HomeMy WebLinkAbout042-180-024U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal Emergency Management Agency Expires February 28, 2009
National Flood Insurance Program Important: Read the Instructions on pages 1-8.
SECTION A - PROPERTY INFORMATION For Insurance Company Use:
Al. Building Owner's Name Policy Number
A2. Building Street Address (Including Apt., Unit, Suite and/ r Bld . No.) or P.O. Route and Box No. Company; NAIC Number
z 9 ZAwe-
lily
e-r4`
City �I o , State ZIP Code
A3. Property Description (Lot andlock Numbers Tax Parcel Number, Legal Description, etc.) /
14vti o z - /6,6 o z -4
Aa. Building Use (e.g., Residential, Non -Residential, Additio Acceaso c.) S/�'�J P
A5. Latitude/Longitude: Lat. /2 / "54 ` /O `� Lon �• .30" Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983
A6. Attach at least 2 photographs of the building 9 the Certificate Is being used to obtain flood Insurance.
A7. Building Diagram Number
A8. For a building with a crawl space or enclosure(s), provide: A9. For a building with an attached garage, provide:
�•
a) Square footage of crawl space orenclosure(s) N sq ft a) Square footage of attached garage sq ft
b) No. of permanent flood openings In the crawl space or. A- b) No. of permanent flood openings In the attach
enclosure(s) walls within 1.0 foot above adjacent grade AIwalls within 1.0 foot above adjacent grade A) garage
c) Total net area of flood openings In A8.b W74 sq In c) Total net area of flood operhinge In A9.b sq in
•• SECTION B --FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bi. NFIP Community Name 8 Community Number B2. County Name B3. State
0"Iti 12 P. X4106 .' OlocO.l t�U 74T -a
84. Map/Panel Number
B5..Sufflx
B6. FIRM Index
B7, FIRM Panel
B8. Flood
B9. Base Flood Elevation(s) (Zone
o 4o6)-7 0485
C
Date ;
.¢ zd 06
Effe tl evlsed Date
6 qqg
Zone(s)
A
AO, use base flood depth)
B 10. Indicate the source of the Base Flood Elevation (BFE) date or.base flood depth entered In tem 89.
❑ FIS Profile ❑ FIRM ❑ Community Determined ❑ Other (Describe)
Bi 1. Indicate elevation datum used for BFE In Item B9: ❑ NGVD 1929. , ❑ NAVD 1988 ❑ Other (Describe)
131F. Is the building located in a Coastal Bartter Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 5' No
Designation Date L) A) 1C/U6GJ J ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRE9)
Ci. Building elevations are based on: cnstruction Drawings' ❑ Building Under Construction' Finished Construction
•A new Elevation Certificate will be Alred when construction of the building Is complete.
C2. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g
below according to the building diagram specified In Item A7. T / p 2 Q
Benchmark Utilized 73iC/f �Z S7—A OE Vertical Datum �Y {7 /J I
Conversion/Comments C Sid' to 'r I It 5/44 ro . 1ST
Check the measurement used.
a) Top of bottom floor (Including basement, crawl space, or enclosure floor) �'� !feet ❑ meters (Puerto Rico only)
b) Top of the next higher floor feet ❑ meters (Puerto Rico only)
c) Bottom of the lowest horizontal structural member (V Zones only) at ❑ meters (Puerto Rico only)
d) Attached garage (top of slab)' ❑ feet ❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building �'';;Z feet ❑ meters (Puerto Rico only)
(Describe type of equipment in Comments) I I /
0 Lowest adjacent (flnlshed) grade (LAG) / � feet ❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade (HAG). feet ❑meters (Puerto Rico only)
SECTION D : SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by low to certify elevation
information. I certify that the Information on this Certificate represents my best efforts to Interpret the data avallabk.
I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Sect/on 001. Q�0
❑ Check here If comments are provided on back of form. G. AGFcc
Certifier' Name License N b 'm
J e �C G C 2% 47
Title Company Na a Noi�1\5
74
�.V, = /1 s : �li�S 7 s�f2 ��
Add res Clty State ZIP Code *••' t �37 f3�.r9ct11 6c.�✓� 12QAV+0ilsg? 04, 6�s civSignature Date/ Talep one . TpQ`
A _ � _ �.: Z/ —X s3 5-36�' -9T7-1.2S,4 F n r aL�F
FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding Information from Section A. For Insurance Company Use:
Building Street Addres!jincluding Apt., Unit, uite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
�9Z/ G)cwP1 w -
city
G U
State
ZIP Code j Company NAIC
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner.
Comments �..�
SraEt,J4
�CEV11TroN
/WdL 1 7 0G ❑ Check here if attachments
SECTION E - BUILDING ELEVATION I OR ION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete items E1 -E5. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items E1 -E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters.
E t. Provide elevation information br the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawl space, or enclosure) is _ ❑ feet ❑ meters ❑ above or H
below the HAG.
b) Top of bottom floor (including basement, crawl space, or enclosure Is
. _ ❑ feet ❑ meters ❑ above or below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided In SeclgfLA Items 8 401or 9 (see poe 8 of Instructions), the next higher floor
(elevation C2.b In the diagrams) of the building Is . _ ❑ feet LJ meters above or LJ below the HAG.
E3. Attached garage (top. of slab) Is [—]feet [-]meters CD above or C] below the HAG.
E4. Top of platform of mchinery and/or equipment servicing the building is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number Is available, Is the top of the bottom floor elevated In accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -Issued or community -Issued BFE)
or Zone AO must sign here. The statements In Secflons A, 8, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑ Check he If attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A. B. C (or E),
and G of this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used In Items G8. and G9.
G 1. ❑ The information !n Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation Information. (Indicate the source and date of the elevation data In the Comments area below.)
G2. ❑ A community official completed Section E for a building located In Zone A (without a FEMA -Issued or community -issued BFE) or Zone A0.
G3. ❑ The following information (Items G4. -G9.) Is provided for community floodplain management purposes.
Ga. Permit Number G5. Date Permit Issued I G6. Date Certificate Of Compilance/Occupancy Issued
G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (Including basement) of the building: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
Local Official's Name Title
Community an Telephone
Signature
Dale
Comments
if tt chm nts
FEMA Form 81-31, February 2006
Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding Information from Section A. For Insurance Company Use:
Building Street Address including Apt., Unit uite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
�9Z/ r4Ptr ww
City State ZIP Code Company NAIC Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner.
Comments b S/TG 13C—A/C1-I A9 (Z f -C Lir S/OEc.J/44-k 11 -5 6 P �400.4
�Ltz V4-rio,U = ) S I , 10 g
❑ Check here If attachments
SECTION E - BUILDING ELEVATION IIWORPWION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete Items E1 -E5. if the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A, B.
and C. For Items E1 -E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters.
E 1. Provide elevation information lor the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawl space, or enclosure) is _ ❑ feet ❑ meters ❑ above or below the HAG.
b) Top of bottom floor (Including basement, crawl space, or enclosure) Is _ F1 feet ❑ meters ❑ above or H below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided In Secti Items 8 a/or 9 (see We 8 of Instructions), the next higher floor
(elevation C2.b In the diagrams) of the building is _ ❑ feet LJ meters above or below the HAG.,
E3. Attached garage (top of slab) Is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number Is available, Is the top of the bottom floor elevated In accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Information In Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -Issued or community -Issued BFE)
or Zone AO must sign here. The statements In Sections A, B, and E are correct to the best ofmy knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address
City
State ZIP Code
Signature Date Telephone
Comments
❑ Chieck here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B. C (or E).
and G of this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used In Items G8. and G9.
G i. ❑ The information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located In Zone A (without a FEMA -Issued or community -issued BFE) or Zone AO.
G3. ❑ The following Information (Items G4. -G9.) Is provided for community floodplain management purposes.
G4. Permit Number G5. Date Penult Issued G6. Date Certificate Of Compllance/Occupancy Issued
L
G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (Including basement) of the building: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Dale
Comments
❑ Check d attachments
FEMA Form 81-31, February 2006 Replaces all previous editions
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Pollq Number
city State ZIP Code CnyNAICNurr'ber
C4/ C cD.. . ^?73
If using the Elevation Certificate to obtain NFIP'flood Insu'ran*, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; `Front View" and 'Rear View"; and, If required, 'Right
Side View" and 'Left Side View." If submitting mbre •photographs than will fit on this page, use the Continuation Page,
following.
F► OAiT VIL=LO
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BUTTE
COUNTY
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 2921 GRAPE WAY
Owner:
Permit No: B07-1902
APN: 042-180-024
ERPINO, MICHAEL
Issued Date: 6/13/2008 By GLB
Permit type: MISCELLANEOUS
2921 GRAPE WY
Subtype: Remodel
CHICO, CA 95973
Expiration Date: 6/13/2009
Description: REMODEL EX GAR/SHOP/STORM
(530) 680-4032
Occupancy: Zoning: A10 7
Contractor
Applicant:
Square Footage:
MOLESWORTH CONSTRUCTION
MOLESWORTH CONSTRUCT
Building Garage Remdl/Addn
P O BOX 4535
P O BOX 4535
1,328
CHICO, CA 95927
CHICO, CA 95927
Other Porch/Patio Total
(530) 321-7684
(530) 321-7684
1,328
FEE INFORMATION
DBEH Building Review Fee $75.70
DBMSC Remodel -Residential $278.58
DBOMSCF Deed Restriction $87.49
Total Charged: $441.77 Fees Paid: $441.77
Balance Due: $0.00 Receipt No: B4631
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
MOLESWORTH CONSTRUCTI( 60050 / B / 12/31/2008
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
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
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
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
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
X 6/13/2008
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractor's Signature Date
�j 1, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
lJ COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
HAVE
the work himself or herself or through his or her own employees, provided that such improvements
❑I AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
❑
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Carrier: Policy Number: Exp. Date:
(This section need not a competed if the permit is or one hundreddollars ($100) or less.)
❑ 1 AM EXEMPT under Section B. 8 P.C. for this reason:
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation Laws of California, and agree that if I should become subject to the workers'X
6/13/2008
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
Owner's Signature Date
provisions.
X 6/13/2008
1 hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. 1 agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
ATTORNEY'S FEES.
County to enter the above mentioned property for inspection purposes. I hereby certify that I am the
prod wner or am authorized to act on the property owner's behalf.
t 0 6/13/2008
CONSTRUCTION LENDING AGENCY
1 HEREBY AFFIRM UNDER PENALTY, OF PERJURY that there is a construction lending agency for
Name of Permittee [SIGN] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
Owner ❑ Contractor OR. FlAgent for Owner ❑Agent for Contractor
FILE COPY
Lender's Address City State Zip
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIIVE OF APPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
APPLICANT INFORMATION
OWNER INFORMATION
Last Name
City
Firs ame ` ,
Mailing Address
a
City
Address
Statto
Zip
Phone
City
Fax
E-mail
Stat
APPLICANT INFORMATION
ARCHITECT/ENGINEER
CONTRACTOR
City
Name
Zip
r
Address
Zip
67�—
5�c
7_i ,
City
i D
Upen Cov
Stat
Phone3
Z (
Fax
E-mail
•
Lic. #
D O
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
7_i ,
Fax
E-mail
Upen Cov
Slate License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
PERMIT
NO.
BIN #
PROJECT LOCATION
API —, —(52,,q
Property Address
City _
,O (11
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
Address
DESCRIPTION OR SCOPE OF WORK:
Ole—
/�
Flood Zone
SRA
I Yes I No
Occ.
Type Const.
Z Aaff
7_i ,
ara e
Sq FT- Living Garage
Upen Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
I
For office use only: Kj
Zoning
Flood Zone
SRA
I Yes I No
Occ.
Type Const.
BUTTE COUNTY -FEE SUMMARY
7 County Center Drive
Oroville, CA 95965
Department of Development Services
Phone (530) 538-7541 Fax (530) 538-2140
Permit Number: B07-1902
Job Address: 2921 GRAPE WAY
Contractor: MOLESWORTH CONSTRUCTION
P O BOX 4535 CHICO, CA 95927
Fee Description
DBOMSCF Deed Restriction
Printed: 9/13/2007
2:19 pm
Account Number Fee Amount Paid Date Pmt Amt
0010-440001-4210500-1010 $87.49 9/13/2007 $87.49
DBEH Building Review Fee
0021-540013-4614901-1010 $75.70 9/13/2007 $75.70
DBMSC Remodel -Residential
0010-440001-4210500-1010 $278.58 9/13/2007 $278.58
Printed By: Gwyn Benedict
441.77 $441.77
Balance Due: $0.00
At the time of permit application, I was advised the above fees are required prior to issuance of the
permit. These fees may change during the plan checking process.
Signature:
Date: 9/13/2007
Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days
from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments
for a protest are specified in Government Code Section 66026(a).
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
NOTICE TO BUILDERS
Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In
addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental
Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to
expedite your permit:
0 Make sure your application is complete.
D Be responsive to requests from County departments for any additional materials or requirements.
The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes
without a complete application adds to processing time.
Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not
started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to
expiration an indefinite number of times, provided construction progress has been documented by the Building Division during
each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In
order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking
and documentation may be required. Upon completion of work covered by this permit, please contact this office for final
inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is
issued without a final inspection.
EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY
Application for which a permit has not been issued will expire one year after date of application.
Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications
(not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are
for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn
before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of
$54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration
of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any
refund amount) to determine no work was done.
Fee/refund information can be read on-line at hqp://municipalcodes.lexisnexis.com/codes/butteco/
Reference Number: B07-1902
Location: 2921 GRAPE WAY
Parcel Number: 042-180-024
Date: 9/6/2007
Owner Name: ERPINO, MICHAEL Phone:
Description: REMODEL EX GAR/SHOP/STORAGE(1328)
Signature of Property Owner: Date: 9/6/2007
LE
Butte County Department of Public Warks
J. MICHAEL CRUMP, DIRECTOR
LAND DEVELOPMENT DIVISION
Storm Water Managment Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266 Telephone
(530) 538-7171 Fax
www.buttecounty.net/dds
s
,ctit'`IfjY��
National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm
Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment
[LESS THAN 1 ACRE 1
Reference Number:
B07-1902
Date: 9/6/2007
Location:
2921 GRAPE WAY
By: KCG
Parcel Number:
042-180-024
Sub Type: Remodel
Owner Name:
ERPINO, MICHAEL
Phone:
Description:
REMODEL EX GAR/SHOP/STORAGE(1328)
By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more
of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California
Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but
when combinedwith 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 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 this project that disturbes one acre or
more of land may result in revocation of grading and/or other permits or other santions provided by law.
Signed: CJ V
Title:
FILE
Date: 9/6/2007
A.
MOLESWORT'H
CONSTRUCTION
August 28, 2007
Butte County Building Department
Dear Sir or Madam:
Molesworth Construction
PO Box 4535
,Chico, Ca. 95927-4535'"
Lic.# 660050
BUTTE
COUNTY
AUG 19 1007
DEVEdOMMT
S"Vg
I am writing this letter to list the changes made to the approved set of plans for permit number 05-2879
in order.to reflect owners' preferences correct original drafting mistakes.
1
Sheet Al Floor Plant..' `
1. Reposition dotted line representing gravel/concrete transition in EXISTING SHOP/ GARAGE
drawing to represent actual existing condition.
Z
2. Reposition openings for BAY1 and STORAGE in PROPOSED SHOP/GARAGE drawing.
3. Add three windows in PROPOSED SHOP/GARAGE drawing
4. Add,three walls in PROPOSED SHOP/GARAGE drawing
5, 'Remove shelf wall in PROPOSED SHOP/GARAGE drawing
6.. - Redo dimensions in PROPOSED SHOP/GARAGE drawing to reflect changes
7. Add washer, dryer, sink in PROPOSED SHOP/GARAGE drawing
Sheet A2 Elevations
1. Height of wall dimension
Sheet S1 Foundation Plans
1. Remove INTERIOR FOOTING drawing
2. Remove interior footing line's in PROPOSED SHOP/GARAGE drawing
3. Draw, exterior footing lines at EAST end of existing concrete slab in PROPOSED
SHOR/GARAGE drawing
4. Draw EXISTING FOOTING lines it PROPOSED SHOP/GARAGE drawing.
5. Reposition EDGE OF CONCRETE SLAB in PROPOSED SHOP/GARAGE drawing
_6. Remove alt bracing note in PROPOSED SHOP/GARAGE drawing
7. Add NEW FOOTINGS AND SLAB note in PROPOSED SHOP/GARAGE drawing
t
8. Move GraveUConcrete Slab lines to represent actual conditions in EXISTING SHOP/GARAGE
I drawing: I
9. Redo dimensions to reflect changes.
f'
r
• Page 2 August 28, 2007
SHEET S2 BRACED.WALL/ SECT/ ELECT PLAN
1. Changed BAY 1 HDR from 6x12 DF #1 to 5-1/2 x 11-7/8 24VF GLULAM
2. Changed ht. of wall in A CROSS SECTION from 8' to 9'-6"
3. Removed Bracedwall Mark AB in PROPOSED SHOP/GARAGE drawing and
Bracedwall Key
4. Removed Bracedwall Key Maris 2 in Bracedwall Key and PROPOSED SHOP/GARAGE `
drawing.
5. Added Bracedwall Key Mark 1 in PROPOSED SHOP/GARAGE drawing at BAY 1/
STORAGE'%wall EAST side and SOUTHWEST corner.
Sincerely,
Tom Molesworth
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
ADMINISTRATION * BUILDING * PLANNING
November 28, 2007
Michael Erpino
2921 Grape Way
Chico, CA 95973-9621
Assessor Parcel Number: 042-180-024 .
Building Permit Number:. 07-1902
Thank you for submitting the plans for your building project. The plans have been reviewed and
comments are listed below. Please respond in writing to each item by completing and returning the
enclosed PLAN REVIEW RESPONSE FORM. Your complete and clear response will expedite the re-
check and approval of this project.
COMMENTS:
This building is located in FEMA Flood Zone A. It appears the improvements to this building may
equal or exceed the definition of Substantial Improvement. Please refer to the attached Butte County
Ordinance Number 3598 for the definition of Substantial Improvement. If the improvement
percentage equals or exceeds 40%, an appraisal is required on the existing building. Submit appraisal
documents prepared by a certified appraiser. A new improvement percentage will be calculated. If
improvement percentage exceeds 50%, a substantial improvement exists. If the substantial
improvement percentage is met, then a Flood Elevation Certificate must be completed by a California
licensed design professional and the whole building must comply with the elevation requirements of
the Flood Elevation Certificate. Enclosed is a copy of the Flood Plain Declaration requested by the
applicant.
A Deed Restriction and Limited Use Facility must be recorded to limit the use of the shop and storage
area of this building. The deed restriction will state that the shop and storage area of this building
shall not be used for sleeping, living, meal preparation and eating. This deed restriction will be
prepared by Butte County and must be signed notarized and recorded by the property owners. The
submitted copy of the vesting grant deed will be used to prepare the deed restriction.
If you wish to discuss any of these requirements, please call (530) 538-7541 between the hours of 1:00
p.m. and 4:00 p.m., Monday through Friday.
Please refer to your Data Sheet for remaining non -plan check items. (You received this form when you
applied for your permit.) The counter staff will answer any questions concerning the Data Sheet.
Carl Nelson �� w� Philo Hunt PE
Plans Examiner ��' Plan Check Engineer
Cc Molesworth Construction
Michael Erpino
2921 Grape Way
Chico, California 95973
Phone 530-894-3134
December 10, 2007
BUTTE
COUNTY
Carl Nelson, Plans Examiner DEC 1 31007
7 County Center Drive DEVELOPmENT
Oroville, CA 95965 SERVICES
RE: 2921 Grape Way, Chico, CA 95973
Parcel Number 042-180-024
Building Permit Number 07-1902
Dear Mr. Nelson:
I've"reviewed'yoiir letter dated November 28, 2007 and the'
commen"ts.',Regarding Butte County Ordinance Number 3598 acid `the
improvements we made arid''are'still making; the cost of what we are
doing will not exceed, 50% of the market value of the structure: The '
main part of the Ordinance states:
Substantial Improvement: "substantial improvement"
means any reconstruction, rehabilitation, addition, or other
proposed new development of a structure, the cost of which equals
or exceeds 50 percent of the market value of the structure before
the "start of construction" of the improvement.
The building at issue is a shop/garage on our property that we
repaired so we could put up a solar energy system on the roof. We began
working with Evergreen Development of Chico in 2004 when we
purchased the property, and they informed us that the existing roof
(corrugated metal) would not support the solar array and that it would
have to be '.strengthened. We made the necessary repairs with new
trusses and composition roofing, arid, poured some new concrete within
an existing perimeter foundation ori part of the building ihat ha—a '
previously contained gravel. ' The footprint of the building �rerriainedt the
same (seventy' by twenty feet); and we put up new siding an&doors.
I estimate that the total costs of the improvements were about 25%
of the "market value" of the building, according to what our Insurance
Company (Allstate) assessed the building to be when we first bought the
property. We actually tried to increase the insurance on the building in
2006 after we'd made some of the improvements but we were informed
that it is covered as an "outbuilding" and the value had not increased
from what it appraised at when we first got insurance on the entire
property. They did allow us to add additional insurance to cover the
solar array.
We also installed a new septic system to serve our "legal non-
conforming" dwelling (2931 Grape Way, which is on the same property
but the existing septic tank and leech field were failing) and a shop
bathroom. That permit has been finalized by Butte County but the
insurance company told us that was not considered part of the building
and would not change our insurance rates.
I hope that this addresses Comment Number 1 in your letter to
your satisfaction, please let me know if there's anything else I need to
do. As for the Deed Restriction please let me know what the next step is
to get that signed. Your letter stated that it would be "prepared by Butte
County" and we are ready so sign it whenever you are. Please let me
know if you have any questions about any of this, you can call the
number above or on my.cell phone. The number is (530) 680-4032.
Thanks.
Sincerely,
Michael Erpino
PLAN REVIEW RESPONSE FORD ,
In order to expedite the review of your plans, please complete the foIlowing information and return this form with your re -submittal. I
this form is not complete, as to all correction items, we will not be able to accept your re -submittal for review. There must be a vatic
response to every item requested in our plan correction letter. By other' is not considered a valid response- Please indicate your
response to each item and the location where the information can be found on the plans/calcs.
ATTArU T"Tc CnbLA 'rn A r^nnv nc vim. I-
— - - -- -- • •. •��.• ..... ..K.. ,. ..ecru
OWNERS NAME
rriir' Ktv.z),t:u NO ORIGINAL PLANS,
DATE:
ASSESSORS PARCEL NUMBER
PERMIT NUMBER
�oovi" = OZr-(
0 L
RESPONSE FOR PLAN CHECK LETTER DATED:
PLAN CHECK ITEM # RESPONSE BY: LOCATION ON PLANS/CALLS:
COMMENTS:
CHECK ITEM A
Z
V.�
BY:
BY:
LOCATION ON PLANS/CALCS:
ITEM # RESPONSE BY: LOCATION ON PLANS/CALCS:
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville; CA 95965
(530) 538-7601 Telephone
(530) 538-7785 Facsimile
ADMINISTRATION * BUILDING * PLANNING
November 28, 2007
Michael Erpino
2921 Grape. Way
Chico, CA 95973-9621
Assessor Parcel Number: 042-180-024
Building Permit Number: 07-1902
Thank you for submitting the plans for your building project. The plans have been reviewed and
.comments are listed below. Please respond in writing to each item by completing and returning the
enclosed PLAN REVIEW RESPONSE FORM. Your complete and clear response will expedite the re-
check and approval of this project.
COMMENTS:
1. This building is located in FEMA Flood Zone A. It appears the improvements to this building may
equal or exceed the defmition of Substantial Improvement. Please refer to the attached Butte County
Ordinance Number 3598 for the definition of Substantial Improvement. If the improvement
percentage equals or exceeds 40%, an appraisal is.required on the existing building. Submit appraisal
documents prepared by a certified appraiser.. .A.new improvement percentage will be calculated. If
improvement percentage exceeds 50%, a substantial improvement exists. If the substantial
improvement percentage is met, then a Flood Elevation Certificate must be completed by a California
licensed design professional and the whole building must comply with the elevation requirements of
the Flood Elevation Certificate. Enclosed is a copy of the Flood Plain Declaration requested by the
applicant.
2. A Deed Restriction and Limited Use Facility must be recorded to limit the use of the shop and storage
area of this building. The deed restriction will state that the shop and storage area of this building
shall not be used for sleeping, living, meal.preparation and eating. This deed restriction will be
prepared by Butte County and must be signed notarized and recorded by the property owners. The
submitted copy of the vesting grant deed will be used to prepare the deed restriction.
If you wish to discuss any of these requirements, please call (530) 538-7541 between the hours of 1:00
p.m. and 4:00 p.m., Monday through Friday.
Please refer to your Data Sheet for remaining non -plan check items. (You received this form when you
applied for your permit.) The counter staff will answer any questions co g the Data Sheet.
_e't ./�
Carl Nelson Philo Hunt;PE
Plans Examiner Plan Check Engineer
Cc Molesworth Construction
E
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #:(530) 538-7541 FAX#: (530) 538-2140
WEBSITE: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 2921 GRAPE WAY
Owner:
Permit No: B08-0635
APN: 042-180-024
ERPINO, MICHAEL
Permit type: MISCELLANEOUS
2921 GRAPE WY
Issued Date: 04/09/2008 By KCG
Subtype: Private Pool
CHICO, CA 95973
Expiration Date: 04/09/2009
Description: IN -GROUND POOL: MSTR# MP08-1
Occupancy: Zoning:
Contractor
Applicant:
Square Footage:
PERFECTION POOLS & SPAS INC
PERFECTION POOLS & SPAr,
Building Garage Remdl/Addn
172 E 20TH ST
172 E 20TH ST
CHICO, CA 95928
CHICO, CA 95928
(530)895-0437
(530)895-0437
Other Porch/Patio Total
FEE INFORMATION
DBEH Building Review Fee $78.90
DBMSC Swim Pool -Master Plan Co $512.42
LICENSED CONTRACTOR'S DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
PERFECTION POOLS & SPAS 566654 / C53 C10 / 11/30/2009
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter
(commencing wJ'1h Section 7000) of Divisiog3 of the Business and Professions Code, and my license
is in full forCB�Had effect. -A /
X ����� f� /09/2008
v
Cont actor's 90ature Date
I 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.
AVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by
section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workers' Compensation insurance carrier and policy number are;
Carrier: STATE FUND Policy Number: 272-0000529 Exp. Date:10/0112008
(This section need not be completed if the permit is for one hundred dollars ($100) or less.)
❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation Laws of California, and agree that if I should become subject to the workers'
compensati54 provisions of Section 3700 of the Labor Code, I shall forthwith comply with those
X �VL 04/09/2008
Signature Date
WARNING: F#fLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALE SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
1.32 Fees
Balance Due: $0.00 Receipt No:
OWNER / BUILDER DECLARATION
1.32
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
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 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];
Please check one of the following:
❑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 Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the 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 improvement is sold within one
year of completion, the owner -builder will have the burden of proof that he or she did not build or
improve for the purpose of sate.).
❑1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
The Contractor's License Law dows not apply to an owner of the property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
❑ I AM EXEMPT under Section B. 8 P.C. for this reason:
LX 04/09/2008
Owners Signature Date
I CONSTRUCTION LENDING AGENCY I
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
the performance of the work for which this permit is issued. (3097 civ. code)
Lenders Address City State Zip
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the
use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte
Count to enter the above mentioned property for inspection purposes. I hereby certify that I am the
C y o�ymer m authorized to act on the property owners behalf.
i/�% :T/ )-7. 04/09/2008
❑ Owner ffContractor OR; DAgent for Owner ❑Agent for Contractor
FILE COPY
rte`
Wu
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION"
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WIZL BE REQUIRED AT TIME OF APPLICATION
Website: www.buttecounty.net/dds �r
PLEASE PRINT CLEARLY
PERMIT
NO.
�a
BIN N
"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
CONTRACTOR
OWNER INFORMATION
Last Name
City C rc U
First Name,
r57 r t_'- �
Mailing Address
2 Z ra e- Wo-
cityC
r�G
State C
Z�p�G,
Phots
f
3/, )'7 -6/!tf
Fax -
E-mail
CONTRACTOR
Name- '_'�>
Fe. -l- F PG I r d p d �5 1F S OcS'
Address 1,7z �, �� y.4 S T -
City C rc U
State C
Zapf �
Phone
Fax
E-mailJ �- -� /J
�s.Ar6G.:o %�Br��G "Or1 �Ca/ta,+eK
Lic. #566,
Class _ S�
ARCHITECT/ENGINEER
Name.
to C�So�
Address S.0 6—,ofd,., 1 -,J Cou.v`7 S �e JDO
City IC va H-, eHTo
State
Zips S$34/
Pho `t t6� G1.2_9- _9690F
/6 ef2� ` e47
E-mail
n 6 iL J d,A, Sol, 1 _,0,
ate License Number
62942% -
APPLICANT INFORMATION
Name —
Address
Flood Zone
city G
SRA
State �,
Zipq s6P-$
Phone _ Dpi 3 -7
Type Const.
Fax -
E -mail __r"1__0e"
APPLICANT SIGYATPRE
X
PROJECT LOCATION
AP# 0942- 1r�0 .
Property Address
�c::izt & vtee 6clti
city C 1`G� C A
WORKER'S COMPENSATION
Policy Number
Carrier S _
If hiring anyone other than licensed contractors, a certificate of
worker's compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
~ Address
4
u�
DESCRIPTION OR SCOPE OF WORK.
SC1/ 1 -n Yti 1' -7 d O'
MPO
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use only:
Zoning
-1
Flood Zone
A
SRA
Yes
No
Occ.
Type Const.
t
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
NOTICE TO BUILDERS**
Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In
addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental
Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to
expedite your permit:
D Make sure your application is complete.
O Be responsive to requests from County departments for any additional materials or requirements.
The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes
without a complete application adds to processing time.
Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not
started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to
expiration an indefinite number of times, provided construction progress has been documented by the Building Division during
each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In
order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking
and documentation may be required. Upon completion of work covered by this permit, please contact this office for final
inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is
issued without a final inspection.
EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY*
Application for which a permit has not been issued will expire one year after date of application.
Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications, if
the permit has not issued, but not after 180 days from the date of fee payment. Fees paid at the time of application are for
Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn
before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge to
process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the
permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund
amount) to determine no work was done.
Fee/refund information can be read on-line at http://municiDalcodes.lexisnexis.com/codes/butteco/
"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application is subject to public inspection and will be posted on the County's website for electronic access.
Reference Number: B08-0635
Location: 2921 GRAPE WAY
Parcel Number: 042-180-024
Date: 04/09/2008
Owner Name: ERPINO, MICHAEL Phone:
Description: IN -GROUND POOL: MSTR# MP08-0005
Signature of Applicant: Date: 04/09/2008
FILE
Butte County Department of Public Works
J. MICHAEL CRUMP, DIRECTOR
LAND DEVELOPMENT DIVISION
Storm Water Managment Program
7 County Center Drive
Oroville, CA 95965
(530) 538-7266 Telephone
(530) 538-7171 Fax
www.buttecounty.net/dds
S
SIC W���
National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm
Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment
(LESS THAN 1 ACRE 1
Reference Number: B08-0635 Date: 04/09/2008
Location: 2921 GRAPE WAY By: KCG
Parcel Number: 042-180-024 Sub Type: Private Pool
Owner Name: ERPINO, MICHAEL Phone:
Description: IN -GROUND POOL: MSTR# W08-0005
By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more
of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California
Regional Water Quality Control Board. Phased projects that contain multiple site buildouts 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 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 this project that disturbes one acre or
more of land may result in revocation of grading and/or other permits or other santions provided by law.
Signed-
Title:
itmed:Title:S
f
FILE
Date: 04/09/2008
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Conn/y olBu•(Lo r
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for (he C r� ny, af(e, pe>Jonauy aypearea
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Seventh SubdiviSion
Of TAE
John B"11 ]Rain&..
_ ,Xe ox, .
CI-IICOr$.UTTE CO,
CALIFORNIA
Surveyed by
ti� •�.Sh�cke\Sora.
L/CLNJlO Jv,�f[rOAt Y
1902
Butte County Department of Development Services.
N ® T E S 7 County Center Drive, Oroville, CA 95965 /
(530)538-7601 r` - r —. .butt(lco�fntynetidds aeOUNty� —Jl
APN:
Owner: X04 rlERP
Site Address 29
nt.
Contractor. OC
Type of Pe l._ _
•
4
RESXDENT IAL
Ferrnit"NDA—OS-2879
/O, MICHAEL
GRAPE WAY, CHICO
OWNER
F STRUCTURE C/O
. i
U"')Zu
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
igAP--1
DATE JOB FINALED:
SIGNATURE:
CHECKED BY
�l
= OK
0 = Not OK
MANUFACTURED HOMES
MI§CE"LLANEOUS
DATE 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 Q or LPQ
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 Q Foundation Q
14 Exits
15 Cert of Occupancy
16 HUD Label/Insignia Numbers Serial Numbers
DATE ID E K 'C O V E R S'C A R P O R T S 'G A R A G E S
t I. i d ing-Setbacks-Easements
) tgs; Soils -Sz-Dpth-Spacing-Cnnctrs-Steel
3 Decks, Girders/Joists-Dcking-Brcing
Stairs-Guard/Handrails
4 Wood Awn; Posts -Beams-Rftrs-Cnnctrs-Shth9
Frmg-Brcng
5 Alum Awn; Columns-CnnctnsSplice-Decal-Enclsrs
6 Carports; Wndws-Doors
7 Electric
8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof; Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wall pnls
°9 0s 14 0�s
DATE IPOOLS
1 Setbacks -Easements
2 Soils; Compaction -Structure Stability
3 Pool Structure; Steel -Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptcls/Lting; Distance-GFI
5 Elec Pool Lting; 15 volts-GF1 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 Pimb; Cir Test-Wtr Supply Test
11 Lt Niche
12 Enclsr; Fencing -Alarms
13 Bonding, Diving board or Slide
d`, s
d
°am11�1
Pool Drawing
1
{
1
l r
= OK
0 = Not OK
RESIDENTIAL (Single & Duplex)
DATE JUNDERFLOOR -
uAit
IPLUMBING
1 Zoning -Setbacks -Easements -Flood -Slope
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
2 Ftg Main; Soils-Elec Grnd Ftg Dpth
54 Wtr Pipe; Test & Anchr-Nail Prtctn
3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth.
55 DWV; Test Fittings & Anchr Nail Prtctn
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth
56 Shwr Pan; Test, First flr-Tub Acc
5 Stemwalls Main; Steel-Blockouts-Wrapped
57 Test Tub & Shwr, 2nd fir - Tub•Acc
6 Stemwalls Garage; Steel-Blockouts-Wrapped
58 Gas Pipe; Sz & Anchrs
69 Hold Downs and Special Anchrs
59 Fire Sprinkler; Test
7 Slab, Steel Wrapped
60 Yard Gas Piping
8 Piers-Frpic Ftg-Steel
9 DWV; Fall -Fitting -Test -2 -way C/O -Sewer Test
''
10 UF, Gas Pipe; Sz Anchrs-Sz Test
\\�
om
1.4 Wtr Pipe; Test-Anchrs-Rgltr-Service Test
12 Elec Undrgrnd
DATE
IMECHANICAL
13 Plenums & Ducts; Clrnc-MaterialSupport-insultn
61 AC Ducts Insultn & Support
14 Girders-Sills-Anchr BoltsJ oists -Vnts -Cripples
62 Vent Fan, Exhaust abv Insultn
15 Acc & Vntltn
63 Condensate Drain & Ovrflw, Sz & Grade
16 Insulation
64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
o
DATE FRAMING
17 Sills Proper Materials & Anchrs
DATE
IFINAL
18 Walls Studs -Nailing Spacing & Braces -Plates -Sound
66 Ext Steps -Door & SideLt Prtctn-Landings
19 Bearing Walls over Girders & fir Nailing
67 Smoke Detector
20 Draft Stop in Walls (rat proof)
68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
In Garage; abv-flr-Ducts-Mech Prtctn
22 Headers & Beams-Sz & Bearing
69 Bedroom Exiting
23 Hangers -Post Caps-Anchrs-Cnnctns
70 GFI & Bath Fxtrs & Tub Acc-Spa
24 Ceiling Joist-Rftr Tles-Purlin-Roof Brac-TrussShthg
71 GFI Arc Fault
25 Frplc Ties or Type A Flue-Frplc Throat Cirnc
72 Elec Trim & Subpnl, Breaker Szs & Labels
26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles
73 Stairs, Guard/Handrails
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
74 Frpic or Stove, Clrnc-Hearth
28 Garage Fire Prtctn Framing -RC Channel
75 Elec Outlets at Wood Pnl, Int & Ext
29 Prprty Line Firewall & Opngs
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc
30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits
77 Elec Outlets & Rcptcls at Ktchn Counter
31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn
78 Garage Fire Door; Swing -Landing -Closure
32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs
79 AC Duct in Garage -Damper
33 Siding -Nailing Veneer
80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir
34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc
Mech Prtctn; LPG Appince Undr House 3" drain
35 Glazing Area -Glass Prtctn-SkyLts-Plastic
81 Plmb; Elec & Mech Eqp Listed for Loctn
36 Shear Walls; Nailing -Bolts
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
37 Brace Int/Ext Wall pnis
83 Insultn-Foam-Looked in Attic
38 Insulin -Walls -Ceilings
84 Guard Rails & Deck Cnstrctn-Post Caps
39 Infiltration-Walls-Wndws
85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Clrnc Drnge Planters ❑Yes [:]No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Plmb
89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs
DATE JELECTRICAL
90 Wtr Well, Dscnnct, Elec, Plmb
40 Fxtr & Trnsfrmr Cirnc-Ins Prtctn
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
41 Elec Rcptcls Spacing-Lts & Switches at Doors
92 Vntltn thru House
42 Sz Boxes & No Of Cndctrs Stapled
93 Glass Prtctn
43 Romex Installed Close to Edge of Studs & CJ
94 Corrections from previous Inspctns
44 Eqp Grnd made up w/Mech Fstnrs
95 Gas Test -Meters Tagged, Gas-Elec
45 Grndng Electrode Bond Gas & Wtr
96 Wtr & Sewer Cnnctd-C/O to grade -HD Apprvl
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
97 Energy Cmpinc Cert -Other Certs
47 Subfeed Wire Sz ga ❑ CU or DAL
98 Address Posted
AC Wire Sz ga [] CU or [—I AL
99 Fire Sprinkler
48 Range Circ ga ❑CU or F-1 AL
Oven Circ 9a ❑ CU or ❑ AL
Insulated Neutral ❑Yes ❑No
01'
4111 1$e e
49 Service -Riser Cndctrs & Grnd Main Dscnnct
50 Eqp Clrncs pnls-Motors-Mech Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
s.
o'er m o'er o`
.'E�s-�'""`-'''"'*L�("'�...F" -,...-.�.»-y,_.,,,.�..--..� _--.-:.:r•----�..r"�'+.#cGs.,.,�"�,�:r.Y..i['sLdk`'�++-�a.+*.�..��';;ti,axt�js..�'3�y"+�.
