDER FEE BATTALION #7 1851 280 1011867 $ - TOTAL $ 46,867.45 Revised 7/1/2005 PREPARED BY: Gwyn Benedict ext 7604 Revised 7H/2005 DEPARTMENT OF DEVELOPMENT SERVICES DATE 9/30/2005 DEPOSIT SHEET - BUILDING DIVISION BAG # 328 DEPOSIT # 63 RANGE OF RECEIPTS: �43�9861 - 439892 MONEY COLLECTED: 9/29/2005 Page 1 of 3 -1 -01 -10 -1 -1 -1 -1 -10 -1 BUILDING PERMITS FIRE - SRA SMIP FEE REMOVE NOTICE OF VIOLATION RETURN CHECK FEE AVA COURT RESTITUTION COPIES PUBLIC SALES WITNESS FEES RECORDERS FEES STREET IMPROVEMENT PERMIT# RECEIPT# 4210500 4617240 280 4350903 4610105 4617252 4711910 4712523 4613701 280 101001 101001 1011298 101001 101001 101001 101001 101001 101001 1011815 052648 439861 $ 467.42 052650 439862 $ 55.00 -052649--439863 $ 1,434.39 $ --"95.00 `052381' 439864---$--'-511:41--$-----`_� $ 3.12 052302 439865 $ 329.94 $ 11.73 052651 439866 $ 55.00 052652 439866 $ 55.00 051916 439867 $ 329.94 052653 439868 $ 55.00 051980 439869 $ 802.86 $ 5.40 copies 439870 $ $ $ 30.00 052654 439871 $ 972.03 $ 052092 439872 $ 1,571.28 $ $ 12.31 052655 439873 $ .1,061.40 $ 193.98 052656 439873 $ 1,061.40 $ 193.98 050394 439875 $ 511.41 $ $ 3.78. 051688 439876 $ 54.99 $ 052660 439877 $ 439.94 $ 052658 439878 $ 819.01 $ 95.00 052659 439878 $ 819.01 $ 95.00 052301 439879 $ 329.94 052662 439880 $ 55.00 052663 439881 $ 55.00 052661 439881 $ 55.00 052664 439882 $ 55.00 052665 439883 $ 55.00 052666 439883 $ 55.00 052667 439884 $ 285.95 052668 439884 $ 82.00 052669 439885 $ 329.94 $ 95.00 052674 439886 $ 55.00 052677 439886 $ 55.00 052680 439886 $ 55.00 052683 439886 $ 55.00 / 052685 439886 $ 55.00 052690 1 439886 $ 55.00 052692 439887 $ 340.94 020806 439889 $ 54.99 052695 439890 $ 55.00 052696 439890 $ 55.00 052670 439891 $ 893.30 $ 95.00 052671 439891 $ 893.30 $ 95.00 052672 439891 $ 893.30 $ 95.00 052673 439891 $ 893.30 $ 95.00 052675 439891 $ 893.30 $ 95.00 052676 439891 $ 893.30 $ 95.00 052678 439891 $ 893.30 $ 95.00 052679 439891 $ 893.30 $ 95.00 052681 439891 $ 893.30 $ 95.00 052682 439891 $ 893.30 $ 95.00 052684 439891 $ 893.30 $ 95.00 052686 439891 $ 893.30 $ 95.00 052688 439891 $ 893.30 $ 95.00 052689 439891 $ 893.30 $ 95.00 052691 439891 $ 939.38 $ 95.00 052693 439891 $ 970.18 $ 95.00 052694 439891 _ $ 970.18 $ 95.00 052697 439891 $ 893.30 $ 95.00 copies 1 439892 $ 1 1$ 0.25 E 29,879.43 $ 2,477.96 $ 36.34 1 $ $ 1 $ 30.25 1 $ $ $ Page 1 of 3 Revised 711/2005 DATE 9/302005 BAG # 328 - DEPOSIT# 63 RANGE OF RECEIPTS: 439861-439892 MONEY COLLECTED: 9292005 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION R.i4ri9� 01111IL9Gi0.