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COUNTY OFBU ZE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISIONS
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER ) 4 G. 1, ; o�e5 ASSESSOR PARCEL NUMBER: --7 -7 J 3 /
Proposed Building Use: G ►.-) 5 F Building Inspector: /I- r� 1. Date: a — Q G 0
At time of permit application, I wa advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
❑ 1. All items have been submitted --------------------------------------------------------------------------------------
02. Plot plans, 3/4 sets, signed by the preparer of plans. ----- -------------------------------------------------------
03. Complete plans, 3/4 sets, signed by the preparer of plans. ------------------------------- ---------------------
r
❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. --------
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------
❑ 6. Energy Design Compliance and supporting documentation.
❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ----
❑ 8. Hazardous Material Form. -----------------------------------------------------------------------------=------------
kan;u,.,factur Isom dat installation instructions including Tie Down Specifications.---------------------------------------------------------------7-------------------------------------- -act fees as shown on the attached schedule.-------------------------------------------------------__fornia Department of Forestry plan approval/fees.-r�----f��`,- .
❑ ood elevation certificate. ----------------------------------------------------------------------------------------
Sanitation and plot plan approv4h; C Q Health Department. ------------------------------------------- (,(.
❑ 15., City of Chico plumbing permit. ------------------------------------------------------- ---------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ----------------------------------------------
t7.
t
Planning approval for (A) Use: V (B) Parking: _ /--------------------------
ent
ntact Land Developmabout Improvements, ❑ Drainage, old Legal Part
eoncroachment Permit for driveway (construction approval prior to occupancy).
❑ 20. Pre -inspection fored. Request to Building Inspector on
regwr eq g hisp (Date)
❑21. Contractor's license information. (Number, Name Style, Classification). -----------------------------------
1122. Workers' Compensation carrier and policy number. -----------------------------------------------------------
❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner E3) - --------------------------------------
e5. etter of signature authorization. --------------------------------------------------------------------------------
ecorded copy of Agricultural Acknowledgment Statement. --------------------------------------------------
026. Letter of intent on building use. ----------------------------------------- =------==--------------------------------
027. Manufactured Home utility clearance. ----------------------------- -- -----------------------------------------
❑28. Existing violations and/or expired permits. --------------=----------------------- -------------------------------
029. E1433 A, ❑Grant Deed, 11D M.H. Title, ❑ Check to H.C.$ . , ---------------
030.
______________❑30. Other:
n you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor.
Telephone O 9�b �7 ';L— and hold for pickup at C �� C 0 office. ❑ Deliver with inspector.
Applicant:`' /'�---� Date: -11--e— 00
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑Air ollution Date: + By:
Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ er: By.
1. Index permit application for the above items numbered:ElPlan Check List
2. Additional items required:
Contractor, designer, owner, was advised of the above required datdby ❑ pho , ❑ mail, ❑ Building bivision counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building D'vision counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
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BUTTE.
COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per'Bullding)
�
School DistrictCsuo
Building Department No.
A.P. Number. (�Ui —
p1(�Q — ���
Jurisdiction: r City County
Property Owner
Property Location/Address
8nac D r 1 ve-
Subdivision4 `(�
m��
Lot No. 7
`
i Residential Development
Q Sq. Footage
No of iving
Mobile Home Addkion/ 'Supplemental to I (Group R)
Units
Installation Conversion Permit #
ti.....................
'(No foundation inspection):
............................ .................................................................. .
Commercial/industrial.
Sq. Footage
New
Addition (Including Exterior
Roofed Areas)
'00�9
Building Department Representative
Date
(Floor Plans reviewed by Sctlobl Vistnct Personnel►
District Identification No. •0 L4
School District certifies that
(Applicant)
1S
(City) �e
has complied with the requirements of Resolution No.
> 3
"` 003
representing square feet.
School District Representative
Paid by Check # + Remarks: A
(%n.t\1,.
N
k
Number)
(State) (Zip Code)
by payment of $
AB 2926 $
FULL MITIGATION $
Date
Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the imposition. of the fees in any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/98)dmm
j.j7`':�i'�(*w•Y11�'_-.".-Mnro.tiiq}f+t,yrir+.'.mea.A..•'ti.rr.iY'1'rK'ti:rfti��i.Is�dh;.v%11.+:11+1��0t".l'fi,++„�-'x�'+'�"tii�"?`ti+Y�'+'^"'.y,^_'lry�*.Y'"e cr.�n.��s�.+rr••�.rr+.-r•.-w
`•� w T
BUTTE COUNTY PARRS DEVELOPMENT FEE CERTIFICATION FOR.
