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056-250-059
0�5(0 FFe ANLEY 56-25-59 e Rd, 3/4 mi from De Creek Hw1 anch 71-89P,E(plbg & ele for future ' 04-1004 LENN / 'STAGE RDN, FOREST R N `— I Cont: OWNER • NSF 056-250-059 ,—: 04-1029 0 , ' STANLEY, GLENN STAGE RD, FORESTRANCH I '(0A Cont: OWNER j GARAGE/SHOP/ iOBBIE a f P I ' I �n col c� u� NOTES 7— 9, minlwl ro N=v RESIDENTIAL C 4j- STANLEY; 056-250-054 —_'_ -'-7-104-1004 STAZ", N LCY,,GLENN PERMITSTAGE RD, FOREST RANCH' ��._Cont:OWNER' ..t, �r � r SPECIAL CONDITIONS • CHECKED - BY: SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. —SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER OFFICE COPY Address GAS y— Date ELECTRIC' Meter By Date w. JOB FINALIED (Date) Signature J=OK 0 = Not OK . = NotReadyable DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 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-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ P' L 'ft. / P Nat. or / P' L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except ft Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 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 8-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-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 -Panel boards -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 = NotOK Applicable - =Not Applicable RESIDENTIAL (Single & Duplex) . = Not Ready OK except #'s $/F ., Main; Soils-Elec. Grnd.-/ 41 Ftg. Depth , Garage; Soils-Steel-Elec. Grnd.- " Ftg. Depth Uo.o"'F,tg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth Syemwalls, Main; Steel -Blockouts-Wrapped \ fia<Hold Downs and Special Anchors T$erbSteel -Wrapped 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-Criopies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLU B G (Permit) OK except #'s 1 ater Htr.; Vent -Access -Combustion Air Baffle 1 T.' D.Yn.; Test Fittings & Anchor -Nail Protection H 'lY— D -W- a0/ShQwer Pan; Test, First Floor -Tub Access 24. Xst Tub & Shower, Second Floor -Tub ccess Gas Pipe; Sixe & Anchors d n 23. Fire Sprinkler; Test Date `j, J!? Card B --M -• ` V Date Card B-1 Date Card B-1 Date Card B-1 Date ELEC RICAL (Permit) OK except #'s 2 . Fixture & Transformer Clearance -Ins. Protection 24!Elec. Receptacles Spacing -Lights & Switches at Doors 2 Size Boxes & No. of Conductors Stapled 2 omex Installed Close to Edge of Studs & C.J. ,,quip. Ground made up w/Mech Fasteners -Bond gas & Water Appliance Circuits in Kitchen & Conductor Size GFI �bfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or AI Insulated Neutral O Yes O No Service -Riser Conductors & Ground Main Disconnect Equip. Clearant%s Panels-Motors-Mech. Equip. thes Closet Light -Shower Light -Spa Light 3 . Smoke Detector Date_and B-1 . Date Card B-1 Date Card B-1 Date Card B-1 Date MEC NICAL (Permit) OK except #'s A.C. Ducts Insulation & Support 3 . Xnt Fan, Exhaust above insulation ; 321"gondensate Drain & Overflowr Size & Grade F rnace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet Attic Access & atform if Furnace in Attic Date , Card B -1 j=7 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s,,; . Sills Proper Materials &"Anchors 4e Walls Studs -Nailing Spacing & Braces -Plates -Sound 4Wj3earing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs r 4ef. Headers & Beams -Size & Bearing Date Ties-Purlin-Roll Brac.-Truss-Shti 40!Ftreplace Ties or Type A Flue -Fireplace Throat Clearance 5 is Access; Size & Romex Protection -Draft Stop -Ins. Baffles 7 t • . B . Windows or Exiting Doors -Sill Ht. & Dimensions arage Fire Protection Framing -RC Channel r operty Line Firewall & Openings . Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits ,75-,Sriairs; Width -Headroom -Rise -Run -Landing -Fire Protection Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 5 ing Area -Glass Protection -Skylights -Plastic S r Walls; Nailing -Bolts 1 race Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -W Windows Dat'7. Card B Date Card B-1 Date Card B-1 Date Card B-1 Date FINA (Plans) OK except #'s $KP<t. Steps -Door & Sidelight Protection -Landings 6 . �Srfioke Detector 66. Furnace Vents -clearance -Comb, Air-Connector- IwGarage; Above Floor-Ducts-Mech. Protection . Jgfdroom Exiting . fx.F.I. & Bath Fixtures & Tub Access -Spa 017 mac. Trim & Subpanel, Breaker Sizes & Labels . Stairs & Rails fireplace or Stove, Clearance -Hearth X-J,'Aec. Outlets at Wood Panel, Int. & Ext. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance c. Outlets & Receptacles at Kit. Counter arage Fire Door; Swing -Landing -Closure �C. Duct in Garage -Damper . Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. iaarage; Above Floor-Mech. Protection P .; Elec. & Mech. Equip. Listed for Location ec. Receptacles in Garage (F.F.I.)-Romex Protection sulation-Foam-Looked in Attic ,Pruard Rails & Deck Construction -Post Caps Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth _ Clearance Looked under Floor O Yes 83. Following Instld./Drive D Yei 0 No/Walks O Yes D No/Planters O Yes ❑ No 94- ucco Brown -Finish C. Unit Disconnect, Electrical -Plumbing nts Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings �UVater Well, Disconnect, Electrical, Plumbing R'xterior Elec. Trim, G.F.I. Receptacle -Underground V ntilation Throughout House I 'ss Protection orrecti ns from Previous Inspections st-Meters Tagged, Gas -Electric 3Z , ID F 'AJater & Sewer Connected -C/O to Grade -HD Approval nergy Compliance Certificate -Other Certificates Address Posted 50- Fire Sprin ler Dat 1 &�arcl B-1 Date Card B-1 Date Card B-1 Date Card B-1 'Date Card B-1 Date Card B-1 .Commehtb'at Final: LOERIE INSULATION CO., INC. INSULATION CERfImATE 1b363 SrAGF RDcES"T',ZANCK Rumwmwgmm 1 n1V DESCRIPTION OF INSTALLATION 1. ROOF Malarial Brand Now 7hidmw ( ) Thwnral Resistance (R Value) Z, CEIUNG Batt or BWnkA Type jRmMhw&Bad Brand Nam Jahns Mam lb Thiel nm (inches) 13 TM= d Reside (R -Value) Loose FIR Type Brand Nwne Johns Manville ContnacloNs ndn. inslaW wWM sq..) S �,, Minhm ThWmw ! -.:7S inches, Mm 1 kdunWo bmW wielo t Per sgme W to achieve MmM d Redatance (R Value) 'Z3$ & EXTERIOR WALL 4. RATS® FLOOR MOWN affamm aaft ThIdaiess (Inches), 'f 5. SLAB FLOOR / PERIMETER Mdww Pwkndw InKilation Depth 6 FOUNDATION WALL DECLARATION r t {-:l:c Brand Name Johns Msnvme Thwmd R (R Value) ' 1q 1 13 Thermal Reser (R -Value) Themed Redeterme QR-Vetoe) Brand Name Thermal Reddence (R -Value) -APA t X...................... .. . _ Certificate of Conform;ance Certificate 052736 THIS IS TO CERTIFY that the glued laminated timber products identified with a colla:.., -�,e mark of Engineered Wood Systems (EWS)-were manufactured in accordance with the applica ;i -standards and associated specifications indicated below: ANSI Standard A190.1-1992, For Wood Products - Structural Glued Laminated Timber NER-486 Glued Laminated Timber Combinations And "GAP" Computer Program For Determining Design Stresses AITC 117-93 - Manufacturing - Standard Specifications For Structural Glued Laminated Timber Of Softwood Species IT. IS.HEREBY CERTIFIED that.the A -PA EWS trademarked structural glued laminated timljer members were prflduced in a manufacturing facility subject to -regular audits in accordance with the Engineered Wood Systema {EWS) Quality Assurance Program. Routine audits include inspection of the manufacturing process and evaluation of the in -plant QA program with adequate sampling to verify conformance to industry standards for lumber grade and giueline bond quality. �'A /��w�' �-. ✓ ��>G �(o r�?i,�% 1(� I �-7.� _off (� t by Thomas G. Williamsci i Executive Vice Presi��e )t ENCINEERED YVOOD SYSTEMSq, a releteo Corpnie)ion of AAA —THE ENGINEERED WOOD ASSOCIA7101y 7011 south 1911smeel - P.O. Box 11700 - 7scoma., YJA 98411-0700 7n)ephone: (253) 566-8000 - Far Number. (253) 565.7265 INTER -DEPARTMENTAL MEMORANDUM BUTTE COUNTY JAN 0.3 2005 DTVELOPMENT TO• gHI sERVicEs LDING DIVISIO , OROVILLE FROM: 7 ----------- ENVIR. HEALTH, CHICO DATE: o ( f .RELEASE ENV." HEALTH HOLD ON BUILDING. FINAL FOR: OWNER NAME: SEPTIC: ' y WELL: AP#: 0 1,20 -J!�2 ADDRESS/LOCATION: S:We- Comments: (24 - i v -o q N s F lo y'/o Z y Gu�.�i yefs`io�, I 'F - /- z g oS say-vy GUmemos/releasehold Job number >> 04-007 -= DATE 9/29/04 i Structural. Calculations for Glen Stanley Forest Ranch Shop building Line A revised Gary Hawkins Architect 1370 Ridgewood Dr—Ste-10 SSD AI�Cyj,, HAWS/� Chico, Ca. 95973 (530) 892-2700 v; s (530) 893-0532 Fax 186 REN. r '9j� OF C Li U.k-.