- Page 2 of 3 Revised 7/1/2005 DATE 91302005 BAG N 328 DEPOSIT # 63 RANGE OF RECEIPTS: 439861 -439892 MONEY COLLECTED: 9292005 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION Page 3 of 3 PREPARED BY: Gwyn Benedict ext 7604 DATE: 9/302005 mom -mil mArm mmm�ymmiiiw��� GRAND TOTAL TO BE DEPOSITED Page 3 of 3 PREPARED BY: Gwyn Benedict ext 7604 DATE: 9/302005 Wednesday, September 20, 2006 Development Services BUILDING DIVISION Voi. 1.0 Counter Karen Person I SAME Payment Date $6,169.60 1 211 212 0 0 5 Permit Number 052649 ' Receipt Number 443139 Check Number or Cas 001 Parcel Number 041-640-001 ' Applicant RUARK Received From I SAME Total Received $6,169.60 Total Fees To Collect $6,169.60 Fund 10 (Bldg Permits) $2,051.91 SRA Fees (Fire) B$46/$43 $0.00 SHR Fees (Sheriff) B$25/$335 $0.00 Copies/ Document Sales $0.00 CUA (Chico Urban Area) B$25 $0.00 I TUA (Therm. Urban Area) B$25/$570 $0.00 Water Tender Btln #1 $200 $0.00 West Chico Fire Station $75 $0.00' Witness Fees B/AII $0.00 Recorders Fees (N.O.C) B$246/$54 r $0.00 Thermalito Drainage $510 $0.00 Oroville Area Traffic $75 $0.00 NSF (Non Sufficient Funds) $25 $0.00 Notice of Violation B$150/$150 $0.00 NCSP Trails System $0.00 NCSP Roads/Bridges $0.00 NCSP Storm Drainage $0.00 NCSP Fire Station $0.00 NCSP Parks $0.00 Value Type $0.00 REQUEST FOR AUDITOR'S CERTIFICATE AND TREASURER'S RECEIPT DEPARTMENT: DEVELOPMENT SERVICES - BUILDING DIVISION DATE: 12/13/2005 BAG NUMBER: 330 DEPOSIT NUMBER: 109 RANGE OF RECEIPTS: 443126-443149 MONEY COLLECTED: 12/12/2005 DESCRIPTION FUND TITLE FUND CODE DEPT CODE ACCT CODE CASH CODE AMOUNT BLDG PERMITS BLDG INSPCTN 0010 440001 4210500 101001 $ 7,303.34 REMOVE NOTICE OF VIOLATION GENERAL FUND 0010 440001 4350903 101001 $ CHRG ON RET CHECK BLDG INSPCTN 0010 440001 4610105 101001 $ AVA COURT ORD RESTIT REIM AVA CRT ORD 0010 440001 4617252 101001 $ COPIES COPY SALES 0010 440001 4711910 101001 $ 0.25 WITNESS FEES BLDGINSPCTN 0010 440001 4712523 101001 $ - RECORDERS FEES GENERAL FUND 0010 470001 4613701 101001 $ DEVELOPMENT SERVICES • CWIF PROC FEE DEV SRVCS - CWIF PROC FEE 0010 440001 4617999 101001 $ AUDITORS - CWIF PROC FEE AUD - CWIF PROC FEE 050 4617998 101001 $ FIRE COMMCL PLNG REV FEES FIRE PROTECTN 0100 4617237 101001 $ FIRE PLNG APPL FEE (SRA) FIRE PROTECTN 0100 4617240 101001 $ 95.00 SMIP FEES SMIP FEES 1001 280 1011298 $ 45.73 SHERIFF DEVELOPMENT (SHR) SHER DEVL FEE 1800 280 1011811 $ 514.00 CHICO URBAN STREET IMPROVEMENT CHICO URBAN AREA 1800 280 1011815 $ OROVILLE AREA TRAFFIC OROVILLE TRAFFIC 1800 280 1011817 $ CHICO VECINO DRAINAGE TRUST CHICO VECINO 1800 280 1011821 $ THERMALITO DRAINAGE THERM. DRAINAGE 1800 280 1011822 $ DRAINAGE DEPOSIT TRUST DRAINAGE DEP. TRUST 1800 260 1011823 $ SUB -DIVISION DRAINAGE TRUST SUB•DIV. DRAINAGE TRUST 1800 280 1011824 $ NCSP - TRAILS SYSTEM NCSP - TRAILS SYSTEM 1800 280 1011888 $ NCSP - ROADS & BRIDGES NCSP - ROADS & BRIDGES 1800 280 1011889 $ NCSP - STORM DRAINAGE NCSP - STORM DRAINAGE 1800 280 1011890 $ NCSP - FIRE STATION NCSP - FIRE STATION 1800 280 1011891 $ NCSP-PARKS NCSP-PARKS 1800 280 1011892 $ CWIF • GENERAL GOVT. FACILITIES CWIF-GEN. GOVT. FACILITIES 1808 280 101001 $ 1,199.62 CWIF - GENERAL GOVT. EQUIPMENT CWIF-GEN. GOVT. EQUIP 1810 280 101001 $ 553.28 CSD #770 - BUTTE CREEK CSD #770 BUTTE CREEK 1821 280 1011970 $ CSD #771 - COMANCHE CREEK CSD #771 COMANCHE CREEK 1821 280 1011971 $ CSD #772 - LITTLE CHICO CREEK CSD #772 LITTLE CHICO CREEK 1821 280 1011972 $ CSD #773 - BIG CHICO CREEK CSD #773 BIG CHICO CREEK 1821 280 1011973 $ CSD #774 - LINDO CHANNEL CSD #774 LINDO CHANNEL 1821 280 1011974 $ CSD #775 - S.U.D.A.D. DITCH CSD #775 S.U.D.A.D. DITCH 1821 280 1011975 $ CSD #776 - MUDDSYCAMORE CREEK CSD #776 MUDDSYCAMORE CREEK 1821 280 1011976 $ CSD #777 - P.V. DITCH CSD #777 P.V. DITCH 1821 280 1011977 $ CWIF - LIBRARY - FACILITIES CWIF-LIBR - FACILITIES 1825 280 1011826 $ 434.68 CWIF - LIBRARY - MATERIALS CWIF-LIBR - MATERIALS 1825 280 1011827 $ 292.40 CWIF - LIBRARY - VEHICLE & EQUIPMENT CWIF•LIBR - VEH & EQUIP 1825 280 1011828 $ 8.72 CWIF - ROADS & BRIDGES (NCSP/CUA) CWIF-ROADS & BRIDGES 1831 280 1011001 $ 2,413.56 CWIF - SHERIFF - FACILITIES CWIF•SHR - FACILITIES 1840 280 1011841 $ 564.78 CWIF - SHERIFF - VEHICLE & EQUIPMENT CWIF-SHR - VEH & EQUIP 1840 280 1011842 $ 275.58 CWIF - FIRE - FACILITIES CWIF-FIRE • FACILITIES 1851 280 1011852 $ 661.08 CWIF - FIRE - VEHICLE & EQUIPMENT CWIF-FIRE - VEH & EQUIP 1851 280 1011853 $ 1,276.06 WATER TENDER FEE BATTALION #7 1851 280 1011867 $ TOTAL $ 15,638.08 Revised 11/22/2005 PREPARED BY: Gwyn Benedict ext 7604 Revised 11/28/2005 DATE 12/13/2005 BAG # 330 DEPOSIT # 109 RANGE OF RECEIPTS: 443126-443149 MONEY COLLECTED: 12/12/2005 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION Page 1 of 4 10 -10 -10 -10 -10 -10 -10 -0100 -0100 F-1001 BUILDING PERMITS REMOVE NOTICE OF VIOLATION RETURN CHECK FEE AVA COURT RESTITUTION COPIES PUBLIC SALES WITNESS FEES RECORDERS FEES FIRE - COMMCL PLNG REV FEES FIRE - SRA SMIP FEE PERMIT# RECEIPT# 4210500 4350903 4610105 4617252 4711910 4712523 4613701 4617237 4617240 280 101001 101001 101001 101001 101001 101001 101001 101001 101001 1011298 053088 441326 $ 90.00 $ 0.92 043313 443127 $ 109.98 050848 443128 $ 54.99 041966 443129 $ 109.98 053246 443131 $ 357.50 053247 443131 $ 55.00 053248 443132 $ 55.00 053249 443133 $ 55.00 053250 443134 $ 428.92 053164 443135 1 $ 90.00 $ 0.22 053251 443136 $ 109.98 053252 443137 $ 55.00 na 443138 $ 54.99 = 052649 —443139 -- =$ --2,051.91 $----20.81' 053253 443140 $ 110.00 053008 443141 $ 560.90 051148 443142 $ 2,327.27 $ 23.78 void 443144 co ies 443147 $ 0.25 053256 443148 $ 165.00 053255 443149 $ 461.92 $ 95.00 $ 7,303.34 $ - $ - $ - $ 0.25 $ - $ - $ - $ 95.00 Page 1 of 4 Revised 11/28/2005 DATE 12/13/2005 BAG # 330 DEPOSIT # 109 RANGE OF RECEIPTS: 443126-443149 MONEY COLLECTED: 12/12/2005 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION Page 2 of 4 Revised 11/28/2005 DATE 12/13/2005 BAG # 330 DEPOSIT # 109 RANGE OF RECEIPTS: 443126-443149 MONEY COLLECTED: 12/12/2005 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION Page 3 of 4 CRIA DRAINAGE IN AREA # 770 # 776 ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ Page 3 of 4 Revised 11/28/2005 DATE 12/13/2005 BAG # 330 