Y, c . • . , .... COUNTY OF BUTTEE ,
s. BUILDING DIVISION
L
DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
z
OWNER
NO.
XI. ,
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
t'. work is completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below.
tAll ��7F (7`L61111111-7 f a/./I �4__1
2)
-o
7 Inspector
REV 4/05 Phone #0 �3 3-K
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
r-r It
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 completed. If you have any questions pertaining to this matter, or need additional
explanation, please contact the Building Inspector as indicated below.
r,
Date
REV 4/05
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #; (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the ar "-for such permit to file a
signed statement that he or she is lict' \ `,}.to the provisions of
the Contractor's State License Law f' �'nq with Section
7000) of Division 3 of the BusinesF -}hat he or
she is exempt therefrom -and the --,9ny
PERMIT NO.
BP052879
Issued Date: 10/28/2005 APN: 042-180-024-000
Site Address: 2921 GRAPE WAY CHI
Map Index:
Description: roof structure replacement, bathroom in fill 72
sq
Owner: MICHAEL ERPINO
2921 GRAPE WAY
CHICO CA
95973
violation of Section 7031.5 by ; OV -1 J �l (530) 894-3134
applicant to a civil penalty of not \`
0011,
I, as owner of the property, or rt,,S'O
sole compensation, will do the woih, ? 41
intended or offered for sale (Sec. 7044, Bus... 30'700
11 0
Code: The Contractors' State License Law does . `IJV ` `�,O I J dlicant:
owner of property who builds or improves thereon, anc 1y ON Z6Z
such work himself or herself or through his or her own empty, ZO- I
provided that such improvements are not intended or offered fo108I l3
sale. If however, the building or improvements are sold within one �0
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Prgfessions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' Stale License Law.).
❑ I am Exempt under Article 3 of the Business and Professions Code
Date: 0 Z Owner: ���
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:
Carrier:
Policy #:
XI certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date: � 017-ekU
Applicant: / /
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued -(Sec 3097 Civ.)
Address:
Contractor:
License #:
Architect:
Engineer:
MICHAEL ERPINO
2921 GRAPE WAY
CHICO CA
95973
Total Square Ft: 72 S. F.
Valuation: $4,680.00
Census Code:
Y_ 6 -�'PL)�-'V��
This permit i,s here y issued under the applicable provisions of the Butte County Code and/or
Resolution` to ork indicated above for which fees have been paid. a �i
By: ( /\Date: d�
PERMIT EXPIRESN: ! G�
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and stale laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name:i(,l�}.FiL �11� J�l�W Signature: Grp
Date:.
.91 Owner
❑ Contractor
❑ Agent for Owner
❑ Agent for Contractor
R r. R..ilriinn P—mit n1.1R-nd nn 1
Last Name
Address
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
yq "*PLEASE PRINT CLEARLY"
OWNER
City4'1— State Zip S �3
Phone_530 g.c `� I
Fax ._
- 3(3
E -mail
ARCHITECT/ENGINEER
Name
Address
City State Zip
Phone Fax
E-mail State License Number .
APPLICANT NAME
CONTRACTOR
Name
City
Address
Zip
City
Fax
State
Zip
Phone
Book
Fax
E-mail
Planner
Lic. #
Class
ARCHITECT/ENGINEER
Name
Address
City State Zip
Phone Fax
E-mail State License Number .
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Flood Zone
1 4 1
SRA
I Yes
VN
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
n%rCO CP110 CI I112It111TTA1 DPni IIRFMFfUT�
PERMIT
NO.
4s-
BP
7
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
Address
DescriotionAW Scooe of Work:
m inhIl 7 5
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action. on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
y0 0
Received by: Amount: • 9s Bldg
/f �j SRA
/J
Receipt #: �/ ' 1 v� q Sheriff
SMIP
/'
ell'.
Total
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND IN INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1.
3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2.
3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER!
OR
3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed
❑ 3.
calculations.
❑ 3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4.
Letter from Engineer or Architect for truss design review.
❑ 5.
2 Energy compliance design and supporting documentation. (Note: Not required for additions to
❑ 7.
mobile or modular homes.)
❑ 6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7.
Detached Accessory Building Form, filled out by the property owner (if required).
❑ 8.
Sanitation and site plan approval from the Environmental Health Department.
❑ 9.
Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1.
3 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2.
2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1.
4 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3.
2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 4.
Letter from Engineer or Architect for truss design review.
❑ 5.
2 Energy compliance design and supporting documentation (if required).
❑ 6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7.
Statement of Intent for Non -heated and A/C (if required).
El8.
Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed. by the engineer.
❑ 9.
Letter of intent.
❑ 10. Hazardous Material Form.
❑ 11. Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
..�..... ....... ... .... ... r�r.e�n�o�_n__o....D....a_ �__ D.,.... 7..t7 RFS/P_I F -OA
' I
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax,(530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER: /✓Z r� fi�(�r'1 C( `eL, ASSESSOR PARCEL NUMBER (6!
J
Proposed Building Use: loo31-to 14ice( 1dalQeSki' Technician: Date: Xj- lel 6
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
r2 1. Site plans, 3 or 4 sets, signed by the preparer of the plans.
P 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
.❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
�& 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Letter from Engineer or Architect for truss design review.
6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and 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. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate.
❑ 11. Letter of intent for non-residential buildings
❑ 12. Hazardous Material Form
❑ 13. Acknowledgement of building permit application without required clearances.
❑ 14. Other
Remaining items needed to issue the permit. (May require additional plan rEview, upon receot of the following items.)
15. Sanitation and site plan approval from the Environmental Health Department in RrChico ❑ Oroville, as applicable
❑ 16. Fire Sprinklers............................................................................................
.bl 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ 18. Soils Report and/or Engineered Foundation required ...........................................
19. Erosion Control Plan Required .............................. :.........................................
20. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
21. City of Chico Plumbing permit........................................................................
0 22. Site plan and business license approval from the City of Biggs ..............................
❑ 23. California Department of Forestry plan approval ❑ paid. Sent by:
❑ 24. Planning approval for (A) Use: (B)Parking: (C) Parcel Check: ............
O 25. Contact Land Development about _ Improvements, _ Drainage........ .................
JE] 26. NPDES Form..............................................................................................
❑ 27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Contractor's license information. (Number, Name Style, Classification) ...................
0 29. Worker's Compensation Carrier and Policy Number ..........................................
1E1 30. Owner -Builder Verification ( ✓Given to owner, _Mailed to owner) .....................
O 31. Letter of Signature authorization....................................................................
❑ 32. Recorded copy of Agricultural Acknowledgment Statement .................................
❑ 33. Existing violations and/or expired permits.........................................................
❑ 34. Deed Restriction..........................................................................................
❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO .........................
❑ 36. Other:
❑ 37. Other:
When issued Telephone 3 43!q and hold for pickup.
I have been informed of the above items and requirements for obtaining a building permit.
Applicant'. --! Date: Cpl(
1. Index permit application for the above items numbered: Plan Check Letter
2. Additional items req uir d
Contractor, designer,wn , 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 Dale:
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter Date:
Plans reviewed by: Date: Plans approved by: Date:
Structural reviewed Dat . ,gr-uctural approved by: Date:Itl
Note transfer by: Date:
Yellow: Building Division
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.buttecounty.net/dds
OWNER C PI el 10 l � l�� = A.P. #
PROPROSED BUILDING USE.DATEka
RECEIPT # DATE REC.
1. BUILDING PERMIT FEES $ /} �j Q 1G
-- Balance Due ................... `7 J
--- FEMA Flood elevation review ... $
--- Additional plan checking Fee .... $_
�. SCHOOL DISTRICT FEES C,A 1 LO6 —6weei ' O7 -C
• (paid at School District Office) (form available after Plan Check)
SHERIFF FEES (paid at Building Division)
Commercial (sq. ftg.)..... X $0.03 = $
Sq.Ftg.
4. RECREATION DISTRICT FEES
(paid at Recreation District Office) (form available after Plan Check)
5. RESIDENTIAL DEVELOPMENT IMPACT FEES
COUNTY WIDE (per dwelling) $
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 (paid at Building Division)
n a
8. SMIP
9. DRAINAGE FEE
10. OTHER
11. OTHER
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 // ; DATE mla
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)
School, District
A.P. Number
Property Owner
Property Location/Address
Subdivision
Residential
Commercial/industrial
-
Build------- ing De &.4
----
BUTTE COUNTY SCHOOLS IMPACT.FEE CERTIFICATION FORM
(One fbrm per Building)
C) Building Department No.
risdiction: city", ]County
hlj- el- l-ri 4
Lot No.
.......................................................................................
EZr Footage
Quivil
qg Mobile Home —Additian/ *Supplemental to (Group. R)
Conversion nits Installation- version Pefmit #
.(No foundation inspection)
...............................
............ * ........ --*****—*— ..........
Deed Restricted Sq. Footage
(Attach a signed copy of Deed Restriction and Notice of Limit se Facility document),*
3(-Sq. Footage 1 -
leve Addition (including Extidor
Roofed Area
/v Itf
tive Date
District Identification No. p4
School District certifies that
02�a ► �,n . way
(Street Address) '
(Applicant)
(Phone Number)_
7
-(City') (State) (Zip Code)
has complied with the eequirerinents of Resolution No. by payment of $
representing. B,2926
square feet' $
U ULI
ILL
MITIGATION $
ACSC /4 0
School District Representative
Date
Paid by Check # Remarks:
Nodco: You may protest the Imposition of the fees identified above by submitting a written protest to the District, In compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a! tlnrely writted;fro"4111 prohibit
you from challenging "'6&*sMon of the fen In any corirt &0
on.
If, subsequent to On School District Representative signing this Butte County Schools Impact Fee Certification Form, the School Dhr&kt is
notified by the applicable Local Planning Agency that this project Is being revieAd under thWCalifonils Environmental QualityAct (CEQA).—
this Prolect may be subleaW-a;�Wonal si=114" to fully mitlante Its lmmd on � the s"VitWcrs4choois11V—/ 5Z-
fteform.xis (3105)dr=
�paas^ �g79
"--e-AM
.�'su__ � wah-r��•;x,r<a�.tts . �ccz+eic-�:r� � .�s_.rr��r,�'�ti =!;
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return this infonnation at your earliest opportunity to avoid unnecessary
delay in processing and issuing your building permit. No building permit will be issued until this
verification is,received.
1. I personally plan to provide the major labor and material for construction of this proposed
property improvement: YES ["v' ] NO[ ].
2. I HAVE [ ] HAVE NOT [ , ] signed an application for a building permit for the proposed
work.
3. I have contracted with the following person (firm) to provide the proposed construction:
NAME: _
ADDRESS:
PHONE:
( A_L
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:
�M
CONTRACTOR'S LICENSE NO:
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
NAME -' ADDRESS
SIGNED:
PROPERTY OWNER: '2/_
DATE: (0 fi FLOE
PHONE TYPE OF WORK
NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California
Health and Safety Code.
This verification must be completed and returned to our office before we are permitted to issue the
permit.
Rev'd 11/4/2004
Butte County Department of Development Services
ADMINISTRATION' BUILDING ` GIS t PLANNING
7 County Center Drive
Oroville, CA 95965
(530) 538-7541 Telephone
(530) 538-2140 Facsimile
IN
ON
-''^n„'c+• -��r_k�"7�r�cLL_ z�=:� •�:7.,,,
Dear Property Owner: .
. An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a
permit. Building permits are not required to be signed by property owners unless they are personally performing their own
work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if
that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license
from the city or county. They are also required by law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be
aware of the following information for your benefit and protection:
o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials
and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or
subcontractors, then you may be an employer.
o If you are an employer, you must register with the state and federal government as an employer and you are subject
to several obligations including state and federal income tax withholding, federal social security taxes, workers'
compensation insurance, disability insurance costs, and unemployment compensation contributions.
o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious
with respect to workers' compensation insurance.
o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and,
if you wish, the U.S. Small Business Administration). For more specific information about your obligations under
state law, contact the Department of Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their
work personally or through their own employees, without a licensed contractor or subcontractor, only under limited
conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "owner -builder" building
permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building
permits are not required to be signed by property owners unless they are performing their own work personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your
community or at 1020 N Street, Sacramento, California 95814.
Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware
of these matters. The building permit will not be issued until the verification is returned.