� U sol-4 e7LA.) C. LOERKE INSULATION CO., INC. INSULATION CERnFICATE 6 S-i—mew— /UoFT> Egj Wumber- DESCRIPTION OF INSTALLATION 1. ROOF Mabdal 2. CEILNG BMW Now Ths vrW ReAftm(R Vahie) Batt or Bir W Type__HWrofass Brand None Johns Manville Thickness ( I ) A - Tutt Resistance (R -Value) );>—,I 9 Loose Fill Type _ Fitergluss Brand Nonre John Manylle Contraaods min. insured WSWM sq•AAinirrttnn Thickness inahes. AND - - ac wW* kmkvkd we1Bl,t per square boat b aaddeve Thenrial Reedence (R Va m) & EXTERM WALL mdeft Ebm-ftm L&. 5 4. RAMED FLOOR Thkkfwn (Inches S. SLAB FLOOR 1 PERIMETER greeter Insulation Dem 6 FOUNDATION WALL DECLARATION Bred Name Johns AftmMe Bram! Name ohna Mmdte Thermel Reslstanoe (R-VMW) 12 l Theennal Rhe (R•Vatus Brand Name Thermal Radit ce (R -Value) rl ='�' 1' 1 �`: 11-a , 77771577M -_'1�1'/�'' x.11{i- M:�� Y � {[�1' •� •11/�[ x.. 1r. r • • . 1 /� :9 rr Certificate of Conform Certificate 0 5 2 7 3 6 THIS IS TO CERTIFY that the glued laminated timber products identified with acone:., mark of Engineered Wood Systems (EW.S)-wereTanufactured in accordance with the applic: iJi. -standards and associated specifications inkated belies r•, ANSI Standard A190.1-1 2 For - 9 v Wood Products Structural Glued Laminated T,�m-ber 'NER-486 Glued Lamina(ed Ti6iber Combinations And °GAP° C, Computer Progr r Determining Design Stresses AITC 117-93 - Manufacturing - Standard Specifications For Structural Glued Laminated Timber Of Softwood Species AT IS HEREBY CERTIFIED that the APA EWS trademarked structural glued laminated tim';se- members t rr were produced in a manufacturing facility subject to regular audits in accordance with the •Criginevred c Wood Systems•�(EWS) Quality Assurance Program. Ro0tine audits in'clu'de inspection of the manufacturing'.process and evaluation of. the in -plant QA program with adequate sampling to verify conformance to`industry standards for lumber grade and' giueline bond quality. Al 1d `G;�9 SHIN ' by Thomas G. Williamscf+ Executive Vice Presidwil ENCrnrFERED s%VC)D SYSTEMS* a refateo cotpomeon of AAA — T) -j[ ENGJNL-FRFD WOOD AuSOCTViOly 701' South 19th Sheet - P.O. 8W: 11700 - 7scomr., VJA 98411-0700 ti 7nlephonr: (253) 568-13600 - Fer Number. (253) SGS 7265 } m SPECIAL CONDITIONS CHECKED BY NOTES RESIDENTIAL — FIRE SPRINKLERS REQ. —SPECIAL INSPECTION ITEMS +' s VERIFY P E RMIT NO. r6 -250-059 0,44029 USE PERMIT CONDITIONS .STANLEY, GLENN SUB -STANDARD HOUSING LETTER STAGE RDJOREST RANCH tp I Cont: OWNER GARAGE/SkOP/HOBBIE m JOB FINALED (Date) Signature SPECIAL CONDITIONS CHECKED BY — SRA — FLOOD CERTIFICATE REQ. — FIRE SPRINKLERS REQ. —SPECIAL INSPECTION ITEMS +' s VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER JOB FINALED (Date) Signature +' s JOB FINALED (Date) Signature J=OK 0 = Not OK . NotReadyable 6. MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 7. 1. Zoning Requirements -Setbacks -Easements 8. 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) Exits; Insp.-Sketch 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 11. 6. Gas; Location -Test-Wrap;-/ /" L'ft. / P Nat. or/ /" L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Date Card B-1 Date Card B-1 Date 12. Card B-1 Date Card B-1 Date Date Card 8-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector Blocking 4. Electricity; MH Test -Crossovers -Breakers -Clearances 4. 5. Drain; MH Test -Fall -Flex Connector MISCELLANEOUS Date 6. Water; MH Test -Regulator -Connector 1. Zoning Requirements -Setbacks -Easements 7. Water and Sewer Connected -C/O to Grade -HD Approval Footings; Soils -Size -Depth -Spacing -Connectors -Steel 8. Gas and Electricity Tagged Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 9. Tie Downs -Type -Installation Cert. 5. 10. Exits; Insp.-Sketch 6. Carports; Windows -Doors 11. Cert. of Occupancy Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Date Card B-1 Date Card B-1 Date 12. Card B-1 Date Card 6-1 Date PERMANENT END SYSTEM (ONLY) Date 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 1. 3. Blocking 2. Soils; Compaction -Structure Stability 4. Gas; MH Test -Demand -Valve Pool Structure; Steel -Connections -Thickness Dead Men -Lining 5. Electricity; MH Test 5. 6. Water; MH Test 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Gas and Electricity Tagged 9. 9. Exits 10. Plumb.; Cir. Test -Water Supply Test 10. License Decals Light Niche 11. Verify #'s with Office Date Date Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-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 sfs� 9fE0 3fhu J=OK a = Not - =Not AAppplicable . = Not Ready RESIDENTIAL Date Uhl?FLOOR (Plans) OK except #'s 25. ing-Setbacks-Easements-Flood-Slope DoO'Ftg., Main; Soils-Elec. Grnd.-/ P' Ftg. Depth , Ft ., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth 4000FtgKPorches & Decks; Soils -Steel-/ P' Ftg. Depth round made up w/Mech Fasteners -Bond & Water temwalls, Main; Steel-Blockouts-Wrapped liance Circuits in Kitchen & Conductor Size GFI em alts, Garage; Steel -Blockouts-Wrapped WH Downs and Special Anchors Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No b, Steel -Wrapped �s-Fireplace Ftg.-Steel %^.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 Dat r 0 Card B c Date Card.6 1. Dat Card B - f. Date Card B-1 Date PLU NG (Permit) OK except #'s 00"Wajor Htr.; Vent -Access -Combustion Air Baffle 1 iter Pipe; Test & Anchor -Nail Protection 1 E. .W.V.; Test Fittings & Anchor -Nail Protection 20. ho er Pan; Test, First Floor -Tub Access .!?4- st Tub & Shower, Second Floor -Tub Access Gas Pipe; Sixe & Anchors -24, Fire Sprinkler; Test Date , Card B-1 , ` Date Card B-1 Date Card B-1 Date Card B-1 (Single & Duplex) Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. SizejRoxes & No. of Conductors Stapled 27. ex Installed Close to Edge of Studs & C.J. X1,1 r,J round made up w/Mech Fasteners -Bond & Water 29.2 liance Circuits in Kitchen & Conductor Size GFI ent Fan, Exhaust above insulation Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. 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 B4' Date MECHANICAL (Permit) OK except #'s . Wtr. Htr; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 3f. . . Ducts Insulation & Support " 79. ent Fan, Exhaust above insulation lation-Foam-Looked in Attic 39- Co ensate Drain & Overflow, Size & Grade Guard Rails & Deck Construction -Post Caps 82. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Odtlet .40. Attic Access & Pla m if Furnace in Attic _ Date Date Q , Q and B-1 . Date Card B-1 V Date Card B-1 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 s Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exitino 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. Stugco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59.,Kazing Area -Glass Protection -Skylights -Plastic rY. j��j LLQ LQV Shear Walls; Nailing -Bolts x,61. grace Interior/Exterior Wall Panels 63. Infiltration -Walls- dows Dat2l 101 Card B-1 Date Card B-1 Date Card B-1 15L Date Card B-1 Date FI A Ian 'OK except #'s Dr E teps-Door & Sidelight Protection -Landings moke 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. Garag ire Door; Swing -Landing -Closure 76. Duct in Garage -Damper . Wtr. Htr; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; EI c. & Mech. Equip. Listed for Location 79. EI ceptacles in Garage (F.F.I.)-Romex Protection lation-Foam-Looked in Attic Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth C earance Looked under fje6r O Yes _ Following Instld./Driv s ❑ No/Walks O Yes D No/Planters D Yes D No 84. Stucco Brown -Finish 85. A.0 nit Disconnect, Electrical -Plumbing e bove Roof, Plbg-Appliance-Fireplace-Clearance to Openings ter Well, Disco Electriea�mbing E rior Elec. Tri G.F.I. Receptacle- "Underground Ventilation Throughout House 90. Glass Protection orrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & er Connected -C/O to Grade -HD Approval Compliance Certificate -Other Certificates ddress Posted 96. Fire Sprinkler Date r ,9Jj and 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: a 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 PERMIT NO. BP041029 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: 05/27/2004 APN: 056-250-059-000 the Business and Professions Code, and my license is in full force and effect. Number: z/ z /�✓ License Class: License Site Address: ✓ Date: Contractor: Map Index: Description: SHOP/GAR (864) ATT CARPORT OWNER -BUILDER DECLARATION from the I hereby affirm under penalty of perjury that I am exempt Contractors' State License Law for the following reason (Sec. 7031.5 (432)GUEST ROOM(432) 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 sugh.permit to file aGLENN OWn@r: AND ELIZABETH STANLEY signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 1985 ORO CHICO HWY 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).): DURHAM, CA 95938 their 530-891-0614 0 I, as owner of the property, or my employees with wages as 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: GLENN AND