DEPOSIT # 109 RANGE OF RECEIPTS: 443126-443149 MONEY COLLECTED: 12/12/2005 DEPARTMENT OF DEVELOPMENT SERVICES DEPOSIT SHEET - BUILDING DIVISION �'�� t�L^II�t�II�tL^II�t9i`/I�tl^/l��i'���� '®• " ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ ------------ GRAND TOTAL TO BE DEPOSITED I I I $ 15,638.08 PREPARED BY: Page 4 of 4 Gwyn Benedict ext 7604 DATE: 12/13/2005 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (630) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7641 PERMIT NO. 649 PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE, OR IF WORK IS DONE IN VIOLATION OF ANY COUNTY OR STATE LAWS. 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 Issued Date: 12/12/2005 APN: 041-640-001-000 effect. License Class : License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penally 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 Contractor's State 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.). Site Address: 3577 LONNIE LN PAR Map Index: Description: NSF(2731)GAR(881)COV(593) Owner: RUARK DONALD E & LEILA A 14 CHAMBERS LANE OAKLAND, CA 94611 Applicant: RUARK-DONALD E & LEILA A 14 CHAMBERS LANE OAKLAND, CA 94611 A1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Slate 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' Slate License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code DatelL'a�— �%`l OwneCl2im"/2�/�� WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: License #: Architect: Engineer: Carrier: Policy#: otal Square Ft: 4205 S.F. I certify that in the performance of the work for which this permit is Valuation: $208,147.00 Issued, I shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date:. a /ilii LLQ 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 Lf\ I 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.) Name: Address: I PERMIT EXPIRES ;r the applicable provisions of the Butte County Code and/or above for which fees have been paid. Date: ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & 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 I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Nam@:1�O,V4&2D �t� Signature: Date: . / 2- Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 41 x Cooper Custom Construction ■■■■■■ Gary Cooper Owner Ca. Lic. # 672664 P. O. Box 658 Paradise, CA. 95969 530-877-8080 Cell 864-1440 dvi GYd ��/ %Vs 'Z tr "Z 00 "'.Fv I e -11- r< I 1f_V N v �� X14410 5 #%,1@ I 'o3 `,, � K. V - c�► _ G I S r , , • i • 2 +. I a ! £4 , .. }: ht is i �'ti,`-^"..' ...-...i..rr S .. :: d;: �( '_ � ,,/•'r «" \ t r...• .. 1 , r / / \ \. N At Lij INN tr. r > = --- {-- , �f� r 4n + / r r "- - • I G Hr"rl �x t r , _ 8- : ,4 L .. e �._ is. V G' ...Y s Z { rr 2d` ,1 t , • • r + :.p O' \ ti MM 00, \ 1 " r• ^/tel /btu 6 C t4:.... :.. . I 00 - t SAt g n '00 , 7."'' : -'/. rte► � 7�T�'�."t37�'.5'i/j..d� �'!•' i , I , z1 "x Bch , . .d..:.' t' ... • .. 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