C. Vieir J C.B.O.
Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
Depart merit
C n u n t y
J. -Michael Crump, Director
of Public Works
o f B u t t e
LAND DEVELOPMENT DIVISION
Storm Water Management Proaram
7 County Center Drive
Oroville, CA 95965
(530) 538-7266
(FAX) 538-7171
National Pollutant Discharge Elimination System (NPDES) Phase 11
Construction Storm Water Permit and Storm Water Pollution Prevention
Pian (SWPPP) Acknowledgement LLESS THAN 1 ACRE
ProlectDescription: _ZE!!�S_ 2:
007 la W1
ct Location and/or Parcel Number:
Project
�
By signing below, L the project ownerlowner's 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: U �j
Roof Beam[ 2001 California Buildinq Code (91 NDS)1 Ver: 6.00.81
By: SCOTT JACKSON, EVERGREEN DEVELOPMENT on: 10-18-2005: 06:47:33 AM
Project: ERPINO - Location: GARAGE ROOF BM
Summary:
5.5 IN x 11.25 IN x 16.0 FT / Select Structural - Douglas Fir -Larch (North) - Dry Use
Section Adequate By: 12.5% Controlling Factor: Section Modulus / Depth Required 10.61 In
Deflections:
Dead Load:
DLD=
0.33
IN
Live Load:
LLD=
0.37
IN = U523
Total Load:
TLD=
0.70
IN = U276
Reactions (Each End):
Live Load:
LL-Rxn=
2080
LB
Dead Load:
DL-Rxn=
1864
LB
Total Load:
TL-Rxn=
3944
LB
Bearing Length Required (Beam only, support capacity not checked):
BL=
1.15
IN
Beam Data:
Span:
L=
16.0
FT
Maximum Unbraced Span:
Lu=
2.0
FT
Pitch Of Roof:
RP=
.
6
:12
Live Load Deflect. Criteria:
U
240
Total Load Deflect. Criteria:
U
180
Roof Loadinq:
Roof Live Load -Side One:
LL1=
20.0
PSF
Roof Dead Load -Side One:
DL1=
15.0
PSF
Tributary Width -Side One:
TW1=
10.0
FT
Roof Live Load -Side Two:
LL2=
20.0
PSF
Roof Dead Load -Side Two:
DL2=
15.0
PSF
Tributary Width -Side Two:
TW2=
3.0
FT
Roof Duration Factor:
Cd=
1.15
Beam Self Weiqht:
BSW=
15
PLF
Slope/Pitch Adjusted Lenqths and Loads:
Adjusted Beam Lenqth:
Ladi=
16.0
FT
Beam Uniform Live Load:
wL=
260
PLF
Beam Uniform Dead Load:
wD_adj=
233
PLF
Total Uniform Load:
wT=
493
PLF
Properties For: Select Structural- Douglas Fir -Larch (North)
Bendinq Stress:
Fb=
1600
PSI
Shear Stress:
Fv=
85
PSI
Modulus of Elasticity:
E=
1600000
PSI
Stress Perpendicular to Grain:
Fc_perp=
625
PSI
Adjusted Properties
Fb' (Tension):
Fb'=
1835
PSI
Adjustment Factors: Cd=1.15 CI=1.00 Cf --1.00
Fv':
Fv'=
98
PSI
Adjustment Factors: Cd=1.15
Design Requirements:
Controllinq Moment:
M=
15778
FT -LB
8.0 ft from left support
Critical moment created by combining all dead and live loads.
Controllinq Shear:
V=
3550
LB
At a distance d from support.
Critical shear created by combining all dead and live loads.
Comparisons With Required Sections:
Section Modulus (Moment):
Sreq=
103.16
IN3
S=
116.02
IN3
Area (Shear):
Areq=
54.48
IN2
A=
61.88
IN2
Moment of Inertia (Deflection):
Ireq=
425.93
IN4
1=
652.59
IN4
Roof Beam[ 2001 California Buildinq Code (91 NDS)1 Ver: 6.00.81
By: SCOTT JACKSON, EVERGREEN DEVELOPMENT on: 10-18-2005: 06:47:33 AM
Project: ERPINO - Location: GARAGE ROOF BM
Summary:
5.5 IN x 11.25 IN x 16.0 FT / Select Structural - Douglas Fir -Larch (North) - Dry Use
Section Adequate By: 12.5% Controlling Factor: Section Modulus / Depth Required 10.61 In
Deflections:
Dead Load: DLD= 0.33 IN
Live Load: LLD= 0.37 IN = U523
Total Load: TLD= 0.70 IN = U276
Reactions (Each End):
Live Load:
LL-Rxn=
2080
LB
Dead Load:
DL-Rxn=
1864
LB
Total Load:
TL-Rxn=
3944
LB
Bearing Length Required (Beam only, support capacity not checked):
BL=
1.15
IN
Beam Data:
Span:
L=
16.0
FT
Maximum Unbraced Span:
Lu=
2.0
FT
Pitch Of Roof:
RP=
6
-12
Live Load Deflect. Criteria:
U
240
Total Load Deflect. Criteria:
U
180
}
Roof Loadinq:
Roof Live Load -Side One:
' LL1=
20.0
PSF
Roof Dead Load -Side One:
DL1=
15.0 1 PSF
Tributary Width -Side One:
TW1=
10.0
FT
Roof Live Load -Side Two:
LL2=
20.0
PSF
Roof Dead Load -Side Two:
DL2=
15.0
PSF
Tributary Width -Side Two:
TW2=
3.0
FT
Roof Duration Factor:
Cd=
1.15
Beam Self Weiqht:
BSW=
15
PLF
Slope/Pitch Adjusted Lenqths and Loads:
Adjusted Beam Lenqth:
Ladj=
16.0
FT
Beam Uniform Live Load:
wL=
260
PLF
Beam Uniform Dead Load:
wD_adl=
233
PLF
Total Uniform Load:
WT=
493
PLF
Properties For: Select Structural- Douglas Fir -Larch (North)
Bendinq Stress:
Fb=
1600
PSI
Shear Stress:
Fv=
85
PSI
Modulus of Elasticity:
E=
1600000
PSI
Stress Perpendicular to Grain:
Fc_perp=
625
PSI
Adjusted Properties
Fb' (Tension):
Fb'=
1835
PSI
Adjustment Factors: Cd=1.15 CI=1.00 Cf=1.00
Fv':
Fv'=
98
PSI
Adjustment Factors: Cd=1.15
Design Requirements:
Controllinq Moment:
M=
15778
FT -LB
8.0 ft from left support
Critical moment created by combining all dead and live loads.
Controllinq Shear:
V=
3550
LB
At a distance d from support.
Critical shear created by combining all dead and live loads.
Comparisons With Required Sections:
q
Section Modulus (Moment):
Sreq=
103.16
IN3
S=
116.02
IN3
Area (Shear):
Areq=
54.48
IN2
!
A=
61.88
IN2
Moment of Inertia (Deflection):
Ireq=
425.93
IN4
\
1=
652.59
IN4
c
1
NOTES
RESIDENTIAL
JPERMIT NO.
• i
a
042-180-024 05-1715 ,
EPRINO, MICHAEL & WENDY
2921 GRAPE WY, CHICO
I Cont: DOSS CONSTRUCTION
MAIN SERV UPGRADE '1
,t
�F
I
i
SPECIAL CONDITIONS
t
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
a
FIRE SPRINKLERS REQ.
e
SPECIAL INSPECTION ITEMS
f
VERIFY
USE PERMIT CONDITIONS
4
SUB -STANDARD HOUSING LETTER
I
OFFICE COPY
Address
GAS
t
Meter By Date
1
ELECTRIC
Meter By Date%
JOB FINALED (D ) "
Signature
t
J=OK
0 = Not OK
NotApplic
. = Not Readyable
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except If's
Card B-1 Date
1. Zoning Requirements -Setbacks -Easements
Date
2. Soils; Special MH Support Sketch
Card B-1
3. Sewer, Location -Test -Fall -C/O -Concrete
PERMANENT END SYSTEM (ONLY)
4. Water; Location -Test -Easement Needed (Sketch)
S. Electricity; location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; location -Test -Wrap;-/ /" L'ft.
/ P Nat. or/ /" L W P LPG
2. Footings; Size -Spacing -Marriage Line
7. Well Clearance 8. Disconnect
8. Utility Clearance
4. Gas; MH Test -Demand -Valve
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except If's
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
8. Gas and Electricity Tagged
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
10. License Decals
6. Water, MH Test-Regulator-Connectoe
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs -Type -Installation Cert.
Date
10. Exits; Insp.-Sketch
Card B-1
11. Cert of Occupancy
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except If's
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.- Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
12. Enclosure; Fencing -Alarms
' Date Card B-1 Date Card B-1
'Date Card B-1 Date Card B-1
Date
Card B-1 Date
Card B-1
Date
Card B-1 Date
Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Blocking
4. Gas; MH Test -Demand -Valve
5. Electricity; MH Test
6. Water, MH Test
7. Water and Sewer Connected,
8. Gas and Electricity Tagged
9. Exits
10. License Decals
11. Verify Ws with Office
Date
Cana B-1 Date
Card B-1
Date
Card B-1 Date
Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except If's
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8.- Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
12. Enclosure; Fencing -Alarms
' Date Card B-1 Date Card B-1
'Date Card B-1 Date Card B-1
J=OK
0 = Not OK
= Not Apprrcable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth
3_ Ftg., Garage; Soils-Steel-Elec. Gmd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card 6-1
Date
PLUMBING (Permit) OK except #'s
Date
17. Water Htr.; Vent -Access -Combustion Air Baffle
Date
18. Water Pipe: Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler, Test
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) .OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI -AC. Wire Size/ /ga Cu or AI
31. Range Circle/ iga Cu or AI -Oven Circ. / /ga Cu or AI
Insulated Neutral 0 Yes 0 No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels-Motors-Mech. Equip.
34. Clothes Closet Licht -Shower Light -Spa Light
35. Smoke Detector
84. Stucco Brown -Finish
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain & Overflow, Size & Grade
39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Cana B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
Date
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
Date
43. Bearing Walls over Girders & Floor Nailing
Date
44. Draft Stop in Walls (rat proof)
Comments at Final:
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting: Rtng.
49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fre Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor -Ducts -Meeh. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit_ Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door, Swing -Landing -Closure
76. A.C. Dud in Garage -Damper
77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor -Meth. Protection
78. Plb.; Elec. & Mech. Equip. Listed for Location
79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
83. Following InsfldJDrive D Yes O No/Walks 0 Yes O No/Plartters 0 Yes 0 No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fre Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
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Date v Inspector
REV 4/05 Phone #
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
.. ... ...... COUNTY OF BUTTE ..............
a -< BUILDING DIVISION
:
. DEPARTMENT OF DEVELOPMENT SERVICES
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
�M<
WNER+
PERMIT NO.
1
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
:=a
explanation, please contact the Building Inspector as indicated below.
y
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Date v Inspector
REV 4/05 Phone #
FOR RE -INSPECTION CALL: 538-7636 OR 891-2834
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT -
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect. { 7.7,2 S3 o
License Class: "' License Number:
G
Date: 6/3610 Contractor: N'w
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior -
to its issuance,- also requires the applicant for such permit to file a
signed statement tha('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 Sectign;_ 703,1.5 by any applicant for a permit subjects the
applicantto;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
,:.intendeQ.gr_gffq ed,.for_sole„(Sec:.7„Og4,.,0usiness.and Professions.
Code: The, Contractors” State, License Law does not apply to an
owner. of. property who builds or.,improves thereon, and who does
such.work.himself or. herself. or. through, his or her own employees,
provided that such. improvements are not intended or offered for
sale. If however; the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build' or'improve for the purpose of
sale.).
❑ I, as owner. •of-.the.,.property,- am., exclusively,. contracting ..with.,.
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt.under Article 3 of the Business and Professions Code
Date: Owner:
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.
❑ I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
insurancp carrier, and, policy. number are:
Carrier: tj J_( ' c Le. I- ►J TJ C.42-
Policy #: 7
❑ I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to 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:
Applicant:
WARNING:'.Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest,.and attorney's fees....
PERMIT NO.
BP051715
Issued Date: 06/30/2005 APN: 042-180-024-000
Site Address: 2921 GRAPE WAY CHI
Map Index:
Description: MAIN SERVICE UPGRADE, MIS REPAIRS
Owner: ERPINO, MICHAEL & WENDY
2921 GRAPE•WAY
CHICO, CA 95973-9621
(818) 317-611.8.:.: ,
Applicant: DOSS CONSTRUCTION, GLENN
4911 VILLAGE DR
FOREST RANCH, CA 95942
530-342-1293
Contractor: DOSS CONSTRUCTION, GLENN
4911 VILLAGE -DR
FOREST RANCH, CA 959.42
530-342-1293. .
License #: 772530
Architect:
Engineer:
Total Square Ft: 0 S. F.
Valuation: $0.00
Census Code:
y312(o0
CONSTRUCTION -LENDING AGENCY This oermit is hereby issued under the applicable provisions of the Butte County Coda anrVpr
I hereby affirm that there is a construction lending agency for the Resolutions to do work indicated ove r which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)�
BY ( ! Date: /n EU
Name: ” U
,� ' PERMIT EXPIRES ON: C, ' i0
Address: VY Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any fficial form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos Is.