-'CHICO AREA RECREATION AND PARR DISTRICT
Assessor Parcel Number (sll) 0!Vz. -j2(, . /
Property Owner
Project Location/Address lQtC. ,lJili/L'
Subdivision �l]`d Lot •Number(s)
Residential Development: (check one)
'$-New Development Alteration/Addition Mobilehome(s) Non -Residential
to Residential
Total Number of Dwelling Units
Comment:
Building Depar ment Representative Dq&e
.Chico Area Recreation and Park District(CARD) certifies that
99 014 2
(Applicant Name) (Phone Number)
A•C-�-
( Street°'Address )
C- 92z
has complied.,with the requirements of Butte Co..Resolution No. 90-140 'by
payment for dwelling units @ $1,189 for total payment of $_�...
( City) , . __.... ( State
(Zip Code)
(fARII Representative
PAID BY CHECK NO. REMARKS:
BANK NO. - 20211al I
PAID BY CASH
RECEIPT NO.
Distribution: White --Applicant
Pink --CARD
park.fee (form revised 11/90)
X71
Yellow--Butte.Co. Building Dept:
Goldenrod --City of Chico Building Dept.
12/ji/00 06430 11:04AM !MT13TAL '1189.00
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-SKI fnPIEk.� 100 4.)ACT-r t^tGzHT
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ENERAL SPECIFICATIONS
,...; SI E / S x :3 0 AREA3 `� ❑ DEPTH 3 TO
AA -
SHAPE 9/ D AlE PERIMETER 7 i
TE PLATE NO. CUSTOM
TIE SIZE % „ x
# TILE COLORC-HOIrE n)Fq--cE R-1-14
--�
POOL,. � � � \ `` \ ING/1!'.r 9U4-4--Al"SC t ftcK
` CO
- ....'
COPING COLOR
POOL CAPACITY GALS.
G.P.M.
� PUMP CAPACITY
MOTOR H.P. J H.P.
FILTER & SQ. FT.
FILTER RATE ce
G.P.M.
- • -=''. '"„I + . ��� ,+ TURNOVER HRS.
40
VACUUM LINE & SKIMMER 2/ "
I RETURN LINE
5 _
lz
LL IN DRAIN t F'1�,� �j T 2 �Tv
rt
SKIMMER --MODEL
«:; / 1-- BACKWASH TO '7� f S5C /4 A )2 C
k • � � + a. (� OF FILL LINE
LU
ANTI -SYPHON VALVE AUTD-F�GG
HEATER SIZE G?d ��� BTU
S 3'c w
GASLINE BY:3 Oreede-!; VENTED BY:
f LIGHT Abp W•�i't`T
�. t
CLOCK 2
ELECTRIC BY:C.f/C� t_.E'C-r)ZyC
ELECTRICAL BONDING BY:S-UA1S141'V5 7'G�LS
• �.� 4 r POOL CLEANER �- E:TR -TE"7"-\/4 G
f
CHLORINATOR
BOARD—SIZE
o • BOARD SUPPORTS Tile -
Tile: (�
(ADDER Mode
1 Tile:
SA Water
T 1 - SLIDE—#—Cotor GA Hookup
j -
ROPE RINGS W/ROPE &FLOATS
DING DIRT WALK
STB PLUMB pS NO TRACTOR SIZ
TIDE & COPING O ASAP ❑ OTN
DECK BY: I IO S+RC7�' I lll x + 1
TREES, ETC. '✓
CONCRETE REMOVAL BY:
RAYS I] OND NO 6---HEIGHT--P--WIDTH
1
s
I E DATE WIMMIN POOL
74gT .1510/Aj1�
f X114 R `��► -._ NAME
I DWN.BY �3�C��L pCiS�. DJ'iV6
ADDRESS
CONC. --
1 CK'D. BY,
,
CROSS STREETS
R 1 if E § RES. PHONE BUS. PHONE -59 �l572
-- -
PRINTS
S. SUN HINE POOLS OF CHICO
VV ELL. :. 2185 . SACRAMENTO AVENUE
'.s=- . a- C- C ICO CALIFORNIA 95973
C
! q,
!Np� �', A�1 Ap $g
-4254
PHONE: RALPH MERLO 345
F305C IJRiV E