ELIZABETH STANLEY 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 Contractor: Z7 `6>41 Owner: ' Date: �� WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit License #: 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 Architect: HAWKINS, GARY insurance carrier and policy number are: Engineer:: Carrier: Policy #: I certify that in the performance of the work for which this permit is Total Square Ft: 1728 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: $55,728.00 and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: , j `�`C-_ 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 o t 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 Cods anrvor I hereby affirm that there is a construction lending agency for the Resolutio'ns, to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) DO: .5122 7 0 Name: BY 7 Address: PERMIT EXPIRES ON: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & 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 official form or document of Butte County. I hereby authorize representatives of Butte to enter upon the above mentioned property for inspection purposes County a e 31 � � ✓�. Print Name: L ti'G�/ Id Signature: Z 7 03,1 Date: *-Owner ❑ Contractor 0 Agent for Owner 0 Agent for Contractor AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this .property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Lot 1, as shown on the Map entitled, 10LITTLE CHICO CREEK ESTATES", which Map was filed for record in the Butte County Recorder's Office, on April 18, 198E in Book 100 of Maps, at pages 91, 92 and 93. . �J Date PROPERTY C 0 PROPERTY OWNERS: 9/ 619V A,, W&�) L7 State of California ) County of P&46 > On Ma -LA 2,1 2004 before me; (24n'r1V\t8 k�(3�lnsOy) personally appearedJf C-,\Qrl✓1 A . Sdan, fA and 5�cgnkN personally known to me (or 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. WITNESS my hand and official seal. O CYNTHIA JOHNSON COMM -1 1335942 A oc ®' HorAAY aueucc� FM1A Signature C%����1 Y u� ►' % Seal: a Comm.CUNTYoeOo BUTTE Ui E A.P. # s�.'® 0 T-9 Z®04-003304 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION �,�Oy Recorded OfficialRecords I REC FEE 7.00 CONFORM 1.00 7 COUNTY CENTER DRIVE � y Of BUTTE i. OROVILLE, CA 95965 CANDACE J. GRUBBS I I Recorder I ROSEMARY DICKSON I Assistant I Barbara 11:33AM 21 -May -2004 I Page 1 of 1 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this .property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Lot 1, as shown on the Map entitled, 10LITTLE CHICO CREEK ESTATES", which Map was filed for record in the Butte County Recorder's Office, on April 18, 198E in Book 100 of Maps, at pages 91, 92 and 93. . �J Date PROPERTY C 0 PROPERTY OWNERS: 9/ 619V A,, W&�) L7 State of California ) County of P&46 > On Ma -LA 2,1 2004 before me; (24n'r1V\t8 k�(3�lnsOy) personally appearedJf C-,\Qrl✓1 A . Sdan, fA and 5�cgnkN personally known to me (or 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. WITNESS my hand and official seal. O CYNTHIA JOHNSON COMM -1 1335942 A oc ®' HorAAY aueucc� FM1A Signature C%����1 Y u� ►' % Seal: a Comm.CUNTYoeOo BUTTE Ui E A.P. # s�.'® 0 T-9 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 PERMIT NO. BP041004 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: 05/27/2004 APN' 056-250-059-000 the Business and Professions Code, and my license is in full force and ' effect. License Class: License Number: Site Address' Date: Contractor: Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: NSF (2192) GAR (720) DECK (146) 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: GLENN AND ELIZABETH STANLEY to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 1985 ORO CHICO HWY she is exempt therefrom and the basis for the alleged exemption. Any DURHAM, CA 95938 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).): 530-891-0614 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: GLENN AND ELIZABETH STANLEY 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.). Contractor: ❑ I 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 declar tions: ❑ 1 have and will maintain a certificate of consent to self -insure for License #: 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 Architect: HAWKINS, GARY the work for which this permit is issued. My workers' compensation Engineer: g insurance carrier and policy number are: Carrier: Total Square Ft: 2192 S. F. Policy #: 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 Valuation: $142,480.00 become subject to the workers' compensation laws of California, Census Code: 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' compensa ion coverage is unlawful, and shall subject a( employer to criminal penalties and one /t I ^5`� i hundred thousand dollars ($100,000), in addition to the cost of /n v//i 34156,9 S compensation, damages as provided for in Section 3706 of the Labor /�/ .LJ-� code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Coda anfvor _I hereby affirm that there is a construction lending agency for the Resolutions to do wort/ 'ndicated above for which fees have been paid. performance of the work for which this permit is -issued (Sec 3097 Civ.) Y Name: By: Date: S Address: PERMIT EXPIRES ON: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & 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 official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection pu oses. Print Name: Ole? �n',�//L� /4 �/� 1l Signature: Date:~ PLQwner ❑ Contractor ❑ Agent for Owner 0 Agent for Contractor BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. BP DATE: APN; ZONING: OWNER'S LA61T NAME: OWNER'S FIRST NAMP- PHONE. STREET ADDRESS:/� I / • 5 /� r� Yl C /-� FAX CITY, ZIP: ^ � � � � C E-MAIL: SITE A SS: NEAREST CR SS STRE -{_ g k.)A T CTIO #' b APPLICANT NAME: s � l O PHE STREETADDRESS: ti FAX CITY, ZIP: E -MAIL - CONTRACTOR NAME: PHONE: a , STREET ADDRESS: FAX. CITY, ZIP: E-MAIL' LICENSE NUMBER LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: R.>- `���� STREETDRESS: /y ,� Lt9 U p_ CJ FAk Z- CITY, ZIP:LICENSE C , I" t- NUM ER 1$ /0 E-MAIL DESCRIPTION OR SCOPE OF WORK: ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) '3.sv-z��.- 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 fees will be required. 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. For office use only: Notes:jj�> 1 1 Application Received by: Date: Receipt number: AmountReceived. U 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 tel, OWNER: ASSESSOR PARCEL NUMBER U ✓VU tt ll t Proposed Building Use: JU� Counter Technician: Date: y sTUa 6 Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in ore apply. r 1. Site plans, 3 or 4 sets, signed by the preparer of the plans." '❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 0 4. Engineered truss details -and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. 4 6. Energy compliance design and supporting documentation in duplicate. 16 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) 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. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings ❑ 13. Detached Accessory Building Form filled out by the owner ❑ 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable. ❑ 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) O17. Fire Sprinklers........................................................................................... ❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........ ❑ 20. Erosion Control Plan Required........................................................................ ........ 21. Fees as shown on the attached Schedule of Fees Due Sheet .............................. Z7 4 '[ ❑ / 22. City of Chico Plumbing permit .................................................... ...p� .. 23. California Department of Forest plan approval aid. Sent by: , .... 24. Planning approval (A) Use:Q•�(B)Parking: (C) Parcel Check: ❑ 25. Contact Land Development about _ I91provements, _ Drainage ......................... 26. NPDES Form.................................... ................................'....................... 27. Encroachment Permit for driveway from the Public Works Dept............ •.............. - � 0 28. Pre -Inspection for. required...:... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier and Policy Number .......................................... 31. Owner -Builder Verification Given to owner, _Mailed to owner) ..................... 32. Letter of Signature authorization ............................ - 33. Recorded copy of Agricultural Acknowledgment Statement.................................�/ 34. Manufactured home utility clearance:.............................................................. V' ❑ 35. Existing violations and/or expired permits...............................................