Print Name: Signature:
I
Date: / 5
❑ Owner
❑ Contractor
.Agent for Owner
❑ Agent for Contractor
NOTES RESIDENTIAL
PERMIT NO. _ 042,180-024 05-1869
EGBERT, VICTOR
—�' 2921 GRAPE WAY, CHICO
CONT: DOSS CONST
ELEC PANEL UPGRD(2ND DWEL
e
`i
SPECIAL CONDITIONS
` CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
t
SPECIAL INSPECTION ITEMS
VERIFY
i
I USE PERMIT CONDITIONS
SUB-STANDARD HOUSING LETTER
OFFICE COPY
Address
GAS Dates
Meter By
ELECTRIC t Dat
Meter By
1
JOB FINALE D (Da
Signature
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.netWds
PERMIT NO.
BPO51869
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 07/15/2005 APN: 042-180-024-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number: s 3�%
Site Address: 2921 GRAPE WAY CHI
r77�
Date: Contractor. �J �bl Qd s5
Map Index:
Description: upgrade elec panel, 2nd dwelling
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: EGBERT VICTOR C TRUST
to its issuance, also requires the applicant for such permit to file a
EGBERT VICTOR C TRUSTEE ATTN
signed statement that he or she is licensed pursuant to the provisions of
MICHAEL EGB
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
2921 GRAPE WAY
she is exempt therefrom and the basis for the alleged exemption. Any
CHICO, CA 95973-9621
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: DOSS CONSTRUCTION, GLENN
-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
4911 VILLAGE DR
proving that he or she did not build or improve for the purpose of
FOREST RANCH, CA 95942
sale.).
530-342-1293
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor: DOSS CONSTRUCTION, GLENN
O 1 am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
4911 VILLAGE DR
FOREST RANCH, CA 95942
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
530-342-1293
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
License #: 772530
Labor Code, for the performance of the work for which this permit
iS issued.
I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Architect:
insurance c.a_rrier and policy number are:
Engineer:
r- r C-'�-
Carrier: lYC! I'U" `- 6.
Policy #: -7 S3c>
❑ 1 certify that in the performance of the work for which this permit is
Total Square Ft: 0 S. F.
issued. I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
/
Valuation: $0.00
and agree that if I should become subject the workers'
Section
Census Code:
compensation provisions of 3700 of the Labor Coda, I shall
forthwith comply with those provisions.
- .'
Date: J < Sv (-I..
Applicant:
1
WARNING: Failure to secure workers' compensation coverage is
/
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
,
code, interest, and attorney's fees. .
CONSTRUCTION LENDING AGENCY
This permit is here issued under th pplica a prbvi ions of the Butte County Coda enrt/or
I hereby affirm that there is a construction lending agency for the
Resolutions to work indi ted a ve for whi h fee ave been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
yf v
Name:
By: �Date:
E IES ON:
�� ..
Address:PERMIT
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.
O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of an �'fficial form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
_� ' J
C o l ( � A- JS S ;-1
Print Name: Signature:
.. I V t ��
Date:
0 Owner ❑ Contractor Agent for Owner 0 Agent for Contractor
J=OK
0= Not OK
_ = NotReali
. =Not Readyy
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer, Location -Test -Fall -C/O -Concrete
4. Water, Location -Test -Easement Needed (Sketch)
5. Electricity, Location-Clearances-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap;-/ /" L'ft.
/ P Nat or/ /" L "ftJ P LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water, MH Test-Regulator-Connectoe
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Tie Downs -Type -Installation Cert.
10. Exits; Insp.-Sketch
11. Cert. of Occupancy
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PERMANENT END SYSTEM (ONLY)
1. Zoning Requirements -Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
3. Blocking
4. Gas; MH Test -Demand -Valve
5. Electricity; MH Test
6. Water, MH Test
7. Water and Sewer Connected
8. Gas and Electricity Tagged
9. Exits
10. License Decals
11. Verify #'s with Office
Date Card B-1 Date Card B-1
Date Card B-1 Date Cana B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs-Connectors
Shthg-Frg-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
T. Electric
8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
12. Braced Wall Panels
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-GFI
5. Elec.; Pool Lighting; 15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. - Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
11. Light Niche
12. Enclosure; Fencing -Alarms
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK
= Not OK
= Not Applicable
o = Not Ready
RESIDENTIAL (Single & Duplex)
Date UNDERFLOOR (Plans) OK except #'s
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Gmd.-/ r Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ /' Fig. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ r Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PLUMBING (Permit) OK except #'s
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sixe & Anchors
23. Fire Sprinkler, Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) .OK except #'s
24. Fixture & Transformer Clearance -Ins. Protection
25. Elec. Receptacles Spacing -Lights & Switches at Doors
26. Size Boxes & No. of Conductors Stapled
27. Romex Installed Close to Edge of Studs & C.J.
28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29. 2 Appliance Circuits in Kitchen & Conductor Size GFI
30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI
31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI
Insulated Neutral O Yes O No
32. Service -Riser Conductors & Ground Main Disconnect
33. Equip. Clearances Panels -Motors -Meth. Equip.
34. Clothes Closet Light -Shower Light -Spa Light
35. Smoke Detector
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
36. A.C. Ducts Insulation & Support
37. Vent Fan, Exhaust above insulation
38. Condensate Drain. & Overflow, Size & Grade
39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet
40. Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41. Sills Proper Materials & Anchors
42. Walls Studs -Nailing Spacing & Braces -Plates -Sound
43, Bearing Walls over Girders & Floor Nailing
44. Draft Stop in Walls (rat proof)
45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46. Headers & Beams -Size & Bearing
Date FRAMING (Continued)
47. Hangers -Post Caps -Anchors -Connectors
48. Cling. Joist-Rftr. Ties -Pullin -Roll Brac: Truss-Shting.-Rtng.
49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance
50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52. Garage Fire Protection Framing -RC Channel
53. Property Line Firewall & Openings
54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57. Siding -Nailing Veneer
58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59. Glazing Area -Glass Protection -Skylights -Plastic
60. Shear Walls; Nailing -Bolts
61. Brace Interior/Exterior Wall Panels
62. Insulation -Walls -Ceilings
63. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Cana B-1 Date Card B-1
Date FINAL (Plans) OK except #'s
64. Ext. Steps -Door & Sidelight Protection -Landings
65. Smoke Detector
66. Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67. Bedroom Exiting
68. G.F.I. & Bath Fixtures & Tub Access -Spa
69. Elec_ Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71. Fireplace or Stove, Clearance -Hearth
72. Elec. Outlets at Wood Panel, Int. & Ext.
73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74. Elec. Outlets & Receptacles at Kit. Counter
75. Garage Fire Door, Swing -Landing -Closure
76. A.C. Duct in Garage -Damper
77. Wtr. Htr.-, Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78. Plb.; Elec. & Mech. Equip. listed for Location
79. Elec. Receptacles in Garage (FFI.)-Romex Protection
80. Insulation -Foam -Looked in Attic
81. Guard Rails & Deck Construction -Post Caps
82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
83. Following 1nstldJ13trive 0 Yes 0 No/Walks 0 Yes O WPlarders 0 Yes O No
84. Stucco Brown -Finish
85. A.C. Unit Disconnect, Electrical -Plumbing
85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87. Water Well, Disconnect, Electrical, Plumbing
88. Exterior Elec. Trim, G.F.I. Receptacle -Underground
89. Ventilation Throughout House
90. Glass Protection
91. Corrections from Previous Inspections
92. Gas Test -Meters Tagged, Gas -Electric
93. Water & Sewer Connected -C/O to Grade -HD Approval
94. Energy Compliance Certificate -Other Certificates
95. Address Posted
96. Fre Sprinkler
Date Card B-1 Date Card B-1
Date Card B-1 Date Card 8-1
Date Card B-1 Date Card B-1
Comments at Final:
~ TO:
FROM:
DATE:
INTER -DEPARTMENTAL MEMORANDUM
BUILDING
RELEASE
VILLE
ENVIR. HEALTH, CHICO
HEALTH HOLD ON BUILDING FINAL, FOR:
OWNER NAME: 70'1//f% SEPTIC: _r/ WELL:
AP#: ADDRESS/LOCATION:
Comments:
GL/memos/releasehold
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.netldds
PERMIT NO.
BP051869
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
Issued Date: 07/15/2005 APN: 042-180-024-000
the Business and Professions Code, and my license is in full force and
effect.
License Class : License Number: 7%� 3U
Site Address: 2921 GRAPE WAY CHI
Date: Contractor. (0 `'e,,tA p6 SS
Map Index:
Description: upgrade elec panel, 2nd dwelling
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: EGBERT VICTOR C TRUST
to its issuance, also requires the applicant for such permit to file a
EGBERT VICTOR C TRUSTEE ATTN
signed statement that he or she is licensed pursuant to the provisions of
MICHAEL EGB
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
2921 GRAPE WAY
she is exempt therefrom and the basis for the alleged exemption. Any
CHICO, CA 95973-9621
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: DOSS CONSTRUCTION, GLENN
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
4911 VILLAGE DR
proving that he or she did not build or improve for the purpose of
FOREST RANCH, CA 95942
sale.).
530-342-1293
❑ 1, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
Contractor: DOSS CONSTRUCTION, GLENN
❑ 1 am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
4911 VILLAGE DR
FOREST RANCH, CA 95942
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
530-342-1293
❑ 1 have and will maintain a certificate of consent to self -insure for
workers' compensation, as provided for by Section 3700 of the
License #: 772530
Labor Code, for the performance of the work for which this permit
is issued.
I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation
Architect:
insurance and policy number are:
Engineer:
/carrier
Carrier:!✓'e-
Policy #: -7 5- 3g
❑ 1 certify that in the performance of the work for which this permit is
Total Square Ft: 0 S. F.
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Valuation: $0.00
and agree that if I should become subject to the workers'
compensation Section 3700 the Code,
Census Code:
provisions of of Labor I shall
forthwith comply with those provisions.
Date: % < TV
/
Applicant: L4 �� �h�a- ✓L
U (
WARNING: Failure to secure workers' compensation coverage is
[ ► /
unlawful, and shall subject an employer to criminal penalties and one
I
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
'
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is here issued undo th pplica a pr vi ions of the Butte County Coda anrl/nr
I hereby affirm that there is a construction lending agency for the
Resolutions to work indit d a ve for whi h fee ave been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
CJ
� / � o \
Name:
By: _ / Date: J J
PERMIT E ES ON: -7—/ S D
Address:
Date
O 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 8 Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. 1 agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of an ictal form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
C 0 / i4 S
Print Name: Signature:
% 13—iJ
Date:
❑ Owner ❑ Contractor Agent for Owner 0 Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER
Last Namer 1�
First Name
Address a q,2, e G d -a LA
City �� t L�
State
Zip
Phone
Fax
E-mail
CONTRACTOR
Name (o -e vi v, D 0 5 S
Address 2 j 316 "(14 W C
City, 1 \ G
StateCA_
Zip �IL8
Phone ��15�' SS�%0
Fax
E mail C a I d i b
Lic. # i7o?5-90
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City 6-4A t CSU
Address
[Tp9 �—y2e,
City
Fax
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name 5 C1 I(tiSQ�
Address
City 6-4A t CSU
State e
[Tp9 �—y2e,
Phone _ �S—q
Fax
E-mail
PPLICAN SIGNATURE
X
For office use only:
Zoning
Property Address / ` ,/
C9 l.0
Flood Zone
Cross Street y.k
SRA
I Yes
I No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO.
♦ I
BIN #
LOCATION
r,
AP# �Z )0U O�-%—C���
Property Address / ` ,/
C9 l.0
City -
Cott i Lc3
Cross Street y.k
WORKER'S COMPENSATION
Policy Number 7S3
Carrier
If hiring anyone other than I cense contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Page 1 of 2
Description or Scope of Work:
L) �Q
2 V D6,L,C24vrJ
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: Amount: Bldg
SRA
Receip Sheriff
SMIP
Date: V Other
Total
REV 2-24-05
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 inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
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.
Lefler of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
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 2-24-05
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under
provisions of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code, and my license is in full force and
effect.
License Class: License Number: 7� r, S3 V
Date: 6 iS 4 Contractor: lD',oiy► v� 7? a 5 S
PERMIT NO.
BPO51715
Issued Date: 06/30/2005 APN: 042-180-024-000
Site Address: 2921 GRAPE WAY CHI
Map Index:
OWNER43UILDERDECLARATION Description: MAIN SERVICE UPGRADE, MIS REPAIRS
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a Owner: ERPINO, MICHAEL & WENDY-.—
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 - . ' 2921 GRAPE WAY
the Contractor's State'License Law (Chapter 9 commencing with Section CHICO, CA 95973-9621
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 (818) 317-6118..,:.--,1,
violation of $ectiq'9.703.1.5 by any applicant for a permit subjects the
applicant to,a civil:penalty of not more than five hundred dollars ($500).):
:4r•. ,
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
;,irttenped Qr offgre� for �le,(Secs70Q4 @usiness.and, Professions_ _AppIICant:.DOSS CONSTRUCTION, GLENN
Code: The -Contractors"State -L•icense 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; 1he building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build' or'improve for the purpose of
sale.).