•......... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ 1 ❑ 38. Other: ❑ 39. Other: When issued Telephone CilO and hold for pickup. I have been informed of the above items a d requirements for obtaining a building permit. Applicant: Date: 1. Index pprmit application for the above items numbered: Plan Check Letter 2. Additional items required 19 1 Contractor, designe owner as advised of the above data byp one, ❑ mail, ❑ counter, by Date: :` 26-� Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: A Date: Plans approved by: XD6 A Date : Structuralreviewed r Date:/Structural approved Date: Note transfer by: Date Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES ,,11� r_f� OWNER 1(1 A.P. #J . 0 PROPROSED BUILDING USE DATE `'C" �� 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- Additional Fees Due........ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division)04 Residential............ - X $360.00 =$ ✓ Y Uni& Commercial (sq. ftg.)..... X$0.03"=$ RECEIPT # DATE REC. s/Zr?1,10-4 TP 4 sq.rtg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Fig. nA 1_�/_5. RECREATION DISTRICT FEES �:%k_-<� Z17 4 (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AN PLAN CHECK FEE 0 (paid at Building Division 8. WATER TENDER FEES BATTALION #. $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. Commercial (sq. ftg.) ......... X-=$ Sq. Ftg, Amt. O. OTHER YAtime 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 dXiog1he plan checking process. APPLICANT DATE 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. 2/2003) O.B. - I OWNER -]BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. personally plan to provide the major labor and materials for construction of the proposed property improvement: YES ;8 NO ❑ I HAVE 11� e HAVE NOT d an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: may: PHONE: CONTRACTOR'S LICENSE NO. I plan to provide portions of this work, but. I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: may: PHONE: CONTRACT'OR'S LICENSE NO. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: DATE: NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit OVER OWNER BUILDER INFORMA'T'ION Dear Property Owner. An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -balder" you are the responsible party ofrecord 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 you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not' licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income talc withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not cagy out these obligations, and these risks are especially serious with respect to worker's compensation insurance. For more specific information about your obligations under Federal Law, contract 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 cont wring the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aww-e of these matters. The building permit will not be issued until the verification is returned. rely, Iv!ic 1 C. Vi ira, C.B.O. ger, Building Inspection NOTE. This Owner Builder Information is required by Section 19830 of the California Health and Safety Code. OVER BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM / (One form b per Building) School District `�ZD A.P. Number �fV Jurisdiction: City Property Owner Property Location/Address Subdivision Building Department No. County ................................................ Residential Development Q Q Q Sq. Footage a No Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation Inspection) .......................................................... _.... Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) Commercial/Industrial Q Q New Addition Sq. Footage (Including Exterior Roofed Area ) Date District Identification No. �.� School District certifies that (Applicant) • � V � l ' Lam( (�C.J / . / C.� / —� (Street Address) / (Phone Number) (City) has complied with the requirements of Resolution No. representing ' ? square feet. School District Representative (State) �f (Zip Code) by payment of $ 7 ' (� 2926 i FULL MRIGATION = Date L Paid by Check # Remarks: Notice: You may protest the Imposition of the fees identified above by subediting a written protest to the District, In compliance with Govenanant Code Section 66020(a), within 90 days from the date fess we paid. Failure to submit a timely written protest will'prohibit you from challenging the Imposition of the fees In any court action. N. subsequent to the School District Representative signing this Butte County Schools Impact Fee Gntlfleation Form, the School District Is r - notlflsd by the spOleable Local planning Agency that thle pnoleet IRbeing w4swed under the California Environmental Quality Act (CEQA� this��bs�to additional school fees to fully malpab.Its Impact on the school dlsbiers schools school fees to fully m1doide.lts Impact on tit school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/03)dmm 14 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Wates Pollution Prevention Plan (SWPPP) Acknowledgement [LESS THAN 1. ACREl Project Title: By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs 1 acre or more of land requires a Construction Storm Water Permit from the State Water Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP), and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs 1 acre or more of land. I, further, certify that this project will .not disturb 1 acre or more of land. I am aware that submitting false and/or inaccurate information may result in revocation of grading and/or other permits or other sanctA'ons provided by law. a 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 PERMIT NO. BP041029 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: 05/27/2004 APN: 056-250-059-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address /1,3/, 3 Date: Contractor: Map Index: Description: SHOP/GAR (864) ATT CARPORT 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 (432)GUEST ROOM(432) 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. GLENN AND ELIZABETH STANLEY signed statement that he or she is licensed pursuant to the provisions of ' the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 1985 ORO CHICO HWY 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).): DURHAM, CA 95938 I, the their •530-891-0614 as owner of property, or my employees with wages as 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: GLENN AND ELIZABETH STANLEY 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 Contractor: Date: ri `L Owner: " WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit License #: 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 Architect: HAWKINS, GARY insurance carrier and policy number are: Engineer: Carrier: Policy #: I I certify that in the performance of the work for which this permit is Total Square Ft: 1728 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: $55,728.00 and agree that if I should become subject to the workers' Census Code: compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: rS " % ? ^ ® 4( Applicant: k. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one11ee1—,a--40&1g1 (f �/� ^, jt/� Dhundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Laborcode, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code 2nftr I hereby affirm that there is a construction lending agency for the Resolutions,to do work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.)�� 5 -2 7 O Name: By: D e: 51-27 �-S- Address: PERMIT EXPIRES ON: 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 official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon above mentioned property for inspection purposes . ntthe P- /V / Id ��` & � Print Name: \J L rte" � Signature: Date: 95 -owner 13 Contractor ❑ Agent for Owner ❑ Agent for Contractor 0 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO. ATE: Al - l `� - d APN: ZONING: o's 6 -- :�'o -- 6.� ' OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE: S7` l/VZ L: �'���� �� Y-? 1 -- PC. IV STREETADDRESS: FAX CITY, ZIP: A—m E-MAIL: SITE RESS: .5 z;- NEAREST CROSS STR ET: c �,�e,�• TITCT/LO n J APPLICANT NAME: Sim S C<-9 A-) 112 - PHONE* STREET ADDRESS: FAX CITY, ZIP: E-MAIL: CONTRACTOR NAME: PHONE: STREET ADDRESS: FAX CITY, ZIP: E-MAIL: LICENSE NUMBER: LICENSE TYPE: ARCHITECT/ENGINEER NAME: PHONE: STREET ADDRESS: o k y ems®®' b12 FAX: -0/ CITY, ZIP: 1 G® C�4 AS7-3 LICENSE N 9413 `/ 4 13 E-MAIL: DESCRIPTION OR SCOPE OF WORK: 8 "--I Ge /eooat- �KCYz- ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) S N OU L-0 F--A'b , 313 -r O az), F-- (_-C - X ©22� C. 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 fees will be required. 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. For office use only: Notes: 16 -I I Application Received by:�/ Date: Receipt number: '301 � (( Amount Received: Master application 3-4-04 COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEE/Tl OWNER: ASSESSOR PARCEL NUMBER v % Proposed Building Use:U k_*&unter Technician: Date: 14-16 2k Items required in order top ply for of rmi . All boxes MUST be checked R marked NA in order& apply. 1. Site plans, 3 or 4 sets, s!gne� by the preparer of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 4. Engineered truss details and layouts in duplicate. No faxes! ❑ 5. Letter from Engineer or Architect for truss design review. 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and AIC for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) 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. Site plan and business license approval from the City of Biggs ❑ 12. Letter of intent for non-residential buildings 13. Detached Accessory Building Form filled out by the owner El 14. Hazardous Material Form 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.. 0 16. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) ❑ 17. Fire Sprinklers............................................................................................ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by 19. Soils Report and/or Engineered Foundation required ........................................... 20. Erosion Control Plan Required........................................................................ 21. Fees as shown on -the -attached Schedule of Fees Due,.Sheet,:= ........................... ❑ / 22. City of Chico Plumbing permit ............................................ . 23. California Department of Forestry plan approval aid. Sent y:� 24. Planning approval A Use: 1�rK (B)Parking: C Parcel Check: d ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 7 26. NPDES Form............................................................................................. 27. Encroachment Permit for driveway from the Public Works Dept ........................... q ❑ 28. Pre -Inspection for required....... ❑ 29. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 30. Worker's Compensation Carrier nd Policy Number .......................................... 31. Owner -Builder Verification (�ven to owner, _Mailed to owner) ..................... ❑ 32. Letter of Signature authorization ......... :........................................................... ❑ 33. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 34. Manufactured home utility clearance............................................................... ❑ -35. Existing violations and/or expired permits......................................................... ❑ 36. Deed Restriction......................................................................................... ❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal -Owner, ❑ Check to H.C.D. $ ❑ 38. Other: ❑ 39. Other: When issued Telephone - and hold for pickup. I have been informed�of the above items and requirements for obtaining a building permit. Applicant:j Date: Lf - � %, - 0, 1. Index pefmit application for the above items numbered: PI n Check Letter 2. Additional items req' n Contractor, designer, a as advised of the above data by p mail, ❑ counter, by % Date: l� Contractor; designer, o er, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Plans reviewed by: Date: Plans approved by: Date: 400* Structural reviewed by: _Date: tructural approved by: Dat Note transfer by: Date Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 TELEPHONE (530)538-7541 SCHEDULE OF RECEIPT OF FEES OWNER PROPROSED BUILDING USE :S ,p 1. BUILDING PERMIT FEES --- Balance Due ..................... --- Additional Fees Due........... $ --- Revised Plan Checking Fee.... $ 2. SCHOOL DISTRICT FEES C. ( t/ 1, C (paid at School District Office) (form available after Plan Check) 3. SHERIFF FEES (paid at Building Division) Residential............ X $360.00 =$ A.P.# DATE RECEIPT # DATE REC. Units Commercial (sq. ftg.)..... X $0.03 = $ _ Sq.Ftg. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit)..... X = $ # Units Amt. Commercial (Sq. Ftg.).... X = $ Sq. Ftg. Amt. 5. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) 7. SRA FIRE INSPECTION AND PLAN CHECK FEE $89.00 (paid at Building Division) 8. WATER TENDER FEES BATTALION #, $200.00 (paid at Building Division) 9. NORTH CHICO SPECIFIC PLAN (paid at Building Division) Residential Zone X = $ Zone # Units Amt. s-zr7-(1-i Commercial (sq. ftg.) ......... X = $ Sq. Fig. Amt. 9)(10. OTHER V'I / L. i • S � �/ 5 2 rh!4 or 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 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. 2/2003) School District A.P. Number Property Owner Property Location/A Subdivision BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) Building Department No. 6—"�"• Ir Jurisdiction: city ( '�1 r�County Residential Development\ Q i . f Living Mobile Home �tallation t Commercial/Industrial 0 Q New Addition Building Department Representative Adtlition/ *Supplemental Conversion Permit # *(No foundation Inswd Sq. Footage (Group R) Deed Restricted Sq. Footage (Attach a signed copy of Deed Restriction and Notice of Limited Use Facility document) 11 (�tl.On—�c n,'o Footage (Including Exterior District Identification No. School District certifies that Roofed Areas) .5•-6 Date (Applicant) ICity► (State) has complied with the requirements of Resolution No. s representing square feet. School District Representative Paid by Check # Remarks: I (Zip Code) by payment of $ IM 2926 $ FULL MITIGATION $ Date r Notice: You may protest the Imposition of the hes Identif! above by submitting a written protest to the District, Inc lance wW v Goijernment Code Section 66020(a), within 90 days from the data hes are paid. Failure to submit a timely written protest wlll'prohlbit you from challenging the imposition of the hes In any court action. K, subsequent to the School District Representative signhV this Brite County Schools Impact Fee Certification Form, the School District Is notUNd by the appacable Local Planning Agency that thio project is being reviewed under the CalBonda Environmental Quality Act (CEQA) this prajeet may be subject to additional school hes to fully mltigste.Ms Impact on the school district`s schools. White (applicant), Yellow (building department), Pink (school district) feeform.xb (10/03)dmm BUTTE COUNTY PARRS DEVELOPMENT FSS CERTIFICATION FORM CHICO AREA RECREATION AND PARK DISTRICT Assessor Parcel Number(s) Property Owner k CA' n Project Location/Address Subdivision Lot Number(s) Residential Development: (check one) V/ New Development Alteration/Addition _Mobilehome(s) _Non -Residential to Residential Total Number of Dwelling Units Comment:PAA 64 Building partment Representative Date ' �r�r�tx�rx�t�r�r,rrt�r**rr�r�r�r*�rrr�r�r�r�r�r�r,t�r��r�r,�wrr�r�r*�rvr�r*�r�rvrrr�r�r�r�r�r*�r�r�r,��r�r*x�r�r�r,��r,t�rrr�rvr*�r*�t Chico�..Area Recreation and Park District(CARD) certifies that �)Tniu Zeq g :1 (Applicant Name) ( (Phone Number) JQ s!2 (Street Address). (City) (State) (Zip Code) has complied with the requirements of Butte Co. Resolution No. 90-140 by payment for dwelling units @ $1,189 for total payment of $ CARD Representative PAID BY CHECK NO. REMARKS; BANK NO. 010— PAID 10-PAID BY CASH RECEIPT NO. Distribution: White --Applicant Pink --CARD park.fec (form revised 11/90) 5� -20 1 Date t?5/27/04 #3,414 8:41PM ;-XXTGTAL *1184';00 "Yellow --Butte Co. Building Dept. Goldenrod --City of Chico Building Dept. .1 National. Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement (LESS THAN 1 ACRE1 Project Title: Y By signing below, I, the project owner/owner's agent, certify that I am aware that a construction project that disturbs 1 acre or more of land requires a Construction Storm Water Permit from the State Water. Resources Control Board and that it is my responsibility to submit a Notice of Intent (N.O.I.), a Storm Water Pollution Prevention Plan (SWPPP), and a check for $700.00 made payable to the State Water Resources Control Board to obtain such a permit if my project disturbs 1 acre or more of land. I, further, certify that this project will not disturb 1 acre or more of land. I am aware that submitting false and/or inaccurate information may result in revocation of gradingA or other permits or other sanction^provided by law. O.B.-1 OWNER -]BUILDER VERIFICATION Attention Property Owner: An "owner-buildee' building permit has been applied for in your name and bearink' your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your -building permit. No building permit will be issued until this verification is received. -1. I personally plan to provide the major labor and materials for construction of the proposed property improvement: YES !