❑ I, as owner -of _the_property,,-am..exclusively,...contracting—wilt,
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
4911 VILLAGE DR
FOREST RANCH, CA 95942
530-342-1293
not apply to an owner of property who builds or improves thereon, Contractor., DOSS CONSTRUCTION, GLENN
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ A I am Exempt under Article 3 of the Business and Professions Code
Date: Owner:
WORKERS:. COMPENSATION DECLARATION
I hereby affirm under.penilty of perjury one of the following declarations:
❑ '-1 have and will. maintain a certificate of consent to self -insure for
workers%compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
❑ . I have andPwillymaintain`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:
Carrier: l7J q Lea, 6 ry G -e -
Policy #: 7
❑ I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
become subject to 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: . , .4/ 3 e I o Soo,, ..
Applicant: / L QZr
WARNING:'- ;Failure to' secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code,interest,. and attomey's fees:...,,.
4911 VILLAGE -DR
FOREST RANCH, CA 95942
530-342-1293 f
License #: 772530
..Architect: �. _....._ ,.....�.,,,......_ .,,._ ,.,.. �...-_.., . �..... .
Engineer:
Total Square Ft: 0 S. F.
Valuation: $0.00
Census Code:
CONSTRUCTION LENDING AGENCY This permit is hereby issued and
1 hereby affirm that there is a construction lending agency for the Resolutions to do work indicated
performance of the work for which this permit is issued (Sec 3097 Civ.) By.
Name: .. "P
Address:
PERMIT EXPIRES
licable provisions of the Butl
which fees have been paid.
Date: a - so, US
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms. -
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of anypfficial form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. a .
L4,l] r7 1�
Print Name: > %�a �'1"�1 Signature
Date: / J
❑ Owner ❑ Contractor .Agent for Owner ❑ Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY**
OWNER
Last Name Co\ PI N D
First Name I h a el
Address � �� rA
City " I G u
State
Zip
Phone 3 y 7 I
Fax
E-mail
CONTRACTOR
Name
Address W
City Leo
State
Zip
Phone Vi 4 C7 0
Fax 6ly_„ 5-05_/
E-mail
Lic. #.77,_63 a I
Class
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City G �c a
Address
Zip 9 S�Zg
City
Fax 5—/j 5—
State
Zip
Phone
Map Book
Fax
E-mail
Planner
State License Number
APPLICANT NAME
Name
Address 2 <_36 iZ':i "Gf z CAj $ ,
City G �c a
StateL1
Zip 9 S�Zg
Phone 550
Fax 5—/j 5—
E-mail
APPLICANT SIGNATURE
X
For office use only:
Zoning
Property Address � I 67
Flood Zone
.
SRA I
Yes I
No
Occ.
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
KAFORMSWILDING FORMS1BldgApplSubRgmts.doc
PERMIT
NO.
BIN N
LOCATION
API
Property Address � I 67
cityG
In
Cross Street
WORKER'S COMPENSATION
Policy Number 75 01
Carrier 6 a U& A�r Y G 2
If hiring anyone other than license contractor , a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
escrlption or Scope of Work:
/nIZr V t c Q u p rc -� .
PI u n1 b old W -0 -It cj r lro T r e oxt
Sq. Footage W ox I
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by:` .# Amount: Bldg
SRA
Receipt #: 1 "�� Sheriff
SMIP
I Date: 6 05 j/}� Other I I
I . Total
Page 1 of 2
REV 2-24-05
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 inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May require additional plan review upon receipt of the following items.)
❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑ 2. Impact Fees.
❑ 3. California Department of Forestry plan approval (if required).
❑ 4. NPDES Form.
❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑ 6. Contractor's license information. (Number, Name Style, Classification).
❑ 7. Worker's Compensation Carrier and Policy Number.
❑ 8. Owner -Builder Verification (if required).
❑ 9. Letter of Signature authorization (if required).
❑ 10. Recorded copy of Agricultural Acknowledgment Statement.
❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑ 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
KAFORMSMILDING F0RMS\BIdgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
Butte County Department of Development Services. eurrF artEa
7 County Center Drive, Oroville, CA 95965
(530) 538-7601 v4%9nv.butteC0itnty neVdds
RESIDENTIAL
APN: Permit No.
Owner. 042-180-024 06-0129
1 ERPINO, MIKE
12921 GRAPE WAYN, CHICO
Site Address: i- Cont: ST CLAIR CONSTR. CO
Contractor. ROOF MT PHOTOVOLT. SYST.
Type of Permit: -
V7
CHECKED BY
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: • ' 3 I
SIGNATURE:
OK
nu
MANUFACTURED HOMES
MISCELLANEOUS
DATE 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 0 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 Q Foundation Q
14 Exits
15 CertofOccupancy
16 HUD Label/Insignia Numbers Serial Numbers
R
DATE D E C KS -C O V E R S`C A R P O R T S `GARAGE S
1 Zoning -Setbacks -Easements
2 Ftgs; Soils-Sz-Dpth-Spacing-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 -An chrs-Studs-Rftrs-Trusses
9 Siding; Nailing -Veneer -Stucco -Lath
10 Roof-, Shthg-Roofing
11 Ext; Steps -Doors -Landings
12 Braced Wall pnls
a`
°"O 4.
DATE JPOOLS
1 Setbacks -Easements
2 Soils; CompactionStructure Stability
3 Pool Structure; Steel-Cnnctns-Thickness
Dead Men -Lining
4 Elec Rcptcis/Lting; Distance-GFI
5 Elec Pool Lting; 15 volts-GF1
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
Bokes-Enclsrs-pnlboards4nsultn to Main Conduit
9 Health Dept Apprvl
10 Pimb; Cir Test-Wtr Supply Test
11 Lt Niche
12 Enclsr, Fencing -Alarms
13 Bonding, Diving board or Slide
Pool Drawing
I
OK
Not OK
RESIDENTIAL (Single & Duplex)
DAIL JUNDERFLOOR
DATE
IPLUMBING
1 Zoning -Setbacks -Easements -Flood -Slope
53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle
2 Ftg Main; Soils-Elec Grnd Ftg Opth
54 Wtr Pipe; Test & Anchr-Nail Prtctn
3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth.
55 DWV; Test Fittings & Anchr Nail Prtctn
4 Ftg Porches/Decks; Soils -Steel Ftg Dpth
56 Shwr Pan; Test, First flr-Tub Acc
5 Stemwalls Main; Steel-Blockouts-Wrapped
57 Test Tub & Shwr, 2nd flr - Tub-Acc
6 Stemwalls Garage; Steel-Blockouts-Wrapped
58 Gas Pipe; Sz & Anchrs
6a Hold Downs and Special Anchrs
59 Fire Sprinkler; Test
7 Slab, Steel Wrapped
60 Yard Gas Piping
8 Piers-Frplc Ftg-Steel
9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test
10 UF, Gas Pipe; Sz Anchrs-Sz Test
°�
1.t Wtr Pipe; Test-Anchrs-Rgltr-Service Test
12 Elec Undrgrnd
DATE
IMECHANICAL
13 Plenums & Ducts; Cirnc-MaterialSupport-Insultn
61 AC Ducts Insultn & Support
_ 14 Girders-Sills-Anchr Bolts Joists-Vnts-Cripples
62 Vent Fan, Exhaust abv Insultn
15 Acc & Vntltn
63 Condensate Drain & Ovrflw, Sz & Grade
16. Insulation
64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet
65 Attic Acc & Pltfrm if Furnace in attic
mac` c`
DATE IFRAMING
17 Sills Proper Materials & Anchrs
18 Walls Studs -Nailing Spacing & Braces -Plates -Sound
19 Bearing Walls over Girders & flr Nailing
20 Draft Stop in Walls (rat proof)
21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
22 Headers & Beams-Sz & Bearing
23 Hangers -Post Caps-Anchrs-Cnnctns
24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg
25 Frplc Ties or Type A Flue-Frplc Throat Clmc
26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles
27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions
28 Garage Fire Prtctn Framing -RC Channel
29 Prprty Line Firewall & Opngs
30 Ext Doors -One T -Check Garage 3rd Story, 2 Exits
31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn
32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs
33 Siding -Nailing Veneer
34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc
35 Glazing Area -Glass Prtctn-SkyLts-Plastic
36 Shear Walls; Nailing -Bolts
37 Brace Int/Ext Wall pnls
38 Insultn-Walls-Ceilings
39 Infiltration-Walls-Wndws
1
0`
DATE JELECTRICAL
40 Fxtr & Tmsfrmr CImc4ns Prtctn
41 Elec Rcptcls Spacing-Lts & Switches at Doors
42 Sz Boxes & No Of Cndctrs Stapled
43 Romex Installed Close to Edge of Studs & CJ
44 Eqp Grnd made up w/Mech Fstnrs
45 Grndng Electrode Bond Gas & Wtr
46 2 Appinc Cires in Ktchn & Cndctr Sz GFI
47 Subfeed Wire Sz ga ❑CU or❑AL
AC Wire Sz ga ❑ CU or ❑AL
48 Range Circ ga F-1 cu or❑AL
Oven Circ ga ❑ CU or ❑ AL
Insulated Neutral Dyes ❑No
49 Service -Riser Cndctrs & Grnd Main Dscnnct
50 Eqp Clrncs pnls-Motors-Mech Eqp
51 Clothes Closet Lt-Shwr Lt -Spa Lt
52 Smoke Detector
1 P `c`
°qa 0 O ' 0
0'•
FINAL
66 Ext Steps -Door & SideLt Prtctn-Landings
67 Smoke Detector
68 Furnace Vnts-Cirnc-Comb, Air-Cnnctr
In Garage; abv-flr-Ducts-Mech Prtctn
69 Bedroom Exiting
70 GFI & Bath Fxtrs & Tub Acc-Spa
71 GFI Arc Fault
72 Elec Trim & Subpnl, Breaker Szs & Labels
73 Stairs, Guard/Handrails
74 Frplc or Stove, Cirnc-Hearth
75 Elec Outlets at Wood Pnl, Int & Ext
76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clmc
77 Elec Outlets & Rcptcls atKtchn Counter
78 Garage Fire Door; Swing -Landing -Closure
.79 AC Duct in Garage -Damper
80 Wtr Htr; Vnts-DImc-Com Air Cnnctr-PRV; abv fir
Mech Prtctn; LPG Appince Undr House 3" drain
81 Plmb; Elec & Mech Eqp Listed for Loctn
82 Elec Rcptcls in Garage (GFI) Romex Prtctn
83 Insultn-Foam-Looked in Attic
84 Guard Rails & Deck Cnstrctn-Post Caps
.85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth
86 Cirnc Drnge Planters ❑Yes E-1 No
87 Stucco Brown -Finish
88 AC Unit Dscnnct, Elec-Plmb
89 Vnts abv Roof, Plmb-Appinc-Frplc-Cirnc to Opngs
90 Wtr Well, Dscnnct, Elec, Plmb
91 Ext Elec Trim, GFI Rcptcl-Undrgrnd
92 Vntltn thru House
93 Glass Prtctn
_ 94 Corrections from previous lnspctns
_ 95 Gas Test -Meters Tagged, Gas-Elec
_ 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl
_ 97 Energy Cmpinc Cert -Other Certs
98 Address Posted
99 Fire Sprinkler
�r
0� O'er
LI BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541
PERMIT NO.
BP060129
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
Issued Date: 01/19/2006 APN: 042-180-024-000
the Business and Professions Code, and my license is in full force and
effect.
License Class: X z3 License Number: ,/ fr/�`/S�
Site Address: 2921 GRAPE WAY CHI
Date: /-/4-0 Contractor: ►
Map Index:
Description: ROOF MOUNT PHOTOVOLTAIC SYSTEM:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
MASTER 01-22
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
to its issuance, also requires the applicant for such permit to file a
Owner: ERPINO MICHAEL THOMAS & WENDY LEW
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
2921 GRAPE WAY
she is exempt therefrom and the basis for the alleged exemption. Any
CHICO, CA
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).):
95973-9621
'
(530) 891-6118
❑ 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,
Applicant: ST CLAIR CONSTRUCTION CO
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
2530 ZANELLA WAY - B
proving that he or she did not build.or improve for the purpose of
CHICO, CA c
sale.).