� NO E3. I HAVE E3 HAVE NOT aligned an application for a building permit for the proposed work. �3. I have contracted with the following person (firm) to provide the proposed construction: SS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: 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: ADDRESS PHONE TYPE Of WORK .li: PROPERTYOWNEI�A. DATE:0 NOTE. This Owner -wilder Verification is required by Section 19831 and 19832 of the Calrfornia Health and Safety Code. This verfication must be completed and returned to our offue before we are permitted to issue the permit OVER OWNER BUILDER INFORMATION Dear Property Owner. OB_I An application for a budding permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -builder" you are the responsible party ofrecord on such a permit Building permits are not required to tie signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yoursel4 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 you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate flumly, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments 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. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revemre 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 budder" building pem3k amneously 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 contracting the Contractors State License Board in your community or at 1020 N Street; Sacramento, CA. 95814. Please complete the "Owner guilder Verification" on the reverse side of this form so drat we can confirm that you are aware of these matxers. The building permit will not be issued until the verification is returned. In I I C. Vi , C.B.O. er, Building Inspection NOTE. This owner -Builder Information is required by Section 19830 of the California Health and Safety Code Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX DETACHED ACCESSORY BUILDING OWNER'S STATEMENT OF USE Plan review will not be started until this form is completed, signed by the property owner, and returned to the Butte County Building Division. Attached Accessory Buildings and Additions will be checked for residential use. Exception: Garages and Carports. Owner: Lo y Phone: Mailing Address /9 3'S Site Address: a Assessor's Parcel Number: 0,6-6 - �S✓O- 05T ^ O0,�;> Zone: (� �?,5?3 s 7—MS- Please answer questions 1-16, and explain any yes answers for questions 2-14 in the space provided on page 2 of this form GENERAL LYFO% ATION: ^/ , 1. Is there a primary dwelling on the property? Yes El No I�RF�Q Rely e� 2. Is the structure already built, under construction, or under notice of code violation? Yes ❑ NoR G 4" 3. Will items produced in this building be offered for sale? Yes ❑ No S't4,e- t. Will the public have access to this building? Yes ❑ No a 5. Will any advertising, on or off site, be associated with the use of this building? Yes ❑ No (�- SITE CONDITIONS: 6. Is the structure foundation within 5' of septic tank or 10' of leach lines? Yes ❑ No [r 7. Is any portion of the structure located closer than 20' to your front property line? Yes ❑ No (9- S. Do you plan to add a driveway or modify existing access to a county maintained road? Yes ❑ No e' 9. Will the proposed structure encroach within any recorded easement? Yes ❑ No B" CONSTRUCTION FEATURES: 10. Will this building have insulated floor, walls, or ceiling? Yes [-No ❑ 11. Will this building be heated or cooled? Yes EFNo ❑ 12. Will this building have a water closet/toilet? Yes Qr No 13. Will this building have a sink? Yes a No ❑ 14. Will this building have a water heater? Yes [Y]" No ❑ 15. What type of floor coverings ill the building have? 4, vy-i 16. What type of wall covering will the building have? .5ke P -A z2e-lC OVER 1 of 2 PROPOSED USE: (check only one box) 1. ❑ Residential Storage Shed — I will be storing in this building and it will not bc used for any other purpose (no bathroom and no heating or cooling). 2. rivate Garage — "A building or a portion of a building not more that 1,000 square feet (3,000 by exception) in area in which only motor vehicles used by tenants of the building or buildings on the premises are stored or kept." A garage door is required 3. 02 -Residential Carport — A covered structure intended for parking of vehicles. Two or more sides must be entirely open. 4. ❑ Residential Occupancy — Structures meant to be occupied, as opposed to a storage shed, garage, or carport If you checked #4, please check the uses below which best fit this building. ❑ GuestHouse ❑ Pool House ❑ Studio Apartment ❑ In-law quarters ❑ Recreation Room ❑ Game Room ❑ Study ❑ Library ❑ Bonus Room ❑ Playroom ❑ Den ❑ Studio ❑ Artist Studio [DHobby Room ❑ Craft Room ❑ Sewing Room ❑ Canning Kitchen ❑ Music Room ❑ Family Room ❑ Sun Room ❑ Private Office ❑ Workshop 1 ❑Home Occupancy Z ❑ Other — Use = t. Describe type or Wofthop 2. bhtat be approved by the Butte Co arty Plarming Division Explanations: This area is for explanation of any "yes" answers on questions 2-14. Please indicate the question Additional Information: Plan review will not be started until this form is completed and received. A Plans Examiner will contact the owner with specific requirements per the use indicated. I hearty affirm under penalty of perjury that the above information is true and correct I understand that any changes to the use, or character of use, of this building will require permits from the permitting authority. I understand that Real Estate Disclosure laws require disclosure of this information if or when the property is offered for sale. Owner's Name: Please �tey Owner's Signature: Date: 2 of 2 ENCROACHMENT PERMIT County of Butte Department of Public Works 7 Count Center Drive Oroville, CA 95965 Phone (530) 538-7157 Ext. 2016 Fax: (530) 538-4356 Download Forms: www.buttecounty.net/publicworks/forms.html NOTIFY COUNTY 24 HOURS BEFORE WORK IS TO BE DONE Permit Number District Phone (530) 538-7157 Ext. 2016 10 3 L 1 R ` .5 -7 G APPLICATION I / WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over the County r and highways, all in accordance with County ordinances and general.laws. All information except signature must be ed or legibly rinted 1. Applicant's Name:' / r 1 a. Company Name: v 2. Address: i Lo tl 1 ,v( y" A,4 3. Phone T(; /; l 4. Assessor's Parcel !um -b 5. Location of Work to be Done J 8. Contract 9. Address 10. Phone: 14. 15. 16 17 7. Date: 's S'ignatur' C. C®N'TRACTOW S ] NIFORMATI®N is Name 11. Fax: (})% C �t/o s License Number: 13. Certificate of Insuran 9 lj s Signature: 14 a. Date Signed: i Agent:. d TYPE OF WORK TO BEPe: :ck: Garb: ❑ Gutter: ❑ Sidewalk: ❑ s (List Type): 18. Other: PERMIT GRANTED In compliance with the above request, and subject to all terms, conditions (including those on page 2 of this permit form) and permission is hereby granted. 19. Conditions �e Y1 0.71G 9 q - `e , Underground Service Alert (USA) must be notified two working days prior to any excavation. 800-227-2600 20. $1 All work shall conform to accompanying: Detail 19 Plans ❑ Special Conditions 53 21. Date Issuedq, O� O 22. Expiration Date: Mike Crump, /Director of Public Works By: 7 ** Note: If permits are faxed to any number besides (530) 538-4356, they can be delayed up to one Page i of 2 General Conditions — See Page 2 -? i3 ;V X41-4-/: Yes ❑ No: ❑ 0 conditions written below, 23 Surety: % Ile :4 • • TO LARRY PAINTER ETURN TO CHICO EH SITE PLAN REVIEW APPLICATION Date: �- 2 `%- C) �� AP# Permit Number (if applicable) ®Li -� �� Bin Number " APPLICANT INFORMATION Parcel Size: 5 1 2'3 A 5 - Owners Name: Owners Address: Telephone No.: Situs Address: Proposed Use: Residential New Single Family Residential ❑ Single Family Addition ❑ Mobile Home ❑ Residential Accessory ❑ Permanent Second Dwelling ❑ Temporary Mobile Home (Aunt Minnie) ❑ Temporary Travel Trailer ❑ Multi -family Non-residential ❑ New Commercial ❑ Commercial Addition ❑ New Industrial ❑ Industrial Addition Other I& Septic ❑ Agricultural Exempt Building ❑ Other: Al ❑ Single Family Remodel ❑ Commercial Remodel ❑ Industrial Remodel ❑ Well ❑ Agricultural Buffer Form ❑ Applicable ❑ N/A Brief Explanation (if necessary): DO NOT WRITE BELOW THIS LINE DEVELOPMENT SERVICES INFORMATION (For Staff Use) Approved ❑ Conditionally Approved ❑ Resolve Problems Prior to Approval ❑ Site Plan Stamped Approved • By VCD Date Page 1 of 5 ALL ITEMS CHECKED APPLY TO THE PROPERTY t Parcel Is In: Snow Load Area: 2 s -T O '36 -r -TO � - ❑ Land Conservation Act Minimum Acreage: El Verify residence can be built per contract • El Nitrate Action Plan (See Environmental Health for standards) ❑ Watershed Protection Overlay Zone (See attached standards and requirements) ❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required) SRA - (CDF to determine specific requirements) ❑ 100 -Year Flood Plain: (See attached) Flood Zone: cA Q Flood Panel No.: 02-1LS C_ Index Date: �" 8 " ) 6 ❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board) ❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements) ❑ Chapman/Mulberry (See attached standards and requirements) ❑ Cohasset Area (See attached standards and requirements) ❑ Grading Zone (See attached handout) Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Minor Variance ❑ Variance ❑ Detached Building Use Form ❑Encroachment Permit ❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement Zoning: —T—rv> — S Applicable Building Setbacks: ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. • Page 2 of 5 Zoning Code Streets & Highways Fire Prevention Subdivision Map Front SO C4L- Side 1 Side Street Rear Q O Height Waterway N/A N/A N/A ❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks. • Page 2 of 5 Applicable Development Fees: Standard Fees Amount Formula ❑Fire • in School* ❑ Parks/Recreation ❑ Roads ❑ Sheriff ❑ Drainage ❑ NCSP/CSA 87 ❑ Chico Urban Area — Road ❑ Thermalito Drainage Area ❑ Thermalito Urban Area ❑ Other Subdivision Map Special Fees ❑ Water Tender ❑ Road Improvement ❑ North Oroville Area ❑ Other (per map) * Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of the building permit • Parcel.Created By ❑ Deeds: Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed of Reference: Legal Access Required ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation:❑ No ❑ Yes Comments: ❑ Parcel Deemed to be legal ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Deed of Creation ❑ Obtain a Certificate of Compliance ❑ Obtain a Merger ❑ Obtain a Lot Line Adjustment ❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23). ❑ Construct road to: ❑ Meet Parcel size required by zone ❑ Meet current Environmental Health Department requirements •------------------------------------------------------------------------------------------------------------------------------ Page 3 of 5 11 Subdivision ME/Parcel Map: LI-T—rLe GFA1 e-0 -LZS7, Map Date of Recording: A4'1 9— 8 (, Lot: 1 Book: )Go_ ❑ Use Permit/Minor Use Permit Permit Number: Date of Approval: R Page: �� 93 • Parcel Map/Subdivision Map/Use Permit Conditions E Comply with the following Conditions of Approval: 4�Ai`r'1::�j4j-4 " ❑ Meet the Fire Safe Regulations of Butte County and P.R.C.-4290 ❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the National Fire Protection Association Standard for installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet the Fire Department specifications, serves the parcel. ❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988, as amended. ❑ Provide an erosion control plan for building and land disturbance. The Erosion Control Pla� must be prepared by a registered civil engineer or other qualified' professional and b submitted to and approved by the Department of Public Works. ❑ In lieu of a pressurized water system or water storage tank, payment into the appropriate Battalion Water Tender Fund may be required. ❑ Measures shall be taken to control fugitive dust emissions from all driveway and other civil construction associated with residential development. Approved dust control measures are found in the fugitive dust control plan for the site approved by the Butte County Air Quality Management District, a copy of which can be obtained from the Butte County Department of Development Services, Building Division." ❑ Engineered foundations are required. ❑ Class A roofs are required. ❑ Property owners responsible for road maintenance, and stop sign maintenance. 0 Page 4 of 5 • • 14th 7q rn U c m O rn ra�A rnZ: V �a N; 74 O 7a O O 1 N n rn -n 7q Zp D ��cy rn�rn alp 3�a z �N N mA o 1 CA Orn _ ���3 �zornsrn oa0� k�'�►?� p f� f 3 w to o r UV m� A Z Z O m .404 14 O 2 E 04 ®� Si e 3 9g9 oe 3 j s6a STe�P D d. o3 qd �e 30. G. 4•g3. _• � � 423.7��i _ U ii �m rav U U a r ti � � f 1V � `N �g o/�•4jP 7q Z w � n 1 aD�m'T^ a ^N' O N ;Nmu'i ASN tT ��n2 rn NZRI� ��'C IC�e fryer m fi U r � nN1 of 5 ot* (A , u�o� � s a 7% ` F 2 m _STAGE pWTCH UNE T29 SH• 3 D� N 37' Sb' M� 919b5 Lq CA _ SEN CTIOZ9 m m ( Nor,rH SECTION (No•17'19'W 50'16'01"E m W \ 919.39 May 19, 2004 Mr. Michael Vieira County of Butte 7 County Center Drive Oroville, CA 95965-3397 .' Phone: (530)538-7541 Fax: (530) 538-2140 Re: Plan, Review: Stanley SFD Address: Stage Road Dear Mr. Vieira: County of Butte- FINAL REVIEW Jurisdiction Application No.: 04-1029 LP2A Job No. 2040015-043 Linhart Petersen Powers Associates (LP2A) has completed a final review of the following documents: 1. Plans: Two (2) copies Plan Sheets 1 through 7 Title/Cover Sheet not dated by Glenn Stanley. 2. Structural Calculations: Two (2) copies dated January 22, 2004 by Ga'ry'Hawkins. 3. Title 24 Energy Compliance Documentation: Two (2) copies dated April 08, 2004 by Gary Hawkins. The 2001 California Building, Mechanical, Electrical, Plumbing and Energy Codes were used as the basis of our review. We are recommending approval of the above noted items and we have no further comments. Enclosed for your use are the above referenced documents bearing the LP2A plan review stamps along with the applicant's response letter. Please let us know if you have any questions. Thank you. Sincerely, LINHART PETERSEN POWERS ASSOCIATES QC7ire RogeK-Veterson S.E. Structural Engineer . PK;MB:ag Enclosures: Cc: Alice Mefford: amefford@buttecounty.net Plans 4--mriner Bin 41 f:\butte county 015\butte county 2004\2040015-043-pcf.doc 9 LINHART PETERSEN POWERS ASSOCIATES Q 7610 Auburn Boulevard • Citrus Heights, CA 95610 (916) 725-4200 • FAX (916) 725-8242 • Toll Free (877) 235-0653 May 19, 2004 Mr. Michael Vieira County of Butte 7 County Center Drive Oroville, CA 95965-3397 - Phone: (530) 538-7541 Fax: (530) 538-2140 Re: Plan Review: Address: Stanley Shop/ Guest Room Stage Road County of Butte- FINAL REVIEW Jurisdiction Application No.: 04-1029 -LP2A Job No. 2040015-042 ,S�--Z.S7f-oaTr Dear Mr: Vieira Linhh`l f Petersen Powers Associates (LP2A) has completed a final review of the following documents: Plans: Two (2) copies Plan Sheets 1 through 4 Title/Cover Sheet not dated by Glenn Stanley. 2. '.Structural Calculations: Two (2) copies dated January 22, 2004 by Gary Hawkins. 3. Title 24 Energy Compliance Documentation: Two (2) copies dated February 10, 2004 by Gary Hawkins. The 2001 'California Building, Mechanical, Electrical, Plumbing and Energy Codes were used as the basis of our review. Weare recommending approval of the above noted items with the following redline comment: Sheets 1 and 3 clarification of occupancy separation. Enclosed for your use are the above referenced documents. bearing the LP2A plan review stamps along with the applicant's response letter. Please let us know if you have any questions. Thank you. Sincerely, ART PET RSEN POWERS ASSOCIATES og6; Veterson S. E. Structural Engineer RP:MB:ag Enclosures: Cc: Alice Mefford: amefford@buttecounty.net Bin 41 Mbutte county 015\butte county 2004\2040015-042-pcf.doc LINHART PETERSEN POWERS ASSOCIATES 7610 Auburn Boulevard • Citrus Heights, CA 95610 (916) 725-4200 • FAX(916)725-8242 • Toll Free (877) 235-0653 E.H. USE ONLY ���• Piot Plan Attached -� Floor Plan Attached Sent to 8.1 ! TO: By mg Department FROM: Environmental Health SUBJECT: Sanitation Clearance 37254146Z F�� 05� 02-f 0 -ash Ownef Location AP# Plan Approved for: Sewage Disposal 1 Water Supply: Public Private Well Clearance for dwelling. Other Final clearance O.K. for: NOTE: nmental Health Specialist Date 8/96 AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CA 95965 COPY of Document Recorded 21 -May -2004 2004-0030304 Has not been compared with original BUTTE COUNTY RECORDER AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code required this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this .property may be subject to inconveniences or discomfort from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Lot 1, as shown on the Map entitled, "L I TTL E CH I CO CREEK ESTATES", which Map ►vas filed for record in the Butte County Recorder's Office, on April 18, 1986 in Book 100 of Pups, at pages 91, 92 and 93. . Date .S~ PROPERTY OWNERS: State of California ) County of LIke- ) On (Y)a.LA Z� . 2D64 before me, 0_4r\kA(\i8 JO�'1r,SOr� r1o�o�r�( b��L personally appeared-* C 1\ 9_ny1 A - Sianit�an E1 5�(qn P.� * personally known to me (or 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. WITNESS my hand and official seal. Le, CYNTHIA JOHNSON COMM. / 1335942 NOTARY PUSuc CAUFaRNU► Signature '��-POt I Seal: o COUNTY OF B z2TT, 2Epps A.P. # ( S�. ,Z.