95928
❑ 1, as owner of theroe
p p rfy, am exclusively contracting with
530-894-5590
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Business and Professions Code
Contractor: ST CLAIR CONSTRUCTION CO
Date: Owner:
2530 ZANELLA WAY - B
CHICO, CA
WORKERS' COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
95928
❑ I have and will maintain a certificate of consent to self -insure for
530-894-5590
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
�ve and will maintain workers' compensation insurance, as
License #: 181845
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:
Architect:
Carrier: 111x. G'
Engineer:
Policy #: SS 1- f nz -img
❑ I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to
Total Square Ft: 0 S. F.
become subject to the workers' compensation laws of California,
and agree that if I should become subject to the workers'
Valuation: $0.00
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Census Code:
Date: —— o
qq 13
ll�
Applicant: zTr
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
^ O/
L"I (p
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
This permit is hereby issued under the applicable provisions of the Butte County Code and/or
I hereby affirm that there is a construction lending agency for the
Resolutions o do work indicated a ove for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
I _ I (1 -(
BY: Date: -'1 l Jll�
Name:
PERMIT E IRES ON: i ` I `'l" M
Address:
(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.
O Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duty authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of an official fo or do erit, of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes.
Print Name: W i �/ .df, � / /�/ Signature:
Date: —��9� o G
❑ Owner ❑ Contractor ❑ Agent for Owner gent for Contractor
B. C. Building Permit 01-16-04 pg 1
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
"PLEASE PRINT CLEARLY"
OWNER
Last Name— d /AlD
irsl Namg
Address Z q�
City e.
State,
Zip9sYZ,Y
Phone .. G
Fax
-mail
APPLICANT NAME
CONTRACTOR
Name ST aZa4oL
Cow,
Address
City C,, e. #
Cil, t5A I `D
Stale bF
State
Zip Z�
Phone
9v-
a
Fax
-mail'
Lic. #CI
ss
APPLICANT NAME
ARCHITECT/ENGINEER
Name
Address
Address
City C,, e. #
City
Stale bF
State
Zip
Phone
Fax
Fax
E-mail
State License Number
APPLICANT NAME
Name
Occ.
Address
Subdivision Name Map
City C,, e. #
Page
Stale bF
Zip Z S�
Phone
5"30 y – d
LENDING AGENCY
Fax
E-mail
APPLICA SIGNATURE
1-214X
For office use only:
Zoning Flood Zone SRA I Yes I No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc
PERMIT
NO. II
13P060P9
BrN N
LOCATION
AP# 09 2- 10-02
Property Address
i Q
Cit
Cross Street
WORKER'S COMPENSATION
Policy Number
L
Carrier
If hiring anyone other than license contr ctors, a certificate of worker's
compensation must be shown at the time of, permit issuance.
LENDING AGENCY
Name
Address
Page 1 of 2
Description or Scope of Work:
Sq. Fo6fage
O Structure Built without Permits
0 Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
req uired.
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by:K.G Amount: 1.g2Aga) Bldg
SRA
Receipt #:4 4, 3 W Sheriff
SMIP
Date:
(` In 0Other
`� � 6 Q 2E .
c Total
REV 2-24-05
EVERGREEN DEVELOPMENT
2530 Zan®Ua way
CHICO, CA 96928
530-894-5590
WWW.. POWERSHACKS..COM
?6 April 2004
ITWO:RTANT ! !
THYS IS X.N IMPORTANT LEGAL DOCUNWINT
PLEASE KEEP THIS ON FILE
ISSUED TO:.
William Austin ,, .for special agency
1SSIJFD By-'
ST CLAM CONSTRUC-TION COMPANY, CSLB #181.845
2S30lnnellsa Way
-916.595-5590
Cbico, Ca., 95928
DA R ISSUEID. 08/28!45 ,
This CERTICICATE authorizes Evergreen Mivtlopment;Wif tarn Austin. to use and to
cause to have drawn, said construction documents and related sales materials, process said
documents, and overseeppernik process, to include %,ance of said permit from drawn
documents.
EXECU'T'ED aIY DATE: AUG., 2005
Williatu ,>".: St Claar, j
St. Clair Construction Company.
—::EUCUT1 iD BY i �.� "1i ATE: 28 AUG., 2At15
Wllilam Austin
Evergreen 'Qevelup meat
RECORDING REQUESM BY
Mid Valley Title & Escrow Company
AND WHEN RECORDED MAIL TO:
Michael Erpino and Wendy Erpino
b34 N • Myevs �1-•
5vtV1oAV11L 1 0,4 Orl1 y0(�
A. P. N .: 042-180-024-000
iF->OQt'4—fdr0CM, 2 723
Recorded
Official Records
County Of
BUrfE
CANDACE J. 6RUNBS
Recorder
RUSLMARY DICKSON
Assistant
09:00AM 13-06t-2004
REL FEE 10.00
TAX 473.00
Mark
Gage 1 of
Space Above This Line for Recorder's Use Only
File No.: 0401-1610245 (TB)
GRANT DEED
The Undersigned Grantor(s) Declare(s): DOCUMENTARY TRANSFER TAX $473.00; CITY TRANSFER TAX $0.00;
SURVEY MONUMENT FEE $
X computed on the consideration or full value of property conveyed, OR
computed on the consideration or full value less value of liens and/or encumbrances remaining at time of sale,
unincorporated area; rA City of Chico, and
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Victar C. Egbert,
Trustee of the Victor C. Egbert Trust -1998 dated December 11, 1998
hereby GRANTS to Michael. Thomas Xrpino and Wendy Lew Erpino, husband and wife
as joint tenants
the following described .property in the City of Chico, County of Butte, State of California:
A PORTION OF LOT 60, AS SHOWN ON THAT CERTAIN MAP ENTITLED, " MAP OF THE
SEVENTH SUBDIVISION OF THE JOHN BIDWELL RANCHO", WHICH MAP WAS RECORDED IN
THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON
NOVEMBER 11, 1902, IN BOOK 5 OF MAPS, AT PAGE(S) 29, AND MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
BEGINNING AT THE INTERSECTION OF THE EAST LINE OF SAID LOT 60 WITH THE
SOUTHEASTERLY LINE OF GRAPE WAY; THENCE FROM SAID POINT OF BEGINNING, SOUTH
880.56 FEET ALONG THE EAST LINE OF SAID LOT 60; THENCE SOUTH 66 DEG. 48' WEST,
262.82 FEET PARALLEL TO THE NORTHERLY LINE OF SAID LOT 60; THENCE NORTH 696.13
FEET PARALLEL TO THE EAST LINE OF SAID LOT 60; THENCE NORTH 18 DEG. 52' WEST,
170.00 FEET TO A POINT ON THE SOUTHEASTERLY LINE OF SAID GRAPE WAY; THENCE
NORTH 66 DEG. 48' EAST, 322.63 FEET ALONG THE SOUTHEASTERLY LINE OF SAID GRAPE
WAY TO THE POINT OF BEGINNING.
Dated: 09/28/2004
Mail Tax Statements To: SAME AS ABOVE
;ESiI 4't'i�;
CWUNTY
S"? 9, '5 2007
PW -NT
S . —75
e
A.P.N.:042-180-024-000
Grant Deed - continued
File No.:0401-1610245
(TB) .
Date: 09/28/2004 '
Victor C. Egbert Trust
Victor C. Egbert, Tru e
STATE OF /
}
` }ss.
'COUNTY OF }
On `7 before
me, .-e ' > personally
appeared
personally known to me (or prove to me on the basis of satisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies) and that his/her/their signature(s) on the instrument the person(s) or the --
entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal. REBECCA L. BLE ea for o>fciai
COMM. ! 1297 ri eal
NOTARY PUBUC-CAUFORNIA
Signature Q COUNTY OF BUTTE
Comm. Expires April 13, 2005
My Commission Expires:
Notary Name: r Notary Phone:
Notary Registration Number: County of Principal Place of Business:
REBECCA L. BLEDSOE '
O COMM. if 1297 551 '
NOTARY PUBUCIEGORNIA
COUNTY OF BUTTE
Comm. Expires April 13,200
5
y.
When recorded return to:
County of Butte
Department of
Development Services
Building Division
7 County Center Drive
Oroville, CA 95965-3397
CWT of Docusent Recorded-
10-3un-20®8. 28®8-0022206
Has not been compared with
` original
BWM COUxry RECORDER
Space above for Recorder's Use
(rev.5/04)
Owner'Name: _ WENDY L. ERPINO AND MICHAEL T. ERPINO
Building Permit No: B07-1902
DEED RESTRICTION AND
NOTICE OF LIMITED USE FACILITY
I. WHEREAS, 'on this 13th day of May, 2008, MICHAEL & WENDY
ERPINO, hereinafter referred to as owner(s), is the record owner of the following real
property:
2921 GRAPE WAY, CHICO,CA 95926 (APN 042-180-024), and as further set forth in
Exhibit "A" attached hereto and hereby incorporated by reference, hereinafter referred
to as "the subject property"; and
II. WHEREAS, the Building Division of the Butte County Department of
Development Services is acting on behalf of the People of Butte County; and
III. WHEREAS, the owner applied to the Building Division for a building
permit in order to develop.the'subject property described above; and
IV. WHEREAS, Building Permit No. B07-1902 was applied for on 9/6/2007
by .the owner in accordance with the provisions of the Butte County Code and the
California Building Code; and
V. WHEREAS, the use allowed by Building Permit No. B07-1902 has been
reviewed and approved for only the limited purposes set forth below; and
VI. WHEREAS, it is intended that this Deed Restriction and. Notice of Limited
Use Facility shall constitute an enforceable restriction and remain in effect until a
change in use or character of use has been approved by the Butte County Building
Official or a change in law has occurred; either of which change allows the uses
otherwise restricted herein to be conducted on the real property described herein.
Under either circumstance allowing such change in use, Owner shall be entitled to have
this Deed Restriction and Notice of Limited Use Facility rescinded by the execution of a
subsequent document entitled Rescission of Deed Restriction and Notice of Limited
Use Facility by the Director of Development Services; and
VII. WHEREAS, Owner acknowledges that Owner will comply with the limited
use restrictions that were• incorporated in, reviewing and approving Building Permit No.
B07-1902which enabled Owner to undertake the limited use authorized by this permit.
NOW, THEREFORE, with the issuance of Building Permit No. B07-1902 to
Owner by Butte County, Owner hereby affirms Owner's desire to develop a limited use
facility, as set forth below, which establishes restrictions on the use and enjoyment of
this limited use facility. The undersigned Owner, for himself/herself and for his/her
heirs, assigns, and successors in interest, acknowledges and agrees to those
restrictions.
This limited use facility shall be utilized in compliance with those limitations
prescribed by the California Building Code occupancy classification assigned by the
building official, except the following uses are not allowed: the _parade is not to be
used for livin4 and sleepin_g. Additionally, the space will not be heated or cooled.
If any provision of these restrictions is held to be invalid or for any reason
becomes unenforceable, no other provision shall be thereby affected or impaired.
This deed restriction and notice of limited use facility shall remain in full force
and effect during the period that this permit, or any modification or amendment thereof,
remains effective, and during the period that the development authorized by this permit,
or any modification of this development, remains in existence in or upon any part of,
and thereby confers benefit upon, the subject property described herein, and to that
extent, this deed restriction and notice of limited use. facility is hereby acknowledged
and agreed to by Owner to restrict the use and enjoyment of this limited use facility and
shall be binding on Owner and all his/her assigns or successors in interest.
Owner agrees to record this Deed Restriction and Notice of Limited Use Facility
in the Recorder's Office for the County of Butte as soon as possible after the date of
execution. This document shall be recorded and returned to the Butte County
Scott Rutherford
Building Manager, DDS
5 t D�
Department of Development Services, Building Division prior to the issuance of Building
Permit No. B07-1902.
DATE: �� cI _ , 20 D 8
Owner Signature:
Print or Type Name of Above
Owner Signature: VJ
W 16f II0
Print or Typ Na a of Above
Scott Rutherford
Building Manager, DDS
5t 0
NOTE TO NOTARY PUBLIC: If you are notarizing the signatures of persons, signing
on behalf of a corporation, partnership, trust, etc., please use the correct notary jurat
(acknowledgment) as explained in your Notary Public Law Book.
STATE OF CALIFORNIA )
SS.
COUNTY OF BUTTE )
On _,_ uyLL 9 � Qct* before me, 4
Public, personally appeared YhI Cha R l F—=r
Notary
who proved to me on
the basis of satisfactory evidence to be person(s) whose name(s) is/are subscribed.to
the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the
instrument the person(s), or..the entity upon behalf of which the person(s) acted,
executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
i nature
Scott Rutherford
Building Manager, DDS
KIM ARMSTRONG
COMM. # 1641334
NOTARY PUBLIC -CALIFORNIA
COUNTY OF BUTTE
Comm. Expires faro. 28, 2010
(Seal)
STATE OF CALIFORNIA )
SS.
COUNTY OF BUTTE )
On __�uyk_L 01 , aO08 before me,/' , Notary
Public, personally appeared _
13 1 , who proved to me on the
basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to
the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the
instrument the person(s), or the entity upon behalf of which the person(s) acted,
executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph -is true and correct.
WITNESS my hand and official seal. CIM ARMSTRONG
COMM. # 1641334
NOTARY PUBLIC-CAUFORNIA
COUNTY OF BUTTE
Comm. Expires Jan. 28, 2010
Signature
(Seal)
•
Scott Rutherford
Building Manager, DDS
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