-q_,n S [ • 'fit tr '�( 1 •r. �-.°. l , r' t-' •�. -� - '. 56-25-59 1771 g , E -8 Pw STANLEY Glenn ` W/S Stage Rd, 3/4 mA from Deer ,.f Forest Ranch Creek Hwy (plbg & elec/future lot development) FTDTA L�j.2 P ETACH FOR SERVING UTILITY U Address dl d GAS Meter By Date ELECTRIC i l _ .. .1.. � Meter By l! Date'b , I,- � ...... � ... ....,,,.. ..Mq.,.�r -. - ,.w � .,- -. ,-wr ..... -.,_ . - .: .. ,�..---r.-v..--..�....�, ,.... s _ u .........-�.qi,-o`-..-.�.. ,+a.y.rwca.'.aYd�s'.Ytl7lfk*T•*'°"wnw f COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS :PERMIT NO. .. 1 7 County Center Drive - LJrovilI6.-Calilorrlia 95965 - Telephone: 916/538-7541., APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER tP� — r� ZONING I BUILDING PERMIT OWNER. TELEPHONE SD. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS ,''�•.�. i CONTRACTOR'S NAME CJ TELEPHONE -CONTRACTOR'S MAILING ADDRESS 1 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING -ADDRESS - i Permit Fee $ ARCHITECT, OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS' y r Permit fee $ PLUMBING PERMIT Filing Fee 10.00 (.t) �� c�Q{ t'� U 7� /YLC�4-s .(Y►1 ... Each Trap 2.00 C1 lf 1 •L LC ��+ 0 Izlb I A Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME // < t {~� C �r Cls -r j'C �S7 -�• PARCEL MAP /-?'J-- �! Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFE] Duplex❑ Mobilehome❑ Other PVTUZr, NOIR SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities [M Installation❑ Other ❑ Describe work: " . CG„G. 4�2el 5',-,- 1 Penult Fee $ = Contractor ELECTRICAL PERMIT Filing Fee 10.00 { Main service GOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 .2 CONTRACTORS LICENSE LAW I I declare under penalty of perjury (check one): I I :❑ I am licensed under provisions of Chapt. 9, Div. 3 of the'Business - and Professions Code and my license is in full force and effect. License No. ` n Classification ! M)/ -I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended 'Proffered for sale. (Sec. 7044) I ❑ I, as the owner, am exclusively contracting with licensed. contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason I NEW CONST. DWELLING OCCUP.51, ) h¢sgft New CCONSTR.(A MULTI -OUTLET NON-RESID .BRA CH CIRC ITS 2.50 ea PowER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES eAL030 FIXED APLNS Ex. Occup. OUTLETS PR IRESID 1EA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 .=- s (L6: xiV5--t_ �z Penult Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ 1The,permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of -Workmen'.s Compensation Insurance or a Certificate of Consent to Self -Insure. ' ® 1 shall not.employ any person in any manner so as to become subject to the W. C. laws of California. ; Notice to Applicant: If after making this statement,should you becomesubject to the W. C. provisions of the Labor Code, you must forthwith comply 7ith such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. also agree to save, indemnify and keep harmless the County of Butte against liabilities, judgments, costs, and expenses which may in any way accrue against'said`County in consequence ofthe-grantingof this permit. X� X-�`�^� �} �-�-+ Date �- — Signature of Applicant - Owner] Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0” deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ SO TOTAL PERMIT FEE $ ,,.. occ"P,CONST.TYPE JSCHOOL JFLOOD PARCEL PD ND 155U.'all "'o, Thisermit is hereb issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC_ By PERMIT EXPIRES Date thea applicable rovi- resolutions to do fees have been paid. WORKS / Date fes`- 7d ?� /'�"' �' .�� Receipt No. WHITE-O.P.W., 7ELLaW-ASSEe 3"OR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 ' 7 County Center Drive, Oroville —.;Phone: 538-7541 - 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE ti OWNER _ PERMIT Nf A routine inspection indicates that the following violations of County Ordinance exist at the above ddress and should be corrected: Please notify this office when correctio work is completed. If you have any question pertaining to this makter, or ed additional explanation, please contact this office immediately. -2\W Ei nn i w 1 r 1 nro 4( 31 over � I n 16—A {7 Inspector Date 8�31-�9 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT N0. 4 ASSES OR PARrc,EL NUMBE J ZONING BUILDING PERMIT OWN TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING AD p 55� — ice u.r CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS ° Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 R &-;i " - Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME 0 1 / PARCEL MAP C C(ru I C �S'7 �Y /-�— I--'1 Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other F071!2E AqQ44— SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities [N Installation❑ Other ❑ Describe work: /�%T- .�(�j1J if- GZFG�, iOy S.I*= T:�b le `ryTrJ,eLe A64166 Permit Fee $ Contractor ELECTRICAL PERMIT FilingFee 10.00 Main service eoov OR LESS 100 AMP OR LESS 10.00 U OU r Main service EA. ADD'L 100 AMP 2.50 2 - CONTRACTORS LICENSE LAW penalty I declare under lt (check one p Y of perjury Y (ec)• El am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 91 I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.a\ , OR ADDNS. ( ACC. BLDGS. / h2sgft NEW CONSTR. U T -OUTLET NON.RESID .BRA CH CIRCU, TS2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. Ex. DCCUp 30 OUTLETS OR FIXTURES eAL930 ZAL@ Ex. OCCup. OUTLETS PRESID IFIXED APLNS KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 1$ — PIZ& ZN508r-,`r %5 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee = Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue again i ounty in co sequenc of the ranting of this permit. �� _�(� X Date Signature of Applicant - Ownerx Contract ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or Construct- ion of structures over 3 st-oriiess in height. Mobile Home Installation Fee $ Energy Inspection Fee $ s� TOTAL PERMIT FEE $A 17.� OCCUP. CONST.TTPEJ SCHOOL I FLOOD PARCEL PD HD Iss This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By - PER EXPIRES Date _ the applicable provi- resolutions to do fees have been paid. WORKS Date b — r �'-��9a Receipt No. `f��—�; 7 WHITE-D.P.W., TELLOW-ASeESOOR, PINK -INSPECTOR. GOLDENROD -APPLICANT . ,. 7 ��,. '+' .•t+Fk.,.Sx ems. ' � .r .>a ;'a'!'��45:'. -... , �. � .r � ,� . i .«:vo• Www...., ,.�.: r. .,�+^ L� COUNTY OF BUTTE - DEPARTMENVOF PUBLIC WORKS - BUILDING DIVISION • 7 COUNTY CENTER DRIVE - OROVTLLV,:CALIFORNIA 95965 -TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No.. /F OWNER G6C-Al STAAA. R/ A. P. No. S-6 — -4S —<q r Proposed Building Use�l� ���� Building Inspector .l . Date,!!�-Z— At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................ ....:'...:... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings ..:........... 7. Engineered truss details and layout in duplicate (required prior to'plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 12. School District fees paid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing. permit ..................................... . 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) V 19. Pre -Inspection forte Gf ik Lf required ... • Pre-Insrequest to p q � ' Buildingg Inspector _/ (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner o) ... ... . 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... 25. 26. When you issue the permit, /process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at 9WZ(_-0 office. Deliver w/inspector. Other Applicant vl �LL'Q�.c�.(U �-! Date — � Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by date Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW & COUNTY OF BUTTE -s Department of Public Works_ 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER-BUILDER.VERIFICATION Attention Property Owner: An "owner -builder" building permit has been Applied for in your name and bearing your signature. Please complete and return this information at your earliest.opportunity to avoid unnecessary delay in processing and issuing your building .permit. No building permit will be issued until this verification is received. . 1. I. personally.plan to provide the major labor and materials for construction of .the p.ropos.ed property improvement (yes or 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. City Phone Contractors License No. 4. I plan to provide .portions of this.work, but I have hired the.following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors 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 Phone Type of Work Signed: Property Owner Social Security Number Date _1 NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. 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